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문합부 후방 탈장으로 발생한 위 허혈과 소장 경색 1예
이상훈 ( Sang Hoon Lee ),박성철 ( Sung Chul Park ),이성준 ( Sung Joon Lee ),강창돈 ( Chang Don Kang ),남승주 ( Seung-joo Nam ),이승엽 ( Seung Yup Lee ),홍성권 ( Seong Kweon Hong ),이승구 ( Seung Koo Lee ) 대한소화기학회 2019 대한소화기학회지 Vol.73 No.2
After gastrojejunostomy, a small space can occur between the jejunum at the anastomosis site, the transverse mesocolon, and retroperitoneum, which may cause an intestinal hernia. This report presents a rare case of intestinal ischemic necrosis caused by retroanastomotic hernia after subtotal gastrectomy. A 56-year-old male was admitted to Kangwon National University Hospital with melena, abdominal pain, and nausea. His only relevant medical history was gastrectomy due to stomach cancer. Endoscopic findings revealed subtotal gastrectomy with Billroth-II reconstruction and a bluish edematous mucosal change with necrotic tissue in afferent and efferent loops including the anastomosis site. Abdominopelvic CT showed strangulation of proximal small bowel loops due to mesenteric torsion and thickening of the wall of the gastric remnant. Emergency laparotomy was performed. Surgical findings revealed the internal hernia through the defect behind the anastomosis site with strangulation of the jejunum between 20 cm below the Treitz ligament and the proximal ileum. Roux-en-Y anastomosis was performed, and he was discharged without complication. Retroanastomotic hernia, also called Petersen’s space hernia, is a rare complication after gastric surgery, cannot be easily recognized, and leads to strangulation. (Korean J Gastroenterol 2019;73:109-113)
순창지역 섬진강 지류별 토양유실량 산정과 하상퇴적물의 주공급원에 관한 고찰
곽재호,양동윤,이현구,김주용,이승구,Kwak Jae-Ho,Yang Dong-Yoon,Lee Hyun-Koo,Kim Ju-Yong,Lee Seong-Gu 대한자원환경지질학회 2005 자원환경지질 Vol.38 No.6
하상퇴적물의 공급원을 규명하고자 전라남북도의 경계부근에 위치하는 섬진강 본류와 그 지류들을 포함하는 유역에서 발생하는 하상퇴적물의 희토류원소 분포양상과 토양유실량을 결석하였다. 연구지역 수계는 섬진강 본류를 비롯하여 순창읍을 관통하는 경천, 옥과면의 옥과천, 입면의 창정천과 입천이면, 각 수계에 직${\cdot}$간접적으로 퇴적물을 공급할 수 있다고 생각되는 10개 유역을 대상으로 토양유실량 분석을 실시하였다. 토양유실량 예측공식인 RUSLE 인자를 생성하기 위하여 토지이용도, 지형도, 토양도 등의 자료를 사용하었고, grid 기반의 10m 셀의 격자형 데이터로 구축한 RUSLE 인자들의 중첩분석을 통하여 연간 토양유실량을 예측하였다. 당위면적당 토양유실량은 밭(53,140.94 tons/ha/year), 과수원(25,063.38 tons/ha/year), 논(6,506.7 tons/ha/year), 산림 (6,074.36 tons/ha/year) 지역 순으로 우세한 것으로 나타났다. 침식위험지역으로 분석된 지역은 대부분 밭 지역 내에 분포하였다. 토양유실은 하천을 따라 분포하는 근원암 지역에서 주로 발생하였으며, 토양유실량, 침식위험지역 분포, 하상퇴적물과의 희토류원소 분포양상에 있어서의 상관관계 등을 고려해볼 때, 경천은 순창엽리상화강암, 옥과천은 대강엽리상화강암, 입천은 설옥리층의 퇴적물이 하천에 주로 유입되는 것으로 판단된다. 특히 여러 암종이 넓은 면적에 분포하고 있는 옥과천의 경우, 하싱퇴적물, 기반암 및 토양의 희토류원소 분포양상과 토양유실량 분석결과를 함께 활용함으로써 더욱 신뢰도 높은 상관관계를 밝힐 수 있을 것으로 사료된다. This study was carried out in order to evaluate where the soil loss was mainly occurred, .and to verify how riverbed sediments in the tributaries of the Seomjin River were related to their source rocks distributed in Sunchang area. The study area including the Seomjin River with 4 tributaries of Kyeongcheon, Okgwacheon, Changjeong-cheon and Ipcheon was divided into 10 watershed. The RUSLE (Revised Universal Soil Loss Equation) was estimated for all the grids (10 m cells) in the corresponding watershed. The amount of soil loss per unit area was calculated as follows: dry fold (53,140.94 tons/ha/year), orchard (25,063.38 tons/ha/year), paddy field (6,506.7 tons/ha/year) and Idlest (6,074.36 tons/ha/year). The differences of soil loss per unit area appear to be depends on areas described earlier. Soil erosion hazard zones were generally distributed within dry fields. Several thematic maps such as land use maps, topographical maps and soil maps were used as a data to generate the RUSLE factors. The amount of soil loss, computed by using the RUSLE, showed that soil loss mainly occurred at the regions where possible source rocks were distributed along the stream. Based on the this study on soil loss and soil erosion hazard zone together with chondrite-normalized REE patterns that were previously analyzed in same study area, a closed relationship between riverbed sediments and possible source rocks is formed. Especially in the Okgwacheon that are widely distributed by various rocks, chondrite-normalized REE pattern derived from the riverbed sediments, source rock and soil is expected to have a closed relationship with the distribution of soil loss.