절제된 정상위벽의 자기공명영상기법에 관한 연구:조직소견과의 비교

서보경,설혜영,이남준,차인호,정규병,김정혁,박철민,이지영,Seo, Bo-Gyeong,Seol, Hye-Yeong,Lee, Nam-Jun,Cha, In-Ho,Jeong, Gyu-Byeong,Kim, Jeong-Hyeok,Park, Cheol-Min,Lee, Ji-Yeong 대한영상의학회 2001 대한영상의학회지 Vol.45 No.5

목적:급속자기공명영상기법을 이용하여 절제된 정상위벽을 관찰하고,이를 조직소견과 비교 연구하여,위벽의 관찰을 위한 최적기법을 찾고자 하였다. 대상과 방법:25명 환자의 모두 41개 절제된 정상위조직을 수술후 수지(polyethylene)통에 넣고,생리식염수로 채워 자기공명영상을 시행하였다.T1강조FLASH,지방억제T1강조FLASH, T2강조TSE와 True-FISP 등 4가지 기법으로 위조직의 영상을 얻었다.자기공명영상에서는 위벽의 층수와 각층의 신호강도를 관찰하였고,이를 조직소견과 비교하였다.자기공명영상소견을 조직소견과 비교한 후 위벽 각층의 명확성과 각층간의 구분,및 전체 영상의 질에 대하여 비교하였다.4가지 기법 중 가장 좋은 방법은 3,가장 나쁜 방법은 0으로 하여 등급을 판정하였다. 결과:자기공명영상에서 위벽의 층수는 T1강조FLASH에서 2층이 41예 중 6예(14.6%),3층 31예(75.6%),및 4층 4예(9.8%)였고,지방억제T1강조FLASH에서 2층 6예(14.6%)와 3층 35예(85.4%),T2강조TSE에서 3층 24예(58.5%),4층 11예(26.8%),및 5층 6예(14.6%)였으며,True-FISP에서 1층 2예(4.9%),2층 8예(19.5%),3층 23예(56.0%),4층은 4예(9.8%), 및 5층 4예(9.8%)이었다.위벽의 신호강도는 T1강조FLASH와 지방억제T1강조FLASH에서 2층으로 보인 예는 위내강으로부터 고-중등도,3층인 경우는 고-저-고/중등도,4층인 예는 고-저-고-중등도신호강도였다.T2강조TSE에서는 3층으로 보인 예는 등도/고-저-중등도,4 층인 경우는 중등도-저-고-중등도/저,5층인 예는 저-고-저-고-저신호강도였다.자기공명 영상소견을 조직소견과 비교하였을 때 위벽이 3층으로 보인 경우 이것은 “점막층-점막하층-근층 ”에 해당하였다.관찰한 3가지 면 모두에서 T1강조FLASH,지방억제T1강조FLASH,T2강조TSE 기법이 True-FISP보다 통계적으로 유의하게 우수하였다(p=0.001).점막층의 명확성에 있어서 가장 우수한 기법은 T1강조FLASH와 지방억제T1강조FLASH이었고(p<0.05),점막하층의 명확성과 점막하층과 근층간의 구분은 T2강조TSE가 가장 우수하였다(p<0.05).전체적인 영상의 질은 T1강조FLASH와 T2강조TSE에서 가장 우수하였다(p<0.05). 결론:자기공명영상은 위벽의 각 층을 구별할 수 있는 우수한 검사로 조직소견과 높은 연관성을 보이며,전체 영상의 질,점막하층의 명확성 및 점막하층과 근층간의 구분이 T2강조TSE에서 가장 우수한다. Purpose: To evaluate normal human gastric wall layers in vitro using magnetic resonance*(MR) imaging, to correlate the results with the histologic findings, and to determine the optimal technique for evaluation of the gastric wall. Materials and Methods: Forty-one normal resected gastric specimens obtained from 25 patients were dissected and placed in a polyethylene tube filled with normal saline. MR imaging with four MR sequences, T1-weighted FLASH*(T1FLASH), fat-saturated T1-weighted FLASH, T2-weighted TSE*(T2TSE), and True-FISP, was performed. The number of gastric wall layers and signal intensity of each layer were determined, and after correlating MR images with the histologic findings, the conspicuity of each layer*(mucosa, submucosa, and muscle), the distinction between each layer, and overall image quality were assessed. results: The gastric wall was shown by TIFLASH to have two (n=6, 14-6%), three (n=31, 75.6%) and four layers (n=4, 9.8%); by fat-saturated TIFLASH to have two (n=6, 14.6%) and three (n=35, 85.4%) ; by T2TSE to have three (n=24, 58.5%), four (n=11, 26.8%), and five (n=6, 14.6%); and by True-FISP to have one (n=2, 4.9%), two (n=8, 19.5%), three (n=23, 56%), four (n=4, 9.8%), and five (n=4, 9.8%) . The signal intensity of each layer at T1FLASH and fat-saturated T1FLASH was high-intermediate from the lumen in two-layer cases, high-low-high/intermediate in three-layer cases, and high-low-high-intermediate in four-layer cases. The signal intensity of each layer at T2TSE was intermediate/high-low-intermediate in three-layer cases, intermediatelow-high-intermediate/low in four-layer cases, and low-high-low-high-low in five-layer cases. Three-layered gastric wall corresponded mostly to mucosa, submucosa, and muscle from the inner to outer layers, respectively. T1FLASH, fat-saturated T1FLASH, and T2TSE were superior to True-FISP in evaluating the gastric wall. T1FLASH and fat-saturated T1FLASH were the best sequences for demonstrating mucosa (p<0.05), and T2TSE was the best for submucosa and the distinction between this and muscle (p<0.05). Both T1FLASH and T2TSE provided the best overall image quality (p<0.05). Conclusion: In-vitro MR imaging is an excellent technique for the evaluation of layers of normal gastric wall. T2TSE is the sequence which best demonstrates the conspicuity of submucosa, the distinction between submucosa and muscle, and overall image quality.

중학교 과학 수업에서 협동을 위한 협동학습 모형의 적용 방안 연구

김인환,이승민,차정호 대구대학교 2006 대구대학교 학술논문집 Vol.1 No.2

과학 수업을 더욱 의미 있는 학습 경험으로 구성하기 위해서는 학생들의 능동적인 수업참여와 활발한 토의를 유도할 수 있는 교수-학습 전략이나 학습 환경에 대한 연구가 필요하다. 우리나라에서는 다양한 협동학습 방법이 소개되었으나 과학과에 적용된 수업 모형으로는 STAD, LT, Jigsaw, 등에 국한되어 있는 것으로 나타나고 있다. 따라서 과학과 수업에 적용해 볼 수 있는 좀 더 변화된 수업 모형 적용에 관하여 연구해 볼 필요가 있다. 본 연구에서는 학생들 사이의 협동기술을 증진시킬 수 있는 과학과에서의 새로운 협동학습 모형으로 협동을 위한 협동학습(Co-op Co-op)모형을 선정하여 적용가능성을 탐색해 보고 일선 교육 현장에서 곧바로 활용할 수 있는 교수-학습 자료를 개발하고자 하였다. 이 수업 모형이 중학교 과학과에 적합한지, 중학교 교과 수업에 적합한지, 중학교 교과에 적용시 기대되는 효과는 어떠한 것들이 있는지에 관하여 검토하였으며, 중학교 과학1 교과 '물질의 세가지 상태' 단원을 적용시켜 6차시 분량의 수업지도안과 탐구 활동지를 개발하였다. 협동을 위한 협동학습(Co-op Co-op)모형은 교사들이 교단에서 쉽게 적용할 수 있는 수업 모형으로 적절히 사용한다면 과학 수업에서 결여된 협동성과 사회성이 가미되어 과학과 탐구 실험 활동에서 보다 나은 참여와 효과적인 수업이 될 수 있다고 생각된다. 본 연구에서는 중학교 교과에서 협동을 위한 협동학습(Co-op Co-op)모형의 적용가능성을 검토했지만, 더 나아가 고등학교 교과에 적용 시킬 수 있는 연구도 요구된다. A study is needed on strategies or learning environment to form science classes as meaningful learning experience. In our country, various methods of cooperative learning have been introduced, but learning models applied in the science subject are limited in STAD, LT, Jigsaw, etc. Thus, it is neccessary to study application of more changed learning models for science classes. In this study, Co-op Co-op model was selected as a new cooperative learning model to promote cooperative technique between students in the science subject and its applicability was examined. Based on this process, this study purposed to develop teaching-learning material which can be directly used in the educational field. Accordingly, whether this learning model is suitable to the science subject of middle school was examined. Laying emphasis on whether Co-op Co-op model is fit for the science subject and classes of middle schools, and what effects are expected when it is applied in subjects of middle schools, a study and an analysis were conducted and teaching plan, research activity sheet and assessment sheet of the sixth session were developed by applying it in the unit of "three states of material" of the science subject of middle schools. Co-op Co-op model should be conducted with a class model which is fit for our actual situations and the most suitable to students, and teachers easily apply in the class instead of applying cooperative learning in science classes unconditionally. If this is implemented, cooperation spirit and sociality that science classes lack in are added and it is expected that better participation and effective learning are performed in experimental activity. In this study, applicability of Co-op Co-op model was examined only in subjects of middle schools, alternative plans are demanded to apply it in subjects of high schools.

Clinical impact of admission hyperglycemia on in-hospital mortality in acute myocardial infarction patients

Kim, Eun Jung,Jeong, Myung Ho,Kim, Ju Han,Ahn, Tae Hoon,Seung, Ki Bae,Oh, Dong Joo,Kim, Hyo-Soo,Gwon, Hyeon Cheol,Seong, In Whan,Hwang, Kyung Kuk,Chae, Shung Chull,Kim, Kwon-Bae,Kim, Young Jo,Cha, Kwa Elsevier 2017 INTERNATIONAL JOURNAL OF CARDIOLOGY Vol.236 No.-

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Acute hyperglycemia on admission is common in acute myocardial infarction (AMI) patients regardless of diabetic status, and is known as one of prognostic factors. However, the effect of hyperglycemia on non-diabetic patients is still on debate.</P> <P><B>Methods</B></P> <P>A total of 12,625 AMI patients (64.0±12.6years, 26.1% female) who were enrolled in Korea Acute Myocardial Infarction Registry-National Institute of Health between November 2011 and December 2015, were classified into 4367 diabetes (65.4±11.6years, 30.4% female) and 8228 non-diabetes (63.3±13years, 23.9% female). Patients were analyzed for in-hospital clinical outcome according to admission hyperglycemic status.</P> <P><B>Results</B></P> <P>In diabetic patients, independent predictors of in-hospital mortality were old age, high HbA<SUB>1</SUB>C, pre-Thrombolysis In Myocardial Infarction (TIMI) flow 0, left ventricle ejection fraction<40%, cardiogenic shock and ventricular tachycardia. In non-diabetic patients, independent predictors of in-hospital mortality were old age, high admission glucose (≥200mg/dL), pre TIMI flow 0, failed percutaneous coronary intervention, low left ventricle ejection fraction<40%, cardiogenic shock, stent thrombosis and decreased Hb≥5g/dL. In hospital mortality was significantly higher in diabetic patients compared to non-diabetic patients (5.0% vs. 3.4%, <I>p</I> <0.001). However, non-diabetic patients with hyperglycemia have significantly higher mortality compared to diabetic patients (17.4% vs. 7.2%, <I>p</I> <0.001). Comorbidity including cardiogenic shock (<I>p</I> <0.001), cerebral hemorrhage (<I>p</I> =0.012), decreased Hb≥5g/dL (<I>p</I> =0.013), atrioventricular block (<I>p</I> <0.001) and ventricular tachycardia (<I>p</I> =0.007) was higher in non-diabetic with hyperglycemia than in diabetic patients.</P> <P><B>Conclusions</B></P> <P>These findings underscore clinical significance of admission hyperglycemia on in-hospital mortality in non-diabetic AMI patients.</P>

과학 전자교과서의 학습동기 분석 : 중학교 1학년 화학영역을 중심으로

류주희,차정호,김인환 대구대학교 사범대학 부설 교육연구소 2008 敎育硏究 Vol.3 No.2

본 연구에서는 과학 전자교과서의 동기유발전략을 분석하였다. 분석에는 Keller의 ARCS 동기이론이 사용되었다. 에듀넷의 중학교 1학년 화학 내용을 선택하였으며, 두 명의 연구자에 의해 동기 유발과 동기 유지 측면에서 분석되었다. 분석자간 일치도는 90%이상이었다. 연구 결과, 각 동기 전략이나 학습단계에 대한 차이는 없는 것으로 나타났다. 가장 많이 사용된 전략은 “사진의 패턴이나 글자를 돋보이게 하거나 거꾸로 나타내기”, “점진적으로 드러내기를 통한 교수 조각 맞추기”, “제목이나 키워드에 밑줄 긋기, 이탤릭체 또는 큰 글자크기를 사용하기”였다. “학습자의 집중력을 빼앗는 요소”는 가장 적은 빈도를 나타내었다. 학습의 마지막 단계에서는 전략 사용 빈도가 학습의 처음 단계에 비하여 상대적으로 낮았다. In this study, learning motivation strategies of the science e-textbooks, were analyzed. Keller's ARCS model was used for analysis. The 7th-grade chemistry contents ware selected from the EDUNET (edunet4u.net), then analyzed in aspect of gaining and sustaining attention by two researchers. Intercoder agreement of the analysis was over 90%. The results indicated that the frequencies of each motivation strategies were not different by learning stages. The most frequent strategies were "use inverse and flash in text and patterns in pictures as attention getters", "keep instructional segments relatively short with progressive disclosure", and "use underlines, italics, or bigger font sizes for the headings or key words". "Avoid disfunctional attention-getting effects such as a flashing word that distracts learners' concentration" was the lowest frequent strategy. At the end stage of learning, frequencies of the strategies were relatively low than those of early stage of learning. Educational implications are discussed.

염증성 근섬유모세포종의 증례보고

은상아,박혁,차인호,김현실,정호걸,김기덕,박창서 대한구강악안면방사선학회 2006 Imaging Science in Dentistry Vol.36 No.3

The inflammatory myofibroblastic tumor (inflammatory pseudotumor) is a rarely occurring soft tissue lesion of unknown etiology. It can be of any location, but commonly it is found in lungs. It has been considered as a nonneoplastic reactive inflammatory lesion, but nowadays, confusion and dispute about its character is increasing due to its high recurrence rate and metastasis. We present a patient who had been diagnosed with an inflammatory pseudotumor in the right maxilla area, 1 year before visiting our hospital. After that, her pain and swelling did not resolved and she visit our hospital. On radiographic examination, aggressively infiltrative growth of the lesion with destruction of adjacent bony structure was noted. We found unusual aggressiveness of the inflammatory myofibroblastic tumor of the head and neck region. Because the typical behavior of the inflammatory myofibroblastic tumor is not defined yet, we recommend the surgical excision of the lesion and close follow-up.

AI/CFRP 혼성튜브의 적층각과 단면형상에 따른 축방향 압궤 특성

김선규,이길성,김성훈,차천석,김정호,양인영 朝鮮大學校 機械技術硏究所 2004 機械技術硏究 Vol.7 No.1

알루미늄은 수송기계용 구조부재로 널리 쓰이고 있으며 복합재료가 이러한 수송기계용 구조부재로 쓰일 때 경량화와 많은 에너지 흡수 측면이 기대된다. 알루미늄 튜브는 CFRP(탄소 섬유 강화 복합재료)튜브에 비해 압궤하중은 낮지만 안정적인 소성변형에 의해 압궤되는 반면 CFRP 튜브는 알루미늄 튜브에 비해 압궤하중은 높지만 불안정한 취성파괴에 의해 압궤된다. 따라서 알루미늄과 CFRP의 조합은 안정적이며 뛰어난 에너지흡수를 기대할 수 있다. 본 연구에서는 알루미늄 원형과 사각튜브의 외측을 CFRP로 감싸 Al/CFRP 혼성튜브를 제작하여 축방향 압궤특성에 관하여 연구하였다. 알루미늄 튜브와 CFRP 튜브의 압궤특성을 기초로 하여, Al/CFRP 흔성튜브의 이방성 재료인 CFRP의 적층각과 단면형상의 변화를 주었다. 실험결과, Al/CFRP 흔성튜브는 알루미늄 튜브의 좌굴을 계기로 하여 CFRP 튜브의 불안정한 취성파괴의 단점을 보완하였다. 경량화 측면에서 단위 질량당 흡수에너지는 원형튜브가 사각튜브에 비해 약 45~70% 이상 높았으며 CFRP 적충각이 90˚일 때 가장높았다. Aluminum materials have been widely used in various vehicle structures. If composite materials are applied to vehicle structures, it is expected that not only the weight of the vehicle is decreased but also it absorb large amounts of energy. Aluminum tubes are lower than CFRP (Carbon Fiber Reinforced Plastics) tubes in the collapse load but absorb energy by stable plastic deformation. On the other hand, CFRP tubes are higher than aluminum tubes in the collapse load but absorb energy by unstable brittle failure. The combination of aluminum and composite may result in stable deformation and excellent energy absorption efficiency. The compressive axial collapse tests were performed to investigate collapse characteristics of Al/CFRP compound tubes which are aluminum tubes wrapped with CFRP outside the aluminum circular and square tubes. Based on collapse characteristics of aluminum tubes and CFRP tubes respectively, the axial collapse tests were performed for Al/CFRP compound tubes which have different CFRP orientation angles and cross-sections. Test results showed that Al/CFRP compound tubes supplemented the unstable brittle failure of CFRP tubes due to ductile nature of inner aluminum tubes. In the light-weight aspect, Absorbed energy per unit mass of circular tubes was higher than square tubes'. Absorbed energy per unit mass showed highest when CFRP orientation angle was 90 degrees.

前腕部 經穴 取穴에서 骨度分寸法과 一夫法의 比較 硏究

박히준,채윤병,차웅석,박종배,이혜정,이향숙,인창식,고형균,김수영,최일환,김강식,문정배,배기태,유경환,육근영,정병주,손인철,임사비나 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2004 東西醫學硏究所 論文集 Vol.2004 No.-

Background : The cun measurement System, an essential and convenient method in locating acupoints, has been widely used in the practice of acupuncture. However, traditional cun measurement has been criticized for its lack of reliability. Objectives : The purposes of this study are to determine if one cun measured by the directional methods have a consistency with that of proportional methods and to investigate which factors are related with these differences, especially in forearm. Methods : The distance between the elbow crease and the wrist crease of forearm was compared to a reference value of one cun obtained by the directional method. In this method, one cun is one third of the distance between index finger and Small finger of a subject, measured at proximal interphalangeal joint. In addition, to investigate the factors influencing the differences between these two methods, we measured the height and body weight and calculated body mass index (BMI). Finally we analyzed the factors correlated with these lengths by linear regression test. Results : The results showed that one cun obtained by the directional methods were significantly different from one cun by the proportional methods in forearm. It was demonstrated that the length acquired with the directional method was more correlated with body weight and body mass index, while the length obtained by the proportional method was more correlated with the height.

HASA 교육과정 기반의 과학캠프 프로그램 개발과 개발 과정 분석

김창만,김인환,차정호,황북기,최정훈 大邱大學校 師範大學 附設 敎育硏究所 2009 學校敎育硏究 Vol.5 No.1

본 연구에서는 학교 밖 탐구활동의 실태 분석 결과와 수공적 기능이 강조된 HASA 교육과정 기준안에 근거하여 체험 중심 과학캠프 프로그램의 개발 내용과 과정을 분석하였다. 과학캠프 프로그램을 개발하고 적용하는 과정에 대해서는 개발자들과 운영자들이 기획한 자료와 면담 내용을 바탕으로 개발과정에서의 문제점과 개선방안을 분석하였다. 분석한 캠프 프로그램은 개발진이 설정한 개발 방향과 수업 모형을 토대로 과학 강연, 과학 체험학습, 과학 경연, 탐구주제 토론으로 구성되었다. 이 프로그램들은 HASA 교육과정에서 강조하는 수공적 기능, 탐구, 지식, 태도를 모두 포함하였다. 프로그램의 개발 과정에 대한 분석한 결과, 개발 기관의 인적 물적 인프라는 부족함이 없었으나, 프로그램 개발자 중 과학교육학 전공자가 부족하다는 점과 참가 대상 및 비용 측면에서 문제점이 지적되었다. In this study, practice-centered science camp programs developed based on the HASA science curriculum standard and its developmental processes were analyzed. For this purpose, materials related with development of programs and interview protocols were overviewed, and the shortcomings and revision points of the science camp were introduced. The camp programs included science lecture, science experiment, science contest, and inquiry topic discussion. These were based on manipulative skill, inquiry, knowledge, and attitude which were emphasized in HASA curriculum. As a results of analysis, we found that the institutions had enough infrastructures. However, there was no expert in science education, and had some problems in participant's school grade level and participation fee.

DBD 반응기에서 플라즈마 방전형태에 따른 PFC_(s) 가스의 분해 특성

김관태,김용호,차민석,송영훈,김석준,류정인 한국대기환경학회 2004 한국대기환경학회지 Vol.20 No.5

Perfluorocompounds(PFC_(s)), such as tetrafluoromethane (CF₄) and hexafluoroethane (C₂F_(6)), have been widely used as plasma etching and chemical vapor deposition (CVD) gases for semiconductor manufacturing processes. Since these PFC_(s) are known to cause a greenhouse effect intensively, there has been a growing interest in reducing PFC_(s) emissions. Among various CF₄ decomposing techniques, a dielectric barrier discharge (DBD) is considered as one of a promising candidate because it has been successfully used for generating ozone (O₃) and decomposing nitrogen oxide (NO). Firstly, optimal concentration of oxygen for CF₄ decomposition was found to figure out how many primary and secondary reactions are associated with DBD process. Secondary, to find effective discharge method for CF₄ decomposition, a streamer and a glow mode in DBD are experimentally compared, which includes (ⅰ) coaxialcylinder DBD, (ⅱ) DBD reactor packed with glass beads. and (ⅲ) a glow mode operation with a helium gas. The test results showed that optimal concentration of oxygen was ranged 500 ppm~1% for treating 500 ppm of CF₄ and helium glow discharge was the most efficient one to decompose CF₄.

A new risk score for ventricular tachyarrhythmia in acute myocardial infarction with preserved left ventricular ejection fraction

Lee, Seung Hun,Jeong, Myung Ho,Kim, Ju Han,Kim, Min Chul,Sim, Doo Sun,Hong, Young Joon,Ahn, Youngkeun,Chae, Shung Chull,Seong, In Whan,Park, Jong Sun,Chae, Jei Keon,Hur, Seung Ho,Cha, Kwang-Soo,Kim, H Elsevier 2018 Journal of cardiology Vol.72 No.5

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Ventricular tachycardia or fibrillation (VT/VF) is a major cause of sudden cardiac death after acute myocardial infarction (AMI). This study aims to investigate the clinical characteristics and outcomes of VT/VF, to identify the variables associated with VT/VF, and to construct a new scoring system.</P> <P><B>Methods</B></P> <P>Patients with relatively preserved left ventricular ejection fraction (LVEF) (≥40%) included in the Korea Acute Myocardial Infarction Registry-National Institutes of Health registry were enrolled in this study. Among 13,109 patients in the registry, a total of 10,334 (78.8%) had relatively preserved LVEF after AMI. Patients were divided into two groups based on whether they experienced life-threatening VT/VF during hospitalization or not. The predictors for VT/VF during hospitalization were assessed. In-hospital mortality and complications were recorded.</P> <P><B>Results</B></P> <P>A total of 358 (3.5%) experienced life-threatening VT/VF. The VT/VF group was at an increased risk of in-hospital mortality (odds ratio 2.99) and cardiac death (odds ratio 3.40). Variables of diagnosis, Killip class, smoking, initial rhythm, left bundle branch block, and LVEF were significant indicators of VT/VF. A new risk score system yielded acceptable discrimination function (<I>c</I>-statistics=0.773).</P> <P><B>Conclusions</B></P> <P>Relatively preserved LVEF patients could still be at risk of life-threatening VT/VF, which is related to a poor prognosis during the admission period. This new scoring system can be adopted to stratify the risk of VT/VF.</P> <P><B>Highlights</B></P> <P> <UL> <LI> 3.5% of acute myocardial infarction patients experienced ventricular tachycardia or fibrillation (VT/VF) even if their left ventricular ejection fraction was preserved. </LI> <LI> Early VT/VF during hospitalization was associated with a poor prognosis. </LI> <LI> The VAMIR score could predict VT/VF, and it yielded acceptable discriminant function. </LI> <LI> The VAMIR score supported the strategies of earlier discharge after revascularization. </LI> </UL> </P>