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      • 소아외과의 지수 질환 - 대한소아외과학회 정회원을 대상으로 한 2000년도 전국 조사 -

        이명덕,김상윤,김우기,김인구,김성철,김신곤,김재억,김재천,김현학,박귀원,박우현,서정민,송영택,오수명,유수영,이두선,이석구,이성철,정상영,정성은,정을삼,정풍만,조마해,Lee, M.D.,Kim, S.Y.,Kim, W.K.,Kim, I.K.,Kim, S.C.,Kim, S.K.,Kim, J.E.,Kim, J.C.,Kim, H.H.,Park, K.W.,Park, W 대한소아외과학회 2001 소아외과 Vol.7 No.2

        Membership qualifications and recognition of the subspecialty training programs by the Korean Association of Pediatric Surgeons(KAPS) have been determined by criteria based on the number of neonatal and total pediatric surgical cases registered, since 1989 (Index cases). The numbers are based on a survey of the 14 founding members of the society by Jung et al. in 1987. The current survey is to review the present status of the index cases from 1997 to 1999 among 36 members of the KAPS. Two surveys were undertaken for this study. In the first survey, cases were collected by the registration form, composed of neonatal(N), important pediatric surgical cases (I), tumor and other similar operations(T) and other common pediatric surgical cases(O). Thirty members responded. and the result was discussed at the Topic Discussion section of the 15th Annual Congress of KAPS, 2000. The second survey analyzed additive data, proposed during discussion at the Congress. Twenty-three members responded. This report is the analysis of the both surveys. The average numbers of the cases/year/surgeon of N, I, T, O and total were 19.5, 51.8, 9.5, 77.1 and 356.5. respectively. The number of index cases(N+I+T)/year/surgeon was 80.8. The ratio of (N+I+T)/total cases was 0.3. Seventeen of 30 members have more than 20 cases of N per year. Twelve members have more than 150 cases, and 13 do more than 100 cases of I per year. Fourteen members have more than 10 cases of T per year. Nineteen and 10 members experienced more than 150 and 100 of index cases(N+I+T) per year. A new list of the index cases and coding system are proposed for the future regular update. 대한소아외과학회의 연례 행사인 2000년도 주제토의를 소아외과의 지수 질환으로 정하여 1999년 말 현재 3년 이상의 진료 실적을 가진 대한소아외과학회 정회원 36명을 대상으로 미리 작성된 조사서에 의하여 2차례의 수술 증례 수 등록을 시행하였다. 대상 환자는 1997년부터 1999년 말까지 3년간 수술이 시행된 환자로 하였으며, 1차 조사에서 30명이 응답하였고, 미비점 보완을 위한 2차 조사에는 26명이 응답하여 이 성적을 요약하였다. 본 성적을 바탕으로 향 후 대한소아외과학회의 지수 질환 대상 목록표를 작성 제시하였으며, 이를 코드화 하고자 제안하였다.

      • 한국의 항문-직장 기형 -1999년도 대한소아외과학회 회원 대상 전국 조사-

        이명덕,김상윤,김우기,김인구,김재억,김재천,김현학,박귀원,박우현,송영택,오수명,유수영,이두선,이석구,이성철,장수일,정상영,정성은,정을삼,정풍만,Lee, M.D.,Kim, S.Y.,Kim, W.K.,Kim, I.K.,Kim, J.U.,Kim, J.C.,Kim, H.H.,Park, K.W.,Park, W.H.,Song, Y.T.,Oh, S.M.,Yoo, S.Y 대한소아외과학회 2000 소아외과 Vol.6 No.2

        The purpose of the survey was to clarify the clinical features and management of the anorectal malformations (ARM) in Korea. Twenty-seven members of the Korean Association of Pediatric Surgeons were surveyed. The members completed a case registration form for each patient during the two years period of 1996-1997, and a questionnaire that contained their management preferences for primary and complicated patients. Twenty-four members of the 22 institutions registered 295 cases of the ARM, and 27 out of 34 members (77.1 %) responded to the questionnaire. The patients were classified by the Wingspread classification of ARM(1984). The case registration form was a modification of Wingspread workshop for the postoperative assessment and case registration. The male to female ratio was 1.7 : 1. The average number of patients per surgeon was 6.1 cases per year. Prematurity(< 36 weeks) was present in 1.9 % of cases and low birth weight (< 2.6 Kg) in 12.1 %. Among 187 male patients, 62 were high(H) type, 29 intermediate(l) type, 88 low(L), and 8 unclassified. In female, there were 2 cases of cloacal anomalies(C), 4 H type, 30 I type, 66 L type and 6 unclass ified. For male, 87.9 % of H and I type were operated by the Pena procedure, but only 7.9 % in L types. In female, all of C, H and I types, and 40.9 % of L type were done by the Pena procedure. One case expired (MR; 0.003%) as a result of surgical complication. Over-all complication rate was 12.5 %. Among 6 cases of reoperation, 4 were failed Pena procedures. Among 140 colostomies sigmoid colon was utilized in 75.7%, and loop colostomy was commonly used. Ten surgeons prefered primary maturation of the stoma. In conclusion, posterior sagittal anorectoplasty is popular for high types of ARM in this country, but considerable number of patients are still suffering from failed operations. For better understanding and analysis, necessity of prospective study by new classification was discussed.

      • 가톨릭 이식센터에서 경험한 생체 부분 간이식의 임상분석

        김동구 ( D. G. Kim ),문인성 ( I. S. Moon ),안상태 ( S. T. Ahn ),이명덕 ( M. D. Lee ),김인철 ( I. C. Kim ) 대한소화기학회 2002 대한소화기학회 춘계학술대회 Vol.2002 No.-

        <목적> 생체 부분 간이식은 뇌사자 간이식의 증례 감소에 대한 대체 치료법으로 인정되고 있다. 1988년 처음으로 소아에서 부분이식이 시도 된후 소아에서는 제공자가 안전하고 좋은 결과를 나타내었다. 최근에도 부분이식이 성인에게도 적용되어 시행되고 있는데 성인의 경우에는 제공자의 간 우엽을 절제하여 이식해야 하므로 수취자에게는 충분한 양의 간 실질과 제공자에서는 안전성이 함께 충족되어야 하는 문제가 있어 생체 부분 간이식에 대한 제공자와 수취자에 대한 결

      • 1999년도 한국 신생아외과 현황 -대한소아외과학회 회원대상 전국조사(제 2 차)-

        김우기,김상윤,김신곤,김인구,김재천,김현학,박귀원,박우현,송영택,오수명,유수영,이두선,이명덕,이성철,이석구,서정민,정상영,정성은,정을삼,정풍만,Kim, W.K.,Kim, S.Y.,Kim, S.K.,Kim, I.K.,Kim, J.C.,Kim, H.H.,Park, K.W.,Park, W.H.,Song, Y.T.,Oh, S.M.,Yoo, Y.S.,Lee, D.S 대한소아외과학회 2001 소아외과 Vol.7 No.1

        To understand the current status of neonatal surgery in Korea, a survey was made among the 36 members of the Korean Association of Pediatric Surgeons. The response rate was 75 % (26 surgeons in 20 hospitals). Five hundred fifty three neonatal surgical patients treated in 1999 were analyzed. Regional numbers of patients were closely related to the regional population in most areas. Ano-rectal malformations (17 %), pyloric stenosis (16 %), Hirschsprung's disease (13 %), atresia/stenosis of the gut (11 %), esophageal atresia (8 %) were the most common anomalies treated. The majority of operations were done within the first week of life. Seventy one per cent of cases were major life threatening or so-called neonatal index cases. Over-all mortality was 8 per cent. Higher mortality was observed in patients with diaphragmatic hernia (26 %), gastro-intestinal perforation (18 %), NEC (18 %), and esophageal atresia(14 %). Higher mortality was observed in patients with extremely low birth weight (33%) and low birth weight (18 %). Associated anomalies were observed in 20 %. Prenatal ultrasound was performed in 36 per cent with sensitivity of 20 %. Result of this study was compared to the previous report (1994) and that of Japan (1998).

      • KCI등재

        Hyperglycemia 환자에서의 TNA (Total Nutrient Admixture) 효과

        윤정이,김진선,나현오,이명덕 한국병원약사회 1998 병원약사회지 Vol.15 No.1

        This study investigate whether hyperglycemia patient's nutrition and glucose tolerance that were failed by IVH(Intra Venous Hyperalimentation) are improved by TNA(Total Nutrient Admixture). This research was conducted from March 1995 to October 1996 with 21 patients ; ① group A was treated with TNA administration after IVH(12 patients), ② group B was started with TNA(9 patients). As a result of observing glucose, insulin dose and nutritional condition retropectively before and after TNA administration, ① the glucose of group A - mean glucose was 289.4±82.71 before IVH administration and was 332.2±66.3 after IVH administration - decreased to 261.3±73.31 after a week, 237.9±45.40 after 2 weeks and 187.7±51.1(㎎/㎗) after 3 weeks ; ② the mean glucose of group B also decreased to 180.8±60.0 after TNA administration - before was 229.9±93.7(㎎/㎗) ; ③ insulin dose went down after TNA administration than before ; ④ the nitrogen balances of group A and B showed both positive conditions - the nitrogen balances of group A were 0.6±3.9 and 3.0±3.2 respectively when finished IVH and TNA administration, and group B was 1.7±4.6.

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