• Title/Summary/Keyword: 장폐쇄

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A Case of Expulsion of an Adult Ascaris Worm from the Anus of a 2-year-old Boy (2세 남아에서 충체 배출로 발견된 회충증 1예)

  • Cho, Yeonjong;Choi, Sik Kyung;Kim, Su Jung
    • Pediatric Infection and Vaccine
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    • v.27 no.1
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    • pp.77-82
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    • 2020
  • Ascariasis is the most common helminthic infection in humans. However, its prevalence has been very low in Korea since the 1990s. Recently, there have been several case reports on intestinal obstruction or pancreaticobiliary disease due to infection with Ascaris lumbricoides in adults. However, cases of ascariasis in children have rarely been reported in Korea. We report a case of ascariasis in a 2-year-old boy who experienced expulsion of an adult ascaris worm from his anus. His mother found the worm in his diaper in the morning. His medical history was nonsignificant for any previous illnesses. There were no specific symptoms, and no abnormal findings were found on physical examination. The worm was pink, elongated, and cylindrical; it was 25 cm long and 5 mm wide. Unfertilized eggs of A. lumbricoides were detected in his stool specimen. He was treated with albendazole and remained asymptomatic at follow-up. As long as the number of immigrants from endemic areas and people returning from overseas trips, and import of agricultural products keep increasing, ascariasis can still occur in Korea. Therefore, it is necessary to raise awareness regarding ascariasis.

A Comparative Study on Business Ecosystem of Samsung and Xiaomi: Focus on CPND Value Chain of IoT Industry (삼성과 샤오미의 기업생태계 비교 연구: IoT 산업의 CPND 가치사슬을 중심으로)

  • Sawng, Yeong-Wha;Cho, Yeong-Eun;Park, Sun-Young
    • Information Systems Review
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    • v.18 no.2
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    • pp.1-22
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    • 2016
  • In response to changes in the global market environment, companies in the Information and Communications Technology (ICT) industry have begun to pursue cooperation and competition on a business ecosystem level. In particular, to become a leader in the new growth engine industry of Internet of Things (IoT), companies around the globe aim to consolidate vertically up the value chain through a solid establishment of their platforms. This paper looks at Samsung and Xiaomi, whose strategies for creating an ecosystem based on their own platforms differ in accordance to the ecosystem in which they compete. An analysis of these two companies indicate that Samsung pursues a strategy to become the market standard by openly sharing its platform with complementary companies, whereas Xiaomi pursues a strategy that achieves value as a channel owner through the restriction on which companies may become partners. This paper concludes that as Samsung and Xiaomi strive to become IoT industry leaders, each company pursues a variant of a platform-based value chain integration strategy based on the specific nature of the ecosystems in which they compete, thereby creating value through a symbiotic relationship with their partner companies.

Acute Type A Aortic Dissection Mimicking Penetrating Atherosclerotic Ulcer (침투성 동맥경화성 궤양과 흡사한 급성 A형 대동맥 박리증 -1l례 보고 -)

  • Choi, jae-Sung;Kwak, Jae-Gun;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.36 no.1
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    • pp.30-34
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    • 2003
  • As classical acute aortic dissection, atherosclerotic penetrating ulcers and intramural hematoma have different pathophysiology and natural history, treatment strategy should be different and, therefore, accurate differential diagnosis is necessary. However, these three aortic diseases may be indistinguishable by clinical observation and even by various diagnostic modalities such as cardiac echocardiography, CT and MRI. The patients was a 71-year-old female with chief complaints of anterior chest pain, nausea and vomiting which occurred suddenly 3 days before admission. CT angiographic with 3 dimensional reconstruction shows intramural hematoma in ascending aorta, aortic arch, descending thoracic aorta and right brachiocephalic trunk, heompericardium, and blood in mediastinum and both pleural cavities. The CT angiographic finding of focal out-bulging in the ascending thoracic aorta was diagnosed as penetrating atherosclerotic ulcer. The patient underwent emergency operation under a preoperative diagnosis of penetrating atherosclerotic ulcer with a sign of aortic rupture. In the intraoperative findings, however, intimal tear was seen in the anterior portion of the ascending aorta about 1cm below the brachiocephalic trunk and falselumen appeared after hematoma was removed from the layer of tunica media. We report a case of type A aortic dissection which mimicked clinical and diagnostic features of penetrating atherosclerotic ulcer.

Location Benefit Analysis According to Flood Safety Increase (치수안전도 향상에 따른 자산이용고도화 효과 분석)

  • Lee, Jin Ouk;Choi, Seung An;Kim, Hung Soo;Shim, Myung Phil
    • Proceedings of the Korea Water Resources Association Conference
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    • 2004.05b
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    • pp.777-783
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    • 2004
  • 하천 세내지 주변은 급속한 시가지 조성과 인구밀집으로 유역의 불투수층이 증가하여 홍수도달시간이 짧아지고 홍수유출량이 증가하고 있다. 또한 엘리뇨${\cdot}$라니냐 등의 이상기후로 홍수사상의 발생 빈도와 규모가 증가하면서 홍수피해도 대형화되어 가고 있다. 그러나 치수사업은 다른 공공사업에 비해 경제성이 저평가 되어 투자우선순위가 밀려 사업시행이 지연되고 예방적 차원의 대책도 미흡하여 피해가 증가하는 악순환이 계속되고 있다. 따라서 본 인구에서는 우리나라의 치수경제성 분석에 있어 계량화하지 못하고 있는 자산이용고도화 효과를 치수안전도와 더불어 분석하고자 한다. 자산이용고도화는 치수사업 시행으로 해당지역의 치수안전도 향상에 따른 자산가치의 상승을 말하는데, 특정지역의 자산가치를 가장 객관적으로 표현할 수 있는 공시지가를 근거로 분석을 수행하였다. 치수사업 시행으로 인한 편익과 하천 특성에 따른 지가변동률의 차이가 통계적으로 유의성이 있는지를 분산분석을 통해 검증하였으면, 자산가치의 상승을 순수 연평균지가변동률로 나타내었다. 치수안전도는 홍수피해 잠재성과 홍수방어능력으로 구분하였는데 홍수피해 잠재성은 도시화율에 따라 구분하였고, 홍수방어능력은 홍수량의 빈도해석과 불확실성을 고려하여 조건부 비초과확률로 나타내었다. 본 연구에서는 소도시 지역(경안천, 복하천, 청미천)을 대상으로 200년 빈도의 홍수사상에 내해 10년, 50년 설계빈도로 건설된 제방의 조건부 비초과확률을 산정하여 지가변동률의 추이를 비교 분석하였다. 분석 결과, 소도시 지역에서는 조건부 비초과확률이 $10\%$ 상승했을 때 순수 연평균지가변동률이 5배정도 상승함을 알 수 있었다.다시 입력자료로 사용하는 업데이트 방식을 사용하기 때문에 예측결과의 오차가 완전하게 보정되지 않으면 다음 결과에 역시 오차를 주게 되어 오차보정이 상당히 중요하다는 것을 알 수 있었다. 오차를 보다 효과적으로 보정하기 위해서는 퍼지제어에 사용되는 퍼지규칙의 수를 늘리고, 유입량에 직접적인 영향을 주는 강우량과 연계한 2변수의 Fuzzy-Grey 모형을 이용한다면 보다 정확한 유입량 예측이 가능할 것으로 사료된다.이 작은 오차를 발생하였으며, 전체적으로 퍼프 모형이 입자모형보다는 훨씬 적은 수의 계산을 통해서도 작은 오차를 나타낼 수 있다는 것을 알 수 있었다. 그러나 Gaussian 분포를 갖는 퍼프모형은 전단흐름에서의 긴 유선형 농도분포를 모의할 수 없었고, 이에 관한 오차는 전단계수가 증가함에 따라 비선형적으로 증가하였다. 향후, 보다 다양한 흐름영역에서 장${\cdot}$단점 분석 및 오차해석을 수행한 후에 각각의 Lagrangian 모형의 장점만을 갖는 모형결합 방법을 제시할 수 있을 것으로 판단된다.mm/$m^{2}$로 감소한 소견을 보였다. 승모판 성형술은 전 승모판엽 탈출증이 있는 두 환아에서 동시에 시행하였다. 수술 후 1년 내 시행한 심초음파에서 모든 환아에서 단지 경등도 이하의 승모판 폐쇄 부전 소견을 보였다. 수술 후 조기 사망은 없었으며, 합병증으로는 유미흉이 한 명에서 있었다. 술 후 10개월째 허혈성 확장성 심근증이 호전되지 않아 Dor 술식을 시행한 후 사망한 예를 제외한 나머지 6명은 특이 증상 없이 정상 생활 중이다 결론: 좌관상동맥 페동맥이상 기시증은 드물기는 하나, 영유아기에 심근경색 및 허혈성 심근증 또는 선천성 승모

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분포형 수문매개변수 산정을 위한 GIS의 활용 - 금강상류유역을 중심으로 -

  • 정승권;정동양
    • Proceedings of the Korea Water Resources Association Conference
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    • 2004.05b
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    • pp.809-813
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    • 2004
  • 강우시 유역 내에서 발생하는 수문특성을 구명하고자 하는 연구는 지속적으로 진행되고 있다. 특히 최근 몇년간 집중호우로 인한 홍수피해가 매우 실각한 수준으로 발생하였고, 이에 지방 소하천을 포함한 전국의 하천정비사업이 새로운 설계홍수빈도를 토대로 진행되고 있다. 우리나라의 강우특성은 여름철에 편중되는 특성을 지니고 있어 홍수시의 홍수방어 대책 등 치수에 많은 어려움이 있는 것이 현실이다. 집중호우로 인한 피해는 전 세계적인 문제로 제기되고 있으며, 이에 강우-유출 관계를 규명하고자 하는 노력이 지속적으로 이루어지고 있다. 강우-유출과정은 시간적, 공간적 다변성을 지닌 수문학적 인자에 의해 좌우되기 때문에 이러한 문제를 해결하기 위해 다년간의 강우-유출 자료를 바탕으로 알고리즘을 생성하고, 이를 바탕으로 정확한 모의가 가능한 수문 모형 및 시스템들을 개발하는데 노력을 기울이고 있다(심순보 등, 1998, 신사철 등, 2002). 그러나 이러한 모형들은 많은 매개변수와 다양한 정보들을 필요로 하게 되어 이들을 처리하는데 많은 어려움이 따른다. 따라서 최근에는 GIS(Geographical Information System)를 활용하여 유역과 분수계를 결정하고 하천형태학적인 특성인자를 추출하는 자동화된 유역정보 추출기술 개발에 대한 관심이 집중되고 있다(Bhaskar, 1992, Francisco, 1995, Yeon, 1999). 이에 본 연구에서는 GIS기법을 이용하여 지형자료로부터 하천연장, 배수면적, 지체시간, 도달시간 등 유역내의 분포형 수문매개변수를 추출하였고 추출된 매개변수를 통해 강우-유출식을 적용하여 분포형 유출량을 산정하는데 활용하고자 한다.ansverse Mercatro) 지구좌표계의 DEM 자료로 변환하였다. 또한 유역의 고도차를 이용한 흐름특성 분석을 위해 수치고도자료를 이용하여 유역흐름특성을 분석할 수 있는 TOPAZ(Topographic PArameteri-Zation) 프로그램을 이용하였다. TOPAZ 프로그램을 통해 분석된 각 격자별 분포형 수문 매개변수는 적합한 관계식을 통해 분포형 유출량을 모의하는데 적용된다.다 정확한 유입량 예측이 가능할 것으로 사료된다.이 작은 오차를 발생하였으며, 전체적으로 퍼프 모형이 입자모형보다는 훨씬 적은 수의 계산을 통해서도 작은 오차를 나타낼 수 있다는 것을 알 수 있었다. 그러나 Gaussian 분포를 갖는 퍼프모형은 전단흐름에서의 긴 유선형 농도분포를 모의할 수 없었고, 이에 관한 오차는 전단계수가 증가함에 따라 비선형적으로 증가하였다. 향후, 보다 다양한 흐름영역에서 장${\cdot}$단점 분석 및 오차해석을 수행한 후에 각각의 Lagrangian 모형의 장점만을 갖는 모형결합 방법을 제시할 수 있을 것으로 판단된다.mm/$m^{2}$로 감소한 소견을 보였다. 승모판 성형술은 전 승모판엽 탈출증이 있는 두 환아에서 동시에 시행하였다. 수술 후 1년 내 시행한 심초음파에서 모든 환아에서 단지 경등도 이하의 승모판 폐쇄 부전 소견을 보였다. 수술 후 조기 사망은 없었으며, 합병증으로는 유미흉이 한 명에서 있었다. 술 후 10개월째 허혈성 확장성 심근증이 호전되지 않아 Dor 술식을 시행한 후 사망한 예를 제외한 나머지 6명은 특이 증상 없이 정상 생활 중이다 결론: 좌관상동맥 페동맥이상 기시증은 드물기는 하나, 영유

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The Management of Spontaneous Pneumothorax -Clinical Review in 451 Cases- (자연기흉의 임상적 고찰(451례))

  • 오태윤;장운하;배상일
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.374-379
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    • 1998
  • From March 1985 to June 1997, 451 patients of spontaneous pneumothorax treated at Kangbuk Samsung Hospital were reviewed retrospectively. Most of the patients were male (male to female ratio, 8.2:1). The mean age of the primary spontaneous pneumothorax (PSP) was 26.8 years, and that of secondary spontaneous pneumothorax(SSP) was 53.1 years. 330 out of 451 patients(73%) were PSP. The causes of the SSP were mostly pulmonary tuberculosis and COPD: 87 patients(72%), and 24 patients(19.2%), respectively. All the patient were treated by one of the following modalities: 1)rest and oxygen therapy in 42 patients, 2) closed thoracostomy in 208 patients, 3) thoracotomy in 156 patients, 4) VATS bullectomy in 45 patients. The mean duration of postoperative chest tube drainage was as following: thoracotomy 8.3 days, VATS bullectomy 4.7 days. For recent 3 consecutive years, VATS bullectomy has become the more frequently applied operative procedure than thoracotomy in the treatment of surgically indicated PSP, from 33% in 1994 to 78% in 1996. With the minimally invasive thoracoscopic surgery being more prevalent, VATS bullectomy will be able to be the 1st choice of treatment not only for the recurrent pneumothoracies but also for the some selected cases of the 1st episode pneumothoracies. To verify this approach as clinically acceptable one in terms of cost-effectiveness, recurrence rate, etc, a large scale of multi-institutional clinical study will be needed in a sooner time.

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Clinical Reviews of Spontaneous Hemopneumothorax (자연성 혈기흉의 임상 양상)

  • Kim, Jung-Tae;Chang, Woon-Ha
    • Journal of Chest Surgery
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    • v.40 no.9
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    • pp.613-616
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    • 2007
  • Background: Spontaneous hemopneumothorax is a rare disease and can be life threatening; it occurs in $1{\sim}12%$ of patients with spontaneous pneumothorax. We analyzed clinical reviews and treatments, as well as complications of spontaneous hemopneumothorax patients that were treated to aid in the optimal management. Material and Method: We studied retrospectively 30 cases with spontaneous hemopneumothorax for 11 years, from 1995 to 2006, at our hospital. Result: All the patients were male and most of the patients were under 30 years. The sides with the disorder were as follows: right in 15 cases and left in 15 cases. Patients showed mostly initial symptoms of chest pain, dyspnea and hypovolemic shock. All patients underwent a closed thoracostomy and 27 patients underwent surgery. Chemical pleurodesis was peformed because of postoperative persistent air leakage and one case was treated in the ICU due to re-expansion pulmonary edema, There were no other complications such as fibrothorax seen during the follow-up periods. Conclusion: The most important finding is proper initial management, as the spontaneous hemopneumothorax can potentially lead to a life-threatening condition. Recently, video assisted thoracoscopic surgery (VATS) is common procedure for general thoracic surgery and overcomes the weak points of performing a thoracotomy. The results of VATS are encouraging.

Changes of the Renal Arteries According to Various Embolic Materials (다양한 색전물질에 의한 신동맥의 변화)

  • Cho, Jae-Ho;Cho, Kil-Ho;Chang, Jae-Chun;Park, Bok-Hwan;Kim, Dong-Sug
    • Journal of Yeungnam Medical Science
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    • v.12 no.1
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    • pp.96-104
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    • 1995
  • The transarterial embolization has been widely used to control bleeding. It has a variety of clinical utility; to reduce bleeding on the surgical field, to reduce the size of malignant tumor as a preopearative treatment, to treat arteriovenous malformation or arterial aneurysm as a curative method and to promote life quality of patient with diffuse or multiple hepatocellular carcinoma as a palliative treatment, etc. With the advance of modem technology, various embolic materials have been also developed. However, it has not been fully investigated of histopathologic changes of the embolized organs according to the embolic materials used. This study was undertaken to investigate the histopathologic changes of embolized renal artery in rabbit by various embolic materials, according to each embolic material and to time passed by after embolization. Of the 5 arteries embolized by ethylene vinyl alcohol copolymer(EVAL), one showed abscess formation in embolized kidney. The other 4 allowed to perform further pathologic study: within a week after embolization there was no any specific change in vessels, however, minimal endothelial hypertrophy was observed following 2 weeks of embolization. Of the 8 renal arteries embolized by N-buthyl-2-cyanoacrylate(Histoacryl), 4 showed total occlusion of the main renal arteries as well as renal infarction, which reflects the strong adhesiveness of Histoacryl to vascular wall. The other 4 showed fibrinoid degeneration in vascular wall within a week. However, further change was not observed thereafter. In all the 5 renal arteries embolized by polyvinyl alcohol(Ivalon), there were infiltration of inflammatory cells along the vessel walls, within one week, which represents vasculitis. They showed some fibrosis with appearance of giant cells in the vessel wall two weeks after embolization and also showed marked fibrosis of connective tissues surrounding vessels two months after embolization, respectively. The results suggest that EVAL is useful for the embolization of hypervascular lesion with limited arteriovenous fistula, Histoacryl for the curative treatment of the lesion with high blood flow or severe arteriovenous fistula, and Ivalan for palliative treatment of malignant tumor or arteriovenous malformation, respectively.

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Uncoupled Solution Approach for treating Fluid-Structure Interaction due to the Near-field Underwater Explosion (근거리 수중폭발에 따른 유체-구조 상호작용 취급을 위한 비연성 해석방법)

  • Park, Jin-Won
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.10
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    • pp.125-132
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    • 2019
  • Because the water exposed to shock waves caused by an underwater explosion cannot withstand the appreciable tension induced by the change in both pressure and velocity, the surrounding water is cavitated. This cavitating water changes the transferring circumstance of the shock loading. Three phenomena contribute to hull-plate damage; initial shock loading and its interaction with the hull plate, local cavitation, and local cavitation closure then shock reloading. Because the main concern of this paper is local cavitation due to a near-field underwater explosion, the water surface and the waves reflected from the sea bottom were not considered. A set of governing equations for the structure and the fluid were derived. A simple one-dimensional infinite plate problem was considered to verify this uncoupled solution approach compared with the analytic solution, which is well known in this area of interest. The uncoupled solution approach herein would be useful for obtaining a relatively high level of accuracy despite its simplicity and high computational efficiency compared to the conventional coupled method. This paper will help improve the understanding of fluid-structure interaction phenomena and provide a schematic explanation of the practical problem.

Prosthetic treatment for patient with congenital bilateral cleft lip and palate to close oro-nasal communication using maxillary double crown and clasp retained removable denture (선천성 양측성 구순구개열 환자의 구비강 연결 폐쇄를 위한 상악 이중관과 고리 유지형 국소의치를 이용한 수복 증례)

  • Doh, Seok-Joo;Cho, Jin-Hyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.1
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    • pp.18-23
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    • 2019
  • Patients with cleft lip and palate have several problems such as oro-nasal communication, dental cross-bite caused by the insufficient growth of maxilla, poor pronunciation and esthetic problem. Removable denture with maxillary double crown near cleft palate and with clasp in the posterior teeth was used to solve the problems of the patient with cleft lip and plate. Double crowns make up for the insufficient mucosal support caused by the mucosa and alveolar bone loss in cleft lip and palate. Double crowns also allow easy repair of denture in case of abutment teeth extraction. In this case, 55-year-old female patient had bilateral cleft lip and palate and few remaining teeth on anterior maxilla. Prosthetic treatment was done for patient with bilateral cleft lip and palate to close oro-nasal communication using maxillary double crown and clasp retained removable denture. As a result, oro-nasal communication was effectively closed and the cross-bite was easily corrected by double crown and clasp retained denture. In addition, pronunciation and appearance were also improved.