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급성호흡곤란 환자의 감별진단에서 응급의학과 전공의에 의해 시행된 조직 도플러 심초음파의 유용성
김동언,박득현,조현영,이성실,고찬영,안성준,신태용,김영식,하영록 대한응급의학회 2008 大韓應急醫學會誌 Vol.19 No.6
Purpose: In managing acutely dyspneic patients, differentiating the underlying disease rapidly is important but not easy. Although B-type natriuretic peptide (BNP) is generally accepted as a useful marker, inconclusive results require an emergency physician (EP) to have something more confirmative. We evaluate whether Tissue Doppler Echocardiography (TDE) performed by an EP can better discriminate between heart disease and lung disease than can BNP in the emergency department (ED). Methods: For enrolled ED patients with acute dyspnea and unclear pathology, initial BNP level and TDE performed by EP were checked prospectively. The ratios of peak early diastolic transmitral blood flow velocity (E) versus the peak early diastolic tissue velocity over mitral annulus (Ea) on TDE were recorded. The sensitivity and specificity of tissue Doppler parameters and BNP levels for diagnosing acute heart failure were calculated and we compared the discriminatory ability of the two tools. Results:49 patients (39 heart failure, 10 respiratory disease) were enrolled. The area under the ROC curves for BNP and E/Ea were 0.946 and 0.888 (p<0.001) respectively. Cutoff values were 350 pg/ml for BNP (sensitivity and specificity of 82.1% and 100%) and 9.0 for E/Ea (89.2% and 100%). Especially in the group with low BNP (<350), BNP was a poor discriminator of the underlying disease, whereas E/Ea was still effective (AUC: 0.943, p=0.021). Conclusion: TDE by EP is a useful tool for diagnosing acute heart failure in ED and could easily and rapidly discriminate the underlying disease of acutely dyspneic patients, especially in patients with inconclusive BNP levels.
김동언 한국일러스트레이션학회 2021 일러스트레이션 포럼 Vol.22 No.68
본 연구는 재활용 소재를 활용한 악기 디자인이 음 악과 공연예술의 시대정신을 담아내면서 인류가 당면 한 문제에 어떻게 기여할 수 있는지 그 의미와 활용 가능성을 찾아보는 데 목적이 있다. 연구는 이론적 고찰과 사례 연구를 통해 이루어졌다. 사례 분석 모 형은 쓰레기와 재활용악기를 각각 잠재적 단계와 창 조적 단계로 나누어 비교하면서 디자인의 개입을 통 해 새롭게 변화한 재활용악기의 의미와 활용 가능성 을 도출하였다. 이를 위하여 더이상 쓸모가 없어진 쓰레기와 폐기물에 새로운 예술적 감성과 표현의 가 능성을 확장한 정크아트의 의미와 들뢰즈의 잠재성의 명제들을 분석의 요소로 차용하였다. 연구 결과 다음 과 같은 내용이 도출되었다. 악기가 음악 및 기술 변 화의 역사와 더불어 진화하는 과정에서 재활용 소재 를 활용한 악기 디자인이 환경문제에 대한 인식을 높 이고, 산업 폐기물이 악기로 제작되면서 다양한 표현 방법의 확대와 오브제로서 정크아트의 영역을 확대· 심화시키고 있다. 지금도 거리예술 및 놀이와 결합한 역동적인 악기로 여전히 진화하고 있는 중이다. 또한, 개인과 공동체의 이야기와 정체성을 나타내면서 재활 용악기 디자인이 인류 문명의 새로운 꿈과 희망의 메 시지를 담아내고 있고, 전기·전자 기술과 접목된 재 활용악기의 친환경적 생태 산업디자인으로 발전 가능 성이 크다는 사실을 발견하였다. The purpose of this study is to find out the meaning and application potential of how musical instrument design using recycled materials can contribute to the problems facing mankind while capturing the spirit of the times in music and performing arts. The study was conducted through theoretical considerations and case studies. The case analysis model divided and compared waste and recycled instruments into potential and creative stages, respectively, and derived the meaning and application potential of newly changed recycled instruments through design intervention. For this purpose, the meaning of Junk Art, which expands the possibility of new artistic sensibility and expression in garbage and waste that is no longer useful, and the proposition of potential mentioned in Deleuze's propositions of virtuality were borrowed as elements of analysis. As a result of the study, the following contents were derived. As musical instruments evolve along with the history of music and technological change, musical instrument designs using recycled materials raise awareness of environmental issues, and as industrial wastes are made into musical instruments, various expression methods are expanded and the area of Junk Art as an object. expanding and deepening. It is evolving into a dynamic instrument combined with play, including modern street art. In addition, while expressing the story and identity of individuals and communities, the design of recycled musical instruments captures the message of new dreams and hopes of human civilization, and discovers the fact that it has great potential for development as an eco-friendly ecological industrial design of recycled musical instruments combined with electric and electronic technology.
김동언 대한소아청소년과학회 2006 Clinical and Experimental Pediatrics (CEP) Vol.49 No.5
Sodium is the major cation of the extracellular fluid and the primary determinant of extracellular osmolality. Therefore, hypernatremia causes water movement out of cells, while hyponatremia causes water movement into cells, resulting in cellular shrinkage and cellular swelling, respectively. Serious central nervous system symptoms may complicate both conditions. Since hypernatremia and hyponatremia are accompanied by abnormalities in water balance, it is essential to understand the mechanisms regulating extracellular osmolality and volume as well as the pathophysiology of hypernatremia and hyponatremia, in order to manage both conditions with swiftness and safety.