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.

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.

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.

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.

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.

은닉 마르코프 모델을 이용한 실내 네트워크 맵 매칭

김태훈,이기준,Kim, Tae Hoon,Li, Ki-Joune 한국공간정보학회 2015 한국공간정보학회지 Vol.23 No.3

최근 다양한 센서들의 성능 개선으로 실내측위가 가능해졌다. 하지만 Wi-Fi 라디오 맵을 이용한 실내 측위나 가속도 센서와 디지털 캠퍼스를 이용한 실내 측위는 아직 상당한 오차를 가지고 있어 지금까지의 연구는 실내 측위의 정확성을 높이는 측위 기술에 대해 많이 진행되었다. 하지만 좌표단위가 아닌 방 단위의 정확성을 가진 실내 맵 매칭이 가능하다면 Wi-Fi 라디오 맵, 가속도 센서 기반의 현재 실내측위기술로도 실내 서비스가 가능하다. 이에 본 연구는 방 단위의 정확성을 가지는 실내 맵 매칭을 위해, 실내 네트워크 맵 매칭에 대해 정의하고, 이를 수행하며 생기는 이슈들에 대해 살펴보고, 이를 해결하기 위해 은닉 마르코프 모델을 사용한 방안에 대해 제시한다. Due to recent improvement of various sensor technologies, indoor positioning becomes available. However, Indoor positioning technologies by Wi-Fi radio map and acceleration sensor and digital campus still have a certain level of errors and a number of researches have been done to increase the positioning accuracy of the indoor positioning. If we could provide a room level accuracy, indoor location based services with current indoor positioning methods such as Wi-Fi radio map and acceleration sensors would be possible. In this paper, we propose an indoor map matching method to provide a room level accuracy based on hidden markov model.

Probiotics의 산업적 개발 및 소비 동향

김태훈,Kim, Tae-Hoon 한국축산식품학회 2013 축산식품과학과 산업 Vol.2 No.1

악기별 분리처리를 통한 고음질 오디오 시스템 구현

김태훈,이상학,김대경,이상찬,Kim, Tae-Hoon,Lee, Sang-Hak,Kim, Dae-Kyung,Lee, Sang-Chan 한국음향학회 2013 韓國音響學會誌 Vol.32 No.4

본 논문에서는 노래반주기를 위한 고음질 오디오 시스템 구현에 관한 내용을 담고 있다. 노래반주기의 중요한 기능인 키/템포 변환 음질의 개선을 위하여 악기별 채널 분리를 수행하였다. 악기별로 채널을 분리하여 처리함으로 고음질의 변환이 수행됨을 상관계수의 변화와 MOS 평가를 통하여 확인할 수 있었다. 구현된 오디오 시스템은 TI사의 32비트 부동 소수점과 고정 소수점 연산이 모두 가능한 DSP인 TMS320C6747를 이용하였으며 다채널의 WMA 복호화, MP3 부호화와 복호화, wav, EQ 및 템포/키 변환을 실시간으로 수행 가능하다. WMA 10채널로 구성되어 악기별 분리 처리가 가능도록 하였다. 또한 MP3 부호화/복호화는 녹음과 재생 기능으로 이용되고 wav 채널은 효과음 등으로 사용 가능하다. This paper deals with the implementation of a high-quality audio system for karaoke. For improving the key/tempo changes performance, we separated the audio into many musical instrument channels. By separating musical instrument channels, high-quality key/tempo changes can be achieved and we confirmed this using the cross-correlation distribution and the MOS evaluation. The improved audio system was implemented using the TMS320C6747 DSP with fixed/floating-point operations. The implemented audio system can perform the multi-channel WMA decoding, the MP3 encoding/decoding, the wav playing, the EQ, and the key/tempo changes in real time. The WMA channels used for processing the separated instrument channels. The audio system includs the MP3 encoding/decoding function for playing and recording and the wav channel for the effect sound.

연구논문 - 고분자공업분과 : H12MDI 와 n - Hexanol 의 반응에서의 Isocyanate groups 의 반응성

김태훈,박성훈 ( Tae Hoon Kim,Sung Hoon Park ) 한국공업화학회 1997 한국공업화학회 연구논문 초록집 Vol.1994 No.1

사출성형시 미세패턴 전사성 차이에 관한 연구

김태훈,유영은,제태진,박영우,노승환,최두선,Kim, Tae-Hoon,Yoo, Yeong-Eun,Je, Tae-Jin,Park, Yeong-Woo,Roh, Seung- Hwan,Choi, Doo-Sun 한국금형공학회 2008 한국금형공학회지 Vol.2 No.4

We injection molded a thin type of plate and wedge type of plate with micro prizm patterns on its surface and investigated the fidelity of replication of the micro pattern depending on the process parameter such as mold temperature, melt temperature, injection rate or packing pressure. The size of the $90^{\circ}$ prizm pattern is $50{\mu}m$ and the size of the plate is about $335mm{\times}213mm$ and $400mm{\times}400mm$. The thicknesses are 2.6mm and 0.7mm at each edge of the wedge type of plate and 1mm at each edge of the thin type of plate. The fidelity of the replication turned out quite different according to the process parameters and location of the patterns on the plate. We measured the cavity pressure and temperature in real-time during the molding to analyze the effect of the local melt pressure and temperature on the micro pattern replication.