Poster Session : PS 0831 ; Upper GI Tract : Clinical Factors to Predict Angiographically Detectable Non-Variceal Upper Gastrointestinal Bleeding in Patients Refractory to Endoscopic Treatment

( Tae Hwan Ha ),( Tae Hoon Oh ),( Sung In Yu ),( Min Kim ),( Jong Wook Kim ),( Won Ki Bae ),( Jae Hyung Kim ),( Seung Suk Baek ),( Mi Jin Ryu ),( Ye Na Choi ),( Ji Young Park ),( Eileen L Yoon ),( Tae 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Non-variceal upper GI bleeding (NVUGIB) is a common medical problem that has signifi cant association with morbidity and mortality. Angiographic detection and subsequent transarterial embolization (TAE) is a primary treatment option when medical and endoscopic treatments fail. We investigated clinical factors that could affect the success of the angiographic detection and prognosis after TAE in patients with NVUGIB refractory to endoscopic therapy. Methods: A retrospective analysis of the clinical data was done in patients with failed endoscopic treatment who underwent angiography for the treatment of acute NVUGIB between May 2002 and May 2013. Patients were divided into detection or non-detection groups according to the presence of bleeding stigmata in angiographic fi nding. Rebleeding defi ned as subsequent bleeding event within 7 days and mortality within 30days were analyzed as outcome parameters after TAE following detection in angiography. Results: A total 45 patients 37 (male, mean age, 65.9±14.9 years) were analyzed and classifi ed as a detection group (n=25, 55.5%) and non-detection group (n=20, 44.6%). Peptic ulcers were the most common cause of refractory NVUGIB. Larger transfusion amount (5.7±3.9 unit vs. 3.5±2.8 unit; P=0.03), prolonged aPTT level (34.2±17.3 sec vs. 21.8±13.8 sec; P=0.01) and short time interval between last endoscopy and angiography (17.5±25.9 hours vs. 34.3±59.5 hours; P=0.04) were found to be signifi cant factors for predicting angiographic detection. TAE was performed in all patients detected in angiography. Rebleeding (44%) was significantly associated with higher Rockall score (8.3±1.5 vs. 6.6±2.4; P=0.046) and mortality (12%) was signifi cantly associated with higher Rockall score (9.3±0.6 vs. 7.1±2.2; P=0.002) and higher level of BUN (55.3±47.4 vs. 27.6±17.4; P=0.01). Conclusions: Clinical characteristics associated with angiographic detection in patients with NVUGIB refractory to endoscopic therapy were severe bleeding, bleeding tendency and early angiographic intervention. The Rockall score is useful parameter for predicting rebleeding and mortality after TAE.

Clinical Outcome of Modified Cervical Lateral Mass Screw Fixation Technique

Kim, Seong-Hwan,Seo, Won-Deog,Kim, Ki-Hong,Yeo, Hyung-Tae,Choi, Gi-Hwan,Kim, Dae-Hyun The Korean Neurosurgical Society 2012 Journal of Korean neurosurgical society Vol.52 No.2

Objective : The purpose of this study was 1) to analyze clinically-executed cervical lateral mass screw fixation by the Kim's technique as suggested in the previous morphometric and cadaveric study and 2) to examine various complications and bicortical purchase that are important for b-one fusion. Methods : A retrospective study was done on the charts, operative records, radiographs, and clinical follow up of thirty-nine patients. One hundred and seventy-eight lateral mass screws were analyzed. The spinal nerve injury, violation of the facet joint, vertebral artery injury, and the bicortical purchases were examined at each lateral mass. Results : All thirty-nine patients received instrumentations with poly axial screws and rod systems, in which one hundred and seventy-eight screws in total. No vertebral artery injury or nerve root injury were observed. Sixteen facet joint violations were observed (9.0%). Bicortical purchases were achieved on one hundred and fifty-six (87.6%). Bone fusion was achieved in all patients. Conclusion : The advantages of the Kim's technique are that it is performed by using given anatomical structures and that the complication rate is as low as those of other known techniques. The Kim's technique can be performed easily and safely without fluoroscopic assistance for the treatment of many cervical diseases.

간문부 담관암 환자에서 경피경관 양측성 금속 배액관의 효과

김금래,김주형,박원규,장재천,조재호,김태년,김준화,장병익 영남대학교 의과대학 2005 Yeungnam University Journal of Medicine Vol.22 No.2

Background: The purpose of this study was to determine the effectiveness of percutaneously place self-expanding metallic stent for the relief of biliary obstruction in patients with hilar cholangiocarcinoma. Materials and Methods: From November 2001 to December 2004, 48 patients with hilar cholangiocarcinoma were prospectively studied. After percutaneous placement of bilateral self-expanding, uncovered metallic stents, follow-up evaluation was carried out until July 2005. Results: There were 4 cased of Bismuth type Ⅱ,21 cases of Bismuth typeⅢa 8 cases of Bismuth type Ⅲb and 15 cases of Bismuth type Ⅳ. Stent placement was technically successful in all patients All patients had satisfactory biliary drainage, resulting in one week drainage rate of 72.8% and final drainage of 91.9% There were 12 cases (21.3%) of abdominal pain requiring analgesics and 1 case (7.1%) of cholangitis; both were successfully managed with conservative treatments. Late complications occurred in four patient (8.3%), including two patients with cholangitis, one patient with liver abscess, and one patient with biloma; all were appropriately managed by percutaneous drainage. The average length and median durations of stent patency and median survival time were 303 days (range, 60~815) and 338 days (range, 60 ~1175), respectively. Conclusion: Placement of a percutaneous metallic stent is an effective and safe method of palliation of patients with hilar cholangiocarcinoma.

간세포암환자에서 간동맥 화학 색전술 후 발생한 리피오돌에 의한 폐렴 1예

김소이,김유리,허현미,배서은,이명원,최윤정,김고흔,김태헌,유 권,문일환 이화여자대학교 의과대학 2009 EMJ (Ewha medical journal) Vol.32 No.2

Hepatocellular carcinoma(HCC)is one of common causes of cancer-related death in Korea where the majority of HCC patients were Hepaitc B virus(HBV)carriers and have cirrhosis. Transarterial chemoembolization(TACE)is commonly applied to the treatment of multinodular HCC in Korea and careful selection of candidate is important for the risk of various side effects. Besides common side effects as fever, nausea, abdominal pain and elevation of liver enzyme, TACE may predispose to hepatic failure, ischemic cholecystitis, pulmonary embolism, cerebral embolism and pneumonitis. In previous studies, some cases of pulmonary and cerebral embolism cases were reported but lipiodol pneumonitis after TACE was rarely reported. A 65-year-old woman with a multinodular HCC associated with HBV infection, was treated with TACE. Seven days after the procedure, nonspecific respiratory symptoms such as dyspnea and dry cough developed. Chest X-ray and chest computed tomography showed diffuse ground glass opacities in whole lung fields, suggestive of lipiodol pneumonitis. After several days of supportive care with steroid administration, radiologic abnormalities and subjective symptoms were much improved, considered that the disease was compatible with lipiodol pneumonitis.

Gelation에 의한 방사성 폐기물의 안정화/고형화 : Ca 및 Zr 첨가에 따른 이성분계의 열적 및 수화학적 안정성 Thermal/Hydrochemical Stability of a Binary System with Ca or Zr as an additive

김인태,박환서,유승곤,김환영,김준형 한국공업화학회 2004 응용화학 Vol.8 No.1

In the previous study, we suggested a new concept, named as GRSS(Gel-Route Stabilization/Solidification) and investigated a material system applicable to volatile radioactive waste, a reaction condition and chemical limitations. From these results, this paper investigated the effect of some additives, which have been considered as the major component of ceramic waste forms(apatite and sodium zirconium phosphate), on the thermal stability and chemical durability. The Si-P system with Ca at appropriate composition shows good thermal stability but low chemical durability while the Si-P system with Zr shows relatively low thermal stability but relatively high chemical durability.

겔화 반응 및 열처리한 금속염화물의 결정 및 구조특성

김인태,박환서,유승곤,김환영,김준형 한국공업화학회 2003 응용화학 Vol.7 No.2

A new concept for the stabilization and solidification of volatile radioactive wastes via gelation in a simple material system is introduced in this paper. Using sodium silicate as a reaction module and phosphoric acid as a catalyst or stabilization agent. CsCl is chemically converted to thermally stable compounds. The heat-treated product at 1000℃ contained a cristobalite crystalline framework and a glassy phosphorus-rich phase with a high Cs content. The morphology looked like honey flowing on the honeycomb. From TG/DT analysis, Cs could not be vaporized below 1300℃ by changing the aging conditions and molar ratio of Si/p. As a new concept, GRSS(gel-route stabilization and solidification) could give us the chance to make the high temperature waste conditioning process more stable and economical.

Benzoate, m-Toluate, Phenol의 Pseudomonas putida에 의한 생분해

김장규,김석형,김태환,이대광,김남기 成均館大學校 科學技術硏究所 1993 論文集 Vol.44 No.1

It this study, basic data were obtained for the treatment of industrial waste water which includes aromatic compounds. Substrate concentrations used were 100ppm, 500ppm, and 1,000pprn and initial pH's were pH6, pH7, and pH8 in order to obtain the optimum conditions for treating benzoate, m-toluate, and phenol by Pseudomonas putida(KCTC 1644). Durations were 20hrs for 100ppm, 40hrs for 500ppm, and 60hrs for 1,000ppm before the static growth of Pseudomonas putida. 100% of 100ppm benzoate(0.31g cell/1) was biodegraded at pH6, pH7, and pH8 before 20hrs, 52.8% of 500ppm at pH8 in 40hrs, and 27.9% of 1,000ppm at pH8 in 60hrs. The best initial pH was pH8 for the biodegradation and the growth of Pseudomonas putida in benzoate medium. For m-toluate, the best initial pH was also pH8. At this pH, 40.6% of 10Dppm(0.31 cell/1), 21.9% of 500ppm, and 14.1% of 1,000ppm m-toluate were biodegraded respectively in limited time. But for phenol, the best initial pH was pH7. At this point, 9.8% of 100ppm(0.218 cell/1), 7.1% of 500ppm, and 4.7% of 1,000ppm phenol were biodegraded respectively. Therefore, the best carbon source in this experiment was benzoate. Pseudomonas putida was also able to biodegrade m-cresol, p-hydroxybenzoic acid, and benzaldehyde.

하악골 절제술후 재이식된 돌결자가골 재이식 : 치험 3례

김 식,김수관,김운규,김수민,류종희,이준길,조경안,김수흥,정태영,여환호 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.2

We described three cases of immediate reimplantation of a frozen-thawed autogenous mandible composed of a mixture of iliac bone, marrow, and particulate hydroxyapatite in tumors of the mandible. Acceptable outcomes were obtained in three patients who underwent immediate autogenous mandibular graft reconstruction. The conditions leading to successful outcome of the procedure are also discussed. Reimplantation of frozen autogenous lesioned mandible was performed in three patients with mandibular tumors. Two reimplanted grafts survived without complications following surgery. One case had postoperative infection that resolved with appropriate antibiotic treatment. There were no recurrences of the primary lesions. Satisfactory facial contour after surgery was achieved. These results are most promising, and we believe that, with further refinement, this technique will offer a new and acceptable modality for facial reconstruction in patients with cancer.

치과 기공사들에게서 나타나는 호흡기 증상과 이의 관련 요인

김웅철,오세윤,김지환,김진완,이준석,이가영,이세훈,유진호,김태석 高麗大學校 倂設 保健大學 保健科學硏究所 2001 保健科學論集 Vol.27 No.1

This study was carried out to investigate subjective respiratory symptoms and their attributable factors in Korean dental laboratory technicians. A questionnaire was mailed to randomly selected 1,900 dental laboratory technicians. Among them, 1,344 dental technicians completed the questionnaires and returmned them. Validity and reliability tests on the questionnaires were carried out before the main survey. To investigate risk factors on respiratory subjective symptoms, we performed analysis on distribution of characteristics, and then investigated univariate analysis and multiple logistic regression analysis. The prevalence rate of wheezing, cough and phlegm, and dyspnea was 4.8%, 33.9%, 54.9%, respectively. Statistically significant factors inducing subjective respiratory symptoms by multiple logistic regression analysis were sex, smoking, exercise, health examination, work hours a day, investment gas, investment dust, metal fume, resin vapor, and asbestos dust. Considering the results above, it seems that most subjective respiratory symptoms are related with health habits and occupational environmental-related factors. The result, consideration in mind, suggest that health promotion programs for smoking cessation, regular health examination, and physical exercise in health habit, and improvement on casting and resin work in dental technological environment be necessary.

Gelation에 의한 방사성 금속염화물의 안정화/고정화 : Part2: 알칼리 금속염화물과 이성분계(Si-P)와의 겔화반응 Part2: Gelation with alkali metal chloride in binary system(SiO2/P2O5)

김인태,박환서,김환영,유재형,김준형 한국공업화학회 2002 응용화학 Vol.6 No.2

By gelation with sodium silicate and phosphorous oxide in binary system, we investigated the possibility to fix the volatile alkali metal chlorides in a highly stable matrix at high temperature if the product gel is further solidified to form glass or ceramic waste form. The binary system with different metal chloride(MCl) loadings underwent gelation reaction at 70℃ for 1 day and dried at 110℃ for 1 day. XRD analysis showed that all the dried gel contained NaCl and some unknown crystalline phase. From the experimental results, the reaction mechanism can be proposed as follows. Also, the possibility of Cs vaporization could be lowered by the application of the new gel-route stabilization/solidification to treat waste salt. (G,Na)+MCl→(G,M)+NaCl, (G.H)+MCI→(G,M)+HCl.