Acute Kidney Injury and Postobstructive Diuresis Caused by a 4 mm Urinary Calculus

정의석,양은미,김찬종,Jung, Eui Seok,Yang, Eun Mi,Kim, Chan Jong Korean Society of Pediatric Nephrology 2013 Childhood kidney diseases Vol.17 No.2

결석으로 인한 요관 폐쇄는 신후성 신부전의 주요한 원인으로 즉각적인 치료가 필요하다. 폐색 후 이뇨는 폐쇄성 요로 질환의 막힘 제거될 때 흔히 나타날 수 있는 증상으로 특별한 치료 없이 회복되는 경우가 많으나 저혈압이나 전해질 이상 등의 소견이 나타날 경우에는 수액 요법을 통한 치료가 필요하다. 단일신 환아에서 4 mm 크기의 작은 결석으로 인한 신후성 신부전이 발생하였으며 결석이 배출되고 발생한 폐쇄 후 이뇨는 보존적 치료로 회복되었다. 대부분의 4 mm 미만의 작은 결석은 저절로 배출 된다고 알려져 있으나 저자들은 4 mm 크기의 결석으로 생긴 신후성 신부전 및 폐쇄 후 이뇨가 발생한 예를 경험하였기에 보고하는 바이다. Urinary obstructions from ureteral calculi are one of the causes of postrenal acute kidney injury (AKI). Here we present a case of AKI caused by a 4 mm ureteral calculus with postobstructive diuresis following the spontaneous passage of the calculus. A 13-year-old girl who underwent nephrectomy for the removal of a neuroblastoma eight years previously, visited our institution because anuria had developed over the preceding five days. The serum creatinine level was elevated at 13.4 mg/dL. Radiological examinations showed the right solitary kidney with moderate hydronephrosis and a 4 mm calculus in the upper right ureter. The patient immediately underwent hemodialysis. After the ureteral calculus was passed spontaneously on day 2 of hospitalization, urinary output increased to more than 5,200 mL per day. Intravenous fluid replacement with careful monitoring of weight, intake, output, and serum and urine electrolytes was performed. On day 5 of hospitalization, the patient's condition stabilized.

공동주택사업 주체별 설계변경 요인에 대한 BIM 적용 개선사항 도출에 관한 연구

정의석(Jung, Eui-Seok),김주형(Kim, Joo-Hyung),김재준(Kim, Jae-Jun) 한국BIM학회 2017 한국BIM학회 학술대회 논문집 Vol.2017 No.-

건설 프로젝트에서 디지털 패브리케이션의 프로젝트 이점에 대한 사례 연구

정의석(Jung, Eui-Seok),김성진(Kim, Sung-Jin),함남혁(Ham, Nam-Hyuk),문성곤(Moon, Sung-Kon),김재준(Kim, Jae-Jun) 한국BIM학회 2018 KIBIM Magazine Vol.8 No.2

Recently, the free-form buildings are continuously increasing in the world. However, due to the shortage of experience and technology in the project of the free-form buildings, problems such as increase of construction cost, increase of air and deterioration of construction quality are occurring. In this study, data on the 27 free-form projects in Korea and abroad using digital fabrication were collected through the journals, reports, articles, and websites of the institutes and case studies were conducted based on the collected data. Based on the following case analysis, we conducted evaluation of case data analysis based on the knowledge domain specified in PMBOK. Evaluation of case data analysis shows that the application of digital fabrication is divided into positive and negative effects for each knowledge area in the free-form building project. Using the results of the analysis, we can confirm the knowledge field showing the positive effect on the free-form building project by using digital fabrication. However, the data scale of the project using the digital fabrication is not realized at present and research is insufficient. In Korea, a small number of specialists were interviewed and verified because experts do not exist much in korea. Therefore, this study is expected to suggest the necessity of applying digital fabrication in the free-form building projects in the construction industry.

복막 투석 중인 신증후군 환자의 복막을 통한 단백 소실

안요한,정의석,이세은,이현경,이소희,강희경,하일수,정해일,최용,Ahn, Yo-Han,Jung, Eui-Seok,Lee, Se-Eun,Lee, Hyun-Gyung,Lee, So-Hee,Kang, Hee-Gyung,Ha, Il-Soo,Jung, Hae-Il,Choi, Yong 대한소아신장학회 2009 Childhood kidney diseases Vol.13 No.2

목적 : 신증후군에서 사구체 단백 투과성이 증가하는 것은 전신적인 순환 인자와 관련되어 있는 것으로 여겨진다. 전신적인 순환 인자의 사구체 외 기관에서의 영향과 관련하여, 본 연구에서는 복막 투석 중인 steroid resistant nephrotic syndrome (SRNS) 환자에서의 복막투석을 통한 단백 소실 정도를 파악하고자 하였다. 방법 : 2001년부터 2009년까지 복막 투석 중인 신증후군 환자 12명(SRNS)과 대조군 14명을 대상으로 후향적 환자-대조군 연구를 시행하였다. 성별, 투석 시작 시 연령, 체중, 신장, 투석 방법, 투석양, 투석 시작 시 검사 소견(혈액 요소 질소, 혈청 크레아티닌, 혈청 단백, 혈청 알부민, 24시간 투석액 부피, 24시간 투석액 단백, Kt/V)과 1년 뒤 투석 시 검사 소견(24시간 투석액 단백)을 조사하였다. 단백질 섭취 정도를 평가하기 위해 nPNA (normalized protein equvalent of total nitrogen appearance)를 측정하였다. 결과 : SRNS군과 대조군은 nPNA를 비롯한 다른 지표에 의미 있는 차이를 보이지 않았으나, SRNS군에서 혈청 알부민이 $3.7{\pm}0.3$ g/dL로 대조군($4.0{\pm}0.4$ g/dL, P=0.021)보다 낮았다. 복막액을 통한 단백 소실량은 SRNS군에서 대조군보다 통계학적으로 의미 있게 높았으며($3,044.4{\pm}837.6\;mg/m^2$/day vs. $1,791.6{\pm}1,244.0\;mg/m^2$/day, P=0.007), 혈장 단백에 대한 복막의 투과성은 SRNS군에서 대조군보다 2배 가량 높았다($1.06{\pm}0.46%$ vs. $0.58{\pm}0.43%$, P=0.010). SRNS군과 대조군 모두 초기와 1년 뒤 복막 단백 소실량이 증가하였으나 대조군에서 더 큰 차이를 보였으며 복막 단백 소실량의 시간 경과에 따른 변화는 두 군(SRNS군 vs. 대조군)간에 의미있게 차이가 있었다(P=0.023). 결론 : 신증후군을 앓고 있는 소아 환자에서 복막 투석을 시행할 때는 이들의 영양상태, 성장 및 발달에 평가가 보다 적극적으로 이루어져야 하고, 복막을 통한 단백 소실을 모니터링하여 이를 보충하려는 노력 또한 필요하리라 생각된다. Purpose : The pathophysiologic mechanism of nephrotic syndrome is not yet known clearly. At least in some cases, certain 'circulating factors' are thought to increase the glomerular protein permeability. Considering the systemic effect of the circulating factor on peritoneal membrane, we evaluated the loss of protein through peritoneal membrane in patients on peritoneal dialysis due to the end stage renal disease (ESRD) caused by steroid resistant nephrotic syndrome (SRNS). Methods : We retrospectively reviewed the medical records of 26 pediatric patients on peritoneal dialysis ensued during the period from 2001 to 2007 at our clinic. Twelve patients had SRNS, while 14 patients had ESRD caused by the congenital anomalies of urinary system. Results : While the other parameters including nPNA indicating the adequacy of protein intake were similar between the two groups, serum albumin was lower in SRNS patients than the non-SRNS patients ($3.7{\pm}0.3$ g/dL vs. $4.0{\pm}0.4$ g/dL, P=0.021). Peritoneal protein loss was higher in SRNS patients than in non-SRNS patients ($3,044.4{\pm}837.6\;mg/m^2$/day vs. $1,791.6{\pm}1,244.0\;mg/m^2$/day, P=0.007). The protein permeability of the peritoneal membrane measured by the ratio of total protein concentration in dialysate to plasma was twice as high in SRNS patients as the non-SRNS ($1.06{\pm}0.46%$ vs. $0.58{\pm}0.43%$, P=0.010). After 1 year, peritoneal protein loss increased in both patient groups, but to a significantly greater degree in non-SRNS patient (P=0.023). Conclusion : The results of our study support the notion that in nephrotic syndrome there are some 'circulating factors' with the systemic effect. Since the greater protein loss through peritoneal membrane in SRNS was confirmed in this study, more meticulous nutritional support and close monitoring on the nutrition are required in these patients.

해양 표적을 이용한 대기 상단 가시영역에서의 복사휘도 모의와 위성 센서 검보정에의 활용 가능성 연구

김정근 ( Jung Gun Kim ),손병주 ( Byung Ju Sohn ),정의석 ( Eui Seok Chung ),전형욱 ( Hyoung Wook Chun ),서애숙 ( Ae Sook Suh ),김금란 ( Kum Lan Kim ),오미림 ( Mi Lim Oh ) 大韓遠隔探査學會 2008 大韓遠隔探査學會誌 Vol.24 No.6

위성 센서의 대리 검정은 다양한 표적을 이용하여 모의된 대기 상단의 복사휘도를 이용하여 수행된다. 본 연구에서는 인도양과 태평양상에 있는 다섯 개의 해양 표적을 통해 대기상단 가시영역에서의 복사휘도를 계산하고, 위성 센서 검보정에의 활용 가능성에 대해서 알아보았다. 복사전달모델인 6S를 통해 계산된 대기상단의 복사휘도를 MODIS/Terra와 SeaWiFS 관측 값과 비교하였으며, 모의를 위하여 이들 위성의 기하정보와 복사계의 특징들이 사용되었다. MODIS/Terra의 에어로솔 광학적 두께 (AOT: Aerosol Optical Thickness)와 SeaWiFS의 pigment concentrations, OMI의 오존자료가 모델 입력 값으로 사용되었고 NCEP/NCAR 재분석 자료로부터 바람과 총가강수량에 대한 정보를 얻었다. 전 표적 지역에 대해서 5일 평균한 결과, 2005년 한 해 동안 계산된 복사휘도와 관측된 복사휘도와의 백분율 차이는 약 ±5%의 수준으로 나타났고 이것은 계산된 복사휘도가 위성에서의 관측 값과 잘 일치함을 의미한다. 또한 동일 알고리즘으로 약 ±5%의 오차 수준 이내의 결과를 SeaWiFS를 통해 얻을 수 있었다. 이러한 결과는 위성의 가시채널 검보정이 본 연구의 복사휘도 모의 방법을 통해서 ±5%의 오차범위 안에서 이루어질 수 있음을 보여준다. Vicarious calibration for the satellite sensor relies on simulated TOA (Top-of-Atmosphere) radiances over various targets. In this study, TOA visible radiance was calculated over ocean targets which are located in five different regions over the Indian and Pacific ocean, and its possible use for the satellite sensor calibration was examined. TOA radiances are simulated with the 6S radiative transfer model for the comparison with MODIS/Terra and SeaWiFS measurements. Geometric angles and sensor characteristics of the reference satellites were taken into account for the simulation. AOT (Aerosol Optical Thickness) from MODIS/Terra, pigment concentrations from SeaWiFS, and ozone amount from OMI measurements were used as inputs to the model. Other atmospheric input parameters such as surface wind and total column water vapor were taken from NCEP/NCAR reanalysis data. The 5-day averaged radiances over all targets show that the percent differences between simulated and observed radiances are within about ±5% in year 2005, indicating that the calculated radiances are in good agreement with satellite measurements. It has also been shown that the algorithm can produce the SeaWiFS radiances within about ±5% uncertainty range. It has been suggested that the algorithm can be used as a tool for calibrating the VIS bands within about 5% uncertainty range.

구강 편평세포암종의 반대측 예방적 경부치료

구본석(Bon Seok Koo),이욱진(Wook Jin Lee),나경원(Keong Won Rha),정의석(Eui sok Jung),김유석(Yoo Suk Kim),이진석(Jin Seok Lee),임영창(Young Chang Lim),최은창(Eun Chang Choi) 대한두경부종양학회 2005 대한두경부 종양학회지 Vol.21 No.2

Objectives: The purpose of this study was to evaluate the incidence and predictive factors of contralateral occult lymph node metastasis in oral cavity squamous cell carcinomas to form a rational basis for elective contralateral neck management. Materials and Methods: We performed a retrospective analysis of 66 N0-2 oral cavity cancer patients undergoing elective neck dissection for contralateral clinically negative necks from 1991 to 2003. Results: Clinically negative but pathologically positive contralateral lymph nodes occurred in 11%(7 of 66) . Of the 11 cases with a clinically ipsilateral node positive neck, contralateral occult lymph node metastases developed in 36%(4 of 10, in contrast with 5%(3/55) in the cases with clinically ipsilateral node negative necks(p<0.05). Based on the clinical staging of the tumor, 8%(3 of 37) of the cases showed lymph node metastases in T2 tumors, 25%(2 of 8) in T3, and 18%(2 of 11) in T4. None of the T1 tumors(10 cases) had pathologically positive lymph nodes. The rate of contralateral occult neck metastasis was significantly higher in advanced stage cases and those crossing the midline, compared to early stage or unilateral lesions(p<0.05). Patients with no evidence of contralateral nodal cancer had significantly improved disease-specific survival over patients with any pathologically positive nodes(5-year disease-specific survival rate was 79% vs. 43%, p<0.05). Conclusion: The risk of contralateral occult neck involvement in the oral cavity squamous cell carcinomas above the T3 stage or those crossing the midline with unilateral metastases was high. Therefore, we advocate an elective contralateral neck treatment with surgery or radiotherapy in oral cavity squamous cell carcinoma patients with ipsilateral node metastases or tumors that are greater than stage T3 or crossing the midline.

통행연계 변수를 중심으로 한 경기도 버스정류장 유형 구분

빈미영 ( Mi Young Bin ),정의석 ( Eui Seok Jung ),이원도 ( Won Do Lee ),조창현 ( Chang Hyeon Joh ) 한국경제지리학회 2012 한국경제지리학회지 Vol.15 No.2

본 연구는 합리적 버스 환승체계 구축을 위한 버스정류장의 환승센터로서의 유형 구분이1 목적을 두고 있다. 이 분야 기존 연구는 주로 버스정류장 이용 수요의 특성과 버스정류장을 역세권으로 보았을 때 주변의 토지이용 특성을 확인하고, 이를 근거로 정류장의 유형을 구분한 후 구분된 유형들 각각의 특성을 요약하는 방식으로 진행되었다. 이러한 전통적 역세권 연구들의 공통적인 문제점은 대표적 연구 변수인 토지이용 특성과 정류장 이용 특성 둥 횡단면적 snapshot의 특성만을 고려하여 환승의 본질인 통행 연계의 detail을 확보하지 못한다는 데 있다. 이에 본 연구에서는 환승통행 발생 정류장의 기능 구분을 위해 통행연계 변수로서 교통수단연계, 경유지연계, 이용시간연계 둥의 변수 값 이 각 정류장이 환승센터로서의 특성을 고려할 때 어느 정도와 방향인지를 확인토록 한다. 이를 위해 2009년 4월 20일 월요일 하루 동안 경기도 버스에 승하차한 통행 샘플을 분석하였다. 분석 결과 버스정류장은 연계성 관련 변수를 기준으로 비교적 뚜렷한 구분이 가능하였다. 이러한 결과는 환승센터 입지 선정이나 설계에 유용한 정보를 줄 것으로 기대된다. The current research aims at classifying the bus stops as transfer center in order to establish the rational bus transfer systems. Existing research typically identifies characteristics of demands for bus stops and land use surrounding the bus stops and classifies and profiles the bus stops. A common problem with this type of research is that the results with cross-sectional characteristics of land use and bus stop usage do not capture the details of trip chain, the fundamental characteristics of the trips with transfer. This paper therefore examines bus stop classifications with such variables as transport mode chains, intermediate stop chains and timing chains. The analysis on the data collected on Monday 20 April 2009 for passengers of Gyeong-gi bus results in a clear classification among bus stops in terms of such trip chain variables. The research would provide useful information for the decision support of transfer stops location choice and infrastructure design.

소아 허혈성 뇌졸중의 신경학적 예후:

홍승희(Seung Hee Hong),장성환(Seong Hwan Chang),정의석(Eui Seok Jung),김영옥(Young Ok Kim),최영륜(Young Youn Choi),우영종(Young Jong Woo) 대한소아신경학회 2018 대한소아신경학회지 Vol.26 No.3

Purpose: Ischemic stroke is rarely seen in children, but it could cause mortality and result in developmental disabilities such as motor paralysis, cognitive dysfunction, and epilepsy. In this study, the neurological outcomes of ischemic stroke in children were reviewed and the factors associated with the neurological outcomes were to be analyzed. Methods: Medical records of patients younger than 15 years of age who were newly diagnosed with ischemic stroke between January 2006 and December 2016 in Chonnam National University Hospital were reviewed. Results: This study consisted of 38 patients with ischemic stroke (male/female= 18/20, mean age=6 years 1 month±4 years 8 months). Neurological outcomes assessment was done at least 1 year after the onset of ischemic stroke. 10 patients (26.3%) had no neurological impairments. Motor paralysis was noted in 22 (57.9%), cognitive dysfunction was in 9 (23.7%), and epilepsy in 20 (52.6%). Among the possible risk factors for neurological impairments (age, sex, early seizures, characteristics of the infarcted lesions, abnormal electroencephalogram (EEG) findings), abnormalities on EEG findings were significantly associated with cognitive dysfunction (P=0.026) and the occurrence of early seizures with epilepsy (P=0.000). Conclusion: Neurological impairments were remained in 73.7% of children one year after ischemic stroke. Cognitive dysfunction was associated with abnormalities on EEG findings within 2 weeks after the onset of ischemic stroke and epilepsy with the occurrence of early seizures.