Incisional Hernia in Adult Liver Transplant Recipients

( Ji Soo Lee ),( Kyeong Sik Kim ),( Chan Woo Cho ),( Kyo Won Lee ),( Gyu-seoung Choi ),( Jong Man Kim ),( Choon Hyuck David Kwon ),( Jae-won Joh ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Incisional hernia is one of the complication following abdominal operation. Patients undergoing liver transplantation have a high risk of developing an incisional hernia because of immunosuppression. The purpose of this study is to review incisional hernia cases after liver transplantation and to identify the risk factors for hernia formation. Methods: We retrospectively reviewed and analyzed the medical records of the ninety-four incisional hernia patients after liver transplant recipients from January 2000 to December 2015 in single center institution. Results: 1463 underwent adult liver transplantation during the study period. 94 Incisional hernia patients were found among them. The overall incisional hernia rate was 6.4 %. Mean age was 54 years old and 76.6 % were men. No significant difference was observed for sex, diagnosis, smoking, alcohol, albumin, Child-Pugh score, MELD score, intensive care unit stay, hepatorenal syndrome, ventilator, spontaneous bacterial peritonitis, diabetes, bile leakage, wound problems between patients with incisional hernia and patients without incisional hernia. The characteristics of patients with incisional hernia showed old recipient, more body weight, higher body mass index, living donor recipient compared with patients without incisional hernia. Hypertension, tuberculosis, rejection, postoperative complication event before hernia were significant risk factor (p<0.05). Conclusions: Present study identifies the risk factors for incisional hernia. Surgeons should strive to reduce the risk of incisional hernia after adult liver transplantation.

좌측흉수로 발현된 Boerhaave 증후군 1예

이준,변유미,조민근,조주연,원경준,김영대,박찬국,김만우,유재근,서홍주,이석기 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.2

구토 후 발생한 토혈을 주소로 내원한 환자에서 좌측 늑막 삼출 동반 시 식도 파열의 가능성을 고려하여 흉수 천자 및 지속적인 흉부 단순 촬영의 추적관찰이 필요하며 식도 파열이 배제된 후 환자의 생체 징후 및 토혈 양을 파악하여 내시경 검사 시기를 신중히 결정하는 것이 좋을 것으로 생각된다. 본 증례는 토혈을 주소로 내원하여 Mallory-Weiss 증후군 의심 하에 내시경을 통한 치료 시행 후 추적 관찰에 의해 진단된 Boerhaave 증후군을 경험하였기에 보고하는 바이다. Boerhaave's syndrome is a spontaneous perforation of the esophagus most commonly resulting from a sudden increase in intraesophageal pressure combined with negative intrathoracic pressure caused by straining or vomiting. Surgery should generally be performed within 24 hours because mortality approached 30 to 50 percent in which surgery was delayed. Therefore, early diagnosis and prompt surgical repair are critical for survival. We have experienced a case of Boerhaave's syndrome in a patient presenting with hematemesis with left pleural effusion without any signs or symptoms of pneumomediastinum or pneumothorax.

함안 방어산 마애삼존불의 보존처리를 위한 암석학적 연구

이찬희,서만철,최석원 공주대학교 문화재보존과학연구소 2003 문화재과학기술 Vol.2 No.1

방어산 마애삼존불의 풍화와 훼손도를 진단하였으며, 보존처리를 위한 암석학적 연구를 수행하였다. 이 마애불의 기반암은 니질기원의 퇴적암이 접촉변성을 받아 생성된 치밀견고한 청회색 호온펠스이다. 마애불 주변의 풍화면은 암갈색에서 황갈색을 보이나, 삼존불은 적갈색 또는 암흑색으로 갖는 것으로 보아 인위적 및 자연적인 훼손이 심각한 것으로 나타났다. 본존불 좌중단에는 음각선이 사라지고 없으며 암상의 변색 및 암편의 박락에 따른 계단식 풍화도 관찰된다. 마애불의 표면과 암석의 공극에는 선태류, 조류 및 지의류의 모근과 포자류가 기생하고 있으며, 절리대에서는 이미 토양화의 진행에 의하여 잡초와 잡목이 서식하고 있다. 따라서 식생과 표면의 오염물질을 제거하기 위한 세정작업이 있어야 할 것이다. 또한 마애불 본체의 구조적 안정을 위해 주변에 분포하는 불안정한 암괴의 제거가 필수적이며, 불균형의 재발생과 전면으로 발생하는 응력을 최소화하기 위한 암석지지공법이 필요하다. 균열이 심한 절리면에는 암석용 충전제를 이용한 보존처리가 가해져야 하며, 마애불에 미치는 기상변화를 저감하기 위한 차수벽과 보호각의 설치를 제안한다. The rock standing sculptured Triple Buddha of the Bangeo mountain, Korea was studied on petrological weathering and deterioration diagnosis for the future conservational treatments. Host rock of this Triple Buddha is bluish grey hornfels originated muddy sedimentary rock, which rock is very hard and compact due to the contact metamorphism. Weathered rock surface around the Triple Buddha is yellowish to dark brown color, but main Triple Buddha surface shows reddish brown to dark black because of the severely artificial and natural deteriorations. In the central left-side of the main Buddha, the carved lines are eliminated by weathering, and well developed step-like exfoliations and discoloring of lithology. Rock surface of the Triple Buddha shows partly covered with green algae and lichen. The joint planes occur some weeds and trees. This biological weathering and contaminations need for conservational cleaning and chemical treatments. The unstable rock block around the Triple Buddha most be to remove for the structural stability from the main body, and need to geotechnical methods for the minimum stress against the frontal toppling and reoccurrence of instability. For the conservation of the Triple Buddha, we suggest that fracture systems in the host rock should be to reinforce by petro-epoxy treatments, and set up a water curtain and protection house for attenuation of climatic changes.

계룡산 구룡사지 당간지주의 기원암, 암석학적 및 보존과학적 진단

이찬희,최석원,김사덕,서만철 공주대학교 문화재보존과학연구소 2003 문화재과학기술 Vol.2 No.1

구룡사지 당간지주의 암석학적 풍화와 훼손를 진단하였으며, 보존처리를 대비한 동일 종류의 기원암을 추적하였다. 이 당간지주는 홍장석 화강암으로 구성되어 있으며 주좌는 흑운모 화강암이다. 왼쪽 지주는 완전히 파괴되어 방치되어 있으며, 오른쪽 지주는 하나의 부재로 구성되어 있으나 계단식으로 절단되어 있어 도괴의 우려가 있다. 이 지주들은 균열 및 탈락과 훼손이 심하여 박리와 박락현상이 발생하였고 석재의 표면은 입상분해 작용이 진행 중이다. 이차적 오염현황도 심각하여, 황갈색 수산화철에 의한 암석의 변색과 강수의 유동흔적을 따라 나타나는 암회색 철과 망간의 침전물이 산재한다. 지주의 주변과 암석의 표면에는 지의류와 선태류의 오염이 심각하며, 기단부는 토양화의 진행에 의하여 잡초가 암석의 생물학적 풍화작용을 가중시키고 있다. 따라서 부지 주변의 나무와 잡초 및 불연속면에 서식하는 부착생물을 제거하기 위한 생화학적 처리도 필요하다. 이 당간지주는 석재자체의 성능이 저하되어 있으므로, 균열부의 장기적인 모니터링과 함께 석재의 표면을 강화할 수 있는 처리방법을 강구해야 할 것이다. 특히 왼쪽 지주는 보존처리도 어려운 상태여서 교체하여야 할 상황이다. 이 당간지주와 동일한 암종은 하신리 무지개 농장 부근의 도로변 노두에 있다. The Flag Pole Supporting Rocks (Dangganjiju) of the Guryongsa temple site, Korea was studied on the basis of petrological weathering, conservational scientific diagnosis and presumed to source area of the original supporting rocks. Constituting rocks of this supporting rocks are pink feldspar granite, and the rounded basement is biotite granite. However, the left supporting rock is remained at perfectly destruction state in situ. The right supporting rock showed also highly fractured as step-like cutting plane which is very dangerous state because of possible collapse. As a whole supporting rocks occurred with fracturing, exfoliation or deterioration, and rock surface appeared to grain dissolution. Host rock of the supporting rocks were highly secondary contaminations, and most rock surface was color changed to the dark black to dark brown due to the clay, iron and manganese hydroxides along the rain water flow. In the vicinity of the supporting rocks and rock surface show partly green and black patchs because of coated by algae, lichen and moss. The lower part of the basement rocks are transition to the some weeds. This biological problems are need for cleaning and chemical treatments. The main materials of the supporting rocks is highly degradation, therefore the supporting rocks need to be long term monitoring in the fracture planes and to prepare for synthetic conservation treatments. Especially, the left supporting rock is difficult to conservation owing to nearly perfect destruction. In the Hashinri Mujigae farm area, the same kind of pink feldspar granitic rocks with this supporting rocks are occurred.

상부위장관 출혈을 일으킨 Warfarin Sodium에 의한 위점막내 혈종 1예

이봉규,김태원,박찬국,김만우 조선대학교 부설 의학연구소 1998 The Medical Journal of Chosun University Vol.23 No.2

A case of warfarin sodium-induced intramural hematoma and upper gastrointestinal bleeding is described, and the literature on this adverse effect is reviewed. A 83-year-old woman who has been receiving warfarin came to a emergency room because of hematemesis. She had a history of cerebral infarction. Physical examination was anemic conjunctiva, no abdominal mass and melena. The emergency gastroscopic finding was submucosal mass. Her hemoglobin and hematocrit concentration had falled to 6.7g/㎗ and 20%, Her prothrombin time (PT) was 130 sec and partial prothrombin time (aPTT) was 133 sec. The patient underwent an emergency exploratory laparotomy. The name of operation was hemigastrectomy with gastrojejunostomy(Billorth-Ⅱ). The pathology report indicated the presence of submucosal hematoma formation with mucosal ischemic necrosis and mucosal ulceration and regenerating epithelium.

대학입시 스트레스가 고등학생의 자아정체감발달에 미치는 영향

이영문,김찬영,이만홍 大韓神經精神醫學會 1990 신경정신의학 Vol.29 No.4

In order to find out the correlation between the level of ego identify and the level of entrance examination stress, authors studied 457 samples of high school students of both sex from 4 different areas of Seoul. The results were as follows. 1) The level of entrance examination stress were greater in 3rd grades than in 1st grades and also in girls compared to boys. 2) There were no difference in the mean score of Dignan's ego identity scale between difference sex or grades. 3) Statistically, there was significant negative correlation between level of ego identity and stress of entrance examination.(Pearson's correlation coefficient was-0.4484) 4) Subjects with higher level of entrance examination stress showed lower level of ego identity development. 5) Subjects who developed the same physical or psychiatric symptoms during last 6 months showed lower level of ego identity compared to those who didn't.

십이지장과 대장을 동시에 침범한 결핵 1예

이만재,박치영,곽재정,유보열,기장도,박찬국,김만우,김정용 조선대학교 1995 The Medical Journal of Chosun University Vol.20 No.1

Tuberculosis of duodenum is so rare and is usually secondary to pulmonary or intestinal tuberculosis . It is difficult to diagnose duodenal tuberculosis in clinical and radiologic findings due to its non-specific symptoms and inconsistent lesion. The diagnosis was made on the basis of the histological study of the endoscopic biopsy and resected surgical specimen. so we report a case of tuberculosis of duodenal bulb and of ascending colon with, the brief review of the literatures.

삼천지의 곤충상

이종욱,류성만,서경인,전영태,배찬영 嶺南大學校 基礎科學 硏究所 1998 基礎科學硏究 Vol.18 No.-

We studied insect fauna in the Samchun-impoundment during the period of from September 1997 to August 1998. The total number of insect taxa are composed to 95 species in 86 genera, 39 families and 8 orders in this examination.

운동 트레이닝이 기초대사량에 미치는 영향 : 선행연구간 연구방법의 차이점과 표준화 방안 discrepancies and standardization of experimental design

이만균,박찬호 경희대학교 체육과학연구소 2001 體育學論文集 Vol.29 No.-

Resting metabolic rate (RMR) is the minimum energy expenditure necessary for maintenance of critical body function. Although many scientists have attempted to investigate the effects of exercise training on RMR, these studies have produced contradictory results. Several methodological discrepancies, which may account for the contradictory results, were found among these studies. This study was designed to examine the methodological discrepancies and to suggest the standard research design in this area. The cross-sectional studies were limited by several confounding variables such as: 1) within subject variability due to preceding nutritional status and dietary practices, and 2) failure to control the physical training regimen priorto RMR measurements. Additionally, the cross-sectional studies, which examine the RMR of individuals who have various levels of V02max and consider the difference in RMR as a result of exercise training, need to account or control for other factors, e.g., genetic variations. Several methodological discrepancies which have been suggested frequently in the prospective studies include 1) elapsed time between the last exercise session and the measurement of RMR; 2) methodological errors in indirect calorimetry measurements; 3) insufficient sample size; 4) inconsistency in the units of expressing RMR; 5) differences in age of subjects; 6) initial fitness level of subjects; and 7) training mode. In addition, the mechanism(s) for the change in RMR with exercise training were not investigated in many studies. To standardize the research design and/or experimental procedures, the followings can be suggested: 1) Prospective studies including control group should be designed; 2) At least 24 ? 36 hours should elapse from the last exercise session to RMR measurement and the RMR should be measured longer than 45 min; 3) Inter-test and inter-technician reliability of the indirect calorimetry should be confirmed; 4) A power analysis should be conducted to include sufficient number of subjects; 5) The results of RMR should be expressed in various units for the purpose of comparison with the results of previous studies; 6) Intensity of exercise training should be high enough to induce a chronic elevation in RMR; 7) The mechanisms for the change in RMR with the exercise training should be investigated in integrated manner.

중력가속도의 변화에 따른 자동운반차량용 서스펜션의 진동모드에 관한 연구

주만식,김민주,이승수,최영철,추정근,김중완,전언찬 동아대학교 해양자원연구소 2000 硏究論文集 Vol.13 No.1

This study is to choose the most proper model for AGV Throughout simulation of behavior of suspension to reduce trial and error because there is no AGV treating heavy weight at harbor loading and unloading at home. Therefore, we estimate the vibration modes of the various suspensions applied to AGV, which is over 75 ton included the weight of two containers using the Matlab in the case of G and 5G, one of the simulation programs.