The First Korean Case of Beare-Stevenson Syndrome with a Tyr375Cys Mutation in the Fibroblast Growth Factor Receptor 2 Gene

제보경,이응석,최병민,So Hee Eun,Ki Ssu Ha,이정화,은백린,유기환 대한의학회 2007 Journal of Korean medical science Vol.22 No.2

Benign versus Malignant Solid Nodules in Subareolar Area of the Breast: Radiological, Clinical and Pathological Correlation

제보경,서보경,이남준,이준영,김인선,김석진,전혜정,박정희,조규란,이지영,최은정 대한초음파의학회 2003 ULTRASONOGRAPHY Vol.22 No.3

PURPOSE : To investigate the general applicability of ultrasonography (US) and clinical findings in differentiating benign from malignant solid nodules in the subareolar area of the breast. MATERIALS and METHODS : From March 2001 to March 2003, pathologically proven 84 nodules from 78 patients were included in this study. Two radiologists evaluated the shape, margins, internal echotexture, internal echogenicity, posterior echo intensity and relation with the major ducts, and each nodule was then classified as benign or malignant. Clinical findings were divided into either or absence of symptom. The ultrasonographic, mammographic and clinical classifications were compared with the pathological results. The sensitivity (SE), specificity (SP), positive predictive values (PPV) and negative predictive values (NPV) were calculated for ultrasonographic, mammographic and clinical classifications. RESULTS : Sixteen nodules were proved to be malignant (7 ductal carcinoma in situ and 9 invasive ductal carcinoma), and the remaining 68 nodules were benign. SE, SP, PPV, and NPV of breast cancer according to the ultrasonographical classification were 100%, 61.8%, 38.1% and 100% while those of the clinical classification were 81.3%, 73.5%, 41.9% and 94.3%, respectively. Relation with the major ducts such as ductal communication or intraductal location demonstrated a high SE (87.5%) and NPV (92.0%). CONCLUSION : Ultrasonographic and clinical findings can be helpful in the differentiation of benign solid nodules from malignant lesions in the subareolar area of the breast. 목적 : 이 연구의 목적은 유두하 부위 고형결절에서 양성과 악성을 감별하는데 있어서 유방초음파와 임상 소견의 적용에 대해 알아보고자 한다. 대상 및 방법 : 2001년 3월부터 2003년 3월까지 병리학적으로 확진된 78명 환자의 84예를 대상으로 하였다. 두 명의 유방 방사선 전문의가 결절의 모양, 경계, 내부에코, 후방에코와 주유선과의 연관성 등에 대해 관찰하였다. 임상 소견에 있어서는 증상의 유무로 구분하였다. 초음파와 단순유방촬영을 포함한 방사선학적 소견과 임상 소견을 병리학적 소견과 비교하여 유방암에 대한 예민도, 특이도, 양성예측치와 음성예측치 등을 구하였다. 결과 : 16예는 악성으로 이 중 7예는 상피내암이고 9예는 침윤성 암이었다. 나머지 68예는 양성 결절이었다. 유방 암에 대한 예민도, 특이도, 양성예측치와 음성예측치는 유방초음파에서 100%, 61.8%, 38.1%와 100%이었 고, 임상 소견에서 81.3%, 73.5%, 41.9%와 94.3%이었다. 주유선과의 연관성은 높은 예민도(87.5%)와 음성예측치(92.0%)를 보였다. 결론 : 유방초음파와 임상 소견은 유두하 고형결절에서 양성과 악성을 감별하는데 도움을 주는 유용한 방법이다.

Ultrasonographic features of the normal filum terminale

권명애,제보경,홍도란,최병민 대한초음파의학회 2018 ULTRASONOGRAPHY Vol.37 No.2

Purpose: The filum terminale (FT) is a fibrous band that connects the conus medullaris to the posterior body of the coccyx. Considering the advances of ultrasonography (US) technology and improvements in the resolution of US images, we aimed to re-establish the US features of the normal FT in infants younger than 6 months of age. Methods: We retrospectively reviewed 30 spinal US scans, stored as video clips. The internal structure of the FT and the marginal echogenicity of the FT were assessed, and transverse and longitudinal US were compared. Results: On US, a central echogenic line was defined in 18 (60%) normal FTs; however, there was no visible internal structure in 12 cases (40%). The marginal echogenicity of the FT was hyperechoic in eight cases (27%) in comparison with the cauda equina and was isoechoic in 22 cases (73%). In differentiating the normal FT from the surrounding nerve roots, transverse US was superior in 18 cases (60%), while longitudinal US was superior in two cases (7%). Conclusion: On US, the central canal of the FT was defined in 60% of normal FTs. Hyperechoic marginal echogenicity and the use of transverse US were helpful in distinguishing the normal FT from the nerve roots of the cauda equina.

급성 골수성 백혈병의 최초 증상으로 안구 돌출을 초래한 양측 안와-부비동 과립세포육종: 증례 보고

김희선,제보경,이영흔,김백현 대한자기공명의과학회 2010 Investigative Magnetic Resonance Imaging Vol.14 No.1

과립세포육종은 골수성 백혈병의 발현 형태의 하나로써, 과립세포들의 원시 전구체가 골수가 아닌 연조직에 침착하여 생긴 고형 종괴를 지칭한다. 저자들은 다른 전신 증상 없이 양쪽 안구의 돌출을 주소로 내원하여 광범위한 양쪽 안와-부비동 과립세포육종으로 진단된 22개월 남아의 CT 및 MR 소견을 보고한다. 종괴는 양측 안와 외하벽을 침범하여 양쪽 안구를 돌출시켰으며, 부비동, 상악골, 측두골, 광대뼈, 나비뼈, 벌집뼈, 입천장뼈를 포함한 거의 모든 머리뼈바닥의 골수에 침윤하고 주변에 연부 조직 종괴를 형성하였고, 해면정맥동의 아래 1/2을 침범하고 측두골 안쪽의 경질막이 비후된 소견을 동반하였다. 환아는 골수를 이용한 염색체 검사를 통해 8번과 21번 염색체의 상호전좌 t(8;21) (q22;q22)를 동반한 급성 골수성 백혈병으로 진단되었다.

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.

전국 병원 홈페이지에 사용된 의료장비영상의 실태및 의료장비영상을 이용한 의료광고의 신뢰도 평가

김희선,제보경,김백현,안형식 대한의사협회 2018 대한의사협회지 Vol.61 No.7

A medical advertisement can include media such as newspapers, magazines, and the Internet. Currently, the Internet is responsible for most medical advertising. Our purpose is to investigate the current status of radiologic images posted on hospitals’ websites nationwide, and to evaluate the reliability of online medical advertisements using these images. I investigated the websites of all 1,450 hospitals and 290 oriental medicine clinics nationwide. Specific information on the radiologic images posted was recorded. In terms of body parts, musculoskeletal images account for 78% of the radiologic images on hospitals’ websites and 98% of the images for oriental medicine clinics. The purposes for posting radiologic images are to explain the pathophysiology of diseases or the technique of surgical treatments, and to show the effects of hospital-specialized treatments. The most commonly used modalities of radiologic images are plain radiography and MR. More than 90% of the posted images have no source; 10% have no legends; and 5% to 7% have inappropriate legends. In terms of quality, only 60% of the radiologic images on hospitals’ websites are rated as acceptable. Fifteen percent of the oriental medicine clinics posted the radiologic images without having a medical doctor on staff. Considering the results, I conclude that it is necessary to reestablish a system of pre-screening and post-evaluation for reviewing hospital websites, especially focusing on the radiologic images posted. Then we can prevent the inappropriate information from influencing or damaging public health, and set up healthy medical competition.

Inflammatory Metastatic Carcinoma of Sternum Mimicking Sternal Osteomyelitis with Gas Gangrene

추지영,제보경,이기열,김백현,김성범 대한영상의학회 2013 대한영상의학회지 Vol.68 No.5

Inflammatory metastasis is a metastatic tumor associated with fever, skin changes, soft tissue inflammation, and laboratory abnormalities, suggesting an inflammation that obscures the underlying malignancy. We report a 69-year-old male with inflammatory metastatic carcinoma of sternum. He presented with clinical findings mimicking osteomyelitis of the sternum. The chest CT scan showed the parasternal soft tissue masses and cortical disruption of sternum which was continuous with air bubbles spreading through the pectoralis muscles. He was diagnosed as poorly-differentiated carcinoma with unknown origin.

Ultrasonographic Demonstration of the Tissue Microvasculature in Children: Microvascular Ultrasonography Versus Conventional Color Doppler Ultrasonography

유중현,제보경,추지영 대한영상의학회 2020 Korean Journal of Radiology Vol.21 No.2

Microvascular ultrasonographic imaging is the most recent and unique Doppler ultrasound technique. It uses an advanced clutter filter that can remove clutter artifacts and preserve the low-velocity microvascular flow signal. The potential advantages of microvascular ultrasonography are its superiority in detection and visualization of the small blood vessels in tissues, providing radiologists with more information on the vascular structures. Therefore, it has shown particular value in the clinical fields. The aim of this study was to provide microvascular ultrasonographic images for the tissue microvasculature, including the brain, thyroid gland, kidney, urinary bladder, small bowel, ovary, testis, lymph node, and hemangiomas in children, focusing on the comparison with conventional color Doppler ultrasonographic images.

Kikuchi Disease Manifesting as Multifocal Lymphadenopathy and Splenomegaly: Ultrasonography, CT, and 18F-FDG PET/CT Findings Mimicking Lymphom

하모인,제보경,이응석,이성욱 대한영상의학회 2020 대한영상의학회지 Vol.81 No.6

Kikuchi disease is a type of benign, self-limiting necrotizing lymphadenitis that occurs most commonly in young women and usually manifests as palpable cervical lymph nodes and fever. Patients with an unusual location of lymph node involvement can be misdiagnosed with malignant disease. Here, we report a case of Kikuchi disease in a 15-year-old girl presenting with persistent fever for 2 weeks. Imaging studies, including ultrasonography, CT, and 18F-fluorodeoxyglucose PET/CT, revealed splenomegaly and enlarged lymph nodes in the neck, axilla, abdomen, retroperitoneum, and inguinal region. Laparoscopic excision of the celiac lymph nodes confirmed histiocytic necrotizing lymphadenitis, also known as Kikuchi disease. Conservative treatment with corticosteroids improved the patient’s condition.

장중첩증에서 비수술적 정복의 실패 위험인자

고광민,송영우,제보경,한재준,우찬욱,최병민,이정화,Ko, Kwang-Min,Song, Young-Wooh,Je, Bo-Kyung,Han, Jae-Joon,Woo, Chan-Wook,Choi, Byung-Min,Lee, Jung-Hwa 대한소아소화기영양학회 2008 Pediatric gastroenterology, hepatology & nutrition Vol.11 No.2

목 적: 장중첩증의 일차적인 치료로 사용되는 비수술적 관장 정복은 장천공, 쇼크 그리고 복막염 등과 같은 심각한 합병증과 불필요한 스트레스 및 과도한 방사선 노출의 위험이 있다. 본 연구에서는 무리한 비수술적 정복의 시도를 피하기 위하여 장중첩증 환자의 임상 양상 및 검사 소견 중 비수술적 정복 실패를 예측할 수 있는 인자를 파악하고자 하였다. 방 법: 고려대학교 의료원 안산병원에서 1998년 3월에서 2006년 7월까지 장중첩증으로 진단되어 치료받았던 환자 314명 중 비수술적 정복이 시도되었던 300명을 대상으로 하였다. 비수술적 정복의 성공 군과 실패군으로 나누어 성별, 연령, 임상증상 및 이학적 소견 그리고 증상의 시작에서 비수술적 정복술을 시도하기까지의 시간과 비수술적 정복 실패와의 연관성을 분석하였다. 결 과: 비수술적 정복 실패 군의 경우 성공 군에 비해 연령이 어렸고(12.3${\pm}$17.2개월 vs 18.0${\pm}$15.8개월, p=0.03), 정복 시도까지의 시간 경과가 길었으며(33.6${\pm}$29.0시간 vs 21.5${\pm}$20.3시간, p<0.01), 구토, 기면은 많았음(p<0.01)에 비해 복통이나 보챔은 적었다(p<0.01). 이러한 인자들의 다중회귀분석에서 비수술적 정복 실패와 연관된 인자는 6개월 미만 연령(odds ratio: 2.5, 95% confidence interval: 1.2~5.2, p=0.01), 24시간 경과(odds ratio: 2.1, 95% confidence interval: 1.2~4.2, p=0.03), 혈변(odds ratio: 4.8, 95% confidence interval: 1.9~12.2, p<0.01), 기면(odds ratio: 3.4, 95% confidence interval: 1.1~10.4, p=0.04), 복통 또는 보챔(odds ratio: 0.2, 95% confidence interval: 0.1~0.4, p<0.01)이었다. 결 론: 장중첩증에서 6개월 미만 어린 연령, 혈변이나 기면의 소견, 증상 시작 24시간이 경과된 경우 비수술적 정복 실패의 가능성이 많으므로 이러한 사항을 충분히 고려하여 시행 여부를 결정하는 것이 좋겠다. Purpose: Intussusceptions are one of the most common causes of intestinal obstruction in infants and young children. Although it is easily treated by non-operative reduction using barium, water or air, this treatment is very stressful for young patients and may cause bowel perforation, peritonitis and shock. In this study, we identified the risk factors associated with the failure of non-operative reduction, to identify a group of children that would benefit from the procedure and those who would not. Methods: We reviewed the medical records of patients with intussusception who were treated at the Korea University Medical Center Ansan hospital from March 1998 to July 2006. Three hundred fourteen children with intussusception were identified. Among them, non-operative reductions were performed in three hundred. Clinical and radiological variables were compared according to the failure or success of the non-operative reduction. Results: Non-operative reductions were successful in 243 (81%) and failed in 57 (19%). The group that had failed procedures had a younger age (12.3${\pm}$17.2 months vs. 18.0${\pm}$15.8 months, p=0.03), longer symptom duration before reduction (33.6${\pm}$29.0 hr vs. 21.5${\pm}$20.3 hr, p<0.01), more vomiting and lethargy (p<0.01), but less abdominal pain and irritability (p<0.01), compared with the group that had a successful procedure. Logistic regression analysis showed that the factors associated with the failure of non-operative reductions were a younger age, less than 6 months of age (odds ratio: 2.5, 95% confidence interval: 1.2~5.2, p=0.01), duration of symptoms, longer than 24 hrs before reduction (odds ratio: 2.1, 95% confidence interval: 1.2~4.2, p=0.03), bloody stool (odds ratio: 4.8, 95% confidence interval: 1.9~12.2, p<0.01), lethargy (odds ratio: 3.4, 95% confidence interval: 1.1~10.4, p=0.04), and abdominal pain or irritability (odds ratio: 0.2, 95% confidence interval: 0.1~0.4, p<0.01). Conclusion: For children with intussusception, an age younger than 6 months, and duration of symptoms more than 24 hrs before reduction, as well as the presence of bloody stools, lethargy and abdominal pain or irritability were variables associated with failure of a non-operative reduction. Knowledge of these variables should be considered in making clinical decisions for therapeutic interventions.