• 대한족부족관절학회지
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• 제26권2호
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• pp.66-70
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• 2022

Purpose: A group of patients who were hospitalized for diabetic foot ulcers was classified according to the University of Texas Staging System for Diabetic Foot Ulcers, and we attempted to evaluate whether this staging system could be a criterion for treatment success using vacuum-assisted closure (VAC) technique. Materials and Methods: A total of 32 patients were diagnosed with diabetic foot ulcers according to the University of Texas Staging System for Diabetic Foot Ulcers. Of these, 24 patients who were evaluated as stage B according to the staging system were classified as Group 1, and 8 patients in stage D were classified as Group 2. After applying VAC, the treatment success rate was compared by evaluating the size and severity of ulcers between the two groups. Results: The grade of granulation after VAC was on average 3.75±0.53 in Group 1 and 2.25±0.71 in Group 2. There was better granulation after VAC application in Group 1 (p<0.01). The success rate of the treatment was 22 cases (91.67%) in Group 1 and one case (12.5%) in Group 2. Thus there were statistically significant differences in the success rate of treatment between groups 1 and 2 (Pearson's chisquare test, p=0.01; odd ratio 77.00, 95% confidence interval [CI] 1.26~14.66; relative risk 4.30, 95% CI 1.26~14.66). Conclusion: These results suggest that there was a higher success rate of treatment with VAC in stage B patients. The University of Texas Staging System for Diabetic Foot Ulcers can thus be an index for applying VAC to patients with infective diabetic foot ulcers.

• Journal of Chest Surgery
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• 제40권11호
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• pp.765-769
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• 2007

배경: 농흉의 근치적 치료 방법은 흉막박피술이 우선적으로 시도된다. 그러나 근치적 치료가 힘든 고 위험군 환자의 경우는 위험성이 높다. 과거에는 만성 농흉 치료의 최종 단계로서 개방식 배농술을 선택했으나, 일차적인 근치적 치료가 힘든 경우 개방식 배농술과 근육이식술(일시적 혹은 단계적)시행 후, 최종적으로 개방창 폐쇄술을 시도함으로써 비교적 안전하게 농흉의 치료를 꾀할 수 있다. 대상 및 방법: 1995년 1월 1일부터 2004년 12월 31일까지 농흉으로 개방식 배농술을 시행한 21명의 환자를 대상으로 원인 질환과 치료 경과 및 최종 결과를 후향적으로 조사 분석하였다. 결과: 평균연령은 $57.5{\pm}15.5$세($25{\sim}78$세)였으며, 남자 16명(76.2%), 여자 5명(23.8%)이었다. 폐기능 검사결과는 평균 FEV1이 $1.58{\pm}0.49 L$였다. 농흉의 원인으로는 결핵성 농흉이 13예(61.9%), 폐국균증이 3예(14.3%), 폐렴성 농흉이 3예(14.3%), 폐절제 후 농흉이 2예(10%)이었다. 이들 중 14예에서 기관지 흉막루가 있었고, 8예에서 흉막의 석회화가 동반되어 있었다. 기관지 흉막루가 존재한 환자들 중에서 4예는 첫 수술시 전거근으로 기관지 흉막루를 덮었다. 절제된 늑골의 개수는 평균 $4{\pm}1$개였다. 12예에서 개방창 폐쇄가 가능하였으며 개방식 배농술 후 개방창 폐쇄까지 평균적으로 걸린 기간은 $10.22{\pm}3.11$개월이었고, 최종 수술 전 남아 있는 흉막강 결손의 평균은 $330{\pm}110 cc$였다. 12예 중 자연적으로 개방창 폐쇄가 이루어진 경우가 2예, 술 중 접어 두었던 피부만으로 폐쇄 가능했던 경우가 2예, 근육피판치환술 시행이 7예(광배근 4예, 대흉근 3예), 연조직 이용이 1예였다. 합병증으로는 연조직만으로 개방창폐쇄를 꾀했던 1예에서 조직 괴사가 생겨 폐쇄에 실패하였고, 복직근을 사용한 환자에서 복부 탈장이 생긴 경우가 1예 있었으며, 수술 후 30일내 사망한 예가 1예였고 다른 1예는 전이성 암으로 사망하였다. 걸론: 근치적 방법으로 치료가 힘든 경우의 만성 농흉 환자들에게 있어 개방식 배농술과 근육이식술, 근육피판을 이용한 최종적인 개방창 폐쇄술까지의 단계적인 접근 방법이 안전하고 효과적인 대안이 될 수 있을 것으로 생각한다.

• 한국관개배수논문집
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• 제4권2호
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• pp.38-47
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• 1997

In the final stage of seadike closing, the flow in the tidal gap changes rapidly to high accelerating flow, causing losses of construction materials. As the tidal velocity through the gap of an end dump contraction is highly nonuniform, flow equations on

• 대한구순구개열학회:학술대회논문집
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• 대한구순구개열학회 1997년도 종합학술대회
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• pp.36-36
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• 1997

• Geomechanics and Engineering
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• 제15권5호
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• pp.1039-1046
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• 2018

This paper presents a limit analysis of the series of construction stages of shallow tunneling method by investigating their respective safety factors and failure mechanisms. A case study for one particular cross-section of Beijing Subway Line 7 is undertaken, with a focus on the effects of multiple soil layers and construction sequencing of dual tunnels. Results show that using the step-excavation technique can render a higher safety factor for the excavation of a tunnel compared to the entire cross-section being excavated all at once. The failure mechanisms for each different construction stage are discussed and corresponding key locations are suggested to monitor the safety during tunneling. Simultaneous excavation of dual tunnels in the same cross-section should be expressly avoided considering their potential negative interactions. The normal and shear forces as well as bending moment of the primary lining and locking anchor pipe are found to reach their maximum value at Stage 6, before closure of the primary lining. Designing these struts should consider the effects of different construction stages of shallow tunneling method.

• Journal of Chest Surgery
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• 제24권2호
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• pp.212-216
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• 1991

A surgical correction was successfully performed in a adult female who had pulmonary atresia with almost non-confluent pulmonary artery, PDA and ventricular septal defect. Initially as a first stage of corrective surgery isolation of patent ductus arteriosus, ligation of aortopulmonary collaterals and identification of the pathologic anatomy of left pulmonary artery through left posterolateral approach were performed. At the second stage, a week after the initial operation, total correction was done making both pulmonary arteries confluent with albumin coated woven-dacron graft, external valved conduit and closure of large VSD of subarterial and perimembranous type. The PDA was ligated with previously encircled heavy stitch soon after partial bypass was started. Although massive bleeding from anastomotic site of dilated left pulmonary artery to the graft occurred preoperatively, postoperative functional improvement was excellent in terms of disappearance of cyanosis and normal exercise tolerance.

• Journal of Advanced Marine Engineering and Technology
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• 제23권5호
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• pp.662-670
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• 1999

A numerical prediction was performed to clarify the air motion in the cylinder of an axisymmet-ric four-stroke reciprocating engine at its intake and compression stage. A scheme of finite volume method is used for the calculation. Modified $k-{\varepsilon}$ turbulence model is adopted and wall function is applied to the grids near the wall. The predicted mean velocity and rms velocity profiles showed a reasonable agreement with an available experimental data at its intake and compression stage. The predicted in-cylinder flow fields show that a strong turbulent twin vortex structure is pro-duced during induction but it commences to decay rapidly around inlet valve closure. The mean velocity continues to fall to a low level during compression but the turbulence intensity attains an approximate constant level.

• 한국항공우주학회지
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• 제41권5호
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• pp.383-390
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• 2013

유도탄의 사출성능 중 탄에 충격으로 작용하는 최대가속도의 감소는 유도탄의 비정상작동 방지와 내부 부품들의 크기 및 비용 감소 측면에서 매우 중요하다. 본 연구에서는 사출용 가스발생기의 작동에 의해 탄에 가해지는 최대가속도가 사출초기에 발생됨을 착안하여 사출초기에 영향을 미치는 설계인자를 조사하였다. 가스발생기 설계인자로 점화기 및 노즐마개를 선정하고, 설계인자 변경을 통해 가스발생기에 의해 발생되는 최대가속도를 실험적으로 조사하였다. 최종적으로 최대가속도 감소효과를 정량적으로 비교하기 위해 가스발생기 지상연소시험을 실시하였다. 그 결과 설계인자의 최적값들이 적용된 개선모델의 경우 기준모델에 비해 최대가속도를 약 68% 줄일 수 있음을 확인하였다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권2호
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• pp.113-121
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• 1994

Large oral defects following tumor resection pose formidable challenge for the reconstructive surgeon. Ideally, wound closure should utilize like tissue in providing expedient, single-stage closure, returning maximum function while minimizing deformity. Recent methods have reported and utilize variable mucocutaneous flaps. However, the ideal reconstruction has yet to defined. The small bowel serves as a readily available donor site for satisfying reconstructive needs in oropharyngeoesophageal defects. Segments of jejunum may be opened along the antimesenteric border and transferred to oral defect as free tissue transfers. Some of the benefits of this technique have included a one-stage procedure, abundant donor tissue with characteristics similar to oral mucosa, near normal facial appearance, preservation of maximum tongue function and relief of annoying xerostomia by jejunal mucous secretion. Three cases re presented in which two cases show successful use of this flap. The other one patient developed total necrosis of this flap. We report cases of reconstruction using free jejunal flap transfer in oral reconstruction.

• Archives of Plastic Surgery
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• 제34권3호
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• pp.325-329
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• 2007

Purpose: Mobius syndrome is a rare congenital disorder characterized by facial diplegia and bilateral abducens palsy, which occasionally combines with other cranial nerve dysfunction. The inability to show happiness, sadness or anger by facial expression frequently results in social dysfunction. The classic concept of cross facial nerve grafting and free muscle transplantation, which is standard in unilateral developmental facial palsy, cannot be used in these patients without special consideration. Our experience in the treatment of three patients with this syndrome using transfer of muscles innervated by trigeminal nerve showed rewarding results. Methods: We used bilateral temporalis muscle elevated from the bony temporal fossa. Muscles and their attached fascia were folded down over the anterior surface of the zygomatic arch. The divided strips from the attached fascia were passed subcutaneously and anchored to the medial canthus and the nasolabial crease for smiling and competence of mouth and eyelids. For the recent 13 years the authors applied this method in 3 Mobius syndrome cases- 45 year-old man and 13 year-old boy, 8 year-old girl. Results: One month after the surgery the patients had good support and already showed voluntary movement at the corner of their mouth. They showed full closure of both eyelids. There was no scleral showing during eyelid closure. Also full closure of the mouth was achieved. After six months, the reconstructed movements of face were maintained. Conclusion: Temporalis muscle transfer for Mobius syndrome is an excellent method for bilateral reconstruction at one stage, is easy to perform, and has a wide range of reconstruction and reproducibility.