인체 모형을 이용한 다중 검출기 컴퓨터단층촬영기기의 다양한 자동노출제어 시스템에 대한 연구

김영옥(Kim, Yong-Ok),성열훈(Seoung, Youl-Hun) 한국산학기술학회 2012 한국산학기술학회논문지 Vol.13 No.4

다중 검출기 컴퓨터단층촬영(multi-detector computed tomography; MDCT) 장비에서 이용되는 다양한 자동노 출제어(automatic exposure control; AEC) 시스템에 대한 선량 감소 정도와 영상의 품질을 비교 평가하였다. 연구에 이 용한 AEC 시스템은 General Electric(GE)사의 Auto-mA 3D, Philips사의 DoseRight, 그리고 Siemens사의 Care Dose 4D를 이용하였다. 모든 실험에서 X-선 노출 조건을 가능한 한 동일하게 하였다. 다양한 AEC 시스템에서 선량 감소 평가는 인체 모형을 이용하여 고정관류기법과 비교하여 평가하였다. 또한 영상 품질은 CT 계수(number)의 표준 편차 를 이용하여 영상의 잡음을 측정하였다. 그 결과 AEC 시스템을 적용할 때 Auto-mA 3D는 35.3%, DoseRight는 58.2%, Care Dose 4D는 48.6%의 최대 선량감소가 있었으며, 영상품질에서는 Care Dose 4D의 강함/약함 (Strong/Weak)의 조 합에서 유의한 차이가 없었다(P=0.269). 이런 다양한 AEC 시스템의 적용은 고품질의 영상을 유지하면서 선량을 감소 하는데 매우 유용 할 것이라고 사료된다. The purpose of the study was to evaluation of the radiation dose reduction and the possibility of the maintainability of the adequate image quality using various automatic exposure control (AEC) systems in multi-detector computed tomography (MDCT). We used three AEC systems for the study: General Electric Healthcare (Auto-mA 3D), Philips Medical systems (DoseRight) and Siemens Medical Solutions (Care Dose 4D). The general scanning protocol was created for the each examination with the same scanning parameters as many as possible. In the various AEC systems, the evaluation of reduced-dose was evaluated by comparing to fixed mAs with using human phantom. The image quality of the phantom was evaluated with measuring the image noise (standard deviation) by insert regions of interests. Finally, when we applied to AEC for three manufacturers, the radiation dose reduction decreased each 35.3% in the Auto-mA 3D, 58.2% in the DoseRight, and 48.6% in the Care Dose 4D. And, there was not statistical significant difference among the image quality in the Strong/Weak of the Care Dose 4D(P=0.269). This applies to variety of the AEC systems which will be very useful to reduce the dose and to maintain the high quality.

마우스를 이용한 송화분 섭취의 면역원성 및 안전성 탐색

김영옥(Young Ok Kim),김광호(Kwang Ho Kim),박현지(Hyun Ji Park),박영철(Yeong Chul Park),박성욱(Sung Wook Park),허용(Yong Heo) 한국독성학회 2005 Toxicological Research Vol.21 No.3

Pollen has been used for prevention or treatment of certain diseases such as diabetes, arthritis, or cancer in traditional medicine. Among various pollens, pine tree pollen is known to relieve hypertension, suppress fatty liver progression, and facilitate the digestion, but its immunological activities are less known. To evaluate immunological reactivities and immunotoxicities of pine tree pollen, BALB/c mice were administered to the pollen through oral route. Pine tree pollen suspended in distilled water or extracted with methanol has been administered at the concentration of 0, 10, or 100 ㎎/㎏, five days per week for four weeks. Polyclonal activation of splenic T cells with phytohemagglutinins did not induce a significant difference in IL-4 and IFNγ production between the pollenadministered mice groups and the control mice. Furthermore, polyclonal activation of splenic B cells with lipopolysaccharides did not result a significant difference in IgG1 and IgG2a production among the groups. These findings imply that the intake of pine tree pollen does not bring any humoral and cellular immune-dysregulation. Whereas, viability of Listeria monocytogenes was suppressed in the mice administered with 100 ㎎/㎏ bw methanol extract, indicating the potential ability of pine tree pollen to enhance cell-mediated immunity mediated by type-1 helper T cells. In addition, aberrant upregulation of plasma IgG1 level was observed in the pollen-administered mice, which suggests a possibility of allergic response induction through the pine tree pollen uptake. Overall, pine tree pollenmediated modulation of humoral or cellular immunity is worthy of further systematic investigation.

혈액 투석 환자에서 투석중 정맥압과 요소재순환율 측정에 의한 동정맥루 협착의 조기진단

김영옥(Young Ok Kim),전희경(Hui Kyung Jeon),박용근(Yong Kun Park),윤선애(Sun Ae Yoon),송하헌(Ha Hun Song),김남일(Nam Il Kim),김용수(Yong Soo Kim),김석영(Suk Young Kim),최의진(Euy Jin Choi),장윤식(Yoon Sik Chang),방병기(Byung Kee Bang 대한내과학회 1998 대한내과학회지 Vol.54 No.6

N/A Objectives: The most cammon cause of vascular access loss is thrombosis, usually caused by venous stasis associated with venous stenotic lesions. Therefore early detection of venous stenosis is very important. We studied the correlation of venous dialysis pressure and urea recirculation ratio to venous stenosis in chronic hemodialysis patients. Methods: Venous dialysis pressure and urea recirculation ratio were measured at extracoporeal blood flow of 200 ml/min thruugh 16 gauge needles within initial 30 minutes in 80 chronic hemodialysis patients. Venography was performed in patients with elevated venous dialysis pressure (>100 mmHg) or urea recirculation ratio (>15%), and if significant stenosis was found, venous dialysis pressure and urea recirculation ratio were reevaluated after percutaneous transluminal angioplasty (PTA). Results: Of the total 80 patients, 30 patients had elevated venous dialysis pressure or urea recirculation ratio. In patients with elevated urea recirculation ratio, venous dialysis pressure was high (102±21 mmHg vs 71±20 mmHg, P<0.001) and the past history of subclavian catheterization ipsilateral to fistula site was also high (39.1% vs 15.8%, P=0.02). There were no differences between two groups in terms of age, sex, diabetes mellitus, duration of hemodialysis, fistula site, and interneedle length. Of the total 27 patients undergone venography, 14 patients (51.9%) had venous stenosis. PTA was performed in 11 significant stenotic lesions in 5 patients and initial success rate of 91% was obtained, After PTA, urea recirculation ratios significantly decreased (16.7±5.9% vs 5.0±3.6%, P=0.01) and venous dialysis pressures slightly decreased without statistical significance (117.4±23.0 vs 99.0±8.9 mmHg, P=0.058). Conclusion: Venous dialysis and urea recirculation ratio seem to be active indicator of venous stenosis and outcome of subsequent percutaneous transluminal angioplasty in hamodialysis patients.

혈액 투석시 발생하는 저혈압에 대한 Amezinium Methylsulfate(Risumic)의 예방 효과에 대한 다기관 공동연구

김용수(Yong Soo Kim),방병기(Byung Kee Bang),김영옥(Young Ok Kim),송호철(Ho Chul Song),양철우(Chul Woo Yang),박정희(Jung Hee Park),박주현(Joo Hyun Park),김병수(Byung Soo Kim),박철휘(Cheol Whee Park),안석주(Suk Ju Ahn),최의진(Eui Jin C 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.1

N/A Background : Dialysis-induced hypotension is a very common but difficult complication to manage. Amezi-nium methylsulfate is a newly developed sympatho-mimetic agent which has been reported as effective in postural hypotension. We studied the preventive effect of amezinium methylsulfate on dialysis-induced hypo- tension in chronic hemodialysis patients. Methods: Twenty-five hemodialysis(HD) patients who were maintaining on hemodialysis longer than 3 months and had frequent episodes of dialysis hypoten-sion were enrolled in this study. After 4 weeks of observation period, patients received one tablet of ameziniurn 30 minutes prior to every hemodialysis session for 4 weeks. We com mean arterial pressure(MAP), number of hypotensive episodes and number of nursing interventions(defined as position change, bolus injection of saline or 50% dextrose in water, need to decrease transmembrane pressure or discon- tinuation of dialysis) between observation and medi-cation period in each patient. Results: The number of nursing interventions (mean, 2.5±0.9 interventions vs. 1.4±0.9 interventions, p<0.05) and hypotensive episodes(mean, 1.7±0.7 episodes per session vs. 0.9±0.7 episodes per session; p<0.05) decreased significantly in the medication period and the nadir MAP(57±13mmHg vs 70±15mmHg; p<0.05), mid-HD MAP(65±15mmHg vs. 79±15mmHg; p<0.05) and post-HD MAP(66±14mmHg vs 78±16 mmHg ; p<0.05) are higher in the medication period compared with observation period. Conclusion : These results show that amezinium methylsulfate is useful to prevent dialysis-induced hypotension in chronic hemodialysis patients.

혈액투석, 복막투석 : 투석 환자에서 발생한 급성 심근 경색증의 임상적 특징 분석

김영수 ( Young Soo Kim ),윤혜은 ( Hye Eun Yoon ),장세나 ( Se Na Jang ),김영옥 ( Yong Ok Kim ),신석준 ( Seok Jun Shin ),송호철 ( Ho Cheol Song ),윤선애 ( Sun Ae Yoon ),김용수 ( Yong Soo Kim ) 대한신장학회 2008 춘계학술대회 초록집 Vol.28 No.1

혈액투석 환자에서 발생한 폐렴의 임상적 특성에 관한 연구

김영수 ( Young Soo Kim ),김용환 ( Yong Hwan Kim ),송선화 ( Sun Wha Song ),윤선애 ( Sun Ae Yoon ),정병하 ( Byoung Ha Jung ),김길선 ( Gil Sun Kim ),김용수 ( Yong Soo Kim ),김영옥 ( Young Ok Kim ) 대한신장학회 2007 Kidney Research and Clinical Practice Vol.26 No.5

Purpose : The most common infectious diseases in hemodialysis (HD) patients are sepsis and pneumonia. Although there are many data about sepsis in HD patients, pneumonia in HD patients is rarely reported. This study was conducted to compare clinical severity of pneumonia between HD patients and healthy persons. Methods : This study enrolled 36 HD patients who were admitted for pneumonia. Age- and sex-matched 37 persons with pneumonia who did not have any other medical illness were included as a control. We compared clinical manifestations, laboratory and radiologic findings, complications, and clinical course between HD patients and controls. Results : The positive rates of blood and sputum bacterial culture in the HD patients were higher than in those in the controls (blood; 17.6% vs. 2.7%, p=0.028, sputum; 30.3% vs. 5.4%, p=0.005). Compared to the controls, the HD patients had higher incidence of thrombocytopenia (25.0% vs. 0%, p=0.001) and hypoxia (41.7% vs. 2.7%, p=0.000). The number of the lobes involved was larger and higher incidence of bilateral lesions and parapneumonic effusions were observed in the HD patients. In addition, the HD patients had higher incidence of recurrence than the controls (16.7% vs. 0%, p=0.025). Pneumonia-related mortality rate tended to be higher in the HD patients than the controls but there was no statistical differences between the two groups (11.1% vs. 0%, p=0.054). Conclusion : This study shows that pneumonia in HD patients takes a more severe clinical course than in healthy persons. It seems that pneumonia in HD patients has a higher propensity to develop bacteremia.

신장 ; 무증상의 고립성 혈뇨 환자에서 다검출기 CT로 진단된 방광암의 특성

윤혜은 ( Hye Eun Yoon ),김병수 ( Byung Soo Kim ),신영신 ( Young Shin Shin ),정현화 ( Jeong Hyeon Hwa ),김용균 ( Yong Gyun Kim ),신석준 ( Seok Jun Shin ),김영옥 ( Young Ok Kim ),송호철 ( Ho Cheol Song ),김용수 ( Yong Soo Kim ),최 대한내과학회 2009 대한내과학회지 Vol.77 No.3

목적: 현미경적 혈뇨는 건강검진이 일반화되면서 환자가 증가하고 있다. 최근 혈뇨의 원인 규명을 위한 단일검사 방법으로 신장, 요로, 방광을 동시에 조영하고 있는 다검출기 CT가 이용되고 있어 무증상의 고립성 혈뇨의 환자에서 MDCT를 이용하여 진단된 방광암의 유병율과 임상적 특성을 알아보고자 하였다. 방법: 본 연구는 2005년 3월부터 2008년 3월까지 고립성혈뇨로 가톨릭대학교 성가병원 신장내과와 비뇨기과 외래를 찾은 환자 1,819명을 대상으로 하여 그들의 임상적 특성을 알아보고 방광암으로 진단된 환자의 임상적 특성을 비교분석 하였다. 결과: 고립성 혈뇨로 MDCT를 시행한 환자는 1,819명으로 남자 564명(31%), 여성 1,255명(69%)이었고, 평균 연령은 47.2±16.8세였다. 전체 대상 환자 MDCT의 판독 결과는 정상소견(54.1%), 단순 신낭종(25.7%), 신결석(4.7%), 요로계악성종양(1.7%) 순이었다. 31명의 요로계 악성종양 환자 중방광암을 진단된 환자는 25명(1.3%)으로 이 중 남자는 20명(81%), 여성 5명(19%)이었으며, 방광암의 평균 연령은 74.5±7.3세였다. 방광암으로 진단된 25명의 환자의 경우 비종양환자에 비해 육안적 혈뇨, 연령, 남성의 비율 및 혈중크레아티닌 측정치과 높았으며(p<0.05), 혈색소과 알부민 측정치가 유의하게 낮았다(p<0.05). 전체 환자에서 육안적 혈뇨의 환자를 제외한 무증상의 현미경학적 혈뇨에서 방광암의 발생빈도 6명(0.3%)이었다. 결론: 무증상의 고립성 혈뇨 환자에서 MDCT 사용한 단일검사법이 유용한 수단으로 판단되나 특정한 임상양상을 가진 경우 적극적인 침습적 방법의 도입이 요구된다. Background/Aims: This report discusses the frequency and clinical characteristics of bladder cancer diagnosed with multi-detector computed tomography (MDCT) in outpatients visiting a nephrology and urology clinic with asymptomatic isolated hematuria. Methods: MDCT was performed on outpatients who presented to the nephrology and urology clinic at the Holy Family Hospital of the Catholic University of Korea with asymptomatic isolated hematuria from January 2005 to December 2007. Results: Of the 1,819 patients who underwent MDCT, the results were normal in 54.1%, showed a simple renal cyst in 25.7%, a renal calculus in 4.7%, and a malignant tumor of the urinary tract in 1.7%. Twenty-five patients (1.3%) were diagnosed with bladder cancer, including 20 (80%) men and 5 (20%) women. The average age of the patients with bladder cancer was 74.5±7.3 years. The 25 patients diagnosed with bladder cancer had a higher rate of gross hematuria, older age, and male gender (p<0.05) compared to the other patients. In addition, their hemoglobin and albumin levels were significantly lower (p<0.05). For all patients, the frequency of bladder cancer in those with asymptomatic microscopic hematuria, excluding those with gross hematuria, was extremely low (0.3%, 6 patients). Conclusions: MDCT may constitute an adequate diagnostic test for patients with asymptomatic hematuria. Older male patients with gross hematuria require a thorough urologic evaluation. (Korean J Med 77:328-332, 2009)

복막투석 환자에서 체액량 결정을 위한 Bioimpedance Analysis의 유용성

송호철 ( Ho Cheol Song ),주겨레 ( Kyu Re Joo ),홍유아 ( Yu Ah Hong ),이현정 ( Hyun Jeong Lee ),김용균 ( Yong Gyun Kim ),신석준 ( Seok Joon Shin ),김병수 ( Byung Soo Kim ),김영옥 ( Young Ok Kim ),김용수 ( Yong Soo Kim ),최의진 ( Eu 대한신장학회 2008 Kidney Research and Clinical Practice Vol.27 No.2

목적: 복막투석을 시행하는 말기신부전 환자에서 정확한 체액량의 결정과 조절이 고혈압의 치료에 필수적이다. 그러나 현재의 경험적 방법에 의한 건체중의 결정은 특이성과 감수성이 낮아 객관적인 방법이 필요한 상태이다. 본 연구는 복막 투석환자의 체액량 결정에 bioimpedance analysis (BIA)의 유용성 알아보기 위하여 시행하였다. 방법: 안정적으로 복막투석 중인 환자 32명을 대상으로 하여 24시간 생활혈압 (24 hours ambulatory blood pressure), ANP (atrial natriuretic peptide), PET (peritoneal equilibration test)를 시행하였고, 혈압을 기준으로 정상혈압군 (A군, 11명), 고혈압이 있으나 약물치료를 통해 평균혈압이 130/80 mmHg 이하로 조절되는 군 (B군, 9명), 그리고 2가지 이상의 약물투여에도 불구하고 평균혈압이 130/80 mmHg 이상인 군 (C군, 12명)으로 나누었고, 이들 환자를 대상으로 BIA를 시행하여 nECF (normalized Extracellular fluid: ECF/Height), ECF/ICF (Extracelluar fluid/Intracellular fluid ratio), ECF/TBW (Extracellular fluid/Total body water) 지표를 측정하고 그 결과를 비교하였다. 또한 측정치를 정상신기능을 가진 종합검진 환자에서 측정한 BIA의 결과와 비교하였다. 결과: 대상 환자의 평균 연령은 53±12세였고, 남녀 비 1:1.5이었으며, 평균 49±38개월 동안 복막투석을 받고 있었다. 본 연구의 대상에서 A군 (10.3±7.2 pg/mL), B군 (13.7±8.1 pg/mL)군에 비해 C군 (53.1±13.6 pg/mL)에서 ANP의 측정치가 유의하게 높았고 (p<0.05), BIA를 이용하여 측정한 nECF, ECF/ICF, ECF/TBW 각각의 측정치가 C군에서 A, B군에 비해 유의하게 높았으나 A군과 B군과는 유의한 차이를 보이지 않았다. 또한 정상신기능을 가진 대상에서 측정한 nECF, ECF/ICF, ECF/TBW 측정치는 A, B군과는 차이를 보이지 않았으나 C군에 비해 유의하게 낮게 측정되었다 (p<0.05). ANP의 측정치와 nECF, ECF/ICF, ECF/TBW의 경우 의미있는 상관관계를 보였다 (p<0.05). PET의 결과에 따른 ANP와 BIA 측정치는 의미있는 차이는 보이지 않았다. 결론: 안정적으로 복막투석중인 환자에서 BIA의 측정은 환자의 체액량의 상태를 예측할 수 있는 유용한 지표의 하나로 판단되며 향후 임상에서 적용을 위해 전향적 연구가 필요하다. Purpose: Determination of accurate body fluid is essential for treating hypertension in end stage renal disease patients undergoing dialysis. However, the determination of dry body weight based on clinical assessment has low sensitivity and specificity. This study was done in order to examine the usefulness of bioimpedance analysis in determining the volume of CAPD patients. Methods: Twenty-four hours ambulatory blood pressure and plasma concentrations of atrial natriuretic peptide (ANP) were measured and peritoneal equilibration test (PET) were obtained from 32 stable CAPD patients. Patients were divided into three groups; patients with normal blood pressure (group A, 11 people), and patients who have hypertension but controlled (under 130/80mmHg) with anti-hypertension medication (group B, 9 people), patients who have high blood pressure (over 130/80 mmHg) with 2 more anti-hypertension medication (group C, 12 people). We measured normalized extracellular fluid (nECF), extracelluar fluid/intracellular fluid ratio (ECF/ICF) and extracellular fluid/total body water (ECF/TBW) of each group by using bioimpedance analysis (BIA) and compared the results of each group. We also compared the values of nECF, ECF/ICF, ECF/TBW indices from patients with those from normal renal function people. Result: Thirteen men and nineteen women participated in this test. Their mean age was 53±12 years and mean duration of CAPD was 49±38 months. Among three groups, plasma ANP level in group C (53.1±13.6 pg/mL) was significantly higher than the level in group A (10.3±7.2 pg/mL) and B (13.7±8.1 pg/mL) (p<0.05). The values of nECF, ECF/ICF, ECF/TBW that measured by BIA in group C was significant higher than the values in group A and B, but the values in group A and B were not significant different. The values of nECF, ECF/ICF, ECF/TBW from patients with normal kidney function were not different from those of group A and B, but the values were significantly lower than the values in group C (p<0.05). Plasma ANP level was correlated with nECF, ECF/ICF, ECF/TBW (p<0.05) value. Plasma ANP and nECF, ECF/ICF, ECF/TBW was not influenced different PET result. Conclusion: BIA is considered as a useful standard to predict the volume status in CAPD patients. In the future, prospective studies are demanded for clinical application.

임상 연구 : 복막투석환자에서 복강 내 칼시트리올 충격요법의 부갑상선 호르몬 억제효과

송호철 ( Ho Cheol Song ),유선홍 ( Sun Hong Yoo ),정현화 ( Hyun Wha Jeong ),김용균 ( Yong Gyun Kim ),신석준 ( Seok Joon Shin ),김병수 ( Byung Soo Kim ),김영옥 ( Young Ok Kim ),김용수 ( Yong Soo Kim ),최의진 ( Euy Jin Choi ) 대한신장학회 2008 Kidney Research and Clinical Practice Vol.27 No.6

목적: 투석중인 말기신부전 환자에서 신성 골이양증은 중요 합병중에 하나이며 이의 치료를 위해 칼시트리올이 주로 사용되고 있다. 혈액투석의 경우 칼시트리올 정주요법이 많이 연구되고 임상에서 사용되고 있으나 복막투석 환자의 경우 정주요법의 한계로 인하여 정주요법 보다는 경구요법과 복강 내 주입이 임상에서 시도 되고 있다. 특히 복강 내 주사의 경우 경구요법의 대안으로 제시되고 있으나 아직 이에 대한 치료방법이 확립되지 않은 실정이다. 이에 본 연구에서는 복막투석중인 환자를 대상으로 하여 복강 내 칼시트리올 충격요법의 효과와 부작용의 발생빈도를 알아보고자 이 연구를 시행하였다. 방법: 2006년 1월부터 2007년 1월까지 가톨릭대학교 성가병원에서 6개월 이상 안정적으로 복막투석중이며 연구에 동의한 자를 대상으로 하였고, iPTH의 측정치가 300 pg/mL 이상의 환자를 대상으로 연구를 진행하였다. 대상환자는 한번에 2 ㎍씩 주 2회 복강내로 칼시트리올을 투여하였다. 연구기간 중 고칼슘혈증 (>10.5 mg/dL)과 고인산혈증 (>6.5 mg/dL)의 발생시 연구에서 제외하였다. 결과: 대상환자 18명중, 복막염과 고인산혈증으로 각각 1명이 연구에서 제외되었다. 대상환자의 원인질환은 당뇨병성 신증, 사구체신염, 고혈압증 신증이었다. 3개월간의 복강내 칼시트리올주입 후 iPTH측정치가 투여 전 (490±234 pg/mL)에 비해 3개월 투여 후 (318±315 pg/mL) 의미 있게 감소하였다 (p<0.05). 3개월 동안의 복강 내 투여기간 중 고칼슘혈증은 발생은 없었으며, 1명에서 고인산혈증의 발생으로 연구에서 제외되었다. 투여 후 30% 미만으로 iPTH가 감소한 군이 30% 이상 감소한 군에 (반응군에) 비해 투여 전 iPTH가 유의하게 높았다 (p<0.05). 결론: 복막투석 환자에서 발생한 이차성 부갑상선의 치료에 복강 내 칼시트리올 충격요법은 비교적 낮은 부작용의 빈도로 치료할 수 있는 수단이며 확립된 치료방법을 위해 보다 많은 전향적 연구가 필요하리라 사료된다. Purpose: In hemodialysis patients with secondary hyperparathyroidism, intravenous administration of calcitriol became widely utilized. In CAPD patients, however, the intravenous administration of calcitriol is not practical. The purpose of the present study was to determine the effect and safety of intraperitoneal (IP) calcitriol pulse therapy in CAPD patients. Methods: All patients undergoing CAPD between January 2006 and January 2007 and willing to give informed consent were eligible. Inclusion criteria were age greater 18 years, on CAPD for at least 6 months, and secondary hyperparathyroidism (intact PTH >300 pg/mL). Intraperitoneal calcitriol was given by direct infusion into the dialysate (2.0 ㎍) twice per week. If hypercalcemia (>10.5 mg/dL) and hyperphosphatemia (>6.5 mg/dL) developed, the patients were excluded from study. Results: Eighteen patients were enrolled into the study. Among them, 16 patients completed the study period. After IP calcitriol for 3 months, there was a significant drop of iPTH level from the pretreatment level of 490±234 pg/mL to the level of 318±315 pg/mL (p<0.05). There were no definite hypercalcemia during the study period, and only 1 patient was excluded from study due to hyperphosphatemia. Conclusion: In CAPD patients, IP calcitriol pulse therapy is effective in treating secondary hyperparathyroidism, and that IP calcitriol pulse therapy is associated with a low incidence of hypercalcemia and hyperphosphatemia.

애니메이션 〈파리의 딜릴리〉에 나타난 디지털 이미지 미학

김영옥(Kim, Young-Ok),서영주(Suh, Yong-chu) 한국만화애니메이션학회 2020 만화애니메이션연구 Vol.- No.61

미셀 오슬로는 아름다운 이야기와 영상미, 그리고 끊임없는 다양한 기술적 실험들로 자신만의 독특한 애니메이션 세계를 구축한 프랑스의 대표적 작가주의 감독이다. 그의 애니메이션 철학과 도전정신으로 이루어진 작품들은 끊임없이 애니메이션 영역에서 새로운 미학적 가능성을 제시하고 관객들에게 새로운 시각적 체험 영역의 스펙트럼을 넓혀주고 있다. 본 연구는 미셀 오슬로 감독의 이러한 독특한 스타일을 획기적으로 완성시킨 최근작 〈파리의 딜릴리〉(2018)의 디지털 이미지를 분석하고, 이 이미지들이 어떠한 미학적 의미를 지니는지를 분석해 보고자 한다. 이는 함축적 시간과 다층적 공간이라는 두 가지 측면을 기준으로 분류되고 분석된다. 사진이라는 친숙한 미디어 표상에서 출발하여 디지털 기술로 변형과 재가공을 거친 오슬로 감독의 이미지들은 기존 과거와 현재의 시간으로 얽혀있던 사진이라는 관습적 미디어와는 달리, 현재를 강화하고 미래적 가능성을 담아내는 표현적 표상으로써 역할 한다. 또 이를 비롯하여 전혀 다른 종의 캐릭터와 이질적인 표상 이미지들이 3차원 레이어에 중첩되어 비균질적이고 느슨한 다층적 공간 이미지로 관객에게 그대로 노출된다. 이 독특한 공간 이미지는 여러 연출법을 통해 새로운 차원의 조형적 상상력으로, 또 가능성의 공간으로 승화된다. 이러한 분석들을 통해 오슬로 감독의 디지털 이미지가 비단 단순한 리얼리티의 재현이 아닌, 디지털 시대에 새로운 미학적 가치들을 획득하고 있음을 밝히는 것이 본 연구의 주요 목표이다. 본 연구가 예술적인 면에서 평가절하 되어왔던 디지털 이미지의 가치와 가능성을 재발견할 수 있는 밑거름으로써 역할 할 수 있기를 기대한다. 또한, 몰입과 사실적 재현에 주로 집중된 주류 컴퓨터 애니메이션의 제작 및 연구 환경 속에서도 이러한 주류 애니메이션과는 조금 다른 방향으로 독자적인 길을 가고 있는 작가주의 감독과 그의 독특한 스타일을 새롭게 소개할 수 있는 좋은 계기가 될 수 있기를 바란다. Michel Ocelot is a French animation director who has built his own unique animation world through beautiful stories, visuals, and various technical experiments. The works made up of his animation philosophy and challenging spirit are constantly presenting new aesthetic possibilities in the animation field and expanding the spectrum of new visual experiences to the audience. This study aims to analyze the digital images of his recent work 〈Dilili in Paris〉 (2018), which completed this unique style of director Michel Ocelot, and analyze what aesthetic meaning these images have. It is classified and analyzed based on two aspects: implied time and multi-layered space. Starting from the familiar media representation of photography, the images of Ocelot who have been transformed and reprocessed with digital technology are expressions that reinforce the present and contain future possibilities, unlike the conventional media of photography. In addition, characters of a completely different style and images of heterogeneous representations are superimposed on a three-dimensional layer to expose the audience as a heterogeneous and loose multi-layered spatial image. This spatial image is sublimated into a new dimension of formative imagination and a space of possibilities through several directing methods. Through these analyzes, the aim of this study is to reveal that the digital image of Ocelot is not merely a representation of reality, but acquires new aesthetic values in the digital age. This study serves as a foundation for rediscovering the value and possibility of digital images, which have been devalued in terms of art. In addition, I hope that this will be a good opportunity to introduce a new style and value of Michel Ocelot in Korea.