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PF5 and 6 coil assembly tool is used to transfer, support and align the PF 5 & 6 coil. The tools are comprised of PF5 lifting adapters, PF5 temporary support and align units, PF6 lifting adapters, and PF6 temporary support and align unit. PF 5 and 6 coil will be lifted from assembly hall to the tokamak pit using PF 5 and 6 lifting adapter. Then, PF5 and 6 will be temporarily placed on their temporary support and align unit. These temporary supports will be used until completion of sector assembly in tokamak pit. Then, PF5 and 6 coil will be aligned using the hydraulic jacks to their final position. The structural analysis has been performed to assess the structural integrity of the tools according to their design criteria and EN standards. PF5 and 6 lifting adapters are classified as the lifting accessory (EN 13155). PF5 and 6 temporary support and align units are classified as the steel structure (EN 1993) and the lifting table (EN 1570-1) as well, since the tools have functions of supporting and aligning. The structural stresses of the tools are lower than the allowable stress. This paper provides the design descriptions and the structural analysis results on PF 5 and 6 coil assembly tools.

An ITER Tokamak machine with a torus shape is composed of nine units of 40◦ sectors. The sector sub-assembly tool (SSAT) is dedicated assembly tool to integrate vacuum vessel (VV) sector, VV thermal shield (VVTS) segments, VVTS port shrouds, two toroidal field coils (TFC) and various intercoil structures into 40◦ sector. For the sub-assembly process of 40° sector, SSAT shall have sufficient strength to support and handle heavy components up to 1250 t. And fine alignment system to adjust components considering assembly tolerance should be designed and verified by appropriate means. Although the structural analysis and mock-up tests were completed, structural stability and alignment system should be verified through factory acceptance test with real component and system. In this paper, the factory acceptance test results of the sector sub-assembly tool including VV load simulation and partial load test of VVTS outboard (OB) sector frame will be presented to verify the structural assessment and adjustment of the component.

Sector Lifting Tool (SLT) is purpose-built tool for the lifting and transferring ITER components. The purpose of SLT is to lift and transfer Vacuum Vessel (VV) and Toroidal Field Coil (TFC) from Upending Tool to Sector Sub-assembly Tool (SSAT). After the sub-assembly at SSAT in ITER assembly hall, 40 °Sector which is composed of VV, VVTS and two TFCs is transferred from SSAT to ITER tokamak pit. Sector Lifting Tool and lifted components are connected with the lifting attachments. The lifting attachments have a same function as adaptor for interface between SLT and lifted component. The weight of assembled 40 °Sector is about 1250 tonnes. SLT is designed to withstand even two times component’s weight considering the safety factor of lifting accessary. This paper describes the design of Sector Lifting Tool and shows that the structural integrity has been verified through analysis. The structural analysis was performed in accordance with the ITER load specification and tooling procedure. In analysis result, the stresses and deflections turned out under the allowable ranges.

The Sector Sub-assembly Tool is a special tool for assembly of ITER Tokamak and is used to sub-assemble the 40° Tokamak sector which consists of vacuum vessel sector, vacuum vessel thermal shield sector and two toroidal field coils. The sector assembled in the assembly building is a basic and fundamental unit for the construction of the ITER Tokamak. The functions of the Sector Sub-assembly Tool are to support and handle heavy components which weigh up to 1200 t. The Sector Sub-assembly Tool is one of the most important tools to perform the assembly of ITER. To assess the design and structural integrity of the Sector Sub-assembly tool, the structural analyses have been performed under the load combinations according to load specifications. The results of the structural analyses show that the stresses of the Sector Sub-assembly Tool are below the allowable stress. This paper provides briefly the result of structural analysis for the Sector Sub-assembly Tool.

The purpose of the upending tool (UT) is upending the vacuum vessel (VV) 40-degree sectors and the toroidal field coils (TFC) from the horizontal delivery orientations to the vertical assembly orientations. According to ITER assembly procedure, this upending operation is carried out by four hooks of the tokamak crane. VV or TFC upended by UT is transferred to sector sub-assembly tool (SSAT) for sector sub-assembly. For this reason, UT is classified as a lifting accessory in the ITER load specification. This paper describes UT design and upending sequence by two cranes with target components (VV and TFC) and presents the analysis results performed for the final design to verify the structural integrity of UT. The analysis cases for this verification are composed of the horizontal and vertical supporting on the floor and lifting. The simplified FE models for the lifted components (VV and TFC) that are provided from ITER Organization Central Team (IOCT) are used for this structural analysis.

The tight tolerance requirement is one of key issue to manufacture the ITER blanket shield blocks (SBs) which have many interfaces with the First Wall (FW) and Vacuum Vessel (VV). Manufactured SB shall be satisfied with general tolerances (Class “C” of ISO 2768-1 and “L” of ISO 2768-2) and specific tolerance in 2D general assembly drawings. In order to fulfill the tight tolerance requirements in the final stage of SB, stress relieving after welding operations in the manufacturing process shall be performed. Hot helium leak test, Post Welding Heat Treatment (PWHT) and three-dimensional inspection before and after heat treatment were implemented by using the Full Scale Prototype (FSP) of SB in the framework of domestic R&D activities. The hot He leak test was performed at 250 °C for 30 min, and the result was satisfied the requirements. PWHT was carried out at 400 °C for 24 h by brazing furnace with test chamber. The deformation value before and after was measured by contact type coordinate measuring machine. The objective of this study is to verify dimensional stability of SB after stress relieving. The results will support to determine the machining allowance prior to welding process.

The ITER blanket Shield Block is a bulk structure to absorb radiation and to provide thermal shielding to vacuum vessel and external vessel components, therefore the most significant load for Shield Block is the thermal load. In the previous study, the thermo-mechanical analysis has been performed under the inductive operation as representative loading condition. And the fatigue evaluations were conducted to assure structural integrity for Shield Block according to Structural Design Criteria for In-vessel Components (SDC-IC) which provided by ITER Organization (IO) based on the code of RCC-MR. Generally, ASME code (especially, B&PV Sec. III) is widely applied for design of nuclear components, and is usually well known as more conservative than other specific codes. For the view point of the fatigue assessment, ASME code is very conservative compared with SDC-IC in terms of the reflected Ke factor, design fatigue curve and other factors. Therefore, an accurate fatigue assessment comparison is needed to measure of conservatism. The purpose of this study is to provide the fatigue usage comparison resulting from the specified operating conditions shall be evaluated for Shield Block based on both SDC-IC and ASME code, and to discuss the conservatism of the results.

The assembly and installation tools for the ITER Tokamak machine are special tools which are used to assemble and install ITER Tokamak machine components such as magnets, vessels and thermal shields. The sector sub-assembly tool, requiring six adjustable motions capable of movements in three directions and three-axis rotations for fine and precise alignments of the components of these tools, is a major and very large assembly tool with which to assemble vacuum vessels, thermal shields and two toroidal field coils in a 40° sector that forms the basic unit for the ITER Tokamak machine. To complete the 40° sector, the tool must maintain a sufficient degree of stiffness to support and handle heavy components which weigh up to 1200 tonnes. To meet the tooling requirements, the feasibility of the alignment system with regard to component adjustments in the sector sub-assembly tool was reviewed and verified in a mock-up test. In addition, a structural analysis using ANSYS to verify the structural stability levels under various analysis conditions was also carried out considering the safety factors and seismic load conditions according to the load specifications and codes. The sector sub-assembly sequence and the final design considering the results of the mock-up test and the structural analysis are presented.

The blanket shield block (SB) is located inside the ITER vacuum chamber, and the main function is to provide the thermal and nuclear shielding to the vacuum vessel and external components. The SB is foreseen to undergo a significant heat load which is a body load throughout the whole thickness of the SB under normal operation conditions. Therefore, the cooling configuration in SB should be designed very carefully based on the various experiences. The pressure drop in the cooling design is one of the most important factors to balance a water distribution of overall blanket cooling system. In order to verify the pressure drop characteristic and validate the design methodology of SB, experiment and numerical analysis are performed and compared their results. These results would be a benchmarking of the numerical results with experimental results to assess the gap between calculations and experiments.

The blanket shield block (SB) shall be required the tight tolerance because SB interfaces with many components, such as flexible support keypads, First Wall (FW) support contact surfaces, FW central bolt, electrical strap contact surfaces and attachment inserts for both FW and Vacuum Vessel (VV). In order to fulfil the tight tolerance requirement, stress relieving shall be performed for dimensional stability after cover welding operation. In this paper, effect of Post Weld Heat Treatment (PWHT) conditions, temperature and holding time, was investigated on the residual stress and hardness. The 316L Stainless Steel (SS) was prepared and welded by manual TIG welding by using filler material with 2.4 mm of diameter. Welded 316L SS plate was machined to prepare the specimen for PWHT. PWHT was implemented at 250, 300, 400 °C for 2 and 3 h (400 °C only) and residual stress after relaxation were determined. The evaluation of residual stress and hardness for each specimen was carried out by instrumented indentation technique. The residual stress and hardness were decreased with increasing the heat treatment temperature and holding time.

이 연구는 학생들의 대학 전공 선택과 과학학습동기의 관련성을 분석하였다. 이를 위해 인문계 고등학생들이 연구에 참여하였으며, 예체능계열 학생을 제외한 문과와 이과 학생 중에서 각 집단 별로 무작위적으로 추출된 2012명의 학생을 중심으로 분석하였다. 과학학습동기는 25개의 문항으로 구성되어 있는 Glynn et al. (2011)의 SMQ Ⅱ로 측정하였다. 연구결과 이과에서 비이공계로 진학한 학생이 전체이과학생 중 11.5%, 문과에서 이공계로 진학하는 학생들의 비율이 전체 문과학생 중 14.4%로 나타났다. 또한 계열과 다른 진로를 선택하는 비율에서 성차가 나타났다. 이과에서 비이공계로, 문과에서 이공계로 진학학 학생들의 과학학습동기의 세부요인의 차이를 확인한 결과 직업동기에서만 유의미한 차이가 나타났다. 과학학습동기는 진로 선택에 있어 중요한 예측 변인이었으며 그 중에서도 직업동기는 가장 큰 영향력을 가진 변인이었다. 계열과 다른 진로를 선택하는 학생들을 위한 교육적 장치가 필요할 것으로 판단되며, 그 보다 앞서학생들의 진로를 보다 면밀히 예측할 필요가 있다. 또한 과학학습동기 역시 그런 예측 변수로 판단되며, 학생들의 계열 선택 및 진로와 관련한 교수·학습 및 상담에서 학생들의 과학학습동기를 고려하는 것이 중요하다.

The ITER upper port stub extension (UPSE) which is welded on the upper position of the vacuum vessel (VV) is classified into 2 categories; one is called as the central (even) UPSE which is welded at upper central position of the VV sector at factory. The other is called as the lateral (odd) UPSE which is welded at upper lateral position of the VV sector. The central UPSE is welded at factory before delivery, but the lateral UPSE is welded after whole nine VVs welded in Tokamak pit. The final design including analysis considering design factor and mock-up test for the lateral UPSE assembly have been developed by the Korean domestic agency (KODA). For the final welding between UPSE and VV, alignment system to adjust the UPSE to its final position is also required to meet the functional requirements requested by IO-CT (ITER Organization Central Team). For the verification of the final design to check alignment system and traveling mechanism, a full scaled mock-up was fabricated and tested according to the technical requirement of the UPSE installation tool [ 8 , 9 ]. In this paper, the structural analysis to verify the structural integrity according to Machinery Directive and factory acceptance test (FAT), full load test to check the maximum bending deflection in the worst case, will be introduced.

이 연구는 과잉효능감과 과잉확신이 선다형과 서답형 평가에서 어떻게 나타나는지에 조사하였다. 이 연구를 위하여 204명의 여자중학교 학생들이 참여하였다. 선다형과 서답형으로 된 광합성 개념에 대한 검사도구를 사용하였으며, 각 문항마다 자신의 효능감과 확신을 척도로 나타나게 하였다. 연구결과 선다형과 서답형의 상관관계는0.5가 채 되지 않았으며, 학생들이 생각하는 자신의 문제 해결 능력(효능감)과 실제 능력 간의 상관관계 역시 0.45가 되지 않았다. 학생들은 선다형 문제 해결 과정에서 지식에 대한 확신을 높이는 경향을 보였다. 선다형 문항을 먼저 수행한 집단에서는 그렇지 않은 집단에 비하여 과잉 효능감과 과잉확신의 비율이 더 높게 나타났다. 이 연구결과는 학생들을 평가하는 과정에서 서답형의 사용을 늘릴 것을 제언한다. 또한 두 형태의 검사도구를 동시에 사용하게 될 경우 선다형검사도구를 사후에 사용하여 학생들이 적절한 수준의 효능감과 확신을 유지할 수 있도록 해야 될 것이다.

The objective of this paper is to analyze the structure of the wind power tree using a helical type wind turbine. The blades of a helical rotor is designed with a composite material. The structural analyses of a helical rotor have been implemented by finite element method. The structural analyses of the wind power tree which support four helical rotor, have been performed under a wind load, a rotational velocity of a rotor, and dead weight.

The objective of this paper is to develop 360 W class wind turbine tree using a helical type wind turbine. The performance of 100 W class helical wind turbine which finished the conceptual design has been forecast through the CFD analysis. After performed the analysis of one wind turbine perform-ance, four wind turbine have been installed at the structure of a tree type and then the change of a out-put data has been verified through the CFD analysis. In this study, the CFD results of a helical wind turbine tree have been shown by a velocity and pressure distribution. The result could obtain more than rated power 360 W through the CFD analysis. Keywords: Wind turbine tree, Vertical axis wind turbine, Rotor blade, Flow analysis, Helical wind turbine 1. 서 론 화석연료 사용 등으로 인한 CO 2 증가는 지구 온난화를 야기하며 기후변화 등 인류 생활에 큰 위협이 되고 있다. 이를 극복하기 위한 신재생에너지에 대한 연구는 선택이 아닌 필수이다[1].주위 경관을 고려한 풍력터빈 나무는 기존 나무의 개념을 새롭게 풍력터빈에 적용하여 재해석 한 것으로, 줄기 또는 기둥으로부터 가지가 뻗어나가는 개념을 응용한 것이다. 풍력터빈 나무에 적용되는 설비용량 100 W의 수직축 풍력터빈을 설계하였다. 풍력터빈 나무는 도심 및 공원 등에 설치 가능하여 소음 및 환경적인 요소를 고려하였을 때 100 W의 풍력터빈이 적합하다. 풍력터빈 나무는 단위 용량 100 W 풍력터빈 4기로 구성되도록 설계 하였다. 이 경우 풍력터빈 운전 시 후류에 의한 영향으로 풍력터빈 출력이 감소 될 수 있으며, 이는 단독 설치형 풍력터빈이 풍력발전단지를

Background/Aims: Recently, endoscopic papillary large balloon dilation (EPLBD) using a large balloon (12 - 20 mm) for extraction of difficult common bile duct (CBD) stones has been widely accepted with favorable outcomes. However, there is no consensus with regard to the ballooning time. The aim of our study was to evaluate the efficacy and safety of immediate balloon deflation in EPLBD for the treatment of difficult bile duct stone. Methods: This was a retrospective study of 80 consecutive patients with bile duct stones who were treated with an immediate balloon deflation method in EPLBD combined with endoscopic sphincterotomy (EST) between January 2010 and December 2012. Overall success rate, success rate at first ERCP, and the frequency of mechanical lithotripsy for complete stone removal were assessed for efficacy and safety was evaluated by assessing major complications. Results: Overall success rate for complete stone removal was high (78/80, 97.5%) and success rate for complete stone removal at first ERCP was 86.3% (69/80). The use of mechanical lithotripsy was 0% (0/80). The overall complication rate was favorable (5/80, 6.3%). PostERCP pancreatitis was observed in 3 patients (two: mild, one: moderate). In subgroup analysis, the presence of periampullary diverticulum was the only factor affecting the success rate at first ERCP. Conclusion: This study demonstrated the favorable outcome of immediate balloon deflation for treatment of difficult CBD stones and can be considered for clinical application.

Since the recommendation of blanket redesign by 2007 ITER design review, the blanket system has been developed in the framework of Blanket Integrated Product Team (BIPT) composed mainly of ITER organization (IO) and procuring parties. After the completion of blanket Conceptual Design Review (CDR), the design teams were organized to efficiently implement the preliminary and detailed design in a timely manner. The blanket shield block is a bulk structure to provide the nuclear shielding; therefore it should be designed to accommodate the nuclear heating in parallel with the mitigation of electromagnetic loading by slit optimization. This paper briefly describes the cooling optimization for the preliminary design of ITER blanket shield block 01, 02, 08 and 16. Three-dimensional hydraulic and thermo-mechanical analyses for the preliminary design modules of hybrid structure with poloidal and radial cooling concepts are performed under the inductive operation as a representative loading condition. The pressure drop, heat transfer and coolant uniformity in cooling passages are investigated in detail. In addition, the manufacturability of a blanket shield block is also considered as the important design constraint in the cooling optimization. Our stress evaluation follows the relevant codes and standards outlined in the design protocol provided by the IO. This paper presents the analysis results, identifies issues on the preliminary configuration and makes suggestions on the design improvements.

Background/aims Recurrence is an important late complication of endotherapy of bile duct stones. Endoscopic papillary large balloon dilation (EPLBD) can be used as an alternative method of removing difficult bile duct stones. The aim of this study was to evaluate short term clinical outcomes after removing common bile duct (CBD) stones using EPLBD. Methods A retrospective review was performed based on the medical records of 141 patients who received EPLBD, with or without endoscopic sphincterotomy, between September 2008 and February 2010. Of these, 50 patients, were enrolled in the study. Clinical and endoscopic parameters were analyzed to identify risk factors for CBD stones recurrence. Results Male:Female ratio was 22:28 (mean age, 67.4±14.4 years). Recurrence rate was 24.0% (12/50). Mean follow-up period was 10.8±4.5 months. Nineteen (38.0%) had a history of surgery and 20 (40.0%) were comorbid with periampullary diverticula. Mean diameters of the stones and CBD were 13.8±4.3 mm and 20.1±7.2 mm, respectively. In univariate analysis, large CBD stones (≥12 mm) and angulated CBD (angle ≤145°) were identified as the significant predictors of recurrence. In multivariate analysis, angulated CBD (angle ≤145°) was the significant independent risk factor for recurrence. Conclusions Close follow-up seems necessary in patients with angulated CBD (angle ≤145°).

Since the recommendation of blanket redesign by 2007 ITER design review, the blanket system has been developed in the framework of blanket integrated product team composed mainly of ITER organizati...

This study aims to make improvements to the standard estimation process used to estimate reasonable costs for construction work, and to suggest a work crew based estimation using a new cost estimation model. In addition, work crew shift combination and construction process were systematically organized in order to improve the estimation technique and the construction capability of the cement liquid waterproofing work for apartment buildings. In addition, in terms of manpower and productivity, analyses were performed on the cement liquid waterproofing work for apartment buildings with net areas between and , and the results were then compared with those calculated using the conventional work-crew based estimation method. Through this study, when the results of this study and those calculated by the conventional method were compared, for apartments with the net area of , the differences between specialists were shown to be 1.91 times to 2.13 times on average, while they were 8.82 times to 9.52 times between normal workers on average. For apartments with the net area of , the differences betweenspecialists were shownto be 1.89 times to 2.07 times on average, and 8.57 times to 9.38 times on average between normal workers.

In this study the mechanical behaviors of fiber metal laminates(FMLs) such as ARALL, GLARE and CARE which are recently developed as new structural materials and known to have excellent fatigue resistant characteristics while with relatively low densities compared to the conventional aluminum materials, are considered through the classical lamination theory. The mechanical properties such as elastic moduli, thermal expansion coefficients and hygro-thermally induced residual stresses in the fiber metal laminates are obtained and compared each other. Also, carpet plots of effective elastic moduli, Poisson`s ratio and the thermal expansion coefficient for GLARE FML are plotted.

BACKGROUND/AIMS A combination of peginterferon and ribavirin is the standard therapy for chronic hepatitis C (CHC). However, the respective study has not been carried out in a large scale in Korea. The purpose of this study was to collect the studies that have been reported in Korea in order to analyze the therapeutic effect of combination therapy and compare to find racial difference. METHODS Twenty-eight papers related to the therapeutic effect of combination therapy in CHC patients were analyzed based on pooled analysis. RESULTS Based on the analysis for genotype 1 in Korea, early virologic response (EVR), end of treatment response (ETR), and sustained virologic response (SVR) were 79.6% (125/157), 80.1% (166/207), and 62.7% (341/543). The EVR, ETR, and SVR for genotype 2 and 3 were 89.4% (119/133), 92.2% (203/220), and 84.1% (434/516). Data from other Asians showed that EVR and SVR for genotype 1 were 88.9% (290/326) and 64.4% (491/762) respectively and 88.8% (135/152), and 79.4% (151/190) for genotype 2 and 3 respectively. In Western, EVR and SVR for genotype 1 were 51.3% (1,981/3,860) and 42.4% (1,798/4,231) respectively, and for genotype 2 and 3 were 87.7% (350/399) and 77.8% (533/685) respectively. Based on the comparative analysis, no statistical difference in SVR between Koreans and other Asians (p=0.955) was observed; However, the SVR of Koreans was higher with significance than that of Westerns (p

This paper presents novel design and control of a single-wheel mobile robot that can balance on the single rope by air power induced from ducted fans. A single-wheel mobile robot called the single line play robot (SLPR) is designed for balancing on the rope. SLPR has three directional actuators to move on the plane. A roll angle is controlled for balancing by air pressure generated by ducted fans. The roll angle is detected by a tilt sensor and a gyro sensor. The complementary filter is used to fuse them together to obtain more accurate angle data. Since the main purpose of the single line play robot is to balance on the rope, a roll angle is actuated and controlled by air pressure to maintain balancing. Hardware implementation and sensor fusion are presented. Experimental studies of SLPR balancing control performances both on the floor and on the rope are presented.

We read with interest an article published recently in the World Journal of Surgery regarding the role of unilateral adrenalectomy in ACTH-independent macronodular adrenal hyperplasia (AIMAH) [1]. In our institution, we have experience with a few cases of AIMAH including the familial type that were all treated by bilateral adrenalectomy [2–4]. Among them, we initially treated one case of AIMAH by unilateral adrenalectomy; however, successive completion adrenalectomy was required owing to the detection of hypersecretion of cortisol in the remaining adrenal gland during follow-up [3]. A 39-year-old Asian woman was admitted to our hospital for evaluation and treatment of AIMAH. She had typical cushingoid features and hypertension. The 24-hr urinary free cortisol was 646 lg (20–90 lg/day). ACTH was not detectable. The computed tomography scan showed 2and 3-cm ovoid masses in both adrenal glands. Stimulation with mixed meal, arginine-vasopressin, luteinizing hormone, b-adrenergic agonist, serotonin, and upright posture did not change her cortisol secretion. Selective adrenal venous sampling was performed according to current recommendations [5]. It revealed a localized hyperfunctioning tumor in the left adrenal gland (Fig. 1). After laparoscopic left adrenalectomy was performed, the hypertension and cushingoid features disappeared, and the 24-hr urinary free cortisol level returned to normal. Thereafter, we have checked serial blood pressure measurements, the 24-hr urinary free cortisol level, and the size of the remaining adrenal gland. Two years after the left adrenalectomy, the patient became hypertensive again with an elevated 24-hr urinary free cortisol level and evidence of enlargement of the right adrenal gland. Completion adrenalectomy was performed laparoscopically. The patient is currently on replacement therapy with physiologic doses of steroid hormones. Many studies are underway to help define the pathophysiology of AIMAH, especially with respect to the underlying mechanisms of adrenal autonomy, including ectopic and eutopic expression of several candidate receptor genes in the adrenal gland [6]. When the molecular pathophysiology of AIMAH is completely understood, medical treatment with specific antagonizing agents or

경추 전방 고정판(anterior cervical plate)과 경추 뼈 나 사(cervical screw)를 이용한 경추 전방 유합술(anterior cervical fusion)은 경추부 퇴행성 질환과 외상성 손상 및 종양 에 의한 경추부 손상 등 신경외과와 정형외과의 경추부 척추 수술에 널리 이용되고 있는 방법이다. 하지만 이 방법은 식 도 천공, 심경부 감염, 종격동염, 기도 협착, 인후두 이물감, 연하통 등과 같은 이비인후과 영역과 관련한 합병증도 존재 한다. 이러한 합병증은 경추 전방 유합술을 시행하는 접 근법과 연관이 있을 수 있으며 수술 후 발생하는 고정판과 뼈 나사의 탈출에 의해서 발생할 수도 있다. 이 중 고정판과 뼈 나사의 탈출에 의한 합병증으로 식도 천공과 식도 누공은 종종 보고되고 있다. 최근 저자들은 경추 전방 고정판과 경추 뼈 나사를 이용한 경추 전방 유합술을 시행한지 5년이 지난 후 발생한 경추 뼈 나사의 탈출을 현수 후두경(suspension laryngoscope)을 이용하여 성공적으로 제거한 증례를 경험하였기에 문헌고찰과 함께 보고하고자 한다.

Background/Aims: Periampullary diverticulum (PAD) causes difficulty in the extraction of common bile duct (CBD) stones with conventional endoscopic therapy. Our study was designed to evaluate the effect of PAD on endoscopic large balloon dilation (EPLBD) with/without limited endoscopic sphincterotomy (EST) for CBD stone treatment. Methods: We retrospectively reviewed cases of 141 patients treated CBD stones by EPLBD with/without limited EST at Gachon Gil Medical Center from September 2008 to February 2010. PAD were classified into three groups according to the location of the papilla and diverticulum. Clinical parameters, endoscopic parameters, and procedure outcomes were analyzed. Results: PAD were identified in 46.1% (65/141), with 23 male (35.4%) and 42 female (64.6%) and a mean age of 72.9±11.1 years. Mean diameter of the stones was 14.8±6.0 mm and mean diameter of CBD was 21.6±7.7 mm. PAD group was significantly older than control group (72.9 vs. 68.6, p=0.043) and the incidence of large stone (≥15 mm) was higher in PAD group (60.0% vs. 42.1%, p=0.034). Success rate of complete removal of stones in the first session was 32/65 patients (49.2%) and overall successful complete stone removal rates was 63/65 (96.9%). There was no significant difference between the PAD and control groups in success rate. Major complications were similar between two groups. Conclusions: PAD is associated with an increased incidence of large bile duct stones and older age. PAD seems to not increase technical failure rate or complication risk on EPLBD with/without limited EST. (Korean J Gastroenterol 2011;58:201-207)

Organizing hematomas are rare benign tumors and appear as forms of mass which is composed of neovascularization with organizing fibrous tissue in hematoma. There have been sporadic reports of the organizing hematoma not only in soft tissue but also in brain, spinal cord, lung, and maxillary sinus. We report a case of organizing hematoma that was restricted in the nasal cavity without inclusion of the paranasal sinus. This is the first article describing the organizing hematoma of the nasal septum. We present this case with a review of literature. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:324-6 Key WordsZZOrganizing hematoma·Nasal cavity·Maxillary sinus·Tumor.