간세포암의 CT 소견

유필문,김진우,이성우 인제대학교 1985 仁濟醫學 Vol.6 No.4

최근 3년간 서울백병원 방사선과에서 복부 CT를 시행한 간세포암 환자 30예를 대상으로 방사선학적, 임상적 소견을 통계, 분석하였다. Authors retrospectively analyzed a total of 30 cases of hepatomas which was verified histopathologically or clinically in Paik hospital. A statical analysis of the CT findings was done. The summaries of the analysis are as follows, 1.The location of masses shows: rt. lobe only in 15 cases, It. lobe only in 6 cases and rt. and It. lobes in 9 cases. 2.The size of the mass: less than 5cm in 3 cases, between 5cm and 10cm in 12 cases, larger than 10cm in 10 cases. In 5 cases, identification of the extent of mass was difficult due to lobar attenuation changes. 3.Intrahepatic duct dilatation in 12 cases, especially about the mass lesion. Extrahepatic extension in 21 cases. Adenopathies in 12 cases. 4.Portal vein thrombosis was found in 12 cases, and 5 cases of them shows lobar attenuation changes. IVC thrombosis was found in 3 cases and all of them of the IVC thrombosis shows portal vein thrombosis. 5.Summarizing above mentioned findings, it is concluded that CT is very helpful in determination of extent of the masses or degree of extrahepatic extension, or as preoperative evaluation.

무수에탄올 및 젤폼을 사용한 가토 신동맥 색전술의 비교연구

김태훈,유필문,최영희,김상준,이연희,김승철,서필원,명나혜,윤성철 대한영상의학회 1996 대한영상의학회지 Vol.34 No.4

Purpose : To evaluate the therapeutic effectiveness of absolute ethanol and gelfoam particles and the degree of vascular recanalization after gelfoam embolization. Materials and Methods : Transcatheter renal arterial embolization(TRAE) was performal in 16 rabbits ; Eight were embolized with absolute ethanol, and eight with gelfoam particles. Of this total, three died less than one week after embolization. Pre- and postembolization angiographies at five minutes, one week, two weeks (gelfoam group only) and 5-6 weeks after embolization were performed. Six rabbits were sacrificed at one week, and seven at 5-6 weeks after embolization. Pathologic examination was performed. Results : The ethanol group(n=6) showed complete occlusion of the main renal artery on follow-up angiography at one week and 5-6 weeks after embolization. The pathologic finding was complete total necrosis of embolized kidneys. The gelfoam group(n=7) showed partial recanalization of renal arteries in follow up angiography at one week, two weeks and 5-6 weeks after embolization. The pathologic finding was partial lysis of gelfoam particles within intrarenal arteries. Conclusion : Absolute ethanol can be used as a permanent embolic agent and gelfoam as a temporary such agent in various clinical applications. Gelfoam, however, did not show complete recanalization on angiography and pathology at six weeks after embolization.

大腸癌의 放射線學的 診斷

李聖雨,柳弼文 인제대학교 1983 仁濟醫學 Vol.4 No.4

A complete preparation of a patient such as a relieving constipation of a patient, an intake of a salt laxative of magnesium citrate and others, and taking a modified Brown's method is important for better examination of colon. And the detailed schedule, method and manufacturing a magnesium citrate, even at a local clinic were described. And radiographic indices of colonic carcinoma are described and illustrated such as: a. abnormality of colonic margin and lumen visualized in double contrast study b. collected small barium pool at one haustrum made by colonic taenia and haustral lesion and c. trasverse lines by haustra of colon d. triangular shadow by barium coated 4 surfaces of colon and lesion and e. Many features of polyp.

당뇨병에 관한 폐결핵의 방사선학적 고찰

한창열,이성우,유필문,전우기,전정동 인제대학교 1985 仁濟醫學 Vol.6 No.1

저자는 당뇨병 환자 중 71명의 폐결핵 환자에 대한 흉부 사진상 폐결핵 변화를 관찰하고 문헌적 고찰하였다. We selected seventy one pulmonary tuberculous patients (6.271) among 1150 diabetic patients which were diagnosed at Paik Hospital, Inje Medical College from Jan. 1981 to Jun. 1984. It was found the results as follows. 1.Radiological extend of pulmonary tuberculosis was as follows: minimal 45.1%, moderately advanced 46.5%, far advanced 8.4%. 2.Pulmonary tuberculosis in diabetic patient was most prevalent in 50 decade and 60 decade. It tended that the more taking of age, the more having increase pulmonary tuberculosis. 3.We observed no correlation between FBS and extend of pulmonary tuberculosis on a chest roentegenogram. 4.The longer the duration of diabetes mellitus, the higher incidence of pulmonary tuberculosis. However, there was no correlation between duration of diabetes mellitus and extend of pulmonary tuberculosis on chest roentgenogram. 5.The pulmonary tuberculosis was predominantly in upper lobes in 69.1% and the lower lobe was affected in 11.2%.

動的 電算化 斷層撮影術 및 血管造影術로 診斷한 肝血管腫 一例 報告

朴聖信,兪建,柳弼文 인제대학교 1984 仁濟醫學 Vol.5 No.2

A case of hepatic hemangioma is presented in which dynamic C-T scan provided a favorable diagnostic clue as the dense contrast enhancement spreaded from the periphery to the center of the lesion and remained more than 2 minutes after bolus injection. Cavernous hemangiomas are the most common benign tumors of the lifer which should be differentiated from other space-occupying lesions by procedures other than percutaneous liver biopsy. Selective hepatic angiography showing the characteristic 'cottonwool-like patch densities' has been the most useful technique for the preoperative diagnosis. Recently, dynamic C-T scan using rapid scanner proved to be a reliable and non-invasive diagnostic procedure.

前立腺 原發 小細胞癌

金喆守,金禮會,盧忠熙,徐賢淑,柳弼文,高一香 인제대학교 1985 仁濟醫學 Vol.6 No.2

As the primary small cell carcinoma of the prostate has been rarely seen, there is no consensus regarding the biological behavior and the treatment of the disease. The case, we experienced here, of the extrapulmonary small cell carcinoma originated from the prostate revealed highly malignant nature of the tumor, as was seen in rapid progression of the pulmonary metastatic lesions, which responded dramatically to the combination chemotherapy consisting of vincristine, adriamycin and cyclophosphamide. The huge main prostatic mass also showed excellent response to the palliative radiation therapy, resulting in prompt relief of the urinary retention. Though the duration of the response was short, in part due to the poor compliance of the patient, the dramatic effect of the combined modality treatment suggested the nature of the disease might be similar to that of the bronchogenic small cell carcinoma.

副腎의 電算化 斷層撮影

서상일,전정동,전우기,유필문,한창열 인제대학교 1983 仁濟醫學 Vol.4 No.4

저자들은 CT를 이용하여 정상 봉신의 크기 모양 및 위치를 분석하여 한국인의 부신의 정상 범위를 정하였으며 CT는 재래의 방법보다도 쉽게 부신을 발견할 수 있었고 부신질환의 진단에 중요한 역할을 할 것으로 사료된다. Computed tomography is an excellent screening test far adrenal glands. Abdominal CT scans of 94 randomized patients without evidence of adrenal disease were reviewed to determine the location, size, and shape of both side normal adrenal glands. Results are as follow: 1.Adrenal glands are shorten in 85 patients. (90.4%) 2.Most of the right adrenal glands were linear in shape. (71%) 3.and most of the left adrenal glands were inverted V or Y, or triangular in shape. (79%) 4.Right adrenal glands. Mean length of 2.2cm, Width of 2.35cm, and Thickness of 0.59cm Left adrenal glands, Mean length of 2.5cm, Width of 2.09cm, and Thickness of 0.69cm. 5.Thickness of limbs was always less than 5mm.

풍선 확장술을 이용한 소아 식도 협착의 치료

주성욱,이기재,김인원,김우선,연경모,박귀원,김우기,유필문,한만청 대한영상의학회 1992 대한영상의학회지 Vol.28 No.5

Balloon dilatation has been applied in treatint of various pathologic narrowing of the hollow viscus. It is now accepted as a very effective modality especially in treating esophageal stenosis obviating surgical procedure. We performed 128 ballon dilatations in 29 patients with the number of dilatations in each patient ranging from once to 12 times. The age distribution of the patients was from 3 weeks to 6 years, with the median age of 3 months. Twenty ninepatients consisted of 25 postoperative esophageal strictures (21 esophageal atresia with tracheoesophageal fistula, 1 congenital esophageal stenosis, 2 tracheobronchial remnant, and 1 congenital esophageal stenosis with esophageal atresia), 2 achalasia, 1 congenital esophageal stenosis, and 1 corrosive esophagitis. We had successful dilatation in 22 patients, who showed subsequent relief of symptoms and improvement in the diameter of stenotic segment. In 4 patients, esophageal perforation occured during the procedure, one r quiring emergency thoracotomy and the other threeconservative managment. Seven patients had no improvement in stenotic sites after several balloon dilatations. Failed cases were congenital stenosis, achalasia, corrosive esophagitis and four postoperative strictures. We believe that balloon dilatation is the procedure of choice in the treatment of postoperative esophageal stricture in infants and children and is a safe method as the perforation which can complicate the procedure could be managed conservatively.

단순 흉부 촬영에서의 영유아 상완골 근위부 골화중심의 출현 빈도

김승철,이연희,최영희,김태훈,김상준,장영표,이백희,박희홍,유필문 대한영상의학회 1996 대한영상의학회지 Vol.34 No.2

Purpose : To ascertain the incidence of proximal humeral epiphyseal ossification centers, as shown on chestradiographs, in neonates and infants. Materials and Methods : The distribution of corrected age(CA) of the infantswas from 24 weeks of gestational age to 6 months of postnatal age. They were obtained from inborn and outborninfants without developmental problems. Proximal humeral epiphyseal ossification centers were evaluated by tworadiologists from a total of 440 chest radiographs. Of these, 196 were of the female chest and 244 were of themale. Corrected ages based on postnatal age are expressed as weeks before two months of age and as months aftertwo months of age. The ossified or nonossified epiphyses of the humeral heads were plotted against corrected age.From these graphs, the percentages of ossification according to their corrected age was observed. Results : 37weeks of corrected age in which 9.1%(1\11) was ossified was the earliest age of humeral epiphyseal ossification inthe female. While 35 weeks of CA in which 6.3%(1/16) was ossified was the earliest age in the male. In full-termneonates(=40 weeks of CA), 20%(6/30) of epiphysis was ossified in the female and 23.3%(7/30) in the male. Thefemale group of 43-44 weeks of corrected age showed ossification of 50% and the male group of 44-45 weeks ofcorrected age showed ossification of 50%. By five months of corrected age, 100% of epiphyses, both in the femaleand in the male, were ossified. Conclusion : Humeral ossification centers are seen from 35-37 weeks of correctedage. By five months of age, all humeral epiphyses are ossified.

선별검사 후 수술로 확진된 무증상의 잠재성 유두상 갑상선암 214예에 대한 분석

박해린(Hai-Lin Park),곽진영(Jin Young Kwak),유필문(Pil Mun Yu),조윤덕(Yun Duk Cho) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.72 No.3

Purpose: Occult papillary thyroid carcinomas (OPC) are defined as tumors measuring ≤15 ㎜ in size. They are believed to be a less aggressive subset of papillary cancers, which behave more like benign lesions, and are often treated more conservatively. However, some groups have reported a high incidence of metastases from papillary microcarcinomas and favor an aggressive surgical resection followed by radioiodine therapy. We review our experience in an attempt to characterize the biology and optimal treatment for OPCs. Methods: From October 2001 to March 2006, among impalpable thyroid nodules detected incidentally during screening exams, 214 patients underwent surgery for occult papillary thyroid cancer (OPC) at Kangnam Cha University hospital. The data from these patients were analyzed retrospectively. The mean follow up period was 19.9±11.7 (max:53, min:1) months. Results: The mean age of these patients was 41.4 year, and 188 (87.7%) were female. 41% of the patients underwent a total or neartotal thyroidectomy, 42% had a central lymph node dissection and 41% had radioiodine ablation therapy after surgery. Of the 214 patients, 40 (18.7%) had lymph node metastases. The LN metastases were associated with the tumor size (P=0.0007), extracapsular invasion (P=0.0268) and multifocality (P=0.0024), but there was no association with age and gender. The incidence of the LN metastases (20%) and extracapsular invasion (59.1%) were higher in the tumors between 0.5∼1.0 ㎝ in size. With a follow-up up to 53 months, 3 patients had a local recurrence (0.014%) but no patients currently has active disease. No patients with OPC died died during this period. Conclusion: In OPC patients, a progressively increasing frequency of signs of tumor aggressiveness with increasing tumor size was observed but a small size itself could not guarantee a low risk or low recurrence rate. The prevalence of LN metastases and extracapsular invasion were higher in tumors >0.5 ㎝ in size. Therefore, we prefer near-total or total thyroidectomy with central lymph node dissection. Early detection and treatment of OPC might be warranted by the routine use of thyroid USG and USG-guided FNA.