Background: Descending necrotizing mediastinitis (DNM) is a serious disease originating in odontogenic or oropharyngeal infection with high mortality despite adequate antibiotics and aggressive surgery. We analyzed results of treatment for DNM. Material and Method: We studied 8 cases diagnosed as DNM from 1998 to 2007. All patients received emergent surgical drainage and debridement with broad spectrum antibiotics just after diagnosis. Antibiotics were changed after bacterial susceptibility testing. The surgical approach included 2 cases of cervicotomy, 6 cases of cervicotomy, and a thoracotomy. Result: The interval between symptom onset and hospitalization was $4.6{\pm}1.8$ days ($1{\sim}9$ day). DNM originated in 4 cases of odontogenic infection (50%), 2 cases of oropharyngeal infection (25%), and 2 cases of unknown origin (25%). Causative organisms were found in 6 cases; Streptococcus in 4 cases, Staphylococcus in 1 case, and Klebsiella in 1 case. The Endo DNM classification was type I (2 cases), IIA (3 cases), and IIB (3 cases). The incidence of thoracotomy was 75%. The surgical mortality rate was 25% (2/8). The cause of death was multiple organ failure caused by septic shock. All mortality cases received only cervicotomy and aggravated infections after initial drainage. Conclusion: Early diagnosis, immediate surgical drainage, and adequate antibiotics, including covered anaerobes, are required. Thoracotomy should be performed with cervicotomy even for localized DNM.
Lee, Sang Hwa;Lee, So Ra;Lee, Sang Youb;Park, Sang Muyn;Suh, Jung Kyung;Cho, Jae Youn;Shim, Jae Jeong;In, Kwang Ho;Yoo, Se Hwa;Kang, Kyung Ho
Tuberculosis and Respiratory Diseases
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v.43
no.5
/
pp.683-692
/
1996
Background: Although most of the patients with tuberculous pleural effusions completely reabsorbed their effusions and became asymptomatic within 2 to 4 months, later surgical procedures such as decortication is needed in some patients because of dyspnea caused by pleural loculations and thickening despite anti-tuberculous chemotherapy. It is obligatory to secure adequate drainage to prevent the development of complications. But, the best methods for treating loculated tuberculous pleural effusions remain debatable. Recent several reports revealed that intrapleural instillation of fibrinolytic agents is an effective adjunct in the management of complicated empyema and may reduce the need of surgery. Purpose : The effects of catheterization with intrapleural urokinase instillation were prospectively evaluated in the patients with septated tuberculous pleural effusion, and compared with other therapeutic effects of different modalities of therapy such as repeated thoracentesis and small-bored catheterization. Methods : Forty-eight patients diagnosed with tuberculous pleurisy were randomly separated into three groups; control group(n=13), catheter group(n=12), urokinase group(n=22). In urokinase group, dose of 100.000U urokinase was instilled into the pleural cavity via a percutaneous drainage catheter for complete drainage or total dose of 700,000U of urokinase. After two hours clamping, the catheter was opened and intermittently irrigated. The early and late effectiveness of therapies was assessed by radiographically and by measuring the volume of fluid drained from the catheter. Results : There was statistically significantly better result in the urokinase group in respect of frequency of catheterization, frequency of catheter obstruction and the duration of catheterization in early effectiveness(p < 0.05). There were no difference in radiologic improvement of follow-up in later phase chest X-ray between urokinase group and catheter group in later phase(p > 0.05). But there were more failure rates in control group especially honeycomb septa in pleural effusion sonographically than former two groups. And there were no complications of urokinase such as fever or hemorrhage. Conclusion : In the treatment of septated tuberculous pleurisy, there were better results in urokinase than those of catheterization alone in early effectiveness. And there was no difference in radiographic improvement between urokinase group and catheter group. Intrapleural instillation of urokinase is an effective and safe mode of treatment for septated tuberculous pleural effusions and alleviates the need for thoracotomy.
Most concrete gravity-type dams in and out of the country were constructed by column method to control cracks caused by concrete hydration heat generated during construction, resulting in a certain level of leakage after impoundment through various causes, such as contraction joints and construction joints. However, due to the characteristics of concrete structures that shrink and expand according to temperature, concrete dams have vertical joints and drains to allow penetration. PVC waterproof shows excellent effects in completion of the dam, which however increases the possibility of interfacial failure due to different thermal expansion. Other causes of penetration may include problems with quality control during installation, generation of cracks due to heat of hydration of concrete, waterproofing methods, etc. In the case of Bohyunsan Dam in Yeongcheon, North Gyeongsang Province, the amount of drainage in the gallery was checked and underwater, and it was confirmed that there are many penetrations from drainage holes connected to vertical joints, and that some of the PVC waterproofs are not fully operated. As a new method to prevent penetration through vertical joints, D.S.I.M. (Dam Sealing Innovation Method) developed by World E&C was applied to Bohyunsan Dam and checked the amount of drainage in the gallery. As a result of first testing three most leaking vertical joints, the drain in the gallery was reduced by 87% on the average and then applied to the remaining 13 locations, which showed a 83% reduction effect based on the total drain in the gallery. Summing up these results, it was found that D.S.I.M. preventing water leakage from the upstream face is a valid construction method to reduce the water see-through and penetration quantity seen in downstream faces of concrete dams. If D.S.I.M. is applied to other concrete dams at domestic and abroad, it is expected that it will be very effective to prevent water leakage through vertical joints that are visible from downstream faces.
The Buddha triad and 16 Arhat statues carved on the rock surface at Seongbulsa temple is the only domestic remaining example of all 16 Arhats, so its academic value is very high. However, it is severely damaged and so required a stability evaluation through study of digital documentation and precise diagnosis for the purpose of comprehensive conservation. This process established that the Buddha statues were of similar scale, while the Arhats showed a wide variety of sizes, and the two kith and kin in the volume were larger than the Arhats. It was estimated that the statues of food for Buddha are similar to the Arhat statues, and most of the statues are well-formed. The rock used to carve the Buddha statues is banded gneiss with distinct foliation, alternating between white bands of quartz and feldspar and black bands composed of biotite. The Buddha statues have been damaged by physical weathering, discoloration, and biological contamination. In damage evaluations, joint (3.6 crack index), peeling (5.2%), exfoliation (1.7%), and falling off (0.1%) were observed on the rock surface of the Buddha statues. In particular, due to severe biological weathering, stage 9 and 10 biological coverage of the rock surface accounted for 57.5% of the total area, and stages 5 to 8 also accounted for a high share at 22.3%. The discoloration factors were shown to be dark brown and white with Fe, Ca, and S, and a large amount of C detected in the blackened contaminants, and the damage weight high in all areas. Discontinuities in different directions were identified in the rock surface. Analysis of potential rock failure types indicated that there is a possibility of plane and toppling failure, but wedge failure is unlikely to occur. The mean ultrasonic velocity of the main rock surface was 2,463m/sec, the lower part of the left side with a large number of joints was relatively low, and the highly weathered (HW) type to the completely weathered (CW) type concentrated distribution, showing weak properties. For the Buddha statues, conservation treatment is required for about 14.9% of micro cracks and 58.9% of exfoliation cracks. In addition, in order to improve the conservation environment of the Buddha statues, maintenance of drainage and ground preparations for the rock surface gradient and plants are necessary, and protection facilities should be reviewed for long-term conservation and management purposes.
In the first paper of the series the five soil fertility factors were evaluated by means of principal component analysis and varimax method. They are interpreted as representing, 1) skeletal available phosporus status, 2) organnic matter status, 3) salt status 4) base status, and 5) free oxide status. In order to resynthesize such fragmented information for the overall soil fertility evaluation, the method of multiple regression analysis was adopted, using the five factor scores and yield data for Korean paddy soils as independent and dependent variables respectively. As test of linear models with different combinations of independent variables the results of t-test of regression coefficient were revealed that the organic matter status (FII) has no relevance to the yield of paddy and that the free oxides and salt supply has by it self only an insignificant contribution to the yield. The multiple correlation coefficient (R) revealed its multiple regression analysis was as low as 0.43. Introduction of quadratic terms to the linear model bettered the result. Thus multiple correlation coefficient (R) was increased as 0.59. Therefore, a coefficient of determination 0.35 was obtained by a quadratic model with interaction terms among the five fertility constituents. Generally we think that the fertility factor has more contribution to raise the rice yield in paddy and that the failure of yield prediction by fertility factor scores was caused by one of follows; 1) the roughness of the yield inspection, and 2) missextraction of fertility constituents. The second step in this study, assuming that the residuals by multiple regression analysis were due to factors other than soil fertility, we can now proceed to predicting the yield from the field characters with the classified fertility groups by means of Hayashi's theory of quantification No. 1. Such variables as fertility groups (FTYG), water availability (WATER), soil drainage (DRNG), climatic zone (CLIZ), surface soil's stickiness (STCKT), surface soil's dry consistence (DCNST), and surface soil's texture (FTEXT) are taken up as the explanatory variables. The quantification appears reasonable; the well to extremely well in soil drainage, very sticky of surface soil, inefficiency in water availability, coarse texture, and very hard to extremely hard dry consistence in soil are detrimental to the rice yield. The R was as high as 0.90 for the set of variables. But the given explanatory variables in this study were not quite effective in explaining rice yield. The method developed seems to be promising only if properly collected data are available. Conditions that should be satisfied in the yield inspection obtained from common cultivator for the purpose of deriving a prediction equation were put forward.
The levee is the facility which is constructed along with river for the protection of landside and for passage of water when there is a flood. When the seepage is exposed to the atmosphere on the landside surface of levee, it may eventually lead to levee failure. The seepage water may be removed from the landside surface by a properly designed drainage system. The purpose of the study is to show seepage control effect of a pervious toe drain, and to compare two drainage methods of a pervious toe drain. One is the pervious toe drain suggested by U.S. Army Corps of Engineers (USACE) and the other is that suggested by Japan Institute of Construction Engineering (JICE). The levee model constructed has the following dimension: the base width is 2.6 m; the crest width is 0.4 m; the side slope 1 : 2. The water depth in the riverside is 0.5 m. The shape of the toe drain by USACE is triangular. The shape of the toe drain by JICE is rectangular. They were installed with the base length of 0.4 m. The levee model without the toe drain showed saturation surface on the land side in the experiment but not with the toe drain. The experiment results was applied to a numerical analysis model using SEEP/W to calibrate and verify. The numerical analysis results for 35 cm and 30 cm drain width showed that the drain by JICE is a little bit safer than the drain by USACE. It is also easier to construct the toe drain by JICE. The results in the study would be applied to plan the seepage control for a levee with pervious toe drain.
KSCE Journal of Civil and Environmental Engineering Research
/
v.33
no.1
/
pp.181-194
/
2013
Landslides are known as gravitational mass movements that can carry the flow materials ranging in size from clay to boulders. The various types of landslides are differentiated by rate and depositional features. Indeed, flow characteristics are observed from very slow-moving landslides (e.g., mud slide and mud flow) to very fast-moving landslides (e.g., debris avalanches and debris flows). From a geomechanical point of view, shear-rate-dependent shear strength should be examined in landslides. This paper presents the design of advanced ring-shear apparatus to measure the undrained shear strength of debris flow materials in Korea. As updated from conventional ring-shear apparatus, this apparatus can evaluate the shear strength under different conditions of saturation, drainage and consolidation. We also briefly discussed on the ring shear apparatus for enforcing sealing and rotation control. For the materials with sands and gravels, an undrained ring-shear test was carried out simulating the undrained loading process that takes place in the pre-existing slip surface. We have observed typical evolution of shear strength that found in the literature. This paper presents the research background and expected results from the ring-shear apparatus. At high shear speed, a temporary liquefaction and grain-crushing occurred in the sliding zone may take an important role in the long-runout landslide motion. Strength in rheology can be also determined in post-failure dynamics using ring-shear apparatus and be utilized in debris flow mobility.
The second scientific antarctic station of South Korea is under construction at Terra Nova Bay located in eastern Antarctica. Ground condition in the Antarctica is frozen in general, but there are seasonal frozen grounds with active layers sporadically. When the active layer is frozen, frost heaving occurs that might cause the differential movement of frozen ground and the failure of structures. Therefore, it is necessary to determine the frost heaving susceptibility of soils at Terra Nova Bay before starting antarctic station construction. This study presents experimental investigation of the frost heaving susceptibility of soil samples with variation of particle sizes and unfrozen water contents. The soil samples were taken from five different locations at Terra Nova Bay and physical properties, unfrozen water content, and frost heaving tests were performed. For the frost heaving tests, soil specimens were frozen with constant freezing temperatures at the top and with drainage at the bottom in order to stimulate the frost heaving. The frost heaving tests provide volume expansion, volumetric strain, and heaving rate which can be used to analyze the relationship between the frost heaving vs. particle size and the frost heaving vs. unfrozen water content. Experimental results show that the more the fine contents exist in soils, the more frost heaving occurs. In addition, the frost heaving depends on unfrozen water content. Experimental data can be used to evaluate the frost heaving susceptibility of soils at the future construction site in the Antarctica.
Journal of the korean academy of Pediatric Dentistry
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v.44
no.2
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pp.235-242
/
2017
Marsupialization and decompression constitute a well-established procedure for treating cavitary bone lesions of the jaw. The technique can be a primary treatment option, especially for pediatric patients with large cysts or lesions involving vital anatomical structures, such as a developing tooth germ. In this procedure, a decompression stent, such as a customized acrylic obturator or space-maintaining appliance, silicone tube, or nasal cannula, is inserted to maintain the patency of the cyst. However, this may cause clinical problems, such as irritation or trauma to the adjacent tissues, as well as discomfort to the patient, or failure of the stent due to cyst shrinkage. It can also be a reason for patient noncompliance. In the cases described here, a minimally invasive marsupialization technique using a metal tube made from a 16-gauge needle was used for odontogenic cysts in pediatric patients associated with unerupted teeth. Through this method, the lesions were removed, with patient cooperation, and the cyst-associated teeth erupted spontaneously.
Kim, Il-Kyu;Park, Seung-Hoon;Jang, Keum-Soo;Yang, Jung-Eun;Jang, Jae-Won;Sasikala, Balaraman
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.35
no.6
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pp.451-458
/
2009
Metallic bone plates and screws have been commonly used in oral and maxillofacial surgery for internal fixation. However, there are several disadvantages such as atrophy of cortical bone inherent to excessive rigid fixation systems, growth disturbance in growing individual, allergy reaction, interference with radiographic imaging, palpability, thermal sensitibity and the need for subsequent removal. To overcome these disadvantages and avoid additional surgery of removal of plates and screws, there have been many studies of biodegradable plates and screws. But, It also has complication such as foreign body reactions. We have undertaken a clinical and retrospective study on 140 patients in Dept. of Oral and Maxillofacial Surgery, Inha University Hospital from February 2006 to March 2009. The purpose of this study is to report the clinical cases and review of the literatures with biodegradable plates and screws. And we concluded following results. 1. 6 cases(3.4%) of the 177 operation sites(140 patients) experienced complications. 1 case(0.6%) was a failure of initial fixation, 1 case(0.6%) was a postoperative infection, 4 cases(2.3%) were inflammations or foreign body reaction. 2. Postoperative infections, inflammations and foreign body reactions were completely recovered with incision and drainage, supporative care with antibiotic coverage and removal of biodegradable plates. 3. Biodegradable plates and screws provide acceptable rigidity and stability clinically. But, long-term observation is required for the tissue reactions around the biodegradable plates and screws because of long resorption periods of the biodegradable materials.
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