인체내 발생한 비정형항산균에 관한 방사선학적 고찰

조온구 대한영상의학회 1976 대한영상의학회지 Vol.12 No.1

The incidence of atypical mycobacteriosis is rising, however, the clinical, pathologic and radiographic aspects of atypical mycobacteriosis are generally indistinguishable from those of tuberculosis. There is much differences in epidemiology, diagnosis and therapy between them, it should be clearly differentiated from tuberculosis. At this point, were reviewed 19 cases of confirmed mycobacteriosis and 100 cases of usual tuberculosis by the way of chest film, and found certain roentgen features that might suggest the possibility of atypical mycobacteriosis as follow. 1. Among the 19 cases of atypical mycobacteriosis, group III (Nonchromogens) is highest in number of 12 cases but groupI(photochromogen) is not noticed. 2. Inspite of the advanced extent of disease in roentgenogram, tuberculin skin tests are negative or weakly positive. 3. Cavitation appears to be more common with atypical mycobacteriosis than tuberculosis. Multiple thin walled cavities are more prominent and the i cidence of air fluid level in the cavity is somewhat higher than tuberculosis. 4. The presence of preexisting pulmonary disease if more noted in atypical mycobacteriosis particularly of emphysema. 5. Lack of fibrosis, calcification and hilum elevation with healing process of atypical mycobacteriosis is charactristic findings. 6. Atypical mycobacteriosis are frequently resistant to antituberculous drug therapy, so roentgenological improvement in 1 year follow up film shows less effectiveness in atypical mycobacteriosis with even aggravation. 7. Extrapulmonary manifestations of atypical mycobacteriosis are noted in 3 cases due to group III, involving lumbar spine, meninges and large bowel.

위암 수술후 재발의 전산화단층촬영 진단

조온구 대한영상의학회 1988 대한영상의학회지 Vol.24 No.5

There is almost complete lack of specific reference to the findings of recurrent gastric carcinoma except a few date which have been based on autopsy findings. The purpose of this study is to demonstrate the usefulness of CT for defining the pattern of recurrence and to compare the results of conventional barium studies to identify the lesion. 1. There were 64 cases of postgastrectomy CT scan of gastric carcinoma during recent 3 years and recurrence evidence was identified in 53 cases. 2. Time lapse between operation and detection of recurrence was variable from 3 months to 6 years. Evidence of recurrence less than 1 year were stage III and IV patients and long survivors more than 5 years were stage I and II patients. 3. Local recurence of gastric remnant or anastomosis area was identified in 10 cases. Regional recurrence was noted in 28 cases including 13 gastric bed and 26 lymph node enlargement. Most frequently enlarged nodes were peripancreatic and paraaortic nodes. 4. Peritoneal spread was the most frequent pattern of recurrence occuring 34 cases. Mesenteric mass and ascites were most frequent findings. 5. Distant metastasis was noted in 12 cases and the liver was the most frequent site. 6 Local recurrence was detected in barium study in half of the cases Peritoneal seeding was relatively well identified but regional recurrence was very poorly identified.

단순 신낭종을 제외한 신종괴의 초음파 진단

조온구 대한영상의학회 1986 대한영상의학회지 Vol.22 No.3

Sonography is quite sensitive screeening method for the detection of renal mass lesions, but the specifiencity is relatively low. Authors analized the sonograhic findings of the confirmed 67 cases of renal masses excluding simple cyst for possible differential points between each other. The results were as follows : 1. Among the 67 cases, 44 cases (65.7%) were tumorous lesions and majority were malignant tumors. 2. Iso or hyperechoic lesions are relatively specific finding suggestive of the tumorous lesions. 83.3% of isoechoic lesions and 85.0% of hyeprechoic lesions were tumor. 3. Tumor echogenecity of the renal cell carcinoma was variable. Of the 23 renal cell carcinomas, 10 were isoechoic, 8 were hypoecoic and 5 were hyperechoic lesions. 4. In hypoechoic lesions, findings of acoustic enhancement and wall echo were suggestive of nontumours lesion. 5. There was no direct correlation between echogenecity of the mass and tumor vascularity. 6. IVP findings were not sensitive and nonspecific for renal mass lesions , so ultrasound could be the initial step of diagnostic modality for evaluation of the renal mass.

신막 비후의 CT소견 분석

조온구 대한영상의학회 1990 대한영상의학회지 Vol.26 No.5

CT findings of 120 cases of renal fascial thickening were analyzed to appraise the meanings of renal fascial thickening and to seek the findings which are helpful for the differential diagnosis. Causes of fascial thickening were 46 inflammation, 40 neoplasm, 17 retroperitoneal hemorrhages and 17 retroperitoneal lymphadenopathy. Six cases were intraperitoneal pathology including each 3 cases of hepatocellular carcinoma and subhepatic abscess. Incidence of fascial thickening in acute pancreatitis was 35% and almost all of them were complicated pancreatitis. Ten of 27 pancreatitis and 7 of 17 lymphadenopathy showed bilateral fasical thickening with more tendency to left side. Only right side thickening was noted in 6 cases of pancreatitis. Anterior fascial thickening was prominent in anterior pararenal disease but 11 cases of pancreatitis showed posterior fasical thickening too. In renal disease, posterior fascial thickening was more prominent. In pancreatitis and lymphadenopathy renal fascia was more diffusely thickened but in tumorous condition and renal inflammatory disease, the thickening was more localized. In anterior pararenal disease the fascia was thickened or blurred on outside but in renal disease it was inside, so the space where the lesion originated could be suggested. Repeated CT scans after treatment showed that the degree of thickening improved as the primary disease improved.

하대정맥 혈전증의 진단 : 초음파 및 CT소견을 중심으로

조온구 대한영상의학회 1993 대한영상의학회지 Vol.29 No.1

Forty five patients with inferior vena cava(IVC) thrombosis were studied with the use of ultrasonography (US) and Computed tomography (CT). Thirty seven cases were caused by tumor extension and the primary neoplasms were hepatocelular Ca, 26 cases, renal cell Ca, (6 cases), Wilms' tumor(1 case), IVC leiomyosarcoma (1 case) and retroperitoneal metastatic tumor (3 cases). Non-tumor thrombus were 8 cases which included 5 cases of Budd-Chiari syndrome and 3 cases of thrombophlebitis. US and CT both were good for the diagnosis of IVC thrombosis. Cranial extension was better demonstrated by US whereas CT yielded better delineation of the lower extension. Even though, differentiation of tumor from non-tumor thrombi by the echogenecity and density of the thrombus was not possible, the findings of adjacent tumor mass, complete obstructive thrombus within dilated lumen with bulging wall, and and nontapered acute margin of thrombus made the possibility of turombus made the possibility of thrombus more likely.

유암의 방사선 치료

조온구 대한영상의학회 1975 대한영상의학회지 Vol.11 No.2

62 patients of histologically proven post-mastectomy case of breast cancer who was treated by radiation therapy from Nov. 1969 to Sept. 1963 at Yonsei Cancer Center, was reviewed in respect to the primary tumor, method of radiation therapy and the extend of effect of radiation therapy in the view of prognosis and its complication. 1. The peak age incidence was at the 4th decade (40.3%), and the next was 5th decade (32.3%) 2. The location of the primary tumor site was most frequent at the upper outer quadrant of the involved breat (44%) 3. By UICC staging, stage III of advanced case was relatively frequent (45.2%) that suggests no early detection of the breast cancer. 4. Except 2 patients of inoperable cases, remaining 60 patients received radiation therapy after mastectomy. Although the radiation therapy source and method are somewhat different, average 4000-5000 rads/4-5 wks were given to the peripheral lymphatics. 5. 30 cases were followed up among 62 patients. One year survi als were 25/30 cases(83.3%), 2 years were 10/13 cases(71%), 3 years were 8/11 cases and 4 year survivals were 2/3 cases. 6. Leukopenia (below 4000m㎥) during radiation therapy was noted in 57% of the cases, especially in the case of large radiation field and who received therapy by the conventional 250KV orthovoltage X-ray unit on the chest wall. 7. Skin reaction during radiation therapy was noted in 9 cases, and they were treated by conventional 250KV orthovoltage unit. 8. Local recurrence or metastasis was noted in 20 cases and 11 cases were stage III, and 10 cases were young age group below 35. Most frequent site of recurrence or metestasis was lung and pleura(9), and other site was chest wall (5), supraclavicular lymph node (5), bone (4) and to the opposite breast (2). 9. Deceased patient was 5 cases. Among them, 4 cases were advanced stage III and IV, and delayed visit to the hospital after the discovery of breast mass and further delaying in radiation therapy after mastectomy.

척수종양의 방사선학적 고찰

조온구 대한영상의학회 1977 대한영상의학회지 Vol.13 No.1

Since 60-85% of spinal cord tumors are benign and potentially curable when surgery was done before irreversible pressure changes have occurred in the cord and nerves, early diagnosis of spinal cord tumor is very important. There are many radiological diagnostic methods such as plain film, myelogram and angiogram using either contrast media or radioisotope. High reliability of precise myelographic localization of spinal cord tumor has been stressed by Camp (1934), and Traub (1972) said that myelogram can furnish the information not only about the exact tumor localization but the presence of other lesions such as disk or arachnoiditis and existence of multiple tumors. DiChiro (1957) described angiographic findings of hemangioblastoma and that was the initial attempt of angiography for the spinal cord tumor diagnosis. Previously they said that angiogram is not useful in spinal cord tumor except arteriovenous malformation however Herdt et al (1972) reported angiographic criteria f r differentiation of intra and extramedullary vascular tumor. This paper is a study of confirmed 108 cases of spinal cord tumor in respect to clinical features and pathologic findings. In this analysis, special attention was given to the 86 plain film and myelogram for differentiation of exact tumor localization in relation to spinal cord and dura. 5 cases of angiography was reviewed. The results are: 1. 69% of patients were in the fourth and fifth decade and occured more frequently in the male. 2. Patients's chief complaint was pain with motor and sensory change. Mean average duration of symptoms was 17 months. 3. 56 of 60 cases (93.3%) show spinal fluid protein level above 50mg%. Queckenstedt test was positive in 80% of patient with partial or complete obstruction. 4. Intradural extramedullary tumors are more frequent (50 cases, 46.3%) than extradural tumors (43 cases, 39.9%) and thoracic spine was the most frequently involved site (43.5%). 5. Benign tumors were 72 cases (66.7%) th t is double incidence of malignant tumor. Most frequent tumor was neurofibroma (54 cases) that occurs at any site, however majorities were intradural extramedullary tumor. Metastatic carcinoma was most common tumor of extradural lesion (30.2%) and astrocytoma (36.4%) at intramedullary lesion. 6. 38 of 86 cases (44.1%) show bone changes on plain films of spine and among them extradural tumor was 21 cases. Most common findings of plain film change was pedicle erosion that was noted on 28 cases (73.7%). 7. Myelographic observations in the extradural tumor show displacement of the opaque column from the inner aspect of the bony spinal canal (75.5%), and other useful sign was appearance of a transverse serrated block (43.2%). Majority of intradural tumors caused displacement of the spinal cord (67.6%), clearly outlined concave defect (81%), and narrow distance from dye column to pedicle (70.3%). Characteristic findings of intramedullary tumor was fusiform enlargement of spinal cord (75%) nd streaks of contrast medium diverging upward laterally around the expanded mass. 8. 3 of 5 cases of angiogram were extradural arteriovenous malformation that show abnormal tortuous hypertrophied vessel and 1 case was extradural metastatic Ca. with abnormal neovascularization.

간경변증에 의한 문맥혈전증의 초음파 소견

조온구 대한초음파의학회 1991 ULTRASONOGRAPHY Vol.10 No.2

초음파를 이용한 정상 신의 크기 및 용적의 계측

조온구,박수성 중앙대학교 의과대학 의과학연구소 1984 中央醫大誌 Vol.9 No.3

Renal size and volume were determined by the ultrasonography in 800 Koreans from the neonates to the aged (307 children and 493 adults, 433 males and 367 females). For the determination of renal volume by the three dimensional measurement of length, width and AP diameter, the true volume of 20 canine kidneys were measured by the water displacement technique, and the value was devided by the product of ultrasonographically measured length × width × AP diameter(mean0.540). These values were correlated with age, height, weight and body surface area. Linear regression of these correlations and coefficients of determinations were calculated, and growth charts of normal size were provided. The results were as follows: 1. The mean±standard deviation of the renal length, width, AP diameter and volume in various age, height, weight and body surface area were determined. 2. In childhood, renal measurements increased proportionally with age, and the regression equation showed excellent coefficient of correlation(R=0.838-0.951). 3. In adult, there was not such a correlation between the renal measurements and age as in childhood. Mean renal length was 10.93±0.68㎝ in male left kidney, 10.65±0.68㎝ in male right kidney, 10.65±0.70㎝ in female left kidney and 10.43±0.71㎝ in female right kidney. Renal volume was 137.94±31.5ml in male left kidney and 123.69±25.8ml in male right kidney, and in female, it was about 15-20ml smaller than male. 4. Renal measurements were correlated with height, weight and body surface area and the linear regression equation showed good correlation between them. 5. Comparison of measured lengths and volumes of both kidneys indicated that length of the left kidney was larger than right in 72.2% of cases and the size discrepancy was less than 1 ㎝ in 66.6%. Volume of the left kidney was larger than right in 72.8% and the discrepancy was less than 30ml in most of the cases.

위절제술 후 Carboxy-Methylcellulose를 이용한 위장관 조영술

오재천,김용수,문원진,임현철,고병희,조온구 한양대학교 의과대학 1997 한양의대 학술지 Vol.17 No.1

The purpose of this study was to determine the usefluness of the UGI study with Carboxy-Methylcellulose (CMC) and 140% barium in the patient undergone gastrectomy We reviewed the UGI study with effervescent agent and barium and the UGI study with CMC and 140% barium of twenty one patients, undergone gastrectomy (Billroth-Ⅱ:12, Billroth-Ⅰ:4 total gastrectomy:5). The average interval between these studies was 19 months. The coating quality of the remnant stomach, anastomosis sit e, jejunum and proximal ileum in two studies were compared. The maximum luminal diameter of the same site and the maximum distance between a adjacent valvulae conniventes were measured for evaluating the distensibility of these studies. Compared with the coating quality of the remnant stomach, the UGI study with effervescent agent and barium was superior to the UGI study with C MC and barium in 68% (11/16) patients. The difference of coating quality between these studies was marginal in the anastomosis site and jejunum. The UGI study with CMC and barium provided a better coating quality in the proximal ileum of 95%(20/21). The maximum luminal diameter of the anastomosis site, jejunum and proximal ileum was respectively 2.75cm, 3.36cm, and 2.82cm inthe UGI study with effervescent agent and barium, 3.2cm 3.35cm, and 3.40cm in the UGI study with CMC and barium(p〈0.01). The maximum distance between a adjacent valvulae conniventes of the jejunum and proximal ileum was respectively 0.61cm and 0.51cm in the UGI study with effervesent agent and barium, 0.74cm and 0.72cm in the UBI study with CMC and barium (p〈0.05). Compared with the distensibility, the UGI study with CMC and barium was superior. The UGI study with CMC and barium in subjects, undergone gastectomy, showed the advantage the mucosa distal to anastomosis site except for the remnant stomach and must be supply the more information in finding lesion such as adhesion and peritoneal dissemination.