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신희철,문석배,이성철,정성은,박귀원,Shin, Hee-Chul,Moon, Suk-Bae,Lee, Seong-Cheol,Jung, Sung-Eun,Park, Kwi-Won 대한소아외과학회 2009 소아외과 Vol.15 No.1
The survival of Very Low Birth Weight (VLBW) infants has been improved with the advancement of neonatal intensive care. However, the incidence of accompanying gastrointestinal complications such as necrotizing enterocolitis has also been increasing. In intestinal perforation of the newborn, enterostomy with or without intestinal resection is a common practice, but there is no clear indication when to close the enterostomy. To determine the proper timing of enterostomy closure, the medical records of 12 VLBW infants who underwent enterostomy due to intestinal perforation between Jan. 2004 and Jul. 2007 were reviewed retrospectively. Enterostomy was closed when patients were weaned from ventilator, incubator-out and gaining adequate body weight. Pre-operative distal loop contrast radiographs were obtained to confirm the distal passage and complete removal of the contrast media within 24-hours. Until patients reached oral intake, all patients received central-alimentation. The mean gestational age of patients was $26^{+2}$ wks ($24^{+1}{\sim}33^{+0}$ wks) and the mean birth weight was 827 g (490~1450 g). The mean age and the mean body weight at the time of enterostomy formation were 15days (6~38 days) and 888 g (590~1870 g). The mean body weight gain was 18 g/day (14~25 g/day) with enterostomy. Enterostomy closure was performed on the average of 90days (30~123 days) after enterostomy formation. The mean age and the mean body weight were 105 days (43~136 days) and 2487 g (2290~2970 g) at the time of enterostomy closure. The mean body weight gain was 22 g/day after enterostomy closure. Major complications were not observed. In conclusion, the growth in VLBW infants having enterostomy was possible while supporting nutrition with central-alimentation and the enterostomy can be closed safely when the patient's body weights is more than 2.3 kg.
신희철,김동준,정성엽,문장원,Shin, Hee-Cheol,Kim, Dong-Jun,Jeong, Seong-Yub,Moon, Jang-Won 한국토지주택공사 토지주택연구원 2011 LHI journal of land, housing, and urban affairs Vol.2 No.2
비효율적인 자동차 중심의 교통체계에서 효율적인 친환경 인간중심의 교통체계로의 전환이 필요하다. 특히 무동력, 비탄소 교통수단 중 생활교통수단으로 활용이 가능한 자전거에 대한 중요성이 인식되면서, 최근 우리나라 뿐만 아니라 전 세계적으로 자전거 이용활성화를 위한 노력을 기울이고 있다. 그러나 우리나라의 경우 자전거 이용활성화에 대한 부정적 인식과 함께 자전거 수단분담률은 1.2%로 자전거 선진국에 비해 매우 낮은 수준이다. 이러한 배경하에 본 연구에서는 우리나라 자전거 이용활성화 가능성을 진단하고, 자전거이용이 활성화된 자전거 선진도시의 사례 분석을 통해 자전거 이용활성화 결정요인을 도출하였다. 또한 자전거의 특성을 고려하여 도시 유형을 구분하고, 자전거 인프라 확충 측면의 결정요인별 중요도를 제시하였다. 자전거 이용률 및 보유율, 기술 발전, 경제적 측면, 통행거리 및 목적, 공공자전거 도입 등 7가지 항목에 대해 우리나라 자전거 이용활성화 가능성을 진단한 결과, 잠재적 가능성이 존재하는 것으로 나타났다. 다음으로 자전거 선진도시 사례를 통해 자전거 인프라 확충 측면, 안전 및 이용활성화 측면, 지속가능성 확보 측면 등 3개 분야의 총 41개 결정요인을 도출하였다. 이와 함께 자전거를 고려한 도시 유형을 구분하고, 자전거 인프라 확충 측면의 21개 결정요인별 중요도를 제시하였다. Automobile-oriented urban transport system, continued from the past in Korea, is giving rise to inefficiency and social costs in transport sector. With revitalizing usage of bicycle, human-powered transport mode, it is possible to enhance sustainable green growth, improvement of the city-competitiveness, and the quality of life. In this study, the possibility of bicycle usage promotion in Korean cities is examined at 7 points of views. As a result, though the bicycle usage is low now, we figured that there are many positive signs to increase bicycle usage in Korea. Also, we draw a diverse key policies for building green urban transport system that bicycle have a most important role on transport system. So policies to promote bicycle usage are reviewed to analyze on bicycle-oriented 5 cities, in which have high bicycle mode share. By this review, this study could draw 41 key effective policies to 3 aspects (bicycle infrastructure, safety and promotion, and policy sustainability). In addition to, importance of 21 key effective policies about bicycle infrastructure is suggested as considering city's characteristics.
김주철 ( Ju Cheol Kim ),도진우 ( Jin Woo Doh ),김영아 ( Young Ah Kim ),최석태 ( Seok Tae Choi ),전종관 ( Jong Kwan Jun ),윤보현 ( Bo Hyun Yoon ),신희철 ( Hee Cheol Shin ) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.12
Objective: To evaluate the course of pregnancy and the perinatal outcomes of fetal gastroschisis. Materials and Methods: The retrospective study was done by the review of medical records of 14 pregnancies with fetal gastroschisis diagnosed between January, 1987 and December, 1996. Results: The incidence of fetal gastroschisis was one in 1,411 birth(14/19,765) in this study. Associated anomalies except gastrointestinal anomalies were detected in 57.1%(8/14) of cases; cardiac(n=4), pulmonary hypoplasia(n=2), skeletal(n=2), cystic hygroma(n=2), cleft lip and pa1ate(n=1), central nervous system(n=l). Five fetuses were growth-restricted(62.5%, 5/8). Five were terminated before 20 weeks of gestation. Eight were liveborn. However, 50% (4/8) had low Apgar scores at 5 minutes(<7). Cesarean section was performed in 50% of cases (4/8). Three newborns died immediately after birth. Five newborns received corrective operation, and two of them survived. Perinatal mortality was 77.8%(7/9): one died in utero, and six during the neonatal period. 40%(2/5) of newborn who received corrective operation survived. Conclusion: The perinatal outcome of gastroschisis was dependent on associated anomaly. In conclusion, in the case of fetal gastroschsis, diagnostic work up for detection of associated anomaly should be undertaken.