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Double-guidewire technique for selective biliary cannulation does not increase the rate of post-endoscopic retrograde cholangiopancreatography pancreatitis in patients with naïve papilla

  • Han Taek Jeong;June Hwa Bae;Ho Gak Kim;Jimin Han
    • Clinical Endoscopy
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    • v.57 no.2
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    • pp.226-236
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    • 2024
  • Background/Aims: This study aimed to compare the safety of the double-guidewire technique (DGT) with that of the conventional single-guidewire technique (SGT) in real-world situations. Methods: A total of 240 patients with naïve papilla who underwent endoscopic retrograde cholangiopancreatography (ERCP) at Daegu Catholic University Medical Center between January 2021 and December 2021 were included. The primary outcome was the rate of post-ERCP pancreatitis (PEP) in the SGT and DGT groups. Results: A total of 163 patients (67.9%) belonged to the SGT group, and 77 (32.1%) belonged to the DGT group. The rates of successful biliary cannulation were 95.7% and 83.1% in the SGT and DGT groups, respectively (p=0.002). In the study group, PEP occurred in 14 patients (5.8%). The PEP rates were not significantly different between the SGT and DGT groups (4.3% vs. 9.1%, p=0.150). In the multivariate analysis, the age of <50 years (odds ratio [OR], 9.305; 95% confidence interval [CI], 1.367-63.358; p=0.023) and hyperlipidemia (OR, 7.384; 95% CI, 1.103-49.424; p=0.039) were significant risk factors for PEP in the DGT group. Conclusions: DGT did not increase the PEP rate in patients with naïve papilla. In addition, the age of <50 years and hyperlipidemia were significant risk factors for PEP in the DGT group.

A Study on the Direction of Restoration for Baegun-dong Garden in Gangjin through a Diachronic Interpretation of the Prototype Scenery (통시적 원형경관 해석을 통해 본 강진 백운동 원림의 복원 방향)

  • Ha, Hye-Kyung;So, Hyun-Su
    • Journal of the Korean Institute of Landscape Architecture
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    • v.45 no.3
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    • pp.116-128
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    • 2017
  • In this study, the original scenery of Baegun-dong Garden in Gangjin was compared with that of the reconstructed site to suggest directions for restoration in the future. The diachronic prototype scenery of the Baegun-dong Garden was derived by integrating the elements of the original and contemporary prototype sceneries from the old poetry series. The old poetry series is comprised of "Baegun-dong 8Yeong(詠)" by Lee Damro(李聃老), "Baegun-dong 10Su(首)" by Song Ikhwi(宋翼輝), "Baegun-dong 12Gyeong (景)" by Jeong Yakyong(丁若鏞), and "Baegun-dong 14Gyeong" by Lee Siheon (李時憲). Guidance for directions for future restoration was suggested through a comparative analysis between the diachronic prototype scenery of Baegun-dong Garden and the current scenery of the restored site. The research result is as follows. First, the prototype scenery of Baegun-dong Garden was a harmonic view composed of the camellia forest road, 'Baegun-dong' the letter carved on a rock, a cliff 'Changhabyeok(蒼霞壁)' the red letter written by Jeong Yakyong, paulownia trees, waterfalls and a maple forest. Outside the Byeolseo(別墅), there were a red plum blossom forest, a pine forest, and a bamboo forest, as well as the view of Okpanbong(玉版峯) from Jeongseondae(停仙臺). In the yard, there were Chwimiseonbang(翠微禪房), Jug-gak(竹閣), Pyeongsang(榻), a lotus Bangji(方池), Gogsugeo(曲水渠) and Hwagye(花階). Cranes were even raised in the yard. Second, comparing the diachronic prototype scenery of Baegun-dong Garden with its restored site, following a restoration guide is suggested. There should be more water flow in Baegun-dong Valley and Jug-gak should be restored. 'Changhabyeok' the red letter should be carved on the stone wall. Trees should be controlled for a better view of Okpanbong from Jeongseondae. More trees and plants, such as red plum blossom, pine tree, paulownia trees, azaleas(映山紅), chrysanthemum, orchid, daffodil, and lotus should be planted in the yard. A system of integrated guide boards is also required for effective information transmission for visitors.

A Study on the Change of Materials and Fabrication Techniques of Stone Figures in Royal Tombs of the Joseon Period - Focusing on Shindobi, Pyo-Seok, and Sang-Seok - (조선시대 왕릉 석물의 재료와 제작 방법 변화에 관한 연구 - 신도비와 표석, 상석을 중심으로 -)

  • Cha, Moonsung
    • Korean Journal of Heritage: History & Science
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    • v.52 no.4
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    • pp.56-77
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    • 2019
  • Bi-Seok is a treasure trove of funeral rites and an important cultural asset that can shed light on the historical and social history of calligraphy, but research of the topic is still insignificant. In particular, research on the production method of Bi-Seok remains an unproven field. The production of Bi-Seok can be roughly divided into ma-jeong (refining stone), sculpture, and the Buk-chil (process of engraving letters) process. This article reveals some facts: First, performing ma-jeong to the Sang-Seok, Honyu-Seok, Bi-seok, which are known to be God's things. This process is needed because of the change in the perception of the Honyu-Seok due to the settlement and propagation of Confucian ceremonial rituals in the times of hardship in 1592 and 1636. As the crafting process of ma-jeong did not remain concrete, it was only possible to examine the manufacturing process of Bi-Seok through its materials and tools. Second, the rapid proliferation of Oh-Seok and Sa-jeo-chwi-yong (purchase of things made by private citizens) in the Yeongjo era has great importance in social and cultural history. When the Gang-Hwa-Seok of the commodity were exhausted, the Oh-Seok that was used by Sadebu (upper civil class) were used in the tomb of Jangneung, which made Oh-Seok popular among people. In particular, the use of Oh-Seok and the Ma-Jeong process could minimize chemical and physical damage. Third, the writing method of the Bi-seok is Buk-chil. After Buk-Chil of Song Si-Yeol was used on King Hyojong's tomb, the Buk-Chil process ( printing the letters on the back of the stone and rubbing them to make letters) became the most popular method in Korea and among other East Asian countries, and the fact that it was institutionalized to this scale was quite impressive. Buk-Chil became more sophisticated by using red ink rather than black ink due to the black color that results from Oh-Seok. Fourth, the writing method changes in the late Joseon Dynasty. Until the time of Yeongjo's regime, when inscribing, the depth of the angle was based on the thickness of the stroke, thus representing the shade. This technique, of course, did not occur at every Pyo-Seok or Shindobi, but was maintained by outstanding artisans belonging to government agencies. Therefore, in order to manufacture Bi-Seok, Suk-seok, YeonJeong, Ma-jeong, Jeong-Gan, ChodoSeoIp, Jung-Cho, Ip-gak, Gyo-Jeong, and Jang-Hwang, a process was needed to make one final product. Although all of these methods serve the same purpose of paying respects and propagandizing the great work of deceased persons, through this analysis, it was possible to see the whole process of Pyo-Seok based upon the division of techniques and the collaboration of the craftsmen.

Estimation of Runoff Characteristics of Non-point Pollutant Source by Land Cover Characteristics (토지피복 특성에 따른 비점오염원 유출특성 평가)

  • Lee, Jae-Woon;Yi, Youn-Jeong;Kwon, Hun-Gak;Yoon, Jong-Su;Lee, Chun-Sik;Cheon, Se-Uk
    • Journal of Environmental Science International
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    • v.21 no.8
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    • pp.977-988
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    • 2012
  • This study analyzed the characteristics of stormwater runoff by rainfall type in orchard areas and transportation areas for 2 years(2010~2011year). Effluents were monitored to calculate the Event Mean Concentrations(EMCs) and runoff loads of each pollutant. The pollutant EMCs by volume of stormwater runoff showed the ranges of BOD 0.9~13.6 mg/L, COD 13.7~45.2 mg/L, SS 4.1~236.4 mg/L, T-N 2.123~21.111 mg/L, T-P 0.495~2.214 mg/L in the orchard areas, and was calculated as BOD 2.3~22.5mg/L, COD 4.4~91.1 mg/L, SS 4.3~138.3 mg/L, T-N 0.700~13.500 mg/L, T-P 0.082~1.345 mg/L in the transportation areas. The correlation coefficient of determination in the orchard area was investigated in the order of Total Rainfall(0.81) > Total Runoff(0.76) > Rainfall Intensity(0.56) > Rainfall Duration(0.46) > Antecedent Dry Days(0.27). Also, in the case of the transportation area was investigated in the order of Total Rainfall (0.55) > Total Runoff(0.54) > Rainfall Intensity(0.53) > Rainfall Duration(0.24) > Antecedent Dry Days(0.14). As the result, comparing valuables relating to runoff of non-pollutant source between orchard areas and transportation areas, orchard area($R^2{\geq}0.5$ : X3, X4, X5) was investigated to have more influence of diverse independent valuables compared to the transportation area($R^2{\geq}0.5$ : X3, X4) and the difference of discharge influence factor by the land characteristics appeared apparently.

Utility of Real Time RT-PCR for the Quantitative Detection of Minimal Residual Disease in Hematological Malignancy (백혈병 미세잔존질환 정량검출을 위한 실시간 역전사중합효소연쇄반응법의 유용성)

  • Cho, Jeung-Ai;Kim, Da-Woon;Jeong, Seong-Du;Cheon, Ji-Seon;Na, Gyeong-Ah;Kim, Hye-Ran;Kim, Jin-Gak;Kim, In-Hwan;Kim, Soo-Hyun;Shin, Myung-Geun;Kim, Hyeong-Rok
    • Korean Journal of Clinical Laboratory Science
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    • v.41 no.1
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    • pp.11-23
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    • 2009
  • Chromosomal rearrangements are major pathology in hematological malignancies. The detection of minimal residual disease (MRD) for these gene rearrangements helps in monitoring treatment outcomes and predicting prognosis of patients. Recently, quantification of these gene transcripts based on real-time quantitative polymerase chain reaction (RQ-PCR) has been used as MRD detection. The purpose of this study is to ensure the usefulness of the RQ-PCR technique for detecting MRD in hamatological malignancy patients. The patients had been diagnosed to AML1-ETO positive AML, PML-RARa positive AML and BCR-ABL positive MPN at Chonnam National University Hwasun Hospital from Jan. 2006 to Aug. 2008. The fusion transcript was quntified by RQ-PCR and analyzed in comparison to conventional cytogenetics, FISH and RT-PCR. The fusion gene transcript was quantified by RQ-PCR in 57 samples from 14 patients with AML1-ETO positive AML, 79 samples from 27 patients with PML-RARa positive AML and 108 samples from 36 patients with CML. At diagnosis, the quantitative fusion transcripts for AM1-ETO, PML-RARa and BCR-ABL showed the range of 0.485552651~10.82233683 (mean 3.782217131, SD 2.998052348), 0.005300395~0.29267494 (mean 0.056901315, SD 0.080131381) and 0.1293929~12.94826849 (mean 1.701935665, SD 2.200913158). The increase of AML1-ETO fusion gene transcripts preceded morphologic relapse in two patients. Quantification of fusion gene transcripts by RQ-PCR could detected MRD in samples which were negative by in cytogenetic analysis or FISH. Our findings indicated that quantitative analysis of AML1-ETO, PML-RARa and BCR-ABL transcripts by RQ-PCR might be a useful tool for the monitoring of minimal residual disease in hematological malignancies.

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Water Quality Prediction and Forecast of Pollution Source in Milyanggang Mid-watershed each Reduction Scenario (밀양강 중권역 오염부하 전망 및 삭감 시나리오별 하류 수질예측)

  • Yu, Jae-Jeong;Yoon, Young-Sam;Shin, Suk-Ho;Kwon, Hun-Gak;Yoon, Jong-Su;Jeon, Young-In;Kang, Doo-Kee;Kal, Byung-Seok
    • Journal of Environmental Science International
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    • v.20 no.5
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    • pp.589-598
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    • 2011
  • Milyanggang mid-watershed is located in downstream of Nakdong river basin. The pollutants from that watershed have an direct effect on Nakdong river water quality and it's control is important to manage a water quality of Nakdong river. A target year of Milyanggang mid-watershed water environment management plan is 2013. To predict a water quality at downstream of Milyang river, we have investigated and forecasted the pollutant source and it's loading. There are some plan to construction the sewage treatment plants to improve the water quality of Milyang river. Those are considered on predicting water quality. As results, it is shown that the population of Milyanggang mid-watershed is 131,857 and sewerage supply rate is 62.2% and the livestock is 1,775.300 in 2006. It is estimated that the population is 123,921, the sewerage supply rate is 75.5% in 2013. The generated loading of BOD and TP is 40,735 kg/day and 2,872 kg/day in 2006 and discharged loading is 11,818 kg/day and 722 kg/day in 2006 respectively. Discharged loadings were forecasted upward 1.0% of BOD and downward 2.7% of TP by 2013. The results of water quality prediction of Milyanggang 3 site were 1.6 mg/L of BOD and 0.120 mg/L of TP in 2013. It is over the target water quality at that site in 2015 about 6.7% and 20.0% respectively. Consequently, there need another counterplan to reduce the pollutants in that mid-watershed by 2015.

Automatic Clock and Time Signal System of the Astronomical Agency in East Asia Area (동아시아 천문관서의 자동 시보와 타종장치 시스템의 고찰 - 수운의상대, 자격루, 옥루, 송이영 혼천시계 등을 중심으로 -)

  • Lee, Yong-Sam;Kim, Sang-Hyuk;Jeong, Jang-Hae
    • Journal of Astronomy and Space Sciences
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    • v.26 no.3
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    • pp.355-374
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    • 2009
  • We analysed the old automatic clock and time signal system that was used by the national astronomical agency in East Asian Area. Jagyeongnu is a kind of water clock that was operated by the flowing water in Joseon Dynasty. Seowoongwan managed the water clock so as to keep the standard time system in the dynasty from the 16th year (1434) of King Sejong's reign. In 1438 the Okru that was invented in the period. Such kind of clock system already was used in China, which was Shui $y\ddot{u}n$ i hsiang t'ai (水運儀象壹) in 1092. During the period Joseon Dynasty, China and Japan had been kept the time system that one day is divided into 12 shin (12辰) or 100 gak (刻). However detailed part of the system had a little difference among the three countries. Though the whole system of water clock in Joseon had manufactured on the basis of Chinese, it had been gradually developed by own method and idea. In this study we show the historical records of the standard time keeping system in East Asian history. And then we can inform materials on the structure and functional devises for the purpose of new restoration models about the automatic clock and time system.

A Survey on the Band Injury Patients of Physical Therapy (수부손상환자의 물리치료 실태조사)

  • Kwak, Jeong-ln;Bae, Sung-Soo;Hwang-Bo, Gak;Kim, Ho-Bong;Han, Dong-Uck;Lee, Han-Suk
    • The Journal of Korean Physical Therapy
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    • v.13 no.1
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    • pp.83-96
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    • 2001
  • The purpose of this study is to provide the fundamental information fer the rehabilitation of hand injury and to emphasize the point of early treatment of hand injury after operation. The subjects are composed with the physical therapists who care hand injury and are engaged in 76 university hospitals,59 general hospitals and 88 semi and local clinics respectively. Investigator take the research form chart with 41 questionnaire and use the cross tabulation frequencies and one-way ANOVA of SPSS WIN(ver 10.0) for the statistic analysis. The results of this research are as follows :1. The number of physical therapists who care hand injury are 110 men and 113 women. 2. The beginning period of active assistive exorcise on the various type of injuries are as follows: At the case of flexor tendon injury, the most part of physical therapists make response to the period that is above 4 weeks in the rate of 29.1%. At the case of fracture, the most part of physical therapists make response to the period those are from 3 weeks to less than 4 weeks and from 4 weeks to less than 5 weeks in the rate of 28.7% respectively. At the case of crushing injury, the most part of physical therapists response to the period that is above 4 weeks in the rate of 32.2%. At the case of amputation injury, the most part of physical therapists response to the period that is above 4 weeks in the rate of 40.4%. 3. In the physical therapy request, treatment period are mentioned in 22.0%. 4. The most difficult factors in the hand treatment is to contracture soft tissue and joint to physical therapist in the rate of 59.6%. 5. Among the reasons of the intervention between physical therapy request and actual treatment, the case of wrong physical therapy request is examined in 69.4%.

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Perceptions and Practices of Teachers in an Earth Science Teachers' Research Group About Teaching Geologic Field Trip: A Case Study (지구과학 교사 연구 모임 참여 교사의 야외 지질 학습 지도에 대한 인식과 실행에 대한 사례 연구)

  • Jun, Young-Ho;Kwon, Hong-Jin;Choi, Byeon-Gak;Park, Jeong-Woong;Kim, Chan-Jong
    • Journal of the Korean earth science society
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    • v.28 no.6
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    • pp.686-698
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    • 2007
  • The purpose of this study was to investigate the perceptions and practices of secondary science teachers who participated in an Earth science teachers' research roup about teaching geologic field trips. Four Earth science teachers participated in this study. Data included field trip observations, semi-structured interviews with teachers and students, and analysis of instructional materials and students' reports from the field trip. Field trip observations and interviews were video- and audio-taped and transcribed. Results indicated that teacher participants focused more on aesthetic objectives for geologic field trip. The participants' instruction tended to show rather teacher-centered explanation due to limited time at each field site though various teaching strategies were used at times to engage students in a scientific inquiry. This group of teachers strived to develop their professional ability to guide geologic field trip by working with a small study group with colleagues, participating geologic field trips, and enrolling graduate programs.

Study of BiJeung by 18 doctors - Study of II - (18인(人)의 비증(痺證) 논술(論述)에 대(對)한 연구(硏究) - 《비증전집(痺證專輯)》 에 대(對)한 연구(硏究) II -)

  • Sohn, Dong Woo;Oh, Min Suk
    • Journal of Haehwa Medicine
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    • v.9 no.1
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    • pp.595-646
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    • 2000
  • I. Introduction Bi(痺) means blocking. BiJeung is one kind of symptoms making muscles, bones and jonts feel pain, numbness or edema. For example it can be gout or SLE etc. says that Bi is combination of PungHanSeup. And many doctors said that BiJeung is caused by food, fatigue, sex, stress and change of weather. Therefore we must treat BiJeung by character of patients and characteristic of the disease. Many famous doctors studied medical science by their fathers or teachers. So the history of medical science is long. So I studied ${\ll}Bijeungjujip{\gg}$. II. Final Decision 1. JoGeumTak(趙金鐸) devided BiJeung into Pung, Han, Seup and EumHeo, HeulHeo, YangHeo, GanSinHeo by charcter or reaction of pain. And he use DaeJinGyoTang, GyegiGakYakJiMoTang, SamyoSan, etc. 2. JangPaeGyeu(張沛圭) focused on division of HanYeol(寒熱; coldness and heat) in spite of complexity of BiJeung. He also used insects for treatment. They are very useful for treatment of BiJeung because they can remove EoHyeol(瘀血). 3. SeolMaeng(薛盟) said that the actual cause of BiJeung is Seup. So he thought that BiJeung can be divided into PungSeup, SeupYeol, HanSeup. And he established 6 rules to treat BiJeung and he studied herbs. 4. JangGi(張琪) introduced 10 prescriptions and 10 rules to cure BiJeung. The 1st prescription is for OyeSa, 2nd for internal Yeol, 3rd for old BiJeung, 4th for Soothing muscles, 5th for HanSeup, 6th for regular BiJeung, 7th for functional disorder, 8th for YeolBi, 9th for joint pain and 10th for pain of lower limb. 5. GangSeYoung(江世英) used PungYeongTang(風靈湯) for the treatment of PungBi, OGyeHeukHoTang(烏桂黑虎湯) for HanBi, BangGiMokGwaTang(防己木瓜湯) for SeupBi, YeolBiTang(熱痺湯) for YeolBi, WoDaeRyeokTang(牛大力湯) for GiHei, HyeolPungGeunTang(血楓根湯) for HyeolHeo, ToJiRyongTang(土地龍湯) for the acute stage of SeupBi, OJoRyongTang(五爪龍湯) for the chronic stage of SeupBi, and so on. 6. ShiGeumMook(施今墨) devided BiJeung into four types. They are PungSeupYeol, PungHanSeup, GiHyeolSil(氣血實) and GiHyeolHeo(氣血虛). And he introduced the eight rules of the treatment(SanPun(散風), ChukHan(逐寒), GeoSeuP(, CheongYeol(淸熱), TongRak(通絡), HwalHyeol(活血), HaengGi(行氣), BoHeo(補虛)). 7. WangYiYou(王李儒) explained the acute athritis and said that it can be applicable to HaneBi(行痺). And he used GyeJiJakYakJiMoTang(桂枝芍蘂知母湯) for HanBi and YeolBiJinTongTang(熱痺鎭痛湯) for YeolBi. 8. JangJinYeo(章眞如) said that YeolBi is more common than HanBi. The sympthoms of YeolBi are severe pain, fever, dried tongue, insomnia, etc. And he devided YeolBi into SilYeol and HeoYeol. In case of SilYeol, he used GyeoJiTangHapBaekHoTang(桂枝湯合白虎湯) and in case of HeoYeol he used JaEumYangAekTang(滋陰養液湯). 9. SaHaeJu(謝海洲) introduced three important rules of treatment and four appropriate rules of treatment of BiJeung. 10. YouDoJu(劉渡舟) said that YeolBi is more common than HanBi. He used GaGamMokBanGiTang(加減木防已湯) for YeolBi, GyeJiJakYakJiMoTang or GyeJiBuJaTang(桂枝附子湯) for HanBi and WooHwangHwan(牛黃丸) for the joint pain. 11. GangYiSon(江爾遜) focused on the internal cause. The most important internal cause is JeongGiHeo(正氣虛). So he tried to treat BiJeung by means of balance of Gi and Hyeol. So he ususlly used ODuTang(烏頭湯) and SamHwangTang(三黃湯) for YeolBi, OJeokSan(五積散) for HanBi, SamBiTang(三痺湯) for the chronic BiJeung. 12. HoGeonHwa(胡建華) said that to distinguish YeolBi from Hanbi is very difficult. So he used GyeJiJakYakJiMoTang in case of mixture of HanBi and YeoBi. 13. PiBokGo(畢福高) said that the most common BiJeung is HanBi. He usually used acupuncture with medicine. He followed the theory of EumYongHwa(嚴用和)-he focused on SeonBoHuSa(先補後瀉). 14. ChoiMunBin(崔文彬) used GeoPungHwalHyeolTang(祛風活血湯) for HanBi, SanHanTongRakTang(散寒通絡湯) for TongBi(痛痺), LiSeupHwaRakTang(利濕和絡湯) for ChakBi(着痺), CheongYeolTongGyeolChukBiTang(淸熱通經逐痺湯) for YeolBi(熱痺) and GeoPungHwalHyeolTang(祛風活血湯) for PiBi(皮痺). 15. YouleokSeon(劉赤選) introduced the common principle for the treatment of BiJeung. He used HaePuneDeungTang(海風藤湯) for HaengBi(行痺), SinChakTang(腎着湯), DokHwalGiSaengTang(獨活寄生湯) for TongBi(痛痺), TongPungBang(痛風方) for ChakBi(着痺) and SangGiYiMiTangGaYeongYangGakTang(桑枝苡米湯加羚羊角骨) for YeolBi(熱痺). 16. LimHakHwa(林鶴和) said about TanTan(movement disorders or numbness) and devided TanTan into the acute stage and the chronic stage. He used acupuncture at the meridian spot like YeolGyeol(列缺), HapGok(合谷), etc. And he also used MaHwangBuJaSeSinTang(麻黃附子細辛湯) in case of the acute stage. In the chronic stage he used BangPungTang(防風湯). 17. JinBaekGeun(陳伯勤) liked to use three rules(HwaHyeol(活血), ChiDam(治痰), BoSin(補腎)) to treat BiJeung. He used JinTongSan(鎭痛散) for the purpose of HwalHyeol(活血), SoHwalRakDan(小活絡丹) for ChiDam(治痰) and DokHwalGiSaengTang(獨活寄生湯) for BoSin(補腎). 18. YimGyeHak(任繼學) focused on YangHyeolJoGi(養血調氣) if the stage of BiJeung is chronic. And in the chronic stage he insisted on not using GalHwal(羌活), DokHwal(獨活) and BangPung(防風).

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