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체간부 장기 손상을 동반한 외상성 체간부 동맥 손상 환자의 치료 방침
조충현 ( Choong Hyun Jo ),정용식 ( Yong Sik Jung ),김욱환 ( Wook Hwan Kim ),조영신 ( Young Shin Cho ),안정환 ( Jung Hwan Ahn ),민영기 ( Young Gi Min ),정윤석 ( Yoon Seok Jung ),김성희 ( Sung Hee Kim ),이국종 ( Kug Jong Lee ) 대한외상학회 2009 大韓外傷學會誌 Vol.22 No.1
Purpose: The appropriate management of traumatic truncal arterial injury is often difficult to determine, particularly if the injury is associated with severe additional truncal lesions. The timing of repair is controversial when patients arrive alive at the hospital. Also, there is an argument about surgery versus stent-graft repair. This study`s objective was to evaluate the appropriate method and the timing for treatment in cases of truncal abdominal injury associated with other abdominal lesions. Methods: The medical records at Ajou University Medical Center were reviewed for an 8-year period from January 1, 2001, to December 31, 2008. Twelve consecutive patients, who were diagnosed as having had a traumatic truncal arterial injury, were enrolled in our study. Patients who were dead before arriving at the hospital or were not associated with abdominal organ injury, were excluded. All patients involved were managed by using the ATLS (Advanced Trauma Life Support) guideline. Data on injury site, the timing and treatment method of repair, the overall complications, and the survival rate were collected and analyzed. Results: Every case showed a severe injury of more than 15 point on the ISS (injury severity score) scale. The male-to-female ratio was 9:3, and patients were 41 years old on the average. Sites of associated organ injury were the lung, spleen, bowel, liver, pelvic bone, kidney, heart, vertebra, pancreas, and diaphragm ordered from high frequency to lower frequency. There were 11 cases of surgery, and one case of conservative treatment. Two of the patients died after surgery for truncal organ injury: one from excessive bleeding after surgery and the other from multiple organ failure. Arterial injuries were diagnosed by using computed tomography in every case and 9 patients were treated by using an angiographic stent-graft repair. There were 3 patients whose vessels were normal on admission. Several weeks later, they were diagnosed as having a truncal arterial injury. Conclusion: In stable rupture of the truncal artery, initial conservative management is safe and allows management of the major associated lesions. Stent grafting of the truncal artery is a valuable therapeutic alternative to surgical repair, especially in patients considered to be a high risk for a conventional thoracotomy. (J Korean Soc Traumatol 2009;22:77-86)
양태석 ( Yang Tai Seok ),조영신 ( Jo Young Shin ),이용천 ( Lee Yong Cheon ) 한국이벤트컨벤션학회 2016 이벤트 컨벤션 연구 Vol.12 No.1
This study recognizes the importance of the founder who founded the restaurant business. The AMOS (Analysis of Moment Structure) program located between the arrest of the founder characteristics and determinants to understand the structure and management model. So we want to provide a basis for the proposed improvement of the catering business. Study are as follows : The Restaurant founder`s Personal characteristics is easy accessibility(0.42), swarming(0.264), visibility(0.283) influenced. The Restaurant founder`s administrative characteristics is easy accessibility(0.422), swarming(0.431), visibility(0.354), the position(0.812) influenced. Visibility (0.238) is crazed about this non-financial characteristics. Accessibility (0.036), cluster (0.28), visibility (0.254) and position(0.179) affected the financial characteristics. Therefore, the personal attributes of the restaurant founders showed that may affect the position only by the administrative properties. Visibility in order to make an impact on financial factors on non-financial factors only appears to be possible.