Acute cholangitis is a clinical syndrome characterized by fever, jaundice, and abdominal pain that develops as a result of stasis and infection in the biliary tract. It can be a life-threatening condition if it is not recognized early. Patients with severe cholangitis may present with hypotension, and mental status changes. The most frequent causes of acute cholangitis are biliary calculi, benign biliary stricture, and malignancy. The most common pathogens isolated are gram-negative bacteria (Escherichia coli , followed by Klebsiella species and Enterobacter species). A diagnosis of acute cholangitis requires evidence of systemic inflammation, cholestasis, and imaging with biliary obstruction. Imaging studies may consist of ultrasound, computed tomography, magnetic resonance cholangiopancreatography, and/or endoscopic ultrasound. The mainstay of treatment consists of fluid resuscitation, antibiotics, and biliary drainage. Penicillin/β-lactamase, third-generation cephalosporin, or carbapenem are all acceptable choices for first-line treatment. In patients with severe cholangitis, biliary drainage should be performed within 24 hours. Patients with severe acute cholangitis require urgent (within 24 hours) biliary decompression. Endoscopic retrograde cholangiopancreatography remains the preferred modality for biliary drainage. In conclusion, acute cholangitis is mostly treatable when recognized and treated early. Recognizing and initiating early treatment leads to markedly decreased patient morbidity and mortality.

밸브의 내부 누설 현상은 밸브의 내부 부품의 손상에 의해 발생하며 배관 시스템의 사고와 운전정지를 일으키는 주요 요인이 다. 본 연구는 버터플라이형 밸브의 내부 누설에 따라 배관계에서 발생하는 음향방출 신호를 이용하여 배관 가동 중 실시간 누설 진단의 가능성을 검토하였다. 이를 위해 밸브의 작동 모드별로 측정한 시간영역의 AE 원시신호를 취득하였으며 이로부터 구축한 데이터셋은 데 이터 기반의 인공지능 알고리즘에 적용하여 밸브의 내부 누설 유무를 진단하는 모델을 생성하였다. 누설 유무진단을 분류의 문제로 정의 하여 SVM 기반의 머신러닝과 CNN 기반의 딥러닝 분류 알고리즘을 적용하였다. 데이터의 특징 추출에 기반한 SVM 분류 모델의 경우, 이 진분류 모델에서 구축된 모델에 따라 83~90%의 정확도를 나타냈으며, 다중 클래스인 경우 분류 정확도가 66%로 감소하였다. 반면, CNN 기반의 다중 클래스 분류 모델의 경우 99.85%의 분류 정확도를 얻을 수 있었다. 결론적으로 밸브 내부 누설 진단을 위한 SVM 분류모델은 다중 클래스의 정확도 향상을 위해 적절한 특징 추출이 필요하며, CNN 기반의 분류모델은 프로세서의 성능 저하만 없다면 누설진단과 밸브 개도 분류에 효율적인 접근방법임을 확인하였다.

작물 수분스트레스 지수(CWSI; Crop Water Stress Index)를 통해 관개 시기를 판단할 경우, 정확한 잎의 온도 및 대기 환경을 측정하는 것이 중요하다. 그리하여 본 연구에서는 실시간으로 작물의 생체정보(엽온) 및 대기 환경(대기온·습도, 일사량)을 측정하고 자동으로 CWSI 값이 산정되는 휴대용 수분스트레스 계측기기를 개발하였다. 또한 휴대용 수분스트레스 계측기기와 고정식 온도 측정 방법과의 비교 분석을 통해 휴대용 수분스트레스 계측기기의 성능을 평가하고자 하였다. 본 계측기기는 CWSI 산정을 위한 생체신호 및 기상 데이터를 측정하는 센싱부, 측정된 데이터를 저장하고 CWSI를 산정하는 데이터 수집부, 장치의 기능을 조작하고 측정값을 표시하는 시스템 제어부로 구성하였다. T-test를 실시하여 두 계측 방법에서 측정된 엽온, 일사량, CWSI 평균값의 유의 관계를 분석한 결과, 유의확률은 0.089, 0.318 그리고 0.028로 각각 나타났다. 엽온과 일사량은 유의수준 0.05보다 크므로 유의미한 차이가 나타나지 않았지만 CWSI는 유의확률이 유의수준보다 작으므로 두 측정 방법에 따라 유의미한 차이가 나타났다.

Acute cholecystitis (AC), defined as inflammation of the gallbladder, is mainly caused by gallstones. Over 90% of AC results from obstruction of the cystic duct by stones or sludge, which subsequently increases the intraluminal pressure within the gallbladder and, in conjunction with the presence of bile supersaturated with cholesterol, activates an acute inflammatory cascade. Clinical features play an important role in the diagnosis of AC. The Tokyo Guidelines 2018 for acute cholecystitis designates the presence of local inflammatory signs and systemic inflammatory signs for a suspected diagnosis. It requires confirmation by radiological imaging along with these two factors for a definitive diagnosis. Thanks to less invasiveness, easy availability, ease of use, and cost-effectiveness, ultrasound (US) is usually accepted as the first choice in suspicious AC patients. A meta-analysis comparing methods of diagnosis for AC reported that the US has 81% of sensitivity and 83% of specificity. Abdominal computed tomography is recommended for diagnosing emphysematous or gangrenous cholecystitis. Meanwhile, acute acalculous cholecystitis (AAC) is a life-threatening disease mainly in severely ill patients. It usually affects the patients hospitalized for multiple trauma, burns, cardiopulmonary bypass surgery, long-term total parenteral nutrition or sepsis. The diagnosis of AAC is quite challenging and requires a high index of suspicion. Currently, cholecystectomy is the treatment of choice for AC, although the optimal time for surgery is still controversial. Due to high morbidity and mortality in high surgical risk groups, percutaneous gallbladder drainage can be a safe and feasible alternative to cholecystectomy, particularly for patients unfit for the surgery.

Biliary tract cancer (BTC) are highly aggressive and fatal malignancies. As one of the leading cause of death in Republic of Korea, BTC amoung various malignancies has been one of major public health concerns in the country. Although BTCs, including intrahepatic, perihilar, and distal cholangiocarcinoma, are relatively low-incidence malignancies compared to other cancer, but they represent a major health problem in endemic areas like Korea and Asia contries; moreover, the incidence of intrahepatic cholangiocarcinoma is rising globally. Surgery is the only curative treatment. The optimal surgical approach depends on the anatomical site of the primary tumour, and the best outcomes are achieved through management by specialist multidisciplinary team. Unfortunately, most patients present with locally advanced or metastatic disease. Only up to 20% of patients are diagnosed in early-stage, suitable for the curative surgery. Despite the surgery performed with potentially-curative intent, recurrence rates are high, around 60-70% of patients expected to have disease recurrence. In this review, we present an update of the causes, diagnosis, and treatment with a focus on chemotherapy of BTC.

There is general acceptance that a diagnosis of acute pancreatitis requires two of the following three features: 1) epigastric or upper abdominal pain characteristic of acute pancreatitis, 2) serum amylase and/or lipase ≥3 times the upper limit of normal, and 3) characteristic findings of acute pancreatitis on abdominal images such as ultrasonography, computed tomography (CT) or magnetic resonance imaging. Other pancreatic diseases and acute abdomen have been ruled out before making a diagnosis of acute pancreatitis. Serum lipase may be more useful than serum amylase because serum lipase is thought to be more sensitive and specific than serum amylase in the diagnosis of acute pancreatitis. Contrast-enhanced CT scan is the best imaging technique to rule out the conditions that masquerade as acute pancreatitis, to diagnose the severity of acute pancreatitis, and to identify complications of pancreatitis. The etiology of acute pancreatitis should be made clear as soon as possible to decide treatment policy of acute pancreatitis or to prevent the recurrence of pancreatitis. The etiology of acute pancreatitis in an emergency situation should be assessed by clinical history, laboratory tests such as serum liver function tests, measurement of serum calcium and serum triglycerides and ultrasonography. A differentiation of gallstoneinduced acute pancreatitis should be given top priority in its etiologic diagnosis because early endoscopic retrograde cholangiopancreatography should be considered if a complication of cholangitis and a prolonged passage disorder of the biliary tract are suspected.

해양경찰은 구조, 재난관리, 치안유지, 마약 및 밀수 단속, 주변국 대응, 환경보전, 해양안보 등 다양한 업무를 수행하는 국 내 유일의 해양종합행정기관으로서 그 역할과 임무를 국민에게 제대로 알리는 홍보활동이 매우 중요하다. 하지만 해안가, 도서지역 주 민들을 제외한 대부분의 국민들은 일상생활에서 해양경찰의 치안행정 서비스를 직접 접하는 경우가 드물고, 이로 인해 해양경찰의 역 할과 임무에 대한 국민들의 이해도는 낮다. 이 연구는 해양경찰 재출범 3년차를 맞아 해양경찰 홍보 조직과 업무 현황을 고찰하고, 일 선 홍보담당자를 대상으로 설문조사하여 해양경찰의 홍보 실태를 진단하고, 해양경찰 홍보 강화방안을 제시하였다. AHP분석 결과 해 양경찰 홍보는 전담인력 증강 배치를 통해 홍보조직의 내실화를 기하고, 홍보대상에 따른 홍보 전략을 명확히 한 맞춤형 홍보를 강화 하며, 홍보 담당자의 직무교육을 강화하고, 홍보 업무에 대한 지휘관 및 내부 구성원의 관심과 지원이 필요한 것으로 나타났다.

Although fine-needle aspiration biopsy (FNAB) has been widely accepted as a valuable tool for differential diagnosis of head and neck tumors, the diagnostic value of FNAB in the management of salivary gland tumors has been questioned. This case report presents a patient with mucoepidermoid carcinoma of parotid gland diagnosed as pleomorphic adenoma by FNAB and discusses the pitfalls in the diagnosis of malignant salivary gland tumors.

The purpose of this paper is to understand the key factors for efficient maintenance of rapidly aging facilities. Therefore, the safety inspection/diagnosis reports accumulated in the unstructured data were collected and preprocessed. Then, the analysis was performed using a text mining analysis method. The derived vulnerabilities of tunnel facilities can be used as elements of inspections that take into account the characteristics of individual facilities during regular inspections and daily inspections in the short term. In addition, if detailed specification information and other inspection results(safety, durability, and ease of use) are used for analysis, it provides a stepping stone for supporting preemptive maintenance decision-making in the long term.