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( Sunpyo Lee ),( Sung Koo Lee ),( Myeong Sook Seo ),( Taeeun Kim ),( Tae Young Park ),( Tae Jun Song ),( Sang Soo Lee ),( Do Hyun Park ),( Dong Wan Seo ),( Myung Hwan Kim ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Splenic artery pseudoaneurysm is rare and challenging, so that we reported our recent 10-year experience with the clinical features and management of this aneurysm. Methods: A total of 28 patients were diagnosed with splenic artery pseudoaneurysm from January 2004 to December 2013 at a tertiary referral center in South Korea. The electronic medical records and CT images were reviewed retrospectively. Results: Median age was 54 years (IQR, 45.25-67.25). Men were predominant (78.6%). Common causes were acute pancreatitis (7 patients, 25%) and chronic pancreatitis (7 patients, 25%), followed by surgery (5 patients, 17.9%). Nine patients (32.1%) did not have obvious causes. The most common symptom was abdominal pain (14 patients, 50%), followed by bleeding (4 patients, 14.3%) and syncope (3 patients, 10.7%). Eight patients (28.6%) were asymptomatic. Median diameter was 1.3 cm (IQR, 0.7-2.6). Majority of patients (27 patients, 96.4%) had one pseudoaneurysm. Distal-third of pancreas was the predominant location (20 patients, 71.6%). Sixteen patients (57.1%) had hemorrhage from pseudoaneurysm. Symptoms (p<.001), smoking (p=.019), alcohol (p=.031), recent surgery (p=.033), and age under 50 years (p=.049) were signifi cantly related with hemorrhage. Calcifi cation (6 patients, 21.4%) reduced the hemorrhagic risk (p=.01). A total of 22 patients were treated with endovascular intervention (16 patients, 57.1%) and surgery (6 patients, 21.45%). In three patients with post-op psuedoaneurysm, despite endovascular intervention, the hemorrhage was not controlled. Two of them had surgery, and the other died. Pseuoaneurysm was spontaneously regressed in one patient. The remaining 5 patients (17.9%) did not experiencehemorrhage after conservative management. Conclusions: Splenic artery pseudoaneursym is uncommon, and hemorrhage from it is fatal. In case of suspicious bleeding with symptoms, alcohol, smoking, recent surgery, or age under 50 years, treatment must be done. Incidentally found pseudoansurysm with calcifi cation, however, may yield good results with conservative management.
Jun Jinhae,Lee Ji Hwan,Han Juhee,Kim Sun Hyu,Kim Sunpyo,Cho Gyu Chong,Park Eun Jung,Lee Duk Hee,Hong Ju Young,Kim Min Joung 대한응급의학회 2024 Clinical and Experimental Emergency Medicine Vol.11 No.1
Objective Fall from height (FFH) is a major public health problem that can result in severe injury, disability, and death. This study investigated how the characteristics of jumpers and fallers differ.Methods This was a retrospective study of FFH patients enrolled in an Emergency Department-based Injury In-depth Surveillance (EDIIS) registry between 2011 and 2018. Depending on whether the injury was intentional, FFH patients who had fallen from a height of at least 1 m were divided into two groups: jumpers and fallers. Patient characteristics, organ damage, and death were compared between the two groups, and factors that significantly affected death were identified using multivariable logistic analysis.Results Among 39,419 patients, 1,982 (5.0%) were jumpers. Of the jumpers, 977 (49.3%) were male, while 30,643 (81.9%) of fallers were male. The jumper group had the highest number of individuals in their 20s, with the number decreasing as age increased. In contrast, the number of individuals in the faller group rose until reaching their 50s, after which it declined. More thoracoabdominal, spinal, and brain injuries were found in jumpers. The in-hospital mortality of jumpers and fallers was 832 (42.0%) and 1,268 (3.4%), respectively. Intentionality was a predictor of in-hospital mortality, along with sex, age, and fall height, with an odds ratio of 7.895 (95% confidence interval, 6.746–9.240).Conclusion Jumpers and fallers have different epidemiological characteristics, and jumpers experienced a higher degree of injury and mortality than fallers. Differentiated prevention and treatment strategies are needed for jumpers and fallers to reduce mortality in FFH patients.
의도적 중독으로 응급실을 방문하는 환자들의 특성: 2011-2015년 응급실 손상환자 심층조사 분석
이학수 ( Hak Soo Lee ),한주희 ( Juhee Han ),김지훈 ( Ji Hoon Kim ),김선표 ( Sunpyo Kim ),김선휴 ( Sun Hyu Kim ),이지숙 ( Ji Sook Lee ),조규종 ( Gyu Chong Cho ),한철 ( Chul Han ),박준민 ( Joon Min Park ),정성필 ( Sung Phil Chung ) 대한임상독성학회 2017 대한임상독성학회지 Vol.15 No.2
Purpose: The purpose of this study was to investigate the epidemiologic characteristics of patients who visited emergency departments (EDs) after intentional poisoning in Korea. Methods: This study retrospectively analyzed the data of of 23 hospitals during a five-year period, between 2011 and 2015. We included patients who inflicted injury to themselves - attempt of suicide - by means of poisoning. Results: A total of 18,121 patients visited an ED after intentional poisoning. Among them, 58.3% were females; however, there were more males among those aged 60 years or older. The mortality rate for males was 8.6%, which was 3.1 times higher than that for females with 2.8%. The most common poison was pesticides (35.4%) in males and sedative-hypnotics (44.0%) in females. The most common causative agent of death was pesticide in both sexes (75.2% and 65.3%, respectively). Since the production of paraquat was discontinued in 2011, the number of deaths from pesticide poisoning has decreased. The mortality rate declined in both males and females, from 12.6% and 4.5% in 2011 to 7.1% and 2.1% in 2015, respectively. Conclusion: In this study, we analyzed the epidemiologic characteristics of intentional poisoning, especially the frequency of suicide attempts by gender and age group, the cause of suicide, and the causative agent. This can be used as basic data for establishing policies to reduce and prevent suicide attempts by poisoning.
Efficacy of a Three-Dimensional-Printed Training Simulator for Endoscopic Biopsy in the Stomach
Sunpyo Lee,Ji Yong Ahn,Minkyu Han,Gin Hyug Lee,나희경,Kee Wook Jung,Jeong Hoon Lee,Do Hoon Kim,Kee Don Choi,Ho June Song,Hwoon-Yong Jung 거트앤리버 소화기연관학회협의회 2018 Gut and Liver Vol.12 No.2
Background/Aims: We used three-dimensional (3D) printing technology to create a new biopsy simulator for the stomach and investigated its efficacy and realism in endoscopic biopsy training. Methods: A novel stomach biopsy simulator, with 10 biopsy sites, was produced using a 3D printer. We enrolled 26 participants, including 10 residents, six first-year fellows, five second-year fellows, and five faculty members. We recorded and reviewed five training sessions and evaluated the simulator with questionnaires using a 7-point Likert scale. Results: The mean completion time (seconds) was 244.8±11.5 for the residents, 107.9±33.4 for the first-year fellows, 106.8±20.1 for the second-year fellows, and 103.8±19.2 for the faculty members. The completion time became shorter with repetition and was significantly lower for residents by the fifth trial (first trial, 347.0±159.5; fifth trial, 169.6±57.7; p=0.007). The faculty members strongly agreed that the simulator realistically reflected endoscopic handling and was reasonable for endoscopic training (scores of 6.2±0.8 and 6.4±0.9, respectively). Importantly, experienced endoscopists reported that the difficulty levels of the 10 biopsy sites in the simulator were a realistic match for the actual stomach. Conclusions: This endoscopic biopsy simulator created using a 3D printer is a realistic and useful method to improve the biopsy skills of trainee endoscopists.
홍선표,김정규,함기선,김수철 大韓成形外科學會 1989 Archives of Plastic Surgery Vol.16 No.1
The clinical application of computer imaging which assists plasic surgeons in patient consultation and pe-operative planning has improved the objectivity for the better understanding about postoperative results. An image of the specific feature which the patient desires can be digitalized on a color monitor. The patient and surgeon can discuss and evaluate the real goals of surgery as the image is manipulated on the screen. This kind of computer system has already been utilized in U.S.A. and Janpan for the past few years at the relatively expansive cost. It has wide practical use in most case. But we have found that it is not functional mechanism on the procedure of double eyelid surgery. However our venus? system can specially comparable with the actual functional mechanism of eyelid because we imputted the computer the statistical results that we had obtained from the pre-and post-operative anatomical changes of eyes. Practically any other esthetic procedures can also apply to this system such as augmentation or reduction rhino-plasty, facial bone surgery, breast surgery, and all kind of wrinkle surgery as well as other systems made in foreign countries. The limitation of this system is only the imagination of the surgeon. We have used this system clinically to the patients for 63 cases of eyelid surgery, 58 cases of nostril surgery, 3 augmentation genioplasty and 2 facial bone surgery. The most of the patients (108/126) who used this system responded affirmatively, asserting it was very helpful in eliminating the pre-operative anxiousness about the surgical results.
김인응(InWoong Kim),이선표(SunPyo Lee),최현(Hyun Choi) 한국소음진동공학회 2014 한국소음진동공학회 학술대회논문집 Vol.2014 No.10
The chatter vibration in the machining process plays bad role in machining quality such as high roughness as well as tool life and machine failure. And the grinding process under this risk in the fully automated factory is exposed to the unexpected mass machining quality problem. Studying the vibration signal of the hub bearing grinding process, the reason of chatter vibration was explained with the specific machining pattern of chatter. And this study suggests the chatter detecting method in the production line, which is monitoring the peak acceleration level around the natural frequencies of the specimen, and calculating kurtosis value by assuming the chatter is related to the resonance of the specimen. The suggested method was applied to the vehicle hub bearing grinding process and proved good to detecting the chatter induced machining quality problem.
( Seong Hwan Park ),( Kee Don Choi ),( Kyoungwon Jung ),( Yangsoon Park ),( Sunpyo Lee ),( Eun Jeong Gong ),( Hee Kyong Na ),( Ji Yong Ahn ),( Kee Wook Jung ),( Jeong Hoon Lee ),( Do Hoon Kim ),( Ho J 대한간학회 2018 Gut and Liver Vol.12 No.3
Background/Aims: We aimed to investigate whether the current indications for curative endoscopic resection (ER) of gastric cancer (GC) can be applied to GC caused by adenoma. Additionally, we attempted to identify factors predictive of lesions subsequently found in addition to the expanded indications for ER. Methods: We retrospectively analyzed 342 patients diagnosed with GC caused by adenoma who underwent ER at a single tertiary center between February 2011 and December 2014. The gross whole tumor size was measured using the endoscopically resected specimen. The microscopic whole tumor size was measured using mapping paper. The estimated cancer size was calculated using the microscopic whole tumor size and the square root of the carcinoma component. Results: A gross whole tumor size ≥3 cm, carcinoma component ≥35%, and gross ulceration were predictive of lesions other than the expanded indications for ER. The overall rate of lymph node metastasis was 0.3% (1/327), which only occurred in one patient with a lesion other than the expanded indications (4.5%, 1/22). Conclusions: The current indications for curative ER in GC can be applied to GC caused by adenoma. In cases suspected of having lesions other than the expanded indications, patients should be cautiously selected for ER to reduce the risk of an inappropriate procedure. (Gut Liver 2018;12:246-254)
다공성 탄소층이 코팅된 하이브리드 표면 구조를 갖는 산소 환원 반응용 PtCo 합금 나노 촉매
장정희,모니카 샤르마,성후광,김순표,정남기,Jang, Jeonghee,Sharma, Monika,Sung, Hukwang,Kim, Sunpyo,Jung, Namgee 한국재료학회 2018 한국재료학회지 Vol.28 No.11
During a long-term operation of polymer electrolyte membrane fuel cells(PEMFCs), the fuel cell performance may degrade due to severe agglomeration and dissolution of metal nanoparticles in the cathode. To enhance the electrochemical durability of metal catalysts and to prevent the particle agglomeration in PEMFC operation, this paper proposes a hybrid catalyst structure composed of PtCo alloy nanoparticles encapsulated by porous carbon layers. In the hybrid catalyst structure, the dissolution and migration of PtCo nanoparticles can be effectively prevented by protective carbon shells. In addition, $O_2$ can properly penetrate the porous carbon layers and react on the active Pt surface, which ensures high catalytic activity for the oxygen reduction reaction. Although the hybrid catalyst has a much smaller active surface area due to the carbon encapsulation compared to a commercial Pt catalyst without a carbon layer, it has a much higher specific activity and significantly improved durability than the Pt catalyst. Therefore, it is expected that the designed hybrid catalyst concept will provide an interesting strategy for development of high-performance fuel cell catalysts.