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.

안의료용 렌즈 적용을 위한 Vinyl Group으로 치환된 Naphthalene 및 Anthracene을 포함하는 고분자 소재의 물성평가

김태훈,김동현,이민제,김득현,노정원,성아영,Kim, Tae-Hun,Kim, Dong-Hyun,Lee, Min-Jae,Kim, Duck-Hyun,No, Jung-Won,Sung, A-Young 대한화학회 2014 대한화학회지 Vol.58 No.2

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.

프리캐스트 콘크리트 바닥판을 이용한 합성형교의 설계 및 시공

김태훈,김인규,김영진,김성운,Kim, T.H.,Kim, I.K.,Kim, Y.J.,Kim, S.U. 한국전산구조공학회 2007 전산구조공학 Vol.20 No.2

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.

폐이식 이후에 발생하는 재관류부종의 방사선학적 고찰

김태훈,유영훈,김형중,안철민,백효채,이두연,김상진,Kim, Tae-Hun,Yu, Yeong-Hun,Kim, Hyeong-Jung,An, Cheol-Min,Baek, Hyo-Chae,Lee, Du-Yeon,Kim, Sang-Jin 대한영상의학회 2003 대한영상의학회지 Vol.49 No.4

Purpose: To elucidate the sequential radiologic manifestations of reperfusion edema after lung transplantation. Materials and Methods: The study group comprised five consecutive lung transplant recipients (M:F=3:2; mean age; 47.5 years) who between July 1996 and April 2002 underwent lung transplantation procedures (four, unilateral; one, bilateral) at our institution. We retrospectively reviewed the serial postoperative radiographs obtained and characterized the lung infiltrates. Results: Lung infiltrates compatible with reperfusion edema were present in all patients (5/5). Reperfusion edema appeared on day 1 in four, and by day 2 in the other. In all transplanted lungs, infiltrates were found in the perihilar and basilar regions, and were scored as maximal on day 1 in one, day 3 in two, day 4 in one and day 5 in the other. Conclusion: The recognition of sequential radiological manifestations helps identify recognition of reperfusion edema after lung transplantation. 목적: 본 연구는 폐이식후 재관류부종의 시기에 따른 방사선적 소견을 기술하려고 한다. 대상과 방법: 본원에서 폐이식을 시행받은 5명의 수여자를 대상으로 하였다. 1996년 7월부터 2002년 3월까지 세 명의 남자와 두 명의 여자가 폐이식을 받았고, 평균 연령은 47.5세 였다. 이 중 4 명은 한쪽 폐만 이식을 받았고, 1명은 양폐 이식을 받았다. 모든 수술후 연속적인 수술후 방사선 사진을 분석하고, 폐음영을 기술 하였다. 결과: 재관류부종은 네 명에서는 수술후 1일째에 , 한 명에서는 2일째에 나타났다. 최대치의 폐음영은 한 명에서 수술후 1일에, 두 명에서 수술후 3일째에, 한 명에서 4일째에, 나머지 한 명은 술후 5일째에 있었다. 결론: 재관류부종은 모든 폐이식 이후에 일어나는 현상이며 방사선학적으로는 폐문주위와 하폐에 우세하게 분포하는 미세 망상형 또는 기강경화로 나타나며, 약 5일 이내에 최대 시기를 거치고 3주 이내에 특별한 치료없이 소실된다.

MIMO 수중통신에서 최적의 터보 등화 기법

김태훈,정지원,Kim, Tae-Hun,Jung, Ji-Won 한국정보통신학회 2014 한국정보통신학회논문지 Vol.18 No.5

수중에서의 음향 통신의 성능은 신호의 다중경로 전달과정에 의해 발생하는 지역 확산 현상으로 인하여 인접간섭의 영향을 받는다. 그리고 음파를 이용한 주파수의 제한으로 인하여 낮은 전송 속도로 통신을 한다. 따라서 전송속도의 향상과 함께 인접간섭을 제거하기 위하여 수중 통신에 적합한 시공간 부호화 기술과 등화기 기술, 채널 부호화 기술이 필요하다. 본 논문에서는 이러한 기술들을 시뮬레이션을 통하여 MIMO 수중 통신 시스템에서 최적의 터보 등화 기법을 이용한 복호구조를 제안한다. 각 모듈별 시뮬레이션을 통한 성능결과 본 논문에서 제안한 계층적 시공간 부호화 방식 기반의 터보 등화 기법을 이용하면 일반적인 수중 통신 보다 성능이 우수함을 알 수 있다. The performance of underwater acoustic(UWA) communication system is sensitive to the Inter-Symbol Interference(ISI) due to delay spread develop of multipath signal propagation. And due to limited frequency using acoustic wave, UWA is a low transmission rate. Thus, it is necessary technique of Space-time code, equalizer and channel code to improve transmission speed and eliminate ISI. In this paper, UWA communication system were analyzed by simulation using these techniques. In the result of simulation, the proposed Turbo Equalization method based on layered Space Time Codes has improved performance compared to conventional UWA communication.

수중통신에서 최적의 BCJR 등화 기법

김태훈,정지원,박태두,이동원,Kim, Tae-Hun,Jung, Ji-Won,Park, Tae-Doo,Lee, Dong-Won 한국정보통신학회 2014 한국정보통신학회논문지 Vol.18 No.9

수중에서의 음향 통신의 성능은 신호의 다중경로 전달과정에 의해 발생하는 지역 확산 현상으로 인하여 인접 심볼간 간섭의 영향을 받는다. 따라서 인접 심볼간 간섭을 제거하기 위하여 수중 통신에 적합한 등화기 기술, 채널 부호화 기술이 필요하다. 본 논문에서는 다중 경로 환경에서 원활한 통신과 함께 수신 신호의 성능을 향상시키기 위한 낮은 SNR에서 우수한 성능을 보이는 BCJR 복호기와 다중 경로로 인해 왜곡된 데이터를 보상하기 위한 기법인 결정 궤환 등화기가 결합된 반복기반 BCJR등화기 구조를 제안하고, 경북 문경 경천호에서의 실제 수중 실험을 통하여 제안한 구조의 성능이 반복횟수의 증가에 따라 향상됨을 알 수 있다. The performance of underwater acoustic communication system is sensitive to the inter-symbol interference due to delay spread develop of multipath signal propagation. Thus, it is necessary technique of equalizer and channel code to eliminate inter-symbol interference. In this paper, underwater acoustic communication system were analyzed by experiment using these techniques on the Kyeong-chun lake, Munkyeong City. Based on the results of experiment, we confirmed that the performance of the proposed iterative BCJR equalization method is improved by increasing the number of iterations.

물량저감 중공 철근콘크리트 교각의 설계프로그램과 경제성 평가

김태훈,손윤기,양남석,이승훈,Kim, Tae-Hoon,Son, Yun-Ki,Yang, Nam-Seok,Lee, Seung-Hoon 한국전산구조공학회 2014 한국전산구조공학회논문집 Vol.27 No.5

This paper presents special-purpose design program and plastic design results for hollow RC bridge columns with reinforcement details for material quantity reduction. The developed reinforcement details has economic feasibility and rationality and makes construction periods shorter. This study documents the economic evaluation of hollow reinforced concrete bridge column systems with reinforcement details for material quantity reduction and presents conclusions based on the application findings. As a result, the proposed reinforcement details for material quantity reduction were designed prior to the existing reinforcement details in terms of structural rationality, constructability, and economic. 이 연구에서는 물량저감 철근상세를 갖는 중공 철근콘크리트 교각 시스템의 전용 설계프로그램과 소성설계 적용 결과를 제시하였다. 개발된 물량저감 철근상세는 경제성과 합리성을 갖으며 공사기간의 단축을 가져올 수 있다. 물량저감 중공 철근콘크리트 교각의 적용을 통해 경제성 평가를 수행하였다. 평가 결과 개발상세가 기존상세에 비해 구조적 합리성, 시공성, 그리고 경제성 등이 우수함을 확인하였다.