젊은 남자에게 발생한 통상성 간질성 폐렴과 동반된 폐암 1예

박종숙,이준혁,박성우,장안수,박춘식,박재성,백상현,고은석,신화균 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Usual interstitial pneumonia(UIP) is relatively rare disease of lung parenchyme under the age of 50. Lung cancer is reported to occur as a complication of UIP, but has not been reported in young age patient with UIP in Korea. A 35-year-old man was admitted to the hospital because of dyspnea, cough and mild fever. He had been suffered from dyspnea during 3 years. The dyspnea worsened recent 1 month ago. He had been treated with pneumonia at another hospital during 4 months before this admission. Chest radiographs and High resolution CT showed subpleural and basal dominant reticular opacities in both lung with no change until now. He was smoker and his occupation was car engine-man dealing with benzene. UIP is suspected by history and radiologic findings. Operation for open lung biopsy was performed to obtain lung specimen via video-assisted thoracoscopic surgery. Patient's pathologic examination showed UIP combined with adenocarcinoma in RLL superior segment and posterobasal segment and RLL lobectomy was done. After operation, the patient has been in cancer free condition so far. We report a case of UIP combined with lung cancer in young man with brief review of the literature.

氣管枝擴張症 診斷 時 高解像力 CT의 意義

박재성,최득린,김기정 순천향대학교 1992 논문집 Vol.15 No.4

Bronchography has been classically considered the most accurate procedure by which to evaluate the presence, severity and distribution of bronchiectasis. Recently, the ability of computed tomography (CT) for imaging bronchiectasis was demonstrated. The authors performed a comparative study of HRCT and bronchography. Fifteen consecutive patients who were clinically suspected of having bronchiectasis, were investigated (4 unilateral, 11 bilateral). Fifteen HRCT and 26 bronchography was performed and total of 185 bronchopulmonary segments were evaluated. Segment-by-segment comparison of the 2 studies for the detection of ectatic bronchi were evaluated by 2 radiologists. The results were as follow; 1. The diagnostic concordance rate between the 2 modalities was 87.7%. 2. The sensitivity and specificity of HRCT were 88.1% and 87.5% for bronchography. concordance rate between the 2 modalities was 90.3%. 3. The rate of false negative study of HRCT was 5.5% for bronchography, 3 localized bronchiectasis(33.3%) and 3 mild ectatic change (33.3%) were missed on HRCT. 4. The rate of false negative study of bronchography was 42.9% for HRCT, 9 incomplete opacification of distal bronchi on bronchography. 5. On comparative study of bronchiectatic patterns, 5 varicose bronchiectasis were misdiagnosed as cystic bronchiectasis on HRCT. The HRCT showed a high diagnostic concordance rate with bronchography. Therefore HRCT should be considered as a promising diagnostic modality for detection of bronchiectasis.

저선량 CT촬영을 이용한 폐암의 선별 검사

박재성 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1

저선량 CT를 이용한 폐암 선별 검사는 폐암의 발견에 있어서 단순방사선검사와 비교할 때 예민도가 높은 유용한 검사법으로 혈관조영증강이 필요 없고 피폭선량이 적은 장점을 가지고 있다. 병변의 크기가 작고, 병기가 낮으며, 절제 가능한 비소세포암의 조기 진단은 폐암에 의한 사망률의 감소를 예측할 수 있다. 저자는 저선량 CT를 이용한 폐암 선별 검사의 시행에 있어서, 일반적인 고려 사항, 대상의 선정, 선별검사의 주기, 검사의 프로토콜, 피폭선량, 불확실한 결절에 대한 다음 일정 및 의사의 책임 등에 대하여 문헌고찰과 함께 기술하였다.

신동맥 협착 정도에 따른 도플러 초음파 소견

박재성,이혜경,김대호,최득린,권귀향,홍현숙,임한혁,김기정 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.2

Renal artery stenosis is the one of causes of hypertension in a small percentage of all patients but is only anatomical cause that can be treated by means of surgery and percutanecous transluminal angioplasty. Angiography is the golden standard for diagnosis of renal artery stenosis, but a little invasive. With the advent of abdominal Doppler ultrasonography, renal artery stenosis could be diagnoed noninvasively. The experienced hands appears to be valuable in the doppler examination, ut some investigators consider it almost useless. The authors studied the effect of stenosis of renal artery on the downstream intrarenal blood flow, a snare was placed around renal artery in 12 rabbits and compressed to create stenosis while Doppler ultraonographic curve and flow index were obtained from main renal and interlobar arteries by means of placement of 10-MHz curved linear tranducer directly on the surface of kidney. The Doppler measurements were compared with the percentage of stenosis on angiograms. The results were as follow: 1. Ten satisfactory angiograms and Doppler ultrasonograms were obtained. 2. Three renal arteries were created stenosis below 70% (Group A), Seven were above 70% (Group B). 3. The ranges of RI (resistance index) were 0.61-0.86 (mean 0.78±0.154) at main renal arteries, 0.57-0.85 (mean 0.77±0.231) at interlobar artery. The range of PS (peak systolic velocity) were 13.1-28.8 (mean 21.65±4.445) m/sex at main renal artery, 5.2-18.1 (mean 11.74±4.095) m/sec at interlobar arteries. The RI of rabbits were higher than those of human (mean 0.58±0.05). 4. The range of RI in stenotic arteries of group B were 0.45-0.74 (mean 0.57±0.143) at main renal artery, 0.52-0.65 (mean 59±0.051) at interlobar arteries. The range of PS were 11.2-21.3 (mean 15.04±3.755) m/sec at main renal arte교, 5.7-11.3 (mean 8.24±2.056) at interlobar artery. The difference were statistical y significant (P=0.0302), but without remarkable change in group A. 5. Doppler ultrasonographic curve during progressive compression of renal artery showed dampened systolic waveform and diagonal upstroke at main renal arteries (71.4%) and interlobar arteries (85.7%) in group B, but without remarkable change in group A. 6. Release of the arterial compression caused higher than normal peak systolic velocity initially, at main renal arteries (42.9%) and interlobar arteries (28.6%). but the curve of all rabbits returned to normal within 5 minutes. The Doppler ultrasonographic index and curve were not changed on follow up Doppler ultrasonogram at 5 min. 10 min. 30 min. and 1 hour. The change of the systolic curves that compressed experimentally is identical to change in the pulsus tardus and parvus waveforms seen in both acute and chronic severe renal artery stenosis in humans, can helpul for the diagnosis of renal artery stenosis and the effects of treatment by percutaneous tranluminal angioplasty and surgery.

CT 유도하의 경피적 폐생검 : 임상적 의의 및 합병증에 관한 연구 A Study of Clinical Significance and Complication

박재성,백상현,차장규,홍현숙,김대호,박성진,조준희,임한혁,이혜경 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.2

Purpose : To determine the diagnostic accuracy and predicting factor of pneumothorax on CT-guided percutaneous transthoracic needle biopsy. Materials and Methods : Using automated biopsy devices, 107 CT-guided percutaneous needle biopsies of pulmonary lesions were performed. Final diagnosis was made with operation or other methods. We retrospectively analyzed the frequency of complications and diagnostic yields of 107 biopsies. The clinical features, treatment, and courses of complications were reviewed, and risk factors of pneumothorax such as depth and size of lesion, CT emphysema score of whole lung and pathway of needle, and the result of pulmonary function test were analyzed. Result : 96 biopsies(89.7%) yielded sufficient tissue for pathologic evaluation. For cases of malignant and benign disease, sensitivity was 91.5% and 87.5% respectively; the corresponding figures for diagnostic accuracy were 88.1% and 77.1%. So, sensitivity and diagnostic accuracy of percutaneous transthoracic needle biopsy was 89.7% and 83.2%. Eighteen(16.8%) of 107 patients developed pneumothorax and 3 of these required application of chest tube or percutaneous catheter drainage. In the group with pneumonthorax, the lesion was significantly smaller(p=0.029) and higher CT emphysema score of pathway of needle(p=0.032). But there were no significant difference between two groups(with or without pneumothorax) for depth of lesion, pulmonary function test(% predictive value of FEV1 and FEV1/FVC) and CT emphysema score of whole lung. Conclusion : CT-guided transthoracic needle biopsy of the pulmonary lesions is safe and easy method of obtaining specimens of good quality and quantity. It may be an useful procedure in the diagnosis of localized pulmonary lesions. For the prediction of pneumothorax, size of lesion and CT emphysema score of pathway of a needle are significant risk factors.

6-Sigma경영혁신기법 시행에 따른 방사선과 내부고객만족도의 변화

이근옥,박재성,강충환,김미영,김승식 한국의료QA학회 2005 한국의료질향상학회지 Vol.12 No.1

Background : The concept of 'service' in a hospital is based on the quality of medical staffs who serve as customer-satisfying media, and this is what distinguishes general hospitals from other business corporations in which customer satisfaction is achieved through commercial products. Thus, the internal employee satisfaction is essential in the improvement of the 'service' and subsequent 'competitiveness' of a hospital. The purpose of this study is to establish internal marketing strategies for a general hospital through regular surveys on employee satisfaction. Method : Surveys on employee satisfaction in radiology department were conducted regularly twice a year in a university hospital with 800 beds 2001 in 2004. The subjects of this study were 35 employees who work in radiology department. The authors developed the questionnaires and the surveys were conducted initially during the first 6 months of the year. After necessary improvements were made by applying 6 Sigma techniques, subsequent surveys were conducted during the latter 6 months of the year and the degree of employee satisfaction was compared. Results : Overall satisfaction increased with a constant rate and the authors were able to assess that the hospital is being gradually stabilized. The degree of satisfaction assessed by multiple choices showed only minor changes. However, as a result of focusing on the demands put forth by the employees through the open questions, the degree of satisfaction increased gradually year after year. Conclusions : It is important to heighten the internal employee satisfaction systematically and harmoniously through the assessment on the demands of the internal customers and feedback-based communications between the management officers and the staffs. Continuous surveys on the internal employee satisfaction will serve to be valuable materials in the establishment of internal marketing strategies for a general hospital.

NSIP와 BOOP의 고해상전산화단층촬영 소견과 비교

백상현,박재성,차장규,홍현숙,김대호,박성진,조준희,이혜경,최진수 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.2

Purpose: BOOP and NSIP also share similar clinical features such as subacute flu-like illness, the finding of bronchoalveolar lavage, the result of pulmonary function test and more favourable outcome than usual interstitial pneumonia(UIP). The author try to compare the HRCT findings of NSIP with BOOP by pattern and distribution of diseases. Materials and Methods: HRCT findings of histopathologically proven NSIP(Group Ⅰ; 6, Group Ⅱ; 7, Group Ⅲ; 2) in 15 patients(5 male, 10 female, age range, 39-69 years; mean age, 53 years), BOOP in 15 patients(6 male, 9 female, age range, 26-76 years; mean age, 52 years) were reviewed retrospectively. Results: The common pattern of the two diseases was admixed consolidation, ground glass attenuation & reticular densities with/without architectural distortion(NSIP; 53.3%, BOOP; 46.7%). The main component of the pattern wan predominantly consolidation(NSIP; 46.7%, BOOP; 73.3%) and ground glass attenuation(NSIP; 40.0%, BOOP;20.0%). Architectural distotion was more provinent finding with NSIP(mild ; 3, moderate ; 4, severe; 2) compared with BOOP(mild; 7, moderate; 2, severe; 0). The predominant overall distribution was lower lung, peribronchovascular & peripheral lung field in both of the two entities(NSIP;73.3%, BOOP; 73.3%). Peribronchovascular involvement was more common with NSIP(100%) than BOOP(80%), whereas peripheral involvement was more common with BOOP(93.3%) than NSIP(80%). Conclusion: The HRCT findings of NSIP and BOOP were similar in pattern and distribution. But NIP manifested more frequently ground-glass attenuation, whereas BOOP showed more frequently consolidation. Architectural distortion was more severe with NSIP than BOOP. NSIP invoved more frequently peribronchovascular space and BOOP were more common in peripheral lung field.

관상정맥동과의 연결이 없는 좌상대정맥의 CT 소견 : 1예 보고 case report

백상현,박재성,이혜경,홍현숙,김대호,조준희,박성진,차장규 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

A persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly. It is a persistent remnant of a vessel that is present as a counterpart of normal right-sided superior vena cava(SVC) in early embryological development but normally disappears later. Its diagnosis can be confirmed by many noninvasive and invasive tests, or it is incidentally diagnosed at insertion into the left subclavian or jugular vein or thoracic surgery. If it is not associated with other congenital cardiac anomalies, it is usually asymptomatic and hemodynamically insignificant. We describe the chest radiograph and CT findings of bilateral SVC with drainage to left superior intercostal vein, hemiazygos, azygos vein and right SVC, and no connection of coronary sinus.

원발성 두개골내 수막종 : 1예 보고 A Case Report

김대호,홍현숙,조준희,박재성,박성진,차장규,백상현,이혜경 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Primary intraosseous meningioma of skull is rare, and often confused with a primary bone tumor. We report a case of a 71 years old female patient with an intraosseous calvarial meningioma of frontal bone presenting as a solitary osteolytic skull lesion. Plain skull radiograph, CT and MR images show sharply marginated expansile bony lesion in frontal skull vault, and a small well enhanced soft tissue mass within bone. The mass is extracranially protruded to scalp, and is partially attached to the underlying dura. Outer and inner table of skull vault is slightly bulged out, suggesting intradiploic origin of the tumor. The tumor was treated with surgical excision and cranioplasty. Histological examination revealed fibrous meningioma.

장기투석을 받은 만성 신부전 환자에서 발생한 종양에 관한 고찰

황정화,이혜경,홍현숙,박재성,김대호,권귀향,최득린,황승덕,이희발 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.2

The authors tried to evaluate tumor occurrence in long-term dialysis patients with chronic renal failure. Among 359 patients, 20 patients (about 5.6%) were diagnosed with malignancy during long-term dialysis from the period of 1983 to 1995 at our nephrology department. The ultrasonographic and computed tomographic findings including the clinical features of 20 patients that were retrospectively reviewed. The mean age of the patients was 53 (37-75)years old and the ratio of male to female was 9:1. Among the 20 cases, 7 cases of hepatoma (35%) were developed. Among them, urinary tract tumors such as renal and bladder cancer were developed in 4 (20%) and 2 (10%) of the cases. Other malignant tumors were lymphoma, stomach cancer, uterine cervical cancer, cholangiocarcinoma, lung cancer, meningioma, and acoustic neuroma one case of each (each of 5.3%). The most common tumor in patients with chronic renal failure, who were receiving long-term dialysis, was hepatoma and the second most common tumor was cancer of the urinary tract such as kidney and bladder.