갑상선을 침범한 랑게르한스 세포 조직구증의 증례 보고: 초음파 소견

김육,이승영,차상훈,이경식,조범상,강민호 대한초음파의학회 2013 ULTRASONOGRAPHY Vol.32 No.1

Langerhans cell histiocytosis is a rare, proliferative monoclonal histiocytic disease of unknown cause. Primary involvement of the thyroid gland by LCH is very rare, and most cases show evidence of LCH involving other organs. Herein, we report on a case of thyroid LCH in a patient diagnosed as pituitary gland LCH. When a patient with a history of LCH presents with enlargement of the thyroid gland or a neck mass,and ultrasonography shows a well-defined low echoic mass, LCH should be included in differential diagnosis. Fine needle aspiration can be useful for initial diagnosis; however,for differentiation with thyroiditis or thyroid cancer, core biopsy, positive S-100protein, and CD1a immunohistochemical staining are needed. 랑게르한스 세포 조직구증은 Langerhans 세포의 비정상적인 증식을 특징으로 하는 드문 질환으로 그 원인은 아직까지 명확하게 밝혀지지 않았다. 랑게르한스 세포 조직구증이 일차적으로 갑상선을 침범하는 경우는 매우 드물며 대개의 경우 다기관 침범을 동반하게 된다. 저자들은 뇌하수체를 침범한 LCH 환자를 추적 관찰하던 중 갑상선에병발한 LCH 1예를 보고하고자 한다. 랑게르한스 세포 조직구증의 과거력이 있는 환자가 갑상선 비대 혹은 경부 종괴를 호소하고 초음파상 경계가 분병한 저에코성 종괴를보이는 경우 랑게르한스 세포 조직구증의 갑상선 침범의가능성을 고려해야 할 것이다. 또한 갑상선 랑게르한스 세포 조직구증의 진단에 있어 세침 흡입 세포 검사가 도움이될 수 있지만 갑상선염, 갑상선암 등과 감별을 위해 조직생검술 등을 통한 조직검사 및 면역조직화학 검사가 필요하다.

Infratentorial and Intraparenchymal Subependymoma in the Cerebellum: Case Report

김육,이승영,이경식,차상훈,강민호,조범상,이용문 대한영상의학회 2014 Korean Journal of Radiology Vol.15 No.1

Subependymomas are rare benign tumors located in the ventricular system. Intraparenchymal subependymoma is extremely rare; only 6 cases have been reported, and all were located in the supratentorial region. We describe a case of infratentorial, intraparenchymal subependymoma in a 28-year-old man with intermittent headache. Imaging revealed a well-demarcated cystic and solid cerebellar mass near the fourth ventricle. The mass had a microcystic component and calcification without contrast enhancement. Complete surgical excision was performed, and histopathology confirmed a subependymoma.

MRI의 특징적 소견을 보인 척수경막외 농양 1예

신병준,김철현,김대호,이광호,우준희,김 육 대한감염학회 1990 감염 Vol.22 No.1

Acute bacterial spinal epidural abscess is a rare disease in adults and children. Infection usually reaches the epidural space by hematogenous route, from an infected skin or urinary tract. The most common etiologic agent is Staphylococcus aureus. Left untreated, the natural course leads to paraplegia and death. Thus many authorities have recognized that early diagnosis and prompt management is critical. And the availability of highly sensitive, noninvasive methods such as magnetic resonance imaging of the spine and epidural space has made it possible to treat promptly spinal epidural abscess with antibiotics alone. We recently encountered a 30-year-old Korean male who was managed with flucloxacillin under the diagnosis of acute spinal epidural abscess, and showed characteristic MRI.

개선된 체인코드를 이용한 물체 윤곽선 추척

김육(Yuk Kim),권우혁(Woohyen Kwon),구본호(Bonho Koo),윤경섭(Kyungsup Youn) 대한전기학회 2007 대한전기학회 학술대회 논문집 Vol.2007 No.10

본 논문에서는 경계선 추적에 널리 사용되고 있는 체인코드를 개선하여 윤곽선 추적 시 시간과 메모리 효율을 개선하였다. 일반적으로 정형화된 물체는 윤곽선의 동선이 대부분 이전 검색동선과 짙은 방향으로 움직인다. 기존의 8방향 체인코드에는 같은 동선에 있는 경계선이라도 픽셀하나당 한번 씩 검사를 한다. 개선된 체인코드는 확인된 경계영역에서 상하좌우, 대각선 방향으로 한 픽셀씩 더 확인하여 기존 체인코드보다 시간과 메모리 효율을 개선할 수 있다.

삼첨판 폐쇄 부전증에서 연속파형 Doppler 심초음파 검사에 의한 우심실 및 폐동맥 수축기압 추정에 관한 연구

김육 ( Kim Yug ),조주영 ( Jo Ju Yeong ),김철현 ( Kim Cheol Hyeon ),김학선 ( Kim Hag Seon ),조영덕 ( Jo Yeong Deog ),김홍수 ( Kim Hong Su ),박노춘 ( Park No Chun ),서세웅 ( Seo Se Ung ),김성구 ( Kim Seong Gu ),권영주 ( Kwon Yeong 대한내과학회 1992 대한내과학회지 Vol.42 No.3

저자들은 16예의 삼첨판 폐쇄 부전증 환자에서 연속파형 Doppler 심초음파로 수축기 역류의 최대속도(PV), 가속시간(AT), 감속시간(DT) 및 감속율(DR)을 계측하여 심도자술에 의한 우심실 및 폐동맥 수축기압과 비교하여 다음과 같은 결과를 얻었다. 1) Doppler 법으로 구한 삼첨판 수축기 역류의 PV는 254.0±71.0 ㎝/sec, PG는 26.9±12.8 mmHg였으며 심도자술로 측정한 우심실과 우심방 사이 수축기 압차는 30±13.9 ㎜Hg였으며 이들 사이에 상관관계는 상관계수 0.84(p<0.001), 0.87(p<0.001) 이었다. 2) Doppler 법으로 구한 삼첨판 수축기 역류의 PV 및 PG와 심도자술로 측정한 우심실압 사이의 상관관계는 0.86(p<0.001), 0.87(p<0.001)의 정상관관계 였으며, 폐동맥압과는 상관계수가 0.82(p<0.001), 0.87(p<0.001) 이었다. 3) 삼첨판 역류의 Doppler signal에서 Deceleration rate는 PV, PG 및 심도자술로 측정한 우심실과 우심방 사이의 압차와는 상관계수 0.90(p<0.001), 0.92(p<0.001), 0.82(p<0.001)의 정상관 관계에 있었다. 이상의 결과 삼첨판 폐쇄 부전증에서 Doppler 법으로 계측한 peak velocity, pressure gradient와 Doppler signal의 deceleration rate로써 우심실 및 폐동맥압을 추정 할 수가 있었다. To determine noninvasive estimation of systolic right ventricular and pulmonary artery pressure by continuous wave Doppler echocardiography. We analyzed continuous wave Doppler echocardiography and cardiac catheterization data in 16 patients with tricuspid regurgitation undergoing right heart catheterization. Peak velocity of systolic tricuspid regurgitation flow by continuous wave Doppler echocardiography was 254.0±71.0 ㎝/sec and calculated pressure gradient between right ventricle and atrium was 26.9±12.8 ㎜Hg. Peak velocity and pressure gradient of systolic tricuspid regurgitation flow in continuous wave Doppler echocardiography significantly correlated with systolic right ventricular pressure (r=0.84 p<0.001, r=0.87 p<0.001) and systolic pulmonary artery pressure (r=0.82 p<0.001, r=0.87 p<0.001) measured by right heart catheterization. Deceleration rate of systolic tricuspid regurgitation flow significantly correlated with peak velocity (r=0.90 p<0.001) and pressure gradient (r=0.92 p<0.001) by continuous wave Doppler echocardiography also significantly correlated with systolic pressure gradient (r=0.82 p<0.001) between right ventricle and right atrium measured by right heart catheterization. In conclusion, we could noninvasively estimate systolic right ventricular and pulmonary artery pressure in the patients with tricuspid regurgitation by analyzing peak velocity, pressure gradient and deceleration rate by continuous wave Doppler echocardiography.

Transcatheter Arterial Embolization with N-Butyl Cyanoacrylate for Profunda Femoris Artery Pseudoaneurysms Caused by Femur Shaft Fractures: Two Case Reports

이정환,김육,박길선,이지선,이수현 대한영상의학회 2019 대한영상의학회지 Vol.80 No.4

Pseudoaneurysm formation in the profunda femoris artery (PFA) is a rare complication of femur shaft fractures or, more usually, a consequence of operative repair. Over the past few years, percutaneous transcatheter arterial embolization (TAE) has increasingly been considered the most effective treatment for pseudoaneurysms of the PFA. We report two cases with pseudoaneurysms of the PFA that were caused by femur shaft fractures and were successfully treated using TAE with n-butyl cyanoacrylate (NBCA). When a pseudoaneurysm of the PFA occurs due to a femur shaft fracture, early recognition and prompt radiologic intervention may prevent severe vascular injury without the need for additional surgery. The advent of TAE using NBCA enables minimally invasive treatment to be undertaken and it is effective for managing pseudoaneurysms of the PFA.

Successful Endovascular Treatment of an Infected Aortic Aneurysm Induced by Klebsiella pneumoniae

변홍권,김육,이정환,이지선,박길선 대한영상의학회 2020 대한영상의학회지 Vol.81 No.3

Aortic aneurysms infected by Klebsiella pneumoniae are rarely seen. We describe a 50-year-old man with infected aortic aneurysm that was successfully treated with endovascular aneurysm repair (EVAR). Diagnosis was confirmed using blood culture and computed tomography (CT). Intravenous antibiotics were immediately administered, with improvements in clinical findings and negative blood cultures before the procedure. Twenty-four months after the procedure, the patient was stable and serial CT revealed regression of the infected aortic aneurysm. Therefore, after controlling bacteremia and fever with targeted antibiotic therapy, EVAR can be considered as an alternative for patients who have serious comorbidities and are ineligible for conventional surgery.

Recurrent pulmonary arteriovenous malformation in a patient with Sjögren's syndrome: A case report

김정재,김육,최인아,신윤미,이기만 대한내과학회 2022 대한내과학회 추계학술대회 Vol.2022 No.2

비위관 자극으로 인한 대동맥식도누공: 증례 보고

이상민,김육,김기배 대한소화기학회 2022 대한소화기학회지 Vol.80 No.5

A 91-year-old woman who presented with melena and hypovolemic shock visited the emergency room. She received enteral nutrition by nasogastric tube in a bedridden state due to hip surgery. Gastroscopy initially suggested a simple ulcer that occurred after a nasogastric tube was placed for a long time, but the ulcer was deep, and the amount of instantaneous bleeding was considerable. Therefore, an aortoesophageal fistula was suspected. Angiography was performed instead of endoscopic hemostasis, followed by thoracic endovascular aortic repair (TEVAR). After the TEVAR procedure, the patient recovered without further gastrointestinal bleeding. Prompt judgment and communication between the endoscopist and the interventional physician are important for successful hemostasis in an aortoenteric fistula patient.

임산부에서 발생한 원발성 후복막 점액낭샘암종의 자기공명영상 소견: 1예 보고

이지선,조범상,김육,이경식,강민호,이승영,김성진,박길선 대한자기공명의과학회 2013 Investigative Magnetic Resonance Imaging Vol.17 No.3

Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy. To date, 51 cases have been reported, including 3 in pregnant women. Herein, we report magnetic resonance findings of a 31-year-old Korean woman (15 weeks and 3 days pregnant) with primary retroperitoneal mucinous cystadenocarcinoma. On abdominal magnetic resonance imaging (MRI), a mass was identified in the retroperitoneal area with a nodular lesion showing heterogeneous signal intensity and focal wall thickening on T1- and T2-weighted images. Exploratory laparotomy and tumor excision were performed. Histological examination revealed primary retroperitoneal mucinous cystadenocarcinoma. The patient subsequently underwent total hysterectomy, bilateral salpingo-oophorectomy,and omentectomy for metastatic mucinous cystadenocarcinoma of both ovaries 15 months after her initial surgery. 원발성 후복막 점액낭샘암종은 매우 드문 질환으로 현재까지 전 세계적으로 51예가 보고 되었고 이 중 임산부에서 발생한사례가 3예 있었다. 저자들은 31세 여성에서 임신 15주 3일에 발견된 원발성 후복막 점액낭샘암종의 자기공명영상 소견을보고하고자 한다. 복부 자기공명영상에서 후복막강 내에 위치한 종괴는 경계가 좋은 낭종으로 불규칙하게 두꺼워진 낭벽과내부에 중벽을 가지고 있으며, T1강조영상과 T2강조영상에서 다양한 신호강도를 보이는 부위를 포함하고 있었다. 수술을 통해 원발성 후복막 점액낭샘암종으로 진단 받았고 수술 15개월 후 양측 난소에 전이성 점액낭샘암종이 발생하여 전자궁적출술과 양측 난소난관절제술 및 대망절제술을 시행하였다