척추 종양수술에서 적절한 수술적 절제연을 얻기 위한 수술 중 네비게이션의 역할: 증례 연구

김상일,Samarth Mittal,고영일,고명섭,김영훈 대한척추외과학회 2024 대한척추외과학회지 Vol.31 No.1

연구 계획: 증례 연구목적: 본 연구는 척추 종양 수술 시 O-arm 네비게이션을 이용하였을 때 적절한 수술 절제연을 얻는 비율과 종양학적결 과에 대하여 확인하고자 하였다. 선행 연구문헌의 요약: 최근 척추 종양 수술 영역에서 수술 중 컴퓨터 단층촬영(CT) 기반의 네비게이션을 이용한 수술이 이루어지고 있다. 하지만 이러한수술방법이 수술 과정에 실제로 도움이 되고 더 나은 임상결과를 보여주는지 여부는 명확하지 않다. 결과: 네비게이션과 관련된 수술 중 합병증은 발생하지 않았다. 종양학적 결과에서는 6명의 환자가 생존하였으며, 이 중 5명은 질병의 증거가 없는 상태로 생존하였으며, 한명의 환자는 질병을 가진 채로 생존하였다. 한명의 환자는 6개월 추시 후 사망하였다. 네비게이션 이용 수술은 7명 중 6명의 환자에서(85.7%) 외과적 음성 절제연을 얻는데 도움이 되는 것으로 확인 되었으며, 종양의 단독 전이가 있는 환자 중 한명에서 절제연이 종양을 포함한 것으로확인되었다. 생존한 환자 6명 중에서 천골 골육종 환자 1명이(16.7%) 위성병변으로 국소재발이 발생하였고, 재수술을 실시했다. 결론: 척추 종양에 대한 CT 기반 네비게이션 수술은 정확한 재건술 뿐만 아니라 수술적 절제연의 결정에 유용할 수 있다. 수술 전 철저한 영상의학적 검토와 수술 중 네비게이션의 이용은 안전한 절제연을 얻는데 도움이 될 수 있다. 약칭 제목: 네비게이션을 이용한 척추 종양 절제술 Study Design: Case series Objective: This study aimed to assess the proportion of adequate surgical margins in spine tumor resection procedures using O-arm navigation-assisted surgery, and to examine the associated oncologic outcomes. Summary of Literature Review: Computed tomography (CT)-based intraoperative navigation has been relatively recently adopted for spine tumor surgery. However, whether navigation-assisted surgery shortens procedures and leads to better clinical outcomes remains unclear. Materials and Methods: A retrospective review was conducted on seven patients who underwent tumor resection with O-arm navigation assistance. Clinical data such as general demographic characteristics, intraoperative efficacy of this system for reconstruction, perioperative complications, oncologic outcomes, and pathological reviews of the surgical margins were collected. Results: No intraoperative complications were associated with the use of the navigation system. In terms of oncological outcomes, six patients survived, with five showing no evidence of disease and one remaining alive with disease. One patient died after a 6-month follow-up period. Navigation proved beneficial in achieving negative resection margins in six out of seven patients (85.7%), while only one patient with solitary metastasis showed margin involvement of the tumor. Among the six surviving patients, one with sacral osteosarcoma (16.7%) experienced local recurrence due to a satellite lesion, leading to revision surgery. Conclusions: CT-based navigation-assisted surgery for spinal tumors could be useful not only for accurate reconstruction, but also for determining the surgical margin. A thorough preoperative radiological review and intraoperative navigation could provide additional benefits for a safe resection margin.

Review of family Lucanidae (Insecta: Coleoptera) in Korea with the description of one new species

김상일,김진일 한국곤충학회 2010 Entomological Research Vol.40 No.1

This paper provides a review of the family Lucanidae in Korea, which consists of 17 species belonging to 9 genera. One new species, Dorcus tenuihirsutus sp. nov., is described and the following taxonomical changes are proposed: Aegus laevicollis Saunders, 1854 is newly identified as Aegus laevicollis subnitidus Waterhouse, 1873; Macrodorcas striatipennis Motschulsky, 1861 is removed from the Korean fauna because this record is thought to have been based on the misinterpretation of locality and misidentification; Neolucanus saundersii Parry, 1864 is removed from the Korean fauna because this record is thought to have been based on misidentification.

저탄소 녹색성장 사회구현을 위한 환경산업 · 기술 육성 전략

김상일 한국대기환경학회 2009 한국대기환경학회 학술대회논문집 Vol.2009 No.5월

포스트 植民地文學硏究所식민지문학연구소의 부설을 위하여

김상일 문예운동사 2007 문예운동 Vol.- No.93

근대 擎雲元奇와 儒·佛의 交遊詩文에 대하여

김상일 한국동양철학회 2018 동양철학 Vol.0 No.50

This paper is written about the significance of Kyo-Yu-Simoon(the poems and novels about association) written by Kyoung-Un-Wonki, Confucianists and Buddhist monks. Kyoung-Un-Wonki(called Kyoung-Un) was praised as a great teacher and a high priest of Buddhism with learning and virtue in the late 19th and early 20th centuries. Also, he had a great asceticism. These his presences made a lot of people(like monks and Confucainists etc) come close to him. In this period, the poems and novels written by them show a affinity between Confucianism and Buddhism. Kyoung-Un’s poems and novels was written about shame. He stated about a moral and mental awareness occurred while he was practicing asceticism in his works. Meanwhile, he answered to the monks close to him through the message with his works, and he also sent a message what he had explained about Buddhism to his students. We can find his true heart and modesty in these messages. Moreover, the Confucianists and monks who had a friendship with him wrote about the poems and novels praising his learning and virtue. In this way, his great features made Confucianists weaken their class consciousness. Especially, his style of writing Chinese poems was a important measure what had kept a friendship between Confucianists and Buddhist monks. 이 글은 擎雲元奇와 佛僧 및 儒家들의 교유 과정에서 생산된 交遊詩文을 경운원기 를 중심으로 살펴 그 의의를 밝힌 것이다. 19세기 후반에서 20세기 전반,선암사의 擎雲元奇(1852~1936)는 높은 학덕과 근실한 수행력을 갖춘 講伯, 高僧으로 칭송되었다. 경운은 화엄학과 선학을 회통하고, 또 불교와 유교를 회통하는 선암사의 학풍에서 성장한 강백이었다. 경운의 이러한 풍 모는 주변에 불승은 물론 유가들까지 다가오게 하여 그와의 교유를 꺼리지 않게 하 였다. 이 때 이들이 漢詩文으로 형상화한 교유시문은 당시 유불들 간의 교유의 정도 를 짐작케 한다. 경운의 交遊詩文에는 대개 慙愧[부끄러움]의 주제의식이 들어있다. 이러한 부끄러움 은 그가 자신을 돌아보는 수행 과정에서 일으킨 도덕적 심리의식이라 생각된다. 한 편 그는 가까운 불승들의 시에 화답하고, 제자들에게 서간을 보내 안부를 묻고 격려 하거나 불교의 요점을 전하기도 하였다. 그런 시문과 서간에는 상대에 대한 진정과 겸손이 짙게 배어 있다. 한편, 그와 교유한 불승과 유가들도 시문을 지어 고승다운 그의 학덕과 근실한 수행의 면모를 칭송하였다 이처럼 경운의 높은 학덕과 근실한 수행력은 아직 엄존해 있던 유가들의 班常의식을 얼마간 누그러뜨리고 그들을 불러들인 영향력이 있었다. 특히 경운의 전근대 전통의 한시문 능력은 그들과의 교유를 유지하는 중요한 수단의 하나였음을 알 수 있다.

동명 정두경의 정치적 불우와 도선에의 경도

김상일 동국대학교 한국문학연구소 1992 한국문학연구 Vol.0 No.15

Validity of iPad for Remote Diagnosis of Rib Fracture

김상일,조영신,이영주,장혜영,박준범 대한응급의학회 2015 大韓應急醫學會誌 Vol.26 No.5

Purpose: In elderly and patients with underlying diseases, mortality rate is increased when compared to rib fractures which occurred in other patients. Because there is a shortage of emergency physicians or real-time consultation with radiologists in many countries, it is necessary to receive a formal image reading remotely from an expert. We suggested the use of iPad in X-ray reading and compared the diagnostic validity of iPad, which was highly portable, with that of liquid crystal display (LCD) monitor. Methods: Fifty four X-ray cases of rib fracture and 54 cases without rib fracture were randomized and reviewed by 10 emergency physicians. A total of 108 cases were divided 1st to 54th and 55th to 108th. Two sessions were separated with a four-week interval. If the reviewer interpreted the 1st to 54th with iPad, they did 55th to 108th with LCD monitor. Reviewers reported the presence of rib fracture, the number of fractured ribs, and diagnostic confidence of 5-scale. Results: The interobserver agreement among reviewers in LCD and iPad was 0.551, 0.524 in Fleiss-kappa value. The intraobserver agreement between tools for each reviewer was 0.410-0.859 (Mean=0.628±0.150). Reviewers showed sensitivity over 0.810 regardless of the tool; 0.810- 0.966 (Mean=0.879± 0.054) in LCD, 0.828-1.000 (Mean=0.898±0.052) in iPad. The specificity was 0.520- 0.860 (Mean=0.750±0.117) in LCD and 0.560-0.880 (Mean=0.708±0.111) in iPad. Therefore, remote consultation of X-ray by iPad with a specialist was possible with minimized temporal and spatial limits in the emergency room. Conclusion: In our study, there was no statistical difference in the diagnosis of rib fracture by X-ray via iPad or LCD. Therefore, remote consultation of X-ray by iPad with a specialist in the emergency room was possible, with temporal and spatial limits by iPad.

대담 : 경산 호문혁 교수 정년기념 대담

김상일,오정후,이완근,임상혁,이상훈 서울대학교 법학연구소 2013 서울대학교 法學 Vol.54 No.3

낙동강 하구의 담수 방류와 표층 수온 및 염분 반응 : 계류형 센서 연속관측 결과

김상일,윤석현 해양환경안전학회 2019 해양환경안전학회지 Vol.25 No.1

Mooring observations of water temperature and salinity were conducted to investigate the effects of freshwater discharge patterns on the mouth of Nakdong River from April 2017 to March 2018. More than 500-1000m³ s⁻¹ d⁻¹ of freshwater was frequently discharged into the estuary throughout the rainy season, but less than 200m³ s⁻¹ d⁻¹ was discharged through the normal season. Sluice gates of the estuarine barrage operated depending on the tide level during spring tide, but they were constantly open during neap tide. Water temperature and salinity fluctuated regularly with intermittent discharges of freshwater, whereas they were stable while freshwater discharge was continuous. Mean salinity was 29 during the study period. Salinity exceeded the mean value in the normal season and rapidly recovered after a temporary reduction. In contrast, water with salinity below the mean value prevailed in the estuary for three months over the rainy season. These results indicate that water temperature and salinity were affected by the amount of freshwater discharge, as well as the frequency of discharge on a large scale and the time over which the freshwater discharge continued. 낙동강 하구에서 연속관측 자료를 바탕으로 담수의 방류와 수온 및 염분의 시간에 따른 반응을 조사하였다. 낙동강 하구 서쪽해역에 계류형 센서를 설치하고 2017년 4월 1일부터 2018년 3월 31일까지 10분 간격으로 수온과 염분을 측정하였다. 담수의 방류량은 평상시에 200m³ s⁻¹ d⁻¹ 이하로 유지되었으나, 풍수기에는 500~1000m³ s⁻¹ d⁻¹ 이상의 많은 양의 담수가 빈번하게 방류되었다. 담수의 방류는 대조기에는 간조를 전후하여 발생하였고, 소조기 동안에는 계속적으로 일어났다. 평상시에 수온과 염분은 소조기 동안 큰 변동 없이 안정되는 경향을 보이는 반면에, 대조기에는 방류주기에 따라 규칙적인 변동을 나타내었다. 연구기간 동안 염분은 평균 29이었으며, 평상시에 염분 농도는 평균 이상으로 유지되었고 일시적인 감소 이후에도 빠르게 회복되었다. 풍수기에는 약 3개월 동안 평균 이하의 저염환경이 지속되었다. 이러한 결과는 담수의 방류량뿐만 아니라 방류의 지속시간과 대량 방류의 빈도가 낙동강 하구의 표층 수온과 염분의 변동성에 영향을 미치는 중요한 요인이 된다는 것을 의미한다.

새로운 항진균제의 국내 사용 및 전망

김상일,강문원 대한감염학회 2010 Infection and Chemotherapy Vol.42 No.4

The incidence of invasive fungal infections has been increased worldwide along with the increasing population at high risk for fungal infection. However, no data is available for the current status of usage of antifungal agents in Korea. We described the usage of antifungal agents including second-generation triazole and echinocandins that have been recently introduced. Data from Health Insurance Review and Assessment Service were analyzed. Estimated total DDDs (daily defined doses)/1,000 patient-day of parenteral antifungal agents were 187.6 in 2008 and 143.2 in 2007 and annual rates of increase was 20% to 30% since 2004. Indeed, increased percentage of newer agents were observed. Changes of the treatment guidelines and the regulations for insurance coverage are considered to influence the trend of antifungal usage.