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김건일 부산대학교 병원 암연구소 2007 부산대병원학술지 Vol.- No.21
Purpose: To describe the high-resolution CT findings of Mycoplasma pneumoniae pneumonia. Materials and Methods: l-mrn collimation CT scans obtained in 37 patients with serologically proven M. pneumoniae pneumonia were retrospectively reviewed. The high-resolution CT scans were analyzed independently by two chest radiologists. Results: High-resolution CT finding included the ground-glass opacity (n=34, 92%), air-space consolidation (n=31, 84%), nodules (n=29, 78%), and peribronchovascular and interlobular septal thickening (n=2l, 57%). ’The areas of consolidation was lobular in distribution (n=20, 65%). The nodules were small and centri10bular (n=27, 93%) in location at the secondary pulmonary lobule. Conclusion: The lobular distribution of air-space consolidation, presence of centrilobular nodules and interstitial abnormalities including interlobular septal thickening and peribronchovascular interstitial thickening are characteristic findings of Mycoplasma pneumoniae pneumonia.
요추간판수핵탄출증에 의한 신경근압박의 평가에 있어서 전산화단층촬영술의 가치: 척추강조영술과의 비교
김건일 대한영상의학회 1988 대한영상의학회지 Vol.24 No.2
High resolution computed tomography is the most accurate diagnostic tool to define a lumbar herniated disc disease because it provides a complete in vivo analysis of bony framework of lumbar spine as well as the supporting soft tissue structures and neural elements. The purpose of this study is to estimate the valve of CT in the evaluation of nerve root compression caused by herniated disc disease. We alalyzed 52 roots of 26 patients of single level herniated disc disease with definite evidence of bilateral or unilateral neurologic deficit who had both CT and myelography at Pusan National University Hospital from May 1983 to March 1987. The results were as follows: sensitivity and specificity of CT is 77% and 81% respectively in the diagnosis of nerve root compression caused by lumbar herniated disc disease. sensitivity and specificity of myelography is 77% and 81% respectively in the diagnosis of nerve root compres-sion caused by lumbar herniated disc disease. The results of this study indicate that high resoluation CT was equivalent to myelography in the diagnosis of nerve root compression caused by lumar herniated disc disease.
김건일 대한영상의학회 1996 대한영상의학회지 Vol.34 No.3
Purpose : To describe the characteristic HRCT appearance and to evaluate the usefulness of HRCT in patientswith welders' pneumoconiosis. Materials and Methods : Chest radiographs and high-resolution computedtomography(HRCT) of 45 shipyard welders(male : female=41 : 4 ; age : 36-58 years, mean 47.8) with an occupationalhistory of 4-25(mean 15.8) years were evaluated. Small rounded opacities in chest radiographs were read accordingto the ILO standard films(1980). HRCT were evaluated with micronodules, ground-glass attenuation, and otherfindings. Serial HRCT scans of seven welders taken 27 months apart were also evalauted. Two of these were stillworking in that job ; five had not worked as welders for 1-6(mean 4.4) years. Results : HRCT of welders'pneumoconiosis showed poorly marginated centrilobular branching or dot opacities of low attenuation(n=36, 80.0%)with variable profusion and extent and ground-glass attenuation(n=8, 17.8%). HRCT abnormalities were seen in 39welders(86.7%). It was able to depict micronodules(n=13) and/or ground-glass attenuation(n=3) in 15(68.2%) of 22welders with normal chest radiograph. Serial HRCT revealed no changes in parenchymal abnormalities(n=6) andslightly decreased profusion of micronodules(n=1). There was no HRCT abnormality suggesting gross paren- chymalfibrosis. Conclusion : HRCT is more sensitive than chest radiography in detecting parenchymal changes in welders'pneumoconiosis, with characteristic poorly-marginated centrilobular branching opacities or dots and ground- glassattenuation. These HRCT appearances may be helpful in differentiating welders' pneumoconiosis from other diffuselung diseases.
김건일,송현,유양기,조민섭,마츠다 나루토,소로킨 비탈리,주석중,이재원,송명근,이준승,김순배,박수길,박정식,Kim, Kun-Il,Song, Hyun,Yu, Yang-Gi,Jo, Min-Seop,Matsuda, Naruto,Sorokin, Vitaly A.,Choo, Suk-Jung,Lee, Jae-Won,Song, Meung-Gun,Yi, Joon-Seung 대한흉부심장혈관외과학회 2001 Journal of Chest Surgery (J Chest Surg) Vol.34 No.4
배경: 말기 신부전 환자에서 심장병, 특히 관상 동맥 질환의 이환이 늘어나면서 관상동맥 우회수술의 대상 환자가 지속적으로 증가하고 있다. 이들 환자군은 수술후 유병률과 사망률이 매우 높고 고위험군으로 알려져 있다. 대상 및 방법: 1996년 3월부터 2000년 5우러까지 서울 중앙 병원 흉부외과에서 술전 말기 신부전증으로 진단 받은 후 관상 동맥 우회수술을 시행받은 환자 25명을 대상으로 의무 기록을 중심의 후향적 분석을 하였다. 술전 위험 인자 및 술전 신기능, 수술 결과, 술후 경과, 수술후 합병증, 사망률 및 생존률 등을 분석하였다. 결과: 술전 평균 크레아티닌 청소율은 12.7$\pm$5ml/mim였고 술전 평균 혈중 크레아티닌 치는 6.2$\pm$3mg/dl(1.7-14.4)였다. 술전 투석을 시행중인 환자는 11례(44%)였고 술전 투석을 시행하지 않았던 14례(56%)중 8례(8/14, 57.1%)는 수술전후로 새로이 투석이 필요하였다. 술전 혈액 투석 중이었던 9례중 2례에서 수술후 복막 투석으로 전환하였다. 수술 사망률은 2례(8%)로 흡인성 폐렴과 종격동염으로 1례, 그리고 수술후 출형과 종격도염으로 1례가 사망하였다. 수술후 합병증은 14명(56%)의 환자에서 발생하여 매우 높은 발생율을 보였다. 만기사항은 2례(8%)에서 발생하였으며 사망원인은 카테터에 의한 복막염이었다. 생존 환자의 4년 생존률은 82$\pm$13% 였다. 결론: 말기 신부전 환자에서의 관상동맥 우회수술을 비교적 만족스러운 범위의 수술 사망률(8%)을 보였으나 합병증 발생률이 매우 높고 합병증 발생 시 사망률이 매우 높아 수술주위 감염 예방과 세심한 환자 관리가 필요하다.
김건일,신호승,박희철,홍기우,심정원,김순란 대한흉부심장혈관외과학회 1999 Journal of Chest Surgery (J Chest Surg) Vol.32 No.3
폐림프관평활근종증은 드물게 발생하는 질환으로 거의 대부분 가임기의 여성에서 발생하며 매우 빠르게 호흡부전이 발생하여 평균 10년이내에 사망하게 되는 질환이다. 이 질환은 폐의 림프관, 혈관, 그리고 기도에 비정형적인 평활근이 점진적으로 증식하여 유발되며 결국 원위부의 낭성 변화를 초래하여 자주 재발성 기흉을 일으키게 된다. 저자들은 양측의 재발성 기흉의 병력을 가진 30세 여자환자에서 폐림프관평활근종증을 치험하였다. 환자는 우측 개흉술을 통해 폐생검을 시행하였으며 폐림프관평활근종증으로 진단되었다. 이에 문헌고찰과 함께 보고하는 바이다 Pulmonary lymphangioleiomyomatosis is a rare disease occurring almost exclusively in woman of reproductive age. It is characterized by rapid deterioration of respiratory functions and results in death within an average of 10 years. This disease is caused by a progressive proliferation of atypical smooth muscle in the pulmonary lymphatic vessels, blood vessels, and airways leading to the development of distal cystic changes which causes frequent recurrent pneumothoraces. We experienced a case of pulmonary lymphangioleiomyomatosis in a 30-year old woman who had a history of bilateral, recurrent pneumothoraces. The patient underwent lung biopsy through right thoracotomy which revealed the diagnosis of pulmonary lymphangioleiomyomatosis. We report a case with a review of the literature.