소아 대장용종증 환자의 임상양상 및 내시경적, 조직학적 소견

임미선,서정기,고재성,양혜란,강경훈,김우선,Lim, Mi-Sun,Seo, Jeong-Kee,Ko, Jae-Sung,Yang, Hye-Ran,Kang, Gyeong-Hoon,Kim, Woo-Sun 대한소아소화기영양학회 2010 Pediatric gastroenterology, hepatology & nutrition Vol.13 No.2

목 적: 대장용종증은 소아에서는 드문 질환군으로 다수의 용종으로 인한 출혈, 복통, 장중첩증 등이 반복될 수 있고 용종의 악성화나 장외종양이 발생할 수 있으나 아직은 이에 관한 연구가 많지 않다. 본 연구에서는 소아 대장용종증의 임상 양상과 내시경적, 조직학적 특징을 살펴보고자 하였다. 방 법: 서울대병원 어린이병원에서 1987년부터 2009년까지 대장내시경을 시행 받은 2,956명의 소아 환자중에서 대장용종증으로 진단받은 37명의 환자를 대상으로 의무기록 분석을 시행하였다. 대장용종증 환자들의 진단 시 평균나이는 8세였다. 결 과: Peutz-Jeghers 증후군이 22예로 가장 많았으며 연소성 용종증 7예, 가족성 선종성 용종증 6예, 림프성용종증 2예이었다. 내원 시 가장 흔한 주소는 혈변이었다. 50% 이상의 환자에서 혈변과 복통이 동반되었고 일부에서 항문종괴, 설사, 변비가 동반되었다. 용종의 수와 크기는 다양하였고 위장과 소장에 용종이 동반된 환자는 각각 21명, 17명이었다. Peutz-Jeghers 증후군 환자에서는 주로 다엽성의 목이 있는 용종이 관찰되었다. 연소성 용종증 환자에서는 둥글고 목이 있는 용종이 대부분이었다. 가족성 선종성 용종증 환자에서는 작고 둥글며 목이 없는 용종이 관찰되었다. 림프성 용종증 환자에서는 목이 없는 용종이 관찰되었다. 모든 환자는 내시경적 용종절제술을 시행받았고 14명(38%)은 수술적 용종절제술을 시행받았다. 부분장절제술을 시행받은 환자는 13명(35%)이었고, 가족성 선종성 용종증 환자 4명은 전대장절제술을 시행받았다. Peutz-Jeghers 증후군 환자 중 일부에서 장외 종양이 발생하였으나 용종의 악성화는 없었다. 결 론: 소아의 대장용종증 환자는 출혈, 복통 등의 증상을 보이며 장중첩증 등의 합병증이 발생할 수 있어 조기 진단과 치료가 필요하며 정기적인 대장내시경 검사를 통해 합병증을 예방하고 용종의 악성화나 장외 종양 여부를 확인해야 한다. Purpose: Colonic polyposis is less common in children than in adults. The clinical data pertaining to colonic polyposis in children are limited. Children with colonic polyposis have complications associated with numerous polyps, malignant transformation of the polyps, and extraintestinal neoplasms. We studied the clinical spectrum, endoscopic characteristics, and histologic findings of colonic polyposis in Korean children. Methods: We reviewed the clinical data of 37 children with multiple colonic polyps between 1987 and 2009. The mean age at the time of diagnosis of colonic polyposis was 8.0${\pm}$3.2 years. Results: Peutz-Jeghers syndrome, juvenile polyposis syndrome, familial adenomatous polyposis (FAP), and lymphoid polyposis was diagnosed in 22, 7, 6, and 2 children, respectively. The most common clinical presentation in children with colonic polyposis was hematochezia. A family history of colonic polyposis was noted in 7 children. The colonoscopic findings of colonic polyposis varied with the size and number of polyps. The majority of polyps were multi-lobulatd and pedunculated in children with Peutz-Jeghers syndrome. The polyps in children with juvenile polyposis syndrome were primarily round and pedunculated. For the children with FAP, the colon was carpeted with small, sessile polyps. There were multiple sessile polyps in the patients with lymphoid polyposis. Surgical polypectomy was performed in 14 children (38%). Intestinal segmental resection was performed in 13 children (35%). Four patients with FAP underwent total colectomy. Four children with Peutz-Jeghers syndrome had extraintestinal neoplasms. No malignant transformation of polyp was identified. Conclusion: Children with colonic polyposis should undergo a careful initial evaluation and require periodic re-evaluation.

의사결정나무와 자료포락 분석을 이용한 공공기관 유형별 환경효율성에 대한 연구

임미선(Mi Sun Lim),김진화(Jinhwa Kim),최순재(Soon Jae Choi) 한국경영과학회 2015 韓國經營科學會誌 Vol.40 No.1

This study aims to provide public sectors with eco-efficiency information. To implement the purposes of the study, environmental and economic variables of Eco-Efficiency were identified through decision tree model, then the relative Eco-Efficiencies of 243 public sectors were evaluated through input-oriented DEA (Data Envelopment Analysis) model. Specifically, the amount of public purchasing per a staff and the amount of energy use per a staff were considered as input factors. Sales per a staff was considered as output factor. The result shows that most of the public sectors (94.2%) were evaluated as “inefficient” taking into consideration of average value, 0.501 from market-based public corporations, 0.288 from local public corporations, 0.28 from quasi-market-based public corporations, 0.269 from fund-management-based quasi-governmental institutions, 0.09 from non-classified public institutions, and 0.078 from commissioned-service-based quasi-governmental institutions. Furthermore, it is possible to establish a plan for internal Eco-Efficiency improvement based on information of the reference set. In order to improve the Eco-Efficiency in the public sectors in the long term, environmental impacts of the overall public sectors" operations (e.g., energy saving, water saving, waste reduction, and purchasing of green products) needs to be properly proposed in consideration of BSC (Balanced Scorecard) indicators of public sectors.

조선 후기 정재의 음악

임미선(Lim, MI Sun) 숭실대학교 한국문학과예술연구소 2008 한국문학과 예술 Vol.1 No.-

본고는 조선후기 정재의 반주음악에 대하여 전기와 다른 차이점 및 조선 후기 변화 양상을 논의하였다. 먼저 정재를 반주했던 등가의 편성에 대해 살펴본 다음, 정재별 반주악곡에서 나타나는 변화를 살펴보았다. 반주음악의 형태는 정재의 연행 공간, 향유계층 등에 따른 근본적인 차이를 드러내는 데에 중점을 두었다. 정재의 반주악곡에 대해서는 궁중의 경우와 지방의 교방정재를 비교하였다. 조선후기 궁중정재의 반주음악은 전기와 같이 당악기와 향악기에 의한 관현합주로 연주되었다. 후기에도 전기와 동일한 형태가 지속적으로 쓰인 사실을 통해서 궁중정재는 500년 가까이 관현합주의 형태로 고정되었음을 알 수 있다. 수십명의 악공으로 구성된 악대이거나, 5,6명 정도의 작은 편성이거나 관악기와 현악기가 어울어진 형태였다. 다만 예외적으로 처용무의 경우에 한해 18세기에 와서 관악합주의 독특한 형태로 반주되기 시작하였다. 궁중에서 연행된 정재와 달리 궐밖의 관아나 사가에서 행한 교방정재는 삼현육각 즉, 관악합주의 형태로 반주되었다. 피리?대금?해금?장고?북 등으로 편성된 삼현육각은 지역간의 차이없이 전국적으로 통일된 형태로서 조선 후기 교방정재의 반주음악을 대표하였다. 정재 반주악곡에 있어서 조선 전기에는 향당정재의 성격에 따라 향악과 당악이 각각 구별되어 쓰였을 뿐 아니라 정재별로 반주악곡이 각각 달랐으나, 후기에는 향악과 당악의 구별이 없어지면서 향당정재의 반주악에 구별이 없어졌으며 정재별로 달리 연주되었던 반주악의 변별성도 없어졌다. 조선후기의 변화 중 가곡이 정재의 반주악과 창사용도로 수용된 점, 조선말에 정재반주악으로 쓰인 보허자령?여민락만?여민락령?향당교주를 총괄적으로 지시하는 원무곡으로 획일화된 점이 특히 주목된다. This paper discusses about the accompaniment used in the Jeongjae(dance) in the later period of the Joseon dynasty, focusing on how it differs from that of the earlier period of the Joseon dynasty and how it evolved in the latter periods. First we looked at how Deungga, the accompaniment for Jeongjae, was composed. We then looked at the changes observed in the accompaniment piece for each Jeongjae. We focused on finding the essential difference in the form of the accompaniment piece depending on the venue and the target audience of the Jeongjae. We compared the accompaniment piece of a Jeongjae performed within the Royal Court as opposed to that of a Kyobang Jeongjae performed outside of the Royal Court. The Jeongjae performed within the Royal Court in the later years of the Joseon dynasty did not differ any significantly from the early years of the dynasty in that it remained an orchestra consisting of a mixture of Korean and Chinese instruments. The fact that the form of the accompaniment piece remained unchanged throughout the Joseon dynasty tells us that the Jeongjae performed within the Royal Court remained an orchestra for 500 years. The orchestra could be anywhere between a band consisting of dozens of musicians to a small composition of 5~6 musicians. One exception is the Cheoyoungmu which evolved into a composition of wind instruments in the 18^th century. While Jeongjae was exclusively performed in the Royal Court, Kyobang Jeongjae was performed outside the Royal Court in places such as government offices or private residences. Kyobang Jeongjae was played in the form of Samhhyeonyukgak, i.e.a composition of wind instruments. Samhhyeonyukgak, a combination of Piri, Taegum, Haegum, Janggo, and Buk, represented the accompaniment for Kyobang Jeongjae in the later years of the Joseon dynasty and showed little difference between different regions. During the early years of the Joseon dynasty, Korean instruments and Chinese instruments were used separately in accordance to Hyangdang Jeongjae as well as having different accompaniment pieces for each Jeongjae. However the distinction between Korean instruments and Chinese instruments became non-existent in the later years of the Joseon dynasty as well as the discrimination of the accompaniment pieces for each different Jeongjae. Some of the most notable change in the later years of the Joseon dynasty include the acceptance of songs (in the classical sense) as accompaniment for Jeongjae and substitution for its lyrics as well as the standardization of Boheojaryeong, Yeominrakman, Yeominrakryeong, Hyangdanggyoju into the generalized Wonmugok used in accompaniment for Jeongjae in the last years of the Joseon dynasty.

전북민요에서 나타나는 경기, 동부민요적 음악현상

임미선(Lim Mi-sun) 한국학중앙연구원 2011 한국학 Vol.34 No.2

자외선차단 기능을 갖는 폴리실세스퀴옥산 구형 입자의 개발

임미선 ( Mi Sun Lim ),김영백 ( Young Baek Kim ),정택규 ( Teak Kyu Jung ),윤경섭 ( Kyung-sup Yoon ) 대한화장품학회 2005 대한화장품학회지 Vol.31 No.1

자외선 차단제로 널리 사용되는 p-methoxycinnamoyl기를 함유하는 폴리실세스퀴옥산 전구체를 합성하고 그로부터 자외선을 흡수 차단하는 구 형태의 입자를 제조하였다. 여러 가지 제조 조건을 조절하여 100nm에서 수 ㎛ 사이의 직경을 가진 구를 제조하였으며, 얻어진 구의 피부 도포와 자외선차단 실험을 수행하였다. 직영이 대략 0.6 ㎛인 구를 10%의 농도로 바셀린에 분산시킨 제재를 손등에 도포하였을 때 백화현상이 나타나지 않았고 10% 농도 바셀린 제재의 자외선차단지수, SPF는 5.7로 양호한 편이었다. 또한 자외선을 흡수 차단하는 폴리실세스퀴옥산 구는 옥틸메톡시신나메이트 자외선차단제에 비하여 농도 증가시 SPF의 상승효과가 커, 자외선차단용 기능성화장품 신소재로의 사용이 기대된다. A silsesquioxane precursor that contains p-methoxycinnamoyl group was synthesized to produce UV absorbing spherical polysilsesquioxane (PSQ) spheres with diameters of 10nm to a few ㎛ under different conditions. A dispersion of 10 wt% in Vaseline of these PSQ spheres with diameters of approximately 0.6 ㎛ showed SPF values of 5.7 and the identical dispersion did not turn white when applied to human hands. These UV absorbing PSQ spheres showed higher boosting effect of sun protection factor (SPF) than the well known UV blocking octyl methoxycinnamate (OMC). The results indicated that the PSQ spheres with p-methoxycinnamoyl group should be useful as the ingredients in UV screening functional cosmetics without causing allergies and whitening.

메르스 감염에서 리바비린과 인터페론 사용에 대한 임상 문헌

임미선 ( Mi Sun Lim ) 영남대학교 약품개발연구소 2016 영남대학교 약품개발연구소 연구업적집 Vol.26 No.-

Middle East respiratory syndrome - coronavirus infection has posed substantial threat to public health with extremely high mortality rate in 2015. Although there are no approved novel medications for coronavirus, several antiviral agents such as ribavirin and interferon have been tried to MERS patients according to the in-vitro inhibitory effect, ther-apeutic effect on the animal model and experience from the severe acute respiratory syndrome - coronavirus infection. The aim of this study is to evaluate the clinical evidence of the antiviral treatment for MERS-Co V infection. After systematically searching the medical literature databases, I found five studies described the clinical efficacy of antiviral treatment on MERS patients. All of them were about the combination therapy of ribavirin and interferon (IFN). Two of them were retrospective cohort studies with quality of evidence (QOE) II and the others were observational study and case reports with QOE III. As a result of critical appraisal, it is concluded that none of those studies represented confirmatory clinical evidence of the efficacy of ribavirin and interferon combination therapy on MERS patients. Although Omrani et al. represented that ribavirin and IFN treatment had significantly improved survival at 14 days, it was not enough time to conclude the effect.

메르스 감염에서 리바비린과 인터페론 사용에 대한 임상 문헌 고찰

임미선(Mi-sun Lim) 대한약학회 2015 약학회지 Vol.59 No.6

Middle East respiratory syndrome - coronavirus infection has posed substantial threat to public health with extremely high mortality rate in 2015. Although there are no approved novel medications for coronavirus, several antiviral agents such as ribavirin and interferon have been tried to MERS patients according to the in-vitro inhibitory effect, therapeutic effect on the animal model and experience from the severe acute respiratory syndrome - coronavirus infection. The aim of this study is to evaluate the clinical evidence of the antiviral treatment for MERS-CoV infection. After systematically searching the medical literature databases, I found five studies described the clinical efficacy of antiviral treatment on MERS patients. All of them were about the combination therapy of ribavirin and interferon (IFN). Two of them were retrospective cohort studies with quality of evidence (QOE) II and the others were observational study and case reports with QOE III. As a result of critical appraisal, it is concluded that none of those studies represented confirmatory clinical evidence of the efficacy of ribavirin and interferon combination therapy on MERS patients. Although Omrani et al. represented that ribavirin and IFN treatment had significantly improved survival at 14 days, it was not enough time to conclude the effect.

해방공간기 전라북도 농악의 발전 양상

임미선 ( Mi Sun Lim ) 한국음악사학회 2014 한국음악사학보 Vol.53 No.-

본 논문은 해방공간기(解放空間期)에 전라북도에서 농악(農樂)이 발전하게 된 배경을 살피는 데에 목적을 두었다. 특히 우도(右道)에서 정읍농악(井邑農樂)이, 좌도(左道)에서 남원농악(南原農樂)이 새롭게 발전하게 된 상황, 좌도와 우도 농악이 포장걸립으로 연예농악을 펼치면서 발전하게 된 과정 등에 비중을 두고 논의하였다. 그러한 과정에서 좌도농악(左道農樂)와 우도농악(右道農樂)의 교섭이 이루어진 배경과 시기에 대한 내용도 아울러 다루었다. 논의에서 해방 이전에 보천교가 농악을 장려함으로써 정읍농악이 전문 치배들로 구성되는 농악대(農樂隊)의 형성을 가능케 했던 측면과 전문 예인들에 의해 판굿이 짜여지는 등의 기반이 이루어진 환경을 집중적으로 조명하였다. 해방공간기에 개최되었던 전국농악경연대회(全國農樂競演大會)가 농악 발전의 촉매 역할을 한 점에 주목하여 대회 출전을 위해 이름난 잽이들이 결집하여 농악단(農樂團)이 구성되었던 점, 대회에서 전북팀이 특등상을 받아 전북의 농악이 전국적으로 알려짐으로써 1940년대에 포장걸립이 시작되었던 점 등을 부각시켰다. 비록 짧은 기간이지만, 해방공간기에 호남 농악(湖南農樂)은 좌도에서는 남원농악이, 우도에서는 정읍농악이 주축이 되어 많은 명인들을 배출하고 기예를 발휘함으로써 최고의 전성기를 이루었다. 이 기간 좌도와 우도의 보이지 않는 경쟁구도도 농악의 기예능, 특히 판굿의 형식이 발전하는 데에도 큰 영향을 주었을 것이라 생각된다. 또한 고창에서와 같이 재산가들의 후원을 받아 상업적으로 농악을 연행한 것도 일정 부분 기여한 측면도 제시하였다. This paper examines the background of the development of the North Cholla province 全羅北道 nongak 農樂 (farmers`` music). Expecially, the paper deals with how Chongop nongak 井邑農樂 and Namwon nongak 南原農樂 newly emerged in Chwado 左道 (left region of province) and Udo 右道 (right region of province) respectively, focusing on the process of farmers`` music being advanced into an entertainment music performed in a stage, the tent, called p``ojang kollip 포장乞粒. Also, the paper includes a discussion on how and when Chwado and Udo farmers`` music began to interact each other. In the discussion, the background and the basis of the establishment of North Cholla province farmer``s music are highlighted. A new form of farmer``s music band, which was composed of professional musicians, began in Chongop nongak 井邑農樂 (Chongop farmers`` music) while pan ``gut 판굿 was arranged by professional entertainers, as Poch``on``gyo 普天敎 religion encouraged farmers`` music before the Liberation. First, I paid attention to the role of National Farmers`` Music Competition called Chon``guk nongak kyongyon taehoe 全國農樂競演大會 that it accelerated musical development of nongak during the Post-Liberation period. In consequence, the paper emphasizes the composition of the bands with well-known performers, and presents the history of p``ojang kollip in 1940s after the North Cholla province farmers`` music band became famous winning a special award. Though a short amount of time, however, the liberation period was the hay day of the farmers`` music in South Western region (Honam 湖南 or Chollado 全羅道) in Korea as many talented performers were produced and artistic skill were developed. At the same time, the competitive structure between Chwado 左道 (left region) and Udo 右道 (right region) would have improved the artistic aspects in farmers`` music, more specifically the formality of pan``gut 판굿. The sponsorship, the financial support from wealth people, is also mentioned in terms of commercial performance and the contribution to the development of farmer``s music.

만당 한국음악론의 구조적 시각

임미선 ( Mi Sun Lim ) 한국음악사학회 2015 한국음악사학보 Vol.55 No.-

만당 이혜구는 수많은 연구 업적을 내었지만, 가장 마지막에 몰두한 작업은 한국음악의 구조를 이론적으로 정리하는 데에 두었다. 한국음악의 구조적 특징을 종합적으로 정리하는 것 자체의 중요성과 더불어 학자들마다로 다른 견해의 대립으로 인하여 한국음악학의 기본 이론이 정립되지 않은 상황을 안타까이 여긴 까닭이다. 이에 만당은 한국음악 이론과 관련된 논문 및 개론서 등의 내용에 대해 총체적인 검토를 하였고, 체계화된 정밀한 이론을 정립하고자 하였다. 『한국음악이론』은 그러한 과정에서 출판되었다. 이 이론서는 그간 만당이 이루어 놓은 학술적 성과를 총정리 하는 차원에서도 매우 큰 의미가 있었다. 만당은 한국음악의 기초 이론에서 가장 중요한 핵심 키워드를 장단, 선율, 형식 이상 3가지로 설정하고 그 하위의 중요 요소들을 몇 가지로 나누어 개념을 정립하고자 하였다. 이 가운데 장단과 선율의 부분에는 선행 연구에서 쟁점이 되는 학자들의 견해를 대비적 관점에서 검토한 내용이 많고, 형식 부분에서는 독자적으로 새롭게 정리한 내용이 주를 이룬다. 내용에 따라서는 만당의 독자적 견해를 강력하게 제시한 부분도 있지만, 학자들 간의 견해 차이를 대비적 관점에서 검토하는 것에 역점을 둔 부분도 있으며, 결론은 유보하는 입장을 간혹 취하기도 하였다. 『한국음악이론』은 만당의 음악 편력과 연구의 집적이 있었기에 가능했다. 이론의 체계화, 개념의 정립 등에서 어느 정도는 서양음악 이론에 기초하는 경향을 띠고 있지만, 궁극적으로는 한국음악에만 있는 특징적 음악현상을 이론화하는 데에 의의를 두었고, 그 이론은 음악 실재에 기초하고 있다. Among his many accomplishments, the late Lee Hye-ku 李惠求 [Yi Hye-gu] (1909-2010), a great scholar, devoted himself in arranging theories on structures of Korean music. Arguments among the scholars as well as the need for compiling Korean music theory would have probably weighed heavily upon him. Therefore, Dr. Lee comprehensively reviewed books and journals related to Korean music theory, and tried to establish detailed and systematized theory. As result, the Han``guk umak iron 『韓國音樂理論』(Theory of Korean Music) was published in 2005. This book is meaningful that it compiles and reviews all of Dr. Lee``s academic outcomes. First of all, Dr. Lee categorized the most important key words in Korean traditional music into three parts, the rhythmic cycle (changdan 長短), melodics, and forms, and then proceeded to conceptualize other necessary elements that are subordinate to them. Among his discussions, many of Dr. Lee``s idea on rhythmic cycle and melodies contrast to other scholar``s contention. On the other hand, Dr. Lee put personal opinions and showed new views on forms of Korean traditional music. Thus, the book contains Dr. Lee``s assertion on his own idea, over-view on multiple ideas and contrary perspectives, and reserved conclusions. Han``guk umak iron (Theory of Korean Music) is rooted from Dr. Lee``s passion on music and research accumulation. Even though some of his ideas in systematizing and conceptualizing Korean music theory are based on Western music theory, however, Dr. Lee ultimately put his goal in theorizing unique features in Korean traditional music. His theory is definitely built upon the actual music. Dr. Lee``s note saying the new work born in the middle of a rainstorm shows how much difficult it was to write Han``guk umak iron (Theory of Korean Music). As soon as the book was published in 2005, Dr. Lee again worked on revising it for new edition. I believe that professor Lee would not only expect us to develop Korean music theory but also be ready to accept our comments.

《耽羅巡歷圖》의 정재 공연과 주악 장면

임미선(Lim Mi-sun) 한국학중앙연구원 2011 장서각 Vol.0 No.26

Mr. Lee Hyungsang (1965~1733) was appointed to the post of governor in Cheju Island in 1702. He made a tour of inspection through his area of jurisdiction and carried out several administrative works during his tour. One of his works was that he ordered an painter, Mr. Kim Namkil, to draw and paint several events, conducted in the Island at that time. In such circumstances, the sketchbook, entitled Tamna-sullyeok-do, was born. This book includes several drawings, paintings and illustrations that are invaluable to study court music and dance, accompanied to the official occasions in the Cheju Island during the early 18th century. In this paper, I explore the performing arts that were performed at the official events in Cheju Island during the early 18th century throughout those materials on the Tamnasullyeok- do. Based on the analysis of those materials published on the book, I found that dance in other area, far from Cheju, was introduced into the Cheju area. Also, I recognized throughout the research that court dance was performed by a boy dancer, the entertainment girls in this area during the early 18th century used the komungo, kayagum, pipa, changgo, buk and so on at the performance, and wind instruments such as daegum and piri were performed by only male performers. For the accompaniment of court dance, instruments such as daegum, piri, pipa, and buk (drum) were usually used, whereas string instruments such as komungo, kayagum pipa and so on were added in the case of big events in the early 18th century.