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이보인,이재광,이미진,박성수,정원준 대한응급의학회 2009 大韓應急醫學會誌 Vol.20 No.5
Purpose: Most emergency departments (EDs) treat prisoners; however, in so doing, there is often a disruption in the normal routines of the ED and associated problems for the treating physician. The current study was conducted to describe the use of emergency medical care by the prison population in an effort to better understand the needs of prisoners and to plan specific services to care for prisoners. Methods: We retrospectively analyzed 220 ED admissions involving 188 prisoners at Konyang University Hospital between August 2004 and January 2009. The medical records of all prisoners admitted to the ED were collected and analyzed from the ED computerized database. The following data were extracted for each prisoner: time and reason for admission, age, gender, Emergency Severity Index (ESI), final diagnosis, and disposition. Results: The 220 admissions (188 prisoners; mean age, 42.3 years; range, 20-78 years) consisted of the following: medical illnesses (64.1%), self-injuries (16.8%), surgical conditions (7.7%), injuries sustained from violence (6.4%), accidental injuries (3.6%), sports injuries (0.9%), and miscellaneous (0.5%). Eighty ED admissions (36.4%) had significant medical histories, including hypertension, diabetes, myocardial infarctions, and seizure disorders. Ninety-six ED admissions (43.6%) were subsequently admitted to the hospital as inpatients. Twenty prisoners visited the ED more than 1 time (a total of 52 times), including 2 prisoners who were admitted to the ED 5 times each. There were 19 ED admissions for ingestion of foreign objects by 15 prisoners. The most common foreign body was a metal wire. The overall mortality rate was 6.9%. Conclusion: Prisoners referred to the ED have serious medical conditions with a high mortality rate that require specific emergency management. In rendering care for a confined prison population, the ED staff should be aware of the increased risk of sudden cardiac death.
이보인,홍성필,김성은,김세형,김현수,홍성노,양동훈,신성재,이석호,김영호,박동일,김현정,양석균,김효종,전혜정 대한영상의학회 2012 대한영상의학회지 Vol.66 No.4
우리나라에서 대장암은 남성에서 두 번째, 여성에서 네 번째로 빈번하게 발생하는 암이며, 대장폴립의 발생률도 증가하고 있어서 효율적인 대장암 선별검사의 필요성이 제기되었다. 특히 대장암은 전암병변인 샘종에서 암종으로의 암화과정을 거치기 때문에 대장샘종을 조기에 발견하여 이를 제거하는 것은 대장암 발생을 감소시키기 위한 가장 효과적인 방법이다. 이에 따라 대장암의 선별 및 대장폴립 진단을 위한 국내의 진료 가이드라인의 필요성이 제기되었고, 다학회 기반으로 구성된 가이드라인 개발 실무위원회에서 문헌고찰과 메타분석을 토대로 국내 진료환경에 적합한 근거 중심의 가이드라인을 개발하였다. 본 가이드라인에서는 최근의 국내 대장암 및 대장샘종의 역학과 대장암 선별과 대장폴립 진단을 위한 대변잠혈반응검사, 영상의학 검사, 내시경검사의 효용성에 대해 기술하였다.
할머니와 손녀에서 발생한 Microsporum canis에 의한 체부백선
이보인,박영민,이지현,이준영 대한의진균학회 2014 대한의진균학회지 Vol.19 No.2
Microsporum (M.) canis is one of the zoophilic dermatophytes which can cause ringworm in catsand dogs and is responsible for 3~30% of tinea corporis and tinea capitis in human. It is most likelytransmitted by contact with infected animals, but rare cases of person-to-person transmission and anoutbreak among school girls have also been reported. Herein we report on interesting cases of tineacorporis caused by M. canis in a grandmother and a granddaughter. A 63-year-old woman presented withpruritic, scaly, erythematous plaques on the post. neck and trunk which had started 2 months ago. Alsoher 9-year-old granddaughter presented with pruritic, annular, erythematous plaques on chest and backfor 7 days. They denied contact with animals. KOH smear showed several hyphaes on microscope. Fungus culture on potato dextrose agar showed growth of colonies with whitish fluffy surface and radialfolds, the dorsal surface of the colonies showed golden-brown color which were identified as M. canisin both patients. As for the grandmother the lesions improved with oral itraconazole 200 mg/day for 7days and topical antifungal cream for 5 weeks which resulted in marked improvement of the lesions.
이보인 대한소화기내시경학회 2013 Clinical Endoscopy Vol.46 No.5
Colorectal endoscopic submucosal dissection (ESD) still remains a technically difficult procedure. The maintenance of tissue tension and good submucosal exposure during dissection is one of the most important factors for an effective and safe dissection. Although various traction methods have been developed, traction by gravity is one of the most useful method for colorectal ESD. Traction using adjunctive devices can thus be reserved for extremely difficult cases or for endoscopists in their learning periods for colorectal ESD.
Indications, Knives, and Electric Current: What’s the Best?
이보인 대한소화기내시경학회 2012 Clinical Endoscopy Vol.45 No.3
Endoscopic submucosal dissection (ESD) was developed to overcome the limitations of conventional endoscopic mucosal resection (EMR), and ESD has been also applied for large colorectal neoplasms. Since colorectal ESD is still associated with higher perforation rate, a longer procedure time, and increased technical difficulty, the indications should be strictly considered. Generally, colorectal tumors without deep submucosal invasion or minimal possibility of lymph node metastasis, for which en bloc resection using conventional EMR is difficult, are good candidates for colorectal ESD. The ideal knife for colorectal ESD should avoid making perforations but can make a clean cut of optimal depth at one time. The ideal current for ESD differs depending on the procedure used, the surgical devices used, the tissue to be dissected, and the operator’s preference. Application of the optimal indications and improvements in the technical skill and surgical devices are required for easier and safer colorectal ESD.
Korean Guidelines for Colorectal Cancer Screening and Polyp Detection
이보인,홍성필,김성은,김세형,김현수,Sung Noh Hong,양동훈,신성재,Suck-Ho Lee,박동일,YOUNG HO KIM,김현정,Suk-Kyun Yang,김효종,Hae Jeong Jeon 대한소화기내시경학회 2012 Clinical Endoscopy Vol.45 No.1
Now colorectal cancer is the second most common cancer in males and the fourth most common cancer in females in Korea. Since most of colorectal cancers occur after the prolonged transformation of adenomas into carcinomas, early detection and removal of colorectal adenomas are one of the most effective methods to prevent colorectal cancer. Considering the increasing incidence of colorectal cancer and polyps in Korea, it is very important to establish Korean guideline for colorectal cancer screening and polyp detection. The guideline was developed by the Korean Multi-Society Take Force and we tried to establish the guideline by evidence-based methods. Parts of the statements were draw by systematic reviews and meta-analyses.?Herein we discussed epidemiology of colorectal cancers and adenomas in Korea and optimal methods for screening of colorectal cancer and detection of adenomas including fecal occult blood tests, radiologic tests, and endoscopic examinations.