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박태익 ( Tae Ik Park ),김표준 ( Pyo Jun Kim ),김광하 ( Gwang Ha Kim ),강대환 ( Dae Hwan Kang ),송근암 ( Geun Am Song ),김영규 ( Young Kyu Kim ),이호석 ( Ho Seok I ) 대한내과학회 2008 대한내과학회지 Vol.75 No.4
저자들은 내원 2일 전 갑자기 발생한 삼킴 곤란, 흉부 불쾌감으로 내원한 환자에서 출혈이 합병된 식도 중복 낭종을 진단하고, 성공적인 절제술 후 특별한 부작용 없이 회복한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Esophageal duplication is a rare congenital disorder. Although infrequent, complications such as infection, bleeding, and perforation have been reported. Surgical resection is the standard treatment for esophageal duplication cysts. We report the case of a 45-year-old female with an esophageal duplication cyst that presented with dysphagia, with a review of the literature.(Korean J Med 75:444-448, 2008)
강진 ( Jin Kang ),안성규 ( Sung Gyu An ),김표준 ( Pyo Jun Kim ),박태익 ( Tae Ik Park ),김일두 ( Il Du Kim ),김도훈 ( Do Hoon Kim ),김태오 ( Tae Oh Kim ),김광하 ( Gwang Ha Kim ),강대환 ( Dae Hwan Kang ),송근암 ( Geun Am Song ),김익두 대한소화기기능성질환·운동학회 2007 Journal of Neurogastroenterology and Motility (JNM Vol.13 No.1
Barrett`s esophagus is characterized by a change in the esophageal epithelium, of any length of the esophagus, and this can be recognized via endoscopy and confirmed by the presence of intestinal metaplasia and goblet cells on biopsy from the lower esophagus. It is a premalignant lesion of adenocarcinoma of the esophagus. Barrett`s esophagus is classified as long when it presents as a segment of columnar epithelium longer than 3 cm, and as short when it is shorter than 3 cm. The prevalence of Barrett`s esophagus is low and its malignant change is rare. We report here on a case of esophageal adenocarcinoma that developed from a short segment Barrett`s esophagus, and this was treated by proximal gastrectomy. (Kor J Neuro-gastroenterol Motil 2007;13:68-71)
급성 심근경색증에서 관상동맥 중재술시 발생하는 reflow disturbance 현상의 위험인자
안성규 ( Sung Gyu An ),오준혁 ( Jun Hyok Oh ),박태익 ( Tae Ik Park ),이상현 ( Sang Hyun Lee ),장형하 ( Hyung Ha Jang ),이동원 ( Dong Won Lee ),하재경 ( Jae Kyung Ha ),이한철 ( Han Cheol Lee ),김준 ( Jun Kim ),김준홍 ( June Hong K 대한내과학회 2008 대한내과학회지 Vol.74 No.1
목적: Reflow disturbance 현상은 급성 심근경색증으로 관상동맥 중재술을 받는 환자의 예후를 악화시키는 중요한 요인이다. 본 연구는 급성 심근경색증 환자에게 스텐트를 이용한 경피적 관상동맥 중재술을 시행할 경우 reflow disturbance 현상의 발생빈도와 위험인자를 분석하고자 하였다. 방법: 2003년 2월부터 2005년 6월까지 급성 심근경색증으로 부산대학교병원을 방문하여 경피적 관상동맥 중재술을 성공적으로 받은 475명의 환자를 대상으로 연령, 성별, 흡연, 당뇨, 고혈압의 병력, 심전도 기록, 혈액학적 검사 그리고 관상동맥조영술 소견을 후향적으로 분석하였다. 결과: 475명의 대상 환자 중 86.3%인 410명에서 정상적인 혈류가 관찰되었으며(normal flow 군), 13.7%인 65명에서 reflow disturbance 현상이 관찰되었다(reflow disturbance 군). 재관류 시간이 142시간 이후에서는 reflow disturbance 현상이 관찰되지 않았다. 재관류 시간이 142시간 이내인 경우를 대상으로 다변량 분석을 시행한 결과, 연령(OR=1.03, 95% CI 1.01~1.06, p=0.020), 낮은 수축기 혈압(OR=0.98, 95% CI 0.97~0.99, p=0.026) 그리고 혈전이 있는 경우(OR=2.27 95% CI 1.08~4.79, p=0.031)가 reflow disturbance 현상의 유의한 독립적 위험인자였다. 결론: 급성 심근경색증으로 관상동맥 중재술을 받는 환자에서 고령, 낮은 수축기 혈압 그리고 혈전의 존재가 reflow disturbance 현상의 독립적인 위험인자로, 이러한 요인을 가진 경우는 시술시 주의가 필요하리라 사료된다. Background/Aims: The reflow disturbance phenomenon is associated with poor functional and clinical outcomes for patients suffering with acute myocardial infarction (AMI). In the era of primary coronary intervention (PCI), accurately identifying those lesions that are at a high risk of no-reflow is of crucial importance. Therefore, we investigated the risk factors of the reflow disturbance phenomenon in AMI patients who underwent PCI. Methods: From February 2003 to June 2005, the clinical and angiographic characteristics of 475 patients who had undergone PCI were reviewed retrospectively. Results: 65 patients (13.7%) showed the reflow disturbance phenomenon and the reperfusion times of the reflow disturbance group ranged from 1 hour to 142 hours. On univariate analysis, an older age (p<0.001), low systolic blood pressure (p=0.01), no thrombolysis followed by PCI (p<0.001), primary PCI (p<0.001), less time to PCI (p=0.001), a high peak serum CK-MB level (p=0.013), angiographically visible thrombus (p=0.016), a low pre-TIMI grade (p=0.021) and ST segment elevation on the ECG (p=0.002) were the significant risk factors of the reflow disturbance phenomenon. An older age, a low systolic BP and angiographically visible thrombus were significant risk factors on multivariate analysis. Conclusion: An older age, low systolic blood pressure and angiographically visible thrombus were the independent risk factors for the reflow disturbance phenonmenon in AMI patients who undergo PCI. (Korean J Med 74:16-22, 2008)
능동형 엔진 마운팅 시스템 성능 평가를 위한 6축 시뮬레이터 구축
김정훈(Jeong-Hoon Kim),김재산(Jae-San Kim),이한동(Handong-Lee),박태익(Tae-Ik Park) 한국소음진동공학회 2011 한국소음진동공학회 학술대회논문집 Vol.2011 No.4
As worldwide concern stands on global warming and greenhouse gases from internal combustion engine, the interests in technologies for a highly efficient powertrain has been increased. Concurrently the investigation to improve the deteriorated NVH, a by-product of energy efficient powertrain, is conducted seriously. The NVH performance of a new type of active engine mount that offers increased advantages over a passive hydraulic mount is examined using a newly developed 6-DOF simulator. The simulator is in the shape of Hexapod Stewart Platform adopting LEMA, a new type of actuator which is patented and commercialized by ACT Inc,, the world wide leader in the design, development, and manufacture of high performance linear electro-magnetic actuators for active vibration control. The target vibration signals of an aimed vehicle at four engine mounts are measured and simulated by 6-DOF simulator at the laboratory. The resulting NVH performances of the new active mounting system at a vehicle and on a simulator are examined and compared. Even though the active mount performance of lab test demonstrates less effective than the result of a real vehicle test, vibration reduction is identified through the simulator.
6축 시뮬레이터를 활용한 능동형 엔진 마운팅 시스템 개발
김정훈(Jeong-Hoon Kim),김재산(Jae-San Kim),심재호(Jae-Ho Shim),박태익(Tae-Ik Park) 한국자동차공학회 2011 한국자동차공학회 부문종합 학술대회 Vol.2011 No.5
The NVH performance of a new type of active engine mount that offers increased advantages over a existing mount is examined using newly developed 6-DOF simulators. One is for the Active dynamic damper the other is for the pneumatic active mount. The target vibration signals from several parts of engine and subframe are measured and then regenerated those on the simulators. Active vibration control logic is verified and optimal logic is selected by using simulator. The performance of pneumatic active mount is measured in each control conditions and optimal control condition is selected by using simulator.
증례 : 순환기 ; 좌심방 점액종 수술 후 발생한 동기능 부전 및 심방 빈맥 1예
안성규 ( Sung Gyu An ),김준 ( Jun Kim ),이상권 ( Sang Kwon Lee ),박태익 ( Tae Ik Park ),이태근 ( Tae Kun Lee ),홍택종 ( Taek Jong Hong ),신영우 ( Young Woo Shin ) 대한내과학회 2009 대한내과학회지 Vol.76 No.1
점액종의 외과적 절제 후 발생하는 동기능 부전 증후군은 드문 합병증으로 보고된다. 저자들은 좌심방 점액종을 수술한 63세 여자 환자에서 어지럼증을 동반한 동기능 부전 및 심방 빈맥이 발생하여 영구형 인공심장박동기를 시술하였으며, 항부정맥제로 조절되지 않는 심방빈맥을 전극도자 절제술로 치료한 증례를 경험하였기에 문헌고찰과 더불어 보고하는 바이다. Atrial myxoma is the most common primary cardiac tumor, and surgical removal is the treatment of choice. Atrial flutter-fibrillation is common after the surgical excision of such tumors, whereas sinus node dysfunction is a rare complication. We detected postoperative sinus node dysfunction and atrial tachycardia after the excision of a left atrial myxoma in a 63-year-old woman. The patient underwent the implantation of a permanent pacemaker two weeks after the operation. The patient underwent successful catheter ablation of macroreentrant right atrial tachycardia 16 months after the operation with no recurrence of atrial tachycardia over the next four months. (Korean J Med 76:100-104, 2009)
능동 진동 제어 시스템 성능 및 신뢰성 개발을 위한 6축 시뮬레이터 구축
김정훈(Jeong-Hoon Kim),김재산(Jae-San Kim),심재호(Jae-Ho Shim),박태익(Tae-Ik Park) 한국자동차공학회 2010 한국자동차공학회 학술대회 및 전시회 Vol.2010 No.11
Recently, the interest in technologies for a highly efficient powertrain, i.e. a variable displacement engine or a light weight car body, to improve the fuel efficiency of automobile saving the environment has been increased. However this trend deteriorates NVH performance of a vehicle and the use of a conventional engine mounting system becomes unsatisfactory. In order to solve this dilemma, an active engine mounting system that could isolate or cancel out vibrations occurred at the powertrain was suggested. Not only an actuator with electronically controlled unit but also a successful control algorithm is essential for the development of the active engine mounting system. In many cases, the development of a control algorithm involves many trial and errors and the test with a real vehicle has its own inherent difficulties and risks. In order to minimize the research time and effort considerably, the development of a practical simulator may be necessary consequence. In this paper, the performance test and the reliability verification of an active engine mounting system with a control algorithm are examined with a newly developed 6-DOF simulator. The simulator is in the form of Hexapod Stewart Platform, where newly developed LEMA (Linear Electro-Magnetic Actuator) are applied as driving actuators. Effectiveness of the simulator is verified by using an active engine mounting system in the form of active linear vibration absorber. Firstly, we measured the target signal such as vibrations and RLD of an aimed vehicle at the proving ground. Then, the target signal is compared with the reproduced signal to examine reproducibility of 6-DOF simulator. Finally the controlled signal level at an aimed vehicle with an active engine mounting system is then compared with the level at 6-DOF simulator. Based on the two tests results, it is concluded that the adoption of 6-DOF simulator for the development of an active engine mounting system is very practical.