심장이식후 발생한 대장기종 ( Pneumatosis Cystoides Intestinalis )

이천균(Chun Kyun Lee),송시영(Si Young Song),이용찬(Yong Chan Lee),장병철(Byung Chul Chang),문영명(Young Myung Moon),강진경(Jin Kyung Kang),박인서(In Suh Park) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.5

Pneumatosis cystoides intestinalis(PCl) is a rare disease of undetermined etiology which is characterized by multiple gas-filled cysts in the wall of the small or large intestine or both. It is associated with various medicosurgical conditions including organ transplantation. Fewer than 50 cases of PCI occurring after organ transplantation including 4 cases of cardiac transplantation have been reported in the world literatures. We report a 47-year-old man of PCI who suffered from right lower quadrant abdomina) pain for 1 week. He was taken heart transplantation due to acute myocardiac infarction and ischemic cardiomyopathy 1 year ago. On plain abdominal X-ray revealed the multiple clustered localized collections of gas in the ascending and hepatic flexure of colon. Co]onoscopy showed the typical finding of PCI, which was multiple variable size protruding masses which apperared as round, soft, and somewhat bluish colored cysts. After the puncture of the above cystic mass using endoscopic injection needle, we can observe the deflation of the above ass. This is the first case in Korea. (Korean J Gastroenterol 1995;27: 732 - 737)

식도 운동장애를 동반한 횡격막상부 식도 게실증 3예

박인서(In Suh Park),강진경(Jin Kyung Kain),김충배(Choong Bai Kim),박효진(Hyo Jin Park),문병수(Byung Soo Moon),이천균(Chun Kyun Lee) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.5

Three patients with epiphrenic diverticula were reviewed with foci on esophageal dysfuntion and its relation to treatment. All cases were identified by bariurn esophagogram and confirmed by endoscopy. Manoetric studies of esophagus documented as diffuse esophageal spasm-like disorder in 1 case, and nonspecific motor disorder in 2 cases. One case was managed surgically, and the other 2 were treated conservatively. We found that epiphrenic diverticulum were associated with esophageal motility disorders. Treatment should be considered to focus on associated motility disorders as well as a diverticulum. (Korean J Gastroenterol 1997;29:687-693)

입원환자의 낙상 실태 및 위험요인 조사연구

윤수진,이천균,진인선,강중구,Yoon, Soo-Jin,Lee, Chun-Kyon,Jin, In-Sun,Kang, Jung-Gu 한국의료질향상학회 2018 한국의료질향상학회지 Vol.24 No.2

Purpose: The objective of this study was to report the incidence of falls in hospitals and analyze the risk factors for falls. Methods: This study used data on 1,216 patients who experienced falls from 2015 to 2017 during their hospitalization. The data was collected from the falls incident reports and patient' electronic medical record of hospital. Data were analyzed with descriptive statistics using Chi-square test, Fisher's exact test and multiple Poisson regression analysis with the SAS 9.4 Results: The incidence of falls was 1.38 per 1,000 patients days (2015), 1.81 per 1,000patients days (2016) and 1.99 per 1,000patients days (2017). The incidence of injury caused by falls (level III~V) was 0.05 per 1,000patients days (2015), 0.04 per 1,000patients days (2016) and 0.06 per 1,000patients days (2017). The largest number of falls occurred during night shift (42.5%), specifically in the patients' room (70.8%), and medical unit (66.0%). Average age of fallers was 69.1 years and 61.7% of them were older than 71 years. CCI and the patient's department have statistically significant differences in injury or injury levels from falls, but the integrated nursing care services had no significant difference in injury or injury levels from falls. Conclusion: The result of this study can be used as a reference for establishing a fall prevention strategy for hospitalized patients by presenting index values such as the fall rate.

태권도 도장 운영 실태조사를 통한 발전 방향

정명수(Myong-Soo Jung),이천인(Chun-In Lee) 한국스포츠산업경영학회 2003 한국스포츠산업경영학회지 Vol.8 No.2

현재 태권도 도장 경영의 어려움을 극복하기 위해서는 지도자의 끈임 없는 노력과, 태권도가 생활체육으로서의 태권도 보급에 중추적인 역할을 수행하기 위해서는 태권도장의 활성화가 가장 중요하다고 본다. 이에 본 연구자는 태권도의 활성 방안인 도장 운영의 교육현황 및 시설 현황, 수련생 및 학부모의 만족 등 운영 실태조사를 통하여 태권도 도장 발전 방향을 제시하는 데 목적이 있다. 이에 본 연구는 다음과 같은 결과를 얻었다. 첫째, 수련생의 연령이 초등학생이 70.9%로 가장 높게 나타나, 수련생의 분포가 유년화되고 있는 양상을 나타냈다. 또한 유급자 단계에서 승단과정에 이르는 시기에 현저히 수련인원이 떨어지는 현상을 보이고 있다. 둘째, 태권도 도장의 인지경로는 체육관 간판을 통해서 가장 많이 인지하는 것으로 나타나 체육관 위치가 중요한 것으로 사료된다. 셋째, 태권도 수련의 동기는 호신용으로 배우기 위해, 내성적 성격 때문에 순으로 나타나 호신술에 가장 많은 관심을 나타냈다. 넷째, 태권도 도장 수련 선택의 결정 요인 가운데 부모가 가장 중요한 요인으로 나타났다. 다섯째, 지도자의 교육현황에서는 태권도와 관련된 전공서적 보유율과 VTR 자료가 부족하고, 사범에 대한 자체교육도 부족한 것으로 나타나 태권도 교육의 질적 향상을 이루지 못하고 있는 것으로 나타났다. 여섯째, 태권도 수련 중 품새위주의 교육과 인성위주의 교육을 중요시 하는 것으로 나타나, 태권도의 전반적인 교육인 이론 및 격파술 등과 같은 폭넓은 교육이 필요하다고 사료된다. 일곱째, 태권도 수련 중 학부모들이 가장 우려하는 사항은 운동 시 부상당하는 것과 성격이 난폭해지는 것으로 나타나, 태권도 교육 중 이에 대한 방지 시스템을 모색해야 한다고 사료된다. 여덟째, 태권도 도장 시설만족도에서는 전반적으로 긍정적으로 나타났으나, 타 도장과의 경쟁과 생존 경쟁에서 살아남기 위해서는 더욱 시설만족도를 높이는 전략이 필요하다. The result of this research which has conducted over coaches, trainers, and parents to advance Taekwondo education through learning the management of training institutions was as following. First, the great percentage of people interested in Taekwondo training was younger generations. Second, gymnasium's location and signboards were very important to publicize. Third, the reasons to train Taekwondo were to protect themselves and to change their personality. Fourth, the reason to decide Taekwondo was because of children's parent. Fifth, education present condition of Taekwondo's problem were lack of the monograph possessions and VTR data. Sixth, Taekwondo education needs to educate the Taekwondo comprehensively like theory of Taekwondo. Seventh, Taekwondo education needs to grope some prevention systems of Taekwondo education. Eighth, Taekwondo gymnasiums need to raise facilities satisfaction to compete. After understanding the problems of Taekwondo training, one which nay help. First, the city and the state government must operate classes for Taekwondo coaches such as course for elementary physical education, old age, respiration of dan-qian, qi-gong, and Taekwondo gymnastics. Second, Taekwondo needs some precede new programs for being contact from children and toddlers to adult. Third, Taekwondo gymnasiums has to improve facilities for satisfaction.

두경부 악성 종양환자에서 조기 방사선치료를 위한 구강관리법에 대한 임상적 연구

문원규(Won-Kyu Moon),유재하(Jae-Ha Yoo),차인호(In-Ho Cha),김형준(Hyung-Jun Kim),정영수(Young-Soo Jung),이천의(Chun-Ui Lee),이종영(Jong-Young Lee),유미현(Mi-Heon Ryn) 대한구강악안면외과학회 2010 대한구강악안면외과학회지 Vol.36 No.6

Introduction: Tooth requiring extraction before radiotherapy in head and neck cancer patients should be performed as long as possible before the initiation of radiation therapy. Conventionally, a minimum 2-week waiting primary healing period is recommended. Although the above 2-week period is ideal, it is not uncommon for the radiotherapist and cancer patient to feel an urgent need to proceed with radiotherapy despite the need for dental care. Therefore, alternative approaches for early radiotherapy, including conservative endodontic treatment and a 1-week waiting primary healing period after dental extraction at the time of radiotherapy were considered and applied based on a literature review Materials and Methods: The clinical study involved 120 head and neck cancer patients who were treated at Wonju Christian Hospital, Wonju College of Medicine, Yonsei University, from January 1995 to December 2004. Results: In the clinical study, there were no specific complications, such as, post-extraction wound infections, radiation osteitis and osteoradionecrosis over the recent 10 years despite the early radiotherapy. Conclusion: Based on the clinical study, a minimum 1-week waiting primary healing period for oral care before radiotherapy is suitable for early radiotherapy in head and neck cancer patients.

입지환경인자를 이용한 강원도 지역의 수종별 지위지수 추정

신만용 ( Man Yong Shin ),원형규 ( Hyung Kyu Won ),구교상 ( Kyo Sang Koo ),정진현 ( Jin Hyun Jeong ),이천용 ( Chun Yong Lee ),김인호 ( In Ho Kim ) 한국농림기상학회 2002 학술발표논문집 Vol.2002 No.2

두경부 악성종양 환자에서 조기 방사선치료를 위한 구강관리법에 대한 실험적 연구

문원규(Won-Kyu Moon),차인호(In-Ho Cha),김형준(Hyung-Jun Kim),정영수(Young-Soo Jung),이천의(Chun-Ui Lee),이종영(Jong-Young Lee),유미현Mi-Heon Ryu),유재하(Jae-Ha Yoo) 대한구강악안면외과학회 2011 대한구강악안면외과학회지 Vol.37 No.3

Background: Teeth requiring extraction before radiotherapy in head & neck cancer patients should be removed as long as possible before the initiation of radiation therapy. Conventionally, a minimum 2-week waiting primary healing period is recommended. Although the above 2-week period is ideal, it was not uncommon for the radiotherapist and cancer patient to feel an urgent need to process with radiotherapy despite the need for dental care. Therefore, alternative approaches for early radiotherapy, including conservative endodontic treatment and a 1-week waiting primary healing period after dental extraction at the time of radiotherapy, were considered and applied based on the experimental study Materials and Methods: Eighteen dogs were processed for histopathologic wound healing. The effect of the primary endodontic treatment and extraction before early radiotherapy was examined. Results: No specific complication, such as, post-extraction wound infection, radiation osteitis and osteoradionecrosis, were encountered despite the early radiotherapy. Conclusion: Based on the experimental study, a minimum 1-week waiting primary healing period for oral care before radiotherapy is suitable for the early radiotherapy in head and neck cancer patients.

증례 : 다발성 식도 소세포암 1예

박무인 ( Moo In Park ),장희경 ( Hee Kyung Chang ),박선자 ( Seun Ja Park ),박이천 ( Lee Chun Park ),김규종 ( Kyu Jong Kim ),서정아 ( Jeong Ah Seo ),문원 ( Won Moon ) 대한내과학회 2007 대한내과학회지 Vol.72 No.4

소세포암의 원발 부위는 대부분 폐와 기관지이며 드물게 타액선, 인후두, 식도, 위, 대장, 직장, 전립선, 자궁경부 등에서 발생할 수 있다. 식도의 원발성 소세포암은 매우 드물어 전체 식도암의 약 0.8~2.4%를 차지한다. 국내에서는 지금까지 약 20예 정도의 원발성 식도 소세포암이 보고되었는데 이 중 다발성으로 발생한 증례는 없었다. 저자 등은 2개월 간의 연하곤란을 주소로 내원한 61세 남자의 상부 위내시경 검사에서 다수의 식도 종괴가 발견되어 조직생검을 시행한 결과 소세포암으로 확인된 1예를 경험하였기에 문헌고찰과 함께 보고한다. The extra-pulmonary sites of a small cell carcinoma are the salivary glands, pharynx and larynx, esophagus, stomach, pancreas, colon, rectum, skin and cervix. Primary small cell carcinoma of the esophagus is extremely rare with an incidence ranging from 0.8~2.4% of all esophageal malignancies. There have been approximately 20 cases reported in the Korean literature thus far. However, there has not been a reported case of multiple small cell carcinoma of the esophagus. We report a case of multiple small cell carcinoma of the esophagus in a 61-year-old man who presented with a 2 month-history of progressive dysphagia with a review of the relevant literature. (Korean J Med 72:406-410, 2007)

증례 : 복강 내 종양으로 오인된 미소 위유암종의 림프절 전이 1예

이지숙 ( Jee Suk Lee ),김규종 ( Kyu Jong Kim ),고지호 ( Ji Ho Ko ),박이천 ( Lee Chun Park ),문원 ( Won Moon ),박무인 ( Moo In Park ),박선자 ( Seun Ja Park ) 대한내과학회 2007 대한내과학회지 Vol.72 No.4

위유암종은 드문 질환으로 전체 원발성 위종양의 0.3%, 전체 유암종의 2% 이하로 알려져 있고, 대부분 무증상이다. 그러나 최근 들어 위내시경 검사의 시행이 빈번해지고 면역조직검사의 발달로 이들의 발견 빈도가 점차 증가하고 있는 추세이다. 위유암종은 크게 세 가지 형태로 분류되며, 산발적으로 발생하는 제3형의 경우 공격적인 임상상을 가지고 전이가 잘되는 것으로 알려져 있으나, 크기가 1.0 cm 이하인 미소 위유암종의 경우 일반적으로 전이는 극히 드물다. 저자 등은 연고지 병원에서 우연히 발견된 복강 내 종물을 주소로 내원한 42세 여자의 상부 위내시경 검사에서 약 0.8 cm 크기의 미소 위유암종을 발견하여 내시경적 절제술을 시행한 후 복강 내 종물에 대한 외과적 절제에서 이들이 위유암종의 림프절 전이로 확인된 1예를 경험하였기에 문헌고찰과 함께 보고한다. Gastric carcinoid tumors have been regarded as rare neoplasms, accounting for just 0.3% of all gastric tumors and fewer than 2% of all carcinoid tumors. Recently, there has been an increase in the number of reported studies of gastric carcinoid tumors with the widespread use of gastroscopy and improvements in immunohistochemical methods. Gastric carcinoid tumors are classified into three types. For type III gastric carcinoids not associated with hypergastrinemia, which tend to be larger and demonstrate a biologically more aggressive behavior with metastasis, and also for sporadic lesions, excision with regional lymph node clearance has been recommended. Tumors that are less than 1cm in size are called minute carcinoids, which seldom give rise to regional lymph node metastasis, except in rare cases. We report here a rare case of a minute gastric carcinoid tumor with regional lymph node metastasis that was misdiagnosed as an intraabdominal mass in a 42-year-old woman. Furthermore, we review the available literature on this entity. (Korean J Med 72:411-414, 2007)

위 점막 병변의 겸자 생검과 점막절제술 후의 조직 진단의 비교

김지연 ( Jee Yeon Kim ),이시원 ( See Won Lee ),박이천 ( Lee Chun Park ),신중광 ( Jung Kwang Shin ),박남영 ( Nam Young Park ),문원 ( Won Moon ),김규종 ( Kyu Jong Kim ),박무인 ( Moo In Park ),박선자 ( Seun Ja Park ),장희경 ( Hee Ky 대한내과학회 2006 대한내과학회지 Vol.71 No.6

목적: 위 선종의 정확한 조직학적 진단은 중요한데 이것은 전암성 병변과 국소적 위암과 연관되어 있다는 보고가 있기 때문이다. 그러나 위 선종의 경우 내시경 생검과 점막 절제술로 절제된 조직과의 진단이 일치하지 않는 경우가 관찰된다. 이에 위 선종 및 조기위암으로 의심되는 병변에 대한 내시경 생검과 점막절제술 후의 조직소견의 차이를 내시경 소견에 따라 분석하여 보고자 하였다. 방법: 2002년 5월부터 2004년 8월까지 고신 대학교 복음병원에서 상부 워장관 내시경상 위 선종 또는 조기위암으로 의심되는 병변이 관찰되어 내시경 점막절제술을 시행한 88명의 환자를 대상으로 후향적으로 절제 전 내시경 생검과의 조직소견을 판정하였다. 결과: 내시경 생겁 결과와 점막 절제술 후 조직소견이 일치한 경우가 52예(59.1%)였다. 내시경 생검에서 위염 또는 선종인 71예 중에서 점막절제술 후 선암으로 판명되었던 경우가 13예 있었다. 이렇게 조직 소견이 선암으로 상향 진단된 경우의 내시경 소견은 발적, 함몰형 병변인 경우에서 빈도가 높았다. 결론: 선종이 의심되는 위점막 병연이 관찰된 경우 내시경 생검이 전체 병변의 조직을 반영하기는 어려우므로 특히 발적이 동반되거나, 함몰형 병변인 경우에는 점막절제술 등의 전체 병변 절제를 통한 조직검사를 반드시 시행하는 것이 진단과 치료에 도움이 될 것으로 생각한다. Background: The correct histological diagnosis of a gastric adenoma is important, because an adenoma has been reported to be a precancerous lesion and is associated with focal gastric carcinoma. However, there is some discrepancy between the histology of a forceps biopsy and that of the endoscopic mucosal resection. This study compared the histological findings of a gastric mucosal lesion in the specimens of a forceps biopsy and an endoscopic mucosal resection. Methods: 88 cases of gastric mucosal lesions, which had been removed by the endoscopic mucosal resection, were reviewed retrospectively. All the patients had undergone a forceps biopsy before the endoscopic mucosal resection. The histological findings of the specimens by a forceps biopsy were compared with those by resection. Results: The histological findings were accordant at 52 of the 88 cases (59.1%). Among the 71 cases with adenoma or gastritis in the biopsied specimens. 13 cases (18.3%) were finally diagnosed with gastric cancer in the resected specimens. Among all the gastritis and adenomas determined by the forceps biopsy, the high-risk groups for adenocarcinomas were characterized by the following endoscopic findings: red-colored and depressed lesions. Conclusions: Biopsy specimens may not be representative of the entire lesion. Therefore, an endoscopic resection of a gastric mucosal lesion is needed for making an accurate histological diagnosis and treatment if adenomas such as red-colored or depressed lesions are suspected. (Korean J Med 71:600-608, 2006)