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.

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.

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.

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.

치과용 레진 시멘트의 중합 수축률 특성에 관한 연구

김태훈,양재호,이재봉,한중석,김성훈,Kim, Tae-Hoon,Yang, Jae-Ho,Lee, Jai-Bong,Han, Jung-Suk,Kim, Sung-Hun 대한치과보철학회 2010 대한치과보철학회지 Vol.48 No.1

연구 목적: 치과용 레진시멘트의 중합 수축은 수복물이 치아에 정확하게 합착되는 것을 방해하고, 내부 응력의 원인이 되어 치아에 여러 문제점을 일으킬 수 있다. 이러한 임상적인 문제점을 줄이기 위해서 사용하는 치과용 레진시멘트의 중합 수축률에 대해 아는 것이 중요하다. 본 연구에서는 상업적으로 이용되고 있는 몇 가지 레진시멘트의 시간에 따른 중합 수축률을 측정, 서로 비교하고자 하였다. 연구 재료 및 방법: 3종류의 자가 중합형 레진시멘트(Fujicem, Superbond, M bond)와 3종류의 이원 중합형 레진시멘트(Maxcem, Panavia F, Variolink II) 별로 각각 5개의 시편을 이용하였다. 각 재료의 중합 수축률은 Bonded disk method를 이용하여 측정하였다. 안쪽 직경 16 mm, 두께 1 mm 의 동으로 제작된 링을 유리판 ($74\;mm\;{\times}\;25\;mm\;{\times}\;3\;mm$) 위의 중앙에 위치시켜 부착하고, 그 유리판 중앙에 실험 재료를 구 형태로 만들어 올리고, 다른 유리판으로 눌러서 원판 형태 (직경 8 mm, 두께 1 mm)의 시편을 제작하였다. 시편의 중합 수축률은 재료가 중합이 시작된 후 120분동안, $23^{\circ}C$에서 측정하였다. 시간에 따른 수축량에 대한 kinetics curve를얻고, 각 실험 재료의 수축률의 평균값 (%)과 표준편차를 구한 뒤, one-way ANOVA 및 Scheffe post hoc test를 유의수준 0.05 에서 처리하여 그 결과 값을 비교하였다. 결과: 1. 실험에 사용된 Fujicem, Maxcem, M bond, Panavia F, Superbond, Variolink II 은 중합이 시작 된 120 분 후의 중합 수축률이 각각 3.72%, 4.19%, 4.13%, 2.44%, 7.57%, 2.90%의 값을 보였다. 2. Panavia F가 중합 수축률이 가장 작았고, Superbond가 중합 수축률이 가장 컸다 (P<.05). 3. Maxcem 과 M Bond 간에는 유의한 차이가 없었다 (P>.05). 4. 6종류의 레진 시멘트에서 90% 이상의 대부분의 수축은 중합이 개시된 30분 내에 거의 일어났다. 결론: 자가 중합형 레진시멘트의 혼합 후 나타나는 중합 수축이 이원 중합형 레진시멘트보다 천천히 일어나지만, 혼합 120분 뒤의 중합 수축은 이원 중합형 레진 시멘트 보다 유의할 정도로 높았다. 치과용 레진시멘트의 중합 수축은 혼합한 후 30 분내에 대부분 일어난다. Purpose: The shrinkage of dental resin cement may cause several clinical problems such as distortion that may jeopardize the accurate fit to the prepared tooth and internal stress within the restorations. It is important to know the polymerization shrinkage-strain of dental resin cement to reduce clinical complications. The purpose of this study was to investigate the polymerization shrinkage-strain kinetics of six commercially available dental resin cements. Material and methods: Three self-cure resin cements (Fujicem, Superbond, M-bond) and three dual-cure resin cements (Maxcem, Panavia-F, Variolink II) were investigated. Time dependent polymerization shrinkage-strain kinetics of the materials were measured by the Bonded-disk method as a function of time at $23^{\circ}C$, with values particularly noted at 1, 5, 10, 30, 60, 120 min after mixing. Five recordings were taken for each materials. The data were analyzed with one-way ANOVA and Scheffe post hoc test at the significance level of 0.05. Results: Polymerization shrinkage-strain values were 3.72%, 4.19%, 4.13%, 2.44%, 7.57%, 2.90% for Fujicem, Maxcem, M bond, Panavia F, Superbond, Variolink II, respectively at 120 minutes after the start of mixing. Panavia F exhibited maximum polymerization shrinkage-strain values, but Superbond showed minimum polymerization shrinkage-strain values among the investigated materials (P < .05). There was no significant differences of shrinkage-strain value between Maxcem and M bond at 120 minutes after the start of mixing (P > .05). Most shrinkage of the resin cement materials investigated occurred in the first 30 minutes after the start of mixing. Conclusion: The onset of polymerization shrinkage of self-cure resin cements was slower than that of dual-cure resin cements after mixing, but the net shrinkage strain values of self-cure resin cements was higher than that of dual-cure resin cements at 120 minutes after mixing. Most shrinkage of the dental resin cements occurred in the first 30 minutes after mixing.

웹GIS를 이용한 실시간 자연재해 피해정보 관리시스템 개발에 관한 연구

김태훈,김계현,심재현,최우정,Kim, Tae-Hoon,Kim, Kye-Hyun,Shim, Jae-Hyun,Choi, Woo-Jung 한국공간정보학회 2008 한국공간정보시스템학회 논문지 Vol.10 No.4

본 연구에서는 태풍, 호우 등의 자연재해에 따른 공공시설물의 피해를 조사하여 광역적 무선통신을 통해 웹GIS의 지도상에 실시간으로 표출함으로써 보다 신속하고 효율적인 피해정보의 제공방안을 연구하였다. 연구 대상지역은 여름철 대형 태풍과 집중호우로 인한 피해가 반복되는 부산시 강서구지역 약 $180km^2$를 선정하였으며, 관련 데이터베이스는 GIS 데이터베이스와 재해 데이터베이스로 나뉘어 구축하였다. GIS 데이터베이스는 1:5,000 및 1:1,000 수치지도를 기반으로 행정경계 등 7개의 주제도로 구축하였고, IKONOS위성의 1m급 고해상도 위성영상을 이용하여 실제 피해현장과 주변 환경에 관한 정보들을 제공할 수 있도록 하였다. 웹GIS 시스템은 피해현황을 GIS 데이터와 함께 실시간으로 제공함으로써 신속한 현장파악, 대응책 마련과 복구계획 수립 등을 위한 의사결정에 기여가 매우 높을 것으로 예상된다. 나아가 소방방재청에서 구축하고 있는 NDMS(National Disaster Management System, 국가재난관리시스템)와 연계를 통하여 여러 국가기관에서 얻어지는 다양한 피해정보의 제공 또한 가능할 것으로 사료된다. This study mainly focused on the development of real-time based damage investigation system using web-GIS. The study area was Gangseo-Gu in Busan where frequently has relatively higher magnitude of damages from natural disasters. GIS DB was built to provide geospatial data such as 1:1,000 and 1:5,000 topographic maps and IKONOS high resolution satellite data. The web-GIS system has demonstrated the higher contribution for the better response and recovery against any type of natural disasters through real-time communication and data dissemination among government agencies and personnel. However, further researches need to be made to improve system capabilities. In addition, for more effective system operation and maximizing the benefits of exploiting web-GIS system, linkage with national DB such as NDMS is essential.

미생물 혼합 고로슬래그 모르타르의 강도특성 평가

김태훈,이준철,김화중,Kim, Tae-Hoon,Lee, Jun-Cheol,Kim, Wha-Jung 大韓建築學會 2015 大韓建築學會論文集 : 構造系 Vol.31 No.2

In construction material field, one of the ways to reduce $CO_2$ generation and environmental load is to decrease the use of cement materials. In this study, the cement material was replaced with a by-product from iron production which called BFS(blast furnace slag), when mortar specimens were made and it was expected to reduce environmental load significantly. Moreover, the added value can be created by using a by-product and cutting the production cost of concrete and mortar. 5 types of mixing water, BFS and the activator($Ca(OH)_2$) were used to make mortar specimens and the compressive strength test was carried out. All specimens were cured for 3, 7, 28days. As a result, all experimental groups had better strength than a control group. Above all, 2F-1 group had superior strength to the others. In order to raise confidence of the results, microstructure of mortar was observed and each specimen was analyzed. SEM images from all groups were compared with each other, and the area and the volume of micro-pore were measured through the porosimeter analysis. Through this research, it was tried to examine the potential for developing zero cement mortar and applying the micro-organism as a natural admixture material.

P1 근사법과 S4 방법을 이용한 흡수 , 방사 그리고 산란이 결부된 3 차원 복사계의 해석

김태훈,박흥목 ( Tae Hoon Kim,Hung Mok Park ) 한국화학공학회 1995 화학공학의이론과응용 Vol.1 No.2

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.