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.

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.

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

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.

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.

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.

광대역 멀티미디어 시스템을 위한 WLAN 시스템의 간섭신호 억제방안에 대한 성능분석

김성철,Kim, Seong-Cheol 한국정보통신학회 2011 한국정보통신학회논문지 Vol.15 No.10

2.4GHz 대역 무선통신망을 통해 서비스되는 WLAN과 WPAN시스템은 서로 동일한 환경하에서 상호 보완적인 서비스를 제공하고 있다. 이러한 두 시스템의 상호 패킷이 시간과 가우시안 거리의 불확실성에 존재할 경우 시스템간에 충돌이 발생하게 된다. 따라서 본 논문에서는 두 시스템간의 상호 공존의 방법을 도모하기위해 상호 간섭의 영향을 분석하고 두 서비스간의 공존을 위한 WLAN 시스템에 대한 WPAN 시스템의 간섭을 최소화하기 위한 WPAN신호 주파수 성분을 제거하기 위해 신호를 제공할 수 있도록 하는 제안된 방법에 대한 성능을 심볼 오차 확률에 대해 성능을 분석 하였다. The WLAN and WPAN systems employed on 2.4GHz ISM band wireless networks provide complementary services within the same environments. Coexistence between the networks will be impaired, if the mutual packets are uncertainty associated the timing or gaussian distance. This paper analyzes the impact of the mutual interference on the services performance and in order to minimize the effect of WPAN system signals on the WLAN system, proposed a method of suppressing the interference on the WLAN system. The analysis is illustrated by examining the symbol error rate versus signal to noise interference ratio in terms of the carrier frequency offset.

무선 센서 네트워크에서 공평성과 QoS를 지원하는 MAC 프로토콜

김성철,Kim, Seong-Cheol 한국정보통신학회 2012 한국정보통신학회논문지 Vol.16 No.1

본 논문에서는 무선 센서 네트워크에서 서비스의 질(Quality of Service: QoS)과 공평성을 지원하는 MAC 프로토콜(FQSM)을 제안한다. 제안된 FQSM 프로토콜에서는 센서 노드들이 측정 혹은 수신한 데이터를 전송 응급성에 따라 우선순위를 할당하며, 데이터 트래픽 간의 공평성을 지원하기 위해 부하 예측 알고리즘을 사용한다. 부하 예측 알고리즘에서는 현재 입력되는 부하에 기반으로 최대 전송에 대한 임계값을 조정한다. 이를 위해서 각 버퍼 길이가 연속적으로 일정기간 동안 모니터링 된다. 이 기간 동안의 버퍼 길이 변이에 기반으로 트래픽 부하가 예측되며, 이 예측된 값에 기반으로 전송 순위가 결정 된다. FQSM 프로토콜은 또한 cross-layer 개념을 도입하여 각 센서 노드에서 동일한 목적지로 향하는 데이터를 재정돈하여 가능한 적은 노드들만이 데이터 전송에 참여함으로 에너지를 절약함으로 전체 네트워크 수명을 연장한다. In this paper we propose the FQSM(Fairness and QoS Supporting MAC) protocol that supports fairness and Quality of Service(QoS). The received or measured data traffics will be assigned a priority level according to its transmission urgency in the FQSM. And the load prediction algorithm is used to support the fairness between different priority traffics. For this, the buffer length values of the nodes are continuously monitored for a some period. Based on the buffer length variations for this period, the order of transmission is determined. FQSM also adapts cross-layer concept to rearrange the data transmission order in each sensor node's buffer, saves energy consumption by allowing few nodes in data transmission, and prolongs the network lifetime.

동일 농도0.1mg/ml)의 Sweet Bee Venom과 봉약침의 퇴행성 슬관절염에 대한 임상연구

김성철,나원민,이성용,장은하,임승일,Kim, Sung-Chul,Na, Won-Min,Lee, Sung-Young,Jang, Eun-Ha,Lim, Seung-Il 대한약침학회 2008 Journal of pharmacopuncture Vol.11 No.1

Objectives : To verify pain relief effects and allergy inhibitory action for the osteoarthritis of the knee joint in Sweet Bee Venom in which allergy causing enzyme is removed. Methods : We randomly allocated 30 participants to treatment group Sweet Bee Venom and Bee Venom. Outcomes on pain reduction were measured by 100mm VAS(Visual Analog Scale). And we recorded into details allergic responses during Pharmacopuncture treatment. Results : Whole body condition and pain rate through VAS measurement were improved significantly in 2 weeks. We could get difference in pain score of two Pharmacopuncture groups significantly in 2 weeks. Sweet BV group($0.1{\beta}mg/m{\ell}$) showed superior reduction in pain compared to the BV group($0.1{\beta}mg/m{\ell}$) significantly. And other allergic responses such as edema, itchiness, pain were significantly lower in the Sweet BV group.