갑상선 결절의 감별진단에 있어 탄성 초음파검사

김정훈,최재영,최영식<SUP>1<,SUP>,정미희<SUP>2<,SUP>,정경순<SUP>2<,SUP>,Jung Hoon Kim,M,D,Jae Young Choi,M,D,Young Sik Choi,M,D,<SUP>1<,SUP>,Mi Hee Jung,M,D,<SUP>2<,SUP> and Kyung Soon Jung,M,D,<SUP>2<,SUP> 대한갑상선-내분비외과학회 2011 The Koreran journal of Endocrine Surgery Vol.11 No.1

Purpose: Ultrasound (US) elastography is a newly developed imaging technique for assessing tissue stiffness by measuring the degree of the tissue's deformation in response to the application of an external force. This technique has recently been applied for making the diagnosis of nodular thyroid disease. The purpose of this study was to evaluate the diagnostic utility of US elastography for differentiating benign thyroid nodules from malignant thyroid nodules. Methods: A total of 63 consecutive patients with thyroid nodules and who were referred for surgical treatment were examined in this study. Seventy-five nodules in these patients were examined by US B-mode, color Doppler US and US elastography. The final diagnosis was obtained from the histologic findings. The tissue stiffness on ultrasound elastography was scored from 1 (elasticity in the whole nodule) to 5 (no elasticity in the nodule and in the posterior shadowing). Results: On US elastography, 18 of 32 benign nodules (56.3%) had a score of 1 to 3, whereas 23 of 43 malignant nodules (62.8%) had a score of 4 to 5. With applying a US elastography score of 4-5 as an indicator for malignancy, the sensitivity, specificity, positive predictive value and negative predictive value of US elastography were 65.9%, 52.9%, 62.8% and 56.3%, respectively. Of the 14 follicular tumors, 12 were follicular adenoma and four were follicular carcinoma. The sensitivity and specificity of US elastography for diagnosing follicular carcinoma were 50.0% and 81% (56=69), respectively. The positive and negative predictive values were 55.2% (16=29) and 60.0%, respectively. The accuracy of the technique was 57.1%. The findings of US elastography were not significantly correlated with the histopathologic findings. Conclusion: This study has shown that US elastography may be not useful for differentiating between benign and malignant thyroid nodules. Further studies are needed to confirm the usefulness of US elastography for making the differential diagnosis of thyroid nodules. (Korean J Endocrine Surg 2011;11:12-17)

Recurrence and Extraneural Metastasis in 31 Meningeal Hemangiopericytomas

김정훈,김준수,김창진,황승균,정희원,권병덕,Kim, Jeong Hoon,Kim, Joon Soo,Kim, Chang Jin,Hwang, Sung Kyun,Jung, Hee Won,Kwun, Byung Duk The Korean Neurosurgical Society 2001 Journal of Korean neurosurgical society Vol.30 No.3

Purpose : Meningeal hemangiopericytoma(M-HPC), characterized by a high local recurrency and metastatic potential, is a rare neoplasm arising from perivascular pericytes. A retrospective study was performed to identify the recurrence and extraneural metastasis in M-HPC. Materials and Methods : We reviewed the records of 31 M-HPC patients treated from 1982 through 1999 at our institution. The time to recurrence and the various parameters affecting recurrence were determined. Extreneural metastasis was also analyzed. Results : The rate of local recurrency was 38.7%(12/31). The overall average recurrence-free period(RFP) before the first recurrence was 104 months, with overall recurrence-free rates(RFRs) at 5 and 10 years after first surgery of 59.2% and 33.6%, respectively. Of the 12 patients who experienced local recurrence, 4 had recurrences 5 years later after the first surgery. Complete excision at the first operation significantly extended the average time before first recurrence from 43 to 111 months. The 5-year RFRs for the groups of complete excision and incomplete excision were 72.7% and 20.8%, respectively(p=0.0060). Although there was no statistical significance, complete excision followed by adjuvant radiotherapy of more than 50Gy extended the RFP. The 5-year RFRs for the groups of complete excision and complete excision with adjuvant radiotherapy were 70.3% and 100%, respectively(p=0.3359). Four patients(12.9%) presented one or more extraneural metastases that were developed at an average of 107 months after the first operation with the 5- and 10-year metastasis rates of 4.4% and 24.9%, respectively. Conclusions : M-HPC has a propensity to recur either locally or at distant sites after surgical resection. Complete excision is the most important factor to reduce recurrence. However, even with complete excision, adjuvant radiotherapy of more than 50Gy significantly reduces the risk of recurrence. Local and distant recurrences may occur after a prolonged disease-free interval, emphasizing the need for long-term follow-up.

유료 콘텐츠의 N-스크린 서비스를 위한 일시적 시청권한 위임 기법

김정훈,이훈정,김상진,오희국,Kim, Jung-Hoon,Lee, Hoon-Jung,Kim, Sang-Jin,Oh, Hee-Kuck 한국정보처리학회 2011 정보처리학회논문지 C : 정보통신,정보보안 Vol. No.

최근, 통신기술의 급속한 발전으로 인해 때와 장소에 구애받지 않고 콘텐츠를 소비하고자 하는 사용자의 욕구와 새로운 비즈니스 모델을 찾고자 하는 사업자의 바람이 맞물려 N-스크린 서비스 전략이 주목 받고 있다. N-스크린은 TV, 컴퓨터, 휴대용 단말 등 다양한 기기에서 끊김 없이 콘텐츠를 공유, 소비할 수 있도록 지원하는 스크린 확장 개념의 서비스로서 미국의 통신회사인 AT&T에서 처음 제안했던 3-스크린 서비스 전략이 발전된 형태이다. 유료 콘텐츠에 대한 N-스크린 서비스에서 유료 콘텐츠에 대한 끊김없는 스크린 전환을 지원하기 위해서는 스크린을 전환하고자 하는 기기로 일시적인 시청권한을 부여해야 한다. 하지만 접근제어 시스템을 사용하고 있는 현재의 방송환경에서는 일시적으로 권한을 부여하는 것이 불가능하다. 본 논문에서는 현재 방송환경에서 유료콘텐츠에 사용하고 있는 접근제어 기법에 대해 살펴보고 일시적인 권한 부여를 할 수 없는 이유에 대해서 살펴본 뒤 현재 사용 중인 접근제어 기법을 기반으로 추가적인 키를 사용해 시청권한 문제를 해결하는 방법을 제안한다. Recently, the strategy for N-screen service is in the spotlight along with the consumer's need to use contents regardless of time and place due to the rapid development of communication technology, which is meshing with the desire of service providers seeking a new business model. N-screen, as a screen-extension-concept service which enables consumers to continuously share and use contents in various equipments such as TV, computer and portable terminals, is an advanced type of 3-screen service strategy initially proposed by AT&T, an American telecommunication company. In the N-screen service for pay-contents, in order to support continuous screen changes to and from various equipments, temporary watching right should be given to the equipment intended for screen change. However, it is impossible to give the temporary watching right in the present broadcasting environment, adopting an access-control system. In this paper, the access-control technology being used for pay-contents in the present broadcasting environment and the reason for not being able to give temporary watching right, will be examined. After the examination, the solution for delegation of watching right by using an additional key on the basis of currently used access-control technology, will be proposed.

지하시설물 통합관리를 위한 모니터링 항목 분류에 관한 연구

김정훈,민경주,이미숙,임시영,Kim, Jung-Hoon,Min, Kyung-Ju,Lee, Mi-Sook,Lim, Si-Yeong 대한공간정보학회 2010 한국공간정보학회지 Vol.18 No.1

It is important to manage the underground facilities efficiently because they are directly related to the convenience and safety of citizens. But the fact that the different agencies take on a role of managing the underground facilities respectively makes it impossible. So Korean government has exerted great efforts to solve this problem through several projects. Korean government expects that the ubiquitous technologies such as sensor and wireless communication in the domain of the underground facilities management will be useful. It is main duty of u-City Management Center to monitor several situations about the underground facilities using ubiquitous technologies. But there is no consensus about what concrete situations it has to monitor even though u-cities under construction. Because local governments or related companies are in charge of carrying out these roles yet, there is no legal basis on which to do these tasks by the center. And it is needed to develop new technologies for u-services efficiently. Because technologies for u-service are vast, various and converged, so it necessary to develop them according to priority or in cooperation with other developers. In this paper, we classify the monitoring items for each facility which were investigated by a recent research. It is expected to make use of defining the role of the center and developing technologies with u-service.

지능형 지하시설물관리를 위한 상수도 모니터링 기술개발의 우선순위 평가에 관한 연구

김정훈,이미숙,한재일,Kim, Jung-Hoon,Yi, Mi-Sook,Han, Jay-Il 한국공간정보학회 2008 한국공간정보학회지 Vol.16 No.2

Nowaday, local governments have planned to manage intelligent underground facilities through the u-City project. But, the intelligent underground facilities are in need of the progressive approach because of the required huge financial resources. Therefore, the objectives of this research are (1) to prioritize the monitoring items of sensing technology developments, (2) to study technological feasibilities, and (3) to discover the killer application which expands ripple effects on economy. To achieve these objectives, final monitoring items were derived from the business analysis of the water supply, the local government survey, the hearing expert opinions and so on. The priority order of final monitoring items were technology developments of (1) the flowmeter flux, (2) the water leakage/crack, (3) the pressure of water supply pipes, and (4) the flux of filtration plants. The research significance is obtained from the derivation and the evaluation of the priority order and the actual demand for the water supply facility management. And, the research results will contribute to the strategic planning for the underground facility intelligence.

동해 묵호항 근처에서의 난류세기인자에 따른 음향수신신호의 위상분산 추정

김정훈,복태훈,팽동국,심태보,김영규,박정수,Kim, Jung-Hun,Bok, Tae-Hoon,Paeng, Dong-Guk,Shim, Tae-Bo,Kim, Young-Kyu,Park, Joung-Soo 한국음향학회 2009 韓國音響學會誌 Vol.28 No.4

음향수신신호의 위상은 매질에 대한 정보를 포함하고 있기 때문에 위상 변동을 연구하는 것은 매질에 대한 연구와 동반 되어야 한다. 또한 SAS (Synthetic Aperture Sonar)나 수중통신 등의 신호처리 시 수신신호의 위상변동 보정이 필요하다. 본 연구에서는 미세구조 난류에 의한 수신신호의 위상분산을 고찰하였다. 국지적으로 등방성이고 균질한 난류 환경 하에서 난류세기인자를 구하였고 음파 전달경로에 따라 난류세기가 미치는 영향을 고려하여 위상분산을 계산하였다. 난류세기 계산에 필요한 CTD자료와 ADCP자료는 묵호항 근처에 설치된 부표에서 획득하였으며 음파 전달경로는 Bellhop알고리즘을 이용한 음선 모델을 사용하였다. 결과적으로 난류세기인자는 주로 수온과 유속의 변화에 의해 결정되었으며 수신신호의 위상분산에 영향을 주었다. 이러한 위상분산은 소나 운용에 고려되어야 할 사항으로 여겨진다. Phase variance of the acoustic signals has to be investigated with the research of the medium, because the phase of the acoustic signals carries the information of the medium. The phase compensation of the received signals is required for the signal processing of SAS (Synthetic Aperture Sonar) and underwater communication. In this paper, the phase variance of the acoustic signals was studied depending on the micro-scale-turbulence of ocean. The turbulence strength of the locally isotropic and homogeneous turbulence was calculated, and the phase variance affected by the turbulence strength was computed along the ray paths. The CTD and ADCP data were acquired from a buoy system near the Mukho port in the East Sea of Korea and the ray paths were calculated by the Bellhop algorithm. As a result, the turbulence strength was mainly determined by the variation of temperature and flow speed, changing the phase variance of the received signals. Hence, we thought the phase variance should be considered in the sonar operating system.

아편유사제 복용 중인 암성 통증 환자들에서 경구 Oxycodone/Naloxone으로 전환 후 발생한 금단증상

김정훈,송하나,이경원,강정훈,Kim, Jung Hoon,Song, Haana,Lee, Gyeong-Won,Kang, Jung Hun 한국호스피스완화의료학회 2017 한국호스피스.완화의료학회지 Vol.20 No.2

목적: 경구 oxycodone/naloxone 복합제는 아편유사제에 의해 유발되는 변비를 완화시키거나 예방하는 목적으로 사용되고 있다. Naloxone에 의해 oxycodone의 진통 효과가 상쇄되거나 금단증상이 나타난다는 보고는 거의 없었으나 저자는 실제 임상에서 몇몇 금단증상 예를 경험하였기에 이 환자들에 대한 조사 연구를 수행하였다. 방법: 2012년 1월 1일부터 2016년 12월 31일까지 경남 지역 암센터에 방문했던 진행성 암환자들로 oxycodone/naloxone extended-release tablets를 투약 받고 마약 금단증상이 나타났던 환자들의 의무기록을 후향적으로 조사하였다. 결과: 연구 기간 중 경구 oxycodone/naloxone을 처방 받은 1,641명의 암 환자 중, 총 10예(0.6%) 에서 마약 금단 증상을 겪었다. 금단증상 관련 통증 강도의 변화는 oxycodone/naloxone 투여 전 NRS 3에서 평균 NRS 6점으로 증가하였다. 금단증상 중 오한이 10예 중 7예에서 나타나 가장 많이 나타난 증상이었으며 그 외에 식은땀, 전신 쇠약감, 근육경련, 복부경련(각 5예), 불안(4예), 열, 어지럼증, 의식혼란, 하품(각 2예)의 순으로 빈번하게 관찰되었다. 결론: Oxycodone/naloxone extended-release 복합제에 의한 마약 금단증상은 흔하지는 않아도 적은 수의 환자에서라도 나타날 수 있다. 향후 이에 대한 다기관, 전향적 연구가 필요하다.

전립선암 근접시료시 주변 장기 선량 평가

김정훈,임창선,황주호,Kim, Jung-Hoon,Lim, Chang-Seon,Whang, Joo-Ho 한국의학물리학회 2008 의학물리 Vol.19 No.3

As a part of estimating quantitative radiation treatment doses, we produced a mathematical phantom based on the standard Korean male. Then, with the prostate as the source organ, we calculated the absorbed dose in the prostate and surrounding organs forecasted to occur during brachytherapy for prostate cancer. To simulate the procedure, we selected $^{25}I$ and $^{103}Pd$ useful in brachytherapy of the prostate as the radionucleids and made an assumption that 1 Ci of initial radioactivity is administered. As a result, we found that the prostate, as the source organ, indicated 101 Gy/Ci and 7.24 Gy/Ci, respectively, in case of $^{125}I$ and $^{103}Pd$. With the exception of the prostate, organs with high absorbed doses were found to be in the order of the penis and scrotum, sigmoid colon, testicles and the urinary bladder, which are relatively close to the prostate.

유비쿼터스 시대를 대비한 u-City 계획체계 정립방안

김정훈,조춘만,Kim, Jung-Hoon,Cho, Chun-Man 한국공간정보학회 2008 한국공간정보학회지 Vol.16 No.1

Last February, $\ulcorner$The Act on Ubiquitous City Construction and etc.$\lrcorner$ was approved by the National Assembly. The law stipulates the regulations on the planning, construction and management of the Ubiquitous City. As its national-level law system is about to take its effects, future new city developments are expected to have its legal basis to be built to meet ubiquitous city requirements. Also, it is anticipated that such needs would require much more planning techniques and strategies. In reaction to those upcoming needs, this study is to search for new planning approaches to realize the u-City in reality. It is also to supply with the framework to execute the u-City projects in more structuralize and systemize manner. Therefore, with the purpose of the establishment of comprehensive planning system, the theoretical bases were sought in relation to planning u-City, pre-existing u-City development cases and regarding regulations were analyzed, and then basic concepts, features, and constituent factors were set up.

코눈물관폐쇄 환자의 눈물주머니조영술과 임상적 의의

김정훈,김준모,우경인,Jung Hoon Kim,Joon Mo Kim,Kyung In Woo 대한안과학회 2006 대한안과학회지 Vol.47 No.11

Purpose: To investigate the configuration of the lacrimal sac and its clinical significance in patients who underwent dacryocystorhinostomy. Methods: The subject of this study were 132 eyes of 109 patients who were diagnosed as having nasolacrimal duct obstruction and who underwent surgical therapy from 2001 to 2005. According to the size of the lacrimal sac, eyes were divided into a common canalicular obstruction group, a small sac group, and a large sac group. The relationship between the sac size and clinical characteristics of the patients was evaluated. Results: There were 27 male and 82 female patients with a mean age of 53.6 years. The common canalicular obstruction group included 17 eyes, the small sac group 79 eyes, and the large sac group 36 eyes. The proportion of female patients (p=0.042) and mean age (p=0.029) were higher in the small sac group, compared with the large sac group. Patients in the large sac group had favorable surgical outcomes (p=0.001). Conclusions: Dacryocystography is a useful method to assess the lacrimal drainage system. We found a relationship between the sac size and clinical characteristics of nasolacrimal duct obstruction patients. Further pathophysiologic studies on the mechanism of contraction of the lacrimal sac are needed.