소아에서 복막투석도관 삽입시 복강경을 이용한 방법과 기존의 수술법에 따른 초기 합병증 발생의 차이

정수인,이현영,이철구,서정민,이석구,김수진,곽민정,진동규,백경훈,Jeong, Soo-In,Lee, Hyun-Young,Lee, Cheol-Gu,Seo, Jeong-Meen,Lee, Suk-Koo,Kim, Su-Jin,Kwak, Min-Jung,Jin, Dong-Kyu,Paik, Kyung-Hoon 대한소아신장학회 2007 Childhood kidney diseases Vol.11 No.1

목적 : 복강경을 이용한 복막투석도관 삽입술은 직접 복강 내를 들여다보며 시술할 수 있어 위치 선정이 쉽고, 조직 손상이 적으며 합병증이 적다는 장점이 있으나, 소아에서의 경험은 많지 않다. 본 연구에서는 소아에서 복강경을 이용한 복막투석도관 삽입술의 유용성을 평가하고자 한다. 방법 : 2002년부터 2006년까지 삼성서울 병원에서 31명의 환아를 대상으로 복강경을 이용하여 복막투석도관 삽입술을 시행한 21례와 고식적 수술 방법으로 투석도관을 삽입한 16례의 의무기록을 바탕으로 복막투석관 삽입 후 첫 2개월간 투석도관의 누출, 폐쇄, 삽입 부위의 감염, 위치 이동 등 복막투석관 삽입과 관련된 합병증에 대해 후향적 분석을 시행하였다. 결과 : 고식적 수술을 받은 군(16례)에서 1례(6.3%)에서 수술 직후 심한 출혈로 재수술을 받았고, 복막액의 누출은 2례(12.5%) 있었으며, 보존적인 치료로 호전되었다. 삽입 부위 감염은 없었으나, 2례(12.5%)에서 복막염이 발생하였다. 투석도관의 이동으로 인한 기능부전이 3례 있었고 이중 2례에서 재수술을 받았으며, 1례는 보존적인 치료로 호전되었다. 복강경 수술을 받은 군(21례)에서 2례(9.5%)에서 투석액의 누출이 있었고, 보존적인 치료로 호전되었다. 삽입 부위의 감염은 없었고, 복막염이 2례(9.5%)에서 있었다. 1례에서 투석도관의 막힘이 있었고, 이 경우는 기존의 고식적 수술로 투석관 삽입 후 투석관 이동으로 재 삽입 후 불응성 복막염으로 투석관을 제거한 뒤 복강경 수술을 받은 증례였다. 투석도관의 이동은 없었다. 두 군의 합병증의 발생빈도는 통계적으로 유의한 차이는 없었다. 결론 : 본 연구에서 소아에서 복강경적 투석도관 삽입술을 시행한 경우, 1세 미만의 소아에서도 시술이 가능하였으며, 기존의 수술법에 비해 합병증이 증가하지 않았다. 또한 절개범위를 더 넓히지 않으면서도 장간막 절제 및 투석도관의 고정이 가능하여, 이를 통해 추후 투석도관의 이동이나 폐쇄의 위험요소를 줄일 수 있다는 장점이 있었다. 따라서 소아에서 복막투석도관 수술 시 복강경적 방법을 이용하는 것이 효율적인 복막 투석을 위해 유용하다고 생각된다. Purpose : To assess the early complication of laparoscopic peritoneal dialysis catheter implantation in children. Methods : Medical record review was carried out on 21 laparoscopic and 16 conventional peritoneal dialysis catheter implantations which were performed in 31 children under 18 years of age between 2002 and 2006. All medical records were retrospectively analyzed. The patients were followed until 2 months after catheter placement. Patient characteristics and catheterrelated complications, such as significant bleeding, leakage, obstruction, migration, insertion site infection and peritonitis during the first 60 days after implantation were recorded. Results : After conventional operation, dialysate leakage occurred in 2 of 16 cases and all cases improved after conservative management. In 1 case, significant bleeding occurred and re-operation was performed. Three cases of obstruction due to migration were reported, 2 cases underwent reoperation and 1 case improved without intervention. After laparoscopic surgery, outflow obstruction occurred in 1 out of 21 cases, which was caused by adhesion after several reinsertions of the catheter and recurrent peritonitis. No migration was noted after laparoscopic surgery. There was no significant difference in the complication rate between the two groups. Conclusion : Laparoscopic peritoneal dialysis catheter placement is feasible in children of all age groups, with at least equivalent functional results compared to conventional surgery. The additional advantage of laparoscopic catheter insertion is the option to identify and eliminate anatomical risk factors, such as intra-abdominal adhesions, and to perform partial omentectomy without additional incisions.

천식 소아에서 혈청 렙틴과 만니톨 기관지 과민성과의 관계

유정경 ( Jung Kyung Yoo ),신재영 ( Jae Young Shin ),유정섭 ( Jueng Sup You ),정수인 ( Soo In Jeong ),송준섭 ( Joon Sup Song ),양승 ( Seong Yang ),황일태 ( Il Tae Hwang ),이하백 ( Ha Baik Lee ),백혜성 ( Hey Sung Ba다 ) 대한천식알레르기학회 2014 Allergy Asthma & Respiratory Disease Vol.2 No.1

Purpose: Epidemiological data indicate that obesity is a risk factor in asthma, however effects related to obesity and adipokines on airway inflammation and bronchial hyper-responsiveness (BHR) have not yet been demonstrated in the human airway. The aim of this study was to investigate the relationship between serum adipokine levels and BHR to mannitol in asthmatic children. Methods: Serum adipokine levels were measured and pulmonary function tests were perfomed: baseline, postbronchodilator inhalation, methacholine inhalation, and mannitol inhalation. The response to mannitol was expressed as the dose causing a 15% decrease in forced expiratory volume in one second (FEV1) (PD15), and as the response-dose ratio (RDR) (% fall in FEV1/cumulative dose). Results: Sixty-nine prepubertal children between the ages of 6 and 10 years were participated in the study. They comprised asthmatic children (n=40) and healthy (n=29). Twenty-two subjects (55.5%) with asthma had a positive mannitol bronchial provocation test (BPT) result. The body mass index (BMI) was higher in those asthmatics with positive mannitol BPTs than in asthmatics with negative mannitol BPTs and in the control group (19.30 kg/m2 vs. 17.60 kg/m2 vs. 17.93 kg/m2, P=0.035, P=0.046). Serum leptin levels were also significantly higher in asthmatics with positive mannitol BPTs than in asthmatics with negative mannitol BPTs and in the control group (10.58 ng/mL vs. 5.49 ng/mL vs. 6.75 ng/mL, P=0.002, P=0.016). Leptin values were significantly associated with a PD15 (r=.0.498, P=0.022) and RDR to mannitol (r=0.346, P=0.033) in asthmatic children after adjustment for BMI. Conclusion: Serum leptin levels were significantly associated with BHR to mannitol in asthmatic children. (Allergy Asthma Respir Dis 2014;2:30-37)

뇌수모세포종 및 가족성 선종성 용종증으로 발현한 Turcot 증후군 1예

정수인,서정민,이지혁,이해정,이지현,성기웅,송혜정,최연호,Jeong, Soo-In,Suh, Jung-Min,Lee, Ji-Hyuk,Lee, Hae-Jung,Lee, Jee-Hyun,Sung, Ki-Woong,Song, Hye-Jung,Choe, Yon-Ho 대한소아소화기영양학회 2007 Pediatric gastroenterology, hepatology & nutrition Vol.10 No.2

저자들은 수모세포종이 있는 24세 여자 환자에서 가족성 선종성 용종증이 동반된 Tucot 증후군 1예를 경험하였으며 문헌고찰과 함께 보고하는 바이다. Turcot syndrome is characterized by the concurrence of a primary neuroepithelial brain tumor and multiple colorectal polyposis. We report a case of a 24-year-old woman diagnosed with Turcot syndrome. At first, the patient was diagnosed as having a medulloblastoma after a tumorectomy of the 4th ventricle mass. The patient underwent radiotherapy and chemotherapy. After high-dose chemotherapy, neutropenic fever and severe mucositis developed. For an evaluation of the persistent hematochezia and diarrhea, a colonoscopy was performed. It revealed pseudomembranous colitis and multiple polyps in the entire colon. According to the family history, her father had undergone a total colectomy due to colon cancer and polyposis of the entire colon. Her brother also was found to have multiple polyps in the colon by a colonoscopy. The patient was diagnosed with Turcot syndrome.

항력증가장치(1-D Trajectory Correction Device)의 성능 특성에 관한 연구

윤원근(Won-Kun Yun),정수인(Soo-In Jung),김귀순(Kui-Soon Kim),홍경명(Kung-Mung Hong),백기봉(Ki-Bong Beak) 한국추진공학회 2004 한국추진공학회 학술대회논문집 Vol.2004 No.10

PSC 외부텐던 성능평가 세부지침(안) 적용 사례

김종호 ( Kim Jong Ho ),임재환 ( Im Jae Hwan ),유덕용 ( Yu Deok Yong ),황인백 ( Hwang In Baek ),정수형 ( Jung Soo Hyung ) 한국구조물진단유지관리공학회 2018 한국구조물진단유지관리공학회 학술발표대회 논문집 Vol.22 No.1

As a result of the application in accordance with the assessment procedures given in the Detailed Guide (plan) for the precision safety diagnosis of the external tendon in Prestressed Concrete, it was evaluated with reasonable procedures and results.

비육돈사 작업 종사자의 호흡기 관련 공기 중 분진 농도 측정 및 분석

권경석,이인복,황현섭,하태환,하정수,박세준,조예슬,Kwon, Kyeong-Seok,Lee, In-Bok,Hwang, Hyun-Seob,Ha, Tae-Hwan,Ha, Jung-Soo,Park, Se-Jun,Jo, Ye-Seul 한국농공학회 2013 한국농공학회논문집 Vol.55 No.5

In swine house, dust generation comes from various sources and is known to be harmful both for the animals and the farmers because the dust contains biological and gaseous matters. When farmers are constantly exposed to the dusts, they can suffer chronic or acute respiratory symptoms and have high probability of manifesting various diseases. To address this problem, understanding of the mechanism of dust generation is very important. In this paper, the dust concentration of inhalable, respirable, TSP and $PM_{10}$ were monitored and analyzed according to the pig-activity level, ventilation quantity and feeding method in fattening pig house. From the measured results, in case of the concentration of TSP, an inverse-linear relation with ventilation rate ($R^2=0.88$) and linear relation with the installation height of feed supply pipe ($R^2=0.73$) were determined. However in case of the concentration of $PM_{10}$, no particular relationship with the variables was observed. Using the concentration of inhalable and respirable dust based on the pig-activity level, multi-variate regression analysis was conducted and results have shown that the movement of pigs can contribute to the dust generation (p<0.05, $R^2=0.71$, 0.61). The relationship determined between dust generation and environmental variables investigated in this study is very significant and useful in conducting dust-reduction researches.

차전자,복령의 복합 물추출물(CJB)이 고지방사료로 유도된 비만 생쥐의 조직형태 및 조직병리학적 변화에 미치는 영향

황정수 ( Jeong Soo Hwang ),석장미 ( Jang Mi Suk ),최혜민 ( Hye Min Choi ),신인순 ( In Soon Shin ),황수정 ( Su Jung Hwang ),박지영 ( Ji Young Park ),김성옥 ( Sung Ok Kim ),서부일 ( Bu Il Seo ),김미려 ( Mi Ryeo Kim ) 대한본초학회 2013 大韓本草學會誌 Vol.28 No.1

Objectives : Obesity is a chronic metabolic disease caused by disorder of energy balance and lipid metabolism. This study was conducted by histopathology and histomorphometry to investigate the anti-obesity effects of mixed water extract of Plantaginis Semen & Poria (CJB) on liver, epididymal fat pads and pancreas zymogen granules in obese rats induced with high fat diet, Method : Male Sprague-Dawley rats to be divided four groups were fed into four different treatments: normal (NOR) diet, high-fat (HF) diet, HF diet+CJB (100 mg/kg and 300 mg/kg, P.O.) for 8 weeks. The weekly body weights were measured in four experimental groups, respectively. Also histopathological and histomorphometrical changes of liver, epididymal fat pads and pancreas zymogen granules were observed in normal control and obese rats, respectively, Results : Adminstration of CJB significantly reduced body weights compared to those of HF group for experimental period. After 8 weeks, liver weights in the CJB groups were lower than those of HF group. In addition, HF diet related steatohepatitis, adipocyte hypertrophy, exocrine disturbances (decreases of pancreatic zymogen granules) were also dose-dependently inhibited by treatment of test material, CJB 100 and CJB 300 as compared with HF group, respectively, Conclusion : Based on the results, it is considered that CJB will be showed hepatoprotective and anti-obese effects, may be directly and/or indirectly mediated by pancreatic zymogen granules because they dose-dependently inhibited steatohepatitis, hypertrophy of adipocytes and decreases of pancreatic zymogen granules induced by HF diet supply, respectively.

제 2발표장 : 생물생산시설 및 환경공학 분야 ; 12:24~12:36 : 풍동에서의 PIV실험을 통한 CFD모델 검증 및 간척지 설치 자연환기식 온실 환기량 분석

하정수 ( Jung Soo Ha ),이인복 ( In Bok Lee ) 한국농업기계학회 2014 한국농업기계학회 학술발표논문집 Vol.19 No.2

간척지 기상조건에서의 온실 내부 공기유동 및 환기효율 분석

하정수 ( Jung-soo Ha ),이인복 ( In-bok Lee ) 한국농공학회 2013 한국농공학회 학술대회초록집 Vol.2013 No.-

Development of a large scale of farming region on reclaimed land has been increasing with the purpose of stable production of flower and crop by the demand of large consumption. So it needs a comprehensive technical development for greenhouse design which is suitable for specific climate of reclaimed land and able to cope with the climate change. At the present in Korea, the standard design of greenhouse is not appropriate to apply because it was suggested many years ago and is not proper for today's climate. Among the standard, a heat balance equation for ventilation requirements coming from Japan at 1960s has been used but there is some ambiguous part on the application to Korea's greenhouse design. Therefore, it is necessary to upgrade a technique of greenhouse built on reclaimed land. In this study, a proper ventilation design of greenhouse was studied through the analysis of internal airflow and ventilation efficiency according to the various environmental conditions. A program of CFD(Computational Fluid Dynamics) was used to make a greenhouse airflow simulation model and did a comparison analysis for validation of two results which are CFD simulation, PIV(Particle Image Velocimetry) and wind-tunnel test. Single even span type of greenhouse was used to validate the results. To induce the proper design of CFD model with high accuracy, mesh size, turbulence model and laminar zone to maintain a wind profile were considered based on the results of validation test. It was validated with velocity distribution on specific lines in the middle of greenhouse. From the computed results, the R² values were 0.99, 0.99 in case of the side opening case each external velocities(1m/s, 1.5m/s) and its RMSE values were 0.08, 0.24. At side-roof opening case, R² values 0.98, 0.98, RMSE values 0.29, 0.50 were calculated. It has been studied to make a proper simulation model from validation results and evaluate the airflow, natural ventilation and ventilation requirements at various greenhouse types and environmental conditions.

CFD를 이용한 간척지 설치 자연환기식 단동형 온실의 환기량 해석

하정수 ( Jung-soo Ha ),이인복 ( In-bok Lee ) 한국농공학회 2014 한국농공학회 학술대회초록집 Vol.2014 No.-

원예시설의 대규모화와 자동화의 필요성이 대두되고 있으며 간척지에 대한 다각적 활용을 위한 여러 방안과 더불어 미래형 농업단지 조성이 추진되고 있다. 최근 정부에서는 국내간척지 12지구에 첨단수출 원예단지 등 대규모 시설농업 단지 조성 계획을 고시하였다 (농림수산식품부, 2010). 간척지에서의 풍환경은 내륙에 비해 지형상의 장애가 적어 풍향이 일정하고 풍속이 크기에 내륙의 기후와는 대조적이다. 이러한 현상에 의거하여 기존의 내륙 설치 온실의 설계와는 상이한 간척지 설치 온실 설계기준이 요구되고 있다. 풍환경은 온실의 자연환기에 직접적인 영향을 미치는 인자이기에 매우 중요한 요소이다. 특히 하절기 온실의 경우 고온으로 인한 피해가 매우 심각하기에 환기에 의한 효율적인 온도조절이 필수적이며 경제성을 고려할 시 온실 자연환기에 대한 연구가 반드시 수행되어야 한다 (Hong et al., 2008). 따라서 본 연구에서는 간척지 풍환경 특성에 따른 온실의 환기효율 분석 연구의 일환으로 자연환기식 단동형 온실의 전체, 구역별 환기량 분석을 수행하였다. CFD(Computational Fluid Dynamics) 시뮬레이션 연산결과와 현장실험 데이터의 검증을 통해 온실모델 구성의 기준을 확립한 후, 이를 적용하여 다양한 온실 형태, 환경조건에 따른 환기량을 분석하고자 하였다. ESDU를 통해 재현한 간척지 풍속 프로파일을 적용하였으며, CFD를 통해 온실 시뮬레이션 모델 구성 및 연산을 수행하여 이를 풍동-PIV(Particle Image Velocimetry)실험 결과와 검증하였다. 정확도 향상을 위한 다양한 시도들을 통해 오차는 약 7~10% 범위로 도출되어 적정한 수준으로 판단하였다. 검증모델을 바탕으로 동일한 기준을 적용하여 단동 복숭아형, 양지붕형, 3/4형, 광폭형 온실들의 모델링을 수행하였으며 질량교체 환기율(Mass Flow Rate)과 추적가스 감쇠율(Tracer Gas Decay Rate)을 통해 온실의 전체, 구역별 환기량을 도출하였다. 동일한 환경조건 하AERMFR의 경우 복숭아형 온실이 가장 환기량이 높게 나왔으며, AERTGD의 경우 광폭형 온실이 높게 나왔다. 분석 대상 온실의 내부 체적을 나누어 구역별 환기량 분석을 수행하였으며, 풍향의 영향이 가장 큰 것으로 사료되었다. 동적 에너지 시뮬레이션 기법인 BES(Building Energy Simulation)를 통해 온실의 열적환경을 예측하여 CFD 연산에 접목하였으며 이를 통해 열적환경 고려에 따른 부력효과에 의한 환기량 변화양상을 분석하였고, 필요환기량 열수지 방정식을 통해 설계환기 기준치를 도출하여 특정 환경조건(풍향, 풍속), 환기방식(측창환기, 측창-천창환기, 천창환기)에서의 자연환기량에 대해 환기 적정성을 평가하였다.