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담낭절제술후의 내시경적역행성담췌관조영술의 진단소견과 치료
김원석(Won Seok Kim),조형철(Hyung Chul Cho),조장현(Jang Hyun Cho),추진호(Jin Ho Chu),김명원(Myung Won KIm),오기창(Ki Chung Oh),강명원(Myung Won Kang),임연근(Yun Kun Lim),여향순(Hyang Soon Yeo),박홍배(Hong Bae Park) 대한내과학회 1998 대한내과학회지 Vol.54 No.5
N/A Objectives: Accurate assessment of the retained or recurrent bile duct stone is important in postcholecys-tectomy patients who have signs of cholangitis or other pancreatobiliary disease. This study was performed to evaluate the diagnostic and therapeutic reliability of endoscopic retrograde cholangiography in posteholecystectomy patients. Methods: From October 1975 through August 1995, we reviewed 311 patients retrospectively who had undergone on cholecystectomy, Our study was based on assessment of their age, sex, symptoms and physical findings, comparison between sonographic and endoscopic retrograde cholangiographic findings, and stone removal rate using endoscopic sphincterotomy, basket, electrohydraulic lithotripsy. Results: The ratio of male to female was 1:1.67, and the mean age was 56±14.3 years. After cholecystectomy, they visited our clinic within 2 years in 25 patients (8.4%), beyond 2 years in 286 patients (91.6%). Most common symptoms and physical findings were epigastric pain or tenderrs (63.6%). We detected bile duct stone using endoscopic retrograde cholangiography 219 patients. In case of the bile duct stone, we successfully removed it using endoscopic sphincterotomy, basket, electrohydraulic lithotripsy in 194 patients (88.6%). Conclusion: From the above results, we concluded that endoscopic retrograde cholangiography was the most effective diagnostic and therapeutic method in postch-olecystetomy patients who have signs of cholangitis.
대심도 터널용 가역축류송풍기 근사대칭에어포일의 공력 및 기하학적특성 연구
고희환(Hee-Hwan Ko),정철영(Cheol-Young Jeong),강명원(Myung-won Kang),박준영(Jun-Young Park) 대한설비공학회 2011 대한설비공학회 학술발표대회논문집 Vol.2011 No.7
The reversible axial fan is used to tunnel ventilation such as greate deep tunnel, railway tunnel and mine tunnel. Normally it supply the fresh air of exhaust polluted air and heat. In emergency, it exhaust poisonous gas and the high temperature heat for save peoples or properties. In this study, reversible axial fan in order to apply to transverse ventilation system such as U-smart way, GTX, Longer road tunnels. The blade section shape is designed as "approximate symmetric airfoil" which has bi-directional characteristic. This fan can proof against up to 300 ℃, over 1500 Pa(total pressure), has the 94% flow rate when the flow rate compares reversible flow case to forward flow case. In order to optimizing the reversible fan, I designed the fan through the analysis of 3-dimension viscous incompressible flow and through-flow analysis with ANSYS. All the fan performance tested in certified laboratory as of May 2011.
경피경간적 담도내시경을 이용한 거대 총담관결석의 전기수압쇄석술과 Endocoil 삽입
김명원,박홍배,여향순,오기창,강명원,조장현,조형철,추진호,김원석 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.5
Background/Aims: Electrohydraulic lithotrypsy(EHL) under cholangioscopic control has been performed for difficult bile duct stones. The percutaneous transhepatic approach is technically easy and useful in diagnosis and treatment of bile duct obstruction and stones. Biliary stenting with self expanding metal stent is gaining increasingly wider acceptance as a palliative treatment of bile duct obstruction. Methods: Between Sep. 1994 and Sep. 1996, EHL under choledochoscopy by percutaneous transhepatic approach was performed in 30 cases(Male: 13, Female: 17). After PTBD with 7F pig tail catheter, the percutaneous transhepatic passage was dilated over guide wire with dilaters of increasing size up to 16Fr in 3-Sdays. In one week, after fistula had been estabilished, choledochoscopy was performed. Results: (1) Mean age was 61.3 years. Mean stone number was 2.5. And mean stone size was 1.6 x 2.3 cm. (2) Com.plete removal of the stone was achieved in all patients(100%). (3) There were no serious complications. (4) In six cases, Endocoils were implanted with successful decompression of obstructions and simultaneous removal of biliary stones located at both side of stricutre. Conclusions: Percutaneous transhepatic choledochoscopy is easy and safe and assists in the diagnosis and treatment of biliary stricture and the management of difficult CBD stone.
김명원,박홍배,여향순,오기창,강명원,조장현,조형철,추진호,김원석 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.1
Background: Endoscopic Ultrasonography(EUS), a combination of endoscopy and ultrasonography is one of the most useful tools for diagnosis of digestive system diseases. EUS is useful in staging the primary tumor invasion and regional lymph node metastasis because of its ability to image the gut wall and adjacent structures in unique detail. We performed a study preoperatively for assessing the accuracy and limitation of EUS in gastric carcinoma. Methods: In 75 patients(Male 54, Female 21, Mean age 62.3 years) with a gastric carcinoma confirmed by endoscopic biopsy, we performed EUS preoperatively. The results were compared with the postoperative histopathologic staging. Results: 1) In assessing the depth of tumor invasion, EUS accuracy on depth of invasion was 76.0% and overstaging and understaging were 14.7% and 9.3%, respectively. 2) In assessing the lymph node metastasis, the accuracy rate of EUS was 65.3%. A rate of false-positive diagnosis was 27.3%, and a rate of false-negative diagnosis was 24.5%. 3) In assessing the incidence of lymph node metastasis for each T stage, the involve rate was 10.5% in pT1, 36.4% in pT2, 95.7% in pT3, 100% in pT4. Conclusions: EUS is the most accurate diagnostic methods presently available to determine tumor infiltration depth and lymph node metastasis.