개심술 후 발생한 단순흉부사진 상 변화에 대한 고찰

최시성 대한영상의학회 1988 대한영상의학회지 Vol.24 No.4

this retrospective study was performed to detect thoracic changes on chest films after open-heart surgery. Authors reviewed total 160 cases who underwent median sternotomy from July 1984 to January 1988. The results were as follows; 1. Although aoo cases showed mediastinal widening by the mean 29.9%(SD 16.2) there was no case of reopera-tion due to excessive mediastinal hemorrhage. 2. Among 160 cases 87 cases (54%) showed thoracic alterations after surgery. 3. Abormal sternal findings were radiolucent vertical line in 15 cases (9%) sternal dehiscence in 4 cases(2%) sternal osteomyelitis in 4 cases(2%) 4.The types of pulmonary parenchymal lesions were 24 cases (15%) of atelectasis 15 cases (9%) of pneumonia and 3 cases (2%) of pulmonary edema. 5. Pleural effusion was noted in 39 cases (24%) 6. Among the abnormal extra-alveolar air collections there were pneumothorax in 10 cases(6%) pneumomediastinum and pneumopericardium in 29 cases (18%) and pneumoperitoneum in 5 cases (3%) 7. In 23 cases with phrenic nerve paralysis the involved site was left in all and the associated pulmonary infiltra-tion in left lower lobe was found in 82% (19/23). 8. 4 cases of cardiac tamponade developed 9 to 20 days after surgery ("late" from)uot; from)

스터지 웨버 증후군의 MR 소견 : 안면부 모반이 없는 2예 보고

최시성 대한영상의학회 1994 대한영상의학회지 Vol.30 No.3

목 적: 안면부 모반이 없는 2예의 스터지 웨버 증후군을 경험하였기에 그 특징적인 CT 및 MRI소견을 보고하고자 한다. 대상 및 방법: 증례 1에서는 조영증강 전,후의 CT와 MR을, 증례 2에서는 조영증강 전,후의 MR만을 실시하였다. 결 과: CT는 MR에 비해 피질석회와의 발견에 우수하였고 MR은 뇌실질의 이상 소견과 Gd-DTPA 주입시 뇌연수막 혈관종을 시사하는 강한 연수막 조영증강을 보는데 우수하였다. 결 론: 스터지 웨버 증후군때 안면부 모반을 보이지 않는 경우도 있기에 이 증후군이 의심되는 환자에서 Gd-DTPA조영증강후 MR은 연수막 혈관종의 존재 및 파급정도를 아는데 아주 유용한 검사가 될 것으로 생각된다. Purpose: We reported the CT and MR findings of 2 cases with Sturge-Weber syndrome which were not ac-companied by facial nevi.Materials and Methods: They were examined with both CT and MR in one case and with MR only in the other case.Results : CT was better than MR in the demonstration of the characteristic cortical calcification. MR was superior to CT in the depiction of the abnormalities of the surrounding parenchyma and the intense enhancement of pial angiomatosis with Gd-DTPA enhancement.Conclusion : Gd-DTPA enhanced MR imaging could be useful in the demonstration of the presence and extent of pial angiomatosis in patients with suspected Sturge -Weber syndrome.

MR Imaging of Intradural Spinal Lipoma : A Case Report 1예 보고

Choi, See-Sung,Lee, Jong-Deuk,Juhng, Seon-Kwan,Roh, Byung-Suk,Kim, Chang-Guhn,Won, Jong-Jin 圓光大學校 醫科學硏究所 1996 圓光醫科學 Vol.12 No.2

아주 드물게 발생하는 경막내 척추 지방종이 흉추부에서 발생한 1예를 보고한다. 자기공명영상은 시상면에서 종양의 상부와 하부 범위를 분명하게 보여 주었으며, 또한 종양과 척수와의 관계도 잘 나타내주었다. A case of intradural spinal lipoma in thoracic region is presented. MR imaging clearly showed the upper and lower extent of the tumor on the sagittal images. The relation of the tumor to the cord was also well shown.

경막내 척수외 결핵종의 자기공명영상 소견: 2예 보고

손영준,최시성,전세정,박성훈,정선관 대한자기공명의과학회 2008 Investigative Magnetic Resonance Imaging Vol.12 No.2

경막내 척수외 결핵종은 척추 결핵의 드문 형태로, 몇몇 증례들이 보고되었다. 저자들은 최근 흉추에 발생한 광범위한 경막내 척수외 결핵종 2예를 경험하였기에 문헌고찰과 함께 보고하고자 한다.

Cerebral Air Embolism: a Case Report with an Emphasis of its Pathophysiology and MRI Findings

강세리,최시성,전세정 대한자기공명의과학회 2019 Investigative Magnetic Resonance Imaging Vol.23 No.1

Cerebral air embolism (CAE) is a rare complication of various medical procedures. It manifests with symptoms similar to those of typical acute cerebral infarction, however the treatment is quite different. We present a case of arterial CAE that was associated with a disconnected central venous catheter and appeared as punctate dark signal intensities with aliasing artifacts on the susceptibility-weighted filtered phase magnetic resonance image. The susceptibility-weighted filtered phase image can be helpful for diagnosing CAE and the magnetic resonance imaging reflects the pathophysiology of CAE.

혈관촬영에 이용된 비이온성 조영제가 T-임파구아군에 미치는 영향

이경수,최시성,노병석,정선관,김창근,원종진,전창덕,정헌택 圓光大學校 醫科學硏究所 1993 圓光醫科學 Vol.9 No.1-2

Several investigators have shown that the radiographic contrast media have the ability to influence different biologic systems in blood. However, the influence of contrast media on the subpopulations of T-lymphocyte is scarcely investigated. The immune response, including the production of immunoglo-bulin by B cells, is controlled in part by regulatory signals exchanged between functionally heterogenous subpopulations in the T-cell compartment. To evaluate the influence of contrast media on the subpopulations of T-lymphocyte, the author studied the change of T-lymphocyte subpopulations in peripheral blood of 12 patients, before and after injection of Iopromide (Ultravist® in vivo during angiography. T-lymphocyte subpopulations were analyzed by flow cytometer. In general, lymphocyte, Anti-CD_3^+, Anti-CD_4^+, Anti-CD_8^+, Anti-CD_45R^+, and Anti-CD_4^+/Anti-CD_8^+ ratio statistically were not decreased by Iopromide. In conclusion, our results suggest that human immune system is not influenced by Iopromide during angiography.

신생아 저혈당증에 의한 뇌손상의 확산강조영상: 증례 보고

허은아,최시성,전세정,김은아,이영환,정선관 대한영상의학회 2006 대한영상의학회지 Vol.55 No.4

Profound hypoglycemia results in significant brain injury because glucose is essential for normal brain functioning. We present here a case of transient neonatal hypoglycemia with diffuse brain injury. Magnetic resonance imaging was performed 2 days after onset, and this revealed bilateral regions of restricted diffusion in the parietal, occipital, frontal and temporal lobes. On the T1-weighted images, the regions showed indistinct gray matter-white matter differentiation. There were subtle high signal intensity lesions along the corresponding regions of the FLAIR and T2-weighted images. 포도당은 정상 뇌기능을 유지하는데 필수 요소이기 때문에 심한 저혈당이 있는 경우 심각한 뇌손상을 초래 할 수 있다. 일시적인 저혈당증이 있는 신생아에서 미만성 뇌손상을 보인 예가 있어 보고하고자 한다. 증상 발현 후 2일 후에 얻은 자기공명영상의 확산강조영상에서 양측 후두엽, 두정엽, 측두엽 및 전두엽에 제한된 확산이 광범위하게 관찰되었다. 병변부위는 T1 강조영상에서는 뇌 회질과 백질의 구별이 다소 불분명한 소견으로 보였으며, FLAIR와 T2강조영상에서는 해당 병변부위에 희미한 정도의 고신호강도를 보였다.

전산화 단층촬영을 이용한 신손상의 평가

노병석,최시성 圓光大學校 醫科學硏究所 1991 圓光醫科學 Vol.7 No.1-2

The diagnosis and appropriate management of patents with renal trauma have remained controversal. From February 1987 to December 1990, we evaluated with 43 CT of sustaining renal trauma. Computed tomography provides the most precise anatomical detail of renal injuries as well as valuable information regarding other retroperitoneal and intra-abdominal structures, often resulting in the identification of associated and unsuspected injury. Except 3 cases - severe fracture, shattered kidney with disrupted fragments, renal pedicle injury-, all cases of blunt renal trauma treated conservatively. By precise CT staging and interventional procedure, the main management of renal trauma changed from surgical treatment to conservative management.

전두엽 스파르가눔 충체의 동측 소뇌반구로의 이동: 증례 보고

허은아,최시성,전세정,김혜원,이영환 대한영상의학회 2009 대한영상의학회지 Vol.60 No.5

Most cerebral sparganosis lesions are located in the white matter of the cerebral hemisphere. A few cases of cerebral sparganosis where the sparganum have migrated into the contralateral cerebral hemisphere have been reported. We report a case of cerebral sparganosis where the sparganum migrated from the white matter of the left frontal lobe to the ipsilateral cerebellar hemisphere after failure of surgical removal of the worm. 뇌 스파르가눔증의 병소는 대부분 편측 대뇌 반구 백질에 위치하며, 편측 대뇌 반구에서 반대측 대뇌 반구로 이동한 증례보고도 있다. 저자들은 좌측 전두엽 백질에 발생한 뇌 스파르가눔증의 수술적 충체 적출 실패 후 동측 소뇌 반구로 이동한 1예를 경험하여 보고하고자 한다.

간 허혈성괴상의 CT소견에 대한 실험적 연구 : 간실질 및 피막의 경시적 변화와 병리조직의 비교 Changes of CT Findings of Liver Parenchyama and Capsule with Time Lapse Correlated with Histopathology

김창근,김강득,최시성,정선관,노병석,원종진 圓光大學校 醫科學硏究所 1994 圓光醫科學 Vol.10 No.1-2

In order to evaluate CT findings with time and to confirm the capsular structure correlating with its histopathologic findings, we experimentally induced ischemic necrosis of liver in 20 rabbits. Incision of the abdomen was performed under anesthesia. Ligation of hepatic artery, portal vein and hepatic duct of right inferior posterior lobe of the liver after injection of macroaggregated albumin into right inferior posterior portal vein in order to prevent from developing collateral circulation as possible. Precontrast and postcontrast enhanced CT images were obtained at 1. 2. 4 days and 1, 2. 4. 6 weeks after induction of ischemic necrosis. Necrotic area in the liver showed homogeneous low density compared to normal liver, and no contrast enhancement after contrast material administration, and marked volume loss with time. CT attenuation value of necrotic area at 1 day(36.7±6.4 M±SD, Hounsfield unit) approached to two third of that of normal liver(56.3±7.3) and showed no significant change until two weeks but increased significantly after four weeks. On contrast enhanced CT images, capsular structure was obsereved as a high density rim along the liver surface of the necortic area in 8 of 15 cases. From the first day on, homogenous ischemic or coagulation necrosis was observed but rarely findings of edema, hemorrhage and cystic change were observed on histopathologic specimen. In all of the histologic samples taken from 10 cases during th 2nd to 6th week, fibrous thickening with rich vascularity was observed along the surface of the necrotic area. In conclusion, ischemic necrosis of the liver showed homogeneous low density and no contrast enhancement. CT attenuation value of necrotic area increased significantly with time associated with markedly decrease in volume. Capsular structure attributed to the hypertrophy of the liver capsule and rich vascularity within it.