재발성 위암의 재수술에 대한 임상적 고찰

김순일(Soon II Kim),조장환(Chang Hwan Cho),황규철(Kyu Chul Whang) 대한외과학회 1985 Annals of Surgical Treatment and Research Vol.29 No.6

증례 : 위장관기질종양으로 오인된 미분화 췌장암 1예

김규섭 ( Kyu Seop Kim ),문희석 ( Hee Seok Moon ),고광훈 ( Kwang Hun Ko ),정일순 ( Ii Soon Jung ),김설영 ( Seul Young Kim ),성재규 ( Jae Kyu Seong ),정현용 ( Hyun Yong Jeong ) 대한내과학회 2012 대한내과학회지 Vol.83 No.2

미분화 췌장암은 매우 드문 질환이나, 치료 방법이 제한적이고 그 진행 속도가 빠르다. 또한 진단 당시 십이지장, 위, 결장 간막 등 주위 조직을 침범하는 경우가 많고 간, 폐, 림프절 등으로 원격 전이가 많다. 그 중 위나 십이지장의 침범의 경우 종양 자체의 불량한 예후뿐만 아니라 종양의 급속한 성장에 의한 출혈과 천공의 위험성이 높기 때문에 조기에 정확한 진단이 중요하다. 하지만 임상 증상 및 방사선적, 내시경적 소견 등이 모호하고 비특이적이어서 그 진단이 어렵다. 그러나 앞서 기술한 몇 가지 소견, 즉, 상복부 동통, 황달, 만져지는 복부 종괴, 복부 전산화 단층 촬영상 췌장의 체부나 미부에서 주변 조직들을 침범하는 거대한 중심괴사성종괴, 특히 종양 주변부의 조영 증강 소견, 내시경상 점막하 종양의 형태나 외부에서의 압박 소견 등이 있을 때 이를 종합적으로 판단하여 미분화 췌장암을 의심해보는 것이 필요하리라 생각된다. 본 증례에서는 내시경적, 방사선적으로 위장관 기질종양으로 판단하였으나, 수술 후 조직 검사에서 최종적으로 미분화 췌장암으로 진단된 환자를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Anaplastic carcinoma of the pancreas is an extremely rare but aggressive, rapidly progressive tumor. It often presents with invasion of adjacent organs and distant metastases. Most cases are inoperable and confirmed by autopsy. A correct diagnosis of stomach invasion by anaplastic carcinoma of the pancreas is important due to the risk of bleeding, perforation by rapid tumor growth, and a poor prognosis. However, an accurate diagnosis is difficult as a result of the various clinical presentations, symptoms, and radiological findings. We herein report a case of anaplastic carcinoma of the pancreas in a 78-year-old woman who presented with stomach invasion mimicking a gastrointestinal stromal tumor.

실측에 의한 제주도 일사량자원의 평가

조덕기(Jo Dok-ki),이태규(Lee Tae-Kyu),김은일(Kim Eun-Ill),전일수(Chun II-Soo),이순명(Lee Soon-Myung),조서현(Cho Suh-Hyun),오정무(Auh Chung-Moo) 한국태양에너지학회 1993 한국태양에너지학회 논문집 Vol.13 No.1

본 연구는 정부가 대체에너지기술의 개발과 이용촉진을 목적으로 새롭게 구상하고 있는 "Clean Enertopia 제주"사업과 관련, 최근 관심을 끌고 있는 제주도를 대상으로 이 지역 일사량을 측정, 분석하여 그 분포특징과 향후 에너지자원으로서의 이용가능성을 평가하는데 목표를 두고 수행하였다. 현지 측정사업의 내용을 중심으로 지금까지 나타난 결과를 보면<br/> 1) 제주지역의 일사량은 우리나라 남해안보다 13%이상 낮으며,<br/> 2) 제주도 내에서도 동서지역간의 격차가 현저하게 존재하였다.<br/> 는 점으로 요약된다. Solar radiation intensity in Cheju-Do has been measured and analyzed to study the its characteristic and the possibility of the alternative energy.<br/> This work will also support the on-going project "Clean Enertopia in Cheju" which is strongly driven by government recently.<br/> The results of this project indicate that<br/> 1) Insolation in Cheju-Do is 10 % lower than Southern coastal area.<br/> 2) A significant difference of insolation is observed between western and eastern part of Cheju-Do.

한국인 흡연과 사망위험에 대한 11년 추적연구

지선하(Sun-Ha Jee),조인호(In-Ho Jo),윤지은(Ji-Eun Yun),박정용(Jung-Yong Park),설재웅(Jae-Woong Sull),오희철(Hee-Choul Ohrr),이상이(Sang-Vi Lee),윤유식(Yoo-Sik Yoon),Jonathan M Samet, 김일순(II-Soon Kim) 한국역학회 2005 Epidemiology and Health Vol.27 No.1

Objective : In Korea, male smoking prevalence is among the world's highest and mortality rates from smoking-caused cancers, particularly lung cancer, are escalating. This cohort study examined the effects of cigarette smoking on the risk of mortality from all causes, cancers and cardiovascular diseases(CVD), and characterized the relationship of the risk with the amount and duration of cigarette smoking. Method : A eleven-year prospective cohort study was carried out of on 1,207,592 Koreans, 30 to 95 years of age. The study population includes participants in a national insurance program, who completed a questionnaire on smoking and other risk factors. The main outcome measures were death from all causes, cancer and CVD, obtained through record linkage. At baseline, 482,997 men(60.0%) and 19,755(5.3%) women were current cigarette smokers. Results : In multivariate Cox proportional hazards models, controlling for age, alcohol drinking, exercise, and obesity, current smoking among men increased the risks of mortality from all cause death (relative risk[RR], 1.56; 95% confidence interval[CI], 1.52~1.59), all cancer (1.75, 1.68~1.82), and CVD(1.46, 1.38~1.55). Similar results were found for mortality among women. Smoking also increased the risks of mortality for cancer of the lung(4.60, 4.09~5.33) and other cancers, including larynx, bile duct, esophagus, liver, stomach, pancreas, bladder, and also leukemia. Current smoking among women increased the risk of lung cancer mortality(RR=2.83, 95% CI 2.38~3.36). Conclusion : In Korea, smoking is an independent risk factor for death from all causes, CVD and a number of major cancers. The findings affirm the need for aggressive tobacco control in Korea in order to minimize the epidemic of smoking-caused disease.

Adrenaline 으로 인한 심장정지와 폐부종 발생에 관한 증례보고

이경자,김난숙,신정순,길찬일,서충호 대한마취과학회 1976 Korean Journal of Anesthesiology Vol.9 No.1

A 13-year-old male developed cardiac arrest and pulmonary edema during an elective surgery for chronic mastoiditis following a local injection of 0. 1 ml of 1: 1000 adrenaline under gene- ral anesthesia. After several days, 14-year-old male developed same episode during tonsillectomy under local anesthesia at ENT out patient department. They showed an immediate and favorable response to treatment with CPPB, rapid digitaliz- ation, fluid therapy, etc. The clinical course and pathophysiology of adrenaline induced pulmonary edema will be discussed.

낙상 peer review group 운영을 통한 낙상발생률 감소

성일순,송미라,김희선,김은숙,정미아,이수미,하국희,김성화,이혜란,안경진,심미옥,김낙희,성영희 한국의료QA학회 2008 한국의료질향상학회지 Vol.14 No.1

Background : This study was to reduce incidence of falls by analyzing actual problem and drawing out improvement plan applicable to the clinical practice throughoperation of the staff nurses-centeredfall peer review group. Method: The fall peer review group was composedof 8 nurseshavingpatient nursing experience for over 5years, and each of fall cases was reviewed and the root cause was analyzed. As a result, it was found that the patients and their families did not fully understandthe content of the education, and the staff nurses did not completely inspect the risk factors of falls and performimmediate intervention whenpatient's condition changed. Based on the above-mentioned results, improvement activity was conducted for the purposes of consolidating patients education methodand supplementing computerized systemto supportnurses' decision making as wellas devicesand facilities. Result: As a resultof conducting improvement activity in the aspects of education forpatients, support of nurse's decision-making, and devicesand facilities through operation of the staff nurses-centered fall peer review group, falls decreased by 9.5% comparedto beforeimprovement activity. Conclusion : It is concluded that operation of the clinical nurses-centered fall peer review group played a roleof promoter to draw out practical and applicable improvement plan to the clinicalpractice and apply directions of the field-centered, and increased nurses' interest in falls and ultimately, reduced incidence of falls. Therefore the Center willcontinue to operate the staff nurses-centered peer review group, and recommends participation of nurseswhoactually take the charge of nursingpatients in furtheranalysis ofpatients' safety accidents.

Epinphrine 과 복합요인에 의한 심정지의 증례보고

조강희,김순일 대한마취과학회 1978 Korean Journal of Anesthesiology Vol.11 No.2

It is a well known fact that cardiac arrest can occur during generaI or regional anesthesia. When cardiac arrest occurs, immediate measures to resuscitate and diagnose, whether for ventricular fibrilIation or cardiac standstill, should be taken to save the patients life and to prevent permanent damage to the central nervous system. The authors had experienced of a cirdiac arrest due to ventricular fibrillation during local infiltration anesthesia with xylocaine and epinephrine for tonsillectomy. As soon as the diagnosis of ventricular fibrillation was made by EKG, while the oxygenstion and closed cardiac massage were performed, the external D.C. defibrillation was carried out and drug therapy was given. The cardiac rhythm, was ventricular tachyeardia at first, then sinus rhythm was restored after the defibrillation. The patient recovered completely without any complications and was discharged from the hospital two days later.

신결석 및 뇨관결석 환자 수술시 Mannitol 투여 예

이경자,김난숙,신정순,길찬일 대한마취과학회 1977 Korean Journal of Anesthesiology Vol.10 No.2

It is well known that general anesthesia and surgery cause acute depression of renal function. Also, the occurrence of frank bleeding from the urinary tract can form a blood clot which may block an indwelling catheter or even a normal urethra with development of urinary infection. Many studies have reported that prophylactic use of hypertonic monnitol will prevent acute functional renal impairement during general anesthesia and surgery, and reduce the inci ence of clot formation and acute pyelonephritis. We believe that diuresis itself is a reneprotective mechanism and polyuria may yield two other advantages; 1. Fewer plugged catheters by decreasing the incidence of clots. 2. Decreased incidence of acute pyelonephritis by preventing stasis and washing aut bacteria. since 1972, in our hospital, 100cc or 200cc of 20% mannitol was used for increasing the urine output during operation of urinary stone in 33 patients, We have shown that the prognosis of parients was good.

임신중 환자의 마취관리

조강희,김충환,김순일 대한마취과학회 1978 Korean Journal of Anesthesiology Vol.11 No.4

Surgical inervention during the pregnancy is not rare and the impact of anesthesia and aurgery during the pregnancy is doublefold, because the mother and the fetus in uterus are oncerned. The anesthesiologist must know the progressive' maternal changes during the pregnancy and drug action on the fetus. The authors have experienced 50 cases of pregnant women undergoing various kinds of operation and have analyzed those cases according to the type of disease, the duration of gestation, physical status, premedication, anesthetic technics and agent used, and the outcome of the fetus and the patient during the period between March 1972 to August 1978 The results were as follows: 1) The most of patient, 32 cases were operated for the obstetric and gynecological :reason s. 2) 27 cases (54%) had undergone the operation during the second trimester. 3) Physical status class 2 including 28 cases (56%) was the most commonly found physical status of the patients. 4) Halothane was the main anesthetic agent for 39 cases (78%) and there were 3 cases of spinal anesthesia. 5) We could follow 27 cases among 50 cases about the outcome of the fetus. 17 spontaneous vaginal delivery, 8 Cesarean sections, 1 fetal death in uterus and 1 wanted D&C. 6) Among 5 premature deliveries, 2 premature infants died during the hospitalization. 7) The only maternal motality was the case of intrahepatic stonewho expired 11 days postoperatively and delivered a 1,300 gm premature 7 days postoperatively.

외래환자의 수술을 위한 마취의 임상적 고찰

조강희,이진구,김순일,윤형배 대한마취과학회 1980 Korean Journal of Anesthesiology Vol.13 No.4

There is the trend of increasing number of outpatients who are requiring surgieal intervention because of medical insurance and general improvement of economic state. Ambulatory surgical clinics are prospering in the United States. Thus we have analyzed 1957 cases of outpatient anesthesia excluding local infiltration performed by surgeons from total of 4302 cases o foutpatient surgery during the 5 year period between 1975 and 1979. The results of this analysis were as follows: 1) Ketamine IM or IV was used as a sole agent in 500 cases who were under 12 years of age and mean operation and recovery time were 19.95 and 58. 45 minutes, respectively. 2) Mean operation and recovery time for 1,125 cases of pentothal+N₂O+O₂, anesthesia were 15. 55 and 108. 23 minutes, respectively. 3) For 321 cases of halothane+N₂O+O₂, anesthesia, mean operation and recovery time were 40.67 and 145. 94 minutes, respectively. 4) During recovery period there were no serious complications or mortality. 5) The majority of 1,125 among57cases were gynecological outpatients and the rest were distibuted among the surgical departments and dermatology, 6) Pentothal, nitrous oxide, halothane and ketamine were used safely for the outpatient anesthesia according to our experiences.