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.

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

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.

산화물기반 박막트랜지스터 전극용 ITO박막의 제작시 투입 산소 분압 의존성

김경환,Kim, Kyung Hwan 한국반도체디스플레이기술학회 2021 반도체디스플레이기술학회지 Vol.20 No.2

In this study, we investigated the oxygen partial pressure effect of ITO films for electrodes of oxide-based Thin-Film Transistor (TFT). Firstly, we deposited single ITO films on the glass substrate at room temperature. ITO films were prepared at the various partial pressures of oxygen gas 0-7.4% (O₂/(Ar+O₂)). As increasing oxygen on the process of film deposition, electrical properties were improved and optical transmittance increased in the visible light range (300-800 nm). For the electrode of TFT, we fabricated a TFT device (W/L=1000/200 ㎛) with ITO films as the source and drain electrode on the silicon wafer. Except for the TFT device combined with ITO film prepared at the oxygen partial pressure ratio of 7.4%, We confirmed that TFT devices with ITO films via FTS system operated as a driving device at threshold voltage (V_th) of 4V.

의미론적인 단순화된 그림 및 표의문자를 인지하는 과정에 대한 fMRI 연구

김경환,이성기,송명성,권민정,정준영,박현욱,윤효운,Kim Kyung Hwan,Lee Sung Ki,Song Myung Sung,Kwon Min Jung,Chung Jun Young,Park Hyun Wook,Yoon Hyo Woon 대한자기공명의과학회 2003 Investigative Magnetic Resonance Imaging Vol.7 No.2

문자와 그림을 인식하는데 있어 인식패턴의 반구차이는 인지심리학적으로 널리 연구되어왔고 또 증명되어졌다. 일반적으로 그림을 인식하는 있어서는 우반구 우세를 문자를 인식하는 있어는 좌반구 우세를 이야기하는데 본 논문에서는 그 사실을 바탕으로 fMRI 연구를 진행하였다. 동양문화권에서 문자로 사용되고 있는 한자 역시 그림으로 인식한다는 견해가 있다는 것이다. 한자의 인지가 좌반구 또는 우반구 우세라는 엇갈린 견해들이 있다. 그래서 본 논문에서는 한자와 그림의 인식패턴에 대한 반구차이 및 활성화되는 두뇌의 영역을 규명하기 위해 비교 실험하였다. 자극으로 사용되어진 그림은 한자와 동일한 의미를 가진 단순화된 것이다. 실험 디자인은 일반적으로 사용되는 블록디자인을 사용하였고 SPM을 사용하여 분석하였다. 결론으로 한자와 그림 인식패턴 모두 반구우세성을 이야길 할 경우 시각영역인 후두엽 및 측두엽 부분에서는 우반구 우세가 보이지만 일반적으로 반구우세성을 이야기하기는 무리가 있는 것 같다. The different perceiving patterns of each picture, alphabetic words and Chinese characters, were widely investigated psychophysically. The more precise localisation can be done in terms of brain activity us-ing functional image technique such as PET and fMRI recently, Until now, there was no fMRI study to make direct comparison between perception of single Chinese character and simplified pictures (pictograph). We have made direct comparison of these two components using modern magnetic resonance techniques. We cannot confirm the right hemispheric dominance for perception of single Chinese character and pictographs. These two kinds of perceiving pattern can be underlying different mechanism.

정부의 고가의료장비 수가정책과 병원경영수지

김경환,남은우,Kim, Gyeong-Hwan,Nam, Eun-U 대한병원협회 1997 대한병원협회지 Vol.26 No.5

승모판막 폐쇄부전에 있어 승모판막 성형술의 단기성적

김경환,원태희,김기봉,안혁,Kim, Kyung-Hwan,Won, Tae-hee,Kim, Ki-Bong,Ahn, Hyuk 대한흉부심장혈관외과학회 2000 Journal of Chest Surgery (J Chest Surg) Vol.33 No.1

Background: Reconstruction surgery of mitral valve regurgitation is now considered as an effective operative technique and has shown good long-term results. Although reconstructive surgery of mitral valve has been performed since 1970s, we have started only in early 1990s in full scale because of small number of the mitral regurgitation compared to mitral stenosis and lack of knowledge from the viewpoint of patients and physicians. Material and Method: From January 1992 to December 1996, 100 patients underwent repair of the mitral valve for mitral regurgitation with or without mitral stenosis in Seoul National University Hospital. 45(45%) of the patients were men and 55(55%) were women. The mean age was 39.9$\pm$14.4 years. The causes of the mitral regurgitation were rheumatic in 61, degenerative in 28 and others in 11. According to the Carpentier's pathological classification of mitral regurgitation 5 patients were type I. 55 patients were type II and 40 patients were type III. 7 patients underwent concomitant aortic valvuloplasty and 8 patients underwent aortic valve replacement. 7 patients underwent Maze operation or pulmonary vein isolation. Result: There were no operative death but 3 major operative complications: 2patients were postoperative low cardiac output syndrome(needed intra-aortic ballon pump support) and 1 patient was postoperative bleeding. There was one late death(1.0%) The cause of death was sepsis secondary to acute bacterial endocarditis. 3 patients required reoperation for recurred mitral regurgitation. There were no statistically significant risk factors for reoperation. The other 96 patients showed no or mild degree of mitral regurgitation 99 survivors were in NYHA functional class I or II. There were two throumboembolisms but no anticoagulation-related complications. Conclusion: We concluded that mitral valve repair could be performed successfully in most cases of mitral regurgitation even in the rheumatic and combined lesions with very low operative mortality and morbidity. The early results are very promising.

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.