악성 간문부 담관 폐쇄(malignant hilar biliary obstruction, MHBO) 치료를 위해 시행되는 내시경 담관배액술은 후속 치료, 생존율 및 환자 삶의 질 향상에 필수적이다. 그러나 간문부 담관의 복잡한 해부학적 특징으로 인해 시술의 난이도가 높고 시술 관련 우발증의 위험이 있다. 본 고에서는 완전 피막형 자가팽창성 금속 스텐트(fully covered self-expandable metal stent, fcSEMS)를 이용한 나란한 양측 삽입 담관배액술을 시행 후 근위부 담관내 이탈(proximal stent migration)이 발생한 증례를 보고한다. 현재까지 MHBO에 대해서는 어떤 종류의 스텐트를 어떠한 방법으로 시술할지에 대하여 충분한 근거가 정립되어 있지는 않다. 그렇지만 본 증례와 같이 fcSEMS를 사용할 경우 스텐트 이탈 위험성이 ucSEMS보다 높다는 것은 인지하고 있어야 하겠으며, 환자 진료 시 이러한 사항을 고려하여 적절한 대비가 필요하겠다. 향후 이러한 스텐트 이탈을 줄일 수 있는 다양한 예방법이 고안된다면 많은 도움이 될 것으로 기대 된다.

Farmland spatial data are needed as a basic information in conducting rational use of farmlands in regional scale. This study develops a method that can be used to make up such farmland spatial data in a simple way and to develop a technique to manage them in a unitary way, and examines the effectiveness of the technique by applying it to the case area. A method that Web-Service Raster Image and Digital Cadastal Map can be utilized as a base map was devised. It was designed applying the vector system, in which one lot of farmland is area unit. Raster image and field survey data were combined to increase the accuracy of data. The lot boundaries of the existing boundary map were adjusted to the shapes of actual farmlands using GIS edition function. A proper farmland use classification system to the area characteristics was established and data obtained from the field survey were coded. Usually it is very difficult to identify the size of one lot of actual farmland in the existing space data, based on the results of the case study, the result map showed actual topography very realistically. Also the frequently occurring lot divisions and the serious topographical modifications by natural disasters frequently have made it impossible to survey farmlands on the catastral map in the field. But the final map had a great usefulness in that it may solve such problems by expressing the filed survey results graphically.

The aim of this paper is to investigate the applicability of high spatial resolution remote sensing images for conducting the rural amenity resources survey. There are a large number of rural amenity resources and field reconnaissance without a sufficient preliminary survey involves a big amount of cost and time even if the data quality cannot always be satisfied with the advanced study. Therefore, a new approach should be considered like the state-of-the-art remote sensing technology to support field survey of rural amenity resources as well as to identify the spatial attributes including the geographical location, pathway, area, and shape. Generally high-resolution satellite or aerial photo images are too expensive to cover a large area and not free of meteorological conditions, but recently rapidly-advanced internet-based image services, such as Google Earth, Microsoft Bing maps, Bluebirds, Daum maps, and so on, are expected to overcome the handicaps. The review of the different services shows that Google Earth would be the most feasible alternative for the survey of rural amenity resources in that it provides powerful tools to build spatial features and the attributes and the data format is completely compatible with other GIS(Geographic information system) software. Hence, this study tried to apply the Google Earth service to interpret the amenity resources and proposed the reformed work process conjugating the internet-based high-resolution images like satellite and aerial photo data.