상악의 수직적 과잉과 Gummy Smile을 동반한 장안모 돌출 환자에서 효율적인 수직조절 치료전략

강시원(Si-Won Kang) 대한치과교정학회 2022 대한치과교정학회 임상저널 Vol.12 No.2

In the treatment of a hyperdivergent patient, making sufficient facial change without surgery is challenging because the chin is retrusive, rotated backwardly. The patient may be still protrusive after the treatment if sagittal retraction is only performed. Since the mandible moves in a rotational manner, vertical control can result in significant sagittal correction in profile through the autorotation of the mandible. Since the orthodontic mini-implant is a very effective tool for vertical control, especially, for intrusion, it can play a crucial role in making facial change for a hyperdivergent patient. A 24-year-old girl was presented with chief complaints of protrusion and gummy smile. Her profile showed protrusion, lip incompetency and very retrusive chin. She showed excessive gingival display during smiling. Her diagnosis included skeletally hyperdivergent Class II pattern, anteriorly and vertically excessive maxilla. The patient was treated with total arch intrusion in maxilla and mandible using two orthodontic mini-implants for each arch. Total arch intrusion in both arches created counter-clockwise autorotation of the mandible which dramatically improved her profile. Intrusion in the maxillary anterior region decreased excessive gingival display and made an attractive smile for the patient.

기관지 점액유상피성 암종의 CT 소견

김현,강시원,안국진,박용휘,Kim, Hyun,Kang, Si-Won,Ahn, Kuk-Jin,Bahk, Yong-Whee 대한영상의학회 1991 대한영상의학회지 Vol.27 No.2

Mucoepidermoid carcinoma of the bronchus is an extremely rare tracheobronchial neoplasm arising in the bronchial submucosal glands that shows an intimate admixture of glandular elements and sheets of cells with little or no definte squamous differentiation. we report 3 cases of mucoepidermoid carcinoma of the bronchus found in a 15-year-old boy and a 59-year-old woman. CT scans revealed a well-marginated, exophytic, endobronchial, polypoid soft tissue mass. Bronchial mucoepidermoid carcinoma should be included in the differential diagnosis of endobronchial tumors in young patients and non-smokers.

복부 대동맥류의 합병증에 기인한 대동맥-하대정맥루: 1예 보고

정봉각,김현,강시원,김만득,Jeong, Bong-Gak,Kim, Hyun,Kang, Si-Won,Kim, Man-Deuk 대한영상의학회 2002 대한영상의학회지 Vol.46 No.1

대동정맥루는 복부 대동맥류의 드문 합병증으로 임상적으로 진단이 어려울 수 있지만 특징적인 방사선학적 소견이 진단에 도움을 줄 수 있다. 즉, 대동맥류 환자에서 갑작스러운 울혈성 심부전의 발생과 함께 조영증강 복부 CT상 동맥기에 대동맥과 하대정맥이 동시에 조영증강되고 하대정맥 내경이 늘어나 있는 것이다. 저자들은 신동맥 하방에 발생한 복부 대동맥류가 대동정맥루를 일으킨 1예를 경험하였기에 문헌고찰과 함께 방사선학적 소견을 보고한다. Aortocaval fistula is a rare complication arising from an abdominal aortic aneurysm. A typical feature observed during the arterial phase of contrast-enhanced CT scanning in such patients is simultaneous enhancement of the dilated inferior vena cava and aorta. Awareness of the specific radiologic features of aortocaval fistula may facilitate diagnosis when the condition is unsuspected clinically. We report a case of aortocaval fistula secondary to abdominal aortic aneurysm, and review the previous literature.

출혈성 식도정맥류 내시경적 경화요법후의 전산화단층촬영 소견

김현,노희정,강시원,박용휘,백남종,Kim, Hyun,Ro, Hee-Jeong,Kang, Si-Won,Bahk, Yong-Whee,Baeg, Nam-Jong 대한영상의학회 1990 대한영상의학회지 Vol.26 No.3

Endoscopic esophageal sclerotherapy(EES) has been widely accepted for management of bleeding esophageal varices. Authors reviewed CT indings of mediastinal and pleural changes before and after EES for the evaluation of the effect and complication. The mediastinal and pleural changes within 3 days (n=20) after EES were esophageal thickening(80%), esophageal lamination(40%), paraesophageal gas collection 935%), paraesophageal mediastinal effusion 980%), and pleural effusion 950%). After 2 months (n=5), all these findings were disappeared, except for mild residual esophageal thickening. The knowledge of CT findings after EES appeared essential for CT scan images performed in the patients suspected of having severe postprocedural complications and for the differential diagnosis.

흉곽신 - 1예 보고 -

김현,김기태,강시원,박용휘,Kim, Hyun,Kim, Ki-Tae,Kang, Si-Won,Bahk, Yong-Whee 대한영상의학회 1989 대한영상의학회지 Vol.25 No.4

전위신은 신장이 발생 과정중 어떤 원인에 의해 정상적으로 신와에 위치하지 못하 고 다른 부위에 고정되는 것으로 신장의 위치에 따라 골반신, 요추신 또는 복부신으로 분류 하나 매우 드물게 흉곽내메도 존재한다. 저자들은 희괴한 흉곽신 1예를 경험하였기에 방사 선학적 소견과 함께 보고하는 바이다. Intrathoracic kidney is a very rare developmental anomaly, and to our best knowledge no case has been reported in Korea. We report a case of an ectopic thoracic kidney which presented as a mass in the right lower chest in an asymptomatic lO-month-old infant. This anomaly should be correctly recognized because it may save extensive examinations and possible unnecessary surgery.

기관지 협착 근위부의 연무 침착 : 폐스캔에서 기관지 폐색의 특이한 지표

정수교,김학희,최병길,이상훈,강시원,박용휘 ( Soo Kyo Chung,Hak Hee Kim,Byung Gil Choi,Sang Hoon Lee,Si Won Kang,Yong Whee Bahk ) 대한핵의학회 1995 핵의학 분자영상 Vol.29 No.3

방광암의 공기충만법을 이용한 박편전산화단층촬영 : 표재성 방광암의 전산화단층촬영소견

김현,송하헌,김미혜,김영신,이은자,강시원,신경섭,Kim, Hyun,Song, Ha-Hun,Kim, Mi-Hye,Kim, Young-Sin,Lee, Eun-Ja,Kang, Si-Won,Shinn, Kyung-Sub 대한영상의학회 1994 대한영상의학회지 Vol.30 No.2

목 적: 방과내에 공기를 주입하고 나서 박편절단(thin-section) CT(공기충만법-CT)를 시행하여 방광벽에 국한된 저병기의 암종들을 보다 자세히 관찰하고 이들에 대한 정확한 병기결정에 도움을 주고자 하였으며, 저자들이 시행했던 방법과 경험된 표재성방광암종의 공기충만법-CT 소견을 기술하고 분석하고자 한다. 대상 및 방법: 공기충만법-CT를 시행하고 병기A(pT1)의 표재성방광암으로 확진된 19명, 24예(16명: 단일종괴, 3명: 다발성종괴)를 대상으로 하였다. 공기충만법-CT는 요도도관(Foley catheter)을 이용하여 약 200ml의 공기를 방광에 주입한 다음, 통상적인 골반부 스캔을 하고 나서 암종부위만을 1.5-5mm 두께와 간격으로 박편절단을 하였다.공기충만법-CT를 시행하고 병기 A로 판명된 24예의 암종에 대해 크기, 형태, 위치 등을 알아보았고 또한 암종부위 방광벽의 모습을 후향적으로 분석하였다. 성 적: 표재성방광암종이 방광내의 공기중에 노출되었을 \ulcorner\ulcorner의 형태는 결절형(5예, 20.8%), 유두형(15예, 62.5%), 피라미드형(2예, 8.3%), 반구형(2예, 8.3%)등으로 관찰 되었고, 이들은 목부위가 좁고 넓음에 따라 type I (pedunculated polypoid tumor : 4예, 16.6%), type II ( polypoid tumor with short neck : 13예, 54.2%), type III (sessile tumor :7예, 29.2%)의 3가지의 형태로 단순화 시킬 수 있엇다. 각각의 형태에 따른 평균암종의 크기는 type I : 22x25x6mm, type II : 23x22x18mm, type III : 18x15x18mm 이었다. Type I-II 암종의 목너비(width of tumoral neck)는 평균 15mm이었고, type I 암종의 목길이는 평균 2.5mm이었다. 또한 표재성방광암종이 방광에 집적된 조영제에 잠겨있을 때에는 해초양의 돌기들(papillary fronds)이 전체 24예 중 10예(41.7%)의 종괴 표면에서 관찰되었다. 암종이 발생한 부위 방광벽의 외연은 24예 모두에서 주위의 정상방광벽과 같이 평활 하였다. 결 론: 공기충만법-CT로 방광암종을 보다 세밀하게 관찰할 수 있었으며, 표재성방광암은 그 크기가 작고 대부분에 있어서 짧은 목을 갖는 용종양 종괴로 보이면서 침범된 방광벽의 외연이 평활한 특징을 가지고 있음을 알 수 있었다. Purpose: The staging of bladder carcinoma is a major determinant of operative management. CT of bladder carcinoma has been widely used to diagnose external extension (pT3b and over), but tumors confined to the bladder wall (from pTl to pT3a) are poorly delineated. The authors describe CT findings of the superficial bladder carcinoma (below 71, stage A) in thin -section CT with air insufflation technique (air insufflation-CT) to facilitate early detection and to aid correct staging of the superficial bladder carcinoma.Meterials and Methods: The materials consisted of proved 24 cases (19 patients, single tumor'16 patients, multiple tumors :3 patients) of stage A bladder carcinomas. Air insufflation-CT was performed by the infusion of approximately 200mL of air into the bladder via a Foley catheter. After the routine pelvic CT, bladder tumors were re-scanned with 1.5 to 5 mm thickness and intervals.Results: The superficial bladder carcinomas were detected as nodular(5 cases, 20.8'/, ), papillary(IS cases, 62.5'/, ), pyramidal(2 cases, 8.3%), and domed(2 cases, 8.3%) forms on air insufflation -CT. These tumors were classified into three types according to the size of the tumoral neck : type 1(pedundulated polypoid tumor : 4cases, 16.6%), type 11(polypid tumor with short neck:13 cases, 54.2'/, ), and type 111(sessile tumor .7 cases, 29.2%). The mean size(tumoral width x height x base c, neck/stalk) of the tumors was 22$\times$20$\times$16mm. The average tumoral sizes according to each type of the superficial tumors were type 1 :22$\times$25$\times$6mm, type 11'23$\times$22x18mm, and type 111 :18$\times$1Sx18mm. The mean width of the type 1-11 tumoral necks was 15mm. The mean length of the type 1 tumoral neck(pedicle) was 2.5mm. Papillary fronds of the tumors were seen in 10 cases(41.7%) of24 superficial tumors. Outer margin of the involved bladder wall was smooth in all cases.Conclusion : Thin-sectin CT with air insufflation technique for bladder carcinoma was useful in tumoral demonstration, and characteristics of the superficial bladder carcinomas were small polypoid tumors had a short neck mostly and smooth outer wall of the involved bladder wall.

섬유성 이형성증의 바늘구멍 골스캔 소견

백지희,이성용,김성훈,정용안,김범수,송하헌,정수교,강시원,박용휘,신경섭 ( Jee Hee Baek,Sung Yong Lee,Sung Hoon Kim,Yong An Chung,Bum Soo Kim,Ha Hun Song,Soo Kyo Chung,Si Won Kang,Yong Whee Bahk,Kyung Sub Shinn ) 대한핵의학회 1997 핵의학 분자영상 Vol.31 No.4

To evaluate the pinhole scintigraphic findings and its significance, authors retros- pectively compared the pinhole bone scintigrams and corresponding radiograms of 16 lesions in 14 patients with fibrous dysplasia. They were diagnosed pathologically in 10 lesions and radiologically in 6 lesions. The mean age of patients was 41.1 years. The mean interval between two studies was 1.1 days. Locations were ribs 7, pelvic bone 4, clavicle l, long bones 4(femur 2, titbia 1, humerus 1). The radiographic findings were as follows :the central portions were radiolucent(n=9), ground-glass opacities(n=5) or sclerotic(n=2) and the peripheral appearance were sclerotic rim(n-5), septation(n=7), cortical perforation (n=10) and invisible cortical thinning(n=9). Pinhc>le scintigraphic findings were as follows : Central portions showed normal 1+ uptake in 6 cases(radiolucent 5, ground-glass opacity 1), slightly increased 2+ uptake in cases(radiolucent 4, ground-glass opacity 3), and marked 3+ uptake in,3 cases(ground-glass opacity 1, sclerotic 2). The 15 of 16 lesions showed more intense uptake in the peripheral portion : slightly increased 2+ uptake corresponding to the sclerotic rim(5/5) and unvisible cortical thinning(1/9), and irregular foci of marked 3 + uptake corresponding to septation(7/7), cortical perforation(10/10) and invisible cortical thinning (8/9). One of 16 lesions showed homogeneous 2t uptake. In conclusion, pinhole scintigram provides information on regional activity of the fibrous dysplasia, which would be helpful in diagnosis, prediction of prognosis and determination of treatment plan.