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.

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.

오덕환(五德丸)과 사신환(四神丸)의 항산화 및 항염증 효과

김태훈,조현진,박선동,Kim, Tae-Hoon,Cho, Hyun-Jin,Park, Sun-Dong 대한한의학방제학회 2012 大韓韓醫學方劑學會誌 Vol.20 No.2

Objectives : The aim of this study was verification of the anti-oxidative and anti-inflammatory effects of Odukhwan(ODH) and Sasinhwan(SSH) in mouse macrophage, RAW264.7 cells. Methods : To investigate the anti-oxidative effect and scavenging activities of DPPH radical, superoxide anions, nitric oxide and peroxynitrite were measured. Cytotoxic activity of extract of ODH and SSH on RAW264.7 cells was measured using MTS assay. To proof the reductive activity of intracellular oxidation, DCFH-DA assay was performed. The nitric oxide(NO) production was measured and pro-inflammatory cytokines and $PGE_2$ were measured by ELISA kit. The levels of inducible nitric oxide synthase(iNOS), cyclooxygenase-2(COX-2) and nuclear NF-${\kappa}B$ p65 expression were detected by western blot. Results : After those analyses, we bring to a conclusion as follows. Both herbal formulations scavenged DPPH radical and nitric oxide. But ODH had no scavenging activity of superoxide anions and SSH had low scavenging activity in peroxynitrite. And the results indicated that ODH and SSH inhibited the LPS-induced NO, $PGE_2$ production and iNOS, COX-2 expression accompanied by an attenuation of IL-$1{\beta}$ and IL-6 production in RAW264.7 cells. They also have suppression effects of LPS-induced NF-${\kappa}B$ activation. Conclusions : ODH and SSH have anti-oxidative and anti-inflammatory effects and they may be a part of database for development of new anti-oxidative and anti-inflammatory drugs.

목재 펠릿 생산에 따른 온실 가스 배출량 분석

김태훈,윤성이,Kim, Tae Hoon,Yoon, Sung-Yee 한국유기농업학회 2013 韓國有機農業學會誌 Vol.21 No.3

In this study, it is intended that utilize the LCA (Life Cycle Assessment) method, to evaluate the environmental impact of wood pellet manufacturing facility. As mentioned above, wood pellet manufacturing facility of 20 has produced wood pellets as a raw material sawdust and wood in our country. In this study, in order to feature manufacturing process of wood pellets that resemble almost necessary to analyze evenly size and characteristics of various equipment whether these reasonable, the characteristics of the equipment may be different, the production of 20 places I surveyed the facility one central timber distribution center one large scale most of the equipment.

조립식 물량저감 중공 철근콘크리트 교각의 성능평가

김태훈,박동규,이재훈,신현목,Kim, Tae-Hoon,Park, Dong-Kyu,Lee, Jae-Hoon,Shin, Hyun-Mock 한국지진공학회 2016 한국지진공학회논문집 Vol.20 No.1

This study investigates the performance of hollow precast segmental bridge columns with reinforcement details for material quantity reduction. The proposed triangular reinforcement details are economically feasible and rational, and facilitate shorter construction periods. The precast segmental bridge columns provides an alternative to current cast-in-place systems. We tested a model of hollow precast segmental bridge columns under a constant axial load and a quasi-static, cyclically reversed horizontal load. We used a computer program, Reinforced Concrete Analysis in Higher Evaluation System Technology (RCAHEST), for analysis of reinforced concrete structures. The used numerical method gives a realistic prediction of performance throughout the loading cycles for hollow precast segmental bridge column specimens investigated. As a result, proposed reinforcement details for material quantity reduction was equal to existing reinforcement details in terms of required performance.

공간계획의 개념에 관한 검토 - 유럽의 ESDP와 영국의 PCPA 2004를 중심으로 -

김태훈,권혁진,이천재,Kim, Tae-Hoon,Kwon, Hyuk-Jin,Lee, Cheon-Jae LX Spatial Information Research Institute 2015 지적과 국토정보 Vol.45 No.1

Spatial planning, is required to be conceptualized corresponding to the shifts in planning paradigm through logical and systematic approaches. The concept of planning, thus, should be considered in terms of not only the planning discipline but also the planning activities or practices. This study aims to review and examine the concept of spatial planning based on the different approaches of planning and analyze the difference between land use planning, then review a meaning of spatial planning in terms of its dimensions. The research range will be limited to only the concept of spatial planning and survey was carried on through collecting the secondary research data by literature reviews and both descriptive and comparative approaches will be applied concurrently. The key findings of the study can be found as follows: Firstly, spatial planning has been reviewed with regard to theoretical, practical and integrated approaches. Secondly, the concept of spatial planning has been examined in terms of definitions, dimensions and analysis criteria and then analyzed conceptual differences compared with traditional land use planning. Finally, a meaning of spatial planning has been highlighted based on the dimensions of spatial planning, such as future visions, policy toolbox, sustainable development and inclusivity. 공간계획은 논리적 체계적 접근을 통하여 계획의 패러다임 변화에 상응하는 개념화가 요구되고 있으며, 또한 이러한 공간계획의 개념은 계획 이론과 실제를 고려한 접근이 필요하다. 따라서 본 연구의 목적은 공간계획에 대한 이론적 실제적 통합적 접근방법을 통하여 및 그 개념을 파악하고, 전통적인 개념인 토지이용계획과의 차이점을 분석하여 공간계획의 의의를 재조명하고자 하는 것이다. 이러한 연구목적을 달성하기 위하여 연구범위는 공간계획의 개념으로 한정하고, 조사방법은 문헌조사를 통하여 2차 자료를 수집하였으며, 접근방법은 서술적 접근방법과 비교론적 접근방법을 병용하였다. 연구결과는 다음과 같은 관점에서 도출하고자 하였다. 첫째, 공간계획에 대한 접근은 계획이론의 이론적 실제적 통합적 차원에서 접근하였다. 둘째, 공간계획의 개념은 공간계획의 정의, 차원, 그리고 평가의 측면에서 검토하고, 토지이용계획과의 개념적 차이를 비교 분석하였다. 마지막으로 공간계획의 의의는 미래상, 정책도구, 지속가능한 발전 그리고 개방성 차원에서 파악하고자 하였다.

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.