$\alpha$-chloralose로 마취한 개에서 폐쇄성 무호흡이 심혈관계 기능변화에 미치는 영향

장재순,강지호,이상학,최영미,권순석,김영균,김관형,송정섭,박성학,문화식,Jang, Jae-Soon,Kang, Ji-Ho,Lee, Sang-Haak,Choi, Young-Mee,Kwon, Soon-Seog,Kim, Young-Kyoon,Kim, Kwan-Hyoung,Song, Jeong-Sup,Park, Sung-Hak,Moon, Hwa-Sik 대한결핵및호흡기학회 2000 Tuberculosis and Respiratory Diseases Vol.48 No.3

연구배경 : 수면 무호흡 증후군의 90% 이상을 차지하는 폐쇄성 수면 무호흡 증후군 환자들은 심혈관계 기능부전이 흔히 동반되며 정상인에 비하여 장기사망률이 증가하는 것으로 알려져 있다. 저자들은 동물실험을 통하여 폐쇄성 무호흡이 심혈관계 기능변화에 미치는 영향을 관찰하고자 하였으며, 또한 수면 무호흡과 관련된 앞으로의 연구에서 적절한 실험동물 모델 설정을 위한 기초자료를 얻고자 하였다. 방 법 : $\alpha$-chloralose로 마취한 16마리의 개를 대상으로 폐쇄성 무호흡을 유발하였고, 무호흡-호흡 주기를 5회 내지 7회 반복하였다. 실내 공기만으로 호흡을 유지시킨 8마리를 산소 비투여군으로 하였고 산소를 투여하면서 호흡을 유지시킨 8마리를 산소 투여군으로 하였다. 무호흡 유발 전 기저상태(기저치), 무호흡 시작 후 25초(무호흡시기), 호흡재개 후 10초(호흡재개 초기)와 25초(호흡재개 후기)에 각각 동맥혈 산소분압과 이산화탄소분압, 심박동수, 심박출량, 대퇴동맥압 및 폐동맥압을 측정하였다. 결 과 : 심박동수는 산소 비투여군에서는 기저치에 비하여 무호흡시기에 유의하게 감소하였고(P<0.01), 시기에 비하여 호흡재개 초기 및 후기에 유의하게 증가하였으며(P<0.01), 산소 투여군에서는 무호흡-호흡 주기에 따른 심박동수 변화가 없었다. 산소투여 여부에 따른 두 군 사이에는 유의한 차이가 있었다. 심박출량은 기저치에 비하여 무호흡시기에 감소하는 경향을 보였으나 통계적 유의성이 없었고, 무호흡시기에 비하여 호흡재개 후기에 유의하게 감소하였으며(P<0.01), 산소투여 여부에 따른 두 군 사이에는 유의한 차이가 없었다. 평균 대퇴동맥압은 기저치에 비하여 무호흡시기에 유의한 감소를 보였고(P<0.05), 산소투여 여부에 따른 두 군 사이에는 유의한 차이가 없었다. 결 론 : 실험동물에서 유발된 폐쇄성 무호흡은 심박동수, 심박출량 및 평균 대퇴동맥압 변화를 초래하였으며, 심박동수 변화는 저산소증과 관련성이 있었다. 본 실험을 통하여 간접적으로 혈역학적 변화에 대한 부분적인 이해가 가능하였으나, 수면 무호흡 증후군 환자에서 동반될 수 있는 심혈관계 기능부전의 병태생리학적 기전을 규명하기 위해서는 자연 수면상태에서 실험할 수 있는 새로운 동물모델의 설정과 더불어 심혈관계 기능변화 및 변화요인에 대한 다양한 연구가 필요하다. Background : Patients with obstructive sleep apnea syndrome are known to have high long-term mortality compared to healthy subjects because of their cardiovascular dysfunction. The observation of hemodynamic changes by obstructive apneas is helpful when attempting to understand the pathophysiological mechanism of the development of cardiovascular dysfunction in those patients. Therefore, we studied the changes in cardiovascular function with an animal model and tried to obtain the basic data for an ideal experimental model (this phrase is unclear), a requirement for a more advanced study. Methods : Sixteen anesthetized dogs with ${\alpha}$-chloralose delete were divided into two groups : 8 dogs of room air breathing group and 8 dogs of oxygen breathing group. We measured $PaO_2$, $PaCO_2$, heart rate, cardiac output, mean femoral artery pressure, and mean pulmonary artery pressure at specified times during the apnea-breathing cycle before endotracheal tube occlusion (baseline), 25 seconds after endotracheal tube occlusion (apneic period), 10 seconds (early phase of postapneic period, EPA) and 25 seconds (late phase of postapneic period, LPA) after spontaneous breathing. Results : In room air breathing group, the heart rate significantly decreased during the apneic period compared to that at baseline (P<0.01) and increased at EPA and LPA compared to that during the apneic period (P<0.01). But, the heart rate showed no significant changes during apneic and postapneic periods in the oxygen breathing group. Cardiac output tended to decrease during apneic period compared to that at baseline, but was statistically significant. Cardiac output significantly decreased at LP A compared to at baseline (P<0.01). Mean femoral artery pressure was significantly decreased at during apneic period compared to that at baseline (P<0.05). Conclusion : Through this experiment, we were partially able to understand the changes of cardiovascular function indirectly, but delete new experimental animal model displaying physiological mechanism close to natural sleep should be established, and the advanced study in the changes of cardiovascular function and their causes should be continued.

흘확장법과 억지끼워맞춤에 의한 잔류응력 해석

장재순,양원호,김철,Jang, Jae-Soon,Yang, Won-Ho,Kim, Cheol 대한기계학회 2002 大韓機械學會論文集A Vol.26 No.8

The purpose of this study is comparing cold expansion method with interference fit. Cold expansion method and interference fit of fastener hole is using in the aerospace industry. These treatment lead to an improvement of fatigue life to the compressive residual stresses developed on the hole surface. But Research is nothing to about difference effect of between cold expansion method and interference fit. So, this paper, it is shown that Comparing cold expansion method with interference fit using the finite element method. It is further shown that residual stress distribution according to plate thickness and clamping force.

유한요소법을 이용한 CT 시편의 홀확장 잔류응력 및 응력확대계수 해석

장재순,양원호,김철,고명훈,조명래,Jang, Jae-Soon,Yang, Won-Ho,Kim, Cheol,Ko, Myung-Hoon,Cho, Myoung-Rae 대한기계학회 2002 大韓機械學會論文集A Vol.26 No.5

Cold expansion method is retarded of crack initiation due to the compressive residual stress developed on the hole surface. Previous research has just been study about residual stress distribution in the hole surrounding. But, The purpose of this study was to improve the understanding of the residual stress effect in hole surrounding as crack growth from another hole. In this paper, it is shown that residual stress is redistributed due to the application of cold expansion process for CT specimen using finite element method. It is further shown that tensile stress increases in proportion to cold expansion ratio in the vicinity of crack. It is thought that stress intensity factor increases with cold expansion ratio.

형상봉의 모양이 홀확장 잔류응력 분포에 미치는 영향에 대한 유한요소해석

장재순(Jang Jae Soon),조명래(Cho Myoung Rae),양원호(Yang Won Ho) Korean Society for Precision Engineering 2006 한국정밀공학회지 Vol.23 No.9

한방정신요법 및 치매 검사의 현황, 수가 적절성 연구

장재순 ( Jae Soon Jang ),황의완 ( Wei Wan Hwang ),조성훈 ( Seung Hun Cho ) 대한한방신경정신과학회 2014 동의신경정신과학회지 Vol.25 No.4

Objectives: A large number of patients require psychiatric therapy. We attempted to determine the present situation regarding psychotherapy and neuropsychological tests for dementia in Korean medicine for the benefit of the Health Insurance Review and Assessment Service (HIRAS). The aim of this study was to aware of the current status about psychotherapy and neuropsychological test for dementia in Korean medicine. Methods: We searched the medical practice records for psychotherapy and neuropsychological tests in oriental neuropsychiatry between 2009 and 2013 using the Health Insurance Review and Assessment Service (HIRAS) database. The search categories were: IJeongByunGi (Medical practice code:59001), JiUnGoRoen (59002), Kyungjapyungji (59003), OhJiSangSeung (59004), neuropsychological test for dementia (29005). Results: 1. The number of patients treated with Korean Medical Psychotherapy increased annually by 151%. The total number of patients treated with Korean Medical Psychotherapy was 4,289 in 2013. 2. The total cost for patients treated with Korean medical Psychotherapy in the public health medical insurance budget was 268,032,000 won in 2013. The average medical cost for one therapy was 17,000 won in 2013. 3. The number of patients in local clinics is increasing faster than the number in Korean medical hospitals. 4. The age group between 20¡­30 years of age, for both men and women, is the group with the greatest density in Korean Medical Psychotherapy. 5. Neuropsychological Testing for Dementia in Korean Medicine is slowly decreasing. Conclusions: The prevalence of mental illness in Korea is increasing, therefore, the demand for Korean Medical Psychotherapy has increased recently. Authorizing Korean Medical psychiatrists to utilize Korean mental Health resources is essential. This study could be helpful in understanding the current status for the purpose of expanding Korean Medical Psychotherapy.

한의병증에 대한 신경정신과적 증상 기술 연구

장재순 ( Jae-soon Jang ),김가나 ( Ka-na Kim ),조성훈 ( Seung-hun Cho ) 대한한방신경정신과학회 2016 동의신경정신과학회지 Vol.27 No.4

Objectives: This study aimed to develop a standard understanding of neuropsychiatric symptoms and signs of Disease Pattern Identification/syndrome in Korean Medicine. Methods: We investigated various published articles, and the proposals are based on a comparative analysis between Korean medicine literature and DSM5, ICD-10. To improve our understanding, we engaged in a consultation through discussions with the advisory committee. Results: We describe the physical and neuropsychiatric symptoms in a modern sense of the major dis-ease Pattern in Korean Medicine. We also proposed a profound understanding of the neuropsychiatric symptoms and signs of Disease Pattern Identification/syndrome in Korean Medicine. Conclusions: Compared with DSM5, ICD-10, the system of neuropsychiatric diagnosis in Korean medi-cine, could be profoundly organized into a system in a modern sense. It would be helpful to apply this understanding to clinical practices. There are several points of consideration in this study. The system of neuropsychiatric diagnosis in Korean medicine cannot be a perfect match for DSM5 or ICD-10. In addition, we could not reach a complete consensus on the disease pattern. Although there are some limitations to this study, it is meaningful to have an understanding of the neuropsychiatric symptoms and signs in Korean medicine through discussions with the advisory committee. This trial is expected to be applicable to related research in the future.

MAS 기반 피난시뮬레이션을 이용한 분산대피 비교 연구

장재순 ( Jae Soon Jang ),이동호 ( Dong Ho Rie ) 한국안전학회(구 한국산업안전학회) 2014 한국안전학회지 Vol.29 No.1

Smoke is one of the most critical factor when escaping from the fire since it reduces visibility and interrupts finding emergency exit lights. Therefore, it is recommended that an evacuation simulation program should incorporate the smoke factor. In addition, it is suggested that the program should include not only the unilateral damage by the smoke but also the detour evacuation by risk communication. In this study, MAS (Multi Agent System)-based simulation program which incorporates the reduced walking speed by smoke and adopts the dispersion evacuation logic during escaping from the fire. To make comparison, a commercial evacuation program, Pathfinder was used. It was found that the simulation results of MAS (Multi Agent System)-based program is better than Pathfinder in terms of safe evacuation. It means that evacuation simulation need a additional evaluation categories that include not only quick evacuation time but also safe evacuee number

정신건강 분야에서의 모바일 헬스(mobile health)

장재순(Jae Soon Jang),조성훈(Seung Hun Cho) 대한스트레스학회 2016 스트레스硏究 Vol.24 No.4

모바일 헬스(mobile health, m-Health) 및 건강 빅데이터(big data)는 미래 건강관리 패러다임을 견인하는 주요한 역할을 할 것으로 기대된다. 특히나 스마트폰을 포함한 스마트 기기와 웨어러블 기기(wearable devices) 등을 활용한 애플리케이션의 활용 가치는 나날이 증대되고 있다. 환자가 신경정신건강 영역에서 질환의 회복을 목표로 응용될 수 있는 모바일 애플리케이션도 쉽게 제공받을 수 있으며, 의료인도 환자의 진단과 평가, 치료에서 실질적인 임상 활용이 가능하다. 현재까지 모바일 헬스(m-Health) 관련기기와 신경정신의학 질환별 활용 사례를 정리하였고 빅데이터를 이용한 사례를 살펴보았다. 특히 빅데이터에 대해서는 추후 발생할지 모르는 개인정보 침해 및 유출의 방지와 데이터를 운영하는 시스템의 안정성을 점검할 필요성이 있다. 본 연구에서는 모바일앱의 활용과 빅데이터 실제 활용에서 근거에 기반을 둔 효과성과 신뢰성에 대한 시사점이 논의되었다. Recently, the demand for mental health services using information and communication technology (ICT) such as mobile communication and social network service (SNS) is increasing. Mobile health (m-Health) and health big data are expected to play a major role in driving the future healthcare paradigm. In particular, the value of applications utilizing smart devices including smartphone and wearable devices is increasing day by day. Mobile applications that can be applied to the patient to restore disease in the neuropsychiatric area can be easily provided, and clinicians can also use the clinic in patient diagnosis, evaluation, and treatment. In practical use, it is still a step in the process, so it is necessary to check the stability of the system that operates the data and prevent infringement and leakage of personal information that may occur later. In addition, it is necessary to establish the effectiveness and credibility based on the basis of practical use of mobile health (m-Health) and health big data. With technological advances being made day by day, mental health care workers should be aware of this trend and have an active interest.

α-chloralose로 마취한 개에서 폐쇄성 무호흡이 심혈관계 기능변화에 미치는 영향

장재순 ( Jae Soon Jang ),강지호 ( Ji Ho Kang ),이상학 ( Sang Haek Lee ),최영미 ( Young Mee Choi ),권순석 ( Soon Seog Kwon ),김영균 ( Young Kyoon Kim ),김관형 ( Kwan Hyoung Kim ),송정섭 ( Jeong Sup Song ),박성학 ( Sung Hak Park 대한결핵 및 호흡기학회 2000 Tuberculosis and Respiratory Diseases Vol.48 No.3

인공지능 피난유도설비 적용에 따른 최적 대피시뮬레이션 연구

장재순 ( Jae Soon Jang ),공일천 ( Il-chean Kong ),이동호 ( Dong Ho Rie ) 한국안전학회(구 한국산업안전학회) 2013 한국안전학회지 Vol.28 No.3

For safe evacuation in the fire disaster, the evacuees must find the exit and evacuate quickly. Especially, if the evacuees don′t know the location of the exit, they have to depend on the evacuation guidance system. Because the more smoke spread, the less visibility is decreasing, it is difficult to find the way to the exit by the naked eye. For theses reasons, the evacuation guidance system is highly important. However, the evacuation guidance system without change of direction has the risk introduce to dangerous area. In the evacuation safety assessment scenario by the evacuation simulation has the same problem. Because the evacuee in the simulation evacuate by the shortest route to the exit, the simulation result is same like the evacuation without the evacuation guidance system. In this study, it was used with MAS (Multi Agent System)-based simulation program including the evacuation evacuation guidance system to implement the change of evacuation by fire. Using this method, confidence of evacuation safety assessment can be increase.