외과영역에서 Ornidazole(Tiberal^(�))의 혐기성균에 대한 항균효과에 관한 연구

목우균,김인구 최신의학사 1988 最新醫學 Vol.31 No.4

정상 발달과정 및 일측부신 적출시 부신피질의 형태계측학적 변화

목우균 최신의학사 1993 最新醫學 Vol.36 No.4

34. 위암 환자에게 전산화 단층촬영과 수술후 병기의 비교 연구

목우균,송인상,김종철,김인구,손기섭 대한외과학회 1988 대한외과학회 학술대회 초록집 Vol.1988 No.11

소아 비후성 유문협착증에서 유문근 두께에 따른 임상적 고찰

목우균,배진선 최신의학사 1993 最新醫學 Vol.36 No.4

위암환자에서 전산화 단층촬영과 수술후 병기의 비교관찰

목우균(Woo-Kyun Mok),김인구(In-Koo Kim) 대한외과학회 1989 Annals of Surgical Treatment and Research(ASRT) Vol.37 No.4

소아에서 수술을 요한 멕켈게실의 임상상

이성철,목우균,서정민,정성은,박귀원,김우기,Lee, Seong-Cheol,Mok, Woo-Kyun,Seo, Jung-Min,Jung, Sung-Eun,Park, Kwi-Won,Kim, Woo-Ki 대한소아외과학회 1995 소아외과 Vol.1 No.1

The incidence of Meckel's diverticulum(MD) in general population has been assessed as 2 percent. The major complications of MD are bleeding, perforation, and intestinal obstruction. In spite that the complication rate of Meckel's diverticulum is relatively high(about 4.2% during a lifetime), the preoperative diagnostic rate of complicated MD is very low. Authors investigated the clinical characteristics of complicated MD to improve the diagnostic rate. 16 patients with complicated Meckel's diverticulum who were operated upon at the Department of Pediatric Surgery, Seoul National University Children's Hospital from June 1985 to December 1993 were reviewed. Among the 16 patients with complicated MD, 12 patients(75%) were under 2 year-old and male were predominant(88%). The most common complication was bleeding patients with bleeding MD (8 cases) were diagnosed preoperatively as MD. 8 patients with other complications(perforation : 4 cases, obstruction : 4 cases) could not be suspected as complicated MD except one patient who had previous history of melena. These patients were diagnosed after exploratory laparotomy under the various impression other than MD. Among 12 patients with ulcer related complications such as bleeding and perforation, heterotopic gastric mucosa was found in 11 patients. In conclusion, in any children with unexplained acute abdomen, especially under 2 years old, complicated MD must be included in differential diagnosis. In children with obscure lower gastrointestinal bleeding, $^{99m}Tc$-pertechnetate scintigraphy is a useful diagnostic tool to rule out bleeding MD.

장폐쇄의 임상적 연구

배진선,목우균 충남대학교 의과대학 지역사회의학연구소 1988 충남의대잡지 Vol.15 No.2

113 patients who were admitted and treated under the diagnosis of intestinal obstruction in the department of surgery, Chungnam National University Hospital from 1985. 3. 1. to 1987. 12. 31. , are analyzed, The results are as followings: 1) The sex ratio of male to female was 2 : 1. 2) As to the age distribution, 1st decade was most prevalent (43%), followed by 6th decade (14%), 3rd decade(12%), & 5th decade(12%). 3) 6% of patients was treated previously due to intestinal obstruction. 4) Most frequent symptoms were abdominal pain, vomiting, & abdominal distention. 5) Most frequent physical signs were abdominal distention, abdominal tenderness, followed by hyperperistalsis. 6) The most frequent cause of ileus was postoperative adhesion (50%), followed by intussusception(39%), & cancer(6%). 7) As to the method of treatment, 2/3 of patients with intestinal adhesion were successfully treated with tube decompression, and 2/3 of patients with intussusception with barium enema. 8) As to the method of operation, adhesiolysis was carried out in 40% of patients, and segm ental resection and anastomosis in 36% of patients. 9) Among the patients who had response to nasogastric or nasointestinal tube decompression, 80% of patients was improved within 48 hours, and 96% of patients within 72 hours. 10) Postoperation complications were occured in 24% of patients, such as pleural effusion, enterocutaneous fistula, paralytic ileus, & pneumonia.

非結石性 膽囊炎에 關한 臨床的 硏究

裵振善,睦愚均 충남대학교 의과대학 지역사회의학연구소 1987 충남의대잡지 Vol.14 No.2

A clinical study was undertaken on the 35 cases of acalculous cholecystitis among 392 cases operated for the biliary disease during the period from. January 1980 through June 1987 admitted in the department of surgery Chungnam National University Hospital. The results obtained were as followings; 1. The incidence of acalculous cholecystitis was 8.9% and extragallbladder biliary stone 3.1% among all cholecystitis. 2. The incidence of acalculous cholecystitis was slight more prevalent in female in contrast to many reports, i. e. the ratio of male to female was 1 : 1.2. 3. In regard of the age distribution, 5th decade was most prevalent, followed by 7th, 4th, & 6th decade in order of frequency; 91.4% of all patients were older than 30 years. 4. Right upper quadrant pain (74%) was most frequent clinical symptom, followed by nausea and vomiting (57%), fever & chillness (54%), & epigastric pain (37%) in order of frequency. 5. 37% of patiients was within one week of duration of symptoms, 14% between 1∼2 weeks, & 63% of patients within 4 weeks, 6. Right upper quadrant tenderness (77%) was most frequent positive physical finding, followed by jaundice (26%), & right upper quadrant mass (20%). 7. The elevated SGPT(74%) was most frequent positive laboratory finding, followed by elevated SGOT (69%), elevated serum bilirubin above 1. 5mg% (66%), above 3.0mg% (40%), leukocytosis (37%) & elevated alkaline phosphatase (37%). 8. Ileus on simple abdomen (60%) was most frequent finding as diagnostic measures, nonvisualisation of gallbladder in oral cholecystography or cholescintigraphy (17%) ; in most cases, the findings were nonspecific, therefore it can be said that clinical findings were most important in the diagnosis of acalculous cholecystitis. 9. Preoperatively, it was diagnosed as chronic cholecystitis (37%), empyema gallbladder (11%), gallbladder stone (11%), choledocholithiasis (9%), & acalculous cholecystitis (6%). i. e. the preoperative diagnostic accuracy was very low. 10. The most frequent operation underwent was cholecystectomy with or without T-tube drainage (86%), followed by cholecytostomy (9%), & choledochojejunostomy (5. 7%). 11. Bile culture was performed in 14 cases, 79% being positive, among them E. coli was most frequent (29%), followed by Klebsiella (21%), Proteus mirabilis, Streptococcus intermidius, & Streptococcus epidermidis. 12. Regarding etiologic and predisposing factors, ascaris was found in 14% of cases, Clonorchis sinensis (9%), & common bile duct cancer (9%), gallblader cancer (9%), pancreas head cancer (6%), & unclear(37%). 13. Postoperative complications were developed in 8 cases (23%), among them wound infections were most frequent (4 cases), followed by wound dehiscence (1 case), intraabdominal abscess (1 ,case), biliary fistula (1 case), & cholangitis (1 case).

소아 서혜부 탈장환자에서 반대측에 대한 복강경 검사의 의의

박일경,목우균,Park, Il-Kyung,Mok, Woo-Kyun 대한소아외과학회 2007 소아외과 Vol.13 No.2

저자들은 2000년 3월부터 2005년 9월까지, 건양대학교병원 외과에서 반대측에 대한 잔존 복막 초상돌기 개폐 여부를 복강경으로 확인한 환자 280명을 포함하여, 서혜부 탈장으로 고위 결찰술을 시행받은 만 15세 이하의 환자 601명을 대상으로 임상분석을 실시하여 다음과 같은 결과를 얻었다. 환자의 성비는 3.8:1로 남아에서 호발하였고, 진단 당시의 발생부위는 오른쪽이 57.7%, 좌측이 32.1%, 양측이 10.1%였으며, 복강경으로 반대측 잔존 복막 초상돌기를 확인한 군의 결과도 유사하였다. 복강경으로 복막 초상돌기의 개방을 확인한 결과, 1세 이하에서는 25%, 1세에서 5세 이하에서는 29%, 5세 이상에서는 18%로, 복막 초상돌기의 자연 폐쇄를 확인 할 수 없었다. 편측 서혜부 탈장 수술 후 반대측 탈장이 생긴 경우는 14명(2.5%)이었으며, 복강경으로 반대측 잔존 복강 초상돌기의 개폐 유무의 확인이 가능했던 2003년 3월 이후에는 발견되지 않았다. 추적 기간 중 반대측 탈장이 생긴 경우, 1세 이하에서 증상이 나타난 경우와, 첫 증상이 왼쪽에서 생겼을 때가 통계적으로 유의하였으며 이는 일반적인 반대측 탈장 발생의 고위험군과 일치하는 결과이다. It is known that pediatric inguinal hernia is caused by the incomplete closure of processus vaginalis (PV). In the case of unilateral hernia, possibile contralateral patent PV should be considered because of its delayed appearance as well as its risk of incarceration. Direct visualization of patent PV could be done by contralateral exploration or by indirect exploration through the ipsilateral opening site of the affected hernia assisted with laparoscope. A patient group (321 persons) to whom laparoscopy was not performed from March 2000 to March 2003 was analyzed and compared with a patient group (280 persons) to whom laparoscopy was performed from April 2003 to September 2005. With all 601 patients, the sex ratio (male/female) of patients was 3.8:1. The side distribution was 57.7% in the right, 32.1% in the left and 10.1% in bilateral. There was no difference of sex and side distribution between before and after laparosopy adoption. We did not find an age correlation in natural closure of the residual PV of the peritoneum. Contralateral hernia developed in 14 persons (2.5%) after the operation of unilateral inguinal hernia before laparoscope adoption. But no contralateral hernia developed after April 2003 with laparoscopy. We think that if we use laparoscopy, being a safe and accurate method, to check whether the contralateral residual PV is opened or closed, possible future contralateral operation can be avoided.

소아에서 발생한 일차성 대망 염전

구태영,목우균,Koo, Tae-Young,Mok, Woo-Kyun 대한소아외과학회 2005 소아외과 Vol.11 No.1

Two cases of primary torsion of the greater omentum were described. The first patient was a 5-year-old boy who was admitted to the hospital because of severe abdominal pain for 1 day. The The clinical features were similar to perforated acute appendicitis. Laparotomy revealed a normal appendix and the greater omentum twisted around its pedicle. The second patient was a 7-year-old girl admitted to the hospital because of abdominal pain in right lower quadrant for 2 days. The clinical features? were that of acute appendicitis. Laparotomy revealed a normal appendix and primary torsion of greater omentum around its pedicle. In both cases, resection of twisted omentum and incidental appendectomy were done. The microscopic findings in two cases consisted of congestion and vascular hemorrhage. Both patients recovered uneventfully. Torsion of the greater omentum, therefore, may be added to the entities to consider in the differential diagnosis of acute appendicitis.