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조자윤 ( Jayun Cho ),정희경 ( Hee Kyung Jung ),김형기 ( Hyung Kee Kim ),임경훈 ( Kyoung Hoon Lim ),천재민 ( Jae Min Chun ),허승 ( Seung Huh ),박진영 ( Jin Young Park ) 대한외상학회 2013 大韓外傷學會誌 Vol.26 No.3
Introduction: A post-traumatic mesenteric arteriovenous fistula (AVF) is extremely rare. Case Report: A previously healthy 26-year-old male was injured with an abdominal stab wound. Computed tomography (CT) showed liver injury, pancreas injury and a retropancreatic hematoma. We performed the hemostasis of the bleeding due to the liver injury, a distal pancreatectomy with splenectomy and evacuation of the retropancreatic hematoma. On the 5th postoperative day, an abdominal bruit and thrill was detected. CT and angiography showed an AVF between the superior mesenteric artery (SMA) and the inferior mesenteric vein with early enhancement of the portal vein (PV). The point of the AVF was about 4 cm from the SMA`s orifice. After an emergent laparotomy and inframesocolic approach, the isolation of the SMA was performed by dissection and ligation of adjacent mesenteric tissues which was about 6 cm length from the nearby SMA orifice, preserving the major side branches of the SMA, because the exact point of the AVF could not be identified despite the shunt flow in the PV being audible during an intraoperative hand-held Doppler-shift measurement. After that, the shunt flow could not be detected by using an intraoperative hand-held Doppler-shift measuring device. CT two and a half months later showed no AVF. There were no major complications during a 19-month followup period. Conclusion: Early management of a post-traumatic mesenteric AVF is essential to avoid complications such as hemorrhage, congestive heart failure and portal hypertension.
소아에서 발생한 장중첩증에서 수술적 치료의 필요와 관련된 위험인자
하헌탁,조자윤,박진영,Ha, Heontak,Cho, Jayun,Park, Jinyoung 대한소아외과학회 2014 소아외과 Vol.20 No.1
The aim of this study was to identify the risk factor related to the need for operative treatment and avoid unnecessary non-operative management for intussusception in children. We retrospectively reviewed medical records of patient treated for intussusception at our institution between January 2006 and January 2013. Clinical features such as gender, age, seasonal variation, symptoms and signs, treatment results were analyzed. Univariate and multivariate analyses including a chi-square test for categorical variables and logistic regression analysis were performed. During the study period, 356 patients were treated for intussusception. 328 (92.1%) was treated successfully by the non-operative pneumoreduction, and 28 (7.9%) required operative management. On univariate analysis, risk factors which were related to the need for operative treatment were age, vomiting, bloody stool, lethargy, and symptoms duration. A logistic regression analysis in order to assess for independent predictors of operative treatment was performed. Age (<6 vs ${\geq}12$ months) (OR 4.713, 95% CI 1.198~18.539, p=0.027) and symptoms duration longer than 48 hours (OR 4.534, 95% CI 1.846~11.137, p=0.001) were significantly associated with a requirement for operative treatment. We conclude that younger age and a longer duration of symptoms (${\geq}48$ hours) are the independent risk factor related to the need for operative treatment for intussusception. Early surgical intervention or transfer to a hospital with pediatric surgical capabilities should be considered for patients with these findings.
1D-3D 연동해석을 통한 흡기 매니폴드 형상이 실린더별 유동 분배에 미치는 영향 평가
박상준(Sangjun Park),조정근(Jungkeun Cho),송순호(Soonho Song),조자윤(Jayun Cho),왕태중(Taejoong Wang) 한국자동차공학회 2016 한국 자동차공학회논문집 Vol.24 No.2
CNG engine has been used as a transportation because of higher thermal efficiency and lower CO2 and particulate matter. However its out put power is decreased due to cylinder-to-cylinder variation during the supply of air-fuel mixture to the each cylinder. It also causes noise and vibration. So in this study, 1D engine simulation model was validated by comparison with experiment data and 3D CFD simulation was conducted to steady-state flow analysis about each manifold geometry. Then, the effects of various intake manifold geometries on variation were evaluated by using 1D-3D coupling analysis at engine speed of 2100 rpm range in 12 L CNG engine. As a result, variation was improved about 4 % though 3D CFD analysis and there was a variation within 3 % using 1D-3D coupling analysis.