• 한국관개배수논문집
• /
• 제21권1호
• /
• pp.32-44
• /
• 2014

In Korea, global warming caused by the climate changes impacted on weather system with increase in frequency and intensity of precipitation, and the rainfall pattern changes significantly by regional groups. Furthermore, it is expected that the regional and annual fluctuation ranges of the rainfall in the future would be more severe. Nowadays, agricultural drainage system designed by the existing standard of 20-year return period and 2 days of fixation time cannot deal with the increment rainfall such as localized heavy rain and local torrential rainfalls. Therefore, it is required to reinforce the standard of the drainage system in order to reduce the agricultural flood damage brought by unusual weather. In addition, it is needed to improve the standard of agricultural drainage design in order to cultivate farm products in paddy fields as facility vegetable cultivation and up-land field crop have been damaged by the moisture injury and flooding. In order to prepare for the changes of rainfall pattern due to climate changes and improve the agricultural drainage design standards by the increase of cultivating farm products, the purpose of this study is to examine the impact of climate changes, the changes of relative design standard, and the analytic situation of agricultural flood damages, to consider the drainage design standard revision, and finally to prepare for enhanced agricultural drainage design standards.

• 대한지리학회지
• /
• 제39권6호
• /
• pp.833-844
• /
• 2004

추가령 열곡에서 열하분출에 의한 용암대지가 형성되면서 기존의 하곡들이 매몰되어 하계망 혼란이 일어나고, 새로운 분수계가 형성과 함께 하계망 재편성이 진행되고 있다. 이 지역은 안변 남대천, 북한강, 임진강, 한탄강 유역이 접하는 복잡한 분수계 혼란 지역으로서 분수계의 핵심 지점은 중심분출 화산인 평강의 오리산(453m)과 680봉이며, 보다 평탄한 곳에서는 하천 쟁탈이 복잡하게 전개되고, 평탄면에서 유역이 가까이 접하면서 쟁탈 전선도 형성된다. 특히 오리산은 4개의 분수계를 가르는 분수점 기능을 한다. 고도가 높은 산록에서는 두부 침식에 의해 하천 쟁탈이 발생한다. 수문지형적으로는 용암이 하곡을 메우면서 범람원의 면적이 줄어들어 호우에 의한 침수 가능성이 높아지게 되며, 보다 활발한 용암대지 개석작용을 유발하는 것으로 판단된다.

• 대한지리학회:학술대회논문집
• /
• 대한지리학회 2004년도 추계학술대회
• /
• pp.47-47
• /
• 2004

• Journal of Korean Neurosurgical Society
• /
• 제46권3호
• /
• pp.210-214
• /
• 2009

Objective : Several surgical procedures have been reported for the treatment of chronic subdural hematoma (CSDH). We compared the results of treatments for CSDH obtained from one burr-hole craniostomy with closed system drainage with or without irrigation, two burr-hole craniostomy with closed system drainage with irrigation, and small craniotomy with irrigation and closed-system drainage. Methods : Eighty-seven patients with CSDH underwent surgery at our institution from January 2004 to December 2008. Our patients were classified into three groups according to the operative procedure; group I, one burr-hole craniostomy with closed system drainage with or without irrigation (n=25), group II, two burr-hole craniostomy with closed system drainage with irrigation (n=32), and group III, small craniotomy with irrigation and closed-system drainage (n=30). Results : Age distribution, male and female ratio, Markwalder's grade on admission and at the time of discharge, size of hematoma before and after surgery, duration of operation, Hounsfield unit of hematoma before and after surgery, duration of hospital treatment, complication rate, and revision rate were categories that we compared between groups. Duration of operation and hospitalization were only two categories which were different. But, when comparing burr hole craniostomy group (group I and group II) with small craniotomy group (group III), duration of post-operative hospital treatment, complication and recurrence rate were statistically lower in small craniotomy group, even though operation time was longer. Conclusion : Such results indicate that small craniotomy with irrigation and closed-system drainage can be considered as one of the treatment options in patients with CSDH.

• Archives of Plastic Surgery
• /
• 제47권1호
• /
• pp.97-101
• /
• 2020

Although the success rate of deep inferior epigastric perforator (DIEP) flaps has increased, late flap failures still occur and have a low salvage rate. The present article describes a case of salvage of a case of late flap failure using the pedicle vein as a vein graft source. A 50-yearold woman underwent a bilateral DIEP free flap procedure. On postoperative day 6, she experienced flap compromise and underwent emergency flap revision. In the flap revision, flap venous drainage and the superficial inferior epigastric vein were completely obstructed. A Fogarty catheter was used to remove a thrombus from the completely obstructed pedicle vein, and this pedicle vein was used as a graft source and was ligated in retrograde fashion to the flap vein stump. After injection of urokinase into the arterial branch, venous flow to the flap was restored. At a 6-month follow-up visit in the outpatient clinic, only partial fat necrosis at the flap was noted. By dissecting various perforators in the initial operation, decisions regarding immediate revision can be made with more confidence. Additionally, the combined procedures performed in this case may be helpful even for practitioners treating cases of late flap compromise.

• 물과 미래
• /
• 제19권1호
• /
• pp.57-63
• /
• 1986

유역 추적에 자주 쓰이는 합성 단위 유량도 방법의 일종인 Snyder 방법에 있어서의 계수를 남한강 수계에서 재조정하는 과정을 제시하였다. 그 과정은, 과거의 조사에서 구한 남한강 수계의 Snyder 공식에서 초기값을 구한 다음, 이 값을 HEC-1 모델에 적용시켜 계수를 재조정한 후에 그 계수로부터 Snyder의 개선공식을 구하게 된다. 이와 같은 과정으로 구한 개선 공식은 기존 공식에 비해 계산 수문 곡선의 첨두 유량의 크기가 커지게 되며, 첨두 유량에 도달하는 기울기도 기존 공식보다 급격하게 되는 특성을 가지게 된다. 또한 첨두 유량이 발생하는 시간을 결정하여 주는 지체 시간이 기존 공식에 비해 개선 공식에서 작게 되기 때문에 첨두 유량이 발생되는 시간도 개선 공식을 사용하게 되면 기존 공식을 사용한 경우보다 더 빨라지게 된다.

• Archives of Plastic Surgery
• /
• 제46권3호
• /
• pp.235-240
• /
• 2019

Background The efficacy of Limberg flap reconstruction for pilonidal sinus with acute abscess remains unclear. This study aimed to compare outcomes after Limberg flap reconstruction for pilonidal sinus disease with and without acute abscess. A secondary objective was to perform a review of the literature on the topic. Methods A retrospective chart review was conducted of all patients who underwent excision and Limberg flap reconstruction for pilonidal sinus from 2009 to 2018. Patient demographics, wound characteristics, and complication rates were reviewed and analyzed. Results Group 1 comprised 19 patients who underwent Limberg flap reconstruction for pilonidal sinus disease without acute abscess and group 2 comprised four patients who underwent reconstruction for pilonidal sinus disease with acute abscess. The average defect size after excision was larger in group 2 than group 1 ($107.7{\pm}60.3cm^2$ vs. $61.4{\pm}33.8cm^2$, respectively). There were no recurrences, seromas or cases of flap necrosis postoperatively. There was only one revision surgery needed for evacuation of a postoperative hematoma in group 1. There were comparable rates of partial wound dehiscence treated by local wound care, hematoma, need for revision surgery and minor infection between group 1 and group 2. Conclusions Limberg flap reconstruction for pilonidal sinus in the setting of acute abscess is a viable option with outcomes comparable to that for disease without acute abscess. This practice will avoid the pain and cost associated with a prolonged local wound care regimen involved in drainage of the abscess prior to flap reconstruction.

• 임상간호연구
• /
• 제29권3호
• /
• pp.211-222
• /
• 2023

Purpose: This study was conducted to update the existing evidence-based nursing clinical practice guideline for indwelling urinary catheterization (IUC). Methods: The guideline have been revised in 22 steps based on international standards. The quality of the practice guidelines to be used for revision was evaluated using the Appraisal of Guidelines for Research and Evaluation II. The evaluation of the content appropriateness and applicability of the draft recommendations of the revised practice guidelines was performed using the RAND/UCLA Appropriateness Method, a decision-making method developed by the RAND Corporation. Four guidelines were used for the revision. Results: The updated nursing practice guideline for IUC consisted of 9 domains and 134 recommendations. The numbers of recommendations in each domain were: 4 Assessment, 20 Equipment, 11 Catheter insertion, 52 Catheter maintenance, 4 Catheter and drainage bag change, 9 Catheter removal, 22 Complications management, 5 Education and consult, and 7 Hospital support. The recommended grade was 8.2% for A, 38.1% for B, and 53.7% for C. Among these, the major revision was done in 11 recommendations (8.2%). A total of 29 recommendations (21.6%) were newly added. 30 (22.4%) recommendations had minor revisions such as changes or addition for some words or sentences, and 13 (9.7%) recommendations were deleted. Conclusion: Revised nursing practice guideline is expected to serve as an evidence-based practice guideline for IUC in Korea. This guideline will provide health care providers, patients, and caregivers with information to help manage IUC, leading to improved patient outcomes.

• Journal of Korean Neurosurgical Society
• /
• 제60권1호
• /
• pp.1-7
• /
• 2017

Objective : The diagnosis of shunt malfunction can be challenging since neuroimaging results are not always correlated with clinical outcomes. The purpose of this study was to evaluate the efficacy of a simple, minimally invasive cerebrospinal fluid (CSF) lumbar tapping test that predicts shunt under-drainage in hydrocephalus patients. Methods : We retrospectively reviewed the clinical and radiological features of 48 patients who underwent routine CSF lumbar tapping after ventriculoperitoneal shunt (VPS) operation using a programmable shunting device. We compared shunt valve opening pressure and CSF lumbar tapping pressure to check under-drainage. Results : The mean pressure difference between valve opening pressure and CSF lumbar tapping pressure of all patients were $2.21{\pm}24.57mmH_2O$. The frequency of CSF lumbar tapping was $2.06{\pm}1.26times$. Eighty five times lumbar tapping of 41 patients showed that their VPS function was normal which was consistent with clinical improvement and decreased ventricle size on computed tomography scan. The mean pressure difference in these patients was $-3.69{\pm}19.20mmH_2O$. The mean frequency of CSF lumbar tapping was $2.07{\pm}1.25times$. Fourteen cases of 10 patients revealed suspected VPS malfunction which were consistent with radiological results and clinical symptoms, defined as changes in ventricle size and no clinical improvement. The mean pressure difference was $38.07{\pm}23.58mmH_2O$. The mean frequency of CSF lumbar tapping was $1.44{\pm}1.01times$. Pressure difference greater than $35mmH_2O$ was shown in 2.35% of the normal VPS function group (2 of 85) whereas it was shown in 64.29% of the suspected VPS malfunction group (9 of 14). The difference was statistically significant (p=0.000001). Among 10 patients with under-drainage, 5 patients underwent shunt revision. The causes of the shunt malfunction included 3 cases of proximal occlusion and 2 cases of distal obstruction and valve malfunction. Conclusion : Under-drainage of CSF should be suspected if CSF lumbar tapping pressure is $35mmH_2O$ higher than the valve opening pressure and shunt malfunction evaluation or adjustment of the valve opening pressure should be made.

• Tuberculosis and Respiratory Diseases
• /
• 제79권2호
• /
• pp.98-100
• /
• 2016

We present a rare case of critically compromised airway secondary to a massively dilated sequestered colon conduit after several revision surgeries. A 71-year-old male patient had several operations after the diagnosis of gastric cancer. After initial treatment of pneumonia in the pulmonology department, he was transferred to the surgery department for feeding jejunostomy because of recurrent aspiration. However, he had respiratory failure requiring mechanical ventilation. The chest computed tomography (CT) scan showed pneumonic consolidation at both lower lungs and massive dilatation of the substernal interposed colon compressing the trachea. The dilated interposed colon was originated from the right colon, which was sequestered after the recent esophageal reconstruction with left colon interposition resulting blind pouch at both ends. It was treated with CT-guided pigtail catheter drainage via right supraclavicular route, which was left in place for 2 weeks, and then removed. The patient remained well clinically, and was discharged home.