• 한국건축시공학회지
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• 제6권1호
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• pp.87-91
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• 2006

Since water leakage and cracks are not the source of serious problems such as long-term lowering of performance and durability of a stricture, including damages to operating facilities of a structure, damages to internal finishing materials, exhibition, and goods, and pollution of residential environment, they might have led to development of positive coping skills; however, an instant loss of lives or property due to earthquake, explosion, typhoon, or a fire was indeed neglected. In these days, repair materials for leakage cannot help but being taken in temporary way without any noticeable countermeasure. This kind of repair is socially criticized many times that is defective construction even if this costs a lot. It was not arrange the standard for construction methods of sealer of injection type for leakage maintenance, even it has been used various type of construction methods for leakage part. In conclusion, we suggest that the construction methods of sealer of injection type for leakage maintenance for leakage to establish the leakage repairing technology as increase of structure demand. Therefore, it would be possible to provide a stage-by-stage solution by developing systematic research activities among the industry, schools, and research institutes to spread maintenance management techniques globally through technical solution to water leakage and cracks, acquisition of structural safety with prolonged durability for life cycle, reduction of water leakage repair expense s, and so on.

• Archives of Plastic Surgery
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• 제47권6호
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• pp.613-618
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• 2020

The surgical treatment of extensive urethral strictures remains a controversial topic; although techniques have evolved, there is still no definite method of choice. Since 1968, when Orandi presented an original technique for one-stage urethroplasty using a penile skin flap, the Orandi technique has become the most prevalently used one-stage procedure for anterior urethral strictures. We present a 20-year follow-up experience with one-stage reconstruction of long urethral strictures using a longitudinal ventral tubed flap of penile skin, with some important technical changes to Orandi's original technique to overcome the deficient vascularity caused by periurethral scar tissue. In 1997, a 55-year-old male patient complained of severe voiding difficulty and a weak urinary stream because of transurethral resection of the prostate due to benign prostatic hyperplasia. Another 47-year-old male patient had the same problem due to self-removal of a Foley catheter in 2002. In both patients, a urethrogram demonstrated extensive strictures involving the long segment of the anterior urethra. A rectangular skin flap on the ventral surface of the penis was used considering the appropriate length, diameter, and depth of the neourethra. The modified Orandi flap provided a pedicled strip of penile skin measuring an average of 8 cm. The mean duration of follow-up was 20.5 years. A long-term evaluation revealed stable performance characteristics without any complications.

• 건축역사연구
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• 제8권4호
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• pp.95-112
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• 1999

This Study starts from a recognition that the architecture is based on the process demanded by substantial needs as well as pure theoretical logic system. So this study aims at proposing another point of view differentiating process and principle of architecture from pure theoretical logic system in the creative process of the Governor's Palace by analyzing drawings in chronological order. Even though the Governor's Palace had not been built because of discord between authorities of India and Le Corbusier, it is undoubtedly one of the best proposals which contains very concepts and ideas of later Le Corbusier's architectural intentions. In the first design stage, overall conception of the building was carried out in the sketches and drawings till Jan, 1954 and in the second stage, the elaboration of the project was pursued till Mar. 1995. The scheme tends to begin too large and general in character, becoming tighter and more complex under pressure from the client and adjustments required by the design process itself. For example, scale reduction, division and development of internal circulation system and applying his early 'Five Points'. So new solutions are searched by oscillating between compromise modifications and radically different solutions in contracting the first ideas. From all these, it is concluded that the early doctrine (Five Points) are adjusted and extended towards another stage by the use of restricted pilotis, the concept of fenetre en longueur transformed into a sub stricture of facade, sustained concept of le plan libre, les toits jardins extended towards concept of the urban area. And these formal intentions of the Governor's Place has been carried through other contemporary projects like Mill Owner's Association in 1954 and Villa Shodan in 1952.

• Journal of Chest Surgery
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• 제25권11호
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• pp.1254-1260
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• 1992

Rupture of the posterior left ventricular wall following mitral valve replacement is a rare but fatal complication. Over a 10 year period from August 25 1980 to November 27 1990, we have experienced 6 such patients among 884 cases of mitral valve replacement with 4 deaths and 2 survivors. One patient had a type I rupture and another a type II rapture with the remaining four patients having suffered type III ruptures. All of the ruptures were dis covered intraoperatively enabling prompt reinstitution of the cardiopulmonary bypass and subsequent cardioplegic arrest prior to repair. Overzealous removal of calcified valve leaflets seemed to be responsible for the single type I rupture, and untethering of the so called ventricular loop appeared to be the main mechanism responsible for the type III ruptures. The single type II rupture that had occurred seemed to have been caused by inadvertent laceration of the papillary muscle with resultant rupture of the posterior LV wall at the base of the papillary muscle. Among the type III ruptures, 2 patients required intraaortic balloon pump[IABP] support only for mechanical assistance and 1 patient required both the IABP and the Biomedicus LV assist device for successfull weaning following repair of the LV rupture Another patient with a type II rupture also required the circulatory assistance of both the IABP and the bio-medicus LV assist device for weaning from the bypass. Attention to meticulous technical considerations such as avoiding over aggressive removal of heavily calcified valvular tissue, preservation of as much mural leaflet tissue and chordal stuctures as possible seemed helpful in preventing this catastrophic complication from occurring. Fusion and fibrous stricture of the chordal structures appeared particularly conducive to the type II ruptures as a result of the increased susceptibility to papillary injury during operation.

• Journal of Chest Surgery
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• 제6권1호
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• pp.89-94
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• 1973

Esophagel atresia and tracheoesophageal fistula may occur as separate entities but usually occur in combination. First described by Durston in 1670, esophageal atresia was not successfully treated until 1939 when Ladd in Boston and Leven in St. Paul obtained the first survivors utilizing the methods of gastrostomy, esophagostomy and extrapleural ligation of the tracheoesophageal fistula as multiple operations which required months of hospitalization. Two years later Cameron Haight performed the first successful primary repair and afterward about 2000 cases of esophageal atresia with distal tracheoesophageal fistula reported in the world. In Korea, there appeared about 27 cases in the literature and 8 successful repaired cases noted in these year. Anther report two cases of esophageal atresia, of which one case was successfully treated with Haight`s method. Case 1.: Normal full term delivered boy with chief complaints of respiratory difficulty and persistent drooling with chocking, 3. lkg, was admitted with emergency 5 hours after delivery. Physical findings revealed no specific abnormal signs except distended abdomen and grunting respiration. Esophagograrn and bronchogram revealed proximal esophageal atresia and distal tracheoesophageal fistula proximal to the carina. Parent refused operative therapy and patient died 24 hours after discharge. Case 2. :3. lkg. normal full term delivered girl was admitted 4 days after delivery with chief complaints of regurgitation after feeding, chocking, cyanotic spell and fever since the day after delivery. Physical examination revealed persistent drooling, grunting respiration, and fever with moderate dehydration. Tracheoesophageal suction and fluid therapy with antibiotics improved her condition and subsided ]pneumonic condition. Esophagogram revealed markedly dilated proximal esophagus as blind loop and stomach distended with gas, and repairing operation as Haight`s method was performed on the 7th day after delivery. Patient tolerated all the operative procedure well and recovered uneventfully. Esophagogram on the 7th postoperative day showed passage of the lipiodol through the anastomotic side with moderate stricture,and feeding permitted. Patient tolerated all the feeding amount well and discharged on the 11th postoperative day. Followup revealed intermittent regurgitation after feeding and corrected with bougination.

• 한국가축번식학회지
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• 제23권1호
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• pp.69-73
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• 1999

머리와 목이 두 개인 이두이경체인 한우 송아지를 해부학적으로 관찰하였다. 이 한우 기형 송아지의 외형적 특정은 2 개의 완전한 머리와 목이 형성되어 있었으며 두 개의 경부는 흉강에서 유합되어 한 개의 몸통을 이루고 있었다. 두 개의 두부는 우측의 두부가 좌측의 두부에 비해 크기가 작고 상악과 하악의 비틀림이 심하게 나타나는 편측성 하악골 형성부전을 보였다. 두 개의 경부는 비슷한 길이로 흉부에서 유합되어 있었으며 2 개의 두부와 경부 외에 흉근 내부에 유착되어져 있는 흉골이 1 쌍으로 존재하고 있었다. 전지골격은 외부에 노출된 1 쌍의 완전한 골격과 매몰되어 있는 비교적 완전한 l 쌍의 전지골격외에 견갑부가 소실되고 상완골이 불완전한 l 쌍의 불완전한 전지 골격구조가 흉근과 늑골 사이에서 발견되었다. 그러나 기형적 전지와는 달리 후지는 정상적인 1 쌍의 다리만 보이었다. 경추의 부분적인 유합과 흉추 전반부가 심한 유합으로 척추가 뒤틀려져 있었다. 두개골은 정상적으로 2개의 눈과 귀, 비공과 1개의 업을 가지고 있었으며, 좌측이 우측 두부에 비해 크기가 작았고 하악도 더 심히 뒤틀려져 있었다. 뇌실은 위축되어 대뇌가 작았다. 기관과 식도는 흉강에서 유합되어 1개의 폐와 위로 이어지고 있었다. 흉강내 장기와 복강내 장기는 대부분 정상적인 구조를 유지하고 있었으나 대장의 직장 부분은 항문으로부터 5cm 떨어진 부분에 협착되어 있었으며 항문은 보이지 않았다.

• 한국임상수의학회지
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• 제27권3호
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• pp.295-298
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• 2010

5살의 중성화된 수컷 풍산 개가 서혜부에 지속적인 출혈 증상으로 내원하였다. 내원 5일 전에 멧돼지에게 공격을 받은 병력을 가지고 있었으며, 양성 요도 조영술에서 막성 요도의 파열과 요도 피부 누공이 있음을 확인 하였다. 수술 중 요도 카테터를 장착하여서 요도와 요도 피부 누공을 확인 하였고, 오줌의 누출로 인해 발생한 괴사 조직과 손상된 조직을 제거 하였다. 요도 카테터를 장착하여 요도 문합술을 실시하였다. 술 후 한달 째 배뇨장애나 혈뇨 증상이 없이, 정상적인 배뇨를 유지하였으며, 수술 후 2 달째 실시한 역행성 양성 요도 조영술에서 요도 협착 소견을 보이지 않았다.

• Journal of Chest Surgery
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• 제25권12호
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• pp.1530-1536
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• 1992

From January 1984 to December 1991, One hundred sixty five patients with carcinomoa of the esophagus were treated surgically at the department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital. Among them, hospital records were available in 121 patients and were included in this study. There were 115 men and 6 women, with ages ranging from 40 years to 79 years[mean age of 59.2 years]. The most frequent preoperative symptoms included dysphagia[72.7%], weight loss[60.3%], chest pain or discomfort[14.9%], general malaise[13.2%]. All were treated surgically: 100 patients were managed by curative or palliative resection with reconstruction, and 6 by palliative bypass surgery. In 15 patients, explorative thoracotomy or laparotomy was only done due to unresectability. [operability: 87.6%, resectability: 82.6%] All specimens[those from resectable 100 cases] were sent to pathology, and histopathologic examinations were done; squamous cell carcinomas were found in 95 cases, adenocarcinoma in l. Adenosquamous carcinomas were found in 3, and malignant melanoma in l. Postoperative complications occurred in 34 cases; anastomotic site leakage[10], which was followed by empyema in 9 of them, wound problem[7], hepatic failure[6], pneumonia [3], post-operative bleeding[3], chylothorax[2], post-operative stricture[2], sepsis[1], and tracheobronchial fistula[1]. Hospital deaths were in 6 cases[Hospital mortality: 5.0%]. During the follow up period, 26 patients were proven to be recurrence of cancer locally or distantly. The one, two, and five-year actuarial survival raf.es were 71.3$\pm$4.5%, 57.4$\pm$5.6%, 34.7$\pm$8.9%, respectively. The data from this study suggested that esophagectomy with reconstruction of gastrointestinal tract could be performed with a low operative mortality and a few serious postoperative complications and achieved reasonable long term palliation for carcinoma of the esophagus.

• Journal of Chest Surgery
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• 제19권4호
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• pp.744-749
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• 1986

Even in the hands of the expert endoscopists, an occasional instrumental perforation of the esophagus occurs. But instrumental perforation of the esophagus should not be difficult to diagnose if the possibility is borne in mind. Occasionally patient with esophageal perforations show little reaction at first, but usually they develop systemic manifestation if surgical management is delayed. Early surgical drainage of esophageal perforation is very important & effective therapeutic method. The delayed surgical treatment of esophageal perforation would have increased the morbidity & mortality by allowing mediastinitis & empyema thoracis. We have experienced 6 cases of delayed surgical management of instrumental perforation of esophagus from May 1974 to April 1986 in the department of thoracic and cardiovascular surgery, Yonsei University, college of the medicine. The ages ranged from 4 years to 57 years. The underlying esophageal diseases consisted of esophageal stricture in 3 cases, foreign bodies in the esophagus in 2 cases and esophageal ca. in one case. Most clinical manifestations on admission were high fever, chest discomfort, chest pain, dysphagia and subcutaneous emphysema. Most complications due to esophageal rupture were acute mediastinitis with or without empyema thoracis. Failure to diagnose promptly and failure to promptly institute adequate treatment undoubtedly were largely responsible for this patients death. All 6 patients had been taken delayed surgical drainage more than 24 hours following esophageal perforation. One patient had been in the open drainage state for long time and the another patient has been in the tracheostomy with postintubation vocal cord ulceration. The third patient died due to respiratory failure and sepsis due to fulminant mediastinitis & empyema thoracis. Even if the patients with esophageal perforation have been taken delayed surgical management, the patients should be survived with aggressive & effective surgical drainage with intensive post-operative care.

• Archives of Reconstructive Microsurgery
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• 제11권2호
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• pp.146-152
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• 2002

As the defects of the penis caused by trauma, surgical amputation, or congenital abnormality give the patients both psychological trauma and functional impairment, reconstruction of the penis is mandatory. Radial forearm free flap is reliable one-stage procedure, which can reconstruct both the phallus and the urethra. Chang and Whang's adaptation of the "tube-in-a-tube" concept and its incorporation into a free flap design represented a major advance in microsurgical phallic construction. Biemer described a modification of the radial forearm flap design in which the neourethra was centered over the radial artery, but the phallic shaft was separated into two paraurethral swatches. The authors have performed one-stage penile reconstruction in two patients since 1998, using a radial forearm free flap. Our present design incorporates the original Biemer triple skin island and includes a fourth distal island for neoglans. One case was the amputation of the penis from felonious assault and the other case was the iatrogenic penile amputation from repetitive urologic surgery for congenital hypospadia. All patients showed aesthetically acceptable results and good tactile sensory recovery. Severe complications such as necrosis, fistula, or urethral stricture were not occurred. Biemer's method modified by the authors is reliable one-stage penile reconstruction providing good aesthetic and functional results.