히크만 카테터를 삽입한 소아 환자에서 발생한 합병증 분석

김태훈,김대연,조민정,김성철,김인구,Kim, Tae-Hoon,Kim, Dae-Yeon,Cho, Min-Jeong,Kim, Seong-Chul,Kim, In-Koo 대한소아외과학회 2010 소아외과 Vol.16 No.1

Hickman catheters are tunneled central venous catheters used for long-term venous access in children with malignancies. The appropriate management for various kinds of catheter related complications has become a major issue. We retrospectively analyzed the clinical, demographic, and surgical characteristics in 154 pediatric hemato-oncology patients who underwent Hickman catheter insertion between January 2005 and December 2009. There were 92 boys and 62 girls. The mean age at surgery was $7.6{\pm}5.1$ years old. The mean operation time was $67.4{\pm}21.3$ minutes and C-arm fluoroscopy was used in 47(30.5 %). The causes of Hickman catheter removal were termination of use in 82 (57.3 %), catheter related bloodstream infection in 44(30.8 %), mechanical malfunction in 11(7.7 %), and accidents in 6(4.2 %). Univariate and multivariate analysis for associated factors with catheter related bloodstream infection showed that there were no statistically significant associated factors with catheter related infection complications. All cases except two showed clinical improvement with catheter removal and relevant antibiotics treatment. The mean catheter maintenance period in patients of catheter removal without complications was $214.9{\pm}140.2$ days. And, The mean catheter maintenance period in patients of late catheter related bloodstream infection was $198.0{\pm}116.0$ days. These data suggest that it is important to remove Hickman catheter as soon as possible after the termination of use. When symptoms and signs of complications were noticed, prompt diagnostic approach and management can lead to clinical improvements.

큐라리노 증후군의 임상 경험

김태훈,조민정,김대연,김성철,김인구,Kim, Tae-Hoon,Cho, Min-Jeong,Kim, Dae-Yeon,Kim, Seong-Chul,Kim, In-Koo 대한소아외과학회 2011 소아외과 Vol.17 No.1

Currarino syndrome is a hereditary syndrome characterized by the triad of a sacral bony defect, presacral mass and anorectal malformation. We retrospectively reviewed 13 Currarino syndrome patients who were treated in our center between 1997 and 2010. Demographic data, initial symptoms, initial diagnosis. pathologic diagnosis of presacral mass, associated anomalies and managements were analyzed. There were 8 boys and 5 girls. Four patients were diagnosed as Currarino syndrome immediately after birth with failure of passage of meconium and abdominal distension. Four patients underwent surgery for imperforate anus immediately after birth and W8re diagnosed as Currarino syndrome later and underwent reoperation. Three patients were diagnosed during work-up and management with of the tentative diagnosis of Hirschsprung's disease. Diagnosis of the remaining two patients was at the age of 26 months and 9 years and anorectal malformation was not associated. Twelve patients showed hemi-sacrum and one patient showed bilateral sacral subtotal agenesis. Two patients without anorectal malformation underwent presacral mass excision, untethering of spinal cord and repair of myelomeningocele. Six out of 8 patients, excluding 3 that expired or were lost to follow up, with anorectal malformation underwent colostomy, presacral mass excision, untethering of spinal cord, repair of myelomeningocele, posterior sagittal anorectoplasty and colostomy repair. One patient underwent only posterior sagittal anorectoplasty after colostomy. One waits the scheduled operation only with Hegar dilatation. Pathologic examation of presacral masses showed myelomeningoceles in 4 patients, lipomyelomeningoceles in 3 patients and dermoid Cyst in one patient. Teratoma was combined in 2 patients. Eight patients needed neurosurgical operation for spinal cord problems. Seven patients had urologic anomalies and two of them underwent operation. Currarino syndrome should be considered as a differential diagnosis in pediatric patients with abdominal distension, constipation and anorectal malforlnation. For proper evaluation and treatment, a multi-disciplinary approach is recommended.

체외막 산소화 요법을 적용한 선천성 횡격막탈장 치료의 초기 경험

김태훈,조민정,박정준,김대연,김성철,김인구,Kim, Tae-Hoon,Cho, Min-Jeng,Park, Jeong-Jun,Kim, Dae-Yeon,Kim, Seong-Chul,Kim, In-Koo 대한소아외과학회 2011 소아외과 Vol.17 No.2

Extracorporeal membrane oxygenation (ECMO) has been utilized in congenital diaphragmatic hernia (CDH) patients with severe respiratory failure unresponsive to conventional medical treatment. We retrospectively reviewed 12 CDH patients who were treated using ECMO in our center between April 2008 and February 2011. The pre ECMO and on ECMO variables analyzed included gestational age, sex, birth weight, age at the time of ECMO cannulation, arterial blood gas analysis results, CDH location, timing of CDH repair operation, complications and survival. There were 9 boys and 3 girls. All patients were prenatally diagnosed. Mean gestational age was $38.8{\pm}1.7$ weeks and mean birth weight was $3031{\pm}499$ gram. Mean age at the time of ECMO cannulation was $29.9{\pm}28.9$ hours. There were 4 patients who survived. Survivors showed higher 5 min Apgar scores ($8.25{\pm}0.96$ vs. $7.00{\pm}1.20$, p=0.109), higher pre ECMO mean pH ($7.258 {\pm}0.830$ vs. $7.159{\pm}0.986$, p=0.073) and lower pre ECMO $PaCO_2$ ($48.2{\pm}7.9$ vs. $64.8{\pm}16.1$, p=0.109) without statistical significance. The hernia was located on the left side in 10 patients and the right side in 2 patients. The time interval from ECMO placement to operative repair was about 3~4 days in 5 early cases and around 24 in the remaining cases. There were 3 cases of post operative bleeding requiring re operation and 2 cases of abdominal compartment syndrome requiring abdominal fascia reopening. ECMO catheter reposition was required in 4 cases. Three cases of arterial or venous thrombosis were detected and improved with follow up. Our data suggests that ECMO therapy could save the lives of some neonates with CDH who can not be maintained on other treatment modalities. Protocolized management and accumulation of case experience might be valuable in improving outcomes for neonates with CDH treated with ECMO.

소아외과 영역의 선천성 응급 질환에서 산전 진단이 술후 사망률에 미친 영향

김태훈,이성철,김현영,정성은,박귀원,김우기,Kim, Tae-Hoon,Lee, Seong-Cheol,Kim, Hyun-Young,Jung, Sung-Eun,Park, Kwi-Won,Kim, Woo-Ki 대한소아외과학회 2004 소아외과 Vol.10 No.2

As prenatal ultrasonography becomes popular, the number of prenatal diagnosis of congenital surgical diseases is also increasing. To evaluate the impact of antenatal ultrasonography on outcome the mortality rate in neonatal surgical emergencies was studied. The authors retrospectively reviewed 281 patients (congenital diaphragmatic hernia: 44, tracheoesophageal fistula: 78, intestinal atresia: 98, omphalocele: 28 and gastroschisis: 33 who had been managed at Seoul National University Childrens Hospital, from January 1991 to December 2000. The patients were divided into two groups; group A (1991 to 1995; 139 patients) and group B (1996 to 2000; 142 patients). These two groups were subdivided into prenatally diagnosed subgroup and postnatally diagnosed subgroup. We analyzed the changes of prenatal diagnosis rate, total mortality rate, and mortality rate of subgroups. Prenatal diagnosis rate was increased significantly in group B (Group A: 24.5 % and Group B: 45.1 %). Total mortality rate of group A was 21.6 %, and that of group B was 10.6 %, showing a significant decrease in group B. However, in both group A and B, when compared antenatally diagnosed subgroup with postnatally diagnosed subgroup, the mortality rate was lower in postnatally diagnosed subgroups but statistically not significant. The authors conclude that although prenatal diagnosis rate has been increased, prenatal diagnosis itself has not resulted in significant improvement in outcome.

보건계열 대학생의 학습전략과 학업 성취도 연구

김태훈,윤태형,김요섭,Kim, Tae-Hoon,Yoon, Tae-Hyung,Kim, Yoseob 대한지역사회작업치료학회 2011 대한지역사회작업치료학회지 Vol.1 No.1

목적: 학습전략과 학업성취도 사이에 상관이 있는지와, 높은 학업성취 대학생과 낮은 학업성취 대학생의 학습전략에 차이가 있는지를 조사해 보고자 하였다. 연구방법: K대학교 보건계열 1학년 대학생 103명을 대상으로 Multi-dimensional Learning Strategy Test를 활용하여 45분 동안 183문항을 조사하였다. 결과: 성격적 특성 중 효능감과 실천력이 학업성취도와 의미 있는 상관이 있는 것으로 드러났으며, 동기적 특성과의 관계에서는 학업성취도가 학습동기와는 유의한 정적인 상관을 보였으나, 회피동기와는 부적 상관을 보여 주었다. 학업성취도와 행동적 특성과의 관계에서는 8개요인 모두에서 통계적으로 유의한 상관을 보여주었다. 높은 학업 성취군과 낮은 학업성취군 사이의 학습전략 사용에 차이가 있는지에 대한 조사 결과를 보면, 성격적 특성에서는 두 그룹사이에 효능감과 실천력에서 유의한 차이가 있었으며, 정서적 특성에서는 낮은 학업성취군 학생들이 우울을 느끼는 정도가 높은 학업성취군 학생들보다 더 큰 것으로 나타났다. 동기적 특성에서는 낮은 학업성취군 학생들은 높은 학업성취군 학생들에 비해 현저히 낮은 학습동기를 가지고 있었으며, 회피 동기에서는 반대로 현저히 높은 것으로 나타났다. 마지막으로, 행동적 특성의 사용능력에 있어서는 8개요인 모두에서 낮은 학업성취군 학생들이 높은 학업성취군 학생들에 비해 현저히 뒤떨어지는 것으로 나타났다. 결론: 학업에서 상대적으로 낮은 성취를 보이는 학생들의 주요한 원인 가운데 하나는 이들이 높은 학업 성취를 보이는 학생들에 비해 학습전략의 사용 능력에 있어서 뒤떨어진다는 사실을 확인하였다. 이러한 점은 대학 교육과정에서 교양이나 전공과목의 개설 뿐 아니라 학습전략의 효과적 사용을 위한 특강이나 세미나 등의 프로그램을 설치 운영할 필요가 있음을 시사한다. This study investigated the relationship between learning strategies and achievements of the students in the department of health science, and differences between higher academic achievers and lower academic achievers in the use of the learning strategies. The results were as follows. First, there was a correlation between academic achievements and self-efficacy and power of execution in the personality area. Second, there was a positive correlation between academic achievements and academic motivation, a negative correlation between academic achievements and avoidnat motivation, in the motivation area. Third. there was a correlation between academic achievements and all 8 factors in the behavior area. In the use of learning strategies, there was a difference found in self-efficacy and the power of execution between the higher academic achievers and the lower academic achievers. It also was found that the lower academic achievers perceived more depression, showed remarkably lower motivation and higher avoidance motivation, than the higher academic achievers. Lastly, the lower academic achievers was lagged behind noticeably compared to the higher academic achievers in the ability of using all factors of the behavior area.

드론을 활용한 댐 외관조사 및 대가기준에 대한 연구

김태훈,이재호,김도선,이석배,Kim, Tae-Hoon,Lee, Jai-Ho,Kim, Do-Seon,Lee, Suk-Bae 한국재난정보학회 2021 한국재난정보학회 논문집 Vol.17 No.3

연구목적: 기존의 인력에 의한 안전점검은 기술자의 안전이 우려되거나 접근이 어려워, 평가 및 데이터 확보에 한계가 있었고, 시설물의 노후화로 유지관리 대상이 증가함에 따라 더욱더 큰 문제가 되고 있다. 드론 기술이 발전하면서 외관조사에 이를 활용할 경우, 인력의 안전 보장, 시각적 데이터 확보, 신속한 점검 진단이 가능하며, 최근 드론에 의한 시설물 안전점검이 일부 도입되는 등 활용도가 높아지고 있다. 활용성을 보다 강화하기 위해서는 드론에 의한 시설물 외관조사의 대가기준이 필요하다고 판단되며, 본 논문에서는 댐을 대상으로 연구를 수행하였다. 연구방법:품셈 산출을 위해 기존 국내 안전점검 및 드론관련 대가기준을 조사하고, 드론을 활용한 안전점검 관련 절차를 비교분석하여 작업 절차 및 공종에 대하여 검토하였다. 또한 실제 댐에 대한 드론 촬영 및 입면정사영상 제작을 통해 실증 자료를 수집하였다. 연구결과: 드론을 활용한 시설물 안전점검을 위한 작업공종을 도출하였고, 작업공종에 따라 두 개의 댐을 대상으로 실증조사결과를 수집하였으며, 이를 바탕으로 댐기준시설물 규격 기준으로 품셈 안을 도출하였다. 시설물의 구조형식별, 규격별 조정비는 기존 지침을 적용하고, 기상기준점측량이 필요한 경우 건설공사표준품셈의 무인비행장치측량의 품을 적용하도록 하였다. 결론:드론을 활용한 외관조사 시 GSD를 세밀하게 할수록 촬영 사진 수가 크게 증가하여, 대가기준을 산출을 위한 보정으로 조정비 개념을 적용하였다. 더불어 안전거리 유지를 위해서는 최대 GSD가 한계를 나타내는 문제점도 고려해야 함을 알 수 있었다. Purpose: Safety inspections by existing personnel have been limited in evaluation and data securing due to concerns about the safety of technicians or difficulty in accessing them, and are becoming a bigger problem as the number of maintenance targets increases due to the aging of facilities. As drone technology develops, it is possible to ensure the safety of personnel, secure visual data, and diagnose quickly, and use it is increasing as safety inspection of facilities by drones was introduced recently. In order to further enhance utilization, it is considered necessary to base a consideration standard for facility appearance investigation by drones, and in this paper, research was conducted on dams. Method: To calculate the quality, existing domestic safety inspection and drone-related consideration standards were investigated, and procedures related to safety inspection using drones were compared and analyzed to review work procedures and construction types. In addition, empirical data were collected through drone photography and elevation image production for the actual dam. Result: Work types for safety inspection of facilities using drones were derived, and empirical survey results were collected for two dams according to work types. The existing guidelines were applied for the adjustment ratios for each structural type and standard of the facility, and if a meteorological reference point survey was necessary, the unmanned aerial vehicle survey of the construction work standard was applied. Conclusion: The finer the GSD in appearance investigation using drones, the greater the number of photographs taken, and the concept of adjustment cost was applied as a correction to calculate the consideration standard. In addition, it was found that the problem of maximum GSD indicating limitations should be considered in order to maintain the safe distance.

삼각망 철근상세를 갖는 새로운 중공 철근콘크리트 교각단면: II. 매개변수 연구

김태훈,김호영,손제국,Kim, Tae-Hoon,Kim, Ho-Young,Son, Je-Kuk 한국지진공학회 2015 한국지진공학회논문집 Vol.19 No.3

The purpose of this study is to investigate the behavior characteristics of new hollow reinforced concrete (RC) bridge pier sections with triangular reinforcement details and to provide the details and reference data. Among the numerous parameters, this study concentrates on the shape of the section, the reinforcement details and the spacing of the transverse reinforcement. Additional eight column section specimens were tested under quasi-static monotonic loading. In this study, the computer program, named RCAHEST (Reinforced Concrete Analysis in Higher Evaluation System Technology), was used. A innovative confining effect model was adopted for new hollow bridge pier sections. This study documents the testing of new hollow RC bridge pier sections with triangular reinforcement details and presents conclusions based on the experimental and analytical findings.

미생물 혼합 고로슬래그 모르타르의 강도특성 평가

김태훈,이준철,김화중,Kim, Tae-Hoon,Lee, Jun-Cheol,Kim, Wha-Jung 大韓建築學會 2015 大韓建築學會論文集 : 構造系 Vol.31 No.2

In construction material field, one of the ways to reduce $CO_2$ generation and environmental load is to decrease the use of cement materials. In this study, the cement material was replaced with a by-product from iron production which called BFS(blast furnace slag), when mortar specimens were made and it was expected to reduce environmental load significantly. Moreover, the added value can be created by using a by-product and cutting the production cost of concrete and mortar. 5 types of mixing water, BFS and the activator($Ca(OH)_2$) were used to make mortar specimens and the compressive strength test was carried out. All specimens were cured for 3, 7, 28days. As a result, all experimental groups had better strength than a control group. Above all, 2F-1 group had superior strength to the others. In order to raise confidence of the results, microstructure of mortar was observed and each specimen was analyzed. SEM images from all groups were compared with each other, and the area and the volume of micro-pore were measured through the porosimeter analysis. Through this research, it was tried to examine the potential for developing zero cement mortar and applying the micro-organism as a natural admixture material.

항공전자 응용을 위한 NVIS (Night Vision Imaging System) Green A 호환 LED 개발

김태훈,유창한,윤현주,김민평,윤호신,Kim, Tae Hoon,Yu, Chang Han,Yoon, Hyeon Ju,Kim, Min Pyung,Yoon, Ho Shin 한국반도체디스플레이기술학회 2020 반도체디스플레이기술학회지 Vol.19 No.4

By adapting black body leadflame and thin film type Green A filter, we successfully demonstrated night vision imaging system (NVIS) Green A compatible LED. Fabricated NVIS compatible LEDs show small form factor compared to that of commercialized NVIS compatible LED. Especially, NVIS radiance and chromaticity of MIL-STD-3009 specification can be satisfied simultaneously and easily by controlling the color temperature of the white LED as well as the concentration of the Green A dye and the thickness of the Green A filter. The optimal dye concentration of the NVIS Green A filter is expected to be about 1 wt%. The results of this study are expected to contribute to miniaturization, weight reduction and localization of avionic display and lighting devices.

A Simple Method for Extraction of High Molecular Weight DNA fromPorphyra Tenera (Rhodophyta) Using Diatomaceous Earth

김태훈,황미숙,송주동,오민혁,문용환,정익교,류태형,이춘환,Kim, Tae-Hoon,Hwang, Mi-Sook,Song, Ju-Dong,Oh, Min-Hyuk,Moon, Yong-Hwan,Chung, Ik-Kyo,Rhew, Tae-Hyoung,Lee, Choon-Hwan The Korean Society of Phycology 2006 ALGAE Vol.21 No.2

The innate soluble polysaccharides and phenolic compounds of marine macroalgae are serious contaminants which interfere with experimental procedures such as restriction enzyme digestion, polymerase chain reaction (PCR) and other enzymatic reactions using extracted DNA samples. The viscous polysaccharides are co-precipitated with DNA samples by isopropanol or ethanol precipitation in conventional experiment. To overcome the problem, a method for the isolation of high molecular weight DNA from Porphyra tenera is developed with the application of diatomaceous earth column. The isolated DNAs by this method were about 50-100 kb in size and could be digested well with restriction enzymes. The nuclease activity seemed to be minimal, and high reproducibility in the arbitrary primed PCR for RAPD analyses was a distinctive feature. These results suggest that this method is very efficient in isolating nucleic acid from macroalgae including Porphyra.