수두증을 동반한 송과체 부위 종양에 대한 내시경적 치료

김정훈,나영신,김준수,안재성,김창진,권병덕,Kim, Jeong Hoon,Ra, Young Shin,Kim, Joon Soo,Ahn, Jae Sung,Kim, Chang Jin,Kwun, Byung Duk 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.5

Purpose : In general, pineal region tumors are managed by using microsurgical approach or stereoctactic biopsy. However, in selected cases endoscopic approach to pineal lesions might prove to be as effective as microsurgery and less invasive. We report an alternative surgical strategy for managing certain patients with pineal neoplasms that allows treatment of the symptomatic hydrocephalus as well as tumor biopsy under direct vision in the same sitting. Materials and Methods : Twenty-two patients with pineal region tumors with associated hydrocephalus were treated in one session by endoscopic third ventriculostomy and endoscopic tumor biopsy at our institution from October 1996 to January 2000. All patients were retrospectively evaluated. Results : There was no operative mortality. There was one cause of significant bleeding during biopsy, but was controlled endoscopically, and the patient recovered completely without neurologic deficit resulting from intra-operative bleeding. The symptoms related to increased intracranial pressure(ICP) have resolved in all patients, and the need for a shunt is completely eliminated. Histological diagnosis was achieved in 21 of the 22 patients by this procedure. A biopsy was not obtained in one patient. Although this pineal region tumor was seen endoscopically, this could not be biopsied because of technical difficulties in working around an enlarged massa intermedia. The lesions included fourteen germinomas, three mixed germ cell tumors, and one each of the followings: pineocytoma, pineoblastoma, pineocytoma/pineoblastoma(intermediate type), meningioma, and low grade glioma. Five of the 22 patients subsequently underwent formal microsurgical tumor removal. Additional chemotherapy or radiotherapy could then be initiated according to the histological diagnosis. Conclusion : We consider that endoscopy affords a minimally invasive way of reaching three objectives by one-step surgery in the management of pineal region tumors with associated hydrocephalus : 1) cerebrospinal fluid(CSF) sample for analysis of tumour markers and cytology, 2) treatment of hydrocephalus by third ventriculostomy, and 3) several biopsy specimens can be obtained identifying tumors which will require further open surgery or adjuvant radiation and/or chemotherapy. However, complications and morbidities should be emphasized so as to be avoided with further technical experience.

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

목 적 : 높은 재발율과 전이 가능성의 특징을 갖고 있는 수막 혈관외세포종은 perivascular pericytes에서 기원하는 드문 종양으로, 저자들이 경험한 수막 혈관외세포종에 있어서 종양의 재발 및 신경계외 전이에 대하여 알아 보고자 한다. 연구 대상 및 방법 : 1982년부터 1999년까지 수술을 시행하여 수막 혈관외세포종으로 진단받은 31명의 환자를 대상으로 후향적 연구를 시행하였다. 진단 후 재발까지의 기간, 재발에 영향을 미칠 수 있는 여러 가지 인자들, 그리고 신경계외 전이의 기간 및 부위 등을 분석하였다. 결 과 : 총 31명의 환자들 중 12명의 환자들에서 원발성 부위에 종양이 재발하였다(38.7%). 전체의 환자들에서 재발이 발생하지 않았던 평균 기간(recurrence-free period : RFP)은 104개월이었으며 처음 수술 후 5년, 그리고 10년의 재발이 발생하지 않았던 율(recurrence free period : RFP)은 각각 59.2%, 33.6% 이었다. 원발성 부위에 종양의 재발을 보였던 12명의 환자들 중 4명의 환자들에서 첫 수술 후 5년 이후에 재발을 관찰 할 수 있었다. 처음 수술시의 절제 정도가 재발에 가장 큰 영향을 미쳤다. 처음 수술시에 완전 절제한 군의 RFP는 111 개월이었으며, 추적 관찰 5년째 RFR는 완전 절제한 경우 72.7%, 불완전 절제한 경우 20.8%로 그 차이는 통계 적으로 유의하였다(p=0.0060). 통계적으로 유의성은 없었지만 완전 절제 후 부가적인 방사선 치료를 시행하였을 경우가 완전 절제만을 시행한 경우보다 RFR가 높아 추적 관찰 5년째의 RFR는 각각 100%, 그리고 70.3% 이었다(p=0.3359). 4명의 환자들(12.9%)에서 수막 혈관외세포종의 신경계외 전이가 발생하였으며, 이 경우 신경계 외 전이의 평균 기간은 107개월, 그리고 추적 관찰 5년, 10년째의 신경계외 전이율은 각각 4.4%, 24.9% 이었다. 결 론 : 수막 혈관외세포종은 수술적 제거 후 원발성 부위에 또는 원발성 부위에서 멀리 떨어진 부위에 재발의 가능성이 무척 높은 종양이다. 이러한 재발의 가능성을 줄이는 가장 중요한 인자는 수술적 제거 정도로 처음 수술시에 가능한 완전 절제를 시도하여야 한다. 그리고 처음 수술시에 완전 절제가 가능하였다고 하여도 완전 절제 후 부가적인 방사선 치료를 시행하는 것이 재발의 위험성을 낮출 수 있을 것으로 생각한다. 원발성 부위의 재발 또는 신경계외 전이는 오랜 시간이 지난 후에도 가능할 수 있으므로 장기간의 추적 관찰이 필요하다고 생각한다. 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.

광 PCB 접속용 플러거블 렌즈의 설계 및 제작 연구

김정훈,이태호,김동민,정명영,Kim, Jung Hoon,Lee, Tae Ho,Kim, Dong Min,Jeong, Myung Yung 한국마이크로전자및패키징학회 2014 마이크로전자 및 패키징학회지 Vol.21 No.1

본 연구에서는 기존의 PCB의 한계를 극복할 수 있는 광 PCB에 대한 연구를 수행하였으며, 고효율 수동정렬을 위한 플러거블 렌즈구조를 제안하였다. 제안된 구조는 광 도파로 수동 정렬시 발생할 수 있는 렌즈와 도파로 간의 정렬 오차를 개선하고자 도파로와 렌즈를 합한 형태이다. 또한 탈착에 의해 손상되는 렌즈표면을 보호하기 위한 보호벽 형태를 지님으로써, 고효율의 수동정렬이 가능하게 하였다. 최적화 시뮬레이션을 통하여 구조를 설계하였고, 반복적 포토 리소그래피와 열적 리플로우 공정을 통하여 플러거블 렌즈 구조 제작을 위한 공정 연구를 수행하였다. 렌즈일체형 플러거블 접속구조의 광도파로를 PDMS복제공정으로 제작된 mold를 이용하여 임프린트 공정을 통해 제작하였다. 따라서 본 논문에서는 수동정렬이 가능한 광PCB접속용 플러거블 렌즈 구조의 제작이 가능함을 확인하였다. In this study, an optical PCB was proposed which can overcome the limitations of the conventional PCB, and a new structure with pluggable lens was considered for a high-efficient passive alignment. The structure was a lens-added optical waveguide for the improvement of misalignment between the lens and the waveguide in the alignment. Also, as it had a barrier-type structure to prevent the surface damage of the lens by desorption, the high-efficient passive alignment can be realized. The structure was designed by optimizing the simulation and the fabrication process of the pluggable lens structure was conducted using the repetitive photolithography and the thermal reflow. The optical waveguide with the lens-integrated pluggable interconnection was fabricated by the imprint process using the polydimethylsiloxane(PDMS) replica mold. Therefore, we confirmed the possibility of pluggable lens-added optical waveguide structure fabrication for high-efficient passive alignment.

유두상 갑상선암에서의 BRAF 변이와 임상병리학적 인자와의 관계

김정훈,최재영,Jeong-Hoon Kim,and Jae-young Choi 대한갑상선-내분비외과학회 2010 The Koreran journal of Endocrine Surgery Vol.10 No.3

디지털 스캔 데이터를 활용한 무치악 치조제 관계의 평가와 인공치 선택: 편측 교차교합의 가철성 의치 수복 증례

김정훈,김종은,박영범,이근우,Kim, Jeong-Hoon,Kim, Jong-Eun,Park, Young-Bum,Lee, Keun-Woo 대한치과보철학회 2019 대한치과보철학회지 Vol.57 No.3

치아가 발거된 치조제는 수직, 수평적인 골흡수가 점진적으로 일어나게 되며 흡수의 양상은 수평적으로 서로 다르게 나타난다. 이로 인해 상대적으로 하악궁이 상악궁에 비해 확장되는 경향을 보이며, 상악과 하악 치조제 간의 위치관계에 따라 적합한 인공치 배열 방법을 선택하여 의치의 안정을 도모해야 한다. 본 증례는 77세 남자환자로 기존에 사용하던 상악 총의치, 하악 국소의치의 재제작을 희망하였다. 상악과 하악 치조골의 흡수정도에서 차이를 보여 치조제 간의 위치관계에 대한 정확한 평가가 필요하였고, 이를 위해 치과용 CAD 소프트웨어를 활용했다. 교합기에 부착된 주모형과 교합제를 스캔하여 디지털 스캔 데이터로 변환하고, CAD 소프트웨어 상에서 치조정간선의 법칙에 따라 상악과 하악 치조제간의 위치관계를 평가하여 우측 구치부를 편측 교차교합으로 배열하였다. 보철물 완성 후 주기적인 검진을 거친 결과 의치는 적절한 유지, 안정, 지지를 얻었고 환자 또한 심미적, 기능적으로 만족하였다. 본 증례에서는 상악의 완전 무치악, 하악의 부분 무치악 환자에서 치조제간의 위치관계에 대한 정확한 평가를 위해 디지털 기술을 활용하였으며, 이를 통해 보철치료의 임상 및 기공과정을 보다 효율적으로 진행할 수 있었기에 이를 보고하고자 한다. After the teeth were extracted, maxillary and mandibular alveolar ridges show the opposite resorption pattern and as a result, the mandibular arch is enlarged than maxillary arch relatively. In this situation, we should evaluate both alveolar ridge relationship and arrange the artificial teeth properly for stability of removable prosthesis. This case is a 77 years old male patient who wishes to make removable prosthesis and has atrophic alveolar ridge. By use of model scanner and CAD software, the angle between interalveolar crest line and occlusal plane was easily measured. Depending on the measurement, the artificial teeth are arranged in unilateral cross bite and after completion, patient was satisfied with the denture which showed proper stability, retention, support.

서비스 단계별 확장 가능한 온라인 게임 서버 구조에 대한 연구

김정훈,Kim Jeong-Hoon 한국컴퓨터산업학회 2006 컴퓨터産業敎育學會論文誌 Vol.7 No.3

본 논문에서는 사용자 수 증가로 인한 확장 가능한 온라인 게임 서버 구조를 제시하고 있다. 현재 상용 서비스 중인 대부분의 온라인 게임 서버에서는 로긴서버, 캐시서버, 데이터베이스서버, 게임서버, NPC서버 등으로 구성된 하나의 서버 그룹을 운영하다가 사용자 수 증가에 따라 같은 구조의 또 다른 서버 그룹을 추가 설치하고 있다. 그러나 본 논문에서 제안하는 서버 구조는 서버를 추가 설치할 때 로긴서버, 캐시서버, 데이터베이스서버, 게임서버, NPC서버 등의 한 그룹을 추가시키지 않고 게임서버만을 추가한다. 이후 캐시서버나 데이터베이스서버에 부하가 걸릴 때에만 또 다른 서버 그룹을 추가시켜 서버 추가 비용을 최대한 줄일 수 있게 하였다. The purpose of this study is to propose the online game server architecture which can expand as the number of users increases. In most online game servers, there is a server group composed of a login server, a cache server, a database server, a game server, and an NPC server, and when the number of users increases, an additional server group with the same structure is installed. The server architecture proposed in this study does not install a server group composed of a login server, a cache server, a database server, a game server, an NPC server, etc., but installs a game server only. When there is a need for the cache server and database server, the required servers will be additionally installed, thus reducing costs.

고정형 선배열 음탐기 체계를 위한 효과도 분석 기법 연구

김정훈,Kim Jeong-Hoon 한국군사과학기술학회 2004 한국군사과학기술학회지 Vol.7 No.2

In this paper, a simulation model for FLAS(Fixed Linear Arrays System) is presented and methods for effectiveness analysis are studied to analyze the valid target detection effectiveness of this system. The simulation model is constructed taking the FLAS operational specification into account, and thus the change in system specification is effectively reflected on the simulation results. The computational burden is reduced by using the pre-processed simulation parameters which are calculated from the real environmental database. Also, the cell effectiveness and TMOE(Total Measurement of Effectiveness) are computed. The target detection effectiveness of FLAS can be simulated under the multiple target interference simulation. It is shown that the presented algorithm is suitable for the underwater system which needs the simulation model for the optimum system design.

『성제총록(聖濟總錄)』과 『동의보감(東醫寶鑑)』의 침향 배오 처방 비교 연구

김정훈,김현정,박민주,이장천,이부균,Kim, Jeong-Hoon,Kim, Hyun-Jung,Park, Min-Joo,Lee, Jang-Cheon,Lee, Boo-Kyun 대한한의학방제학회 2019 大韓韓醫學方劑學會誌 Vol.27 No.1

Objectives : In spite of the difficulty of getting Agarwood, the number of species of wild Agarwood is rapidly decreasing by insistent demands. Here, we investigate how various formula of Agarwood is used so that we can make use of them more helpful in clinics today. Methods : Determining the range of 'the Sovereign and Minister' component more than 12.96%" or 'equally used', this study distinguished whether Agarwood is used as 'the Sovereign and Minister' component among 409 Agarwood formulas in "Sheng ji zong lu(聖濟總錄)" and 103 Agarwood formulas in "Donguibogam (東醫寶鑑)". Additionally, we analyzed the component ratio of Agarwood, and also the usage in Deficiency-Excess pattern. Results : Among Agarwood formulas in "Sheng ji zong lu" and "Donguibogam", each percentage of Agarwood formulas which Agarwood comprises 'the Sovereign and Minister' component was 26%(106/406) and 13%(13/99). Analyzing these formulas of "Sheng ji zong lu", 53 formulas were used in Deficiency pattern and other 53 formulas were used in Excess pattern. Also in "Donguibogam", 6 formulas were used in each Deficiency pattern and Excess pattern, and only 1 formula in both of Deficiency and Excess pattern. Conclusions : Showing almost equal ratio of usage in Deficiency-Excess pattern, this study showed that those Agarwood formulas of "Sheng ji zong lu" and "Donguibogam" which Agarwood comprises 'the Sovereign and Minister' component can be used in both Deficiency-Excess pattern evenly.

아메드 녹내장삽입물 수술 후의 각막내피세포 변화

김정훈,김창식,Jeong Hoon Kim,Chang Sik Kim 대한안과학회 2006 대한안과학회지 Vol.47 No.12

Purpose: To evaluate the change in corneal endothelial cells after Ahmed glaucoma valve implantation. Methods: We prospectively evaluated the change in density and shape of the corneal endothelium of 35 eyes of 35 patients those underwent Ahmed glaucoma valve implantation for the treatment of refractory glaucoma. All surgeries were performed by one surgeon. The corneal specular microscopy was performed by non-contact specular microscope before surgery and 1 month, 6 months and 12 months after surgery. Evaluation was performed on the superior, superotemporal, superonasal and central area of the cornea in both eyes at each test. Results: The mean follow-up was 12.1 months (range, 6~24 months). There was a statistically significant decrease in corneal endothelial cell density in operated eye compared to the other eye. Mean percentage decrease in corneal endothelial cell count of operated eye was 5.5% at 1 month, 9.7% at 6 months, and 14.8% at 12 months after surgery. The superotemporal area, which was the closest site from the tube, showed the greatest decrease of endothelial cell density by 17.4%, while the central cornea showed the lowest decrease by 12.8% in 1 year after surgery. The morphological evaluation of the endothelial cells by coefficient of variation and hexagonality suggested the cell were getting stabilized in 1 year after surgery, although the change was not statistically significant. Conclusions: There was a statistically significant corneal endothelial cell loss in operated eye compared to the other eye after Ahmed glaucoma valve implant surgery. The corneal endothelial cell loss was increased in time up to 14.8% at 1 year after surgery.

열보호재료의 열 및 물질전달 현상에 관한 수치해석적 연구

김정훈,권창오,서정일,배철호,송동주,Kim, Jung-Hoon,Kwon, Chang-Oh,Seo, Jeong-Il,Bai, Cheol-Ho,Song, Dong-Joo 대한기계학회 1999 大韓機械學會論文集B Vol.23 No.9

A numerical analysis is performed to predict the thermal response and ablation rate for charring or non-charring material which is designed to be used as thermal protection system (TPS). The numerical program composed of in-depth energy balance equation and the aerotherm chemical equilibrium (ACE) program. The ACE program calculates various thermochemical state from ablation products. The developed numerical program is verified by comparing the reported results from literature. The sensitivity tests for input parameters are performed. The thermal behavior of ablating material is mainly affected by density of ablating material, convective heat transfer coefficient and recovery enthalpy of flow field.