자궁내막에 발생한 점막 연관 림프조직 (MALT) 림프종 1예

전균호,조현진,박성균,김천복,김대연,김종혁,김용만,김영탁,목정은,남주현 대한부인종양 콜포스코피학회 2003 Journal of Gynecologic Oncology Vol.14 No.4

Non-Hodgkin's 림프종의 약 40%는 결절외(extranodal) 림프종으로 대개 위장관에서 발생하며 이들 중 점막 연관 림프조직(mucosa-associated lymphoid tissue: MALT)에서 기원한 림프종은 MALT 림프종으로 분류된다. 위 외의 부위에서 원발성으로 발생하는 MALT 림프종은 매우 드물지만 실제 거의 모든 신체 장기에 발생하는 것으로 알려져 있는데, 가장 흔한 부위인 위 외에도 폐, 갑상선, 침샘, 눈물샘에 발생하고, 드물게 안구, 유방, 방광, 신장, 흉선 등에도 보고된 바 있다. MALT 림프종은 오랜 기간동안 원격 전이하지 않고 국소 병변으로 남아 있는 특징이 있어 치료 방향 또한 국소 병변의 치료에 집중되며, 예후도 림프절 기원의 림프종에 비해 양호한 것으로 알려져 있다. 본 저자 등은 자궁 내막에 원발성으로 발생한 MALT 림프종 1예를 경험하였기에 문헌 고찰과 함께 이를 보고하고자 한다. Mucosa associated lymphoid tissue (MALT) lymphoma can rarely develop primarily in extranodal sites other than stomach which is the most common site for it. Other rare primary sites are small intestine, colorectum, esophagus, lung, thyroid, salivary gland, lacrymal gland, breast and skin. MALT lymphoma represents a distinct clinicopathologic features: it is usually localized to their original site for a long time and shows much more favorable prognosis than lymphoma at other site, but some MALT lymphoma can arise simultaneously or successively in different organ or give rise to another MALT lymphoma of other organ and can be multifocally disseminated or recurred. We report a very rare case of high grade B-cell lymphoma of mucosa associated lymphoid tissue (MALT) of the uterine endometrium, which was confirmed by immunohistochemical assay.

습관성 흡연여성에서 후측 수부에 발생한 Buerger씨병

김삼,이남호,육청미,최영진,백대균,홍경순,두영철,한규록,오동진,유규형,임종윤,이광학,이영 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.7

직렬 리액터를 이용한 계통연계형 태양광 발전 시스템

金大均,鄭春炳,全基英,李丞煥,吳鳳煥,李勳九,金容珠,韓慶熙 명지대학교 산업기술연구소 2005 産業技術硏究所論文集 Vol.24 No.-

Since the residential load is an AC load and the output of solar cell is a DC power, the photovoltaic system needs the DC/AC converter to utilize solar cell. In case of driving to interact with utility line, in order to operate at unity power factor, converter must provide the sinusoidal wave current and voltage with same phase of utility line. Since output of solar cell is greatly fluctuated by insolation, it is necessary that the operation of solar cell output in the range of the vicinity of maximum power point. In this paper, DC/AC converter is three phase PWM converter with smoothing reactor. And then, feedforward control used to obtain a superior characteristic for current control and digital PLL circuit used to detect the phase of utility line.

소아 동종 조혈모세포이식 200예의 분석 : Single Center Study

김학기,조빈,정낙균,정대철,장필상,김선영,김춘추 대한조혈모세포이식학회 2002 대한조혈모세포이식학회지 Vol.7 No.1

연구배경: 1983년 11월부터 2000년 9월까지 시행한 동종 조혈모세포이식의 성적을 분석하여 소아 골수이식의 발전 방향을 모색하고자 하였다. 방법: 1983년 11월부터 2000년 9월까지 가톨릭의대 조혈모세포이식센터, 성모병원 소아과에서 동종 조혈모세포이식을 시행한 200예를 대상으로 조혈모세포이식의 유형 및 대상질환, 이식 당시의 상태 및 전처치에 따른 치료 성적을 후향적으로 분석하였다. 결과: 200예 중 HLA-일치 형제간 골수이식이 146예(73%), HLA-일치 형제간 골수이식 이외의 이식이 54예(27%)였다. 1) HLA-일치 형제간 골수이식: 146예 중 남아와 여아가 각각 78명과 68명이었으며 SAA 50예의 5년 무병 생존율은 95.8±2.9%였고 AML 45예의 5년 무병 생존율은 71.7±7.0%로 일차 및 이차 관해기에 이식 받은 40예와 5예의 5년 무병 생존율은 각각 73.6±7.2%와 60.0±21.9%였다. AML에서 전처치로 Bu/Cy를 사용한 28예와 TBI/Cy를 사용하였던 9예의 5년 무병 생존율은 각각 81.9±7.4%와 33.3±15.7%였으며 Bu/Cu/TBI를 시행한 8예의 무병 생존율은 80.0±17.9%였다. ALL 33예의 5년 이상 무병 생존율은 75.5±7.5%였고 일차 및 이차 관해기에 이식을 시행하였던 18예와 14예의 무병 생존율은 각각 83.0±9.0%와 71.4±12.1%였다. CML 및 MDS 11예의 5년 무병 생존율은 72.7±13.4%였다. 기타 질환으로는 Fanconi 빈혈 2예, 혈구탐식성 조직구증식증 2예, 순적혈구 빈혈 2예, Kostmann 증후군이 1예로 이들의 전체 무병 생존율은 85.7±13.2%였다. 2) HLA-일치 형제간 골수이식 이외의 이식을 시행하였던 54예의 3년 이상 무병 생존율은 45.3±11.6%였으며 HLA-일치 UBMT 26예, CBSCT 15예, 형제 이외의 혈연에 의한 골수이식이 13예로 이들의 무병 생존율은 각각 56.2±10.8%, 58.2±13.1%, 35.9±17.3%였다. 결론: 소아 난치성 혈액질환의 완치요법으로 동종 골수이식의 치료효과를 확인할 수 있었으며, 동종 조혈모세포의 공여원으로 비혈연간 골수나 제대혈의 이용이 점차 증가하고 있음을 알 수 있었다. Background: Bone marrow transplantation was first introduced to Korean children in 1983. Since then the number of children receiving transplants has increased steadily. Methods: We analyzed two hundred pediatric cases of allogeneic hematopoietic stem cell transplantation between Nov. 1983 and Sep. 2000 in Catholic Hematopoietic Stem Cell Transplantation Center of Korea. Results: HLA-matched sibling transplantations were performed in 146 cases (78 males, 68 females, median age; 10 years) with median follow-up of 47 months. The 3-year estimated event-free survival (EFS) of ALL and AML was 76% and 72% respectively. The 5-year estimated EFS of severe aplastic anemia and CML/MDS was 96% and 73% respectively. The 2-year estimated EFS of nonmalignant rare disease was 86%. Twenty-six children underwent unrelated bone marrow transplantation (UBMT), 15 cord blood stem cell transplanta-tion (CBSCT) and 13 familial haploidentical transplantation (FHT). There were 35 males and 19 females with a median age of 6.5 years and median follow-up of 18.5 months. The estimated 2-year EFS of UBMT, CBSCT and FHT were 56%, 58% and 34% respectively. Conclusion: HLA-matched sibling allogeneic BMT showed better survival in children with hematopoietic stem cell disorder compared to UBMT and CBSCT. Recently, transplants using alternative stem cell source are increasing due to lack of suitable matched sibling donor and continuous efforts for reducing transplant-related complications are warranted for improving survival.

한국 성인 유치악자의 하악 치열궁에 관한 조사

김일한,박남수,최대균 慶熙大學校 齒科大學 1995 慶熙齒大論文集 Vol.17 No.2

The purposes of this study are to evaluate the Korean mandibular dental arch and classify the mandibular dental arch shape and size based on the incisal angle, canine angle, inter second molar width and height. In this study the mandibular study models were fabricated using irreversible hydrocolloid impression material from 225 volunteers with a mean age 23.62 (range 19-29). And the study models were measured with 3-dimensional measuring device and the mandibular dental arch was classified by means of K-means clustering method and visual inspection, then obtained data were analyzed with t-test for the statistical analysis. The results `were as follows ; 1. The average canine height was 5.19mm(s.d. 1.17) in both sex, 5.34mm in male, and 35.83mm in female. And the sexual difference was significant(0<p <―0.05). 2. The average second molar height was 39.81mm(sd. 2.44) in both sex, 40.19mm in male, and 39.21mm in female. And the sexual difference was significant(0<p50.01). 3. The average inter-canine width was 27.16mm(s.d. 1.78) in both sex, 27.41mm in male, and 26.77mm in female. And the sexual difference was significant(0<p<0.01). 4. The average inter-first molar width was 46.93mm(s.d. 2.67) in both sex, 47.72mm in male, and 45.7mm in female And the sexual difference was significant(0<p―<0.01). 5. 'the inter-second molar width was average 56.09mm(s.d. 3.01) in both sex, 57.24mm in male, and 54.32mm in woma. And the sexual difference was significant(0<p<―0.01). 6. The arch form was classified into three shapes based on the incisal and canine angle. V-shape showed 124.88 of incisal angle and 141.64 of canine angle, U-shape showed 152.76° and 125.35° , and 0-shape showed 138:03° and 133.66° respectively. Each arch shape distribution was that the V-shape was 142%, the Ushape was 14.7%, and the 0-shape was 71.1% of the 225 study models. 7. It was thought that the use of second molar width is more reasonable than height for classifying the dental arch size. The arch size was classified into four sizes based on the 2nd molar width. Size 1 showed range of 42.24-48.'23 mm, size 2 showed 48.24-54.23mm, and size 3 showed 54.24-60.23mm size 4 showed 60.24-66.23mm respectively Each arch size distribution was that the size I was 1.3%, the size 2 was 27.1%, the size 3 was 63.6%, and the size 4 was 8:0% of the 225 study models.

골다공증을 동반한 다발성 요추 척추관 협착증에서 실시한 선택적 감압술 : 3년 이상의 추시결과 More than 3 Years Follow Up

심대무,김태균,송하헌,조용우 대한척추외과학회 1998 대한척추외과학회지 Vol.5 No.2

Objects : There was a trend to perform fusion and instrumentation in spinal stenosis surgery, because of extensive decompression and instability. However, the introduction of microscope in spine operation can minimize the range of excision of anatomical structure and reduced the decompressin level in the multiple lesions and the incidence of spinal fusion. The purpose of this study were to assess the outcome of this procedure in 3 years follow up and to identify the clinical features of the patients and technical aspects of the operation that were associated with a poor outcome. Materials and Methods : Twenty-one patients were identified as having had a microscopic decompression without arthrodesis, for degenerative lumbar spinal stenosis over 60 years or their who had osteoporosis with Saville's index 2 or higher. The follow up period was more than 3 years. The clinical results was evaluated by Kim's criteria. Results : Eleven cases were above good results in two levels involved 14 cases, 2 cases above good results in three levels involved 5 cases and 1 case above good results in four levels involved 2 cases. In the cases of affected duration, 7 cases are less than I year or more than 5 years each 6 cases and 2 cases were above good results by the criteria. We concluded that the long-term outcome of decompressive surgery in the elderly is good; it does not differ from that reported for younger patients. Conclusions : Selective microscopic decompression is one of the effective method for the elderly patients or patients with osteoporosis in addition to multiple stenotic lesions.

하악골 충격시 안면 두개골의 응력분산양상에 미치는 구강보호장치의 역할에 관한 유한요소법적 연구

김일한,노관태,노현식,김지연,우이형,Kung-Rock Kwon,최대균 대한치과보철학회 2012 대한치과보철학회지 Vol.50 No.1

연구 목적: 이 연구의 목적은 하악골 충격 시 안면 두개골의 응력 분산양상에 미치는 구강보호장치의 효과에 대해 조사하는 것이다. 연구 재료 및 방법:: 구강보호장치를 제작하고 사람의 머리부위와 치열의 3차원적 유한요소 모델을 컴퓨터 토모그래피를 사용하여 제작하였다. 머리부위의 finite element model은 356,092요소와, 87,099절점으로 이루어져 있다. 그리고 skull과 maxillae, mandible, articular disc, teeth, 그리고 구강보호장치로 구성되었다. 경부의 움직임을 묘사하기 위하여 스프링이 사용되었다. 하악골의 충격점은 gnathion, center of inferior border 와 anterior edge of gonial angle이었다. 충격방향은 수직, 경사방향(45 도), 그리고 수평이다. 충격량은 0.1초당 800 N이었다. 결과: 수직충격을 가한 경우에는 구강보호장치의 장착여부와 무관하게 비슷한 응력과 분산양상이 나타났다(P>.05). 경사충격(45 도)을 가한 경우 구강보호장치를 장착한 모델에서는 응력이 치아와 안면골 및 두개골로 넓게 분산되었으나 이에 비하여 장착하지 않은 모델에서는 치아에 응력이 집중되었다(P<.05). 수평충격을 가한 경우 구강보호 장치를 장착한 모델에서는 응력이 치아와 안면골 및 두개골로 넓게 분산되었으나 이에 비하여 장착하지 않은 모델에서는 치아에 응력이 집중되었다(P<.05). 구강보호장치를 장착하지 않은 모델에서는 상악 치아에 응력이 집중되는 반면, 장착한 모델에서는 모든 충격실험에서 계측된 응력이 매우 낮았으며, 전달된 응력이 상악 치아와 안면골 및 두개골로 넓게 분산되었다. 결론: 구강보호장치는 외부충격 시에 하악에 수직으로 가해지는 충격에는 완충효과가 적었고, 45 도 경사 충격과 수평 충격에는 발생하는 응력을 안면골과 두개골의 넓은 범위로 분산시키고 응력을 감소시켜 응력의 완충 효과가 있었다. PURPOSE. The purpose of this study was to investigate the effects of a mouthguard on stress distribution under mandibular impact. MATERIALS AND METHODS. The FEM model of head consisted of skull, maxilla, mandible, articular disc, teeth, and mouthguard. The impact locations on mandible were gnathion, the center of inferior border, and the anterior edge of gonial angle. And the impact directions were vertical, oblique (45 degrees), and horizontal. The impact load was 800 N for 0.1 sec. RESULTS. When vertical impact was applied, the similar stress and the distribution pattern was occurred without the relation of the mouthguard use (P>.05). The model with mouthguard was dispersed the stress to the teeth, the facial bone and the skull when the oblique (45 degrees) impacts were happened. However, the stress was centralized on the teeth in the model without mouthguard (P<.05). The model with mouthguard was dispersed the stress to the teeth, the facial bone and the skull when the horizontal impacts was occurred. However, the stress was centralized on the teeth without mouthguard (P<.05). For all impact loads, stress concentrated on maxillary anterior teeth in model without mouthguard, on the contrary, the stress was low in the model with mouthguard and distributed broadly on maxillary anterior teeth, facial bone, and skull. CONCLUSION. The mouthguard was less effective at shock absorbing when vertical impact was added. However, it was approved that mouthguard absorbed the shock regarded to the oblique (45 degrees) and horizontal impact by dispersing the shock to the broader areas and decreasing the stress.

요추 추간판 탈출증에서 현미경을 이용한 추간판 절제술 : 5년 추시 결과 A 5-years follow up

심대무,김상수,김태균,송하헌,최시호 대한척추외과학회 2000 대한척추외과학회지 Vol.7 No.1

목적 : 저자들은 요추 추간판 탈출증으로 진단받고 고식적 추간판 절제술과 현미경을 이용한 추간판 절제술을 시행한 환자를 대상으로 수술전후 임상결과를 파악하고 현미경을 이용한 수술의 장기 추시결과와 효율성을 알아보자하였다. 대상 및 방법 : 1988년 1월부터 1993년 12월까지 요추 추간판 탈출증으로 진단받고 고식적 방법 및 현미경을 이용한 방법으로 추간판 절제술을 시행하고 5년이상 추시 관찰이 가능하였던 각각 30명의 환자를 대상으로 관찰군과 비교군으로 설정하고 환자의 연령 및 성별분포, 발병 원인과 증상 및 진단과 이환부위에 대하여 분석하고 임상적 결과를 김의 방법으로 평가하고 paired T test를 이용한 통계학적 검증을 하였다. 결과 : 수술시간은 고식적 수술의 경우 평균 117분, 현미경을 이용한 경우 98분이 걸렸으며 직업복귀 까지는 고식적 추간판 절제술시 9.6주, 현미경을 이용한 경우 5.9주가 소요되었다. 임상평가 결과는 술후 1년이상 추시상 고식적 방법에서 양호이상이 76.9%이었으며 현미경을 이용한 경우는 양호이상이 84.6%를 보였다. 5년이상 추시상 고식적인 방법에서 60.0%와 현미경을 이용한 경우 63.3%로 비슷한 결과를 보였다. 결론 : 현미경을 이용한 요추 추간판 절제술시 정상조직에 대한 최소한의 손상과 신경근의 명료한 구분으로 안전하게 시행할 수 있는 방법으로 사료되며 장기적 추시결과에서도 고식적 수술방법과 유사한 결과를 보여 요추 추간판 탈출증 환자의 수술적 치료의 한 방법으로 환자들의 치료에 도움이 되리라 사료되었다. Purpose : This study was performed in an attempt to determine if there was any clnical benefit of microdiscectomy(MD) over standard discectomy(SD). They were all followed up by an impartial observer at 1 year and 5 years. Materials and Methods : All patients were operated on by the same surgeon by either method. We evaluate retrospectively 30 cases of microdiscectomy and 30 cases of microdiscectomy and 30 cases of standard discectomy using data derived from a questionnaire and chart review from January 1. 1988 to December 31. 1993. The operative results were analysed with Kim's creteria and that clinical results were statistically used to Paired two-tailed T test. Results : 1)Mean operating time was about 117 minutes in the standard discectomy, while 98 minutes in the microdiscectomy. 2)Mean time to returm to work was about 9.6 weeks in the standard discectomy, 5.9 weeks in the microdiscectomy. 3)In initial and 1 year follow up, microdiscectomy was superior to the standard discectomy but in 5 years follow up, the two procedures have a similar outcome. Conclusion : The advantage of microdiscectomy was more safe than standard discectomy, because it was mahinfied vision and brilliant illumination, precise identification of structures in deep fields(including nerve root and its related structures), a marked adantage to dissect the adhere nerve root to its surroundings structures, its capacity to preserve the integrity of normal tissue, and meticulous hemostasis. From this analysis, we conclude that microdiscetomy represents a small but significant refinement of standard discectomy

로자탄 대 포시노프릴의 고혈압 환자들에서 항고혈압 효과, 안전성 및 내약성의 비교

박대균,이명묵,채인호,이무용,이홍자,김효수,김철호,손대원,오병희,박영배,최윤식 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.1

1-Arylpyrrole로부터 9-Arylcarbazole의 합성

朴유미,金寅植,李龍均,成大東,金東賢,金倫瑛,鄭大一 東亞大學校附設基礎科學硏究所 1997 基礎科學硏究論文集 Vol.14 No.1

Carbazoles were discovered in anthracene oil of coal tar, and are the parent structure of a number of heterocyclic compounds. Much attention has been paid to carbazole derivatives recently as the materials for semiconductors and photoconductive compounds. Many conventional methods for synthesis of carbazoles were known such as Grabe-Ullmann methods and the Tauber methods. In the course of the investigation for the synthesis of pyrrole derivatives 3. We have found the formation of 9-arylcarbazoles 4 under refluxing glacial acetic acid. Thus we report the results here.