소아 Clostridium Difficile 장염과 관련된 항생제에 대한 연구

김병찬,양혜란,정수진,이경훈,김정은,고재성,김의종,서정기,Kim, Byoung-Chan,Yang, Hye-Ran,Jeong, Su-Jin,Lee, Kyung-Hoon,Kim, Jeong-Eun,Ko, Jae-Sung,Kim, Eui-Chong,Seo, Jeong-Kee 대한소아소화기영양학회 2002 Pediatric gastroenterology, hepatology & nutrition Vol.5 No.2

목 적: 최근 항생제 사용의 증가로 소아에서 C. difficile 장염의 빈도도 증가하였다. 우리나라 소아에서 C. difficile 장염과 항생제와의 관련성에 대한 체계적인 보고는 아직 없기에 저자들은 우리나라 소아에서 C. difficile의 장염과 항생제와의 관련성을 파악하고, 나아가 C. difficile의 진단 및 치료에 도움이 되고자 이번 연구를 수행하였다. 방 법: 2000년 1월 1일부터 2002년 6월 30일까지 서울대학교병원을 내원한 소아 환자 중, 설사가 있으면서 대변 배양에서 C. difficile이 나온 85례를 대상으로 하여, 후향적으로 환자의 의무 기록지를 참고하여 항생제 사용 유무, 사용하였던 항생제의 종류, 항생제 사용 시작 시점과 C. difficile 대변 배양 검사와의 기간 등에 대하여 조사하였다. 대상 환아는 남아가 50례 여아가 35례로 남녀비는 1.4 : 1이었고, 평균 연령은 2.5세이었다. 결 과: 1) 대상 환아는 남아가 50례 여아가 35례로 남녀비는 1.4 : 1 이었고, 평균 연령은 2.5세이었다. 2) 항생제 투여 여부가 불확실한 환아 3명을 제외한 82명의 환아 중, 3달 이내에 항생제를 투여받은 환아가 55명(67%)이었고, 항생제 투여를 받지 않은 환아가 27명(33%)이었다. 3) 대변배양검사를 할 때 항생제를 쓰고 있었던 경우는 43명(78%)이었고, 항생제를 끊고 난 후였던 경우도 12명(22%)이나 되었다. 4) 항생제를 쓰고 있었던 환아 43명 중, 항생제를 처음 투여하기 시작한 시점에서 균 배양까지 걸린 기간은 1일 미만이 5명(12%), 1일 이상 3일 미만이 9명(21%), 3일 이상 1주 미만이 10명(23%), 1주 이상 2주 미만이 10명(23%), 2주 이상 3주 미만이 6명(14%), 4주 이상 5주 미만이 1명, 6주 이상 7주 미만이 7명이었다. 1명은 방광요관 역류가 있어 10개월 전부터 예방적 항생제를 복용하고 있었다. 5) 대변배양검사 당시 항생제를 이미 끊었던 12명의 환아 중, 항생제를 끊은 뒤 대변배양검사까지 기간은 1일에서 3일 사이가 2명, 3일에서 1주일 사이가 3명, 1주에서 2주 사이가 5명이었고, 4주에서 5주 사이가 1명, 7주에서 8주 사이가 1명이었다. 6) 24명(44%)은 1가지 항생제를 투여 받았고, 31명(56%)은 2가지 이상의 항생제를 투여 받았다. 7) 사용된 항생제는 cefotaxime이 20례로 가장 많았고, amikacin 15례, ampicillin 13례, cefazolin, vancomycin 각각 8례 순이었다. 결 론: 특히 어린 연령 층의 소아 설사 환자에서 항생제 사용 중이거나, 최근 항생제 사용력이 있었던 경우 C. difficile 장염을 의심하는 것이 빠른 진단과 치료에 도움이 될 것이다. Purpose: The following study was performed to reveal the relationship between Clostridium difficile colitis in childhood and associated antibiotics. Methods: From January 2000 to June 2002 at Seoul National University Children's Hospital, 85 symptomatic pediatric patients who showed positive stool culture for Clostridium difficile were included. The implicated antibiotics within 2 months before stool culture were analyzed. Of the 85 patients, there were 50 males and 35 females, and their average age was 2.5 years. Results: There was a history of implicated antibiotics within 2 months in 55 cases (67%). Forty-three patients (78%) of them showed Clostridium difficile in stool culture during antibiotics treatment. The time interval between the initiation of antibiotics and stool culture ranged from one day to 7 weeks (mean 10 days) in these patients. In the remaining 12 patients, Clostridium difficile was detected after the discontinuation of antibiotics. The time interval between the discontinuation and stool culture ranged from one day to 7 weeks (mean 12 days). The associated antibiotics were cefotaxime (20 cases), amikacin(15 cases), ampicillin (13 cases), cefazolin (8 cases), vancomycin (8 cases), etc. In 31 cases, more than one antibiotics were prescribed. Conclusion: When diarrhea occurred in young children during antibiotic usage or with a past history of recent antibiotic usage, Clostridium difficile should be investigated as a cause of diarrhea for proper management.

DIACON 정도관리물질의 평가

김병찬,정창기,김상수,박혜미,김지선,Kim, Byung Chan,Jung, Chang Gi,Kim, Sang Su,Park, Hae Mi,Kim, Ji Sun 대한핵의학기술학회 2015 핵의학 기술 Vol.19 No.1

Purpose Quality control used in laboratory help to sustain precision and accuracy consistently to ensure the Diagnostic and treatment for medical employee. To perform an evaluation in statistical manner, it is recommended to use different quality control material than calibrator from manufacturer, quality control material must include analyzed concentration perimeter, must use more than two different concentration materials and recommended to use materials to indicate the concentration in clinical use. However, currently used quality control material has limit of evaluation due to unconsidered concentration or improperly used to get clinical importance data. Therefore, we compared the value of quality control, DIACON Hormone Level 1, 2, 3 (Scantibodies, USA) and DIACON Tumor Level 1, 2, 3 which applied to clinical concentration range. Materials and Methods DIACON Hormone Level 1, 2, 3 (Scantibodies, USA) and DIACON Tumor Level 1, 2, 3 (Scantibodies, USA) that used materials and methods test to compare the result from five RIA testing institution and one institution that used Elecsys (ROCHE) and Architect (ABOTT) for each level. The reagent RIA kit that used in this experiment is followed by Table 2 and 3. Test has performed by instruction itself and follow by instruction. Results Among DIACON hormone result of twenty four items, level 1 have three items, level 2 have four items and level 3 have five items were out of manufacturer set up range based on the average value. Among DIACON tumor result of thirteen items, level 1 have three items, level 2 have four items and level 3 have five items were out of manufacturer set up range. Other result were inside of manufacturer range. Conclusion For quality control material, it is widely available in market, but it is limited for normal range which is only concerned in improper clinical value and difficult to evaluate important concentration area in terms of clinical analyze. In this experiment, we evaluate Hormone twenty three items and Tumor thirteen items with DIACON Hormone and Tumor (Scantibodies, USA) to resolve this limit and we could observe that it ca be substituted and used.

Prostate Cancer 환자에 대한 One Arc와 Two Arc VMAT Plan의 선량 측정 비교 분석

김병찬,김종덕,김효중,박호춘,백정옥,Kim, Byoung Chan,Kim, Jong Deok,Kim, Hyo Jung,Park, Ho Chun,Baek, Jeong Ok 대한방사선치료학회 2018 대한방사선치료학회지 Vol.30 No.1

목 적 : IMRT는 일반적인 3차원 방사선 치료방법보다 Prostate 주변 중요장기(OAR)에 대한 방사선 부작용을 줄이고 Prostate Cancer에 더 많은 선량을 투여할 수 있기 때문에 Prostate Cancer Therapy에 광범위하게 사용되었다. 장비 및 치료 기술의 많은 진보로 인하여 최근에는 체적 변조 아크 치료(VMAT)가 널리 사용되어지고 있으며, VMAT은 IMRT에 비해 치료 시간을 최대 55 % 단축시킬 수 있어 치료 중 움직임에 대한 오차를 최소화 할 수 있는 장점이 있다. 대상 및 방법 : 본 실험에서는 Prostate Cancer 환자 10명에 대해 LN가 포함된 치료 Group 5명과, LN가 포함되지 않는 Group 5명으로 1 Arc와 2 Arc 치료 계획 방법을 총 4 Group으로 분류하여 MU, DVH값들을 비교 분석 하였고, ArcCHECK과 MapCHECK을 사용하여 DQA 관련 측정을 수행했다. 결 과 : Prostate patients의 Target과 OAR 선량분포 결과는 다음과 같다. $D_{max}$는 4개 Group이 100~110 % 범위로 나타났으며, Hot spot인 110 % 이상은 보이지 않았다. LN가 없는 Only-Prostate($P_1$, $P_2$)의 Target $D_{98%}$ 분포도는 1 Arc plan($P_1$)보다 2 Arc plan($P_2$)에서 조금 더 좋은 결과 값을 보였다. LN-Prostate($P_{L1}$, $P_{L2}$) Group에서의 Target $D_{98%}$ 분포도는 1 Arc plan($P_{L1}$)보다 2 Arc plan($P_{L2}$)이 더 좋은 결과 값을 보였고, 1 Arc plan($P_{L1}$)에서는 Target $D_{98%}$의 처방 선량 값에 도달하지 못했다. 또한, OAR에서는 Only-Prostate($P_1$, $P_2$) Group에서 1 Arc와 2 Arc Plan 모두 처방 선량 값에 만족했고, LN-Prostate 1 Arc($P_{L1}$) Plan은 OAR의 처방 선량치보다 높은 선량 값을 보였다. DQA 측정에서 계산된 ArcCHECK과 MapCHECK의 Gamma evaluation pass rate는 99 %보다 조금 더 높았고, CC04 Ion-chamber를 이용한 점 선량(Point Dose) 측정값의 평균 오차 범위는 1 % 미만이었다. 결 론 : 본 연구에서 분석한 결과, Only-Prostate($P_1$, $P_2$) Group의 경우는 두 plan의 선량이 비슷했지만, 치료시간과 MU값 등을 고려했을 때 1 Arc 치료 방법($P_1$)이 더 적합하였으며, LN-Prostate($P_{L1}$, $P_{L2}$) Group에서는 Target $D_{98%}$와 OAR의 처방 선량에 만족하는 2 Arc 치료 방법($P_{L2}$)이 더 적합한 결과를 보였다. Purpose : Intensity-modulated radiation therapy(IMRT) has been widely used for radiation therapy of Prostate Cancer because it can reduce radiation adverse effects on normal tissues and deliver more dose to the Prostate than 3D radiation therapy. Volumetric modulated arc therapy(VMAT) has been widely used due to recent advances in equipment and treatment techniques. VMAT can reduce treatment time by up to 55 % compared to IMRT, minimizing motion error during treatment. Materials and Methods : In this study, compared the MU and DVH values of 10 patients with prostate cancer by classifying them into 4 groups with 5 LN-Prostate groups and 5 Only-Prostate. And DQA measurements were performed using ArcCHECK and MapCHECK. Results : The results of Target and OAR dose distribution of Prostate patients are as follows. $D_{max}$ was in the range of 100~110 % in 4 groups, and more than 110 % of hot spot was not seen. Only-Prostate ($P_1$, $P_2$) without LN had a satisfactory dose distribution for the target dose, but slightly better for 2 arc plan($P_2$) than 1 arc plan($P_1$). The target dose $D_{98%}$ distribution in the LN-Prostate ($P_{L1}$, $P_{L2}$) group showed better 2 arc plan($P_{L2}$) than 1 arc plan($P_{L1}$), But in the case of 1 arc plan($P_{L1}$), the target dose $D_{98%}$ value was not enough. In OAR, the dose distribution of 1 Arc($P_1$) Plan and 2 Arc($P_2$) Plan in the Only-Prostate ($P_1$, $P_2$) Group satisfied the prescribed dose value. But, The dose distribution of 1 arc($P_1$) was slightly higher. In LN-Prostate OAR, 1 Arc($P_{L1}$) Plan showed higher dose than the prescribed dose. The Gamma evaluation pass rate of ArcCHECK and MapCHECK calculated from the DQA measurements was slightly higher than 99 % and the mean error range of the point dose measurements using the CC04 ion chamber was less than 1 %. Conclusion : In this study, Only-Prostate ($P_1$, $P_2$) group, the dose of 2 Arc plan was better. However, considering the treatment time and MU value, 1 Arc treatment method was more suitable. In the LN-Prostate ($P_{L1}$, $P_{L2}$) group, 2 Arc($P_{L2}$) treatment method showed better results and satisfied with Target $D_{98%}$ and OAR prescription dose.

수산물의 기능성 재사용 포장용기 사용을 통한 물류합리화에 관한 연구

김병찬,양대용,Kim, Byeongchan,Yang, Daeyong 디지털산업정보학회 2015 디지털산업정보학회논문지 Vol.11 No.3

Disposable marine product packaging materials such as wooden, Styrofoam, and corrugated cardboard boxes have a very low reuse rate, thus causing the logistics costs to rise and making it difficult to establish a unit load system for marine products. Disposable packing containers to be discarded are accompanied by resource and environmental issues home and abroad. Transportation vehicles for marine products have to return empty without loading different kinds of products after delivery due to the smell and properties of marine products, thus posing as an obstacle to logistics rationalization. In an effort to overcome those limitations, this study examined the stages of transportation including "producer-wholesale market in the producing area-commission merchant-wholesale market in the consumption area-commission merchant-quasi-wholesale market-consumer" and also analyzed the utilization and distribution of disposable packaging materials currently used in the circulation of marine products including wooden, Styrofoam, and corrugated cardboard boxes. Based on the analysis results, the investigator developed a logistics rationalization model capable of promoting semi-permanent reuse and lowering empty vehicle rate on return routes as an alternative to address environmental issues caused by disposable packaging materials, which have been an obstacle to the logistics rationalization of marine products, packaging costs in the process of repeating packing and unpacking at each stage of marine products circulation, and empty vehicle rates on return routes after marine products delivery.

원추형 오리피스의 유출계수와 캐비테이션에 관한 실험적 연구

김병찬,윤병옥,박복춘,조남오,지대성,정백순,박경암,Kim, Byeong-Chan,Yun, Byeong-Ok,Park, Bok-Chun,Jo, Nam-O,Ji, Dae-seong,Jeong, Baek-Sun,Park, Gyeong-Am 대한기계학회 1997 大韓機械學會論文集B Vol.21 No.10

The high pressure drop is frequently required in the by-pass line of the pump or of the heat exchanger in power plants. However, cavitation produced by a high pressure drop could damage the pipe and pump blades. Conical orifices are adopted to reduce cavitation due to high pressure drop. The discharge coefficients of conical orifice plates were measured by weighing method in the standard water flow system. The discharge coefficients were larger when the ratios of thickness of orifice edge to throat diameter were larger. The noise generated from a conical orifice due to cavitation was measured with a sound level meter and a hydrophone. With increasing the bore diameter of the orifice, the sound pressure level or the noise level due to cavitation became higher. The noise level was suddenly increased at the inception of cavitation.

무선국 전자파 노출량 평가기술

김병찬,최형도,Kim, Byeong-Chan,Choe, Hyeong-Do 한국전자파학회 2007 전자파기술 Vol.18 No.3

무선 센서네트워크에서 효율적인 라우팅 알고리즘에 관한 연구

김병찬,임재홍,최홍석,Kim, Byoung-Chan,Yim, Jae-Hong,Choi, Hong-Seok 한국정보통신학회 2009 한국정보통신학회논문지 Vol.13 No.5

무선 센서네트워크를 위해 제안된 기존의 라우팅 알고리즘들은 무선 센서네트워크의 특성을 완벽히 수용하지 못하고 있다. 특히, 위치정보를 이용하면 에너지 소비와 전역 id 문제의 해결 등에서 많은 이득을 얻을 수 있음에도 불구하고, 이를 적극적으로 이용하는 알고리즘은 드물다. 위치정보를 이용하는 대표적인 알고리즘인 GEAR 같은 경우, 그 용도가 질의메시지 전파에 한정되어 있을 뿐만 아니라 고정된 네트워크 환경을 가정하고 있으므로 무선 센서네트워크의 특성을 제대로 반영하지 못한다. 본 논문에서 제안하는 라우팅 알고리즘은 각 노드의 위치정보와 싱크 노드의 위치정보를 기반으로 하여 전송되는 데이터의 방향성을 정의한다. 그리고 각 노드는 이 방향성을 기준으로 경로를 설정하고 신호를 보낸다. 위치정보를 이용하여 데이터 중심석 라우팅을 하므로 각 노드를 식별하기 위한 전역 식별자가 필요 없고, 방향성을 정의하여 그에 따라 신호를 전송하므로 무분별한 에너지 소비를 막을 수 있다. Conventional routing protocols proposed for wireless sensor networks (WSNs) cannot fully accommodate the characteristics of WSNs. In particular, although it is possible to largely obtain benefits in the solution of energy consumption and global identification problems through applying position information, there are few protocols that actively apply such position information. In the case of geographical and energy aware routing (GEAR) that is a typical algorithm, which uses position information, it does not fully represent the characteristics of WSNs because it is limited to forward query messages and assumed as fixed network environments. The routing protocols proposed in this paper defines the direction of data, which is routed based on the position information of individual and target nodes, in which each node configures its next hop based on this direction and routes signals. Because it performs data-centric routing using position information, it does not require certain global identifications in order to verify individual nodes and is able to avoid unnecessary energy consumption due to the forwarding of packets by defining its direction.

Toxicogenomic Analysis on Impacts of EDCs and Other Toxic Chemicals by using Both Japanese Medaka Fish and Bacterial cDNA Microarrays

김병찬,박경서,구만복,Kim Byeong-Chan,Park Gyeong-Seo,Gu Man-Bok 한국유전체학회 2006 유전체소식 Vol.6 No.1

미래 전파기술

김병찬,박상택,강경옥,Kim, B.C.,Park, S.T.,Kang, K.O. 한국전자통신연구원 2017 전자통신동향분석 Vol.32 No.6

The frequency range of a radio wave is from 3kHz to 300GHz, and radio technologies use this range to improve the quality of human lives. Radio technologies have entered a new phase of communication. The core infrastructure used as the basis for technologies leading the fourth industrial evolution, such as artificial intelligence, the Internet of Things, autonomous cars/drones, augmented reality, robots, and remote medical diagnoses, is the 5G network. The 5G network enables transmitting and receiving large amounts of data at very high speed. In particular, application technologies with artificial intelligence have been studied, including radar, wireless charging, electromagnetic devices and their effects on humans, EMI/EMC, and microwave imaging. In this study, we present a future radio technology that is needed to prepare for the upcoming industrial revolution and digital transformation.

터널 갱구사면 쏘일네일링 보강배치계획을 위한 최적화기법 연구

김병찬,문현구,Kim, Byung-Chan,Moon, Hyun-Koo 한국터널지하공간학회 2016 한국터널지하공간학회논문집 Vol.18 No.6

국내 터널 갱구사면에 안정성을 확보하기 위한 사면보강은 앵커, 쏘일네일 및 록볼트 등을 이용한 다양한 공법이 사용되고 있다. 갱구 사면보강공법 및 보강재 배치, 보강재 길이 등을 선정하기 위해서는 시행착오법 등 시간이 많이 소요되기도 하며, 최적조건의 상태가 선정되었는지에 대한 검증이 쉽지 않은 경우도 발생한다. 본 연구에서는 FLAC3D 프로그램에 내장된 FISH 언어를 사용해서, 차분진화 알고리즘(DEA)을 적용한 최적화기법을 개발하였다. 갱구사면 보강공법 중에 쏘일네일링 공법에 대한 데이터베이스를 구축한 후, FLAC3D 해석을 통한 안전율 기반의 최적보강배치 계획을 선정할 수 있도록 하였다. 수치해석 결과, 완전조합(FC)에 비해서 DEA 기반의 최적화기법이 해석회수가 8배 정도 감소함을 확인하였다. 갱구 사면보강 설계 시 개발된 시스템을 활용하면, 최적보강배치 계획을 상대적으로 쉽게 선정할 수 있을 것으로 기대된다. In order to ensure the stability of tunnel portal slope, reinforcement method such as anchors, soil nails and rock bolts have been used in Korea. When selecting slope reinforcement methods in tunnel portal area such as reinforcement arrangement and length, trial and error method can be very time-consuming and it was also not easy to verify the selection of an optimum condition. In this study, using the FISH language embedded in the finite difference code FLAC3D program, the optimization technique was developed with the Differential Evolution Algorithm (DEA). After building a database on the soil nailing method in tunnel portal area, this system can be selected to an optimum arrangement plan based on the factor of safety through the FLAC3D analysis. Through the results of numerical analysis, it was confirmed that the number of analysis was decreased by about 8 times when DEA based optimization technique was used compared to the full combination (FC). In case of the design of slope reinforcement in tunnel portal area, if this built-system is used, it is expected that the selection of an optimum arrangement plan can be relatively easier.