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.

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.

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.

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.

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.

DSP를 이용한 가라오케용 고음질 멀티채널 오디오 시스템

김태훈,박양수,신경철,박종인,문태정,Kim, Tae-Hoon,Park, Yang-Su,Shin, Kyung-Chul,Park, Jong-In,Moon, Tae-Jung 한국음향학회 2009 韓國音響學會誌 Vol.28 No.1

본 논문에서는 멀티채널 라이브 가라오케의 구현에 관한 내용을 담고 있다. TI사의 32비트 floating 연산 DSP인 TMS320C6713를 이용하여 6 채널의 MP3 복호화 및 템포/키 변환을 실시간으로 구현하였다. 6채널은 전면 L/R 악기, 후면 L/R 악기, 멜로디, 우퍼로 구성되며, 4 채널로 동작 시에는 후면 L/R 대신 드럼 L/R이 추가될 수 있다. 최종 출력 데이터는 5.1 채널 스피커에 맞춰서 출력된다. 템포 변환을 위하여 SOLA알고리즘을 적용시켰으며 시간영역에서 인터폴레이션(interpolation)과 데시메이션 (decimation)으로 키 변환을 수행하였다. 드럼 악기가 추가될 경우에는 일반악기와 분리하여 키 변환 시에 드럼 채널을 제외시키고, SOLA (Synchronized Overlap and Add) 수행 시에도 SOLA처리 단위인 프레임 사이즈를 다르게 두어 고음질의 템포 변환이 가능하도록 하였으며, 실시간 처리를 위하여 최적화를 하였다 6 채널을 이용하여 다양한 채널 구성이 가능하며 본 논문의 멀티채널 오디오 시스템은 고음질의 라이브 반주가 필요한 어느 곳에서나 효과적으로 적용될 수 있다. This paper deals with the realization of multi-channel live karaoke. In this study, 6-channel MP3 decoding and tempo/key scaling was operated in real time by using the TMS320C6713 DSP, which is 32 bit floating-point DSP made by TI Co. The 6 channel consists of front L/R instrument, rear L/R instrument, melody, and woofer. In case of the 4 channel, rear L/R instrument can be replaced with drum L/R channel. And the final output data is generated as adjusted to a 5.1 channel speaker. The SOLA algorithm was applied for tempo scaling, and key scaling was done with interpolation and decimation in the time domain. Drum channel was excluded in key scaling by separating instruments into drums and non-drums, and in processing SOLA, high-quality tempo scaling was made possible by differentiating SOLA frame size, which was optimized for real-time process. The use of 6 channels allows the composition of various channels, and the multi-channel audio system of this study can be effectively applied at any place where live music is needed.

오덕환(五德丸)과 사신환(四神丸)의 항산화 및 항염증 효과

김태훈,조현진,박선동,Kim, Tae-Hoon,Cho, Hyun-Jin,Park, Sun-Dong 대한한의학방제학회 2012 大韓韓醫學方劑學會誌 Vol.20 No.2

Objectives : The aim of this study was verification of the anti-oxidative and anti-inflammatory effects of Odukhwan(ODH) and Sasinhwan(SSH) in mouse macrophage, RAW264.7 cells. Methods : To investigate the anti-oxidative effect and scavenging activities of DPPH radical, superoxide anions, nitric oxide and peroxynitrite were measured. Cytotoxic activity of extract of ODH and SSH on RAW264.7 cells was measured using MTS assay. To proof the reductive activity of intracellular oxidation, DCFH-DA assay was performed. The nitric oxide(NO) production was measured and pro-inflammatory cytokines and $PGE_2$ were measured by ELISA kit. The levels of inducible nitric oxide synthase(iNOS), cyclooxygenase-2(COX-2) and nuclear NF-${\kappa}B$ p65 expression were detected by western blot. Results : After those analyses, we bring to a conclusion as follows. Both herbal formulations scavenged DPPH radical and nitric oxide. But ODH had no scavenging activity of superoxide anions and SSH had low scavenging activity in peroxynitrite. And the results indicated that ODH and SSH inhibited the LPS-induced NO, $PGE_2$ production and iNOS, COX-2 expression accompanied by an attenuation of IL-$1{\beta}$ and IL-6 production in RAW264.7 cells. They also have suppression effects of LPS-induced NF-${\kappa}B$ activation. Conclusions : ODH and SSH have anti-oxidative and anti-inflammatory effects and they may be a part of database for development of new anti-oxidative and anti-inflammatory drugs.

물량저감 철근상세를 갖는 중공 철근콘크리트 교각 시스템: I. 개발 및 검증

김태훈,이재훈,신현목,Kim, Tae-Hoon,Lee, Jae-Hoon,Shin, Hyun-Mock 한국지진공학회 2014 한국지진공학회논문집 Vol.18 No.1

The purpose of this study was to investigate the performance of hollow reinforced concrete bridge column systems with reinforcement details for material quantity reduction. The proposed reinforcement details have economic feasibility and rationality and make construction periods shorter. A model of hollow reinforced concrete bridge columns was tested under a constant axial load and a quasi-static cyclically reversed horizontal load. As a result, proposed reinforcement details for material quantity reduction were equal to existing reinforcement details in terms of required performance. The companion paper presents the experimental and analytical study for the performance assessment of hollow reinforced concrete bridge column systems with reinforcement details for material quantity reduction.

생산성 및 비용 분석을 통한 철골 구조체 건설 자동화 시스템의 요구성능 분석

김태훈,이웅균,조훈희,강경인,Kim, Tae-Hoon,Lee, Ung-Kyun,Cho, Hun-Hee,Kang, Kyung-In 대한건축학회 2012 대한건축학회논문집 Vol.28 No.1

Automated building construction systems are currently being employed as an effective alternative for the recent aging of the workforce and the lack of skilled labor. In order to apply such systems effectively in building construction process, the influence on overall construction process by the systems should be examined in the developing phase. Moreover, appropriate performance criteria for the systems should be determined based on the aspect of cost-effectiveness. Therefore, this study analyses performance criteria of an automated building construction system for steel framework by using a simulation technique, CYCLONE, and economic feasibility analysis in order to developing and employing the system efficiently. The study targets the steel girder installation process through a manless steel frame and joint method and bolting robot which is developed by the robot-based construction automation (RCA) group in Korea. The result shows that the manless steel frame and joint method leads substantial productivity improvement for the steel girder installation process by the reduction of loads for resources. In addition, considering productivity and costs of the system on overall process, the maximum permissible capital cost for the bolting robot increases dramatically when a cycle time of the robot ranges from 320 to 440 seconds. The results of this study will help develop cost-efficient system, and serve as a decision support model for appropriate resource inputs of the construction automation method.

물량저감 중공 철근콘크리트 교각의 설계프로그램과 경제성 평가

김태훈,손윤기,양남석,이승훈,Kim, Tae-Hoon,Son, Yun-Ki,Yang, Nam-Seok,Lee, Seung-Hoon 한국전산구조공학회 2014 한국전산구조공학회논문집 Vol.27 No.5

This paper presents special-purpose design program and plastic design results for hollow RC bridge columns with reinforcement details for material quantity reduction. The developed reinforcement details has economic feasibility and rationality and makes construction periods shorter. This study documents the economic evaluation of hollow reinforced concrete bridge column systems with reinforcement details for material quantity reduction and presents conclusions based on the application findings. As a result, the proposed reinforcement details for material quantity reduction were designed prior to the existing reinforcement details in terms of structural rationality, constructability, and economic. 이 연구에서는 물량저감 철근상세를 갖는 중공 철근콘크리트 교각 시스템의 전용 설계프로그램과 소성설계 적용 결과를 제시하였다. 개발된 물량저감 철근상세는 경제성과 합리성을 갖으며 공사기간의 단축을 가져올 수 있다. 물량저감 중공 철근콘크리트 교각의 적용을 통해 경제성 평가를 수행하였다. 평가 결과 개발상세가 기존상세에 비해 구조적 합리성, 시공성, 그리고 경제성 등이 우수함을 확인하였다.