척수동정맥기형의 임상 양상과 영상 소견

김상흠 대한영상의학회 1997 대한영상의학회지 Vol.37 No.6

Purpose:To evaluate the findings of magnetic resonance (MR) imaging and selective spinal angiography of spinal cord arteriovenous malformations (SCAVMs) and to investigate the correlation of these findings with the development of clinical symptoms. Materials and Methods:In 16 patients diagnosed as suffering from SCAVMs, MR imaging and selective spinal angiograms were retrospectively analyzed and correlated with clinical symptoms. Clinical data were reviewed, especially concerning the mode of onset of clinical symptoms, and MR images of SCAVMs were evaluated with regard 개 the following parameters;spinal cord selling with T2 hyperintensity, cord atrophy, intramedullary hemorrhage, and contrast enhancement of the spinal cord. Selective spinal angiographic findings of SCAVMs were also evaluated in terms of the Imaging findings were also correlated with the development of clinical symptoms. Results:Neurologic deficits, either scute(n=4) or insidious(n=11), were noted in 15 patients. One case withput any neurologic deficits was found incidentally. MR showed spinal cord swelling(10/16), atrophy(2/16), intramedullary hemorrhage(0/16), and contrast enhancement of the cord (8/12);spinal angiograms showed the presence of associated aneury는 (6/16) and radicular venous drainage (8/16). SCAVMs were metameric(n=4), intramedullary(n=9), or fistular(n=3). Nine of 11 patients with insidious onset showed spinal cord swelling and no radicular venous drainage with prominent perimedullary venous dilatation. Aneurysms were present in all four patients with abrupt symptoms. Conclusion;Systematic evaluation of the findings of MR imaging and angiography provides detailed information on the type of AVM and status of the spinal cord parenchyma, and this can be correlated with clinical manifestations of SCAVM. In patients suffering from this condition, spinal cord dysfunction due to venous congestion appears to be the main cause of clinical symptoms.

A Less Invasive Strategy for Ruptured Cerebral Aneurysms with Intracerebral Hematomas: Endovascular Coil Embolization Followed by Stereotactic Aspiration of Hematomas Using Urokinase

김상흠,김태곤,공민호 대한뇌혈관외과학회 2017 Journal of Cerebrovascular and Endovascular Neuros Vol.19 No.2

Objective:Aneurysm clipping and simultaneous hematoma evacuation through open craniotomy is traditionally recommended for ruptured cerebral aneurysms accompanied by intracerebral or intrasylvian hemorrhages. We report our experience of adapting a less invasive treatment strategy in poor-grade patients with intracerebral or intrasylvian hemorrhages associated with ruptured cerebral aneurysms, where the associated ruptured cerebral aneurysms were managed by endovascular coil embolization, followed by stereotactic aspiration of hematomas (SRH) using urokinase. Materials and Methods : We retrospectively analyzed 112 patients with ruptured cerebral aneurysms. There were accompanying intracerebral or intrasylvian hemorrhages in 36 patients (32.1%). The most common site for these ruptured aneurysms was the middle cerebral artery (MCA) (n = 15; 41.6%). Endovascular coil embolization followed by SRH using urokinase was performed in 9 patients (25%). Results : In these 9 patients, the most common site of aneurysms was the MCA (n = 3; 33.4%); the hematoma volume ranged from 19.24 to 61.68 mL. Four patients who were World Federation of Neurological Surgeons (WFNS) grade-IV on admission, achieved favorable outcomes (Glasgow Outcome Score [GOS] 4 or 5) at 6-months postoperatively. In the five patients who were WFNS grade-V on admission, one achieved a favorable outcome, whereas 4 achieved GOS scores of 2 or 3, 6-months postoperatively. There was no mortality. Conclusion : If immediate hematoma evacuation is not mandated by clinical or radiological signs of brain herniation, a less invasive strategy, such as endovascular coil embolization followed by SRH using urokinase, may be a good alternative in poor-grade patients with intracerebral or intrasylvian hemorrhages associated with ruptured cerebral aneurysms.

Transarterial Balloon-assisted Onyx Embolization of Intracranial Arteriovenous Malformations Using a Dual-lumen Balloon Microcatheter: Two Case Reports

김상흠,김태곤,공민호 대한뇌혈관외과학회 2017 Journal of Cerebrovascular and Endovascular Neuros Vol.19 No.3

The Onyx system has been well established in recent years as a very important material in the treatment of arteriovenous malformations (AVMs). When using the Onyx, it is essential to wait for the creation of a plug around the tip of the catheter, which enables the effective forward penetration of Onyx. Recent reports have shown that the introduction of a dimethyl sulfoxide compatible dual-lumen balloon microcatheter improves the efficiency of AVM embolization. We report our recent experience of two cases of intracranial AVM embolization using Onyx and the transarterial balloon-assisted technique. In both cases, the procedures were successfully performed and the nidus of the AVM was totally occluded in a relatively short time. This technique may enable immediate forward flow and penetration of Onyx without concern about reflux. It may also reduce the procedure time and increase the angiographic occlusion rate. Navigation of the dual-lumen balloon microcatheter nevertheless remains a challenge.

스마트사회의 인재적 특성, 정보화 역량, 사회적 네트워크의 관계성에 관한 탐색적 연구

이복자(李福子),명승환(明承煥),김상흠(金相欽) 한국지역정보화학회 2012 한국지역정보화학회지 Vol.15 No.1

본 연구는 스마트사회의 인재적 특성과 정보화 역량에 관한 탐색적 연구로서 두 변수가 사회적 네트워크 구축에 어떠한 영향을 미치고 있는지 행정관료를 중심으로 상관성을 알아보았다. 스마트사회의 발전을 위하여 반드시 필요한 인재적 특성과 정보사회에 효율적으로 대처할 수 있는 개인의 정보화 역량에 따라서 과연 사회적 네트워크 정도는 어떻게 달라지는가? 연구의 분석을 위하여 서울ㆍ경기ㆍ인천의 행정관료 676명을 표본으로 분석해 본 결과 첫째, 자신의 능력향상을 위해서 꾸준히 노력하는 경우 둘째, 정보관리능력이 우수하여 효율적으로 업무수행을 하고 있다는 자부심이 충만한 경우 셋째, 미래사회ㆍ정보가 성숙한 스마트사회에 대하여 긍정적인 정보인식을 강고 있는 경우 넷째, 50대의 연령층에서 사회적 네트워크에 영향을 미치고 있었다. 본 연구는 탐색적으로 시도된 연구결과이므로 일반화 하는 것에는 무리가 있으나 연구결과를 바탕으로 하여 개인의 역량강화와 공적인 인재양성 측면에서 방안을 논의하였다. This study explores the relationship between talent characteristics and information capability with its effects on building social network. The study conducted the survey on the 676 public officers sample in Seoul, Gyeonggi, and Incheon. The survey results show that self confidence on individual"s capacity and talent is statistically significant with the social network building. It also found the positive attitude on information and future smart society is positively related with information capability. It is somewhat interesting finding that public officers in age of 50"s show more active and positive attitude on building social network. Regardless of the information capability or talent, self actualization needs in that ages might affect the social network building including more active communications and information sharing with related people and groups. This study is an exploratory and needs develop more reliable measurement instruments for the sake of generalization.

Pituitary magnetic resonance imaging abnormalities in young female patients with hypogonadotropic hypogonadism

강지연,김상흠,김훈영,기효진,이미화 대한산부인과학회 2019 Obstetrics & Gynecology Science Vol.62 No.4

ObjectiveTo elucidate the association between clinical and laboratory characteristics and pituitary magnetic resonance imaging(MRI) abnormalities in young female patients with hypogonadotropic hypogonadism (HH). MethodsWe retrospectively investigated a series of 74 female patients (age range, 14–42 years) with normoprolactinemic HHwho underwent pituitary MRI. Pubertal milestones and hormonal features of patients with small pituitary glands (PGs)and space-occupying lesions were compared with those of patients with normal PGs. ResultsThe overall frequency of abnormal PGs was 35.1%, with space-occupying lesions observed in 8 patients (10.8%),and small PG observed in 18 patients (24.3%). The mean serum gonadotropin level was not different betweenpatients with and without pituitary MRI abnormalities (P>0.05). Space-occupying lesions were not associated withlow gonadotropin levels, type of amenorrhea, or presence of secondary sex characteristics. The frequency of spaceoccupyinglesions was higher in patients with interrupted puberty (25.0%) than in patients who did not go throughpuberty (4.8%) or had a normal puberty (9.8%), but were not statistically significant (P>0.05). Small PG was associatedwith low gonadotropin levels and type of amenorrhea (P<0.05). ConclusionClinically significant space-occupying lesions were not associated with low gonadotropin levels, type of amenorrhea,or presence of secondary sex characteristics. However, the frequency of space-occupying lesions was higher in patientswith interrupted puberty than in patients who did not go through puberty or who with normal puberty.

Analysis of the Occurrence of Major Hemorrhagic Incidents in Patients with Low-Dose Aspirin Usage in Korean Populations – Does Low-Dose Aspirin Really Increase the Risk of Bleeding?

김태곤,김상흠 대한신경중재치료의학회 2020 Neurointervention Vol.15 No.1

Coexistence of the Absence of the Left Common Carotid Artery, a Common Origin of the Left External Carotid Artery and the Right Common Carotid Artery, and an Aberrant Right Subclavian Artery: A Case Report

이수정,최혜정,김상흠 대한영상의학회 2021 대한영상의학회지 Vol.82 No.4

The absence of the common carotid artery (CCA) and the common origin of the left external carotid artery (ECA) and the right CCA are rare anomalies of the cervical vascular system. We report here a case involving the coexistence of these vascular anomalies with an aberrant right subclavian artery, which is a common congenital anomaly in the aortic arch, and review the embryologic mechanism and clinical importance of this case.

Pregnancy and Natural Delivery Following Magnetic Resonance Imaging-Guided Focused Ultrasound Surgery of Uterine Myomas

윤상욱,김경아,김상흠,하두회,이찬,이선영,정상근,김승조 연세대학교의과대학 2010 Yonsei medical journal Vol.51 No.3

This report discusses a pregnancy case following a series of two consecutive magnetic resonance imaging-guided focused ultrasound surgery (MRgFUS) procedures for the treatment of two different myomas in an individual patient. Both procedures were completed without adverse events, and the patient conceived naturally four months after treatment. At 39 weeks, she gave birth to a healthy baby girl, via a vaginal delivery. There were no complications in the pregnancy or during labor.

춘계학술대회 : 구연 ; 급성간질환등 : 여성에서 낮은 대퇴부 지방량은 비알코올성 간질환의 위험인자인가?

전대원,한지혜,김상흠,김남인,이준석,송문희,이한효,김성환,조윤주,박영숙 대한간학회 2007 Clinical and Molecular Hepatology(대한간학회지) Vol.13 No.3(S)

빠르게 성장한 종격동 성숙 기형종: 증례 보고

정경화,정규식,김상흠,허진도,조영덕,천봉권 대한영상의학회 2002 대한영상의학회지 Vol.47 No.5

Mature teratoma is a benign tumor composed of a number of different types of well-differentiated tissues. Mature teratomas of the mediastinum usually grow slowly and are commonly asymptomatic. We report a case of mediastinal mature teratoma with rapid growth resulting in rupture 종격동의 성숙 기형종은 잘 분화된 조직으로 이루어진 양성 종양으로 대개 서서히 자라며 무증상일 경우가 많다. 저자들은 빠르게 성장하여 파열을 일으킨 종격동 성숙 기형종 1예를 경험하였기에 이를 보고하고자 한다.