장중첩증에서 비수술적 정복의 실패 위험인자

고광민,송영우,제보경,한재준,우찬욱,최병민,이정화,Ko, Kwang-Min,Song, Young-Wooh,Je, Bo-Kyung,Han, Jae-Joon,Woo, Chan-Wook,Choi, Byung-Min,Lee, Jung-Hwa 대한소아소화기영양학회 2008 Pediatric gastroenterology, hepatology & nutrition Vol.11 No.2

목 적: 장중첩증의 일차적인 치료로 사용되는 비수술적 관장 정복은 장천공, 쇼크 그리고 복막염 등과 같은 심각한 합병증과 불필요한 스트레스 및 과도한 방사선 노출의 위험이 있다. 본 연구에서는 무리한 비수술적 정복의 시도를 피하기 위하여 장중첩증 환자의 임상 양상 및 검사 소견 중 비수술적 정복 실패를 예측할 수 있는 인자를 파악하고자 하였다. 방 법: 고려대학교 의료원 안산병원에서 1998년 3월에서 2006년 7월까지 장중첩증으로 진단되어 치료받았던 환자 314명 중 비수술적 정복이 시도되었던 300명을 대상으로 하였다. 비수술적 정복의 성공 군과 실패군으로 나누어 성별, 연령, 임상증상 및 이학적 소견 그리고 증상의 시작에서 비수술적 정복술을 시도하기까지의 시간과 비수술적 정복 실패와의 연관성을 분석하였다. 결 과: 비수술적 정복 실패 군의 경우 성공 군에 비해 연령이 어렸고(12.3${\pm}$17.2개월 vs 18.0${\pm}$15.8개월, p=0.03), 정복 시도까지의 시간 경과가 길었으며(33.6${\pm}$29.0시간 vs 21.5${\pm}$20.3시간, p<0.01), 구토, 기면은 많았음(p<0.01)에 비해 복통이나 보챔은 적었다(p<0.01). 이러한 인자들의 다중회귀분석에서 비수술적 정복 실패와 연관된 인자는 6개월 미만 연령(odds ratio: 2.5, 95% confidence interval: 1.2~5.2, p=0.01), 24시간 경과(odds ratio: 2.1, 95% confidence interval: 1.2~4.2, p=0.03), 혈변(odds ratio: 4.8, 95% confidence interval: 1.9~12.2, p<0.01), 기면(odds ratio: 3.4, 95% confidence interval: 1.1~10.4, p=0.04), 복통 또는 보챔(odds ratio: 0.2, 95% confidence interval: 0.1~0.4, p<0.01)이었다. 결 론: 장중첩증에서 6개월 미만 어린 연령, 혈변이나 기면의 소견, 증상 시작 24시간이 경과된 경우 비수술적 정복 실패의 가능성이 많으므로 이러한 사항을 충분히 고려하여 시행 여부를 결정하는 것이 좋겠다. Purpose: Intussusceptions are one of the most common causes of intestinal obstruction in infants and young children. Although it is easily treated by non-operative reduction using barium, water or air, this treatment is very stressful for young patients and may cause bowel perforation, peritonitis and shock. In this study, we identified the risk factors associated with the failure of non-operative reduction, to identify a group of children that would benefit from the procedure and those who would not. Methods: We reviewed the medical records of patients with intussusception who were treated at the Korea University Medical Center Ansan hospital from March 1998 to July 2006. Three hundred fourteen children with intussusception were identified. Among them, non-operative reductions were performed in three hundred. Clinical and radiological variables were compared according to the failure or success of the non-operative reduction. Results: Non-operative reductions were successful in 243 (81%) and failed in 57 (19%). The group that had failed procedures had a younger age (12.3${\pm}$17.2 months vs. 18.0${\pm}$15.8 months, p=0.03), longer symptom duration before reduction (33.6${\pm}$29.0 hr vs. 21.5${\pm}$20.3 hr, p<0.01), more vomiting and lethargy (p<0.01), but less abdominal pain and irritability (p<0.01), compared with the group that had a successful procedure. Logistic regression analysis showed that the factors associated with the failure of non-operative reductions were a younger age, less than 6 months of age (odds ratio: 2.5, 95% confidence interval: 1.2~5.2, p=0.01), duration of symptoms, longer than 24 hrs before reduction (odds ratio: 2.1, 95% confidence interval: 1.2~4.2, p=0.03), bloody stool (odds ratio: 4.8, 95% confidence interval: 1.9~12.2, p<0.01), lethargy (odds ratio: 3.4, 95% confidence interval: 1.1~10.4, p=0.04), and abdominal pain or irritability (odds ratio: 0.2, 95% confidence interval: 0.1~0.4, p<0.01). Conclusion: For children with intussusception, an age younger than 6 months, and duration of symptoms more than 24 hrs before reduction, as well as the presence of bloody stools, lethargy and abdominal pain or irritability were variables associated with failure of a non-operative reduction. Knowledge of these variables should be considered in making clinical decisions for therapeutic interventions.

당본풀이에 나타난 갈등(葛藤)과 대립(對立) -송당(松堂),세화(細花),서귀당(西歸堂) 본풀이의 경우-

고광민 ( Kwang Min Ko ) 제주대학교 탐라문화연구소 1983 탐라문화 Vol.0 No.2

文學 : 詩探<毛穎傳>之寓意

고광민 ( Kwang Min Ko ) 한국중국학회 2004 國際中國學硏究 Vol.7 No.-

韓愈<毛穎傳>是一篇較獨特的作品。韓愈運用遊戱筆法,爲毛筆立傅, 倂表達「秦眞少恩」。不過, 韓愈爲何運用遊戱筆法批評「秦眞少恩」?「秦眞少恩」倂不是在政治上較敏感的問題, 無妨直接發出議論。歷代有關<毛潁傳>的評論, 幾乎偏於韓愈的藝術技巧, 極少提出<毛穎傳>的寓意。在此, 筆者認爲<毛潁傳>可能有령外一個眞正寓意, 所以, 根據於韓愈的創作傾向、<毛穎傳>寫作背景以及<毛穎傳>的內容, 探討<毛穎傳>的寓意。中庸的陸贄是, 符合<毛穎傳>中的毛潁的角色, 而且他是韓愈的「坐主」, 韓愈是他的「門生」。령外, 韓愈對德宗的評價不高。他在《願宗實錄》揭露出德宗末年的社會弊病, 以及德京的無能。根據以上的硏究, 筆者認爲毛穎與秦王, 흔可能指著陸贄與德宗, 所以, <毛穎傳>也許暗地裡指責「德宗少恩」。

중국문학 : 류종원(柳宗元) 유기문(遊記文)에 나타난 정경융합(情景融合)의 과정과 특징 연구 -영주팔기(永州八記)를 중심으로-

고광민 ( Kwang Min Ko ) 한서대학교 동양고전연구소 2009 東方學 Vol.16 No.-

『史記 · 四君子列傳』에 나타난 褒貶 양상 연구 - 養士 관련 記述을 中心으로

高光敏(Ko, Kwang-min) 중국어문학연구회 2020 중국어문학논집 Vol.0 No.124

The core idea of “Sijunziliezhuan” in Shiji is the provision of sustenance for “Shike” (a hanger-on scholar), and for that reason, the narratives of Sijunzi are placed next to one another. The central arguments of this paper are four-fold. Firstly, in his description of how to treat shike, Simaqian focuses on the sincerity of Sijunzi in treating hangers-on. Mengchangjun is described as showing up his vested interest in the maintenance of Sijunzi: he is portrayed as being often irritated by the demands of hangers-on and backbiting them. Pingyuanjun is depicted as a man who is discriminatory against scholars of lesser fortune or family background, and who cares about the appearance of good deed without caring to discern and nurture talent. On the other hand, Xinlingjun is shown in minute detail to be a man of sincerity who puts great value on scholarly fellowship with hangers-on. Secondly, both “Mengchangjunliezhuan” and “Pingyuanjunliezhuan” praise the great deeds of hangers-on and criticize the unappreciative lords by using the narrative structure of reversal that shows the great performances of those hangers-on who have been poorly treated. Thirdly, Simaqian locates Xinlingjun at the center of story-telling while placing Mengchangjun and Pingyuanjun as passive characters at the receiving end of their stories Lastly, Simaqian uses additional accounts, which is not integral to the main narrative, to praise or criticize Sijunzi. Simaqin’s appraisal of Sijunzi is predicated on the presence of genuine sincerity toward hanger-on scholars. He seems ambivalent about the social reality made up of the Sijunzi of higher social backgrounds and the hanger-on scholars whose enormous effort to make a name for themselves often proves futile. In the end, Simaqin applies a stricter standard of evaluation for the Sijunzi than that allowed for the hangers-on.

대립의 관점으로 본 「伍子胥列傳」의 구도 연구

高光敏(Ko, Kwang-min) 중국어문학연구회 2021 중국어문학논집 Vol.- No.129

The “Wuzixuliezhuan(伍子胥列傳)” in Shiji(史記) is to show the damaging effects of “yuandu.怨毒” Simaqian(司馬遷) constructs a binary opposition, setting up Baipi(伯嚭) and Fucha(夫差) as perpetrators and Wuzixu(伍子胥) as a victim. In so doing, he stresses the wickedness and injustice of the perpetrator and underscores the loyalty and innocence of the victim. The revenge plot of Baigon(白公) Sheng(勝) is also structured in binary opposition, setting Sheng(勝) up against Zixi(子西). The prevalent structure of binary opposition has several effects. First, the evils of the perpetrator and the innocence of the victim are both highlighted. Second, The evil imagery of Baipai(伯嚭) and Fucha(夫差) recalls the memory of Chupingwang(楚平王) and Feiwuji(費無忌), which creates the sympathy for Wuzixu(伍子胥) who went through the same painful experience twice. Third, we begin to understand and accept the necessity of Wuzixu’s “yuandu(怨毒)” excepting from our moral judgment his excessive action in the face of the outlandish vengeance and death of pouguanzhanshi(剖棺斬屍). Consequently we are alerted to the danger of “yuandu(怨毒)” in the evocation of rage and sympathy. In the end, the binary structure that is adopted by Simaqian(司馬遷) makes the life of Wuzixu(伍子胥) an exciting kaleidoscopic story of great literary quality.

논문 : 대학 중국어교육에 있어서의 번역교육 -현황, 의의 및 방법을 중심으로

고광민 ( Kwang Min Ko ) 중국어문학회 2007 中國語文學誌 Vol.24 No.-

대학 중국 고전 산문 교육의 새로운 방향 모색

高光敏(Ko Kwang-min) 중국어문학연구회 2012 중국어문학논집 Vol.0 No.73

韓愈 〈送窮文〉의 후대 수용 연구

高光敏(Ko, Kwang-min) 중국어문학연구회 2018 중국어문학논집 Vol.0 No.109

Hanyu’s 〈Songqiongwen〉 consisting of a motif of chasing a poverty ghost, it takes the form of a virtual dialogue between oneself and the poverty ghost as the person drives out the poverty demon that is attached to him. As if it seemed to appeal to the ghost for his destitution through a peculiar topic and the creation of the comical ghost image, in the later years, 〈Songqiongwen〉 is evaluated as a representative work of Hanyu due to the dual features of self-boasting in fact and criticising things that were wrong with the world. Since a number of works mimicking 〈Songqiongwen〉 have appeared after Hanyu, the purpose of this research is to examine the acceptance of 〈Songqiongwen〉 through the analysis of the imitative works. Although Wantang Duanchengshi’s 〈Songqiongwen〉 was the first imitative work, it had accepted only the motif of expelling a poverty ghost but the form and the contents had been scaled down and thus it is difficult to find the characteristics of Hanyu` 〈Songqiongwen〉. Since then, the works of the Song dynasty and the Yuan dynasty such as Wangling"s 〈Songqiongwen〉, Wangzhiwang`s 〈liuqiongwen〉, Cuidunli`s 〈liuqiongwen〉, and Haojing`s 〈yaoqiongwen〉 have all accepted the format of Hanyu’s 〈Songqiongwen〉 as it was but have modified the contents from Songqiong to liuqiong, which can be interpreted as the succession of Hanyu’s 〈Songqiongwen〉 with a little change in the state of the poverty ghost. The works of the Ming dynasty and the Qing dynasty including Liuji`s 〈Songqiongwen〉, Pusongling`s 〈Churijiqiongshenwen〉 and 〈Qiongshendawen〉, and Daimingshi"s 〈Songqiongzhuan〉 have drastically transformed the genre of Hanyu’s 〈Songqiongwen〉 into chuqi, jiwen, and a novel, added new contents and thus recreated Hanyu’s 〈Songqiongwen〉.

조선시대 제주 해녀 울산으로 간 까닭

고광민(Kwang-min Ko) 제주학회 2017 제주학회 학술발표논문집 Vol.2017 No.2

During the Joseon era, Ulsan (a city located on the southeastern tip of the Korean peninsula) became home to a large population from Jeju (the largest island off the southern tip of the Korean peninsula). What could be the push factors of their migration? Interestingly, many historic documents found in the city of Ulsan provide records on the existence of migrants from Jeju. The term Dumoak from the Joseon period referred to those Jeju natives that left the island of Jeju and settled on Korea’s mainland. Being a nickname for Hallasan (the mountain located in the central part of Jeju Island), Dumoak was used to refer to the native people of Jeju residing in such places as Ulsan that made their living by diving in the coastal seas. Notably, The Census Register for the Ulsan Region, Gyeongsang Province (from the Joseon dynasty), jotted down the details of Dumoak. The state-recorded family register implies that the people called Dumoak had been isolated from the original settlers in the mainland area by the 18th century, creating a unique village of their own. In general, Dumoak were classified as Cheonin (the term that referred to lower class people in the Joseon era). As earlier mentioned, they resided in the villages they had created for themselves and married within their community. They were shunned by the original settlers on the mainland, took the responsibility of providing specialized labor for the nation, and further, had restricted options for residence in and entrance to towns other than their own. Why did Dumoak have to move to Ulsan and be treated as people of lower class in the Joseon period? The answers may lie in both the ecology related to the so-called ‘field of sea mustard’ in Ulsan and the neighboring fishing villages, as well as the relationship between the people of those villages and the haenyeo who migrated from Jeju. In detail, Jeju haenyeo were responsible for removing weeds and collecting sea mustard in the sea mustard fields in the near waters. The women divers from Jeju were paid for the afore-mentioned labor. Additionally, they were allowed to collect as much seafood as they wanted, to earn a living for themselves. This ecological background offers explanation into the reasons why Jeju haenyeo relocated their livelihood to Ulsan and the neighboring coastal villages in the Joseon era.