啓明大學敎 醫科大學 放射線科學敎室

金洪,徐修之,李珍雨,朱亮求 啓明大學校 醫科大學 1988 계명의대학술지 Vol.7 No.2

It is important to determine the normal range of the spinal cord dimension for screening or localizing spinal pathologic processes which could change the size of cord, such as intramedullary tumor, syringomyelia, radiation and trauma. Although CT has been used extensively for the evaluation of spinal disease, the spinal cord cannot be defined from th subarachnoid space and dura without intrathecal injection of a contrast medium. A few studies have been reported that determined the dimensions of normal spinal cord and subarachnoid space, and moreover, a cross-sectional area of the thoracic cord has not yet been known. CT measurements of coronal and sagittal diameters including the coss-sectional area in the thoracic spines were obtained in 31 cases of normal Korean adults who were undergoing the contrast (Isovist) myelography without any pathology in the thoracic spines. The results were as follows: 1. The transverse diameters of the thoracic cord were 9.1mm(SD 1.1) in level (T1), 7.9mm(SD 0.8) in level 2(T5) and 7.3mm(SD 0.7) in level 3(T9). The sagittal diameters were 7.0mm(SD 0.9) in level 1, 6.1mm(SD 0.8) in level 2, and 6.3mm(SD 0.7) in level 3. 2. The transeverse diameters of the thorthratic subarachnoid space were 15.8mm(SD 1.4) in level 1, 14.3mm(SD 1.6) in level 2, and 13.9mm(SD 1.3) in level 3. The sagittal diameters were 12.9mm(SD 1.5), 12.3mm(SD 1.6) and 11.6mm(SD 1.5) in order of the levels. 3. The cross-sectional areas of the thoracic cord and the subarachnoid space were 58.0㎟(SD 7.5) and 165.4㎟ (SD 27.5) in level 1, 46.4㎟(SD 6.2) and 147.1㎟(SD 27.3) in level 3 separately. 4. The shape of the thoracic cord was elliptical in the upper thoracic spines, then became more round in the lower thoracic levels. The cross-sectional area of the thoracic cord is relatively smaller in the midthoracic spines than those of the upper and lower thoracic spines.

결절성 및 괴상성 간세포암에서 역동적 전산화단층촬영 소견에 따른 경동맥화학색전술결과의 예측

이성문,김홍,지성우,우성구,이정형,서수지,손철호 啓明大學校 醫科大學 1997 계명의대학술지 Vol.16 No.2

Purpose: To evaluate retrospectively whether it is possible to predict the transarterial chemoembolization(TACE) result with the pre-TACE dynamic CT findings. Materials and Methods: The dynamic CT findings of 33 patients with 35 nodular and 8 massive hepatocellular carcinoma(HCCs) who was taken follow up CT after TACE, were reviewed retrospectively. After excluding the diffuse or infiltrative HCCs, the mass was classified into two groups of nodular and massive types. The size, location, degree of enhancement, pseudocapsule, portal vein(PV) thrombosis and arterioportal(AP) shunt were evaluated on the dynamic CT scans. The vascularity, multiple or parasitic blood supply, AP shunt and the possibility of superselection were considered on the angiography. After TACE, the pattern of lipiodol uptake and residual enhancing nodules were evaluated on the follow-up CT scans. Results: The good TACE results could be obtained in 18 of 35 nodular HCCs with dynamic CT findings of small size(mean=2.94cm), peripheral location, hyper-or iso-enhancement, and absence fo PV thrombosis, with angiographic finding of possible superselection, but the pseudocapsule did not give important effect on the result. Most of the massive HCCs had poor TACE results. Conclusion: The prediction of the TACE results of nodular and massive HCCs was possible with dynamic CT findings. If the good prognostic factors were not observed on the pre-TACE dynamic CT, the multiple TACE and/or combination therapy with percutaneous ethanol injection(PEI), surgical resection or others should be considered for the effective control of the HCCs.

Surgical Outcomes of Adrenocortical Carcinoma; 20 Years of Experience in a Single Institution

Min Jhi Kim,Eun Jeong Ban,Soo Jung Jung,Hai Young Son1,Cho Rok Lee,Sang-Wook Kang,Jong Ju Jeong,Kee-Hyun Nam,Woong Youn Chung,Cheong Soo Park 대한갑상선-내분비외과학회 2014 The Koreran journal of Endocrine Surgery Vol.14 No.4

Purpose: Adrenocortical carcinoma (ACC) is a rare malignant tumor. Early detection is difficult and prognosis is poor. We report on 20 years of ACC surgical experience at our institution. Methods: This study included 32 ACC patients who underwent surgical resection at the Department of Surgery of the Yonsei University Health System in South Korea between January 1990 and February 2012. We reviewed these 32 patients and retrospectively analyzed long-term clinical outcomes and prognosis after radical surgery for ACC. Results: The median age of the 32 patients at diagnosis was 42.25 years (range 3∼81 years). There were 16 (50%) female and 16 (50%) male patients. Mean tumor size was 12.36 cm (range 1.8∼20 cm). Twenty-five patients (78.12%) had nonfunctioning tumors while the other seven patients (21.87%) had functioning tumors. Seventeen patients (53.12%) were classified as stage II, two (6.25%) as stage III, and 13 (40.62%) as stage IV. Fourteen patients underwent radical surgical resection, while 14 patients received adjuvant chemotherapy, two received adjuvant radiotherapy, and two received adjuvant chemoradiation. Four patients were lost to follow-up. Among the remaining 28 patients, 15 patients survived. The 5- and 10-year overall survival was 60.6% and 37.8%, respectively (median survival=85±24.3 months). Seventeen patients (53%) experienced disease recurrence. Five- and 10-year recurrence-free survival was 41.5% and 29.7%, respectively (median survival=18±5.5 months). Conclusion: Early stage at diagnosis and surgical resection were the most important prognostic factors associated with prolonged survival. The role of additional therapy remains controversial and new agents should continually be evaluated for efficacy.

내시경으로 진단된 위 및 십이지장의 전이성 악성흑색종 1 예

지창준 ( Chang Jun Jhi ),허만하 ( Man Ha Huh ),김수겸 ( Su Kyeom Kim ),양완수 ( Wan Soo Yang ),현명수 ( Myung Soo Hyun ),심봉섭 ( Bong Seob Shim ),정일동 ( Il Dong Jung ) 대한내과학회 1982 대한내과학회지 Vol.25 No.9

선천성 폐 낭종성 질환의 임상적 고찰

이동희,김천수,박근수,김명성,권태찬,이희정,서수지,이상숙,박창권,유영선 啓明大學校 醫科大學 1997 계명의대학술지 Vol.16 No.1

Congenital cystic diseases of the lung(CCDL) is a clinical group of disorders characterized by a cystic appearance of pulmonary tissue. It can be classified into four distinct categories:Congenital lobar emphysema(CLE), Congenital cystic adenomatoid malformation(CCAM), Pulmonary sequestration(PS), and Bronchogenic cyst(BC). 17 patients with congenital cystic diseases of the lung admitted to the Department of Pediatirics, Keimyung University, Dongsan Hospital from January, 1986 to December, 1995 were investigated for their pathologic classification, clinical characteristics, diagnostic measures and treatment outcome. The results were as follows: 1) 17 cases of CCDL were classified pathologically into four distinct categories: BC 8 cases, PS 5 cases(intralobar 4 cases, extralobar 1 case), CCAM 4 cases. 2) CCDL were seen more commonly in males. 3) In age distribution, 64.7% of CCDL were diagnosed at over 6 years. 4) In BC and PS, right lower lobe was the most frequent site affected. 5) The most frequent presenting symptoms were respiratory distress and recurrent respiratory infection. 6) Chest radiographic findings were quite effective in differentiating cystic lesions of the lung from other conditions. 7) Associated anomalies were obserbed in 4 cases (23.5%). 8) In the symptomatic patient, prompt surgical treatment was recommended. 9) Surgical treatment was quite effective and safe.

直腸의 生檢과 Replica Cytology

池昌準,鄭克守 慶北大學校 醫科大學 1974 慶北醫大雜誌 Vol.15 No.1

直腸의 生檢과 Replica Cytolgoy

池昌準,鄭克守 慶北大學校 醫科大學 1974 慶北醫大誌 Vol.15 No.1

大腸 또는 下腹部症狀을 가진 患者中 直腸鏡檢査에 依해 直腸粘膜이 正常 또는 여러 程度의 炎症所見을 나타낸 140例(cholera 27例 包含)에 對해서 直腸生檢 및 replica cyeology를 施行한 結果 다음과 같은 成績을 얻었다. 1. 直腸鏡檢査上 炎症의 所見이 있을때 生檢에서 粘膜의 炎症細胞가 增加해 있는 수가 흔히 있고 이 境遇에 replica cytology所見에서도 炎症細胞가 多數 觀察되는 수가 흔히 있기는 하나 그 關聯性은 그렇게 密接하지는 않았다. 2. 直腸鏡檢査上 異常所見이 없고 生檢 結果 亦是 正常인 例의 約 15%에서 replica cytology上 炎症細胞가 多數 觀察되어 炎症의 存在를 疑心케 하였고 3.8%에서는 아주 多數의 多形核白血球가 集團的으로 觀察되므로서 뚜렷한 炎症의 存在를 시사하였다. 3. 直腸鏡檢査所見上 充血像을 본 境遇에는 生檢에 依해 40%에서 粘膜炎症細胞의 增加를 볼 수 있었고 replica cytology檢査上으로는 50%에서 炎症의 所見을 볼 수 있었으며 10%에서는 아주 多數의 多形核白血球가 觀察되므로서 뚜렷한 炎症이 있음을 시사하였다. 4. 潰瘍을 隨伴한 大腸炎의 境遇(全 10例中 8例가 ameba性 大腸炎으로 判讀되었음) 潰瘍이 없는 粘膜部位에서 生檢과 細胞診을 한 結果는 生檢所見에 正常이 40%, replica cytology上 正常이 20%이었다. 5. Cholera例(27)例의 直腸鏡檢査所見은 多少間의 炎症所見을 나타낸 것이 18.5%이었고 生檢上 直腸粘膜에 炎症細胞의 增加는 29.6%에서 觀察되었으며 replica cytology檢査上으로는 18.5%에서 炎症의 所見을 나타내었고 7.4%에서 아주 多數의 多形核白血球가 觀察되어 뚜렷한 炎症이 있음을 시사하였다. 直腸鏡檢査, 生檢 및 replica cytology檢査上 cholera에 特異하여 보이는 所見은 없었다. 6. Replica cytology檢査는 大腸炎症의 診斷에 있어서 直腸鏡檢査 및 直腸生檢과 더불어 臨床에 利用해서 많은 도움을 줄 수 있는 檢査라고 생각되었다. Sigmiodoscopy, biopsy and replica cytology of rectum were done on 140 cases with colonic symptoms or lower abdominal discomfort including 27 cases of cholera and the following results were obtained. 1. Inflammatory findings by biopsy and replica cytology correlated fairly well with sigmoidoscopic findings but no close relationships between these three methods were noted. 2. About 3.8% of those with negative sigmoidoscopy and rectal biopsy (93 cases, excluding cholera) showed definite evidence of inflammation. 3. About 40 and 50% of those with hyperemic mucosa by sigmoidoscopy (10 cases) showed increased inflammatory cells by biopsy and replica cytology respectively and 10% showed definite evidence of inflammation by replica cytology. 4. On cases of colitis with ulcerations by sigmoidoscopy (10 cases), biopsy and replica cytology were done on areas of intervening mucosa between ulcers or erosions and about 60 and 80% of cases showed inflammatory evidence by biopsy and replica cytology respectively. 5. Among 27 cases of cholera, about 18% showed pictures of colitis by sigmodioscopy. Rectal biopsy presented increased inflammatory cells in the mucosa in about 29.6% of cases while replica cytology showed increased inflammatory cells in 18.5% and definite evidence of inflammation in 7.4%. 6. Replica cytology appeared to be a valuable method for the detection of inflammation of the rectal mucosa.

직장암의 병기결정에 있어서 전산화단층촬영의 의의

서수지,주양구,김옥배 啓明大學校 醫科大學 1987 계명의대학술지 Vol.6 No.2

The prognosis in patient with rectal cancer is strongly related to the tumor stage. Computed tomography (CT) has the potential to demonstrate early stages of malignant invasion outside the rectum, and therefore give more precise diagnostic information leading to an improved staging of the malignant disease. CT was performed to evaluate the accuracy of tumor stage, and compared with operation findings in eighteen cases of rectal cancer. The brief result cases of rectal cancer. 1. The CT scan identified primary cancer of rectum in all cases, and correctly determined the stage in 14 patients(77%) 2. The CT showed an accuracy for detecting lymph nodes involvement of 67%, and invasion to adjacent organ of 83%.

CT 上 固型腫塊로 보인 巨大 囊腫性頭蓋咽頭腫

李秀東,金 洪,禹聖龜,徐修之 啓明大學校 醫科大學 1985 계명의대학술지 Vol.4 No.1

著者들은 最近 CT 上 固型腫塊로 나타난 巨大한 同一密度의 裏腫性頭蓋咽頭腫 一例를 經驗하였기에 文獻考察과 함께 報告하는 바이며, 同一 或은 高密度의 頭蓋咽頭腫일지라도 境界가 明確하고 造影增强이 없는 均質한 X線吸收計數를 가진 腫瘍이 腫塊外綠의 石炭化 및 環狀造影增强을 보일 境遇 裏腫性의 可能性을 有意하여야함을 强調코자 한다. Craniopharyngioma is one of the most common brain tumor in childhood, with characteristic computed tomographic findings, that is, calcification, contrast enhancement, and cyst formation. Sharp margins associated with a hypodense centrum usually characterize the CT appearance of a cystic tumor. The suthors report a case of giant cystic cranipharyngioma in a 22 year-ole male patient, presenting as isodense "solid" tumor in the CT.

미만성 폐 림프관종증의 CT 소견 : 증례 보고

서수지,우성구,이희정,이진희,권건영 啓明大學校 醫科大學 1996 계명의대학술지 Vol.15 No.3

Diffuse pulmonary lymphangiomatosis(DPL) is a very rare, progressive pulmonary abnormality of lymphatic system that occurs in children and young adults. We presented CT findings of DPL in a young girl, which was characterized by diffuse, smooth thickening of bronchovascular bundles and interlobular septa especially in the subpleural regions of both lower lobes, associated with recurrent pleural effusion. Pathologically, the disorder revealed increased numbers of anastomosing lymphatic channels in the pleura and subpleural interlobular septa.