• Clinical Endoscopy
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• 제55권6호
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• pp.793-800
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• 2022

Background/Aims: Fully covered self-expanding metal stents (FCSEMSs) are a relatively novel option for treating painful main pancreatic duct refractory strictures in patients with chronic pancreatitis. Herein, we aimed to assess the efficacy, feasibility, and safety of FCSEMSs in this patient group. Methods: This prospective single-center study included patients who underwent endoscopic retrograde pancreatography with FCSEMS placement. The primary endpoints were the technical and clinical success rates. A reduction in visual analog scale pain score of >50% compared with that before stent placement was defined as clinical success. Secondary endpoints were resolution of pancreatic strictures on fluoroscopy during endoscopic retrograde pancreatography and the development of stent-related adverse events. Results: Thirty-six patients were included in the analysis. The technical success rate was 100% (n=36) and the clinical success rate was 86.1% (n=31). There was a significant increase in stricture diameter from 1.7 mm to 3.5 mm (p<0.001) after stent removal. The mean visual analog scale pain score showed statistically significant improvement. At 19 months of follow-up, 55.6% of the patients were asymptomatic. Stent migration (16.7%), intolerable abdominal pain (8.3%), development of de novo strictures (8.3%), and mild pancreatitis (2.8%) were the most common adverse events. Conclusions: FCSEMS placement showed good technical and clinical success rates for achieving pain relief in patients with refractory main pancreatic duct strictures.

• Tuberculosis and Respiratory Diseases
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• 제47권3호
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• pp.304-310
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• 1999

연구배경: 결핵에 대한 면역 반응은 T-림프구와 단핵 식세포를 주축으로 하는 세포성 면역 반응이 주률 이루는데 여기에 IFN-$\gamma$와 TNF-$\alpha$등의 cytokine 이 관여하고 있다. IFN-$\gamma$는 주로 T-림프구에서 분비되어 활성화된 단핵구에서의 TNF-$\alpha$생성을 증가시키는 기전을 통해 결핵균 증식을 억제하고 치유에 이르는 과정을 매개하는 것으로 알려져 있다. 효과적인 화학요법에도 불구하고 난치성 결핵으로 이행하는 기전에 IFN-$\gamma$가 관여하는지 규명하고자 본 연구를 시행하였다. 대상 및 방법: 정상 대조군과 최근 결핵으로 진단받아 치료를 시작한 환자, 난치성 결핵 환자에서 혈액을 채취하여 단핵구를 분리하고 아무런 자극을 하지 않은 경우, 12시간 LPS($l{\mu}g/ml$)만으로 자극을 한 경우, IFN-$\gamma$($2{\mu}g/ml$)로 2시간 전처치한 후 12 시간 LPS 자극한 경우로 니누어 TNF-$\alpha$의 농도를 측정, IFN-$\gamma$ 활성화 효과에 변화가 있는지를 살펴보았고 IFN-$\gamma$ 수용체 항제를 이용, IFN-$\gamma$ 활성화 효과의 변화가 IFN-$\gamma$ 수용체의 숫적 변화와 관련이 있는지를 확인하였다. 결과: IFN-$\gamma$ 활성화 효과를 알아보기 위해 LPS 만으로 지극한 경우와 IFN-$\gamma$ 전처치 후 LPS로 자극한 경우에 생성된 TNF-$\alpha$의 비를 구하여 보았을 때 정상 대조군 $13.5{\pm}7.6$, 최근 결핵환자로 진단받은 군 $10.8{\pm}6.4$, 난치성 결핵 환자군 $6.7{\pm}3.9$의 결과를 보였다. 난치성 결핵환자군의 경우 정상대조군에 비해 IFN-$\gamma$의 활성화 효과가 통계적으로 유의하게 감소되어 있음을 알 수 있었다 (p=0.002). IFN-$\gamma$ 수용체수의 감소는 대상 환자 중 난치성 결핵 환자 1명에서 관찰되었다. 결론: 난치성 결핵으로의 이행에 있어 단핵구에서의 IFN-$\gamma$ 활성화 효과의 감소가 중요한 역할을 할 것으로 생각되며 IFN-$\gamma$ 활성화 효과의 감소는 일부 환자의 경우, IFN-$\gamma$ 수용체의 감소와 관련되어 생기는 것으로 판단된다.

• 한국주조공학회지
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• 제35권5호
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• pp.114-119
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• 2015

This paper reports the effect of a refractory crucible type on the microstructure of duplex stainless steel (DSS) cast with the addition of gadolinium using air-induction melting. Grade 4A DSSs with 1 wt% of gadolinium (Gd) were fabricated in various crucibles including alumina ($Al_2O_3$), magnesia (MgO), calcia (CaO) coated with yttria ($Y_2O_3$) and graphite. The standard free energies of the formation of calcium and yttrium oxide were lower than those of gadolinium oxide and other crucible elements based oxide. The yield of Gd in DSS using $Al_2O_3$, MgO, CaO-coated $Y_2O_3$ and graphite was 5, 19, 83 and 96%, respectively. As Gd yield increased, the amount of Gd-based inclusions increased, the size of the inclusions were reduced, and the inclusions became evenly distributed.

• Journal of Gastric Cancer
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• 제20권3호
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• pp.337-343
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• 2020

Distal gastrectomy with Billroth I or II reconstruction may cause duodenogastroesophageal reflux (DGER), thereby resulting in digestive or respiratory symptoms. The mainstay of treatment is medication with proton pump inhibitors. However, these drugs may have limited effects in DGER. Laparoscopic fundoplication has been proven to be highly effective in treating gastroesophageal reflux disease (GERD), but it cannot be performed optimally for GERD that develops after gastrectomy. We report the case of a 72-year-old man with a history of distal gastrectomy and Billroth I anastomosis due to early gastric cancer. GERD due to bile reflux occurred after surgery and was refractory to medical therapy. The patient underwent Roux-en-Y conversion from Billroth I gastroduodenostomy and hiatal hernia repair with only cruroplasty. Fundoplication was not performed. His symptoms improved significantly after the surgery. Therefore, laparoscopic hiatal hernia repair and Roux-en-Y conversion can be an effective surgical procedure to treat medically refractory DGER after Billroth I gastrectomy.

• 상하수도학회지
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• 제20권1호
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• pp.79-85
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• 2006

Innovated technique to oxidize pollutants has been developed. The technique for this study uses plasma discharge in 2-phase (Air-Water) and is called Discharged Water Generating (DWG) system. It produces electric arc which generates not only the physical decomposing power against the pollutants but also oxidants to sterilize pollutants depending on the inlet gas species. These physical and chemical products play an important role in COD decrease and biodegradability enhancement. The enhancement of biodegradability for the refractory organic substances in aqueous solution was estimated in this study. Argon discharge reduced NBDCOD of EDTA from 58.7mg/L to 38.8mg/L, but oxygen discharge and ozonation reduced it to 37.74mg/L and 38.73mg/L respectively. Furthermore, Argon discharge changed 1181mg/L of NBDCOD of dye effluent into 606mg/L but oxygen discharge and ozonation changed it into 888mg/L and 790mg/L respectively.

• 한국재료학회지
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• 제19권9호
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• pp.473-480
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• 2009

In order to provide the mechanism of nozzle clogging, recovered nozzles for high strength steel grade were examined carefully after continuous casting. The thickness of clogged material in SEN is increased in the following order: from the bottom to the top of the nozzle, upper part of slag line, and the pouring hole. Nozzle clogging material begins to form due the adhesion of metal to nozzle wall, the decarburization, and reduction of oxide in the refractory by Al and Ti in the melt. The reduction of oxide in the refractory by Al and Ti improves the wettability of the melt on the refractory and forms a thin Al-Ti-O layer. Metal containing micro alumina inclusions is solidified on the Al-Ti-O layer, and the solid layer grows due to the heat evolution through the nozzle wall. Thermodynamic calculation has been made for the related reactions. The effect of superheat to the nozzle clogging is discussed on ultra low carbon steel and low carbon steel.

• Journal of Advanced Marine Engineering and Technology
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• 제35권3호
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• pp.329-334
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• 2011

The cooling water circulation plates had been used to drop the temperature of refractory outside shell of common cooling system by using cooling plate or stave type. When they are attacked by surrounding gas, they are corroded and the water flows in the refractory due to leakage of water. So, the life of refractory material is shortened and changed due to the worse conditions of cooling system. The automatic sensing device for water leakage of cooling plate is developed to check the position of trouble by using the microprocessor system when cooling water leak and gas are flowed into the cooling plate through the leakage position. The flowed gas is detected in the micro-process system which delivers the detected position of cooling plate or stave to main control room through the wireless-radio relay station. This system can be possible to detect the position of cooling plate or stave against the water leakage part immediately and then deliver the signal to main control room by using the microprocessor system and wireless-radio relay station. This system will be developed in changing the working condition from manual system to unmanned auto alarm system.

• 한국물환경학회지
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• 제29권4호
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• pp.476-488
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• 2013

Refractory Dissolved Organic Carbon (RDOC) is becoming more important index on management of water quality, water regulation as well as ecosystem management. We analyzed trends of RDOC using elasticity in the Nakdong river basin. If climate elasticity of streamflow is positive, change of streamflow can be defined by the proportional change in a climatic variable such as precipitation and temperature. Elasticity of streamflow to precipitation and elasticity of RDOC to precipitation were estimated in the present, and we also analyzed the variation of elasticity in the future using climate change scenarios, RCP 8.5/ 4.5. Mean streamflow elasticity is 1.655, and mean RDOC elasticity is 1.983. RDOC is more sensitive to precipitation change than streamflow. The variation of RDOC is directly proportion to precipitation in all scenarios, but the Load of RDOC is dependent on precipitation as well as others. There is a need for additional correlation analysis between RDOC and other factors for accurate prediction.

• 한국주조공학회지
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• 제30권3호
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• pp.115-120
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• 2010

Recently, an advanced raw material supplying system in diecasting industry that molten metal produced by the raw material supplier can be directly delivered to the diecasting shops was proposed. It was known to have advantages of reducing melting process cost and improving working environment. However, for its successful mass production, the development of high insulation ladle is inevitable. In this study, the optimal mixing ratio of $SiO_2-Al_2O_3$ was investigated and the high insulation ladle with computer simulation result was built in a prototype and evaluated. The prototype which has refractory wall of $SiO_233%-Al_2O_3$ 35%-CaO 33% showed high insulation sufficient for carrying the Al molten metal for 138 minutes. Gas quantity result and SEM-EDS analysis on the melt poured in the ladle also showed extremely low level of 0.028 cc / 100 g and no penetration of Al molten metal into the refractory wall, satisfying the requirements for mass production.

• Journal of Korean Neurosurgical Society
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• 제54권3호
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• pp.268-271
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• 2013

Occipital neuralgia is a rare pain syndrome characterized by periodic lancinating pain involving the occipital nerve complex. We present a unique case of entrapment of the greater occipital nerve (GON) within the semispinalis capitis, which was thought to be the cause of occipital neuralgia. A 66-year-old woman with refractory left occipital neuralgia revealed an abnormally low-loop of the left posterior inferior cerebellar artery on the magnetic resonance imaging, suggesting possible vascular compression of the upper cervical roots. During exploration, however, the GON was found to be entrapped at the perforation site of the semispinalis capitis. There was no other compression of the GON or of C1 and C2 dorsal roots in their intracranial course. Postoperatively, the patient experienced almost complete relief of typical neuralgic pain. Although occipital neuralgia has been reported to occur by stretching of the GON by inferior oblique muscle or C1-C2 arthrosis, peripheral compression in the transmuscular course of the GON in the semispinalis capitis as a cause of refractory occipital neuralgia has not been reported and this should be considered when assessing surgical options for refractory occipital neuralgia.