Common Bile Duct Perforation Developed During Simple Endoscopic Retrogradc Cholangiography

박상흠 ( Sang Heum Park ),정일권 ( Il Kwun Chung ),김은주 ( Eun Joo Kim ),김홍수 ( Hong Soo Kim ),이문호 ( Moon Ho Lee ),김선주 ( Sun Joo Kim ) 대한내과학회 1999 대한내과학회 추계학술대회 Vol.57 No.-

청탁금지법상 직무관련성의 개념

박상흠(Park, Sang-Heum) 동아대학교 법학연구소 2017 東亞法學 Vol.- No.76

형법상 뇌물죄는 직무관련성과 대가성을 구성요건으로 하고 있기 때문에 공무원의 부패행위를 근절하는데 한계가 있다. 이를 극복하기 위해 제정된 청탁금지법의 입법취지가 금품 등 수수 금지를 통한 직무수행의 공정성 확보라는 점을 고려해볼 때 공무수행의 불가매수성을 보호법익으로 하고 있는 뇌물죄보다 직무관련성의 개념이 확대 적용되어야 할 필요성을 알려준다. 청탁금지법이 입법례로 참고한 미국의 불법사례수수죄의 경우를 살펴보면 직무관련성의 적용범위에 관해 시사 하는바가 크다. Sun-Diamond 판결에서는 불특정행위에 대하여 영향을 미칠 가능성만으로는 뇌물죄나 불법사례수수죄가 적용되지 않는다고 판시하여 불법사례수수죄의 역할에 한계를 노출시켰다. 청탁금지법은 이같은 전철을 밟지 않기 위해 직무관련성의 개념을 넓게 적용해야 할 것이다. 그런데 청탁금지법의 규정의 형식과 구조를 살펴보면 소극적 공제형식을 취하고 있으며 법 제8조 제3항 3호에서 정당한 권원에서 증여를 배제하고 있다는 점을 볼 때 직무관련성의 범위는 최소한 뇌물죄의 영역 그 이상이라는 점을 보여준다. 또한 직무관련성을 명시적으로 규정하고 있는 법 제8조 제2항과 그 예외사유에 해당하는 법 제8조 제3항 제2호의 조문구조를 살펴볼 때 직무관련자와 원활한 직무수행 등을 위한 목적의 범위 안에서 금품제공을 하여야 할 뿐만 아니라 가액의 범위도 충족시켜야 하므로 직무관련성의 개념은 뇌물죄보다 넓게 해석된다. 청탁금지법에서는 금품제공에서 특정 행위와 사례관계, 특정 한 행위에 영향력을 줄 의도가 없었다 하더라도 포괄적 직무관련성을 인정하는 방향으로 나아가야 할 것이다. Criminal bribery has a limitation in eradicating corruption of public officials because bribery crime requires relevancy to duty and Quid pro quo. Considering that the purpose of legislative acts to overcome this is securing the fairness of job performance through the prohibition of money laundering, the notion of relevancy to duty is greater than the bribery crime, It indicates the need to be applied. If we look at the case of Bill on the prevention of Unjust Solicitations and Conflicts of Interest , which the Referral Protection Act refers to as a legislative example, there is a great deal of suggestion about the scope of job relevance. In the Sun-Diamond judgment, the bribery or illegality cases were not applied only to the possibility of affecting unspecified behavior, thus limiting the role of illegal cases. The Improper Solicitation and Graft Act should apply the concept of relevancy to duty broadly so as not to take such a train. However, when we look at the form and structure of The Improper Solicitation and Graft Act, we take a “negative Grenzziehung”(passive deduction form and exclude the bestowal from legitimate rights) in Article 8 (3) 3 of the Act. Or more. In addition, when looking at the structure of Article 8 (2) of the Act explicitly stating job relevance and Article 8 (3) (2) of the Act for the exceptional reason, The concept of relevancy to duty is interpreted more broadly than bribery because it is necessary to provide money within the scope of facilitate performance of duties or for social relationships as well as to cover the scope of the value. In other words, The Improper Solicitation and Graft Act, it is necessary to move toward recognizing comprehensive relevency to duty even if there is no intention to influence specific acts, case relationships, or specific acts.

성인의 환상췌장

박상흠(Sang Heum Park),김선주(Sun Joo Kim),황성규(Seong Gyu Hwang),이문호(Moon Ho Lee),송옥평(Ok Pyeong Song),김진오(Jin Oh Kim),문수남(Soo Nam Moon),박성규(Seong Gyu Park),김종봉(Jong Bong Kim),김표년(Pyo Nyeon Kim) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.6

Annular pancreas is a rare congenita! abnormality consisting of a ring of pancreatic tissue around the second part of the duodenum. Although it present at birth, it may cause few symptoms until adulthood. The onset of symptoms in the adult are result from associated chronic partial duodenal obstruction, peptic ulcer disease and pancreatitis. Annular pancreas can be diagnosed more frequently under clinical suspicion. Recently, we are experienced a case of annular pancreas detected in 59-year old female patient suffered from chronic intermittent abdominal pain, nausea and vomiting. We diagnosed as incomplete obstruction of the second part of the duodenum by clinical and radiologic information and confirms the annular pancreas by surgery. We report it with a review of the literature

구연2 : 내시경적역행성담도조영술에서 Conventional Method로 담도삽관에 실패한 경우에, Needle-knife(침형절개도)를 이용한 Infundibulotomy(누두절개술)의 유용성

박상흠 ( S H Park ),김은주 ( E J Kim ),정일권 ( I K Chung ),김홍수 ( H S Kim ),이문호 ( M H Lee ),김선주 ( S J Kim ) 대한췌담도학회 1999 대한췌담도학회지 Vol.4 No.1

후복막강에 발생한 신경초종

박상흠(Sang Heum Park),김선주(Sun Joo Kim),이문호(Moon Ho Lee),문수남(Soo Nam Moon),정일권(Il Kwun Jung),백진기(Jin Ki Paik),김도진(Do Jin Kim),황성규(Seung Gyu hwang),김의한(Eu Han Kim) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.6

Bengn solitary neurilemmoma of the retroperitoneum is a rare disease of nerve sheath origin. A 40-year-old male patient was admitted to our hospital for evaluation of retroperitoneal mass. Abdominal ultrasonography and computed tomogaphy (CT) revealed a solid tumo in the retroperitoneum. On exploratory laparatomy, this mass turned out to be an baseball sized mass of the retroperitoneum. The mass was excised surgically in an encapsulated state. Histological section and immunohistochemical stain revealed a typical neurilemmoma. We report it with a review of literature.

담석성 췌장염 치료에서 내시경적 유두부 괄약근절개술의 임상적 유용성

박상흠(Sang Heum Park),권광안(Kwang An Kwon),김인호(In Ho Kim),김은주(Eun Joo Kim),정일권(Il Kwun Chung),김홍수(Hong Soo Kim),이문호(Moon Ho Lee),김선주(Sun Joo Kim) 대한소화기학회 2000 대한소화기학회지 Vol.36 No.3

Background/Aims : Gallstone pancreatitis has been classically treated by cholecystectomy to prevent recurrence of pancreatitis. However, for patients whose condition is not suitable to operation, endoscopic sphincterotomy (EST) without cholecystectomy was recently performed. Thus, we analyzed the result of EST without cholecystectomy in patients with gallstone pancreatitis and evaluated its clinical usefulness. Methods: Seventeen patients who were diagnosed as gallstone pancreatitis from January 1997 to January 2000 and treated by EST without cholecystectomy because of difficulties in operation were enrolled in this study. The patients were followed up by visiting outpatient department or interview by telephone. Results: The mean age was 64.4 years and the mean duration of follow-up was 15.5 months. According to modified Glasgow criteria, the disease status of 14 patients were mild and the other 3 patients were severe. The site of gallstones were gallbladder in 6 patients, common bile duct (CBD) in 2, and both in 6. Success rate of stone removal in CBD was 100%(11/11) and EST-related complication rate was 6%(1/11). During the follow-up period, there were no pancreatobiliary diseases. Conclusions: EST without cholecystectomy is a safe and useful therapeutic modality in patients with gallstone pancreatitis who had diffculties in operation. (Kor J Gastroenterol 2000;36:383 - 389)

대한간학회지 제8차 춘계학술대회 초록집 : 구연 ; Histoacryl을 이용한 위정맥류 출혈의 치료와 내시경소견 및 재출혈 요인

박현준 ( Park Hyeon Jun ),김영훈 ( Kim Yeong Hun ),정일권 ( Jeong Il Gwon ),김홍수 ( Kim Hong Su ),박상흠 ( Park Sang Heum ),이문호 ( Lee Mun Ho ),김선주 ( Kim Seon Ju ) 대한간학회 2002 Clinical and Molecular Hepatology(대한간학회지) Vol.8 No.2(S)

잔재물 배출계수를 활용한 자원순환목표설정에 관한 연구

박민선 ( Minseon Park ),김지원 ( Jiwon Kim ),박상흠 ( Sangheum Park ),정민정 ( Minjung Jung ) 한국폐기물자원순환학회 2022 한국폐기물자원순환학회 추계학술발표논문집 Vol.2022 No.0

담즙 누출 환자에 삽입된 담도 스텐트 제거 후 발생한 대량의 혈액담즙증 1예

박병준 ( Byung Joon Park ),이태훈 ( Tae Hoon Lee ),박상흠 ( Sang Heum Park ),장영환 ( Young Whan Jang ),곽윤미 ( Yun Mi Kwak ),이웅희 ( Woong Hee Lee ),배상호 ( Sang Ho Bae ),김창호 ( Chang Ho Kim ) 대한췌담도학회 2015 대한췌담도학회지 Vol.20 No.2

외상으로 인한 혈액담즙증은 드물지 않게 보고되고 있고 경피경간 경로를 이용한 담도내시경이나 배액술 등에 의한 의인성 손상이 증가하고 있다. 그러나 담도스텐트 제거에 따른 대량의 혈액담즙증의 보고는 매우 드물다. 본 증례는 복부 외상으로 간엽절제술을 받은 환자에서 발생한 담즙 누출을 치료하기 위해 삽입한 담도 스텐트를 제거하면서 혈액담즙증이 대량 출혈로 악화된 사례이다. 간외상 수술 후 담즙누출로 플라스틱 담도 스텐트 삽입 후 호전 중에 혈액담즙증 및 담도염 발생으로 스텐트 교체 목적으로 제거하였으나 제거하자마자 대량의 활동성 혈액담즙증으로 악화되었다. 수술 후의 담즙 누출로 인한 주변조직 손상 및 삽입된 담도 스텐트로 인한 자극과 제거시의 손상이 원인이 될 수 있을 것으로 생각된다. 치료는 대량 출혈로 내시경 시야가 확보되지 않아 응급 혈관조영술로 지혈술을 시행하였다. 따라서 복부외상 환자나 수술 환자에서 담즙 누출 후 담도 배액 스텐트는 일반적으로 시행되는 효과적인 치료 방법이나 혈액담즙증 및 합병증으로 담도 스텐트를 교체할 때 주변 담도나 혈관계의 합병증 유무에 대한 사전 검사를 시행하고 스텐트 제거시에도 주의를 요한다. Biliary plastic stent induced life-threatening hemobilia is very rare. In this case, hemobilia seriously worsened following removal of a biliary stent, which had been placed for treatment of a postoperative bile leak in a patient who had undergone lateral liver segmentectomy for abdominal trauma. Following placement of the biliary stent, the bile leak improved, but hemobilia and cholangitis developed five days later. To manage the stent malfunction, we removed the biliary stent. However, lifethreatening hemobilia developed immediately after removal. Endoscopic hemostasis was impossible; therefore, emergency angiographic embolization and stent graft were performed successfully. In such cases, angiographic embolization and stentgraft placement are effective diagnostic and therapeutic alternatives. When a patient develops hemobilia or cholangitis after biliary stent placement, endoscopists should pay special attention to remove the stent, which might exacerbate hemobilia. Korean J Pancreatobiliary 2015;20(2):99-104

흡연이 기관지폐포세척액내의 Elastase 에 미치는 영향

박춘식(Choon Sik Park),박상흠(Sang Heum Park),조종근(Jong Geun Cho),양동호(Dong Ho Yang),어수택(Soo Tak Uh),정연태(Yun Tae Jung) 대한내과학회 1988 대한내과학회지 Vol.35 No.2

N/A Many experimental animal studies have confirmed the protease-antiprotease theory of emphysema that a destructive enzymatic activity against elastin is present within the lung in excess of antiprotease, especially α1-antitrypsin, resulting in degradation of elastin fiber and emphysema. Although cigarette smoking could lead to this imbalance by producin an excess of elastase activity, studies examining the presence of elastase in human bronchoalveolar lavage (BAL) fluid have produced variable results. To further characterize the presence and type of elastase activity in human BAL fluid, we studied 42 subjects, 20 smokers and 22 nonsmokers. We sought to discover 1) Whether BAL fluid collected from smokers and nonsmokers contained free elastolytic activity, 2) Whether BAL fluid collected from smokers contained more free elastolytic activity than that collected from nonsmokers and if this activity had primarily originated from neutrophils or macrophages. The results were as follows: 1) The percentage of recovered fluid after infusion with 100 ml of normal saline in smokers was 42.55±2.68% compared with 49.13±2.52% in nonsmokers (p<0.05). 2) The total cell count recovered from BAL fluid in smokers was 23.07±4.84×10(6) compared with 12.94±2.76×10(6) in nonsmokers (p<0.05), the macrophage count in smokers was 19.44±4.46×10(6) compared with 9.83±1.36×10(6) in nonsmokers (p<0.025), the neutrophil count in smokers was 1.82±0.37×10(6) compared with 0.42±0.10×10(6) in nonsmokers (p<0.025) and lymphocyte count in smokers was 0.97±0.20×10(6) compared with 0.85±0.16×10(6) in nonsmokers (p>0.05). 3) The percentage of macrophage recovered from BAL fluid in smokers was 89.27×1.12% compared with 88.86±0.86% in nonsmokers (p>0.05), that of neutrophils in smokers was 6.01±0.84% compared with 3.83±0.46% in nonsmokers (p<0.025) and that of lymphocytes in smoker was 4.72±0.74% compared with 7.26±0.86% in nonsmokers (p<0.05) 4) The total activity of elastase recovered from BAL fluid in smokers was 557.6±131.2 U compared with 302.0±52.1U in nonsmokers (p<0.05), the activity of neutrophil-elastase in smokers was 302.8±56.S U compared with 146.2±36.9U in nonsmokers (p<0.025) and the activity of macrophage elastase in smoker was 235.3±47.0 U compared with 148.3±30.1 U in nonsmoker (p>0.05). 5) The corrected concentration of elastase with recovered fluid volume in smokers was 12,93±2.22 U/ml compared with 6,77±1.10 U/ml in nonemokers (p<0.05), the corrected concentration of neutrophil-e1astase in smokers was 6.85±1.25U/ml compared with 3.23±0.86 U/ml in nonsmokers (p<0.05) and the corrected concentration of macrophage elastase in smokers was 5.41±1.11 U/ml compared with 3.17±0.47 U/ml in nonsmokers (p>0.05). 6) The coreected concentration of elastase with albumin in smokers was 363.10±97.69 U/ml compared with 173.70±33.93U/ml in nonsmokers (p<0.05), that of neutrophil-elastase in smokers was 204.10±65.43 U/ml compared with 90.3±24.6 U/ml in nonsmokers (p>0.05) and that of macrophage-elastase in smokers was 157.9+ 51.6 U/ml compared with 75.4±9.73 U/ml in nonsmokers (p>0.) 7) The proportion of elastase in smokers that originated from neutrophil elastase was 57.64±7.039 and 42.64+4.47A originated from macrophage elastase (p>0.05). In nonsmokers 43.79±6.79% of elastase originated from neutrophil and 52.50±7.29% from macrophages (p>0.05). 8) The neutrophil-elastase recovered from BAL fluid was correlated with the number of total recovered neutrophil count (r=0.577, p<0.005) and the macrophage-elastase was not correlated with the number of total recovered macrophage count, In conclusion, 1) Smoking increased the total count of inflammatory cells, especially neutrophils and macrophages in BAL fluid. 2) Free elastolytic activity was found in all cases of BAL fluid and smoking increased the total elastase and the fraction of neutrophil elastase in BAL fluid.