표상적 관계에 대한 영유아의 이해와 발달

박찬형(Chan Hyung Park),이종희(Jong Hee Lee) 한국아동학회 2011 아동학회지 Vol.32 No.1

This study examined how young children understand representational relations between referents and their representational objects. Ninety-four children aged 2- to 4.5-years of age were individually tested; firstly in the scale-model tasks, and then in the scale-map tasks. Data were analyzed both by means of Chi-Square test and by a more descriptive, micro analysis. According to the results, there were significant age differences in the understanding of representational relations, regardless of the type of representational objects. In the descriptive, micro analysis, it was found that before 3 years of age, young children have a great deal of difficulties in understanding representational relations. More importantly, young children under three seemed unable to understand representational relations, especially when the similarities as well as the differences between the representational object and the referent were very high. These results suggest that teachers of very young children need to select representational materials carefully, taking into consideration children`s understanding of representational relations.

흉통환자에서 아최대 다단계 자전거 운동 부하 검사의 진단적 가치

박찬형(Chan Hyung Park),조정관(Jeong Gwan Cho),강정채(Jung Chaee Kang) 대한내과학회 1989 대한내과학회지 Vol.36 No.3

N/A Although exercise ECG has been accepted as the first choice of diagnostic procedures, documenting valuable indirect evidence of insufficient myocardial perfusion during exercise induced stress, its value in predicting the presence of coronary artery disease (CAD) in an individual patient has been questioned because of its low sensitivity and specificity. This limited value of the exercise test in predicting CAD is particularly real in the society with a low prevalence of CAD. The idea that the exercise test should be ordered and interpreted based on the results of pretest probability for CAD is gaining consensus. In order to study how accurately CAD can be predicted, we formulated the 5 predictor scoring system (5 PSS) which is modified from Goldman's scoring system and based on 5 parameters of the patients such as age, sex, nature of chest pain, serum cholesterol level and smoking habits. The scoring system was evaluated in 38 patents who had bicycle ergometer GXT and coronary arteriography at our Division of Cardiology. The following results were obtained: 1) In predicting CAD the sensitivity and specificity of the 5 PSS were 86% and 88% respectively and the positive and negative predictabilities were 90% and 83% each, while the sensitivity, specificity, positive predictability and negative predictability of bicycle GXT were 62%, 71%, 72% and 60% respectively. 2) By combining the results of the 5 PSS, the predictability of the bicycle ergometer GXT for CAD increased. The positive predictability of GXT for CAD increased from 72% to 100% when the 5 PSS scores were above 30 and the negative predictability of GXT for CAD increased from 60% to 91% when the scores were below 30. 3) Only 29% of the cases with positive bicycle ergometer GXT had CAD when the 5 PSS scores were below 30; while 78% of the cases with negative bicycle GXT had CAD when the scores were above 30. These results suggested that in predicting CAD, the pretest probability derived from clinical parameters using the 5 PSS can be very helpful in rational evaluations of the bicycle ergometer GXT.

유아기 자녀와의 과거경험 이야기에 나타난 어머니의 대화양식

박혜경(Park Hye-Kyung),강은진(Kang Eun-Jin),박찬형(Park Chan-Hyung) 한국영유아보육학회 2011 한국영유아보육학 Vol.0 No.68

본 연구의 목적은 우리나라 어머니들이 자녀와 과거 경험에 대해 이야기를 나눌 때 나타내는 대화양식을 살펴보는데 있다. 이를 위해 서울시에 소재한 어린이집 세 곳의 만 4세와 5세 유아 54명과 그 어머니를 연구대상으로 하였으며 간편한 소형 MP3녹음기(녹음기 기종)를 가정에 제공해 자연스러운 상황에서 어머니와 유아가 나눈 과거 경험에 관한 이야기를 수집하였다. 녹음된 수집자료는 전사하여 분석되었다. 결과로 나타난 어머니의 대화양식은 다섯 가지 범주로 나뉘어지며 ‘이야기해봐: 단도직입형’, ‘그 다음에... 또...?: 사건순서와 상황묘사 집착형’, ‘어땠어?: 정서지지형’, ‘그랬구나, 멋지구나!: 칭찬격려형’, ‘그래서 이렇게 해야 해: 교훈형’의 양식들이다. 어머니의 대화양식에 따라 유아들이 이야기를 엮어가는 양식도 달랐음을 발견할 수 있어 추후에는 어머니의 대화양식과 유아의 이야기 수준을 함께 보는 연구를 제언으로 제시하였다. This study was designed to explore mothers’ conversational styles talking with their children about shared past experiences. Fifty four mother-child dyads, aged 4-to 5-years were participated in this study. To collect data, Each of mother-child dyad was provided portable MP3 and was requested to record spontaneous speech of past shared experiences. As a result, mothers’ conversational styles were able to categorized prominently into the 5 types as follows: straightforward conversations such as “talk to something”, sequential and circumferential descriptive conversations such as “next, and then”, emotional conversations such as “how do you feel?”, applauding and encouraging conversations such as “good job” or “It’s wonderful”, and instructional conversations such as “you must do this way”. The findings indicate that mothers’ conversational styles have relevance to children’s personal narrative ability.

AR Foundation을 이용한 조명기기 3차원 배치 및 3D뷰어 기술 개발

이수영(Su-Young Lee),박찬형(Chan-Hyung Park),곽영태(Young-Tae Kwak) 한국컴퓨터정보학회 2022 한국컴퓨터정보학회 학술발표논문집 Vol.30 No.2

유아의 연령, 성별, 경험 공유 여부가 어머니의 대화기술에 미치는 영향

강은진(Kang Eun-Jin),박혜경(Park Hye-Kyoung),박찬형(Park Chan-Hyung) 한국영유아보육학회 2009 한국영유아보육학 Vol.0 No.59

본 연구는 어머니와 유아가 나누는 과거 경험에 대한 대화를 중심으로, 유아의 연령, 성별, 경험 공유 여부가 어머니의 대화 기술에 미치는 영향을 살펴보기 위한 것이다. 연구 대상은 4ㆍ5세 유아와 그들의 어머니 64쌍이었다. 유아와 어머니가 가정에서 자연스럽게 나눈 두 가지의 대화(어린이집에서 있었던 일과 부모님과 함께한 특별한 일)를 수집하여, 어머니의 발화수와 화제 수, 그리고 대화기술의 세 가지 범주(촉진 유형, 대화촉진 기능, 내러티브 요소)에 따라 분석하였다. 연구 결과는 다음과 같았다. 1) 유아의 연령에 따른 어머니의 대화 기술은 통계적으로는 유의미한 차이가 나타나지 않았다. 2) 유아의 성별에 따른 어머니의 대화 기술은 통계적으로는 유의미한 차이가 나타나지 않았다. 3) 대화 주제의 공유경험여부에 따른 어머니의 대화 기술은 통계적으로 유의미한 차이가 나타났으며, 대체적으로 공유경험 상황보다 비 공유경험 상황에서 어머니가 좀 더 다양하고 많은 대화기술을 활용하였음을 알 수 있었다. This study examined the effects of young children's age, gender, and unshared or shared experiences on maternal reminiscing style in mother-child conversation about the past. Sixty-four mothers and their preschool children were asked to talk about two past events the children had experienced. Results showed that mothers reminiscing style differed by young children's age and gender, even though there were not statistically significant differences. When mothers talked their children about unshared experiences, mothers tend to use more diverse conversational skills.

영구형 심박조율기 시술에 대한 임상경험

조정관(Jeong Gwan Cho),정명호(Myung Ho Jeong),박종춘(Jong Chun Park),양승진(Seung Jin Yang),박찬형(Chan Hyung Park),길광채(Gwang Chae Gill),조길우(Keal Woo Cho),강정채(Jung Chaee Kang) 대한내과학회 1989 대한내과학회지 Vol.37 No.1

N/A Pacemaker implantation for symptomatic bradycardia is becoming popular recently in this country. Though its clinical benefit has been documented clearly there are still a lot of clinical problems arising from surgical problems, implanting techniques and pacemaker inherited problems. This study was designed to evaluate the indications, clinical manifestations and complications of 62 implantation procedures in 55 patients who had undergone the implantation procedure in Chonnam University Hospital by reviewing the pertinent clinical records. From 1983 to 1988, 62 implantation procedures in 55 patients (19 men and 36 women) were carried out. Annual numbers of implantation had been increasing, with 5 cases in the beginning year up to 20 cases in 1987, the numbers increased. The most common age was the fifties and patients older than fifty years comprised 74.5% of the total. The main symptoms which brought the 52 patients who underwent the first implantation to the hospital were syncope in 26, dyspnea in 14, dizziness in 9, shock in 2, and nonspecific in l. Electrocardiographic manifestations of the patients were atrioventricular block in 32 (58.2%, 28 complete AV blocks, 3 type II 2nd AV blocks, and one trifascicular block) and sick sinus syndrome in 23 patients (41.8%, 10 sinus arrests, 9 sinus bradycardias, 3 tachy-bradycardias, and one second degree SA block). Associated diseases were hypertension in 20, coronary artery disease in 7, cerebral infarction in 4, surgical correction of VSD in 2, dilated cardiomyopathy in 2, diabetes mellitus in 2, thyrotoxicosis in l, and liver cirrhosis in 1 patient. But, abaut one fourth of the patients had no associated disease. The systems implanted were all ventricular demand pacing system, among which 41 (70%) were multi-programmable. Pacing leads were introduced via the cephalic vein in most of the cases and via the external jugular vein in some cases. At implantation the pacing threshold was 0.67±0.25 volts (M±SD), electrode impedance 1258±266 ohm (M±SD), and intracardiac R wave amplitude 10.3±9.7 mvolts (M±SD). The causes of revision due to complications were 2 chronic exit blocks, 2 erosions of the generator or lead, one preerosion followed by infection after a revision, one generator pocket abscess shortly after an implantation, one power depletion, and 3 occasions of twiddler's syndrome in a patient. Other complications which were controllable without revision of the system were one indifferent electrode skeletal muscle pacing treated by reprograming the output, chronic increase of threshold in another 2, pacemaker syndrome in one treated by reprograming, and a hematoma in the generator pocket resolved by needle aspiration. We learned from this review that although pacemaker implantation has been helpful in the majority of the patients treated, same annoying and potentially life threatening complications warranted, and efforts to prevent or detect them early are necessary mention.

표면 활성화 된 그래핀 위 원자층 증착법을 통한 얇고 균일한 ZrO₂ 증착을 위한 연구

신정우(Jeong Woo Shin),강명훈(Myung Hoon Kang),오성국(Seongkook Oh),양병찬(Byung Chan Yang),박찬형(Chan Hyung Park),안효석(Hyo-Sok Ahn),이태훈(Tae Hoon Lee),안지환(Jihwan An) 대한기계학회 2018 대한기계학회 춘추학술대회 Vol.2018 No.4

신 대용량/초경량 복합체 가공송전선을 적용한 154kV AC / ±80kV DC Hybrid 제주 Test-bed 구축현황

안상현(Sang-hyun Ahn),강승훈(Seung-hun Kang),김동희(Dong-hee Kim),심정운(Jung-woon Shim),신구용(Koo-yong Shin),박찬형(Chan-hyung Park),이동일(Dong-il Lee) 대한전기학회 2012 대한전기학회 학술대회 논문집 Vol.2012 No.10

항암화학요법 중 호중구감소증이 발생한 저위험군 발열 환자들을 대상으로 한 경구 항균제 요법의 임상적 유용성 및 안정성에 대한 연구

김연숙,이혁,기현균,김춘관,김신우,김성민,백경란,김원석,윤성수,이홍기,강원기,박찬형,박근칠,송재훈 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.1

목적 : 항암화학요법 중 호중구감소증을 동반한 발열이 발생하는 암환자들을 치료하기 위한 다양한 항균제와 여러 가지 방법들이 시도되고 있는 가운데, 합병증과 사망률의 발생가능성이 적은 저위험군 환자들을 대상으로 초기 72시간동안 정주 항균제를 투여한 이후 경구 항균제로 전환하는 요법의 유용성과 안정성을 평가해보고자 본 연구를 시행하였다. 방법 : 1998년 2월부터 1999년 9월까지 본원에서 항암화학요법 중 호중구감소증과 발열이 발생한 환자들 가운데 기저 암질환이 고형암이거나 림프종이고, 입원당시 패혈증의 증후가 없으며 입원 72시간이내에 해열되고 백혈구수치가 증가 추세인 환자들을 대상으로 하여 72시간 동안 정주 항균제를 투여한 이후 경우 ciprofloxacin 750㎎을 하루 2회씩 투여하여 총 4일간 투여하였다. 모든 환자들은 열이 떨어지고 호중구감소증이 회복될 때까지 입원하도록 하였다. 결과 : 총 38명 환자의 40예가 등록이 되었고, 환자들의 기저암 질환은 고형함이 72.5%, 림프종이 27.5%였다. 입원당시 평균 호중구치수는 156/㎕였고, 호중구수치가 100/㎕미만인 경우는 65%였으며, 호중구감소증이 지속된 기간의 평균은 2.4일이었다. 40예 중 39예가 항균제의 변형이나 추가 없이 호중구감소증과 발열로부터 회복이 되어 97.5%의 성공율(95% 신뢰구간: 86.8-99.9%)을 보였다. 부작용으로 피부발진이 있었던 경우가 한 예 있었는데, 증상이 경하여 경구 항균제를 지속할 수 있었다. 심와부의 동통으로 복용을 지속할 수 없어서 대상에서 제외된 예가 또 한 예 있었다. 결론 : 항암요법 중 호중구감소증과 발열을 동반한 환자들 가운데 저위험군 환자들에서 항균제 72시간정주 이후 경구 항균제로의 전환요법은 효과적이고도 안전한 치료방법이라고 할 수 있다. Background : Oral antibiotic therapy following empirical intravenous antibiotics may be effective and safe for febrile neutropenic patients with lowrisk for complications. Methods : We conducted a prospective clinical trial of oral antibiotic therapy in the patients with neutropenia and fever during chemotherapy for cancer. Underlying malignancies were solid tumor or lymphoma with short duration of neurtropenia and the patients had no evidence of clinically or microbiologically documented infections. Oral ciprofloxacin was given to the patients who lacked signs of sepsis on admission, had a rising tendency of neutrophil count (ANC >100 /㎕ ) at 72 hours, and were afebrile at 72 hours. All patients were hospitalized until neutropenia and fever resolved. Results : A total of 40 episodes of 38 patients were enrolled from February 1998 to September 1999. The mean neutrophil counts on admission were 156/㎕ and the mean duration of neutropenia was 2.4 days. The episodes which had neutrophil count below 100 /㎕ were 26 (65%). Treatment was successful in 39 of 40 episodes (97.5% : 95 % confidence interval, 86.8% to 99.9%). Adverse reactions of oral ciprofloxacin were skin rash and epigastric soreness in two cases, respectively. There were no deaths during the study. Conclusions : For low-risk febrile patients with neutropenia during cancer chemotherapy, switch therapy to oral ciprofloxacin at 72 hours following intravenous broad-spectrum antibiotics is effective and safe,

말초혈액으로부터 Clini-MACS®를 이용한 CD34 양성세포 분리의 안정성과 효율성

박성규,이남수,원종호,박희숙,김원석,박찬형,김현수,김효철,김형준,홍영선,김춘추,홍대식 대한조혈모세포이식학회 2002 대한조혈모세포이식학회지 Vol.7 No.1

연구배경: 최근 자가 또는 동종조혈모세포이식 분야에서 말초혈액에서 채취된 단핵구 중 CD34 양성 세포만을 선택적으로 분리하여 조혈모세포이식에 응용되고 있는데 일부 악성 림프종, 유방암, 다발성 골수종 환자에서 종양세포의 오염 가능성을 감소시키고 자가면역질환이나 동종 조혈모세포이식 중 병적으로 활성화된 T 림프구를 제거할 목적으로 사용되어 치료성적 향상에 도움이 될 것으로 기대된다. 방법: 저자들은 고용량항암요법의 적응이 되는 예후가 불량한 악성 림프종(n=14), 유방암(n=5), 다발성 골수종(n=1)을 앓고 있는 20명의 환자들을 대상으로 말초혈액으로부터 Clini-MACS®을 사용하여 선택적으로 분리한 CD34 양성세포만을 이용한 조혈모세포이식의 안정성과 효율성을 분석하고자 하였다. 분리방법의 효율성을 확인하기 위하여 CD34 양성세포 분리 전후에 단핵구 수, CD34 양성률 및 세포수를 분석하고 CD34 양성세포의 순도 및 획득률을 계산하였으며 CFU-GM 집락 배양검사와 같은 질적 분석도 병행하였다. 실제 이식이 진행된 경우는 15명이었으며 조혈모세포이식 이후 골수기능의 회복 정도를 분석하여 안정성을 확인하였다. 결과: 분리 전의 CD34 양성세포 수는 1.30×10^(8) (range 0.30~29.0)이었으며 분리 후의 CD34 양성세포 수는 0.93×10^(8) (range 0.11~10.80)이었고 CD34 양성세포의 순도는 96.0% (range 35.7~99.9%)이었으며 획득률은 70.5% (range 34.5~94.4%)이었다. 말초혈액 조혈모세포가 채취되었던 20명 중 15명이 고용량항암요법 후 조혈모세포이식이 이루어졌으며 CD34 양성세포의 수는 2.12×10^(6)/kg (range 0.44~18.1)이었다. 조혈모세포이식 후 골수기능 회복에 대한 분석에서 호중구 500/μL 이상으로 회복된 시기는 이식 후 12일째 (range 7~36일)이었고 혈소판 수가 20,000/μL 이상 유지된 시기는 15일째 (10~43일)이었다. 2명의 환자에서 3주 내에 골수정착이 이루어지지 않아 추가적인 조혈모세포 투입이 이루어졌고 그 이후 성공적인 정착이 이루어졌으며 특히, 2.0×10^(6)/kg 이상의 CD34 양성세포를 확보한 경우에서 보다 빠른 백혈구 및 혈소판 회복을 보였다(ANC>500/μL; 9 days vs 13 days, platelet>20,000/μL; 8 days vs 16 days). 320일간 추적관찰을 통하여 9명이 생존 중이며 이중 1명이 재발하여 동종조혈모세포이식을 시행하였으며 사망한 6명 교통사고로 사망한 1명 제외한 5명은 재발 후 병의 진행으로 사망하였다. 전체 생존율은 56.9%이었으며 무병생존율은 50.9%이었고 중앙 생존기간은 아직 도달하지 않았다. 결론: 말초혈액 CD34 양성세포을 이용한 조혈모세포이식은 안정적으로 이루어질 수 있으며 특히 조기 골수기능회복을 위해서는 2.0×10^(6)/kg 이상의 CD34 양성세포를 확보하여야 할 것으로 생각된다. 또한, Clini-MACS®을 이용한 CD34 양성세포의 선택적 분리는 효과적으로 이루어졌으나 향후 광범위한 연구가 필요할 것으로 생각된다. Background: The leukapheresis products of patients with breast cancer, multiple myeloma, and low grade lymphoma contain significant numbers of malignant cells. Results of previous studies suggested that graft-contaminating tumor cells can have an impact on clinical outcome. Recently, a number of devices have been developed for the positive selection of CD34+ peripheral blood progenitor cells for clinical use in autologous or allogeneic transplantation. The rationale for CD34+ selection is based on clinical studies showing a two to five log reduction of contaminating tumor cells in patients with breast cancer, multiple myeloma and low grade lymphoma. Methods: We have investigated the safety and efficacy of the CD34+ selection of peripheral blood progenitor cells for auto-transplantation. Twenty patients (14 malignant lymphomas, 5 breast cancers, 1 multiple myeloma) were mobilized using chemotherapy plus G- or GM-CSF. Results: The leukapheresis products from twenty patients with a median of 1.30×10 exp (8) (range 0.30~29.0) CD34+ cells were collected during mobilization. After Clini-MACS® procedure, the median number of CD34+ selected cells was 0.93×10 exp (8) (range 0.11~10.80) with a median recovery of 70.5% (range 34.5~94.4%) and a median purity of 96.0% (range 35.7~99.9%). Fifteen patients have been infused with CD34+ selected grafts after myeloablative preparation. The median number of reinfused CD34+ cells was 2.12×10 exp (6)/kg (range 0.44~18.1). The median time to reach an absolute neutrophil count of 500/μL and an unsupported platelet count of 20,000/μL were 12 days (range 7~36) and 15 days (range 10~43), respectively. But two patients were not reconstituted bone marrow function until 3 weeks after CD34+ cell infusion. They received un-manipulated PBPC in addition to selected CD34+ cells and then all had successive engraftment. Patients who received more than 2.0×10 exp (6) CD34+ cells/kg showed a significantly faster neutrophil and platelet recovery than patients who received less than 2.0×10 exp (6) CD34+ cells/kg (log-rank test, p<0.05). With a median follow-up of 320 days, 9 patients are alive without disease recurrence and 5 patients died of relapse. Conclusion: The selection of CD34+ cells using Clini-MACS® yield highly purified autografts, and also the engraftment ability of the progenitor and stem cells is fully retained. And auto-transplantation of CD34+ PBPC results in a rapid and stable neutrophil and platelet engraftment in patients who received an infused dose of at least 2.0×10 exp (6) CD34+ cells/kg. Further additional randomized phase III trials are required to determine whether tumor cell purging by CD34+ cell selection will have a significant impact on progression-free and overall survival in autologous transplantation.