앉고 일어서기 동작에서 점진적 체중 이동을 이용한 시각적 되먹임 훈련이 만성 편마비 환자의 균형 및 보행능력에 미치는 영향

김경환,박성훈,김형민,박노욱,김다연,Kim, Kyung-hwan,Park, Sung-hoon,Kim, Hyung-min,Pak, Noh-wook,Kim, Da-yeon 대한고유수용성신경근촉진법학회 2017 PNF and Movement Vol.15 No.1

Purpose: This study aimed to investigate the effect of visual feedback training-for gradual weight shift in sit-to-stand training-on the balance and walking abilities of chronic hemiplegia patients. Methods: Twenty patients with chronic hemiplegia volunteered to participate in this study. The experimental group received visual feedback for gradual weight shift in the sit-to-stand training, while the contrast group followed the standard process for the sit-to-stand training. The evaluation of the balance and walking ability was conducted with the functional reach test (FRT), Berg balance scale (BBS), five time sit-to-stand (FTSTS) test, timed up and go (TUG) test, 10 m walk test (10MWT), balancia, activities-specific balance confidence (ABC) scale, and falls efficacy scale (FES). Results: In the results before and after intervention, there was a significant difference in TUG, 10MWT, ABC, and FES in the visual feedback training group (p < 0.05). In the control group, there was a significant difference in the 10MWT and ABC (p < 0.05). Also, in the evaluation of the postural fluctuations, the control group data showed a significant increase in Covar. The visual feedback group showed a significant difference in the W average. Conclusion: The visual feedback training group showed some improvement in terms balance and walking ability and on the ABC scale and FES. Therefore, if the diagonal progressive weight bearing exercise is combined with the various patterns and basic principles of PNF, it may be a more efficient intervention method.

고양지역 두 병원에서의 약물 중독 양상

김경환,박준석,신동운,노준영,김혜진,구홍두,조진경,김아진,Kim Kyung-Hwan,Park Jun-Soek,Shin Dong-Wun,Rho Jun-Young,Kim Hey-Jin,Gu Hong-Du,Cho Jin-Kyung,Kim Ah-Jin 대한임상독성학회 2006 대한임상독성학회지 Vol.4 No.1

Purpose: In the year of 2005, it enforced the basic study for establishing program of Poison Control Center by National Institute of Toxicologic Research. The object of our survey is to analyze the characteristics of intoxication from the City of Goyang by same protocol. Methods: We retrospectively reviewed the data of medical records of the intoxication patient in the two hospitals of the Goyang from 2004 June 1st to 2005 May 31th. The investigation protocol applied the TESS report form which was used from the Basic study for establishing program of Poison Control Center. Results: The intoxication patients were total 269 persons, the patients of A hospital were 184 persons, B hospital were 185 persons. The most common intoxication materials were medicines, in afterwords it was an agricultural chemical. The most common place of intoxication was the home. The intentional suicidal attempts in the reason of intoxication were 51.2%. The rate of the patients who discharges from the emergency department was 50.4% and death rate was 4.3%. Conclusion: We concluded that the continuous and systemic report and analysis should be accomplished from the Goyang area.

CPM Bar Chart 기법을 활용한 일정계획

김경환,김수유,김재준,Kim Kyung-Hwan,Kim Soo-Yoo,Kim Jae-Jun 한국건설관리학회 2004 건설관리 : 한국건설관리학회 학회지 Vol.5 No.5

본 연구에서는 바차트(bar chart) 기법과 CPM 기법의 장점을 결합한 CPM bar chart(CBC) 기법을 제시한다. CBC는 기존의 fenced bar chart(FBC)의 장점을 유지하면서 단점을 보완한 것으로, 작업 관계를 나타내는 fence에 방향성을 부여함으로써, 기존 FBC에서 상당한 혼란을 유발하는 fence의 분리과정 없이 작업들의 관계를 표현할 수 있다. 또한, fence의 분리를 파악하기 위해 더미작업(dummy activity)을 확인하는 과정이 생략되어 보다 손쉽게 작성할 수 있는 장점도 있다. 바차트의 간결성을 유지하면서 CPM의 네트워크 논리 표현이 가능해짐에 따라, CBC는 다양한 프로젝트 참여자들 간의 원활한 의사소통에 기여하리라 예상된다. 또한, resource constrained scheduling, resource leveling, 작업 분리가 고려된 일정 조정, 공기 지연 분석 등의 CPM 기법에 기초한 다양한 일정 계획 및 관리에도 적용이 용이하여, 실무뿐만이 아니라 공정관리 교육과정에서도 활용성이 높으리라 기대된다. This paper proposes the CPM bar chart (CBC), a hybrid of the bar chart and the critical pad method (CPM). The CBC overcomes shortages of the fenced bar chart, while still keeping advantages. The fence with direction is applied instead of the broken fence, which triggers considerable problems to identify and apply in the fenced bar chart. In addition, the notorious task to find dummy activities is no longer required. Upon the benefits of simplicity in the bar chart and logical work sequence in the CPM network. the CBC provides a relatively easy way to create and understand a schedule, thus improving communication quality between project participants. With the advantages, the CBC can also be effectively applied to various scheduling techniques such as resource constrained scheduling, resource leveling, scheduling with activity split, delay impact analysis, etc.

베체트씨병에 의한 대동맥판 폐쇄부전의 수술적 치료

김경환,김기봉,김원곤,김주현,안혁,Kim, Kyung-Hwan,Kim, Ki-Bong,Kim, Won-Gon,Kim, Joo-Hyun,Ahn, Hyuk 대한흉부심장혈관외과학회 2000 Journal of Chest Surgery (J Chest Surg) Vol.33 No.5

Background: Cardiac involvement of Behcets disease is very rate, however, the prognosis of Behcet disease depends on cardiovascular complications. In this article, we described surgical treatment of aortic insufficiency with Behcets disease. Material and Method: From March 1986 to February 1998, we operated on 10 patients of aortic insufficiency with Behcets disease. Male to female ratio was 8 to 2, and age ranged from 21 to 40 years(mean 32.8 years). There were 8 patients with evidence of Behcets disease and another 2 patients had some suspicious findings of Behcets disease(i.e., prosthetic value dehiscence, hypertrophied aortic wall). Adequate preoperative medical treatment for Behcets disease was done in 3 patients. Result: We performed 24 open heart surgeries in 10 patients. Redo value replacements using prosthetic valves were done in 4 patients. Among them, 2 patients were operated on for a second redo valve replacement and one of them operated on for a 4th and 5th operation because of recurrent paravalvular leakage. These 4 patients expired. 1 patient who had undergons tissue value replacement is alive. 1 patient who underwent Cabrol operation expired dut to rupture of graft anastomosis site. We used homografts in 3 patients. In 2 of them, we performed aortic root replacement and subcoronary valve replacement in another patient. The patient who underwent subcoronary valve insertion had remnant aortic insufficiency, so we are closely observing him. We also performed Ross operation in a 24 year old female who suffered severs aortic insufficiency and endocarditis after aortic valvuloplasty. 5 patients are alive and mean follow up duration is 49.0 months. Among them, we used homografts or sutografts in 4 patients. We could observe excellent clinical results in the patients who underwent aortic root replacement using homograft and they were treated medically for Behcets disease. Conclusion: We concluded that adequate preporative diagnosis, clinical suspicion, and periopertive medical treatment for Behcets disease are very important for the result of surgical management of aortic insufficiency with Behcets disease. The use of homograft or autograft was helpful for the healing of anastomosis site and we should carefully observe the long term follow up results.

수직자기기록용 박막의 제작

김경환,김명호,손인환,김재환 ( Kyung Hwan Kim,Myung Ho Kim,In Hwan Son,Jae Hwan Kim ) 한국전기전자재료학회 1997 한국전기전자재료학회 추계학술대회논문집 Vol.1997 No.1

PET 섬유의 친수성(I) -아민분해 PET섬유의 친수성-

김경환,조현혹,성우경,Kim, Gyeong-Hwan,Jo, Hyeon-Hok,Seong, U-Gyeong 한국섬유공학회 1987 한국섬유공학회지 Vol.24 No.4

In order to improve hydrophilicity of PET fabric, PET fabric was aminolyzed with 5%, 15%, 25%, and 35% hydrazine hydrate aqueous solutions at 30$^{\circ}C$ for various time intervals. The changes of properties such as weight loss, crystallinity, moisture regain, intrinsic viscosity, dyeability of acid dye, moisture permeability, and morphology were investigated on the aminolyzed fibers. The results obtained from this study were as follows. 1. Weight loss, increase in degradation, increase in crystallinity, decrease in intrinsic viscosity, and depression in melting point, etc. were found to increase gradually with increase of hydrazine hydrate treatment time. 2. Moisture regain and moisture permeability coefficient of aminolyzed fabrics increased in accordance with increasing the crystallinity of fibers. 3. Aminolyzed PET showed improved dyeability toward acid dye. 4. Chemical stress crack occurred on fiber surfaces in proportion to reaction time with hydrazine hydrate aqueous solution.

Peripheral Blood Immune Cell-based Biomarkers in Anti-PD-1/PD-L1 Therapy

김경환,Chang Gon Kim,신의철 대한면역학회 2020 Immune Network Vol.20 No.1

Immune checkpoint blockade targeting PD-1 and PD-L1 has resulted in unprecedented clinical benefit for cancer patients. Anti-PD-1/PD-L1 therapy has become the standard treatment for diverse cancer types as monotherapy or in combination with other anti-cancer therapies, and its indications are expanding. However, many patients do not benefit from anti-PD-1/PD-L1 therapy due to primary and/or acquired resistance, which is a major obstacle to broadening the clinical applicability of anti-PD-1/PD-L1 therapy. In addition, hyperprogressive disease, an acceleration of tumor growth following anti-PD-1/PD-L1 therapy, has been proposed as a new response pattern associated with deleterious prognosis. Anti-PD-1/PD-L1 therapy can also cause a unique pattern of adverse events termed immune-related adverse events, sometimes leading to treatment discontinuation and fatal outcomes. Investigations have been carried out to predict and monitor treatment outcomes using peripheral blood as an alternative to tissue biopsy. This review summarizes recent studies utilizing peripheral blood immune cells to predict various outcomes in cancer patients treated with anti-PD-1/PD-L1 therapy.

개선된 자원 평준화 기법을 활용한 적정 공기산정 방안

김경환,윤영상,김재준,Kim Kyung-Hwan,Yoon Yung-Sang,Kim Jae-Jun 한국건설관리학회 2004 건설관리 : 한국건설관리학회 학회지 Vol.5 No.5

건설프로젝트는 일정한 기간 동안 주어진 목표를 수행하기 위한 작업들의 모임이라 정의할 수 있으며, 이를 위해서는 필요한 자원의 효율적 계획 및 관리가 필요하고, 이때 자원배당 및 자원평준화 기법이 활용된다. 하지만 자원제약이 있는 자원배당과 공기 제한이 있는 자원평준화 방법은 하나의 프로젝트에 개별적으로 적용되고 있어 전체 프로젝트의 공기와 효율적 자원이용 측면에서 적정화하기는 어렵다. 따라서 본 연구는 자원 평준화 방법의 Minimum Moment Algorithm 개념을 확대$\cdot$적용하여 적정 자원이용 및 공사기간을 산출하고자 한다. 이때 자원 활용의 상태를 나타내는 5가지 지표가 사용되며, 이들간의 중요도를 파악하기 위해 공정전문가를 대상으로 설문조사를 실시하였다. 마지막으로 가상 프로젝트의 적용을 통해 본 모형의 적용 가능성을 검증하고자 하였다. Since a construction project is a series of works that utilizes resources to accomplish the project goal for a given time period, efficient resource management is a prerequisite for the success of the project. Two major areas of resource management are resource constrained scheduling focusing on the limited resource availability and resource leveling focusing on smoothing resource usage pattern on the fixed project completion time. It is not available, however, to apply both techniques to a project at the same time. This paper proposes a model to enhance the minimum moment algorithm of resource leveling, aiming to find an efficient usage of resources and an appropriate project completion time. A survey was performed to evaluate the major five factors in the model. A case study demonstrates the value of the proposed resource leveling technique.

특급(特急)과 고속(高速)버스 이용자(利用者)의 수단선정행태(手段選定行態)에 관한 경험적(經驗的) 연구(?究)

김경환,Kim, Kyung Whan 대한토목학회 1983 대한토목학회논문집 Vol.3 No.2

본(本) 연구(硏究)의 목적(木賊)은 특급(特急)과 고속(高速)버스 이용자(利用者)의 수단선정행태(手段選定行態)(mode choice behavior)를 분석(分析)하고 모형(模型)을 개발(開發)하여 교통정책결정(交通政策決定)의 자료(資料)를 제공(提供)하는데 있다. 기본자료(基本資料)로는 1980년(年) 3월(月)부터 1981년(年) 11월(月)까지의 서울과 지방(地方) 19개도시간(個都市間) 수단별(手段別) 수송실험(輸送實驗)이 수집(收集)되었으며, 여행시간(旅行時間), 여행비용(旅行費用), 평균배차간격(平均配車間隔), 1일운행시간(日運行時間), 수단별(手段別) 가변수(假變數)를 변수(變數)로 하고 선형(線形) 및 대수효용함수(對數?用函數)를 이용(利用)한 Logit모형(模型)에 의하여 분석(分析)되었다. 본(本) 연구(硏究)의 결과(結果), 본문(本文) 식(式) 2.의 Type I 모형(模型)에서 가장 좋은 결과(結果)를 얻었으며, Group III, IV의 매개상수(媒介常數)가 최적(最適)으로 판단(判斷)된다. 추정(推定)된 매개상수(媒介常數)중 "${\beta}$"의 값이 가장 신뢰(信賴)할 수 있었으며, 10, 11월(月)에는 특급(特急)보다 고속(高速)버스를 선호(選好)하였다. The purposes of this study are to analyze/model the mode choice behavior of the regional traveler by express bus/express train and to offer useful source in deciding the public transportation policy. The data analyzed were trips of both modes from March, 1980 to November, 1981, between Seoul and other nineteen cities; the data were grouped as five groups according to the change of service variables. Service variables were travel time(unit: minute), cost(:won), average allocation time(:won), service hour(:hour), and dummy variables by mode. As model Logit Model with linear or log utility function were postulated. As the result of this study, some reseanable models were constructed at Model Type I(eq. 2. of this paper) based on the above data except the dummy. It was judged that the parameters calibrated by Group III and Group IV data in table 4, were optimal. Among the parameters, the parameter of travel cost was most reliable. There was a tendency preferring express bus to train in October and November. With the constructed model and Pivot-Point Method. the demand change of express train caused by the service variables' change could be forecasted over 99%.

돼지에서 초저체온 순환정지 하의 역행성 뇌관류시 뇌대사, 혈류역학 지표, 뇌조직 소견 및 혈청 내 neuron-specific enolase의 변화

김경환,안혁,Kim, Kyung-Hwan,Ahn, Hyuk 대한흉부심장혈관외과학회 2000 Journal of Chest Surgery (J Chest Surg) Vol.33 No.6

Background: Retrograde cerebral perfusion(RCP) is currently used for brain protection during aorta surgery, however, for the safety of it, various data published so far are insufficient. We performed RCP using pig and investiaged various parameters of cerebral metabolism and brain injury after RCP under deep hypothermia. Material and Method: We used two experimental groups: in group I(7 pigs, 20 kg), we performed RCP for 120 minutes and in group II (5 pigs, 20 kg), we did it for 90 minutes. Nasopharyngeal temperature, jugular venous oxygen saturation, electroencephalogram were continuously monitored, and we checked the parameters of cerebral metabolism, histological changes and serum levels of neuron-specific enolose(NSE) and lactic dehydrogenase(LDH). Central venous pressure during RCP was mainained in the range of 25 to 30 mmHg. Result: Perfusion flow rates(ml/min) during RCP were 130$\pm$57.7(30 minutes), 108.6$\pm$55.2(60 minutes), 107.1$\pm$58.8(90 minutes), 98.6$\pm$58.7(120 minutes) in group I and 72$\pm$11.0(30 minutes), 72$\pm$11.0(60 minutes), 74$\pm$11.4(90 minutes) in group II. The ratios of drain flow to perfusion flow were 0.18(30 minutes), 0.19(60 minutes), 0.17(90 minutes), 0.16(120 minutes) in group I and 0.21, 0.20, 0.17 in group II. Oxygen consumptions(ml/min) during RCP were 1.80$\pm$1.37(30 minutes), 1.72$\pm$1.23(60 minutes), 1.38$\pm$0.82(90 minutes), 1.18$\pm$0.67(120 minutes) in group I and 1.56$\pm$0.28(30 minutes), 1.25$\pm$0.28(60 minutes), 1.13$\pm$0.26(90 minutes). We could observe an decreasing tendency of oxygen consumption after 90 minutes of RCP in group I. Cerebrovascular resistance(dynes.sec.cm-5) during RCP in group I incrased from 71370.9$\pm$369145.5 to 83920.9$\pm$49949.0 after the time frame of 90 minutes(p<0.05). Lactate(mg/min) appeared after 30 minutes of RCP and the levels were 0.15$\pm$0.07(30 minutes), 0.18$\pm$0.10(60 minutes), 0.19$\pm$0.19(90 minutes), 0.18$\pm$0.10(120 minutes) in group I and 0.13$\pm$0.09(30 minutes), 0.19$\pm$0.03(60 minutes), 0.29$\pm$0.11(90 minutes) in group II. Glucose utilization, exudation of carbon dioxide, differences of cerebral tissue acidosis between perfusion blood and drain blood were maintained constantly during RCP. Oxygen saturation levels(%) in drain blood during RCP were 22.9$\pm$4.4(30 minutes), 19.2$\pm$4.5(60 minutes), 17.7$\pm$2.8(90 minutes), 14.9$\pm$2.8(120 minutes) in group I and 21.3$\pm$8.6(30 minutes), 20.8$\pm$17.6(60 minutes), 21.1$\pm$12.1(90 minutes) in group II. There were no significant changes in cerebral metabolic parameters between two groups. Differences in serum levels of NSE and LDH between perfusion blood and drain blood during RCP showed no statistical significance. Serum levels of NSE and LDH after resuming of cardipulmonary bypass decreased to the level before RCP. Brain water contents were 0.73$\pm$0.03 in group I and 0.69$\pm$0.06 in group II and were higher than those of the controls(p<0.05). The light microscopic findings of cerebral neocortex, basal ganglia, hippocampus(CA1 region) and cerebellum showed no evidence of cerebral injury in two groups and there were no different electron microscopy in both groups(neocortex, basal ganglia and hippocampus), but they were thought to be reversible findings. Conclusion: Although we did not proceed this study after survival of pigs, we could perform the RCP successfully for 120 minutes with minimal cerebral metabolism and no evidence of irreversible brain damage. The results of NSE and LDH during and after RCP should be reevaluated with survival data.