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 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.

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.

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.

스마트폰용 영상품질 측정을 위한 주관적 화질평가 분석

김성철,김병일,Kim, S.C.,Kim, B.I. 한국전자통신연구원 2013 전자통신동향분석 Vol.28 No.3

본고에서는 ITU-T P.910 권고사항을 이용하여 영상 화질의 주관적 평가를 실시하였다. 최악의 평가 결과의 경우를 고려하더라도 스마트폰 등의 무선단말기에서는 500kbps 이상으로 부호화할 경우 원본의 영상과 뚜렷한 차이를 인지하지 못하는 것으로 분석되었으며, 원본영상 대비 테스트 영상의 주관적/객관적 화질평가 결과는 시각적으로 원본 영상과 테스트 영상 간의 품질 차이를 인지하지 못하는 수준인 것으로 나타났다. 이와 같은 점을 고려할 때 입력 영상 및 출력 영상 그리고 대역폭 관계를 고려하여 타깃 비트 레이트(target bitrate)를 적절하게 설정하는 것이 필요하다. 비트 레이트가 증가함에 따라 느끼는 이용자들의 주관적인 만족도는 점차 감소하지만, 네트워크 비용은 체증하기 때문에 적절한 수준의 비트 레이트 설정이 사회적으로 바람직할 수 있다.

수순(水醇)추출법으로 조제된 오공 약침액의 생리활성 효과

김성철,서근영,이성원,박성주,김재효,안성훈,황성연,Kim, Sung-Chul,Seo, Geun-Young,Lee, Sung-Won,Park, Sung-Joo,Kim, Jae-Hyo,Ahn, Seong-Hun,Hwang, Sung-Yeoun 대한약침학회 2010 Journal of pharmacopuncture Vol.13 No.3

Reactive Oxygen Species(ROS) are continuously produced at a high rate as a by-product of aerobic metabolism. Since tissue damage by free radical increases with age, the reactive oxygen species(ROS) such as hydrogen peroxide($H_2O_2$), nitric oxide(NO). Several lines of evidence provided that ROS appears to cause to develop aging-related various diseases such as cancer, arthritis, cardiovascular disease. Our reserch objective was to examine the in vitro biological activity of Scolopendrid Pharmacopuncture, including the total poly-phenol content, DPPH radical scavenging, ABTS radical scavenging, Superoxide dismutase(SOD)-like activity, Nitrite scavenging ability. The total poly-phenol contents of Scolopendrid Pharmacopuncture was 35.859mg/L. Elctron donation ability on DPPH was 36.82%. The 2,2'-azinobis-3-ehtlbezothiazoline-6-sulfonic acid radical decolorization (ABTS) was 84.7%. The superoxide dismutase (SOD)-like activities of Scolopendrid Pharmacopuncture was 44.33%. The nitrite scavenging effects were pH dependent, and were highest at pH 1.5(45.2%) and lowest at pH 6.0(11.3%). We conclude that Scolopendrid Pharmacopuncture may be useful as potential sources of antioxidant.

항문직장기형의 교정

김성철,Kim, Seong-Chul 대한소아외과학회 2006 소아외과 Vol.12 No.1

Major advances in the management of anorectal malformations have been achieved during the last 20 years. Alberto Pena introduced the posterior sagittal anorectoplasty (PSARP) in 1982. He divided all the sphincteric muscles at the exact posterior midline and fully exposed the crucial anatomy. He was able to manage the associated fistula under direct vision with minimal urinary tract injury. The rectum could be placed in the middle of the sphincteric muscle complex. Even with PSARP by Alberto Pena himself, only 37.5% of all cases were considered totally continent. Anorectal malformation is still acontinuing challenge for the pediatric surgeons.