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.

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.

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.

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.

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.

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.

확장된 블록 펄스 연산 행렬을 이용한 분포정수계의 시불변 파라미터 추정

김태훈,이승,김종부,Kim, Tae-Hoon,Lee, Seung,Kim, Jong-Boo 한국조명전기설비학회 2001 조명·전기설비학회논문지 Vol.15 No.6

대부분의 시스템은 그 구조가 시간과 공간에 널리 분포되어 있기 때문에 집중정수 모델로 표현하여 시스템의 동적 특성을 해석하고 제어하기에는 여러 가지 문제점들이 있다. 시스템의 상태는 시간과 공간의 영향을 받는 상태변수가 되므로 그 동적 특성은 편미분 방정식으로 표현되어 분포정수계로 모델링하게 된다. 본 연구에서는 직교 함수의 특성을 이용하여 선형 편미분 방정식으로 표현되는 분포정수계의 두 변수에 대하여 연속적으로 적분을 취하여 적분 방정식으로 변환하고, 확장된 블록 펄스 연산 행렬[3]을 도입하여 적분 방정식을 간단한 대수 방정식으로 변환하는 방법을 제시하였으며, 최소자승오차법을 이용하여 분포정수계의 파라미터들을 추정하는 알고리즘을 제안하였다. 또한 시뮬레이션을 통하여 기존의 방법을 사용하는 것보다 본 연구에서 제안하는 방법을 사용하는 것이 오차가 적음을 보였다. This paper considers the problem of the identification of the time invariant parameters of distributed systems. In general, the parameters are identified by using the CBPOM(Conventional Block Pulse Operational Matrices), but in this paper, the parameters ard identified by using the EBPOMS(Extended Block Pulse Operational Matrices) which can reduce the burden of operation md the volume of error caused by matrices multiplication. The simulation cloves the effectiveness of the proposed method.

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.

고속 월쉬 변환을 이용한 이동 유체간 열교환 상태 해석에 관한 연구

김태훈,이승,Kim, Tae-Hoon,Lee, Seung 한국조명전기설비학회 2001 조명·전기설비학회논문지 Vol.15 No.6

분포정수계는 시스템이 두 개 이상의 독립변수로 표현되면서 또한 각 변수에 대한 미분을 포함하는 편미분 방정식으로 표현되므로, 분포정수계에 직접적인 최적제어 논리를 도입하는 것은 매우 어렵다. 본 연구에서 제시하고자하는 새로운 알고리즘은 월쉬 함수 고유특성을 그대로 유지할 수 있는 유한급수전개방법을 이용함과 동시에 계산의 편리성을 위하여 고속 월쉬 변환을 사용하는 것으로서, 본 연구 방법을 사용하면 역행렬 연산이 필요 없게 되므로 기존의 방법에 의해 처리하기 힘든 분포정수계, 선형시변계, 비선형계의 해석 및 제어문제어도 쉽게 적용할 수 있다. This study uses the distributed parameter systems resented by the spatial discretization technique. In this paper, the distributed parameter systems are converted into lumped parameter systems, End fast Walsh transform and the Picard's iteration method are allied to analysis the state of the systems. This thesis presents a new algorithm which usefully exercises the optimal contro1 in the distributed parameter systems. In exercising the optimal control of the distributed parameter systems, the excellent consequences are found without using the existing decentralized contro1 or hierarchical control method. This study can be applied to the linear time-varying systems and the non-linear systems. Farther researches are required to solve the problems of convergence in case of the numerous applicable intervals. The simulation proves the effectiveness of the proposed algorithm.

중공원형 철근콘크리트 교각의 횡방향철근에 따른 내진성능평가

김태훈,강형택,Kim, Tae-Hoon,Kang, Hyeong-Taek 한국지진공학회 2012 한국지진공학회논문집 Vol.16 No.1

이 연구의 목적은 중공원형 철근콘크리트 교각의 횡방향철근에 따른 지진거동을 파악하고 합리적이면서 경제적인 내진 설계기준의 개발을 위한 자료를 제공하는데 있다. 3개의 중공원형 교각 실험체에 일정 축하중 하에서 횡방향 반복하중을 가하는 준정적 실험을 수행하였다. 정확하고 올바른 성능평가를 위하여 신뢰성 있는 비선형 유한요소해석 프로그램을 사용하였다. 이용된 해석기법은 조사된 실험체에 대하여 하중단계에 따라 내진성능을 비교적 정확하게 예측하였다. 실험적, 해석적 결과로부터 중공원형 철근콘크리트 교각의 설계와 시공 실무를 향상하기 위한 내진상세를 제시하였다. The purpose of this study was to investigate the seismic behavior of hollow circular reinforced concrete bridge columns with confinement steel, and to develop improved seismic design criteria. Three hollow circular columns were tested under a constant axial load and a quasi-static, cyclically reversed horizontal load. The accuracy and objectivity of the assessment process can be enhanced by using a sophisticated nonlinear finite element analysis program. The numerical method used gives a realistic prediction of the seismic performance throughout the loading cycles for the several test specimens investigated. Based on the experimental and analytical results, design recommendations are presented to improve current practice in the design and construction of hollow circular reinforced concrete bridge columns.