비촉진 유방병변에 대한 초음파 유도 자동총생검의 유용성

곽민숙 대한영상의학회 1997 대한영상의학회지 Vol.37 No.5

Purpose : To evaluate the clinical usefulness of ultrasonography(US) - guided automated gun biopsy ofnonpalpable breast lesions. Materials and Methods : In 30 nonpalpable breast lesions over 0.6cm and detected onUS, we performed US-guided biopsy using an 18-gauge automated biopsy gun. Two to four specimens were obtained fromeach lesion. We analyzed the site, size and depth of the lesions, and the length and histopathologic results ofthe specimens. In four lesions, surgical biopsy and gun biopsy results were compared. Results : In 29 of 30lesions(96.7%), specimens were adequate for histopathologic diagnosis, and this was as follows: one case ofinfiltrating ductal carcinoma, 13 of fibrocystic disease, 10 of fibrocystic disease versus fibroadenoma and one offibroadenoma. There was also one reactive hyperplasia of LN, and one fatty one and two normal tissues, and inthese four lesions, agreement between gun and surgical biopsy results was 100%. The only complication was minorbleeding, which was controlled by compression. Conclusion : US-guided automated gun biopsy is a clinically usefuland safe procedure for evaluating nonpalpable breast lesions detected on US.

과학일지 쓰기가 초등학생의 과학 학업성취도와 정의적 영역에 미치는 영향

곽민숙,이용섭,한영욱 대한지구과학교육학회 2009 대한지구과학교육학회지 Vol.2 No.1

초음파상 갑상선 종양에서 보이는 주변부 석회화의 양상과 중요성

곽민숙,백정환,김윤숙,정현조 대한영상의학회 2005 대한영상의학회지 Vol.53 No.6

Purpose: We wanted to analyze the peripheral calcification patterns of thyroid tumors that were seen on ultrasound and we also wanted to evaluate the clinical usefulness of the peripheral calcifications of the thyroid tumors. Materials and Methods: We retrospectively analyzed 21 peripheral calcifications of the thyroid tumors of 18 patients; these were histopathologically confirmed by fine needle aspiration biopsy, automated gun biopsy and surgery. The peripheral calcification patterns were categorized into three types: type 1, peripheral nodular calcification, type 2, peripheral smooth rim calcification, and type 3, peripheral irregular rim calcification. The histopathologic results obtained during surgery, fine needle aspiration or automated gun biopsy were compared. Results: Of the total 21 peripheral calcifications of thyroid tumors, 5 cases showed as being type 1 (24%), 3 cases showed as being type 2 (14%) and 13 cases showed as being type 3 (62%). Of the total 21 peripheral calcifications of the thyroid tumors, 18 were histopathologically confirmed as papillary carcinoma (86%). Among the type 1 peripheral calcification patterns, 3 cases were coincidentally diagnosed as papillary carcinoma and 2 cases were follicular neoplasm on the preoperative biopsy results and on the surgical results. Two cases of type 2 peripheral calcifications (67%) and three cases of type 3 peripheral calcifications (23%) were diagnosed as benign lesions upon preoperative biopsy, but the postoperative results were papillary carcinoma. Conclusion: Peripheral calcifications of thyroid tumors are important feature that suggest malignancy together with the microcalcification and peripheral calcifications of the type 2 and type 3 patterns, and these lesions may be difficult to accurately diagnose with using only biopsy. 목적: 갑상선 종양의 주변부 석회화를 분석하여 임상적 유용성을 알아보고자 하였다. 대상과 방법: 18명의 환자에서 세침 흡인검사, 자동총생검 및 수술에 의해 병리조직학적으로 확진된 21개의 갑상선 종양의 주변부 석회화의 초음파 소견을 후향적으로 분석하였다. 종양의 주변부 석회화를 제 1형(주변부 결절성 석회화), 제 2형(평활한 테두리 석회화), 제 3형(불규칙한 테두리 석회화)로 분류하고 각각에 대하여 수술 전 조직 검사와 수술 후 조직 병리 결과를 비교해 보았다. 결과: 21예의 갑상선 종양 중 제 1형은 5예(24%), 제 2형은 3예(14%), 제 3형은 13예(62%)에서 보였다. 21예의 주변부 석회화를 가지고 있는 갑상선 종양 중 18예가 병리조직학적으로 유두상 암종으로 확진되었다(86%). 제 1형은 3예에서 수술 전 조직검사 결과와 수술 후 결과가 유두상 암종이었고 2예에서 여포성 종양으로 조직검사 결과가 비교적 정확하였다. 제 2형은 3예 중 2예(67%)에서 제 3형은 13예 중 3예(23%)에서 수술 전 조직검사 결과는 양성이었으나 수술 후 결과는 악성인 유두상 암종으로 나왔다. 결론: 갑상선 종양의 주변부 석회화 소견은 미세석회화와 함께 악성을 시사하는 중요한 소견이며 2, 3형의 주변부 석회화는 조직검사만으로는 정확한 진단이 어려울 수 있다.

평형감각자극이 정신지체아동의 시선 집중력 향상에 미치는 영향

곽민숙(Min Suk Kwak) 대한물리치료학회 1990 대한물리치료학회지 Vol.2 No.1

The purpose of this study was to determine if any differences exist in eye contact before and after vestibulaar stimulation in mentally retarded children. The subjects of this study were 20 mentally retarded children with a mean age of 9 years and 8 months and a mean intelligence quotient of 30.4±9.1. Vestibular stimulation was given for 15 minutes, 5 times a week, for 4 weeks from September 1 to September 30, l989. Equipment used included a rocking-horse, see-saw and scooter board. Two testers used a digital watch calibrated to 1/100 second to measure object-eye contact duration and the Blocks and Shapes test for determining frequency of object -eye contact in the subjects. The results of this study were as follows 1. There was a significant prolongation in the duration of eye contact after 15 minutes of vestibular stimulation (P$lt;0.005). 2. There was no significant difference in duration of eye-object contact between the first and last vestibular stimulation. 3. There was no significant difference in the length of time of attention paid to objects (frequency of eye-object contact) before and after 15 minutes of vestibular stimulation on the first vestibular stimulation. 4. There was no significant difference in the frequency of eye-object contact between the first and last vestibular stimulation. In conculusion, there was a significant improvement in duration of eye-object contact on intrasession measurement in mentally retarded children. However, there was no significant improvement over time after 4 weeks of vestibular stimulation on intersession measurement. Nor was there any statistically significant improvement in frequency of eye-object contact over time during the study period.

초등 과학 지구 영역 '암석' 단원에 대한 학습차원의 하위 범주 분석

한영욱,최정미,곽민숙 부산교육대학교 과학교육연구소 2005 科學敎育硏究 Vol.30 No.-

In this study, the earth units rock in center of elementary school science were classified to the lower categories of Dimensions of Learning out of the 7th National Curriculum using the Demensions of Learning Project developed by ASCD in USA. Also they were investigated which lower categories of Dimensions of Learning were used to the Curriculum. The results were as follows ; First, the percentages of using lower categories of Dimensions of Learning were difference especially subject. subject F, C(21varieties) were used plentifully and subject D(16varieties) was used few. This result is because quality of subject. second, the average percentages of using the lower categories of Dimensions of Learning was similar according to grade 3 to 6. For example, the average percentages of using the lower categories of Dimensions of Learning was similar by 69.6%, 66.1%, 60.7%, 67.9%. third, percentages of using the lower categories of Dimensions of Learning was becoming intensively in Dimension 1 and Dimension 2 (Attitudes and Perception, Acquir and Integrate Knowledge). forth, Consequently in Grade especially use ratio of Dimension 5, grade 3, 4 to compare in grade 5, 6 was plentifully used. fifth, Consequently in time especially the average percentages of using the lower categories of Dimensions of Learning was a great extent in 6th grade. the results are considered to agrees with a research result which evenly using, accomplishing is high. sixth, look of Dimension 2 were used plentifully. Because of observatioing is many and data provision picture is many.

갑상선 양성 결절의 고주파 열치료법

백정환,정현조,김윤숙,곽민숙,임현철,장선희 대한영상의학회 2005 대한영상의학회지 Vol.52 No.6

Purpose: We wanted to evaluate the efficacy and safety of using ultrasound guided percutaneous radiofrequency ablation for the benign nodules of the thyroid gland. Materials and Methods: We studied 148 patients with benign thyroid nodules (200 total nodules) that were confirmed histopathologically, and we performed ultrasound guided radiofrequency ablation. The radiofrequency ablation was done 1 to 5 times per one nodule, and follow-up ultrasonography was performed one to nineteen months after the ablation procedures. The physical changes and the decrease of volume of the nodules were evaluated, and the complications related to radiofrequency ablation were observed. Results: The mean initial nodule volume was 0.01-95.61 ml (mean; 6.83±SD of 10.63 ml) and the nodule volume after radiofrequency ablation was decreased to 0.00-46.56 ml (mean; 1.83±SD of 4.69 ml). The mean volume reduction rate was 73.2%. Reduction of more than 50% was noted in 90% of all cases. For 180 nodules (90%), the decrease was 50% or more, in 20 nodules (10%), the decrease was 49% or less. On gray-scale ultrasonogram obtained after ablation, the echogenicity of the nodules changed to darker, and on the doppler-sonogram, the vascular flow within the nodules disappeared in all cases. Most patients complained pain during or right after the procedure, but the pain was transient and subsided after medication. Two patients developed hoarseness that was improved in 1 week and 2 months, respectively. Conclusion: Sonoguided percutaneous radiofrequency ablation can be one of the treatments for benign nodules of the thyroid gland. 목적: 갑상선 결절의 치료로써 초음파 유도 경피적 고주파 열치료법(sonoguided percutaneous radiofrequency ablation)의 효과와 안전성에 대해 알아보고자 하였다. 대상과 방법: 초음파 유도 경피적 고주파 열치료법을 받은 148명 환자, 200개 결절을 대상으로 하였으며 모든 결절은 병리조직학적으로 양성으로 확진되었다. 고주파 열치료법은 결절 한 개당 1-5회 시행하였고 추적 초음파검사는 시술 후 1-19개월에 시행하여 결절 부피의 감소와 변화 그리고 시술에 따른 부작용을 확인하였다. 결과: 고주파 열치료법 시행 전 결절의 부피는 0.01-95.61ml(평균 6.83±SD 10.63 ml)이었고, 시술 후 결절의 부피는 0.00-46.56 ml(평균 1.83±SD 4.69 ml)로 감소하였다. 평균 부피 감소율은 73.2% 이었다. 결절의 부피가 50%이상 감소한 경우가 180개(90%) 이었고, 이중에서 결절이 완전히 소실된 경우는 17개(8.5%)였다. 반면에 부피가 49% 이하로 감소한 경우가 20개(10%)였다. 시술후 모든 예에서 결절은 열치료법 이전보다 더 검은 저에코로 변하였고 결절의 혈관성이 사라졌다. 시술 도중과 직후 대부분 통증을 호소하였으나 약물치료로 모두 호전되었다. 두 예에서 시술직후 목소리 이상이 발생하였으나, 각각 1주일, 2개월후에 정상으로 되었다. 결론: 갑상선 양성 결절 치료의 한 방법으로써 초음파 유도 경피적 고주파 열치료법은 안전하고 효과적인 치료 방법이라 생각된다.

수두증 환아에서 뇌실 복강 단락술과 관련된 합병증의 영상 소견

전석,김지혜,오은영,황희영,이선규,이은주,곽민숙,김형식,Jeon, Seok,Kim, Ji Hye,Oh, Eun Young,Hwang, Hee Young,Lee, Seon-Kye,Lee, Eun Joo,Kwak, Min Sook,Kim, Hyung Sik 대한영상의학회 1999 대한영상의학회지 Vol.40 No.1

Purpose : To evaluate the frequency and imaging findings of various ventriculo-peritoneal shunt-relatedcomplications in pediatric patients with hydrocephalus. Materials and methods : We retrospectively reviewed 246plain radiographs, three shuntograms, 53 ultrasounds, 133 CT scans, and 24 MR images obtained before and after theventriculo-peritoneal shunt procedure in 33 pediatric patients with hydrocephalus. Using preoperative images, theetiology of the hydrocephalus was assessed. Changes in the size and shape of the ventricles, the location andcontinuity of shunt apparatus, and the presence of any abnormal enhancement, hemorrhage, edema or tissue loss, orother findings of complications, were analyzed on postoperative images; the frequency and imaging findings ofshunt-related complications such as shunt malfunction, infection, hemorrhage or isolated ventricle, andcomplications caused by overdrainage, were thus evaluated. The frequency of such complications was analyzedaccording to the etiology of the hydrocephalus, and in addition, medical records were reviewed and correlated withimaging findings. Results : In 18 of the 33 patients(54%), a total of 31 complications was detected. These werepresent in four of five cases (80%) of hydrocephalus caused by meningitis and ventriculitis, seven of twelve (58%)intraventricular hemorrhage, two of four (50%) unknown cases, three of nine (33%) congenital malformations, one oftwo (50%) tumors, and one (100%) congenital infection. Shunt malfunction was most common(n=15), and wasaccompanied by findings of enlarged ventricles, periventricular and peritubal edema, and abnormal location of theshunt tube. Symptoms and signs of increased intracranial pressure were also noted. Subdural hemorrhage andinfection were present infour cases each;findings of infection were enhancement of the ventricular wall, meninges,and parenchyma, as well as sonographically noted intraventricular septation and increased ventricular wall echo.Isolated lateral ventricle (n=4) or 4th ventricle (n=1) was persistently distended in spite of the presence of ashunt tube within the other ventricle. Collapsed ventricles, thick calvarium, and symptoms of increasedintracranial pressure were helpful in the diagnosis of slit ventricle syndrome(n=1). Immediate postoperativeintraventricular and parenchymal hemorrhage were noted in one case each. Conclusion : Shunt-related complicationswere found on postoperative images in 54% of pediatric patients with hydrocephalus; the frequency was highest incases of hydrocephalus caused by infection. Shunt malfunction occurred most frequently and each complication hadvarious imaging findings. For the diagnosis of post-operative shunt-related complication, continuous follow-upstudies are therefore necessary.