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심재철,황지영,김도균,이형종,양회생 東國大學校醫學硏究所 2004 東國醫學 Vol.11 No.1
난소암은 대부분 증상발현이 늦고 이학적 소견이 불분명하여 병의 경과가 진행된 상태에서 발견되는 경우가 많아 부인과 암 중 사망률과 유병율이 증가하는 추세에 있다. 따라서 난소암 환자의 생존율을 높이기 위해서는 새로운 치료 기술의 개발 못지 않게 난소암 조기 진단법의 개발이 중요한 과제이다. 이를 위해 난소암의 고위험군인 1) 난소암 가계의 여성 2) 이보다 낮은 고위험인자를 가진 여성 즉 미산부, 조기 초경, 늦은 폐경, 폐경 후 여성, 과배란 유도를 한 여성, 유방암, 자궁내막암, 대장암 등의 과거력이 있는 여성 등을 선별하여 조기 검진하는 것이 필요하다. 정기적인 골반 내진, CA125 등의 종양표지물질, 질식 초음파, 질식 초음파 도플러 검사 등이 난소암의 조기 진단 및 선별 검사에 도움이 된다. Ovarian cancer manifestates indefinite physical exam results and usually asymptomatic which results in late diagnosis, therefore is the leading cause of death in all gynecologic cancers and the mortality rate and prevalence rate is increasing. Therefore, in order to increase the survival rate of the ovarian cancer patients, early diagnosis as well as improvements in treatment technology is important. Early detection through selected patients who are at high risk for ovarian cancer such as previous family history, nulliparas, early menarch, late menopause, postmenopausal women about to receive superovulation, breast cancer, endometrial cancer and colorectal cancer history should be needed. Routine pelvic examination, tumor markers along with TVUSG and doppler can aid the early diagnosis and screening of ovarian cancer.
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Localization of the genicular arteries under ultrasound guidance
심재철,한경희,윤성렬,정유진,임현영 대한마취통증의학회 2019 Anesthesia and pain medicine Vol.14 No.1
Background: The genicular arteries (GAs) can be utilized for genicular nerve block. We aimed to evaluate the ability to localize GAs under ultrasound in patients with chronic knee pain. Methods: Twenty-four knees from 14 osteoarthritic patients were enrolled. The target GAs included the superomedial GA (SMGA), superolateral GA (SLGA), and inferomedial GA (IMGA). GAs were observed at the relevant adductor tubercle and epicondyle-shaft transition under ultrasound. Distribution of the SMGA at the adductor tubercle was evaluated using defined zones in transverse and longitudinal ultrasound images. SLGA and IMGA were also categorized using defined zones in longitudinal images. Distance from bony cortex to the relevant GA was then estimated. Results: Among 24 knees, 91.7% of SMGAs were located at the upper part of the adductor tubercle. The distances between the SMGA and bony cortex on transverse view (dSMGAt) and on longitudinal view (dSMGAl) were directly correlated (rs = 0.6539, P = 0.0005). Conclusions: Under ultrasound guidance, the SMGA was found to be mainly localized to the upper part of the adductor tubercle. Likewise, the SLGA and IMGA were mainly localized at the distal and proximal parts of the epicondyle-shaft transition, respectively. Our results support the feasibility of ultrasound guidance for GA localization in patients with knee osteoarthritis.
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