병발한 종양이 있는 낭성 성숙 난조 기형종의 CT 소견

김택군 대한영상의학회 1998 대한영상의학회지 Vol.38 No.1

Purpose: A tumor and mature ovarian cystic teratoma rarely coexist, but since it may affect treatment andprognosis, appropriate pre-surgical diagnosis is important. The purpose of this study was to evaluate thedifference in CT findings between a tumor coexisting with a mature ovarian cystic teratoma and a simple matureovarian cystic teratoma. Materials and Methods: CT scans of seven cases of tumor coexisting with mature ovariancystic teratoma were reviewed. In each case, size, margin, nature, septation, solid portion, ascites, invasion,and metastasis were analysed. Results: Coexistent tumors were histopathologically diagnosed as squamous cellcarcinoma in three patients, carcinoid in three, and fibrothecoma in one. In contrast with a simple matureteratoma, a tumor coexisting with a mature cystic teratoma developed in older patients and had a more solidportion, which showed contrast enhancement but did not show calcification or a fat component. Where a tumor andmature cystic teratoma coexisted, ascites and the invasion of adjacent structures were also common. Conclusion:If, in an older patient, CT scanning reveals an ovarian cystic tumor with a large solid portion but nocalcification or fat, coexistent tumor should be suspected.

슬관절 반월판 열상의 진단에 있어 지방억제 고속 스핀에코 영상의 유용성

김택군 대한영상의학회 1999 대한영상의학회지 Vol.40 No.1

Purpose : Suppression of the relatively high signal intensity of fat leads to more efficient use of thedynamic range for display of tissue contrast. In order to evaluate meniscal tears, we compared a fat-suppressedturbo spin-echo(FSTSE) sequence with turbo SE(TSE). Materials and Methods : One hundred and seven knees in 103consecutive patients referred for MR study of the knee were imaged using both FSTSE and TSE sequence. The turbo SEsequence provided proton density-weighted and T2-weighted images (dual echo technique) with an effectiveecho-train length of five. For fat-suppression, a frequency-selective chemical presaturation pulse was applied.Forty-two knees (84 menisci) were studied arthroscopically and the findings were taken as the reference standard.FSTSE and TSE images were reviewed retrospectively by two radiologists. Next, for each patient, the quality ofFSTSE and TSE images was compared;the former were scored by each reviewer as either superior to, equal to, orinferior to TSE images. Results : Among the 214 menisci evaluated, the results of FSTSE and TSE imaging were verysimilar (kappa index 0.87). Twenty four tears were found during arthroscopy in 84 menisci. FSTSE imaging was moresensitive than TSE (96% versus 83%), though specificity was equal(98%). Among the 107 cases, FSTSE images wererated by both observers as superior to TSE images for overall quality and visualization of the meniscus itself.Conclusion : For the evaluation of meniscal tears, FSTSE sequences were more sensitive than those obtained withTSE, and their image quality was superior. For the study of meniscus tears among a large population, FSTSE istherefore more useful than TSE.

복부 나선 CT의 동맥기에서 보이는 일시적 불균등 비장 조영

김택군 대한영상의학회 1997 대한영상의학회지 Vol.36 No.2

Purpose : To assess the relationship between splenic transient inhomogeneous contrast enhancement(CE) on the arterial phase of spiral CT, and splenic volume, and to classify the CE pattern in liver cirrhosis. Materials and Methods : We measured the splenic volume of 120 patients, 60 showed inhomogeneous splenic CE on arterial phase, and 60 showed homogeneous splenic CE. CT scans with intrinsic splenic pathology were excluded. Sixteen patients with clinically confirmed liver cirrhosis were included. Splenic volumes of the inhomogeneous and homogeneous CE group were compared. The inhomogeneous group was divided into three grades according to areas of non-enhanced portion (grade I, focal geographic; grade II, multifocal patchy, grade III, extensive serpentine inhomogeneous CE), and these were correlated with splenic volume. Results : Among the 60 inhomogeneous CE scans, 23 cases (38.3%) showed splenomegaly (spleen volume>220㎤); in contrast, this applied to only 8 cases (13.3%) of the 60 homogeneous CE scans. Mean splenic volume in the inhomogeneous CE group (226.74$\pm$129.78㎤) was greater than in the homogeneous CE group (184.56$\pm$77.44㎤) (p<0.033). A larger splenic volume and extensive inhomogeneous CE (grade III) were noted, and most liver cirrhosis patients(14/16) were grade III. Three such patients who had shown inhomogeneous splenic CE on arterial phase showed inhomogeneous CE even on portal phase. Conclusion : Inhomogeneous splenic CE on arterial phase was more common in cases of an enlarged spleen, and more extensive in liver cirrhosis. These findings suggest hemodynamic change of the spleen may be a contributory factor.

급성 뇌경색 환자에서 풍선카테터를 사용한 두개 내 혈관의 경피 경관 혈관성형술

최재철,김택군 대한신경과학회 2004 대한신경과학회지 Vol.22 No.6

Although the results of intra-arterial thrombolysis for the treatment of acute ischemic stroke have been encouraging, the failure of arterial recanalization and intracranial hemorrhage were unresolved problems of this procedure. Because of this limitation, there has been increasing interest in the use of percutaneous transluminal angioplasty (PTA). Recently, we have treated three patients with acute ischemic stroke using PTA of the intracranial artery. Although the arterial recanalization was achieved initially in all cases, only one patient showed clinical improvement.

초음파 유도하 생검후 병리학적 진단이 불가능하였던 간종괴에 관한 고찰 : Analysis of False Negative Results

서보경,서형석,김택군,이기열,조성범,김윤환,박철민 대한초음파의학회 1998 ULTRASONOGRAPHY Vol.17 No.1

5개월 남아의 코입술주름에 생긴 결절성 근막염의 증례

안경식,제보경,김영식,김택군,김백현,차상훈 대한영상의학회 2006 대한영상의학회지 Vol.55 No.6

We report the case of a 5-month-old infant with a rapidly growing mass on the right nasolabial fold; to our knowledge, this is the youngest infant diagnosed with nodular fasciitis in the literature. Based on the anatomic location, this was a subcutaneous type of nodular fasciitis and it had a mixed cellular and fibrous histologic composition, which is rare in infancy. Here we present periodic ultrasonographic images and MR images, as well as a detailed comparison of the pathologic and radiologic findings. 결절성 근막염은 빠른 성장 속도 때문에 악성으로 오인되기도 하는 양성 병변이다. 저자들은 5개월 남아의 코입술주름에서 발견된 결절성 근막염을 경험하였고 이는 보고된 예 중 가장 어린 나이이다. 병변은 피하층에 있었고 병리적으로 세포형과 섬유형이 혼합되어 있었으며 이는 유아에서 드문 형태이다. 초음파 추적 관찰 소견과 컴퓨터단층 촬영 소견, 자기공명영상 소견과 병리 소견을 비교하였다.

귀밑샘에 발생한 경화성 점액표피양암종 - 1예 보고 -

김현철,이주한,이응석,권순영,김택군,김영식 대한병리학회 2007 Journal of Pathology and Translational Medicine Vol.41 No.3

There have been eight cases of SMEC reported in the medical literature; this is the first reported case in Korea. A 51-year-old woman presented with a right infra-auricular mass that she had for 3 years. We performed superficial parotidectomy. Grossly, the resected parotid gland showed a well-circumscribed firm mass. Histologically, the tumor consisted of central solid or ductal tumor nests within a dense fibrous stroma surrounded by peripheral lymphoid infiltration. The tumor nests were composed of squamous, intermediate and mucin-secreting cells. However, the tumor cells lacked mitosis and nuclear anaplasia. The lymphoid cells were mostly composed of lymphocytes and plasma cells with occasional eosinophils and neutrophils. Immunohistochemically, the tumor cells were positive for high- and low- molecular weight cytokeratins, cytokeratin 7, p16INK4A, Bcl-2 and cyclin D1. The patient also underwent radiation therapy. We report here on a case of SMEC of the parotid gland along with the immunohistochemical characteristics, and we review the relevant literature. Sclerosing mucoepidermoid carcinoma (SMEC) is a very rare tumor of the salivary gland. There have been eight cases of SMEC reported in the medical literature; this is the first reported case in Korea. A 51-year-old woman presented with a right infra-auricular mass that she had for 3 years. We performed superficial parotidectomy. Grossly, the resected parotid gland showed a well-circumscribed firm mass. Histologically, the tumor consisted of central solid or ductal tumor nests within a dense fibrous stroma surrounded by peripheral lymphoid infiltration. The tumor nests were composed of squamous, intermediate and mucin-secreting cells. However, the tumor cells lacked mitosis and nuclear anaplasia. The lymphoid cells were mostly composed of lymphocytes and plasma cells with occasional eosinophils and neutrophils. Immunohistochemically, the tumor cells were positive for high- and low- molecular weight cytokeratins, cytokeratin 7, p16INK4A, Bcl-2 and cyclin D1. The patient also underwent radiation therapy. We report here on a case of SMEC of the parotid gland along with the immunohistochemical characteristics, and we review the relevant literature.

충수주위 농양의 치료에서 초음파 유도 흡입술하의 Urokinase 주입의 유용성

하종수,차상훈,서보경,김백현,정환훈,김택군,박철민,정규병 대한초음파의학회 2002 ULTRASONOGRAPHY Vol.21 No.4

목적 : 경피적 도관배액술의 적응증이 되지 않는 적은 크기의 충수주위 농양에서 urokinase 를 투여 후, 초음파 유도하에 흡입술을 실시해 그 유용성을 알아보고자 하였다.대상 및 방법 : 진단된 6명의 환자(남:여=1:5)를 대상으로 하였다. 시술 전 출혈 시간을 검사하여 정상임을 확인한 후, 초음파 유도하에 18G(gauge) 바늘을 사용하여 가능한 많은 양의 농양을 흡입하고, 남은 농양의 최대길이를 측정하여 5000 IU/cm의 urokinase를 투여하였다. urokinase투여한 뒤 24시간 후 초음파 유도하에 남은 농양을 흡입한 뒤, 다시 추적 초음파를 시행하였다. 각 환자의 초기 농양의 크기는 5.8×3.4-1.6×1.2 cm(평균: 3.9×2.4)이었고, urokinase 투여 전 초기에 최대로 흡입된 농양의 양은 3-31 cc(평균: 11.8)였고, urokinase 투여 24시간 후에 흡입된 농양의 양은 4-13.5 cc(평균: 10.4)였다. 3-10일(평균: 5.2) 후 추적 초음파를 시행하여 농양이 없음을 확인하였다. 6명 환자의 재원 일수는 4-8일(평균 5.5)이었다. 결론 : urokinase를 이용한 충수주위 농양의 흡입술은 도관배액술이 적용되지 않는 적은 크기의 충 PURPOSE : To evaluate usefulness of intracavitary urokinase injection for the treatment of small sized periappendiceal abscess which was not unsuitable for percutaneous catheter drainage. MATERIALS and METHODS : From December 1997 to December 1999, we performed intracavitary injection of urokinase as a treatment of periappendiceal abscess in six patients. Initially, aspiration of the abscess was done using a 18 G needle under sonographic guidance. We measured the maximal length of residual abscess and injected 5000 IU of urokinase per centimeter of the diameter of the residual abscess. 24 hours after the injection of urokinase, repeated aspiration of the residual abscess was done, and follow-up sonographic examination was performed. RESULTS : The size of initial abscesses in each patients was ranged from 1.6×1.2 to 5.8×3.4 cm (mean = 3.9 ×2.4 cm), and initial volume of aspirated pus was ranged from 3 to 31 cc (mean = 11.8 cc). 24 hours after the injection of urokinase, the volume of reaspirated pus was ranged from 4 to 13.5 cc (mean = 10.4 cc). Follow-up sonography performed 3 to 10 days later revealed no residual abscess. The mean duration of hospitalization was 5.5 days. CONCLUSION : Intracavitary urokinase injection under the sonographic guidance can be a useful method for the treatment of small sized periappendiceal abscess which is not suitable for percutaneous catheter drainage.

대퇴 동맥 천자에 관한 연구: 서혜부 피부 주름선과 골격 지표의 비교

정환훈,하종수,차상훈,김백현,이기열,김택군,이승화,김정혁,설혜영 대한영상의학회 2006 대한영상의학회지 Vol.54 No.4