대장수술 후에 발생한 급성신부전의 위험인자

이혜미,황창재,김재황,김흥대,박대팔,서일숙,송선옥,김세연,이덕희,지대림 영남대학교 의과대학 2007 Yeungnam University Journal of Medicine Vol.24 No.2

연구 배경 : 급성 신부전은 술 후 발생할 수 있는 합병증 중에서 사망률은 큰 영향을 줄 수 있으므로 이 연구를 통해 위험인자를 알아보려고 한다. 재료 및 방법 : 2004년 1월부터 2006년 12월까지 3년간 영남대학교 의과대학 부속병원에서 대장 수술을 받은 570명의 환자들을 대상으로 하였다. 환자들의 성별과 연령, 미국 마취과학회 신체등급, 동반질환, 수술의 종류, 응급수술의 여부, 수술 시간, 재수술의 여부, 술 중의 투약 상황, 술 후에 자가 통증 조절기에 사용한 약제, 술 중에 저혈압의 유무, 수혈 여부, 술 후 기계적 환기를 시행한 경우를 비교하였다. 결과 : 비교 결과에서 성별과 수술의 종류, 응급 수술의 여부, 개복여부 등에는 유의한 차이를 보이지 않았다. 반면 환자의 나이와 수술 시간, 재수술의 여부, 술중에 이뇨제 등을 사용한 경우, 술 중에 저혈압의 유무, 술 후에 기계적 환기를 시행한 경우 등에는 유의한 차이를 보였다. 결론 : 이상의 결과로 급성신부전의 원인은 어느 한 가지라고 하기 보다는 위험인자에 얼마나 노출되어 있는가가 결정하는 것 같고, 그 원인들이 모여서 상승효과를 내는 것 같다. 그러므로 수술 전부터 많은 위험에 노출된 환자는 술 중 더 적극적인 감시를 시행하여 수술 후의 합병증 발생을 줄이는 노력을 기울여야 하겠다. Background : Acute renal failure is one of the leading causes of postoperative morbidity and mortality. The purpose of this study was to determine the risk factors that are associated with acute renal failure after colorectal surgery. Materials and Methods : Five hundred seventy patients who operated colorectal surgery at the Yeungnam University Medical Center over three years from 2004 to 2006 were enrolled in this study. The effects of gender, age, ASA classification, concomitant disease, surgery type and duration, reoperation, urogenital manipulation, medication, hypotension, hypovolemia, transfusion, and postoperative ventilatory care on the occurrence of acute renal failure after colorectal surgery were studied. Results : The major risk factors of acute renal failure after colorectal surgery were age of patients (P=0.003), ASA classification (P<0.001), concomitant disease (P<0.001), duration of the time surgery (P=0.034), reoperation (P=0.001), use of intraoperative diuretics (P=0.005), use of postoperative diuretics (P<0.001), intraoperative hypotension (P=0.018), intraoperative transfusion (P<0.001), postoperative transfusion (P<0.001), and postoperative ventilatory care (P=0.001). Conclusion : Multiple factors cause synergistic effects on the development of acute renal failure after colorectal surgery. Therefore, efforts to reduce the risk factors associated with acute renal failure are needed. In addition, intensive postoperative care should be provided to all patients.

DSP Architecture for Weak Signal Acquisition in Assisted GPS

Deuk Jae Cho,Il Heung Choi,Sung Wook Moon,Sang Hyun Park,Sang Jeong Lee 제어로봇시스템학회 2002 제어로봇시스템학회 국제학술대회 논문집 Vol.2002 No.10

폐렴간균(Klebsiella pneumoniae)과 그 외의 다른 세균에 의한 화농성 간 농양의 임상적 비교

진흥용,이식,박주형,최유진,이흥범,이수택,안득수 대한감염학회 2001 감염 Vol.33 No.3

Background : There are increasing reports of hepatic abscess cause by K. pneumoniae, especially in Asia and its more frequent occurrence in diabetes mellitus but the reason remains unclear. This study was conducted to clarify the different clinical presentations between patients with K. pneumoniae (KP group) and those with non-K. pneumoniae (non-KP group) hepatic abscess. Methods : A retrospective clinical survey was done from April 1997 to February 2001. The medical records of 20 adults with culture-confirmed pyogenic liver abscess who had attended Chonbuk National University hospital were reviewed. Results : Hepatic abscess caused by K. pneumoniae accounted for 10 (50%) of 20 patients with pyogenic liver abscesses. Compared to KP group, non-KP group showed higher proportions of polymicrobial infections (50% vs 20%) including E. coli, Proteus sp., Enterobacter sp., Citrobacter sp., P. aeruginosa, viridans streptococcus, Enterococcus, and Bacteroides sp.. Although, the clinical presentations of the two groups were similar, but KP group showed higher association with diabetes mellitus, lower hepatobiliary diseases, and larger abscess formation than non-KP group. Conclusion : K. pneumoniae was one of the most important causative organism in pyogenic liver abscess. Clinical findings were similar between K. pneumoniae heatic abscess and non-K. pneumoniae-induced abscess, though, K. pneumoniae-induced hepatic abscess was more frequently associated with diabetes mellitus and single large abscess. (Korean J Infect Dis 33:202∼205, 2001)

서울대학교병원의 방사선치료장비 운용 통계에 관한 고찰

박흥득,김완선,안희용,Park, Heung-Deuk,Kim, Wan-Sun,Ahn, Hee-Yong 대한방사선치료학회 1994 大韓放射線治療技術學會誌 Vol.6 No.1

To analyze the states of operation of radiotherapy facilities in the period from 1979 to 1992 and to get the base for efficient operation and maintenance of the radiotherapy facilities. Data on the records of annual number of patients operated by each facility; span of suspension of operation, the cost and span of repairing, and parts of oui-of-order in the period from 1979 to 1992 were analyzed. We made a comparative analysis of average annual number of patients, annual span of the suspension of operation, annual cost ratio of repair, span of repairing per break down, and total number of broken parts. We could get following annual number of patients(day), span of the suspension of span ($\%$)(day). annual cost ratio fo repair($\%$), span of repairing per break down(Min-Max, day), and number of broken parts from this analysis. 1. Cobalt unit (Picker C-9) : 10,389(43), 0.4(0.83) 0.07, 1hr-2, 3 2. Linac(Clinac 6/100) : 11,492(50), 4.0(9.57), 0.98, 1hr-30, 12 3. Linac(Clinac 18) : 9.115(44), 12.7(30.5), 3.54, 1hr-108. 41 4. Simulator(Picker Ther-X) : 2,017(9), 0.51(1.3), 0.24, 1hr-2, 7 5. RTP(Capentec Cap-plan) : 528(2), 0.4(0.93), - hrs, - The conclusion obtained from statistical analysis above are as follows. 1. The rate of operation of Cobalt unit($99.6\%$) was higher that of Linear Accelerators ($87.3\%$). The rates operation of Simulator and RTP computer were very close to that of Cobalt unit. 2. In order to raise up the working ratio of accelerator. it is desirable that we keep our engineer to learn a sufficient technical skill and the equipment agent to stock sufficient spare parts. 3. In order to maintain Linear Accelerator efficiently, it is desirable to have annually $2.3\%$ of the purchase price of equiment for repairing.

Statistic consideration on the detection frequency of the invasive likelihood hitchhiker insect pests through foreign vessels

Tae Hwa KANG,Sangwook PARK,Ki Jeong HONG,Tae Won HONG,Deuk Soo CHOI,Heung Sik LEE,Jung Hoon HWANG 한국응용곤충학회 2019 한국응용곤충학회 학술대회논문집 Vol.2019 No.04

DNA 바코드를 기반으로 하여 외국발 국내 입항 선박에서 검출되는 편승자 해충(hitchhiker insect pests)에 대한 모니터링을 수행하였다. 국내 입항 선박 조사는 2018년 6월 1일부터 2018년 9월 17일까지 약 109일간 111개 선박에 대해 실시하였다. 모니터링 대상 해충은 ‘보고잡기법(simply collecting method by hands)’으로 확보하였으며, 총 336개체에 대해 종동정을 실시하였으며, 이를 통해 확보된 정보들은 선박정보(선박명, 선박번호, 출항지, 입항지), 조사정보(조 사일, 채집시 표본 상태, 조사자), 유전자 분석 정보(프라이머 정보, 서열판독 결과), 분자생물학적 종동정 정보(NCBI GenBank Accession No., NCBI Blast Searching Results, BOLD Identification Request), 분류학적 통합종 확증 정보(목명, 과명, 종명, 동정자, 비고) 등으로 구분하였으며, MS-Excel을 이용하여 각 필드값에 맞게 기초정보를 입력하였다. 이를 기반으로 하여 편승자 해충에 대한 선박 경로에 따른 편승 양상뿐만 아니라, 월별, 분류군별, 미서식종별로 편승 양상을 분석하였다. 그 결과, 편승사례는 선박 경로에 따라서는 중국에서 출항하거나 중국을 거쳐 편승하는 사례가 207건, 월별로는 9월이 134건, 분류군별로는 나비목이 208건으로 가장 많았다. 특히, 미서식종별 편승 양상에서 는 총 3목 9과 13종 21개체가 국내 입항 선박에서 검출된 것으로 나타났으며, 이 중 2목 6과 9종 15개체는 살아있는 상태로 채집된 것을 확인되었다. 이와 같은 결과로 볼 때, 앞으로 더욱 많은 정보가 확보된다면, 현재의 통계 분석 방법은 편승자 해충의 모니터링뿐만 아니라 대상 해충의 위험성 평가 및 검역검사에 매우 효율적인 정보를 제공할 수 있을 것으로 사료된다.

유도전동기의 새로운 직접 토크 제어

박준현(Jun-Hyun Park),이경주(Kyung-Joo Lee),이득기(Deuk-Kee Lee),정종진(Jong-Jin Jeong),최종우(Jong-Woo Choi),김훙근(Heung-Geun Kim) 전력전자학회 2001 전력전자학술대회 논문집 Vol.2001 No.7

This paper describes a control scheme for direct torque and flux control of induction machines. The proposed predictive flux control scheme has directly calculated the reference voltage space vector based on flux errors in order to control the torque and flux.<br/> This proposed control scheme has not the requirement of a separate current regulator and proportional-integral (PI) control of the flux, torque, and/or current error, thereby improving transient performance and also has the advantage of less torque ripple in steady state with a fixed switching period. The effect of proposed method has been proven by simulations.

고관절 비구순 파열 진단의 초음파에 대한 유용성

김필성 ( Pil Sung Kim ),정흥태 ( Heung Tae Jung ),전유선 ( Yoo Sun Jeon ),이문종 ( Mun Jong Lee ),박유진재진 ( Yoojin Jaejin Park ),황득수 ( Deuk Soo Hwang ) 대한고관절학회 2013 Hip and Pelvis Vol.25 No.3

목적: 대퇴비구 충돌 환자에서 비구순 파열의 진단에 있어 초음파의 유용성에 대해 알아보고자 한다. 대상 및 방법: 2010년 3월부터 2011년 10월까지 대퇴비구 충돌로 관절경적 수술을 시행 받은 환자 중 비구순 파열이 확인된 58명(58예: 남자 26예, 여자 32예)을 대상으로 하였다. 대상 환자들은 수술 전 시행된 고관절 초음파 검사와 자기 공명 관절 조영술의 비구순 파열의 유무와 형태를 확인하고 관절경의 비구순 파열과 비교하여 그 상관 관계에 대해 조사하여 초음파의 민감도와 양성 예측률을 측정 하였다. 결과: 대퇴비구 충돌을 동반한 비구순 파열의 초음파를 이용한 진단의 민감도와 양성 예측률은 각각 89.6%, 100%였다. 또한 초음파의 비구순 파열의 일치율은 84.6%(44/52)였다. 결론: 고관절 초음파 검사는 대퇴비구 충돌 환자에서 비구순 파열의 병변의 진단에 유용한 방법으로 판단된다. Purpose: This study evaluated the usefulness of ultrasonography for a diagnosis of acetabular labral tear in femoroacetabular impingement (FAI). Materials and Methods: From March 2010 to October 2011, an ultrasonographic examination was performed in 58 patients(58 hips: 26 men and 32 women) with acetabular labral tear. The sensitivity and positive predictive value of ultrasonography were evaluated for 58 cases with acetabular labral tear confirmed by hip arthroscopy. Results: The sensitivity and positive predictive value for an acetabular labral tear using ultrasonography was 89.6% and 100%, respectively. The concordance rate of an acetabular labral tear between arthroscopy and ultrasonography was 84.6%. Conclusion: Hip ultrasonography can make a significant contribution to a pathologic diagnosis and isa useful diagnostic tool for acetabular labral tears.

전립선암의 세기조절 방사선치료 시 불균질부에 의한 선량변화에 관한 고찰

윤일규,박장필,이제희,박흥득,Yoon, Il-Kyu,Park, Jang-Pil,Lee, Jae-Hee,Park, Heung-Deuk 대한방사선치료학회 2007 대한방사선치료학회지 Vol.19 No.2

Purpose: The pelvic phantom was fabricated in the following purposes: (1) Dose verification of IMRT plan using Eclipse planning computer, (2) to study the interface effect at the interface between rectal wall and air. The TLD can be inserted in the pelvic phantom to confirm the dose distribution as well as uncertainty at the interface. Materials and Methods: A pelvic phantom with the dimension of 30 cm diameter, 20 cm height and 20 cm thickness was fabricated to investigate the dose at the rectal wall. The phantom was filled with water and has many features like bladder, rectum, and prostate and seminal vesicle (SV). The rectum is made of 3 cm-dimater plastic pipe, and it cab be blocked by using a plug, and film can be inserted around the rectal wall. The phantom was scanned with Philips Brillance scanner and various organs such as prostate, SV, and rectal wall, and bladder wall were delineated. The treatment parameters used in this study are the same as those used in the protocols in the SNUH. TLD chips are inserted to the phantom to evaluate the dose distribution to the rectal wall (to simulate high dose gradient region), bladder wall and SV (to simulate the high dose region) and 2 spots in anterior surface (to simulate the low dose region). The TLD readings are compared with those of the planning computer (ECLIPSE, Varian, USA). Results: The target TLD doses represented as the prostate and SV show excellent agreements with the doses from the RTP within +/-3%. The rectal wall doses measured at the rectal wall are different from the those of the RTP by -11%. This is in literatures called as an interface effect. The underdosages at the rectal wall is independent of 3 heterogeneity correction algorithm in the Eclipse RTP. Also the low dose regions s represented as surface in this study were within +/-1%. Conclusion: The RTP estimate the dosage very accurately withihn +/-3% in the high dose (SV, or prostate) and low dose region (surface). However, the dosage at the rectal wall differed by as much as 11% (In literatures, the underdosage of 9$\sim$15% were reported). This range of errors occurs at the interface, for example, at the interface between lung and chest wall, or vocal cord. This interface effect is very important in clinical situations, for example, to estimate the NTCP (normal tissue complication probability) and to estimate the limitations of the current RTP system. Monte-carlo-based RTP will handle this issue correctly.

Doxycycline에 의한 광독성 반응

한기덕,김종경,조윤향,박기민,김태흥 ( Ki Deuk Han,Jong Kyeong Kim,Yoon Hyang Cho,Ki Min Park,Tae Heung Kim ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.5

We report a case of doxycycline-induced phototoxicity in a 62-years-old male. The patient, had erythematous macules and patches on sun-exposed areas. A Phototest revealed a marked decreased minimal erythemai. dose (MED) to UVA (MEDuva=-10J/cm2). Photopatch tests with 1%, 5% Doxycycline ointment were negative. An oral provocation test was performed, which showed a positive result with a decrease of MED to UVA (MEDuva= 20J/cm2). After the cessation of doxycycline, his skin lesioris were improved markedly with complete loss of photosensitivity. (Korean J Dermatol 1997;35(5): 997-1000)

응용논문 : 알루미늄전해콘덴서의 가속수명시험에 관한 실험연구

김흥진,정호성,김성득,박영택,진홍기,박찬웅 ( Heung Jin Kim,Ho Sung Cheon,Seong Deuk Kim,Young Taek Park,Hong Gee Jin,Chan Woong Park ) 한국품질경영학회 1995 품질경영학회지 Vol.23 No.4