중환자실 환자에서 발생한 급성 하부 장관 출혈의 진단과 치료에 병상 대장내시경의 유용성

박종하 ( Jongha Park ),예병덕 ( Byong Duk Ye ),이재근 ( Jae Keun Lee ),양동훈 ( Dong Hoon Yang ),윤순만 ( Soon Man Yoon ),김경조 ( Kyung Jo Kim ),변정식 ( Jung Sik Byeon ),명승재 ( Seung Jae Myung ),양석균 ( Suk Kyun Yang ),김진호 대한장연구학회 2009 Intestinal Research Vol.7 No.2

Background/Aims: Most studies on acute gastrointestinal (GI) hemorrhage of intensive care unit (ICU) patients have focused on upper GI hemorrhage (UGIH), but reports on acute lower GI hemorrhage (LGIH) with the role of bedside colonoscopy are still lacking. Therefore, we determined the clinical characteristics of acute LGIH in ICU patients and the efficacy of bedside colonoscopy in ICU setting. Methods: We reviewed the medical records of 76 ICU patients who underwent bedside colonoscopy for acute LGIH between January 2005 and December 2007. The clinical characteristics of the patients, the outcomes of colonoscopy, and the clinical course after colonoscopy were investigated. Results: Of 76 patients, 43 patients (56.6%) were males and the median age was 67 years. End-stage renal diseases were the most common underlying diseases, followed by cardiovascular diseases. Cecal intubation was possible in 18 patients (23.7%) and bleeding foci were identified in 41 patients (53.9%). The two main causes of bleeding were rectal ulcers (48.8%) and ischemic colitis (22.0%). Endoscopic treatments were successful in 12 patients (15.8%), and there was only 1 case of rebleeding after 7 days. There were no severe complications associated with bedside colonoscopy; 3 patients (3.9%) died of uncontrolled LGIH during hospital period. Conclusions: Bedside colonoscopy is effective and safe for the diagnosis of acute LGIH in ICU patients. In addition, endoscopic treatment can be successfully performed in select patients. Therefore, in acute LGIH of ICU patients, bedside colonoscopy can be performed as a first-line procedure. (Intest Res 2009;7:86-92)

염증성 장질환 환자의 치료에 대한 주관적인 필요와 생각: Q 방법론 적용

박용은 ( Yong Eun Park ),이진 ( Jin Lee ),박종하 ( Jongha Park ),최준혁 ( Joon Hyuk Choi ),허내윤 ( Nae Yun Heo ),박승하 ( Seung Ha Park ),이윤경 ( Yoon Kyoung Lee ),김태오 ( Tae Oh Kim ) 대한소화기학회 2021 대한소화기학회지 Vol.78 No.1

Background/Aims: Inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, is a chronic inflammatory disorder of the gastrointestinal tract that requires lifetime management. Many studies have attempted to establish questionnaires and/or parameters to assess the quality of care for IBD patients. However, no study to date has investigated patients using the Q-methodology, which is subjective and has been studied systematically, to identify and categorize their opinions and subjective thinking about their disease and treatment. We have therefore aimed here to conduct a preliminary study of the Q-methodology to investigate the subjective thinking of IBD patients in Korea. Methods: Q-methodology, a method of analyzing the subjectivity of questionnaire items, was examined in this study. Inputs from 50 IBD patients were classified into 34 normalized statements using a 9-point scale with a normal distribution. The collected data were analyzed using the QUANL PC program. Results: Using the Q-methodology, IBD patients were classified into type I, II, III, and IV treatment needs: medical staff-dependent, relationship-oriented, information-driven, and social awareness, respectively. Conclusions: The subjective needs of IBD patients and their thoughts about the treatment can be classified into four types. Our findings suggest that we can establish a systematic strategy for personalized care according to patient type. (Korean J Gastroenterol 2021;78: 37-47)

증례 : 소화기 ; 폐전이 및 뼈전이를 동반한 십이지장 혈관육종

박재현 ( Jae Hyun Park ),박종하 ( Jongha Park ),김민성 ( Min Sung Kim ),유종원 ( Jong Won Yu ),전기정 ( Gi Jung Jeon ),임성남 ( Sung Nam Lim ),김우경 ( Woo Gyeong Kim ) 대한내과학회 2015 대한내과학회지 Vol.89 No.2

An angiosarcoma is a rare soft-tissue neoplasm that develops anywhere in the body, and most commonly presents cutaneously in elderly white males, involving the head and neck, particularly the scalp. The neoplasm occurs only very rarely in the gastrointestinal tract. A patient was initially admitted to our hospital for treatment of dyspnea and hemoptysis. Both lungs contained multiple nodules, and a computed tomography (CT)-guided lung biopsy was performed. Endogastroduodenoscopy used to evaluate the anemia revealed a duodenal polypoid tumor. Microscopic examination showed that the tumor was a primary angiosarcoma of the duodenum with metastasis to the lung. In addition, positron emission tomography/CT revealed metastasis to the femur and the pelvic bone. Thus, we report a case of primary duodenal angiosarcoma with metastases to the lung and bone. (Korean J Med 2015,89:201-205)

범죄연구에 있어 가변적 공간단위 문제(MAUP)의 스케일효과 검증

정진성(Jinseong Cheong),박종하(Jongha Park) 한국콘텐츠학회 2015 한국콘텐츠학회논문지 Vol.15 No.10

본 연구는 지역사회 차원의 범죄연구에 있어 분석단위의 규모에 따라 결과가 달라지는 MAUP의 스케일 효과를 검증하고자 했다. 특히, 국내 최초로 전국의 모든 읍면동과 시군구를 대상으로 최근 이슈의 중심에 서있는 성범죄에 대한 공간적 자기상관, 변수들 간의 상관관계, 인과관계 분석을 시도했다. 분석 결과, 성범죄율의 자기상관은 가설과 달리 시군구의 Moran’s I가 읍면동보다 큰 반면, 상관계수와 회귀분석의 결정계수는 가설에 맞게 대부분 시군구에서 더 큰 것으로 드러났다. 이는 합역수준이 높아질수록 자료의 통합으로 인해 발생하는 평균효과 때문으로 사료되었다. 성범죄의 원인에 대해서는 두 가지 특이한 점이 발견되었는바, 첫째, 비아파트거주비율이 읍면동과 시군구 단위에서 모두 성범죄를 감소시켰고, 둘째, 숙박음식업비율은 읍면동 단위에서만 성범죄를 증가시키는 것으로 드러났다. 이는 향후 지역특성(예, 도시 vs. 시골, 풍요지역 vs. 빈곤지역)에 따른 세부적인 분석과 독립변수가 분석 단위별로 갖는 차별적 의미에 대한 추가적인 연구가 필요함을 시사한 결과였다. 본 연구가 지역사회 범죄연구를 촉진하고 성범죄에 대한 효과적인 대안 마련에 기여할 수 있기를 바란다. This study attempted to test the scale effect of MAUP, particularly focusing on the spatial autocorrelation of sex crime, correlations among neighborhood structural variables, and causal mechanism leading to sex crime. Analysis results of nation-wide Eup-Myon-Dong and Si-Gun-Gu data discovered that the spatial autocorrelation, correlations among independent variables, and determinant coefficient of multiple regression of Si-Gun-Gu level were generally bigger and stronger than those of Eup-Myon-Dong, which appeared to be due to the averaging effect. Regarding the causal effect to sex crime, two interesting results were found: First, the ratio of non-apartment residency lowered sex crime at both levels contrary to the hypothesis. Second, the ratio of food and lodging increased sex crime only at Eup-Myon-Dong level. These suggested that future research need to perform more detailed analyses dividing data into subsets such as urban vs. rural and/or economically advantaged vs. disadvantaged areas.

대규모유통업법의 적용 범위에 관한 고찰 - 대규모유통업법의 입법 취지를 중심으로 -

김정헌 ( Kim Junghun ),박종하 ( Park Jongha ),김규식 ( Kim Kyusik ),김영석 ( Kim Youngseok ),김윤수 ( Kim Yunsoo ) 한국유통법학회 2020 유통법연구 Vol.7 No.2

대규모유통업법은 공정거래법상 거래상 지위 남용행위에 대한 특별법임을 감안하여 대규모유통업자가 거래상 우월적 지위를 가지지 않는 거래에 대하여는 대규모유통업법을 적용하지 않도록 규정하였다. 그런데, 최근 공정거래위원회 및 법원은 대규모유통업법상 대규모유통업자에 해당하기만 하면 실질적으로 납품업자에 대하여 거래상 우월적 지위를 가지고 있는지에 대한 심도 있는 검토 없이 그대로 대규모유통업법을 적용하는 경향을 보이고 있다. 그러나, 대규모유통업법이 대규모유통업자와 납품업자 간의 사법상의 권리관계에 제한을 가하는 것으로서 본질적으로 사적 자치의 한계 내지 예외에 해당한다는 점, 공정거래법상 거래상 지위 남용행위의 특별법으로서 강력한 규제가 부과된다는 점 등에 비추어보면, 그 적용 범위를 엄격하게 해석 및 운용할 필요가 있다. 현실적으로 규제당국이 각 납품업자와 대규모유통업자간의 거래상 지위를 일일이 판단하는 것이 어렵다면, 일정한 매출액 규모 요건 등 보다 객관적인 기준을 통해 누가 보더라도 대규모유통업법 적용 대상인지 여부를 쉽게 판단할 수 있도록 개선할 필요가 있다. 한편, 대규모유통업법은 일정 규모 이상의 가맹본부에 대해서도 대규모유통업자로 간주하고 있다. 그러나, (ⅰ) 대규모유통업법은 기본적으로 백화점, 대형마트 등 거래상 지위를 가진 소매업자의 중소 납품업자나 임차인에 대한 불공정거래행위를 규제하는 것을 그 목적으로 하는 법률이어서 도매업자에 가까운 가맹본부에 대해서까지 적용하는 것이 타당한지에 대한 의문이 있다는 점, (ⅱ) 가맹본부에 대규모 유통업법을 적용함으로써 가맹본부로 집결된 협상력을 제한한 결과, 공동구매에 따른 협상력 제고라는 가맹사업의 본질을 해하고 결과적으로 가맹점사업자 보호에 역행한다는 점, (ⅲ) 특히 편의점 가맹본부의 경우 전체 구매 상품 중 67~90%에 이르는 상품을 대기업으로부터 구매하는바, 대규모유통업법으로 인하여 영세한 가맹점사업자보다 오히려 대기업인 납품업자를 보호하게 되는 불합리한 결과가 초래 된다는 점 등에 비추어보면, 관련 규정을 개정할 필요성이 인정된다. 즉, 가맹본부를 대규모유통업법 적용 대상인 대규모유통업자의 범위에서 제외하는 방안을 적극 검토할 필요가 있다. 아울러, 최근 대규모유통업법 개정으로 인해 유통업자가 아닌 부동산 임대사업자에 대하여도 대규모유통업법이 적용되게 되었는바, 이는 대규모유통업자를 규제하는 대규모유통업법의 취지에 부합하지 않고, 상가임대차법과 중복된 이중적 규제라는 등의 문제점이 있으므로 이러한 규제를 유지할 것인지에 대하여도 신중한 검토가 필요하다고 생각된다. The Act on Fair Transactions in Large Retail Business (hereinafter the Large Retail Act) shall not apply to a transaction which is not deemed to give a large retailer a superior bargaining position over a supplier (Article. 3.1.). Nonetheless, recently, the Korea Fair Trade Commission and courts tend to apply the Large Retail Act directly to a certain retail business entity without an in-depth analysis of whether it has actually superior bargaining position over a supplier as long as it is a large retailer under the Large Retail Act However, considering that the Large Retail Act is essentially an exception to principle of private autonomy and it substantially regulates the business activities of large retailer, it is necessary to narrowly interpret the scope of a large retailer. In particular, the Large Retail Act stipulates that the franchisers of a certain size or larger also fall within the scope of a large retailer. However, considering the following, it is highly recom- mended to revise the relevant regulations;(ⅰ) the purpose of the Large Retail Act is basically to regulate the abuse of market dominance or unfair trade practices by large retailers, such as department stores and supermarket. (ⅱ) If the bargaining power aggregated into the franchiser is limited by applying the Large Retail Act to the franchiser, the nature of the franchise business, which is enhancing franchisee's bargaining power by purchasing jointly will be undermined and consequently the protection of franchisees will be impaired;(ⅲ) especially, since convenience store franchisers purchase 67 to 90 percent of the total purchased goods from large companies, the application of the Large Retail Act to franchiser results in unfairly protecting the large suppliers more than the franchisees, which are much smaller than the large suppliers. In order to solve these problems, it is desirable to establish sales volume requirements to determine whether to apply the Large Retail Act, and furthermore, exclude the franchiser from the scope of a large retailer which is subject to the Large Retail Act. Meanwhile, due to the recent revision, the Large Retail Act also applies to real estate rental businesses, which is not distributor. This is not consistent with the objective of the Large Retail Act, which regulates a large retailer, and causes overlapping regulations between the Commercial Building Lease Protection Act and the Large Retail Act. Therefore, a careful consideration is also required on whether to maintain this regulatory framework.

CRW형식 무인항공기 추진시스템의 밸브 작동을 고려한 비행모드 전환에 따른 천이 성능특성 연구

공창덕(Changduk Kong),박종하(Jongha Park),양수석(Sooseok Yang) 한국추진공학회 2005 한국추진공학회지 Vol.9 No.3

유육종증과 저나트륨혈증이 병발한 1예

이주원 ( Ju Won Lee ),박종하 ( Jongha Park ),박승현 ( Seung Hyeon Park ),이주형 ( Juhyoung Lee ),박종화 ( Jong Hwa Park ),김지연 ( Ji Yeon Kim ) 대한내과학회 2016 대한내과학회지 Vol.91 No.3

Syndrome of inappropriate antidiuretic hormone secretion (SIADH), the most common cause of euvolemic hyponatremia, results from the inappropriate release of antidiuretic hormone. SIADH may be caused by a variety of malignant tumors, central nervous system (CNS) disorders, intrathoracic disorders, and pharmacological agents. We experienced a case of SIADH associated with sarcoidosis that involved the lungs and mediastinal lymph nodes. A 72-year-old male was admitted to hospital with epigastric and back pain. Laboratory tests showed hyponatremia and low serum osmolality, while the urine sodium concentration and urine osmolality were inappropriately high. A chest x-ray and computed tomography showed mediastinal lymph node enlargement, and a mediastinoscopic lymph node biopsy revealed a noncaseating granuloma. Brain magnetic resonance imaging showed no evidence of CNS sarcoidosis. Systemic corticosteroid therapy improved the observed mediastinal lymph node involvement, and tolvaptan as an SIADH treatment corrected the patient`s abnormal sodium level and restored the laboratory findings to normal. (Korean J Med 2016;91:296-299)

다중노즐 전기방사공정을 이용한 PCL/HA 나노섬유 제작

김지웅(Jiwoong Kim),박종하(Jongha Park),윤현(Hyun Yoon),손준곤(Jungon Son),박고은(Koeun Park),박수아(Sua Park),김완두(Wandoo Kim) 대한기계학회 2008 대한기계학회 춘추학술대회 Vol.2008 No.5

Electrospinning is the process using electrical charge to distort a pendant droplet of polymer solution into a fine fiber to be deposited onto a target substrate. The merits of electrospinning are the fiber fabrication of small diameter and good mechanical properties. This means the nanofiber formation with high surface area to volume ratio and the ability to control pore size. Nanometer-diameter nanofibers have the potential applications of filter membranes, biomedical device, wound dressing materials, artificial organs, nanoelectronics, nano-composites, and protective clothing. To fabricate the uniform thickness and oriented morphology of PCL/HA nanofiber, multi-nozzle spinnerets were manufactured with rotatable grounded target collector in this study. We measured SEM observation, mechanical property, and contact angle of PCL/HA nanofiber.

대장 점막을 침범한 피부 병변이 없는 Blastic Plasmacytoid Dendritic Cell Neoplasm 1예

최현주 ( Hyun Ju Choi ),박종하 ( Jongha Park ),이진 ( Jin Lee ),김미령 ( Mi Young Kim ),정희정 ( Heui Jeong Jeong ),이지운 ( Ji Woon Lee ),김보미 ( Bomi Kim ) 대한내과학회 2018 대한내과학회지 Vol.93 No.5

BPDCN은 드문 혈액종양으로 80%에서 피부 병변을 동반 한다. 피부 병변을 동반하지 않는 BPDCN은 이전 문헌 고찰에 따르면 폐침범, 연부 조직 종괴 등으로 내원하여 경피적 조직 검사로 진단된 경우가 대부분이다. 저자들은 피부 병변을 동반하지 않은 BPDCN을 대장 내시경을 통한 조직 검사와 해당 임파선의 조직 검사를 통하여 진단한 증례를 보고 한다. Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a relatively rare hematological malignancy, and most cases present with characteristic skin lesions. The skin lesions appear as nodules, plaques, and bruise-like macules with redness or ulcerations. BPDCN without skin lesions is rare. Cases with hepatosplenomegaly, pulmonary involvement, multiple lymphadenopathies, renal masses, sinonasal sinus, and subcutaneous masses have also been reported. Here, we report the first case of ileocecal valve involvement of BPDCN without skin lesions. (Korean J Med 2018;93:487-492)

시각장애인을 위한 터치 기반 공간적 스크린 리더

정대헌(Daeheon Jeong),김용현(Yonghyeon Kim),박종하(Jongha Park),조명재(Myeongjae Cho) 한국정보과학회 2022 한국정보과학회 학술발표논문집 Vol.2022 No.12