Fluid Collection in the Right Lateral Portion of the Superior Aortic Recess Mimicking a Right Mediastinal Mass: Assessment with Chest Posterior Anterior and MDCT

신동락,류대식,박만수,정승문,안재홍,이종혁,최수정 대한영상의학회 2012 Korean Journal of Radiology Vol.13 No.5

Objective: We observed patients in whom the fluid collection in the right lateral portion of the superior aortic recess on computed tomography (CT) scans mimicked a right anterior mediastinal mass on chest PA radiographs. The purpose of this study was to assess chest PA and CT features of these patients. Materials and Methods: All chest PA radiographs and CT scans in 9 patients were reviewed by two radiologists on a consensus basis; for the presence of pleural effusion, pulmonary edema and heart size on chest PA radiographs. For the portion of the fluid collection in the superior aortic recess (SAR), a connection between the right lateral portion of the SAR (rSAR) and posterior portion of the SAR (pSAR) on CT scans, and the distance between the right lateral margin of the rSAR and the right lateral margin of the superior vena cava. Results: Fluid collection in the rSAR on CT scans caused a right anterior mediastinal mass or a bulging contour on chest PA radiographs in all women patients. All patients showed cardiomegaly, five patients had pleural effusion, and two patients had mild pulmonary edema. Further, eight patients showed a connection between the rSAR and the pSAR. Conclusion: The characteristic features of these patients are the right anterior mediastinal mass-like opacity due to fluid collection in the rSAR, are bulging contour with a smooth margin and cardiomegaly regardless of pulmonary edema on the chest PA radiographs, and fluid connection between the rSAR and the pSAR on CT scans. Objective: We observed patients in whom the fluid collection in the right lateral portion of the superior aortic recess on computed tomography (CT) scans mimicked a right anterior mediastinal mass on chest PA radiographs. The purpose of this study was to assess chest PA and CT features of these patients. Materials and Methods: All chest PA radiographs and CT scans in 9 patients were reviewed by two radiologists on a consensus basis; for the presence of pleural effusion, pulmonary edema and heart size on chest PA radiographs. For the portion of the fluid collection in the superior aortic recess (SAR), a connection between the right lateral portion of the SAR (rSAR) and posterior portion of the SAR (pSAR) on CT scans, and the distance between the right lateral margin of the rSAR and the right lateral margin of the superior vena cava. Results: Fluid collection in the rSAR on CT scans caused a right anterior mediastinal mass or a bulging contour on chest PA radiographs in all women patients. All patients showed cardiomegaly, five patients had pleural effusion, and two patients had mild pulmonary edema. Further, eight patients showed a connection between the rSAR and the pSAR. Conclusion: The characteristic features of these patients are the right anterior mediastinal mass-like opacity due to fluid collection in the rSAR, are bulging contour with a smooth margin and cardiomegaly regardless of pulmonary edema on the chest PA radiographs, and fluid connection between the rSAR and the pSAR on CT scans.

소규모 협동연구 Complex의 효율적 운영 및 확산에 관한 연구

조성락,박필,이희열,신동일,이기재,유연미 과학기술정책연구원 1996 연구보고 Vol.- No.-

최근에 와서 기업, 대학, 연구기관 동 연구개발수행 주체별로 인력,자금,시설‘기자채, 기술정보 퉁 연구개발자원의 편중현상이 두드러지는 반면 연구분야는 점차 복합화,대형화되고 기술의 국제화도 빠르게 진행되는 상황이어서 특히 기술수준 및 자원이 부족한 우리나라에 경우 이에 대처하기 위한 협동연구의 증요성은 지속적으로 강조되어 왔다.이러한 중요성에 기초하여 협동연구률 활성화하기 위해 정부차원에서 협동연구개발 프로젝트의 개발·시행을 비롯 대학중심의 우수연구센터 지정, 산업기술연구조합 결성 동 일련의 제도화 조치가 이어졌으며, 최근 틀어서는 산·학·연 협동연구의 구체척 장으로써 KAIST 협동연구시범단지, 고대 Techno Complex, 연대 YRC 퉁이 계획 · 실행됨으로써 소규모 협동연구 Complex가 태동되기 시작하는 양상을 보이고 있다. 또한 아직은 단일기업차원을 크게 넘어서고 있지는 않으나 포항제철-포항공대-산업과학기술연구소, 대우그룹-아주대학-고동기술연구원 체계의 산·학·연 협동체제가 운영되고 있는 풍 새로운 차원에서의 협동연구가 점차 구체적인 모습으로 자리를 잡아가고 있다.이밖에 기업집단간 효율적 협동연구를 위한 종합연구소체제가 성숙되면서 산업계 중심의 협동연구 Complex가 삼성의 기흉핀, 현대의 마북련, 두산의 용인핀 동에서 형성되어 있고 이후 포항제철의 광양핀, 대우의 군장핀, 기아자동차의 아산핀 동에서 협동연구 Complex 형성 가능성도 커지고 있는 것이 현실이라 할 수 있다.이들 협동연구 Complex는 시법적 성격을 갖고 있어 동 단지의 성공적 운영이 협동연구의 활성화뿐 아니라 협동연구 Complex 조성의 전국적 확산 기본모델이 되어 국토의 Techno Be lt화를 도모할 수 았다는 점에서 그 중요성이 매우 크다고 하겠다. 특히 협동연구의 중요성은 미국, 일본, EU 풍 선진국에서 크게 강조되어 미국의 실리콘밸리나 일본의 쓰꾸바 연구단지 동과 같은 대규모 테크노폴리스에서 부터 미국의 대학유관 Science Park, Research Park, Research Center, 영국 및 호주의 Sci ence Park 동 소규모 집적화단지에 이르기까지 크게 활성화 되고 있다는 점율 감안할 때 우리나라 협동연구단지의 성공적 운영을 바탕으로 한 협동연구의 활성화가 절실한 실정이다.‘ 80년대 이후 기업의 기술획득 전략의 변화와 함께 활발하게 발생하고 있는 협동연구 현상은 국가 및 기업차원에서 기술개발자원을 효율적으로 결합하고자 하는 천략적 개념이 내포되어 있다는 점에서 과거의 기업간 기술협력이나 오랜 천통율 가진 산·학 협동연구와는 다른 특정을 보이고 있다. 이러한 현상은 국가별로 정부의 공공정책에 의해 더욱 확산되어 가는 양상율 보이는데 여기서의 협동연구에는 국제적인 장기 연구개발 협력에서 부터 국내에서 수행되는 단기 기술적 문제의 해결에 이르기까지 기업과 대학 그리고 공공연구소 등이 협력하여 수행하는 다양한 종류의 현상이 내포되어 있다. 따라서 협동연구는 참여주체의 형태, 협력의 내용, 계약 및 연구수행 형태, 협동기간 동에 따라 매우 다양한 조합으로 나타날 수 있는 바, 일반적으혹 산·학·연 협동연구는 협동연구 가운데 기업간의 협동연구률 제외한 대학 흑은 공공연구소와 기업간의 협력을 지칭하는 용어로 쓰이고 있다.현재 각 국가들은 국가적 특색에 맞는 산·학·연 협동연구체제의 구촉을 위한 노력과 함께 다양한 정책과 제도를 시행하고 있다. 물론 이들 국가들이 시행하는 협동연구의 개념과 체제가 우리나라 풍토에 그대로 들어 맞을 수는 없으며 그렇기 때문에 우리도 나름대로 우리의 현실에 적합한 그리고 국가 고유의 륙성을 지닌 산·학·연 협동연구 체제의 정립과 운영·활성화 방안을 모색할 필요성이 대두되는 것이다. 물론 협동연구 범주에 드는 모든 사례를 총 망라해서 살펴보고 성공척인 운영사례에서 나타나는 나름대로의 특성과 장단점을 상쩨히 비교·검토해서 우리나라의 현실에 적합한 Model을 도출해 낸다면 가장 이상적이겠지만 본 연구의 성격상 시간적으로나 불량면에서도 무리가 있고 또한 현실적으로도 국내의 주변여건상 꾀리감이 따르게 되는 문제점도 없지 않다. 이에 본 연구에서는 가능한한 시간척으로나 내용면에서 최소한의 주어진 범주안에서 현재 시법적 수준에서 계획, 실행되고 있는 국내의 소규모 협동연구 Complex 현횡을 검토하고, 각 Complex의 성격을 규명한 후, 선진 주요국 가운데 비교적 성공적이라는 형가를 얻고 있는 중·소 규모의 유사 협동연구단지 운영현황과 특정적인 시사점을 도출하는 한면, 국내 기업부설연구소의 의견과 소규모 협동연구 Complex의 운영·실무자의 의견까지도 수렴함으로써 보다 실질적이고 현실에 적용 가능한 소규모 협동연구Complex의 조성 방안을 제시하는데 역점을 두고자 한다.

Performance of Screening Mammography: A Report of the Alliance for Breast Cancer Screening in Korea

이은혜,김금원,김영중,신동락,박영미,임효순,박정선,김혜원,김유미,김혜정,전재관 대한영상의학회 2016 Korean Journal of Radiology Vol.17 No.4

Objective: To analyze the diagnostic accuracy and trend in screening mammography in Korea. Materials and Methods: We retrospectively linked the information from hospitals participating in the Alliance of Breast Cancer Screening in Korea (ABCS-K) and the database of the National Cancer Screening Program. We calculated performance indicators, including the recall rate, cancer detection rate (CDR), positive predictive value (PPV), sensitivity, specificity, false-positive rate (FPR), and interval cancer rate (ICR). Changes in the performance indicators were calculated as the annual percent change with 95% confidence interval (CI). Results: We enrolled 128756 cases from 10 hospitals from 2005 to 2010. The recall rate was 19.1% with a downward trend over time (-12.1% per year; 95% CI, -15.9 to -8.2). The CDR was 2.69 per 1000 examinations, without a significant trend. The PPV was 1.4% with an upward trend (20.8% per year; 95% CI, 15.2 to 26.7). The sensitivity was 86.5% without a significant trend, whereas the specificity was 81.1% with an upward trend (3.3% per year; 95% CI, 2.1 to 4.5). The FPR was 18.9% with a downward trend (-12.4% per year; 95% CI, -16.2 to -8.4). The ICR was 0.5 per 1000 negative examinations without a significant trend. There were institutional variations in the diagnostic accuracy and trend except for the CDR, sensitivity, and ICR. Conclusion: The sensitivity and CDR of screening mammography in the ABCS-K from 2005 to 2010 were compatible with those for Western women. The recall rate, PPV and specificity, however, were suboptimal, although they showed significant improvements over this period. A further analysis is required to explain institutional variations.

CT Findings of Esophageal Schwannoma: A Case Report

이만호,류대식,엄대운,신동락,최수정,안재홍,박만수,유동곤 대한영상의학회 2015 대한영상의학회지 Vol.72 No.3

Esophageal schwannomas are a relative rare benign neoplasm that usually occurs in the upper esophagus, in the middle aged women. We report a case of a 67-year-old man with a lower esophageal schwannoma. This lesion was composed of homogenous density, iso-attenuating with the chest wall muscle on pre- and post-contrast chest computed tomography (CT). The CT findings of the esophageal schwannoma are similar to those of esophageal leiomyoma. Hense, esophageal schwannoma may be a differential diagnosis with esophageal leiomyoma.

Analysis of Participant Factors That Affect the Diagnostic Performance of Screening Mammography: A Report of the Alliance for Breast Cancer Screening in Korea

김영중,이은혜,전재관,신동락,박영미,김혜원,김유미,김금원,임효순,박정선,김혜정,조혜미,the Alliance for Breast Cancer Screening in Korea (ABCS-K) 대한영상의학회 2017 Korean Journal of Radiology Vol.18 No.4

Objective: To analyze participant factors that affect the diagnostic performance of screening mammography. Materials and Methods: We enrolled 128756 cases from 10 hospitals between 2005 and 2010. We analyzed recall rate, cancer detection rate (CDR) per 1000 examinations, positive predictive value (PPV), sensitivity, specificity, false positive rate (FPR), and interval cancer rate (ICR) per 1000 negative examinations according to participant factors including age, breast density, and number of visit to the same institution, and adjusted for confounding variables. Results: Increasing age improved recall rates (27.4% in 40’s, 17.5% in 50’s, 11.1% in 60’s, and 8.6% in 70’s), CDR (2.7, 3.2, 2.0, and 2.4), PPV (1.0, 1.8, 1.8, and 2.8%), sensitivity (81.3, 88.8, 90.3, and 94.7%), specificity (72.7, 82.7, 89.0, and 91.7%), and FPR (27.3, 17.3, 11.0, and 8.4%) (p < 0.05). Higher breast density impaired recall rates (4.0% in P1, 9.0% in P2, 28.9% in P3, and 27.8% in P4), PPV (3.3, 2.3, 1.2, and 1.3%), specificity (96.1, 91.2, 71.4, and 72.5%), and FPR (3.9, 8.9, 28.6, and 27.6%) (p < 0.001). It also increased CDR (1.3, 2.1, 3.3, and 3.6) and ICR (0.2, 0.3, 0.6, and 1.6) (p < 0.05). Successive visits to the same institution improved recall rates (20.9% for one visit, 10.7% for two visits, 7.7% for more than three visits), PPV (1.6, 2.8, and 2.7%), specificity (79.4, 89.6, and 92.5%), and FPR (20.6, 10.4, and 7.5%) (p < 0.001). Conclusion: Young age and dense breasts negatively affected diagnostic performance in mammography screening, whereas successive visits to the same institution had a positive effect. Examinee education for successive visits to the same institution would improve the diagnostic performance.

A Case of Intrathoracic Ectopic Liver in a Patient without Diaphragmatic Defect

이상근,류대식,박만수,강채훈,최수정,신동락 대한영상의학회 2016 대한영상의학회지 Vol.74 No.6

We reported a patient with intrathoracic ectopic liver without diaphragmatic defect that was incidentally detected on chest radiography. Chest dynamic CT showed a subpleural mass abutting the diaphragm with isodense enhancement to liver tissue during arterial and delayed images, suggesting intrathoracic ectopic liver.

Computed Tomography Findings of Alveolar Adenoma of the Lung with Histopathologic Comparison: A Case Report

김도영,류대식,박만수,최수정,안재홍,신동락,유동곤,강길현 대한영상의학회 2014 대한영상의학회지 Vol.70 No.5

Alveolar adenoma is a rare pulmonary neoplasm with a female predominance, and it was considered to be a histologic variant of sclerosing hemangioma in the past. A chest X-ray usually shows a well-defined, peripheral, solitary nodule similar to that of sclerosing hemangioma. Chest CT shows a solitary, well-defined, peripheral nodule with homogeneous density and no contrast enhancement, which is contrary to marked contrast enhancement of sclerosing hemangioma. We report the first case of alveolar adenoma with spotty enhancement of the nodule similar to that of sclerosing hemangioma on contrast enhanced CT, based on the presence of stromal vessels in the interstitium of the compact alveolar area on histopathologic comparison.

A Case of Pseudoaneurysm Due to Fungus Ball within the Progressive Massive Fibrosis in a Patient with Pneumoconiosis: Computed Tomography-Pathologic Correlation

이상근,류대식,박만수,최수정,강채훈,신동락,안재홍 대한영상의학회 2016 대한영상의학회지 Vol.75 No.3

We reported a case of pseudoaneurysm in the upper lobar branch of the right pulmonary artery, which was caused by a fungus ball within the progressive massive fibrosis (PMF) in a patient with pneumoconiosis. Coil embolization of the pseudoaneurysm initially stopped the bleeding. After right upper lobe lobectomy to prevent the recurrent hemoptysis, pathology confirmed pseudoaneurysm within the PMF due to aspergilloma.

Ground-Glass Nodule on Thin-Section CT: Differentiation among Adenocarcinoma In Situ, Minimally Invasive Adenocarcinoma and Lepidic Predominant Invasive Adenocarcinoma

이만호,류대식,김도영,안재홍,최수정,강길현,유동곤,신동락 대한영상의학회 2015 대한영상의학회지 Vol.73 No.6

Purpose: To investigate different computed tomography (CT) features among adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), and lepidic predominant invasive adenocarcinoma (LPA) that appeared as ground-glass nodules (GGN). We also analyzed different CT findings between Group A (AIS and MIA) and Group B (LPA). Materials and Methods: We evaluated 19 AIS, 4 MIA, and 9 LPA images that were histologically confirmed and manifested as GGN on thin-section CT scans. CT scans were assessed for lesion characteristics: size, shape, solid portion, internal air density, marginal irregularity and pleural tag. CT findings of Group A and Group B were analyzed using the Kruskal-Wallis test or Fisher’s exact test. Results: A significant statistical difference was seen between AIS and LPA for lesion characteristics (p < 0.05). No significant difference was observed between AIS and MIA. Round or polygonal shape with smooth margin was significantly associated with Group A, and complex shape with marginal irregularity was associated with Group B. Conclusion: Group A (AIS and MIA) could be distinguished from Group B (LPA) by smaller lesion size, round or polygonal shape, smaller solid portion and smooth margin.

Blunt Rupture of Left Ventricle Diagnosed Using Two Phase Contrast Enhanced CT: A Case Report

김도영,류대식,안재홍,박만수,정승문,최수정,신동락,유동곤 대한영상의학회 2014 대한영상의학회지 Vol.70 No.6

This report is about a case of left ventricle rupture after blunt trauma diagnosed using two phase contrast enhanced CT. Arterial phase images suggest presence of cardiac tamponade. Delayed images suggest cardiac injury that shows a linear low density on the left ventricle wall.