간문맥성 고혈압 진단에 있어서 Duplex Doppler 초음파 검사의 의의

권혁포,박복환,장재천,이헌주,정문관 대한소화기학회 1989 대한소화기학회 추계학술대회 Vol.1989 No.-

경부지방종의 전산화단층촬영 소견

권혁포 대한영상의학회 1991 대한영상의학회지 Vol.27 No.4

Ordinary lipomas are the most common neoplasm of mesenchymal origin. About 13% of them arise in the head and neck region, especially in the posterior neck. More than 80% of lipomas are ordinary lipoma, and histologically they are composed of mature fat. CT scan provides a definite diagnosis of lipoma in virtually all cases due to their characteristic finding: a homogenous, well-defined low-attenuation mass that usually measures between -65 to -125 HU. The authors reviewed the clinical and CT characteristics of 14 cases of lipoma in the neck. The results were as follows: 1. A palpable neck mass was the most common symptom having a variable duration(months to years). 2. The age distribution of the patients was from 29 to 64 years, and the 6th decade was the most commonly affected. Men(12 cases) were more common than women(2 cases). 3. The most common location of the lipoma was the subcutaneous layer of the posterior neck. 4. Ten cases were ordinary lipoma, and CT scan showed a well-defined capsule in 8 of them. 5. Four cases were multiple symmetrical lipomatosis, and CT showed an irregular margin to the adjacent muscle without evidence of encapsulation suggesting a local infiltrating nature.

결핵성 슬관절염의 방사선학적 고찰 : 관절강내 스테로이드 주사와의 연관성

권혁포 대한영상의학회 1990 대한영상의학회지 Vol.26 No.6

We reviewed radiologic and clinical findings I patients with tuberculous arthritis of the knee, especially in regard to the history of intraarticular steroid injection, from Jan. 1988 to Dec. 1989. 1. Age distribution was widely varied form 10 to 74 years (mean : 52 years) and women were 3 times more commonly affected than men. 2. About 20% of the patients were associated with pulmonary tuberculosis and two of them were active. 3. The positive rate4 of AFB stain and culture of the aspirated joint fluid was 43% and 56% respectively and that of biopsy was 98%. 4. Radiologic findings were soft tissue swelling and joint effusion (84%), cortical bone destruction(50%), joint space narrowing(48%), periarticular osteoporosis(30%), subchondral cyst(27%) and other associated findings such as spurs, loose body, synovial calcification, periosteal reaction and bony ankylosis. 5. About 82% of the patients had a history of previous intraarticular steroid injection. Knee joint tuberculosis se ms to be related with intraarticular steroid injection, although it's epidemiologic study should be done. Tuberculous arthritis is suggested when the radiologic findings mentioned above are seen in unilateral knee, especially in patients with a history of intraarticular steroid injection, and in these case we should keep in mind to perform joint fluid analysis or synovial biopsy for confirmation.

Neuromuscular Choristoma of the Sciatic Nerve- A Case Report -

김선영,권혁포,곽경덕,안기백 대한병리학회 2005 Journal of Pathology and Translational Medicine Vol.39 No.3

Neuromuscular choristoma is a rare benign tumor of the peripheral nerves. To the best of our knowledge, 21 cases have been reported to date. We describe here a 20-day-old female infant who presented with a buttock mass (4.5×4.1×3.2 cm on MRI) arising from the left sciatic nerve. Microscopically, it was characterized by an intimately disorganized mixture of nerve fibers and striated muscle fibers that were occasionally surrounded by the perineurium and separated by fibrous bands of varying thickness. In some areas, there appeared to be some cells in transitional forms between nerve fibers and muscle fibers, revealing variously positive expressions for S-100 protein in the muscular components. These findings are consistent with the hypothesis that neuroectodermal-derived Schwann cells can give rise to mature skeletal muscle. It appears that the fibrosis may be related to the degeneration of the neural components. The size of the mass on MRI has been unchanged during the 3-year follow-up period.

소아복부 종괴의 방사선학적 고찰

변우목,권혁포,황미수,장재천,김선용,박복환 영남대학교 의과대학 1988 Yeungnam University Journal of Medicine Vol.5 No.1

최근 5년간의 소아의 복부종과 23예를 발생빈도, 부위 및 방사선학적 소견을 중심으로 비교분석하여 다음과 같은 결론을 얻었다. 1. 전체 23예중 신경아세포종이 6예로 가장 많았고, 그 다음이 Wilms'종양 5예, 담도낭종, 난소종양, 수전증 등의 순위였다. 2. 발생연령별로 분석해 본 결과 6세 이하가 78%(14예)를 차지했고 특히 후복강 종양은 6세 이하에 집중되어 있었다. 3. 부위별로는 후복강 종양이 60%(14예)로 가장 많았다. 4. 방사선학적 소견을 분석하여 본 결과 1) 단순 복부촬영상 신경아세포종의 50%에서 특징적인 석회화 음영을 볼 수 있었고 후복강 종양의 대부분에서 비특이적인 석회화 음영을 볼 수 있었다. 2) 초음파 소견상 저에코, 고에코 또는 혼합에코 등의 종괴 내부성장을 알 수 있었으나 종괴의 정확한 해부학적 위치를 파악할 수 없는 경우가 많았다. 3) 경정맥 신우 조영촬영상 신우신배의 비정상적인 소견과 신장의 전위소견으로부터 신장내 종양과 신장외 다른 부위의 종양을 구분할 수 있었다. 4) 전산화 단층촬영상 종괴 내부의 성상뿐만 아니라 종괴의 해부학적인 위치, 주위 구조와의 관계, 임파절이나 다른 부위로의 전이유무를 알 수 있었다. The abdominal tumors in children are different from those of adult. These tumors are the third most common one, preceded by leukemia and brain tumors, in children under 15 years. X-ray examination is the most important method among diagnostic approaches. The role of diagnostic imaging is to identify the precise anatomic location and extent of pathologic process with the minimal number of imaging procedures. 23 cases of abdominal tumors were reviewed in respect of age incidence, site of origin, radiologic findings. The results are briefly summarized as follows: 1. Neuroblastoma was the most common(6cases) and wilm's tumor(5 cases), choledocal cyst(4 cases), ovarian mass(3 cases), hydronephrosis(2 cases), were descending order in frequency. 2. The most common site was retroperitoneum(60%) Kidney was the single most common site of origin. 3. Radiologic findings. The most common findings of plain radiography was ill defined soft tissue mass and this method was helpful in the presence of calcification especially in neuroblastoma. Ultrasonographic pattern was anechoic(cystic), echoic or mixed pattern, but this method provide less precise anatomical details, nevertheless ultrasonography was paticullary useful imaging modality for the pediatric abdominal tumors. IVP findings were renal displacement, caliceopelvic system distortion or nonvisualization of kidney, these information was helpful in determining the location of tumors. CT scan showed homogenous or inhomogenous, cystic or solid, mass with their anatomic location. 4. Ultrasonography was the most widely used specific diagnostic method, but had limited value in detecting the anatomic location of tumors. CT scan was superior to ultrasound for determining the extent of tumors.

거골에서 발생한 유윙 육종/원시신경 외배엽종양 - 1예 보고 -

김선영,권혁포,노재수,조현오,Kim, Sun-Young,Kwon, Hyuck-Po,Roh, Jae-Su,Cho, Hyoun-Oh The Korean Society for Cytopathology 2004 대한세포병리학회지 Vol.15 No.2

Ewing's sarcoma (ES)/PNET is common in both axial and appendicular skeletons, but is extremely rare in the talus. Here, we report a case of ES/PNET of the left talus in a 29-year-old male patient diagnosed by fine needle aspiration cytology, and review the literature on similar cases. The cytological smears were composed of individually dispersed small round cells and occasional clusters of loosely cohesive cells. The tumor cells were fragile, frequently exhibiting naked nuclei. Two distinct types of cells were observed. The light (chief) cells displayed round or slightly oval nuclei with frequent indentations, generally inconspicuous nucleoli, and a thin rim of cytoplasm, which sometimes harbored small vacuoles. The dark cells were smaller, displaying scanty cytoplasm with dense hyperchromatic nuclei, intermixed with chief cells, and often manifesting as small molded groups. However, no significant nuclear pleomorphisms or mitoses were noted. Tumor cells in the ceil block revealed positive cytoplasmic glycogen, as determined by a PAS stain with diastase control, and also exhibited positive immunoreactivity for CD99.

종아리에서 발생한 과립세포종양의 세침흡인 세포학적 소견 - 1예 보고 -

김선영,황진석,권혁포,양주헌,노재수,양완석,Kim, Sun-Young,Hwang, Jin-Seok,Kwon, Hyuck-Po,Yang, Ju-Heon,Roh, Jae-Su,Yang, Wan-Suk 대한세포병리학회 2004 대한세포병리학회지 Vol.15 No.2

Granular cell tumor is characterized by large eosinophilic cells with granular appearances. These are mostly benign. Approximately $1\sim2%$ are malignant, and establishment of reliable criteria for diagnosing malignant granular cell tumor has been difficult to establish because oi the rarify. Reports on the cytologic features of this neoplasm are hardly found in Korea. We report a case of rarely-occurring granular cell tumor in the lower leg of a 40-year-old male, diagnosed on fine needle aspiration cytology, together with a review of the literature regarding significant adverse histology and prognostic factors. The aspirates revealed cellular smears of isolated cells, syncytial clusters, and occasionally stripped nuclei in a nine, bluish-purple, granular background. Tumor cells were polygonal, rounded, or slightly spindled, and showed ill-defined granular cytoplasm. Nuclei were small and round or oval, with inconspicuous or small, prominent nucleoli. The nuclei showed rare intranuclear cytoplasmic invagination. Occasionally, there were mild to moderate nuclear pleomorphisms with vesicular nuclei, with large, prominent nucleoi, but no mitosis. The immunocytochemical stain for S-100 was strongly positive in the cytoplasm of tumor cells with occasional nuclei.

경골 고평부 골절의 자기공명영상 : 골절양상 및 동반된 연부조직 손상에 대하여

이건,허찬,김용조,권혁포,권중혁,김원호,이영환,Lee, Geon,Heo, Chan,Kim, Yong-Jo,Kwon, Hyeok-Po,Kwon, Jung-Hyeok,Kim, Won-Ho,Lee, Yeong-Hwan 대한영상의학회 1997 대한영상의학회지 Vol.36 No.5

종격동 종양의 전산화단층촬영 소견

정호선,이상진,손미영,권혁포,황미수,김선용,장재천,박복환 영남대학교 의과대학 1989 Yeungnam University Journal of Medicine Vol.6 No.2

30례의 종격동 종양의 CT분석 결과, 저자들은 다음과 같이 요약 할 수 있었다. 1. 가장 흔한 종양은 흉선질환 이었으며, 그 다음으로는 기형종, 림프종, 기관지성 낭종, 신경종, 심막낭종의 순이었다. 2. 5례의 흉선종은 균일한 충실성 음영의 종괴로 보였으며, 석회침착, 소엽형성이 각각 1례에서 보였다. 악성흉선종 중 1례에서 피낭형성이 잘된 낭성 종괴로 보였으며, 흉선암종은 주위 경계의 소엽형성을 보인 균일한 음영의 종괴로 보였다. 3. 전 례의 기형종은 모두 낭성종괴로 보였으며, 지방과 석회음영은 각각 2례, 4례에서 보여졌다. 4. 신경종은 4례 모두에서 후종격동에 위치한 균일한 음영의 종괴로 보여졌다. 5. 기관지성 낭종은 기관분기부 하방, 부흉곽지역에 각각 1례, 후기관부에 2례 있었으며, 모두 균일한 음영의 낭성 종괴로 보여졌다. 6. 심막낭종은 심장 주위 경계를 따라 난형모양의 낭성 종괴로 보여졌다. 결론적으로 종격동 종괴의 진단에 CT를 실시 함으로써 종괴의 정확한 위치, 크기및 특징적인 구성성분을 관찰할 수 있으며, 이러한 소견으로 종괴의 감별진단에 도움을 얻을 수 있다. Computerized Tomography is now well established and important noninvasive method of diagnosting mediastinal mass lesions because of its superior imaging of their size, location and internal composition. Authors analysed and present CT findings of 30 surgically proven mediastinal tumors and cysts that were studied and treated at the Yeungnam University Hospital during recent years. The most common tumor was thymona(9cases), and teratoma(6 cases), lymphoma(6 cases), bronchogenic cyst(4 cases), neurogenic tumor(4 cases), pericardial cyst(1 case) were next in order of frequency. There were 5 cases of thymoma showing homegenous solid density mass, 2 cases were malignant thymoma and myasthenia gravis was present in 2 cases, A case of thymolipoma and a case of thymic carcinoma were included. All teratomas were cystic masses but pathognomic fat, and calcified density were seen only in 4 cases, 5 cases were located in anterior mediastinum and 1 case was in posterior mediastinum. Lymphoma(3 Hodgkin's and 3 non-Hodgkin's) appeared as irregular lobulated mass in anterior mediastinum. Neurogenic tumor(2 ganglioneuroma and 2 neurilemmoma) appeared as homogenous density mass located in posterior mediastinum. Among the 4 bronchogenic cysts, 2 were located in retrotracheal area, I was located in subcarinal and I was in parathoracic area. One case of pericardial cyst was oval shaped cystic mass located in left pericardiac border.

건강검진 수진 성인 남성에서 초음파검사를 이용한 갑상선결절의 유병률

김정현,박상준,김상억,이광희,조일권,장선익,이진관,서금수,권혁포,정성창 대한내분비학회 2007 Endocrinology and metabolism Vol.22 No.2

Background: Thyroid nodules are a common disease in clinical practice. The prevalence of thyroid nodules has recently been increased by according to the development of thyroid ultrasonography. Thyroid nodules are more commonly found in women, but the potential for malignant nodules is much higher in men. So, we aimed to focus on the prevalence of thyroid nodules in the adult male population. Methods: We studied men over the age of 30 who visited our health care center for routine health check-ups from January, 2005 to December, 2005. After excluding the patients with previous thyroid disorders, 1081 men were selected to undergo thyroid ultrasonography for detecting the presence of thyroid nodules. If nodules were found, then their size and numbers were recorded. These data were then correlated with the age of the patients. If needed, ultrasound-guided fine needle aspiration was performed. Results: Among the 1,081 subjects, thyroid nodules were detected in 152 (14.1%) with its prevalence increasing with the increasing age of the patients (age 30 to 49: 12.3%, over 50: 17.2%, P = 0.026). Among these study subjects, nodules larger than 5 mm in size were detected in 99 patients and fine needle aspirations were performed on 53 of these patients. Six patients were diagnosed with papillary carcinoma. Conclusion: The prevalence of thyroid nodules in the male population was 14.1%, with an increasing prevalence in the over 50 age group. (J Kor Endocrine Soc 22:112~117, 2007) 연구배경: 갑상선결절은 촉지를 통해서 진단할 때 4~7%의 유병률을 보이는 흔한 질환이며 갑상선초음파검사를 시행하면 성인의 19~46%까지도 진단된다. 갑상선결절은 여성에서 4배 정도 유병률이 더 높으나 남성에서 여성보다 악성결절의 빈도가 높다. 저자들은 건진 센터를 찾은 일반 남성을 대상으로 갑상선초음파검사를 시행하여 갑상선결절의 유병률을 연구하였다. 방법: 1년간 본원 건진 센터를 방문했던 30세 이상의 성인 일반 남성 중 과거력상 갑상선 수술을 받았거나 갑상선질환으로 치료 중이거나 추적관찰 중인 경우를 제외한 1,081명을 대상으로 갑상선초음파를 실시하여 갑상선결절을 진단하고 필요시 미세침흡인세포검사를 시행하였다.결과: 1,081명 중 152명에서 갑상선결절이 진단되어 14.1%의 유병률을 보였으며 높은 연령 군에서 결절의 빈도가 증가하였다(30~49세 12.3%, 50세 이상 17.2%)(P = 0.026). 결절의 크기가 5 mm 이상의 수진자 중 53명이 미세침흡인세포검사를 시행 받았으며 6명이 악성으로 진단되어 수술을 통해 확진하였다.