고립성 폐결절의 악성 감별에서 Integrated PET/CT의 유용성

박원종,김동희,유성근,신경철,정친홍,이관호,천경아,조인호 영남대학교 기초/임상의학연구소 2006 Yeungnam University Journal of Medicine Vol.23 No.2

연구 배경: 고립성 폐결절의 30%~40%는 악성결절의 가능성이 높다. 따라서 고립성 폐결절의 악성감별이 무엇보다 중요하다. 최근 PET/CT가 악성 감별에 널리 사용되며, 또한 그 중요성이 커지고 있다. 이 연구의 목적은 integrated PET/CT의 여러 인자들을 비교하여 고립성 폐결절의 악성 여부를 구별하는데 유용한 지표를 찾기 위한 것이다. 재료 및 방법: 2005년 12월부터 2006년 4월 까지 3 cm 미만의 고립성 폐결절로 내원한 환자 19명을 대상으로 하였다. 환자는 integrated PET/CT의 최대 SUV는 FDG 주입 후 1 시간, 2 시간에 측정하였다. 또한 대상 환자 모두 경피세침술로 조직검사를 하였다. Levene's test를 이용하여 integrated PET/CT에서, 조직검사로 확인된 양성결절과 악성결절의 SUV1, SUV2, 보존지수(retention index)의 차이를 비교하였다. 성적: 조직검사 결과 12명이 악성결절로 확인되었고, 7명은 양성결절로 진단되었다. SUV1(p=0.006)과 SUV2(p=0.022)는 양성결절보다 악성결절에서 높았으며 이들 값은 통계적으로 유의하였으나 보존지수는 유의한 차이가 없었다(p=0.526). ROC 곡선을 이용한 양성결절과 악성결절을 구분하는 기준값은 SUV1은 5.40, SUV2는 7.45였다. 이때 SUV1의 민감도는 66.7%, 특이도는 71.4%였으며, SUV2의 민감도는 75%, 특이도는 71.4%였다. 결론: 이상의 결과로 integrated PET/CT에서 일반적으로 널리 사용하고 있는 SUV1은 양성결절과 악성결절을 구별하는데 있어 유용 하다는 것을 확인할 수 있었고, 아직 많이 연구되지 않은 SUV2 또한 통계학적으로 의미 있는 차이를 보임을 알 수 있었다. 양성결절과 악성결절을 구분하는 기준값은 각각 5.40, 7.45였다. 연구결과 고립성 폐결절의 악성여부를 구별하는데 SUV1, SUV2 모두 유용하게 사용 될 수 있으나 SUV2가 SUV1에 비교하여 특이도는 같으나 더 높은 민감도를 나타내었다. Background: Malignant pulmonary nodules account for about 30 to 40 percent of solitary pulmonary nodules (SPN). Therefore, tissue characterization of SPNs is very important. Recently, PET/CT has been widely used for tissue characterization, and has become of importance. The purpose of this study was to compare and to assess multiple factors in PET/CT comparing benign and malignant nodules. Materials and Method: Nineteen patients with SPN underwent PET/CT and biopsy. The difference of standardized uptake value 1 (SUV1), standardized uptake value 2 (SUV2) and retention index in PET/CT between malignancy and benignancy were compared by Levene's test. Result: There were twelve malignant and seven benign nodules. SUV1 and SUV2 were significantly different between malignant nodule and benign nodule (p=0.006 and 0.022), but retention index was not significantly different between malignant nodule and benign nodule (p=0.526). By receiver-operating-characteristic (ROC) analysis, the sensitivity was 66.7% and the specificity was 71.4% at a cut off value of 5.40 in SUV1. The sensitivity was 75% and the specificity was 71.4% at cut off value of 7.45 in SUV2. Conclusion: There was a statistically significant difference in SUV1 and SUV2 between benign and malignant nodules. However, the cut off value of SUV1 and SUV2 by receiver-operating-characteristic (ROC) analysis was 5.40 and 7.45 which is different from previous studies. Therefore, studies on a larger sample of patients are required for confirmation.

배란유도방법에 의한 과배란주기에서 혈중및 요중 황체화호르몬 Surge에 관한 연구

박원종,서병희,이재현,Park, Won-Jong,Suh, Byung-Hee,Lee, Jae-Hyun 대한생식의학회 1988 Clinical and Experimental Reproductive Medicine Vol.15 No.2

Ovulation induction was done with 3 different regimens as clomid combined with HMG, HMG only, and FSH combined with HMG in 28 menstrual cycles for IVF-ET and GIFT program. The appearance of endogenous LH surge, estradiol plateau, atypical LH surge, and time from initiation to peak of LH surge in serum and urine were observed and compared in 3 groups. 1. The estradiol concentration of serum LH surge day was similar in three groups but 1st group (Clomiphene Citrate+Sequential HMG) was slightly higher at $1924.0{\pm}865.1\;pg/ml$. In regards to the existence of serum estradiol plateau, 3rd group (FSH+Sequential HMG) was highest at 60%, and 1st group and 2nd group (HMG only) were similar at 33% and 44% respectively. 2. The number of ovarian of ovarian follicle which was more than 18mm in diameter was $4.1{\pm}2.0$, $4.2{\pm}2.1$ respectibely for 2nd group and 3rd group. Although the numbers were slightly higher thean 1st group for each ovarian follicle, serum estradiol value per follicle was higher for 1st group at $583.0{\pm}261.2pg/ml$. 3. When measuring the urine LH surge according to Hi-Gonavi and according to the standard set by three different types of surge, simultameous satisfaction for 1st group, 2nd group, 3rd group was two cases, five cases, four cases respectively at 40%, and the remained cases were composed of numorous type combination which satisfied the two definition, simultaneously in this study, the LH surge starting time was determined only in the cases tow combination were satisfied simultaneously at first, but there are something to study more. In one case of the 3rd group. 4. The concentration of LH surge start in urine and serum of 2nd group was highest at306. $0{\pm}287.2IU/l$ and $34.0{\pm}9.9mIU/ml$ and 1st group was low at $116.6{\pm}66.1IU/l$ and 7.4mIU/ml. The urine and serum value of LH was highest at $1644.4{\pm}988.8IU/l$, $65.9{\pm}15.0mIU/ml$ for 2nd group, 1st group was low at urine, and 3rd group was low of serum. With pregnancy established, the LH concentration of urine was relatively high but on the contrary the LH concentration of serum was low compared to urine concentration. 5. Time from LH surge start to the maximun of urine and serum value was highest at 15. $7{\pm}9.1$ hrs and $10.8{\pm}4.9$ hrs for 1st group and 3rd group. With pregnancy established, time was shortened for urine but on the contrary serum showed an increase in time. 6. The concentration of LH which increases with time on urine was highest at 2nd group ($194.6{\pm}76.8\;IU/hour$). The lowest increase for serum was at 3rd group (2.1mIU/hour). With pregnancy established, urine showed more increase than control group ($266.5{\pm}47.4\;IU/hour$) and for serum there was similar increase ($3.4{\pm}0.8\;mIU/hour$). 7. There were two examples of non-typical surge from 1st group and 3rd group each. Among these three cases showed a reestablishment of LH surge after 10-24 hours. 8. Endogenous spontaneous Lh surge occurs once for each 2nd group and 3rd group.

국소 방사선조사가 가토의 대퇴골 및 골수에 미치는 조기효과- 골 및 골수스캔, 자기공명영상 및 조직소견-

박원종,문명상 가톨릭대학 (가톨릭신학대학) 대학원 1993 가톨릭大學醫學部 論文集 Vol.45 No.4

상완골 경부 전위골절의 핀고정 치험례 : 경피 핀고정 3례, 제한된 절개의 관혈적 정복 및 핀고정 4례 보고 3 Cases of percutaneous pinning, 4 cases of open reduction through a limited incision and pin fixation

박원종,손종민,공준택,장주해 대한골절학회 1992 대한골절학회지 Vol.5 No.1

Most fractures of the proximal humerus respond satisfactorily to conservative treatment, however operative treatment is indcated in certain types of displaced surgical neck fracture. Three displaced fractures of humerus surgical neck (Neer Group lIl) were treated with closed reduction and percutaneous pinning, and 4 cases were treated with open reduction and pinning from October 1987 to October 1990 at the Our Lady of Mercy Bospital, Catholir. University Medical College. The results were as follows: 1. Six out of 7 patients were male, and the average age of the patients was 30 years (from 8 to 58 years). Causes of fracture were falling down (4 cases) and motor vehicle accident (3 cases). 2. After closed (3 patients) or open reduction through a limited incision (4 patients), multiple K-wires or Steinmann pins (average 3 in number) were msertecl to enable early mobilization by providing stability at tracture site. 3. Open reduction was performed for the cases in which closed reduction was failed because of interposition of the periosteal sleeve or the long head of Biceps brachii muscle. 4. Range of motion exercise was started from 3 to 4 weeks after the operation. The shoulder motion was regained full in all patients except one who had a slight limitation of abduction. There was one case of K-wire loosening with pin tract infection. 5. Excellent result was obtained in 5 cases and satisfactory in 2 cases by Neer's numerical

추출 방법을 달리한 친환경 구기자 젤리의 물리적 관능적 평가

박원종,김태수,문은영,박소이,나준영,김지혜,정지혜,이진영,강명화 동아시아식생활학회 2010 동아시아식생활학회 학술발표대회논문집 Vol.2010 No.11

구기자(Lycium chinensis Miller)의 휘발성 성분

박원종,복진영,백순옥,한상빈,주현규 한국식품영양학회 1997 韓國食品營養學會誌 Vol.10 No.1

건조 구기자의 휘발성 성분을 분석하기 위하여 SDE 방법으로 정유성분을 추출한 다음 GC 및 GC-MS로 성분을 확인하였다. 확인된 성분은 54종으로써 알코올류 12종, 에스테르케톤류 12종, 알데히드류 7종, 산류 6종, 탄화수소류 5종, 케톤류 8종, 푸란류 1종 및 피라진류 3조이었다. 그중 에스테르류의 상대적 면적비가 가장 높았다. 건조 구기자의 주요 휘발성 성분은 hexadecanoic acid의 에틸에스테르, 1-octadecanone, tetrapyrazine, 2-furancarboxaldehyde, ethyl linoleate 등으로 구성되어 있다. The volatile components of Lycium chinesis Miller were isolated by simultaneous steam distillation-extraction(SDE) method and analyzed by combined GC and GC-MS. Fifty-four volatile components, including 12 alcohols, 12 esters, 7 aldehydes, 6 acids, 5 hydrocarbons, 8 ketones, 1 furan and 3 pyrazines were confirmed in the fruit of Lycium chinensis Miller. The major components were hexadecanoic acids ethyl ester, 1-octadecanone, tetrapyrazine, 2-furancarboxaldehyde and ethyl linoleate.

사지에 발생한 신경초종

박원종,이승구,강용구,이안희,Bahk, Won-Jong,Rhee, Seung-Koo,Kang, Yong-Koo,Lee, An-Hi 대한근골격종양학회 2003 대한골관절종양학회지 Vol.9 No.2

목적: 신경초종은 말초신경 혹은 중추신경에 발생하는 종양이나 대개 무통성 종괴를 주소로 내원하며 신경증상이 드물기 때문에 임상적으로 신경섬유종, 결절종 혹은 지방종 등과 감별이 어려운 경우가 자주 있다. 이에 신경초종의 자기공명영상의 특징적 소견 찾아 조직학적 소견과 비교, 분석하고 임상적 특징 및 수술적 치료의 결과를 알아보기 위해 본 연구를 시행하였다. 대상 및 방법: 1996년 1월부터 2002년 6월까지 수술적 제거술 후 병리조직학적으로 신경초종으로 확진 된 73명의 환자 중 사지에서 발생한 67명을 대상으로 임상기록, MRI 및 EMG 소견, 조직병리 소견, 수술 후 경과 및 합병증 등을 후향적으로 분석하였다. 남녀의 발생빈도 차이는 없었으며, 초진시 나이는 최소 8세에서 최고 75세로 평균 44.7세였다. 추시기간은 최단 3 개월에서 최장 46개월, 평균 9.7개월이었다. 결과: 자기공명영상 검사는 근육들 사이에 T1강조영상에서 중간 신호강도, T2강조영상에서 높은 신호강도를 나타내는 경계가 분명한 방추형의 연부 조직 음영이 특징적으로 모신경에 연결되어 보였다. T2 강조상에서는 주변부의 고강도 신호와 중심부의 저강도 신호를 나타내는 target pattern이 6례(15%)에서 나타났고, 24례(62%)에서 높은 신호강도 내부에 특징적으로 비균질의 저강도 신호 음영이 나타나 fasciculation 같이 보였다. 25례(64%)에서는 다양한 크기의 낭종성 변화를 보였다. 수술 후 합병증은 5명에서 저림증, 2명에서 감각이상, 1명에서 비복신경 손상, 1명에서 요골신경 손상이 발생하였으나 추시 관찰 중 모두 호전되었다. 수술 후 재발한 경우는 없었으며, 악성변화를 한 경우도 없었다. 결론: 수술 전 자기공명영상 검사에 의한 정확한 진단과 조심스러운 적출술로 좋은 치료결과를 얻을 수 있을 것으로 사료된다. Purpose: To correlate the significant MRI findings and histologic features of the Schwannoma of the extremities and to review the clinical characteristic and the result of the surgical enucleation. Materials and Methods: 67 patients with pathologically proven Schwannoma of the extremities, who were surgically treated at our institutes between January 1996 and June 2002, were selected for this study. The clinical records, EMG, MRI and histologic findings were reviewed. Age of the patients ranged from 8 to 75 years with average of 44.7 years. Mean follow-up period was 9.7 months with raging from 3 months to 46 months. Results: On MRI, Schwannoma shows a well-demarcated fusiform mass with a low to intermediate signal intensity on T1-weighted images and high signal intensity on T2-weighted images, which is connected to parent nerve. A target pattern with peripheral hyperintensive rim and central low intensity on T2-weighted images was seen in 6 cases (15%), and fasciculation pattern with inhomogenous intensity in the hyperintensity on T2-weighted images was observed in 24 cases (62%). Various degree of cystic degeneration was discovered in 25 cases (64%). Postoperative complications include tingling sense or radiating pain in 5 patients, paresthesia in 2 patients, nerve palsy in 2 patients, but all of the complications were recovered during followup period. There were no local recurrence or malignant change. Conclusion: MRI demonstrates characteristic findings of Schwannoma, and very useful tool for preoperative diagnosis and planning of surgery. Exact preoperative diagnosis and meticulous enucleation are enough option of treatment.

방사능방재 기상자료수집시스템의 운영

박원종 한국원자력산업회의 1995 원자력산업 Vol.15 No.5

방사능방재 기상자료수집시스템(REMDAS)은 방사선비상시 방사능방재대책기관이 방사성물질의 대기중 확산정도를 실시간으로 평가하여, 주민을 보호하기 위한 방지대책을 수립하는데 필요로 하는 기상정보를 제공해 주는 유익한 대응수단이다. 이 시스템이 운영됨에 따라 원자력시설의 안전성을 확보하기 위한 방사능방재대책이 전산화되는 일대 전기를 맞이하였다.

고립성 폐결절의 조직 특성화: dynamic CT와 integrated PET/CT의 비교

박원종,박찬서,진현정,김규진,유성근,신경철,정진홍,이관호 대한결핵 및 호흡기학회 2006 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.103 No.-

갑상선 종양의 치료 시 하위부 최소침습수술의 미용성과 안전성

박원종,이영돈 대한외과학회 2003 대한외과학회 학술대회 초록집 Vol.2003 No.11