선천성 장폐쇄증 2차 조사 - 대한소아외과학회 회원을 주 대상으로 한 전국조사 -

김성철,김대연,김상윤,김인구,김인수,김재억,김재천,김현영,박귀원,박우현,박진영,서정민,설지영,오수명,오정탁,이남혁,이명덕,이석구,이성철,정상영,정성은,정연준,정풍만,최금자,Kim, Seong-Chul,Kim, D.Y.,Kim, S.Y.,Kim, I.K.,Kim, I.S.,Kim, J.E.,Kim, J.C.,Kim, H.Y.,Park, K.W.,Park, W 대한소아외과학회 2010 소아외과 Vol.16 No.1

본 조사는 2007년부터 2009년까지 3년간 본 학회 정회원들에 의하여 수술받은 장폐쇄증 환아를 대상으로 한 후향적 조사이다. 또한 본 학회에서는 1994년부터 1996년까지 3년간의 증례를 대상으로 같은 조사(1 차조사)를 진행한 바 있다. 1 차 조사와 비교하여 본 조사에서 보이는 특징은 아래와 같이 요약할 수 있다. - 총 증례 수는 비슷하였으나 출생률을 감안하여야 할 것이다. - 각 기형별 비율은 비슷하였다. - 미숙아 및 저출생체중아의 비율은 증가 하였다. - 산전진단율은 증가하였다. - 복부단순촬영만 한 경우는 감소하였다. - 다른 기형이 동반된 예가 증가하였다. - 사망률이 13.8 %에서 3.6 %로 감소하였다. 장운동의 회복은 공장폐쇄증에서 십이지장이나 회장폐쇄증에서 보다 더뎠다. 하지만 십이지장-공장 이행부에서 문합부까지의 거리가 기술되지 않은 예가 많아 소위 "High Jejunal obstruction"에서의 장운동 회복기간을 알아 보지 못 하는 아쉬움이 있었다. 또한 주름형성술(plication) 또는 장의 직경을 줄이는 수술(tapering)의 효과도 시행한 예수가 작고, 문합부 위치의 기술 부족으로 알아 보지 못 하였다. 십이지장폐쇄증의 화타씨유두부와 위치 역시 향후 보다 정확한 수술기록을 토대로 조사되어야 할 것으로 생각된다. 치료 성적의 눈부신 향상은 여러 회원들의 각고의 노력과 의학의 발달에 기인한 것으로, 사망률 0 %를 향한 노력이 지속되어야 할 것이다. The members of the Korean Association of Pediatric Surgeons conducted a retrospective study of two hundred and twenty-two cases of intestinal atresia for the period from January 1, 2007 to December 31, 2009. Seventeen hospitals were involved. There were 76 duodenal, 65 jejunal, and 81 ileal atresias (3 colonic). The male to female ratio was 0.85:1 in DA and 1.34:1 in JIA. Ninety-four patients(43.3 %) were premature babies (DA 40.3 %, JA 64.6 %, IA 28.8 %), and 70 babies (32.0 %) had low birth weight (DA 38.7 %, JA 44.4 %, IA 16.0 %). Antenatal diagnosis was made in 153 cases (68.9 %). However, 27 infants (17.6 %) with antenatal diagnosis were transferred to the pediatric surgeon's hospitals after delivery. Maternal polyhydramnios was observed in 81 cases (36.59 %) and most frequent with proximal obstruction. In forty-four cases (19.8 %), only simple abdominal film was taken for diagnostic study. The associated malformations were more frequently observed in DA - 61.8 % in DA and 22.6 % in JIA. Meconium peritonitis, small bowel volvulus and intussusception were more frequently associated with ileal atresia. The overall mortality rate was 3.6 %. (Abbreviations: DA;duodenal atersia, JA;jejunal atresia, JIA;jejunoileal atresia, IA;ileal atrsia).

선천성 식도무공증의 임상적 고찰

김성철,김대연,김애란,김기수,피수영,김인구,Kim, Seong-Chul,Kim, Dae-Yeon,Kim, Ellen Ai-Rhan,Kim, Ki-Soo,Pi, Soo-Young,Kim, In-Koo 대한소아외과학회 2003 소아외과 Vol.9 No.1

This study reviews 14 years' experience treating esophageal atresia with special emphasis on the clinical profile and outcome. From May 1989 to February 2003, 65 cases of esophageal atresia (EA) were treated at Asan Medical Center. Boys outnumbered girls 2.4 to 1. Prematutity and low birth weight were 27.7% and 38.5%. Esophageal atresia with distal tracheoesophageal fistula (TEF) was the most common type (87.7%), followed by pure EA and H type fistula. Forty-six patients (70.8%) had one or more associated anomalies, cardiac malformations were the most common. Duodenal atresia was found in 7 cases. There were 6 patients (9.2 %) with VATER cluster. VACTERL cluster was present in 18 patients (27.7%), one of who fulfilled the complete syndrome. Waterston group A, B and C made up 21.5%, 40.0% and 38.5% of the total group. Surgical treatment was attempted in 63 patients and deferred in 2 who had severe associated malformations. For EA with distal TEF, primary esophago esophagostomy was carried out in 51 cases, and division of TEF and gastrostomy in 4 cases and no operation in 2 cases. For pure EA, colonic graft was done in 2 after gastrostomy and esophagostomy, and esophago esophagostomy was performed in 2 after gastrostomy. Two patients with pure EA are waiting for the second operation after gastrostomy. Division of TEF was carried out in 2 cases with H type TEF. The overall survival rate was 76.9%, and survival by Waterston classification was 100% in group A, 80.8% in B and 60.0% in C. Thorough workup for associated anomalies, interdepartmental approach and more careful surgical decision and technique are required to improve the outcome of EA.

물관리시설에 AI적용을 위한 플랫폼 알고리즘의 중요성

김성철,류범수,장근수,김광식,정준연,구자옥,이권재,한동일,김창용,심규대,송성옥,박득호,우일,장인재,김석기,김성호,최범순,나병국,홍석환,Kim, Seong-Cheol,Ryu, Beom-Su,Jang, Geun-Su,Kim, Gwang-Sik,Jeong, Jun-Yeon,Gu, Ja-Ok,Lee, Gwon-Jae,Han, Dong-Il,Kim, Chang-Yo 한국수자원학회 2022 물과 미래(한국수자원학회지) Vol.55 No.8

소아 위식도 역류 질환의 외과적 치료

김성철,김대연,김경모,김인구,Kim, Seong-Chul,Kim, Dae-Yeon,Kim, Kyung-Mo,Kim, In-Koo 대한소아외과학회 2000 소아외과 Vol.6 No.2

Eleven children with gastroesophageal reflux disease underwent fundoplication. Eight had neurological impairment, two had hiatal hernias and one had a history of esophageal repair for esophageal atresia. The most common and significant symptom was vomiting(81.8 %), followed by recurrent respiratory infections(72.7 %) and failure to thrive(72.7 %). The most common diagnostic tool was 24 hour esophageal pH study, which showed pH less than 4 for more than 10 % of the total recorded time in 6 of 9 patients. Nissen fundoplication was performed in 10 patients. Thal fundoplication was carried out in one patient with esophageal atresia. Stamm gastrostomy was added for nutritional and/or swallowing problem in all 8 patients with neurological impairment. The median follow up period was 13 months. There was one late death of unrelated cause and one recurrence. The quality of life after antireflux surgery was greatly improved. Antireflux surgery should be done if indicated, and a simultaneous gastrostomy considered in a patient with neurological impairment.

일란성 쌍둥이 모두에서 발생한 식도무공증

김성철,남소현,김대연,김인구,Kim, Seong-Chul,Nam, So-Hyun,Kim, Dae-Yeon,Kim, In-Koo 대한소아외과학회 2009 소아외과 Vol.15 No.2

Although the incidence of esophageal atresia (EA) is higher in twins than in singletons by two to three times, EA usually affects only one member of twins. We report one pair of twins concordant for EA. A 31-year-old healthy woman bore monozygotic female twins at 36 weeks of gestation. They weighed 2,216 and 2,480 g, respectively. They had EA with distal tracheoesophageal fistula and underwent primary esophageal anastomosis on the birth day and the $2^{nd}$ day of life, respectively. Twin A also had suspicious antral obstruction and pyloroplasty was done simultaneously with esophageal repair. She needed antral web excision for continued gastric stasis one month after $1^{st}$ operation and three balloon dilatations of the esophagus. Twin B recovered uneventfully.

불순물 첨가 BGO 섬광체 단결정의 육성과 열형광 특성

김성철,김중환,김종일,정중현,도시홍,김기동,이대원 ( Sung chuel kim,Jung Hwan kim,Jong Il Kim,Jung Hyun Jeong,Sih hong Doh,Gi Dong Kim,Dae Won Lee ) 한국센서학회 1995 센서학회지 Vol.4 No.3

Eu or Fe doped BGO scintillation crystals were grown by Czochralski method. In order to get information about traps in the grown BGO crystals, we measured trap parameters including activation energy, frequency factor and the kinetic. order of thermoluminescence, and compared such parameters with thermoluminescent characteristics of pure BGO scintillation crystals. In addition, optical transmittance of the grown BGO crystals was measured.

소아 및 청년층의 치루와 항문주위농양

김성철,김진천,김인구,Kim, Soong-Chul,Kim, Jin-Cheon,Kim, In-Koo 대한소아외과학회 1995 소아외과 Vol.1 No.1

Anal fistula and perianal abscess in pediatric patients have been reported to have several characteristics, e.g. prevalent in less than 2 years of age, male preponderance, straight course of tract, and low type of fistula. We performed a retrospective study of twenty nine pediatric patients to see these characteristics comparing with the transitional age group of adolescents. Between June 1989 and December 1993, twenty-nine pediatric (<15year-old) and sixteen adolescent patients(${\geqq}$15, <25 year-old) with anal fistula and perianal abscess were treated by surgical intervention. Perianal abscess and anal fistula in the pediatric group had the predilection for male(100%), age less than two years (72.4%), low type(100%), and lateral localization(87.5%). But the features of the adolescent group were similar to those of adult. Twenty-one(87.5%) and 10(66.7%) enteric bacterial colonies were isolated from 16 pediatric and 11 adolescent patients, respectively. Considering the predominance of low type and the organisms cultured in the pediatric group, crypt-glandular infection seems to be a major preceding event. Incision and drainage were sufficient for cure in 15 among 16 perianal abscesses, and fistulas were cured by either fistulotomy or fistulotomy in all the 14 patients. The importance of effective drainage of perianal abscess and fistulotomy including internal opening cannot be overemphasized.

최신기술로 만드는 국내 최대 용량의 해수담수화시설 "대산임해산업지역 공업용수(해수담수화)사업"

김성철,구자옥,정준연,한동일,김용순,송성옥,윤정희,윤준석,박범주,이길영,안현,Kim, Seong-Cheol,Gu, Ja-Ok,Jeong, Jun-Yeon,Han, Dong-Il,Kim, Yong-Sun,Song, Seong-Ok,Yun, Jeong-Hui,Yun, Jun-Seok,Park, Beom-Ju,Lee, Gil-Yeong,An, Hyeon 한국수자원학회 2022 물과 미래(한국수자원학회지) Vol.55 No.4

슬라이딩 상관기를 적용한 디지털 직접대역확산 송수신기의 설계 및 성능분석

김성철,진고환,Kim, Seong-Cheol,Jin, Go-Whan 한국정보통신학회 2012 한국정보통신학회논문지 Vol.16 No.9

In this paper, we design the sliding correlator SS transceiver which supports short message service. We also analyze the PN code acquisition circuit that is essential for spread spectrum receiver. Using Maxplus II tool provided by altera Co., Ltd, we have designed PN code generator, and sliding correlator for PN code acquisition. Then, they have been made into FPGA by way of EPM7064SLC44-10 - a chip of Altera Co., Ltd. Additionally, we have designed delay clock circuit which is faster than the clock of Tx PN clock, designed switching circuit to control the clock rate and data demodulation circuit. The performance of the transceiver is evaluated from the experimental results. Especially, the performance of PN code acquisition accomplished by sliding correlator which is very important to evaluate spread spectrum receiver is evaluated with the comparison of the lock states. 본 논문에서는 sliding상관기를 적용한 단문 메세지 서비스를 위한 대역확산 송수신기를 설계하고 대역확산 수신기에서 필수적인 PN코드 동기회로에 대한 성능을 분석하였다. 대역확산 시스템에 대한 이론적인 분석과 대역확산 수신기에 있어서 중요한 PN 코드 동기 회로에 대한 분석을 토대로 PN 코드 발생기, 클럭 발생을 위한 분주회로, 수신기에서의 PN 코드의 상관을 위한 슬라이딩 상관기 등을 Altera사의 칩 EPM7064 SLC44-10을 사용하여 FPGA화하였으며 디지털 설계가 용이하지 않은 주변회로인 슬라이딩 상관기에 필요한 PN코드 지연 클럭 발생회로, 동기 스위치제어회로, 데이터복조회로를 설계하여 전체적인 송수신기회로를 설계하였다. 설계된 회로를 실험을 통하여 송수신기의 성능을 평가 관찰하였다. 특히, 수신기에 있어서 역 확산을 위한 PN 신호의 동기과정의 성능 즉, 동기가 이루어 졌을 때의 동기 탐색/유지신호와 동기가 이루어지지 않았을 때의 게이트 지연시간으로 인한 동기 탐색/유지신호등의 결과를 통해 성능을 평가하였다. 슬라이딩 상관기의 경우 코드 동기를 위한 시간이 송수신 PN 코드의 불확정성이 클 경우 상당히 큼을 알 수 있었다.

휴대용 핵종분석기를 활용한 사이클로트론실 내 차폐벽 방사화 평가

김성철,권다영,전여령,한지영,김용민,Kim, Seongcheol,Gwon, Da Yeong,Jeon, Yeoryeong,Han, Jiyoung,Kim, Yongmin 대한핵의학기술학회 2021 핵의학 기술 Vol.25 No.2

최근 사이클로트론 시설의 GMP 인증 및 핵의학과 검사 보험 미적용 등으로 인해 핵의학 검사 수가 감소함에 따라 사이클로트론도 조기에 해체될 가능성이 높다. 이에 본 연구에서는 사이클로트론 해체 시 방사성폐기물 발생량과 관련성이 높은 사이클로트론 차폐벽 내 방사성핵종을 확인하였다. 국내에는 해체가 진행중인 사이클로트론이 없으므로 사이클로트론 차폐벽 Coring이 불가능하고, 국내 모든 사이클로트론에 대한 실험을 수행하는 것은 현실적으로 불가능하다. 따라서, 대구 K대학교 병원 내 KIRAMS-13이 설치된 사이클로트론실에서 Target 진행 방향을 중심으로 총 30 곳에서 방사성핵종을 분석하였다. 본 연구에서 활용한 장비는 Thermo사의 RIIDEye이며, 측정 지점별 측정시간은 24시간으로 설정하였다. 측정 결과 일부 측정 지점에서 장반감기 방사성핵종인 Co-60과 Cs-137이 검출되었다. 또한, 가장 많은 측정 지점에서 검출된 Co-60의 방출에너지별 방사능을 확인한 결과, target 방향을 중심으로 우측 상부에서 좌측 하부로 이어지는 대각선 방향으로 방사능이 높은 것을 확인하였다. 따라서, 향후 사이클로트론 해체 전 차폐벽 coring 위치 선정 시 휴대용핵종분석기를 활용할 수 있을 것으로 예상된다. 하지만, 본 연구는 하나의 사이클로트론에 대한 실험 결과이므로 다수의 사이클로트론에 대한 추가 연구가 필요할 것으로 예상된다. 또한, 본 연구 결과는 휴대용핵종분석기를 사용한 연구결과로서 HPGe를 활용한 추가 연구를 수행하여 일치성을 확인하는 추가 연구가 필요할 것으로 판단된다. 최종적으로 다년간의 각 기관별 콘크리트 표면에서의 방사화 자료가 구축된다면, 사이클로트론 해체 준비 시 보다 정확한 방사성폐기물량을 예측할 수 있을 것으로 판단된다. Purpose There are many cyclotrons compared to the land area of the Republic of Korea. Because GMP certification is required and the nuclear medicine test does not apply for insurance, the number of examinations for nuclear medicine is decreasing. Therefore, there is a high probability of early decommissioning of the cyclotron. However, we do not unusually perform the radioactivation evaluation on concrete that can be classified as radioactive waste during the decommissioning of the cyclotron. In this study, we aim to confirm the radioactivation in the concrete surface using Handheld Radionuclide Identification Devices (RIDs). Materials and Methods Because there is no cyclotron being decommissioning in the Republic of Korea, it was impossible to perform the coring of concrete for radioactivation analysis. In this study, we used the KIRAMS-13 and analyzed the concrete surface in the target direction in the cyclotron room. After setting the target direction as the center, radionuclides were measured for about five months at thirty points with vertical and horizontal intervals of 30 cm. We used the RIIDEye(Detector: NaI(Tl) detector, manufacturer: Thermo) in this study and set the measurement time per point to one day (24 hours). Results Co-60 and Cs-137 were detected in some measurement points, and we confirmed the radioactivity of Co-60 detected at the most points. As a result, we found that the radioactivity of Co-60 was high in the diagonal direction (from the lower-left direction to the upper right direction) based on the center of the target. However, we think it is impossible to apply the corresponding results to all cyclotrons because we performed the study using only one cyclotron. Conclusion In thirty measurement points, we could confirm the radioactive nuclides and the relative radioactivity using the results of portable nuclides analyzer. Therefore, we expect that we can use the portable nuclides analyzer to select the coring position of concrete during the decommissioning of the cyclotron. Also, if we secure the radioactivation data for several years, we expect to make a more accurate estimate of radioactive waste during the preparation period of decommissioning of the cyclotron.