갑상선 절제 수술 후 Guardix-SG<SUP>Ⱂ</SUP>의 유착방지 효과

박재현,정종주,강상욱,남기현,장항석,정웅윤,박정수,Jae Hyun Park,M.D.,Jong Ju Jeong,M.D.,Sang Wook Kang,M.D.,Kee Hyun Nam,M.D.,Hang Seok Chang,M.D.,Woong Youn Chung,M.D. and Cheong Soo Park,M.D. 대한갑상선-내분비외과학회 2009 The Koreran journal of Endocrine Surgery Vol.9 No.3

Purpose: Postoperative adhesion of the surgical field seems to be troublesome not only to the patients, but also to the surgeons. Guardix-SG<SUP>Ⱂ</SUP> is a poloxamer/alginate mixture that reduced the incidence of postoperative adhesions when it is added to the abdominal surgery in animal models and also in clinical trials. This study was a randomized, prospective, double-blinded study to evaluate the antiadhesive efficacy and safety of Guardix-SG<SUP>Ⱂ</SUP> after total thyroidectomy. Methods: A total of 89 patients who underwent total thyroidectomy between July 2008 and February 2009 in Severance Hospital and Gang-Nam Severance Hospital were randomized to either the Guardix-SG<SUP>Ⱂ</SUP> treatment group (n=45) or the non-treatmentcontrol group (n=44). The patients were asked about their clinical symptoms (hypesthesia or paresthesia on the operative site (SN) and swallowing discomfort (SW)) by using a questionnaire, and the swallowing function was evaluated using Marshmallow Esophagography by one physician. The clinical symptoms and Marshmallow Esophagography were scored according to the results of assessment. The most severe state was scored as 0 and normal was scored as 3. Results: The scores of the clinical symptoms (SN and SW) were 2.67 and 2.49 in the treatment group, and 2.09 and 1.80 in the control group, respectively, at the postoperative 6th week (P=0.001, <0.001). The scores of the Marshmallow Esophagography were 2.93 in the treatment group and 2.73 in the control group (P=0.033). Abnormal findings were seen in 2 patients (4.4%) in the treatment group and in 10 patients (22.7%) in the control group (P=0.014). Conclusion: Guardix-SG<SUP>Ⱂ</SUP> seems to be effective in preventing adhesion after thyroidectomy. Further studies involving a larger number of subjects will be needed to make an application guideline. (Korean J Endocrine Surg 2009;9: 127-132)

북한산국립공원의 계류수질 보전 전략(I)

박재현,우보명,김우룡,안현철,조현서,추갑철,김춘식,최형태,Park, Jae-Hyeon,Woo, Bo-Myeong,Kim, Oue-Ryong,Ahn, Hyun-Chul,Cho, Hyun-Seo,Choo, Gab-Chul,Kim, Choon-Sig,Choi, Hyung-Tae 한국환경복원기술학회 2001 한국환경복원기술학회지 Vol.4 No.3

This study was conducted to investigate physicochemical property changes from July 1998 to August 2001 in Mt. Bukhansan National Park. Four water sampling points were selected to measure the quality of stream water in the northeastern part of the Mt. Bukhansan National Park. The results were summarized as follows; In spring, the average pH of stream water was below the first class of the river water quality standard, while it was normal level in summer. The average electrical conductivity was about 2.3~3.3 times higher in downstream water than in upstream water during spring and summer. The contents of anions($Cl^-$, $NO{_3}^-$, $SO{_4}^{2-}$) were about 1.1~7.4 and 0.4~11.4 times higher in downstream than in upstream water, respectively. These results indicate that water quality was poorer in downstream than in upstream water. We suggest that stream water in the Mt. Bukhansan National Park should be protected from impacts of snow melting mineral particles in spring season and human impacts like wastewater of point source in summer season.

홍수시 얕은기초의 세굴위험도 평가 사례연구

박재현,이주형,정문경,곽기석,Park. Jae-Hyun,Lee. Ju-Hyung,Chung. Moon-Kyung,Kwak. Ki-Seok 한국방재학회 2008 한국방재학회 학술발표대회논문집 Vol.2008 No.1

Scour vulnerability evaluation for shallow foundations was performed to assure bridge safety against scour in the national capital region. The case studies for 26 shallow foundations consisted of site investigation including boring test, bridge scour analysis for the design flood, bearing capacity evaluation of the bridge foundation before and after scour, and comprehensive evaluation of bridge scour vulnerability. Bridge scour vulnerability was determined based on the interdisciplinary concept considering predicted scour depth for the design floods and bearing capacity of foundation as well as dimensions of foundation. Nine of 26 shallow foundations showed the potential future vulnerability to scour with significant decrease in the bearing capacity of foundations due to scour and the remaining 17 were expected to maintain their stability against scour.

갑상선 주위 종양으로 표현된 식도 신경초종 1예

박재현,김충배,전혜민,강상욱,정종주,이용상,남기현,장항석,정웅윤,박정수,Jae Hyun Park,Choong Bai Kim,Hyae Min Jeon,<SUP>1<,SUP>,Sang-Wook Kang,Jong Ju Jeong,Yong Sang Lee,Kee-Hyun Nam,Hang Seok Chang,Woong Youn Chung,and Cheong Soo 대한갑상선-내분비외과학회 2011 The Koreran journal of Endocrine Surgery Vol.11 No.1

802.11 Ad-Hoc 네트웍에서 Power Save Mechanism을 개선한 DAPSM 알고리즘

박재현,이장수,김성천,Park, Jae-Hyun,Lee, Jang-Su,Kim, Sung-Chun 한국정보처리학회 2007 정보처리학회논문지 C : 정보통신,정보보안 Vol.14 No.6

최근 무선 네트워킹 장치들이 등장 하면서 제한된 배터리에 의존하는 무선 호스트들의 전력 절감은 중요한 이슈 가 되었다. 특히 Ad-Hoc에서 배터리는 제한된 에너지를 제공하기 때문에 무선 호스트에 의해서 소모되어지는 에너지의 양을 감소시키기 위한 기술은 대단히 중요하다. 특히 MAC 과 라우팅 에서 전력 절감을 이루기 위한 논문들이 기존에 발표 되었다. 이 논문에서는 IEEE 802.11 표준의 DCF(Distributed Coordination Function)에서의 전력 절감 메카니즘을 향상 시킨 논문 이다. DCF를 위한 IEEE 802.11 전력 절감 메카니즘에서는 비콘 간격 이라는 시간으로 나누어지며 또한 이러한 각각의 비콘 간격이 시작될 때 각각의 노드들은 ATIM 창 동안 깨어 있어야 한다. 물론 모든 노드는 같은 시간에 깨어 있기 위해서는 동기화 되는 것이 필요하다. ATIM 창 동안 노드들은 비콘 기간 동안 깨어 있는 상태로 있을 것인지를 결정하기 위해서 control packet을 교환 한다. 이러한 ATIM 창 크기는 각각의 노드들의 전력 절감에 상당한 영향을 미친다. 따라서 이 논문은 ATIM 창 크기를 동적으로 증감시켜서 보다 에너지 효율을 발휘 하고자 하는 논문이다. Recently, wireless networking devices that depend on the limited Battery and power-saving of wireless hosts became important issue. Batteries can provide a finite amount of energy, therefore, to increase battery lifetime, it is important to design techniques to reduce energy consumption by wireless hosts. This paper improved power saying mechanism in Distributed Coordination Function(DCF) of IEEE 802.11. In the IEEE 802.11 power saving mechanism specified for DCF, time is divided into so-called beacon intervals. At the start of each beacon interval, each node in the power saving mode periodically wakes up during duration called the ATIM Window. The nodes are required to be synchronized to ensure that all nodes wake up at the same time. During the ATIM window, the nodes exchange control packets to determine whether they need to stay awake for the rest of the beacon interval. The size of the ATIM window has considerably affected power-saving. This paper can provide more power-saving than IEEE 802.11 power saving mode because ATIM window size is efficiently increased or decreased.

선천성 간 섬유증을 동반한 Kabuki 증후군 1예

박재현,정명화,이희정,이지현,최연호,송상용,서연림,황진복,Park, Jae-Hyun,Chung, Myung-Hwa,Lee, Hee-Jung,Lee, Jee-Hyun,Choe, Yon-Ho,Song, Sang-Yong,Suh, Yeon-Lim,Hwang, Jin-Bok 대한소아소화기영양학회 2008 Pediatric gastroenterology, hepatology & nutrition Vol.11 No.1

저자들은 어린 영아기에 선천성 간섬유증으로 진단받은 후 특징적인 얼굴 모습과 함께 발달 및 지능 저하를 보이는 10세 남아에서 가부키 증후군으로 진단된 1예를 경험하였기에 문헌고찰과 보고하는 바이다. Kabuki syndrome is characterized by peculiar facial features, developmental delay, and mental retardation. Congenital hepatic abnormalities in Kabuki syndrome patients have been sporadically reported in the literature and consist of extrahepatic biliary atresia, neonatal sclerosing cholangitis, and transient neonatal cholestasis. We report here a case of congenital hepatic fibrosis in a patient with Kabuki syndrome. To our knowledge, only one case of congenital hepatic fibrosis has been reported in the setting of Kabuki syndrome.

회전근 개 파열의 수술적 치료시 초음파 연속 검사의 유용성

박재현,최원기,최창혁,Park, Jae-Hyun,Choi, Won-Ki,Choi, Chang-Hyuk 대한정형외과초음파학회 2008 대한정형외과 초음파학회지 Vol.1 No.2

목적: 회전근 개 파열 환자에서 수술 전의 자기 공명 영상 검사와 초음파 검사에 따른 관절경 소견을 비교하고, 수술 후 2주, 6주 및 3개월의 회전근 개의 건재 상태를 초음파로 확인하는데 있다. 대상 및 방법: 2008년 2월부터 5월까지 본원 정형외과에 내원하여 회전근 개 파열로 관절경적 치료를 시행한 환자 29명을 대상으로 초음파 검사와 자기 공명 영상 검사를 시행한 후 관절경적 시술을 이용하여 비교하였으며, 수술 후 2주, 6주 및 3 개월에 회전근 개의 건재 상태를 초음파를 이용하여 관찰하였다. 결과: 회전근 개 파열을 확인할 수 있는 초음파 검사와 자기 공명 영상 검사의 예민도는 각각 100%였다. 전층 회전근 개 파열에서 초음파 검사와 자기 공명 영상 검사의 예민도는 각각 95%, 82%였으며, 부분층 회전근 개 파열에서 초음파 검사는 50%, 자기 공명 영상 검사는 33%의 예민도를 나타내었다. 전체 환자에 대한 초음파 검사의 정확도는 86%, 자기 공명 영상 검사의 정확도는 69%이었다. 전층 회전근 개 파열로 복원술을 시행한 22예 중 수술 후 2주에 시행한 추시 관찰 초음파 검사상 11예(50%, 소 및 중 파열 2예, 대 및 광범위 파열 9예)에서 회전근 개의 봉합 부위에서 수술 소견과 일치하는 틈새로 진단되는 저에코를 확인할 수 있었으며, 수동적 신장 운동을 시행한 후 수술 6주의 추시 관찰 초음파 검사상 5예(23%, 소 및 중 파열 1예, 대 및 광범위 파열 4예)에서 재파열 소견을, 능동적 운동을 시행한 후 수술 3개월의 추시 관찰 초음파 검사상 7예(32%, 소 및 중파열 2예, 대 및 광범위 파열 5예)에서 재파열 소견을 보였다. 결론: 회전근 개 파열에 대한 관절경적 치료 후 초음파 연속 검사는 술 후 틈새와 술 후 재파열을 구분하는데 도움을 줄 수 있었으며, 수술 후 6주에 23%, 3개월에 32%의 재파열 소견을 보인 바 재활 치료시 추가 치료의 방침을 세우는데 도움을 줄 수 있을 것으로 생각되었다. Purpose: The findings of preoperative magnetic resonance imaging (MRI) and ultrasonography (US) examination in the diagnosis of rotator cuff tear were then compared with the findings of arthroscopic examination, and to evaluate the postoperative integrity of rotator cuff using serial US examination. Methods: Between February and May 2008, 29 patients with rotator cuff tear had undergone preoperative US and MRI examination and subsequent arthroscopic examination. And the results of MRI and US were compared with intra-operative results of the arthroscopic examination. We observed the postoperative integrity of rotator cuff using serial (postoperative 2 weeks, 6 weeks, 3 months) US examination. Results: The sensitivity of US and MRI for identifying rotator cuff tear were 100% and 100%. The sensitivity of US and MRI were 95% and 82% in full thickness tear, and 50%, 33% in partial thickness tear, respectively. Overall accuracy of US and MRI were 86%, 69%. Among 22 patients were operated for full thickness tear, intra-operative gap formation was identified in 11 patients (50%, small to medium 2 cases, large to massive 9 cases) which were identified at 2 weeks postoperative US. We could find 5 re-tears (23%, small to medium 1 case, large to massive 4 cases) on 6 weeks postoperative US after passive range of motion (ROM) exercise, and could also find 7 re-tears (32%, small to medium 2 cases, large to massive 5 cases)on 3 months postoperative US after active ROM exercise. Conclusion: Serial US after arthroscopic rotator cuff repair was useful to differentiate intra-operative gap formation from postoperative re-tear. We found 5 retears (23%) at 6 weeks and 7 retears (32%) at 3 months postoperative US, it was useful to make treatment plan during postoperative rehabilitation.

신장의 투명세포 육종 1예

박재현,정재희,이아원,송영택,Park, Jae-Hyun,Jung, Jae-Hee,Lee, Ah-Won,Song, Young-Tack 대한소아외과학회 2001 소아외과 Vol.7 No.2

Clear Cell Sarcoma of the Kidney(CCSK) is a rare malignant childhood tumor with frequent metastasis to the bone. We report a case of right sided in a 5 month-old girl. A radical nephrectomy was performed. It was clinical stage III with renal capsular invasion and lymph node metastasis by the classification of NWTS-5. Histologic examination revealed the classic pattern of CCSK. Postoperative adjuvant chemotherapy with doxorubicin and radiotheraphy were applied.

소아 IgA 신병증의 예후에 관한 고찰

박재현,김병길,정현주,최인준,Park Jae-Hyun,Kim Pyung-Kil,Jeong Hyeon-Joo,Choi In-Joon 대한소아신장학회 1997 Childhood kidney diseases Vol.1 No.1

목적 : IgA 신병증은 다양한 임상 소견을 보일 수 있으며 초기에는 대부분 예후가 양호한 것으로 알려졌었으나 현재는 발병 20년후 20-30%가 말기 신부전증을 초래한다고 알려져 있다. IgA 신병증의 예후를 예측하기 위한 여러 조사에서 발병 초기의 심한 단백뇨, 고혈압, 조직 병리학 상의 심한 변화 등이 있을 경우 예후가 나쁘다고 하였다. 1996년 Yagame등은 IgA 신병증에서 새로운 조직 병리학적 분류를 하였고 WHO 분류 방법이 사구체 병변을 중심으로 한데 비해 세뇨관과 간질의 변화까지 포함하고 있어 이들의 분류 방법이 더 우수하며 추적관찰 결과 만성 신부전의 예후 인자로써 유용하다고 발표하였다. IgA 신병증에서 임상 증세, 검사 소견, WHO 및 Yagame 등의 조직 병리학적 분류 등과 추적 관찰시 만성 신부전과의 상관 관계를 알아보고자 하였다. 방법 : 1984년 1월부터 1996년 2월까지 소아과에 입원하여 신생검상 메산지움에 IgA가 현저히 침착되어 있어 IgA 신병증으로 진단된 환아 79명을 대상으로 평균 27개월의 추적관찰시 신 기능이 정상인군(73례)과 만성 신부전으로 진행한 군(6례)을 서로 비교하여 IgA 신병증에서의 예후 예측 인자에 대하여 알아보고자 하였다. 결과 : 1) 성별, 나이, 증상기간 등은 양군간 차이가 없었으나 내원시 고혈압이 있을 경우 만성 신부전으로의 진행이 많았다. 2) 내원시에 여러 임상 검사중 심한 단백뇨가 만성 신부전으로의 진행이 많았다. 3) WHO 및 Yagame 등의 조직 병리학적 분류 모두 소아 환자에서는 예후와의 관련을 찾을 수 없었다. 결론 : 이상의 결과로 보아 IgA 신병증 환아에서 내원시에 심한 단백뇨, 고혈압이 있을 경우 추적 관찰 결과 예후가 좋지 않았다. 그러나 본 연구의 경우 치료에 대한 평가가 이루어지지 않았고 대상 환아가 적었기에 향후 이를 포함하는 광범위한 연구가 진행되어야 할 것으로 사료된다. After the first description of IgA nephropathy by Berger in 1968, the prognosis of this disease was considered favourable. However recent studies have revealed that IgA nephropathy result in end stage renal desease in 25-30% by 20 years. Heavy proteinuria, hypertension, histological high class are regarded as poor prognostic factors. In 1996, Yagame et al reported the new histopathologic grading with a strong correlation between the grading, heavy proteinuria, high s-Cr level and renal survival. The aims of this study are to determine whether the pathological grading and other clinical parameters could contribute to predicting the outcome of this disease eventhough pediatric patients. Seventy nine patients (59 males, 20 females) with IgA nephropathy were examined. Patients were 2.08-15.17 years of age ($9.85{\pm}2.83$). The mean follow-up duration were $27{\pm}28$ months. Six of seventy nine patients progressed to chronic renal failure during the follow-up periods. High 24h urinary protein excretion at diagnosis were significantly higher in chronic renal failure patients (p<0.05). Hypertension at diagnosis were the significant associated factors in progression of chronic renal failure (p<0.05). Histological changes of IgA nephropathy in light microscopy were classified into five classes by WHO classification, four grades in Yagame's gradings. Among the seventy nine patients, 24 were as class 1, 30 as class 2, 23 as class 3; 4 as class 4, 0 as class 5 by WHO classification. 23 were classified grade 1, 31 as grade 2, 24 as grade 3, 1 as grade 4 by Yagame's grading. Among six patients who progressed to chronic renal failure, 1 clssified as class 1, 1 as class 2, 3 as class 3, 1 as class 4, 0 as class 5 by WHO Classification. 1 patients were classified as grade 1, 1 as grade 2, 3 as grade 3, 1 as grade 4 by Yagame's grading. (p>0.05) In conclusion, hypertension and heavy proteinuria at initial presentation were significantly associated with progression of chronic renal failure. The classification of WHO & Yagame's grading has no significant association with the progression of chronic renal failure in pediatric patients.

기후정보를 반영한 확률적 일정계획수립 모델 개발

박재현,김경훈,김재준,Park, Jae-Hyun,Kim, Kyong-Hoon,Kim, Jae-Jun 대한건축학회 2011 대한건축학회논문집 Vol.27 No.2

This study aims to overcome problems of scheduling established by planner's institution and judgment. By introducing stochastic approach, this study proposes a method to predict work duration on the construction sites reflecting work information generated around unit work of previous cases and non-working day, and this model was verified by its application to a case study. As a result of analyses on previous researches in an attempt to develop work duration model, there were several studies on estimating work duration based on stochastic approach. However, previous researches could not predict work duration in different construction sites because unit work was not separated. Accordingly, this study attempts to suggest a practical method to predict work duration in advance in pre-construction phase where construction is not under way. After predicting construction time of a site where duration is supposed to be predicted based on the data of measuring case study, verification of this model was carried out in compared to real construction time. In consequence, work duration within twelve days was been estimated with a margin of error of 5%. In addition, the period for actual construction turned out ten days, which was analyzed within twelve day. Therefore, model of this study show the practical method estimating work duration in pre-construction phase.