일개 대학교 5년간 인트라넷 건강상담 내용분석

김형대(Hyeung-Dae Kim),이무식(Moo-Sik Lee),배석환(Seok-Hwan Bae),나백주(Bak-Ju Na),김건엽(Keon-Yeop Kim),김철웅(Chul-woung Kim),강문영(Moon-Young Kang),김대경(Dae-Kyung Kim),오경희(Kyung-Hee Oh) 한국농촌의학 지역보건학회 2007 농촌의학·지역보건 Vol.32 No.2

순산소 연소를 위한 초저온 공기분리장치의 최적공정 설계 연구

최형철 ( Hyeung-chul Choi ),문흥만 ( Hung-man Moon ),조정호 ( Jung-ho Cho ) 한국화학공학회 2018 Korean Chemical Engineering Research(HWAHAK KONGHA Vol.56 No.5

지구 온난화 문제 해결과 온실가스 감축을 위하여 화력발전소를 중심으로 순산소 연소를 통한 CO₂ 포집 기술이 개발되었으나, 산소 생산 비용이 높아 경제성이 떨어지는 문제를 가지고 있다. 순산소 연소에 필요한 대량의 산소(>2,000 tpd)를 생산하는 방법은 초저온 공기분리장치(ASU: Air Separation Unit)가 가장 적합한 것으로 알려져 있으나, 대부분 고순도(>99.5%) 산소 생산에 최적화되어 건설되었다. 이런 초저온 공기분리장치에서 순산소 연소에서 사용이 가능한 낮은 순도(90~97%)의 산소를 생산하고 공정을 최적화할 경우, 공정 효율이 높아져 산소 생산 비용 절감이 가능하다. 본 연구에서는 순산소 연소 발전시스템에 산소를 공급할 수 있는 초대형(>2,000 tpd O₂) ASU 개발을 위하여 공정 분석 및 비교 평가를 수행하였다. 상용 프로그램인 AspenHysys를 이용하여 산소 순도에 따른 회수율 및 전력소모량을 계산하고 공정의 효율을 평가하였다. 그 결과 ASU를 통해 순산소 연소에 공급되는 산소는 약 95%가 최적이며, 생산 공정 최적화 시 약 12~18%의 전력소모량 절감이 가능한 것을 확인 할 수 있었다. In order to solve the global warming and reduce greenhouse gas emissions, it has been developed the CO₂ capture technology by oxy-fuel combustion. But there is a problem that the economic efficiency is low because the oxygen production cost is high. ASU (Air Separation Unit) is known to be most suitable method for producing large capacity of oxygen (>2,000 tpd). But most of them are optimized for high purity (>99.5%) oxygen production. If the ASU process is optimized for low purity(90~97%) oxygen producing, it is possible to reduce the production cost of oxygen by improving the process efficiency. In this study, the process analysis and comparative evaluation was conducted for developing large capacity ASU for oxy-fuel combustion. The process efficiency was evaluated by calculating the recovery rate and power consumption according to the oxygen purity using the AspenHysys. As a result, it confirmed that the optimal purity of oxygen for oxyfuel combustion is 95%, and the power consumption can be reduced by process optimization to 12~18%.

Qi-deficiency in the Patients with Allergic Disorders

Yei, Young Chul,Jin, Chul,Choi, Won Woo,Hwang, Jae Woong,Jang, Hyeung Jin,Kim, Bum Joon,Lim, Kook Jin,Kwon, Seungwon,Cho, Seung Yeon,Park, Seong Uk,Park, Jung Mi,Ko, Chang Nam,Moon, Sang Kwan,Cho, Ki The Society of Stroke on Korean Medicine 2015 대한중풍.순환신경학회지 Vol.16 No.1

■ Introduction Allergy refers a hypersensitive immune response to the various environmental factors and Qi is considered as vit al energy to defend oneself from environments in Traditional Chinese Medicine. Therefore, this study was performed to assess the relationship between allergy and Qi-deficiency ■ Methods We enrolled the subjects with allergic disorders and the healthy controls without allergic disorders. We got the information on the general characteristics, and the score of Qi-deficiency from all of the subjects, and measured their total Immunoglobulin E(IgE) level. ■ Results There were one hundred forty three subjects with allergic disorders and 211 of the control. The educational level, total IgE, and the scores of the Qi-deficiency were higher in the allergy group than in the control. ■ Conclusion Allergic subjects tend to have more severe Qi-deficiency. This could suggest the clinical effectiveness of some herbal medicines for Qi-deficiency on allergic disorders.

Poster Session:PS 1154 ; Gastroenterology (Pancreatobilliary) : Biliary Ascariasis Infestation after Endoscopic Sphincterotomy

( Su Sie Rah ),( Seug Won Jung ),( Dong Chul Lee ),( Geum Soo Lee ),( Hyeung Chul Moon ),( Sang Wook Park ),( Gun Young Hong ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Ascarias lumbricoides is a common parasitic infestation in gastrointestinal tract. Migration of adult worm to biliary system implicates biliary complication. Interestingly, biliary ascariasis is known as one of the complication of EST in endemic area. But biliary ascariasis after endoscopic sphicterotomy is rarely reported in Korea. We report the case of biliary ascariasis caused after performing EST for treatment of common bile duct stones. 58- year-female Combodian from South East Asia visited our hospital for epigastric pain from 2 weeks ago. Laboratory fi nding revealed AST 122 IU/L, ALT 35 IU/L, ALP 122 IU/L, GGT 244 IU/L. CT scan showed multiple large stones in common bile duct. We extracted multiple brown stones by basket after endoscopic sphincterotomy and endoscopic papillary large balloon dilatation. Next day, we performed follow up ERCP for removal of remnant CBD stones. On cholangiogram, giant roundworm with remnant stone was noted in CBD, which wasn`t seen at prior ERCP. We caught the worm by snare and successfully pulled it out from common bile duct. The worm, 30cm long, round, whitish-pink colored, was identified as ascariasis lumbricoides. We detected round worm after performing endoscopic sphincterotomy which wasn`t noticed at fi rst ERCP. The worm seems to migrate to common bile duct easily because opening of major papilla was widened after EST. As the demand for organic food and immigration from endemic area increase in Korea, biliary ascariasis should be considered a diagnostic possibility especially in patient from the tropics.

Poster Session:PS 1152;Gastroenterology (Pancreatobilliary):A Case of Peroral Cholangioscopic Management of Impacted Common Bile Duct Stone During Emergent Mechanical Lithotripsy

( Dong Cheol Lee ),( Sang Wook Park ),( Gun Young Hong ),( Hyeung Chul Moon ),( Geum Soo Lee ),( Seung Won Jung ),( Su Sie Rah ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Introduction: Difficult common bile duct(CBD) stone often requires mechanical lithotripsy for successful extraction. But we can experience several complications such as trapped or broken basket, wire fracture, broken handle during the mechanical lithotripsy. These complications can be managed by additional endoscopic procedure or emergent mechanical lithotripsy. But peroral direct choledochoscopic treatment of complicated stone during mechanical lithotripsy have not be reported. We present a case of impacted CBD stone with basket in distal CBD successfully treated with peroral cholangioscopy-directed elctrohydraulic lithotripsy(EHL). Case report: A 79-year-old female visit out hospital due to abdominal pain. Abdominal computed tomography(CT) revealed large stone in CBD. About 3x4cm sized large fi lling defect was noted in CBD on ERCP. Endoscopic papillary large balloon dilatation after endoscopic sphinterectomy(EST), We tried mechanical lithotripsy. But the stone was too hard to crushed by mechanical lithotripsy. During additional emergent mechanical lithotripsy the wire was broken at 30cm away from mouth with the dormia basket entrapped in the distal CBD with the stone. We performed peroral direct cholangioscopy with ultra-slim endoscopy. The endoscopic fi nding showed basket-captured large brown stone at distal CBD, just above papillary orifi ce. We tried peroral cholangioscopy-directed elctrohydraulic lithotripsy and succeeded in breaking the stone. After removing the trapped basket from the fragmented stones, We extracted the stone successfully. Conclusion: Several clinical studies reported the utility of peroral cholaniograpy for the diagnosis and management of bile duct disease. We suggest that electrohydraulic lithotripsy under direct peroral cholangioscopy can be an effective and safe therapeutic option for treatment of impacted stone during mechanical lithotripsy.

금속스텐트 삽입술로 호전된 총담관의 자연 천공

양동훈 ( Dong Hoon Yang ),박상욱 ( Sang Wook Park ),문형철 ( Hyeung Chul Moon ),유경완 ( Kyoung Wan You ),은서준 ( Seo Joon Eun ),문승기 ( Seung Ki Moon ),박철민 ( Choel Min Bak ),조신형 ( Shin Hyoung Jo ) 대한췌담도학회 2016 대한췌담도학회지 Vol.21 No.4

총담관의 자발적 천공은 흔하지 않으며, 이에 대해 충분한 연구와 경험이 부족한 상태이다. 본 저자들은 원인을 알 수없는 복통과 난치성 복수를 호소하는 환자에서 총담관의 자발적 천공을 진단하고, 내시경역행담췌관조영술을 통한 완전피막형 자가팽창형 금속스텐트의 삽입술과 보존적 치료를 통하여 치료에 성공했던 증례를 경험하였기에 보고한다. Perforation of the biliary tree mostly results from injury to the bile duct during surgery or procedures such as endoscopic retrograde cholangiopancreatography (ERCP) and spontaneous bile duct perforation is rare in adults. As the clinical picture varies, early diagnosis and treatment of spontaneous biliary peritonitis is difficult. A 52-year-old male patient presented with abdominal pain and intractable ascites. He already experienced severe abdominal pain 2 months ago and underwent percutaneous pigtail drainage for the ascites at nearby hospital. ERCP showed large filling defect with leakage of contrast media from the mid common bile duct (CBD) into the peritoneal cavity. We performed endoscopic sphincterotomy and extracted CBD stones with basket and balloon catheter. Then fully covered self expandable metal stent was placed in CBD. After the procedure, the symptom was improved and the amount of pigtail drainage from abdominal cavity was dramatically decreased. 6 weeks later, removing the metal stent, there was no more leakage of contrast media into peritoneal cavity. We report a very rare case of spontaneous bile leakage which was successfully managed with placement of metal stent.

Poster Session:PS 1161 ; Gastroenterology (Pancreatobilliary) : Repeated Sessions of Common Bile Duct Washing for Hemobilia by Gallbladder Adenosquamous Carcinoma before Cholecystectomy

( Seung Won Jung ),( Gun Young Hong ),( Sang Wook Park ),( Hyeung Chul Moon ),( Geum Soo Lee ),( Susie Rah ),( Dong Cheol Lee ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Introduction: Hemobilia is a bleeding from the biliary tract and is relatively rare cause of bleeding in the digestive tract. Hemobilia is often developed due to trauma, surgery in biliary tract, gallstone, cholangitis and rarely by the tumors of the biliary tract. Biological behavior and clinical course of gallbladder adenosquamous carcinoma are not clear. Few cases of hemobilia caused by gallbladder adenosquamous carcinoma have been reported. Here, we describe a rare case of gallbladder carcinoma containing squamous component manifested by hemobilia. Case report: A 66-year-old female patient referred to our clinic due to acute cholecystitis. Patient`s symptoms are chill, fever, right upper quadrant abdominal pain for 7days. Computed tomography(CT) showed gallbladder distension, CBD dilatation and 39x25mm sized soft tissue mass with enhancement in the gallbladder. We performed ERCP for evaluation of biliary obstruction. Fresh blood was gushing out from major papilla on duodenoscopy. Cholangiography revealed amorphous fi lling defect in common bile duct with duct dilatation. We observed amorphous isoechoic lesion from proximal bile duct to distal duct in intraductal ultrasound (IDUS). We performed endoscopic sphincterotomy (EST) and removed blood coagula by basket and balloon sweeping. Biliary tract obstruction was not resolved due to persistent gallbladder bleeding. Repeated clot removal and cleansing of CBD releaved biliary obstruction and decreased liver function test. Seven days later, she underwent laparoscopic cholecystectomy. Pathologic fi nding of gallbladder was adenosquamous carcinoma. Conclusion: Hemobilia can occur with trauma, cholelithiasis, acalculous infi ammatory disease, medical intervention, neoplastic disease and surgury. Clinical feature and course of gallbladder cancer containing squamous component is not well known. We experienced a persistent hemobilia by bleeding from adenosquamous gallbladder cancer, and resolved the CBD obstruction by EST and washing the CBD following cholecystectomy.

밀도와 구속압력이 노상토의 탄성계수에 미치는 영향에 관한 실험적 연구

김수일,김문겸,유지형,김철수,Kim, Soo Il,Kim, Moon Kyum,Yoo, Ji Hyeung,Kim, Chul Soo 대한토목학회 1988 대한토목학회논문집 Vol.8 No.2

In this study, effects of the density of soil and the confining pressure applied to the soil sample on the elastic moduli of subgrade soils are experimentally analyzed. Through investigation of subgrade materials of domestic expressways, five typical types of subgrade soils are selected for the experiments. A series of unconsolidated undrained triaxial tests is performed on samples prepared with various water contents and densities at the confining pressures of 1.02, 2.04, and $3.06kg/cm^2$. Initial tangent modulus is inferred from the unloading-reloading portion of the stress strain curve obtained during an individual loading-unloading-reloading test. As a result of the analysis, it is found that the effect of the confining pressure on the elastic modulus of subgrade material is well consistent with the equation proposed by Janbu, and that the elastic modulus can be related to the dry unit weight expressing the Janbu constants as exponentiial functions of it. It is also found that the water content has little effect on the elastic modulus for the samples with the degree of saturation less than 70%. 본 연구에서는 밀도와 구속압력이 노상토의 탄성계수에 미치는 영향을 살펴보기 위하여 전국 고속도로로 노상토를 채취분석하여 얻은 전형적인 5가지 노상토 재료에 대하여 함수비, 밀도 및 구속압력을 달리하면서 비압밀 비배수 삼축압축시험을 실시하였다. 삼축압축시험시 unloading-reloading 실험을 수행하여 얻은 응력-변형을 관계로부터 최대탄성계수를 측정하였다. 실험결과 노상토의 탄성거동은 Janbu의 제안식에 잘 부합하였으며, 구속압력으로 표준화된 탄성계수는 건조단위체적중량과 지수함수의 상관관계가 있음을 알 수 있었다. 또한 포화도가 70%이하에서는 함수비가 탄성계수에 영향을 거의 미치지 않음이 밝혀졌다.

Usefullness of J-turn,pull-release method for intubation of bile duct without accessory in DPOC

( Moo Woong Kim ),( Seo Joon Eun ),( Ui Sin Lee ),( Susie Rah ),( Geum Soo Lee ),( Hyeung Chul Moon ),( Sang Wook Park ),( Gun Young Hong ) 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1

Background and Study Aims: The Direct peroral cholangioscopy (POC) using an ultraslim endoscope provides endoscopic visualization of the biliary trees with following major advantages, high quality endoscopic images, a working channel and economical benefit. Despite of these advantages, an accessory usually is required to insert into the bile duct because of acute angle between the duodenum and bile duct and loop formation in stomach. But it has been reported that the intubation without an accessory was possible, so we carried out the study for how to be successful intubation without any accessories under the direct POC. Patients and Methods: From April 2014 to June 2015, we carried out the direct POC using ultraslim endoscope without any accessories in patients who had large or hard stone. Ultraslim endoscopy (Olympus GIF-XP260N) was used for choledochoscopy. Before POC, the orifice of major papilla should be widened enough by EST or EPBD. First, entering the 2nd portion of duodenum, the scope was shortened by right turn, pulling method. Second, it was deflected up (J-turn) carefully and positioned in front of the major papilla. Then pull it slowly toward the major papilla. When the tip of scope reached at papilla orifice, release the J-turn by down regulation of endoscopy with advancing the scope into the bile duct simultaneously. After entering the common bile duct, we performed stone fragmentation with EHL. If the scope could not reach the stone, balloon catheter was used for advancing the scope. Finally the stones were extracted by ERCP. Results: DPOC using an ultraslim endoscope without an accessory was successfully performed in 21 of the 29 (24 for impacted CBD stone, 4 mirrizi syndrome, 1 IHD stone) patients. No significant procedure- related complications such as bleeding, pancreatitis, perforation except one air embolism was noted. Conclusions: Despite of limitation for advancing endoscopy to upper CBD and IHBD, POC using J-turn, pull-release method is considered for successful maneuver for intubation of bile duct. We reported 21 successful cases by this method, further cases are needed to evaluate the effectiveness and safety of this method.

모든 상부 위장관 간엽 종양(Mesenchymal Cell Tumor)의 침습 접근이 필요한가?

이은주 ( Eun Ju Lee ),김태동 ( Tae Dong Kim ),오현아 ( Heun Ah Oh ),이형철 ( Hyeung Chul Lee ),김준환 ( Jun Hwan Kim ),장병익 ( Byung Ik Jang ),김태년 ( Tae Nyeun Kim ),정문관 ( Moon Kwan Chung ),배영경 ( Young Kyeong Bae ) 대한소화기학회 2005 대한소화기학회지 Vol.45 No.6

Background/Aims: Mesenchymal tumors are the most frequent submucosal tumors in gastrointestinal trail. We reviewed the mesenchymal tumors which are confirmed by pathology to examine whether the invasive approach of all mesenchymal tumors is necessary. Met