http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Colonic Perforation: Can We Manage It Endoscopically?
변정식 대한소화기내시경학회 2013 Clinical Endoscopy Vol.46 No.5
Colonic perforation occurs in a variety of clinical scenarios and colonoscopy-associated perforation is one of the important reasons for colonic perforation. Colonoscopy-associated perforation may be diagnosed during colonoscopy procedure by the visualization of evident colonic wall defect or, after the completion of colonoscopy, by the visualization of leaked air in the peritoneal or retroperitoneal space. Recently, the incidence of colonoscopy-associated perforation increased because of the introduction of colorectal endoscopic submucosal dissection. Traditionally, colonoscopy-associated perforation was managed surgically. However, medical management has been introduced widely and endoscopic clipping is the most important component for the medical management of colonoscopy-associated perforation. Timely administration of antibiotics is also important. Large perforations, diagnostic colonoscopy-associated perforations, large amount of pneumoperitoneum, and severe abdominal pain have been reported to be predictive of the necessity of surgery after endoscopic clipping. Surgery should be performed if patients show clinical deterioration even after the initiation of medical management.
신발제조업체의 접착제 사용에 따른 직접·간접폭로 근로자들의 복합유기용제 폭로량과 자각증상 비교
변정식,김정윤,조영채,김동현,Byun, Jeong-Sik,Kim, Jeong-Yun,Cho, Young-Chae,Kim, Dong-Hyun 한국산업보건학회 1995 한국산업보건학회지 Vol.5 No.1
This study was performed to find out the exposure level of mixed organic solvents, excretion of urinary hippuricacid and subjective symptoms according to the exposure of organic solvents of female workers who works on 5 shoes manufacturing industries in Taejon City from 24, september to 20, october 1993. The studied groups were divided into 3 groups that were consist of direct exposure group(48 workers), indirect exposure group(49 workers) and non-exposure group(68 workers) to the organic solvents. The exposure levels of toluene of direct exposure group which $89.86{\pm}56.20ppm$ had higher than that of indirect exposure group which had $40.23{\pm}47.21ppm$. In the exposure level of mixed organic solvent(R-value), direct exposure group was $2.84{\pm}1.53$ and exceeded approximatly 3 times the R-value. Whereas, indirect exposure group was not exceeded the R-value as $0.80{\pm}0.61$. In the excretion level of urinary hippuric acid, direct exposure group was $1.78{\pm}1.25g/l$, indirect exposure group was $1.22{\pm}0.93g/l$ and non-exposure group was $0.51{\pm}0.18g/l$ respectively. Therefore both direct exposure group and indirect exposure group were significantly higher than non-exposure group(P<0.01). In the correlation between toluene levels and urinary hippuric acid level, the direct exposure group had positive correlation(R=0.8309, P<0.01), also indirect exposure group had positive correlation(R=0.5859, P<0.05) and also in the correlation between the R value of mixed organic solvents and the urinary hippuric acid levels, the direct exposure group had positive correlation(R=0.4492, P<0.05), and indirect exposure group had ositive correlation(R=0.7911, P<0.01). In the complain rates of the worker's subjective symptoms at work, both direct exposure group and indirect exposure group were higher than non-exposure group(P<0.05, P<0.01). But the sujective symptoms of "floating sensation" of direct exposure group had significantly higher than indirect exposure group. In the percent of subjective symptoms complaints during the worker's daily life, both direct exposure group and indirect exposure group had generally more statistical significance than nonexposure group(P<0.01), direct exposure group had not statistical significant difference from indirect exposure group. As the results mentioned above, it has been analysed that the indirect at the adjacent manufaturing process are exposed to the considerable amount of solvent. Therefore, I think that there should be the betterment of surrounding through the complete working environment management to the occurrence source of the organic solvent, the changes of health management system to the indirect-exposed workers, and the systematic management of the special medical examination and the like.