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김병창,Kim, Byoung-Chang 한국광학회 2007 한국광학회지 Vol.18 No.2
광역의 자유곡면 형상을 나노미터 정밀도로 측정하기 위한 새로운 형상 측정법으로서 곡률에 근거한 형상 측정법을 제안한다. 곡률 형상 측정기는 피측정물을 일정간격으로 스캔하는 간섭계로써 각 국부영역의 형상으로부터 곡률을 획득하여, 이로부터 전 영역의 형상을 복원한다. 제안된 곡률 형상 측정기는 비구면 형상 측정을 위해 개발된 보상 광학계(Null optics)나 국부영역의 형상을 측정하고 결합하는 subaperture-slicking 법에 비해 측정 장비로부터 발생하는 시스템 오차를 근본적으로 제거하는 특징을 가진다. $80mm\times80mm\times25mm$ 작동구간을 갖는 Stewart Platform과 상용 트와이만 그린 간섭계를 이용하여 곡률간섭계를 구성하였으며, 자유곡면의 형상측정을 위한 첫 단계로서 잘 알려진 구면형상을 측정하고, 기존 장비의 측정값과 비교한 결과 32 mm영역에서 최대 56 nm의 차를 보임을 확인하였다. I present a novel curvature profilometer devised fur the profile measurement of aspheric and free-form surfaces on the nanometer scale. A profile is reconstructed from measuring the curvature of a test part of the surface at several locations along a line. For profile measurement of free-farm surfaces, methods based on local part curvature sensing have strong appeal. Unlike full-aperture interferometry they do not require customized null optics. The measurement accuracy of the curvature profilometer was assessed by comparison with a well-calibrated interferometer in NIST. Experimental results prove that the maximum discrepancy turns out to be 37 nm on the 28 mm measurement range for the spherical mirror.
Variable Clinical Classifications and Diagnostic Coding Systems of Colorectal Neuroendocrine Tumor
김병창,박철희,김태일,이석호,김진오,김현수,양동훈,금보라,홍성필,김성은,김현건,신정은,차재명,주영은,박동일,최황,허규찬,명승재,장동경,박선자 대한장연구학회 2013 Intestinal Research Vol.11 No.1
The incidence of colorectal carcinoid tumor is recently increasing as screening colonoscopy increased. Traditional carcinoid tumor had been known as low grade, malignant neuroendocrine cell orign tumor. In 2000, World Health Organization (WHO) suggested that carcinoid was called well-differentiated neuroendocrine tumor (NET). It recently updated in 2010 by WHO; according to the differentiation and malignant potential, NET classified with NET Grade 1, Grade 2, and neuroendocrine carcinoma. They suggested that NET had malignant potential in accordance with histopathologic characteristics. Therefore, WHO recommended the behavior code of NET as malignant. However, European Neuroendocrine Tumor Society (ENETS) proposed the behavior of NET to four grades based on the histopathologic features; benign, benign or low grade malignant, low grade malignant, and high grade malignant. Also, American Joint Committee on Cancer (AJCC) suggested that topography codes of NET were defined as malignant. Korean Standard Classification of Diseases (KCD) described the different codings of carcinoid (NET). The discrepancies of behavior code or coding system exist among WHO, ENETS, AJCC and KCD. Also, there were differences in the perception for topographic coding system between clinicians and pathologists. NETs of colorectum were reported with the variable clinical characteristics (especially, metastasis) and long term prognosis from many studies. Especially, risk of metastasis and long term prognosis of small sized NET (<1 cm) had some discrepancies and should be investigated prospectively. Therefore, the consensus about topographic codes of NET should be needed with multidisplinary approach among gastroenterologists,pathologists and surgeons. (Intest Res 2013;11:14-22)
김병창,이상길,김태일,김호근,김원호,천재희 연세대학교의과대학 2008 Yonsei medical journal Vol.49 No.4
Colonic inflammatory fibroid polyp (IFP) is an uncommon benign polypoid lesion, which is composed of fibroblasts, numerous small vessels and edematous connective tissue with marked eosinophilic inflammatory cell infiltration. This condition is frequently detected in the stomach and small intestine, but uncommon in the colon. Although IFP is a benign lesion, surgical resections are performed in most colonic cases because the polyps are usually too large to resect endoscopically. Only three patients underwent endoscopic polypectomy in our literature reviews. Here, we present a case of IFP in the descending colon successful endoscopically resected using a novel technique of trapping its stalk with an endoloop, forming the stalk into an omega shape, and then dissecting the stalk with a needle knife.
내시경적 유두괄약근 절개술 후 발생한 담석성 장폐쇄 1예
김병창,김희만,문창모,서정훈,조용석,이천균,원선영,박인서,윤성현 대한소화기내시경학회 2004 Clinical Endoscopy Vol.29 No.4
Gallstone ileus is caused by mechanical obstruction of the gastrointestinal tract by the gallstone and accounts for 1∼3% of all intestinal obstructions. Endoscopic sphincterotomy (EST) is the accepted treatment of choice for choledocholithiasis. Recognized complications of EST include bleeding, acute pancreatitis, retroperitoneal perforation. However, gallstone ileus is a rare complication of EST. A 70-year-old woman was admitted to our hospital with right upper quadrant pain. Abdominal ultrasound revealed single common bile duct (CBD) stone. ERCP was performed to remove the large CBD stone without mechanical lithotripsy. Nausea, vomiting and abdominal pain were developed after stone removal. Plain abdomen X-ray and computerized tomography represented marked dilatation of small bowel loops without definite obstructive lesion. Because the mechanical obstruction was sustained, explorolaparotomy was performed. On the operation, single stone was impacted at the distal ileum, narrowed by previous radiotheraphy. We reported a case of gallstone ileus after the removal of CBD stone following EST without lithotripsy. 담석성 장폐쇄는 담석에 의해 형성된 담낭-장관 누공을 통해 장관으로 배출된 담석에 의해 장관이 폐쇄되는 질환이다. 담석성 장폐쇄는 기계적 장폐쇄의 원인 중 약 1~2%를 차지한다. 담관 담석은 내시경적 유두괄약근 절개술을 통한 제거술이 일반적인 치료이며, 합병증으로는 출혈, 급성췌장염, 천공, 담관염 등이 있다. 그러나 내시경적 유두괄약근 절개술 후 발생한 담석성 장폐쇄는 보고가 드물다. 70세 여자 환자가 한 달 동안의 우상복부 동통을 주소로 내원하였고, 복부 초음파 검사에서 총담관에 거대 담석이 있었다. 내시경적 유두괄약근 절개술 후 기계적 쇄석술 없이 담관에서 담석을 제거한 후 대변으로 자연 배출을 시도하였다. 그러나 담관 담석 제거 후 오심, 구토, 복통을 호소하였고, 단순 복부 촬영에서 소장폐쇄 소견이 발생하였다. 복부 전산화 단층 촬영에서도 명확한 장폐쇄 병변은 없었으나 소장이 확장된 소견이 있었다. 장폐쇄 소견이 지속되어 담석성 장폐쇄 의심하에 개복술을 시행하여 말단 회장에서 담석을 확인하고 담석 제거와 소장 분획 절제술을 시행하였다. 저자들은 거대 담관 담석을 유두부 대절개로 기계적 쇄석술 없이 담관에서 제거한 후 대변으로 자연 배출을 시도하였으나, 소장에서 발생한 담석성 장폐쇄 1예를 경험하였기에 보고하는 바이다.