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      • 가천의대 길병원에서의 비장 농양 경험

        김건욱 한국간담췌외과학회 2005 한국간담췌외과학회지 Vol.9 No.3

        Purpose: A splenic abscess is a rare disease, but appears to be increasing in frequency. The key to successful treatment is early diagnosis, effective antibiotics treatment and surgical management when needed. This study was intended to clarify the clinico-pathological and radiological findings of splenic abscesses from their therapeutic aspects. Methods: Between Jan. 1993 and Dec. 2003, the outcomes of 8 splenic abscess patients were retrospectively analyzed. Results: The male to female ratio was 6:2, with a mean age of 57 years, ranging from 34 to 70 years. Predisposing conditions were identified in 7, including diabetes mellitus, steroid medication, chronic alcoholism, infective endocarditis and lymphoma. As chief complaints, fever/chills was present in 2, left upper quadrant pain/tenderness in 4, diffuse abdominal pain in 1 and dyspnea in 1, with leukocytosis found in 6 (75%). Ultrasonography or computed tomography detected left pleural effusion, splenomegaly and splenic abscess in 7 (88%). The solitary to multiple ratio was 2:6. An emergency laparotomy for peritonitis detected a solitary abscess rupture in 1. The original site of infection was detected in 5, including endocarditis, dental abscess, urinary tract infection and pancreatitis in 2. Blood cultures were positive in 3 (43%), with Escherichia coli in 1 and Streptococcus viridans in 2. 3 (75%) of 4 specimens had positive culture results, including Pseudomonas, Streptoccus viridans and Enterococcus. 1 (25%) had pathogens identical to bacteria isolated form the blood culture. 1 was identified as mixed infection, with actinomycosis. A splenectomy was performed in 5, including 2 with a distal pancreatectomy, intraoperative fine needle aspiration in a lymphoma and endoscope-guidedaspiration in a gastrosplenic fistula. One lymphoma patient, with multiple abscesses, died of aspiration pneumonia during chemotherapy. Conclusion: A splenic abscess is rare, and failure of early diagnose and institution of treatment is fatal. Although patients have various underlying diseases, a splenic abscess can develop arising from a dental abscess in a healthy man. Percutaneous drainage may not be suitable for multiple or hilar locations; therefore, a splenectomy, with appropriate antibiotics, is the definitive treatment. A less-invasive treatment modality can be considered, taking into account the patient's clinical situation from an immunological aspect for preservation of the spleen. Purpose: A splenic abscess is a rare disease, but appears to be increasing in frequency. The key to successful treatment is early diagnosis, effective antibiotics treatment and surgical management when needed. This study was intended to clarify the clinico-pathological and radiological findings of splenic abscesses from their therapeutic aspects. Methods: Between Jan. 1993 and Dec. 2003, the outcomes of 8 splenic abscess patients were retrospectively analyzed. Results: The male to female ratio was 6:2, with a mean age of 57 years, ranging from 34 to 70 years. Predisposing conditions were identified in 7, including diabetes mellitus, steroid medication, chronic alcoholism, infective endocarditis and lymphoma. As chief complaints, fever/chills was present in 2, left upper quadrant pain/tenderness in 4, diffuse abdominal pain in 1 and dyspnea in 1, with leukocytosis found in 6 (75%). Ultrasonography or computed tomography detected left pleural effusion, splenomegaly and splenic abscess in 7 (88%). The solitary to multiple ratio was 2:6. An emergency laparotomy for peritonitis detected a solitary abscess rupture in 1. The original site of infection was detected in 5, including endocarditis, dental abscess, urinary tract infection and pancreatitis in 2. Blood cultures were positive in 3 (43%), with Escherichia coli in 1 and Streptococcus viridans in 2. 3 (75%) of 4 specimens had positive culture results, including Pseudomonas, Streptoccus viridans and Enterococcus. 1 (25%) had pathogens identical to bacteria isolated form the blood culture. 1 was identified as mixed infection, with actinomycosis. A splenectomy was performed in 5, including 2 with a distal pancreatectomy, intraoperative fine needle aspiration in a lymphoma and endoscope-guidedaspiration in a gastrosplenic fistula. One lymphoma patient, with multiple abscesses, died of aspiration pneumonia during chemotherapy. Conclusion: A splenic abscess is rare, and failure of early diagnose and institution of treatment is fatal. Although patients have various underlying diseases, a splenic abscess can develop arising from a dental abscess in a healthy man. Percutaneous drainage may not be suitable for multiple or hilar locations; therefore, a splenectomy, with appropriate antibiotics, is the definitive treatment. A less-invasive treatment modality can be considered, taking into account the patient's clinical situation from an immunological aspect for preservation of the spleen.

      • KCI등재

        Bullae and Sweat Gland Necrosis in the Differential Diagnosis for Vibrio vulnificus Infection in an Alcoholic Patient

        김건욱,박현제,김훈수,김수한,고현창,김문범,김병수 대한의학회 2011 Journal of Korean medical science Vol.26 No.3

        Bullae and sweat gland necrosis remain rare cutaneous manifestation, and these conditions can be misdiagnosed as Vibrio vulnificus infections or other soft tissue infections because of their low index of suspicion. A 46-yr-old man with a history of continued alcohol consumption presented with erythematous and hemorrhagic bullous lesions on his left arm. The patient reported that after the ingestion of clams, he slept for 12 hr in a heavily intoxicated state. Then the skin lesions started as a reddish patch that subsequently became hemorrhagic bullae. V. vulnificus infection, cellulitis, and necrotizing fasciitis were considered in initial differential diagnosis. However, on the basis of sweat gland necrosis on histopathologic examinations and negative results on bacterial cultures, we made the diagnosis of bullae and sweat gland necrosis. Therefore, bullae and sweat gland necrosis should also be considered in chronic alcoholic patients who present with bullae and a previous history of unconsciousness.

      • KCI등재

        다중 DSP 프로세서 기반의병렬 수중정합장처리 알고리즘 설계

        김건욱 대한전자공학회 2007 電子工學會論文誌-SP (Signal processing) Vol.44 No.4

        Parallel processing algorithms, coupled with advanced networking and distributed computing architectures, improve the overall computational performance, dependability, and versatility of a digital signal processing system. In this paper, novel parallel algorithms are introduced and investigated for advanced sonar algorithm, conventional matched-field processing (CMFP). Based on a specific domain, each parallel algorithm decomposes the sequential workload in order to obtain scalable parallel speedup. Depending on the processing requirement of the algorithm, the computational performance of the parallel algorithm reveals different characteristics. The high-complexity algorithm, CMFP shows scalable parallel performance on the array of DSP processors. The impact on parallel performance due to workload balancing, communication scheme, algorithm complexity, processor speed, network performance, and testbed configuration is explored. 고성능 네트워크와 분산처리구조가 병렬처리와 함께 결합되면, 전체적인 디지털 신호처리 시스템의 계산능력, 신뢰도, 다양성을 향상시킨다. 본 논문에서는, 발전된 형태의 수중레이더 (sonar) 알고리즘인 수중정합장처리 (Matched-Field Processing; MFP)를 위한 병렬처리 알고리즘을 디자인하고 다중 DSP 프로세서 기반의 병렬처리 시스템 상에서 성능분석과 함께 최적의 병렬처리 솔루션을 제안한다. 각각의 병렬 알고리즘은 특정한 도메인에서 주어진 계산량을 분산시키며 이를 통한 속도향상을 추구한다. 필요한 연산량과 형태에 따라서 병렬 알고리즘은 각기 다른 성능향상을 보여준다. 또한, 알고리즘의 계산량 분산방식, 프로세서간의 통신방식, 알고리즘의 복잡도, 프로세서의 속도, 목적하는 시스템의 구성에 따라서 다양한 성능지표를 보여준다. 제안하는 주파수와 출력값 기반의 병렬 알고리즘은 상당한 계산량을 요구하는 수중정합처리 알고리즘을 적절히 다중 프로세서에 균형 있게 분산시켜 프로세서의 개수와 비례하는 성능향상을 보여주고 있다.

      • KCI등재후보

        격자형 및 평형 구조를 가지는 박막공진 여파기에 관한 연구

        김건욱,구명권,육종관,박한규 한국전자파학회 2002 한국전자파학회논문지 Vol.13 No.10

        본 논문에서는 2 GHz 대역의 격자형 및 평형 구조를 가지는 박막공진 여파기를 설계, 제작하고 분석하였다. 단위공진자의 앞전물질은 AIN를 사용하였고, 전극도체로는 백금을 사용하였으며, 하부도체와 기판사이에 공기층이 있는 구조로 제작되었다. 제작된 여파기들은 크기가 작고 낮은 삽입손실과 격자형의 경우 약 15 dB, 평형 구조의 경우 약 30 dB 정도의 선택도를 가진다. 격자형 및 평형 구조는 사다리형 구조와 같이 실리콘 기판위에 제작되었으며, 사다리형 구조에 비해 넓은 대역폭을 가지며 평형구조의 경우 이외의 튜닝과정 없이 RF 여파기로 사용될 수 있다. In this paper, thin film bulk acoustic resonator(TFBAR) lattice and balanced type filter topologies are designed and fabricated. Aluminium nitride and platinum are used for piezoelectric material and top and bottom electrodes, respectively. Air-gap is placed to avoid silicon substrate loading effect and the performance of these lattice and balanced filters is compared with ladder filters. These filters have selectivity over 15 dB for lattice type and 30 dB for balanced type and reveal wider bandwidth of the ladder filters. For balanced type filters, minor tuning procedure is not needed and they are readily available for RF filter in wireless applications.

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