• 대한핵의학회지
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• 제21권1호
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• pp.39-46
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• 1987

The stress fracture is a disease caused by and abnormal stress to the normal bone with constant, repeated pull. Early detection of stress fracture plays an important role in treatment and prevention of its complication. Bone scintigraphy was performed to evaluate 18 patients with stress fracture of the lower extremities from May, 1985 to April, 1987, in the Department of Internal Medicine of National Police Hospital. The results were as follows: 1) Seventeen of the 18 cases showed positive bone scans at the initial study performed from 1 week to S months after the onset of symtom. 2) Ten of the 18 patients had findings of stress fracture at the initial X-ray film. Two out of 8 negative case revealed positive findings in the follow-up studies. 3) The bone scans in the 2 cases taken 5 months after the onset of symton; the one showed only slightly increased radiouptake, the other showed no abnormal findings. In conclusion, bone scanning is a more sensitive indicator of early stress fracture than radiologic study. The healing phase is characterized by a gradual decline in radioactivity at the fracture site in concordance with subsidence of symptom.

• 대한두경부종양학회지
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• 제35권2호
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• pp.39-43
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• 2019

Peripheral giant cell granuloma (PGCG) is an benign non-neoplastic lesion most commonly occurring in oral cavity but extraoral PGCG is extremely rare. Recently, we experienced a case of an isolated PGCG in the parotid gland in 59-year-old man. FNAB findings and radiologic findings including CT and US were suggestive of Warthin's tumor. Partial parotidectomy was performed. Pathologic findings showed fibrillar connective tissue stroma with spindled, ovoid, and round histiocytes-like cells mixed with uneven multinuclear giant cells, small capillaries, hemorrhage, hemosiderin-laden macrophages, and necrosis which were consistent with giant cell granuloma. We report a case of an PGCG in parotid with a review of literature.

• 대한영상의학회지
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• 제81권3호
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• pp.583-590
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• 2020

코로나바이러스감염증-19는 전 세계적에서 급속도로 확산되고 있다. 몇몇 논문에서 코로나바이러스감염증-19의 영상의학적 소견들이 보고되었다. 우리는 한국에서 코로나바이러스감염증-19로 확진된 세 명의 환자에 대한 임상적 소견과 흉부 일반촬영 및 흉부 전산화단층촬영에서 나타난 영상의학적 소견에 대하여 보고하고자 한다.

• 한국방사선학회논문지
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• 제5권5호
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• pp.267-275
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• 2011

본 연구의 목적은 병원에서 근무하고 있는 방사선사의 업무소진과 업무자율성이 이직의사에 미치는 영향에 대해 분석하였다. 본 연구의 결과를 요약하면, 방사선사의 업무소진과 업무자율성 및 이직의사의 평균값과 표준편차는 전체적인 업무소진은 3.15점을 보여 방사선사의 업무소진은 보통수준 이상인 것으로 나타났으며, 업무자율성에서는 2.88점으로 업무에 대한 자율성이 보통수준에 미치지 못하는 것으로, 이직의사에서는 3.30점으로 이직하려는 경향이 높은 쪽으로 나타났으며, 이직의사에 영향을 미치는 요인 중에서 정서적 소진, 일에 대한 흥미상실, 일에 대한 열의상실이 유의한 영향을 미치는 것으로 나타났다. 방사선사가 방사선검사와 관련하여 자신의 전문지식과 판단을 근거로 방사선 업무를 수행하고, 업무상 의사결정을 충분히 가질 수 있으면서, 적극적으로 참여할 수 있는 환경이 조성되어진다면, 방사선사의 업무소진은 최소화 할 수 있으며, 업무의 자율성을 강화하기 위한 프로그램을 개발하여 적용하게 될 때, 이직의사를 줄이면서 방사선 인력관리 및 방사선사의 질적인 면을 향상시켜, 병원 조직 내에서 방사선사의 위상을 높일 수 있을 것으로 사료된다.

• Journal of Chest Surgery
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• 제8권1호
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• pp.19-28
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• 1975

The thoracoscopic study was reported on 21 cases of spontaneous pneumothorax requiring surgical management, and clinical values of thoracoscopic examination on spontaneous pneumothorax were also discussed. patients were treated in the Department of .Thoracic Surgery, Hanyang University Hospital for the period of two Years from May 1972 to April 1974. For exact detection of etiologic factors on spontaneous pneumothorax, the thoracoscopic examination in the intrapleural space was performed in parallel with X-ray study. this study, the difference of diagnostic and therapeutic significance between radiological and thoracoscopic findings were observed and compared simultaneously. The results are summerized as follows: Patients age was distributed between 3 and 70 years old with highest incidence in the age group of sixty decade [33. 3%], and sex ratio of male to female was 5:2. The tuberculous processes which developed superficial subpleural layer in the lung parenchyme, on the pulmonary surface could be observed by thoracoscopic examination in a characteristic picture. detection ratio of pulmonary tuberculosis by the radiologic study to that by thoracoscopy was 8:2. The adhesion between the visceral and the parietal pleura which could possibly make a rupture of the alveola and the visceral pleura was found to be localized in a small area of the lung surface. The other part of the lung surface was free of the adhesion and, therefore, the movement of the lung took place completely without any difficulty. The ruptured orifice of the pleura and pathological changes surrounding the orifice can be detected by thoracoscopy, but not by other means such as radiologic examination. A single tuberculous bleb and multiple emphysematous blebs were found on 6 cases out of 21 cases of spontaneous pneumothorax. Among these cases, radiologic Study revealed the bleb only in one patient. On the other hand, the blebs were found in all the six patients by means of thoracoscopic examination. It gives the detection ratio of bleb by radiologic study to that by thoracoscopy was 1:6. By thoracoscopy, the rupture on the lung surface were visualized on the 10 patients out of a total of 21 patients [10 patients of visual rupture]. However, the rupture of the pleura was not observed on the rest of 11 patients even by thoracoscopic examination [11 patients of non visual rupture]. Five patients [50%] out of ten who had the visual rupture on the lung surface was required a surgical operation to remove pneumothorax. For the patients who were detected to have the visual rupture of the pleura by thoracoscopy, be considered in the early stage of closed thoracostomy. of 21 patients, 16 patients [11 patients of non visual rupture of the pleura and 5 patients of visual rupture of the pleura] who received no surgical management, were treated with closed thoracostomy with continuous suction, and the` pneumothorax was healed completely up in each cases. Therapeutic measures for the remaining 5 patients of visual rupture of the pleura who were subjected to surgical approach for radical treatment of spontaneous pneumothorax were accordingly complicated, and the following different procedures were properly indicated case by case, that is, rib resection thoracostomy, simple closure of ruptured visceral pleura, wedged resection of the lung, and lobectomy.

• Journal of Korean Neurosurgical Society
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• 제61권2호
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• pp.212-218
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• 2018

Objective : Surgical clipping of the cerebral aenurysm is considered as a standard therapy with endovascular coil embolization. The surgical clipping is known to be superior to the endovascular coil embolization in terms of recurrent rate. However, a recurrent aneurysm which is initially treated by surgical clipping is difficult to handle. The purpose of this study was to research the management of the recurrent cerebral aneurysm after a surgical clipping and how to overcome them. Methods : From January 1996 to December 2015, medical records and radiologic findings of 14 patients with recurrent aneurysm after surgical clipping were reviewed retrospectively. Detailed case-by-case analysis was performed based on preoperative, postoperative and follow-up radiologic examinations and operative findings. All clinical variables including age, sex, aneurysm size and location, type and number of applied clips, prognosis, and time to recurrence are evaluated. All patients are classified by causes of the recurrence. Possible risk factors that could contribute to those causes and overcoming ways are comprehensively discussed. Results : All recurrent aneurysms after surgical clipping were 14 of 2364 (0.5%). Three cases were males and 11 cases were females. Mean age was 52.3. At first treatment, nine cases were ruptured aneurysms, four cases were unruptured aneurysms, and one case was unknown. Locations of recurrent aneurysm were determined; anterior communicating artery (A-com) (n=7), posterior communicating artery (P-com) (n=3), middle cerebral artery (n=2), anterior cerebral artery (n=1) and basilar artery (n=1). As treatment of the recurrence, 11 cases were treated by surgical clipping and three cases were treated by endovascular coil embolization. Three cases of all 14 cases occurred in a month after the initial treatment. Eleven cases occurred after a longer interval, and three of them occurred after 15 years. By analyzing radiographs and operative findings, several main causes of the recurrent cerebral aneurysm were found. One case was incomplete clipping, five cases were clip slippage, and eight cases were fragility of vessel wall near the clip edge. Conclusion : This study revealed main causes of the recurrent aneurysm and contributing risk factors to be controlled. To manage those risk factors and ultimately prevent the recurrent aneurysm, neurosurgeons have to be careful in the technical aspect during surgery for a complete clipping without a slippage. Even in a perfect surgery, an aneurysm may recur at the clip site due to a hemodynamic change over years. Therefore, all patients must be followed up by imaging for a long period of time.

• Journal of Yeungnam Medical Science
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• 제14권2호
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• pp.393-398
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• 1997

1987년 5월에서 1997년 10월까지의 영남대학교 의과대학 부속병원에서 임상적으로 선천성 중장 회전 이상을 의심하여 방사선학적으로 진단되고 수술을 시행한 17명의 환아를 대상으로 임상소견과 수술 기록 및 방사선학적 소견을 후향적으로 분석한 결과는 임상적인 주된 증상은 구토나 구토를 동반한 복통이었으며, 수술 소견상 16명의 환아에서 선천성 중장 회전 이상이 확진되었고, 1명의 환아에서 중장 회전 이상 없이 윤상 췌장으로 진단되었다. 모든 환아에서 상부 위장관 조영술과 바륨 관장술을 시행한 결과, type I인 경우가 3명, type IIA가 2명, type IIC가 1명, type IIIA가 5명, type IIIc가 4명이었으며 이중에서 type IA로 진단된 1명은 수술 소견상 윤상 췌장으로 확인되었다. 수술로 확진된 16명의 환아중 13명은 상부 위장관 조영 소견에서 선천성 중장 회전 이상이 진단되었고 3명의 환아에서는 상부 위장관 조영 소견은 확실하지 않았으나 바륨 관장 소견상 선천성 중장 회전 이상이 증명되었다. 결론적으로 선천성 중장 회전 이상은 중장 염전과 장 괴사와 같은 치명적인 합병증으로 출생 첫 주에 높은 사망률을 보이기 때문에 조기 진단이 매우 중요하며, 임상적으로 선천성 중장 회전 이상이 의심되면 상부 위장관 조영술을 먼저 실시해야 하고 십이지장 공장 접합부가 정상적으로 위장 유문부와 같은 축상에 있는지 우측 측사위 촬영에서 확인해야된다. 비록 정상 소견을 보일지라도 위음성이 있을 수 있으므로 반드시 바륨 관장술을 실시해서 압박, 사위, 좌측와위 촬영에서 맹장과 회장 말단부의 위치를 확인해야 될 것으로 생각된다.

• Journal of Korean Neurosurgical Society
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• 제30권2호
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• pp.194-200
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• 2001

Object : Anterior cervical discectomy and fusion is accepted as appropriate surgical intervention for disease processes of the ventral cervical spine. In some cases, however, improvement of symptom following operation develop myelopathy or rhizopathy at longterm follow-up. We studied to clarify the correlation between clinical results and plain radiologic findings at long term follow-up. Methods : A total of 86 patients who underwent anterior cervical discectomy and fusion were grouped into deteriorated and good recovery group. These two groups were compared in lateral functional roentgenograms on the cervical kyphosis and disc height at fused level, sagittal plane rotation and dynamic sagittal canal diameter at adjacent level. Results : The presence of cervical kyphosis and disc height at fused level do not correlate with long term followup results. Sagittal plane rotation of more than 20 degrees were identified in 36% of the cases in deteriorated group, whereas the same findings were identified in 15% of the cases in good group. Sagittal diameter of less than 12mm were identified in 48% of the cases in deteriorated group, whereas the same finding were identified in 8% of the cases in good group. Preoperatively, sagittal plane rotation of more than 20 degrees at adjacent level were identified in 28% of the cases in deteriorated group, whereas the same findings were identified in 13% of the cases in good group. Preoperatively sagittal diameter of less than 12mm at adjacent level were identified in 40% of the cases in deteriorated group, whereas the same finding were identified in 7% of the cases in good group. Conclusion : Large sagittal plane rotation and small dynamic sagittal diameter at adjacent level were factors that might be associated with later clinical deterioration after cervical anterior fusion.

• Korean Journal of Radiology
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• 제2권3호
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• pp.138-144
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• 2001

Objective: Bronchogenic carcinoma can mimic or be masked by pulmonary tuberculosis (TB), and the aim of this study was to describe the radiologic findings and clinical significance of bronchogenic carcinoma and pulmonary TB which coexist in the same lobe. Materials and Methods: The findings of 51 patients (48 males and three females, aged 48-79 years) in whom pulmonary TB and bronchogenic carcinoma coexisted in the same lobe were analyzed. The morphologic characteristics of a tumor, such as its diameter and margin, the presence of calcification or cavitation, and mediastinal lymphadenopathy, as seen at CT, were retrospectively assessed, and the clinical stage of the lung cancer was also determined. Using the serial chest radiographs available for 21 patients, the possible causes of delay in the diagnosis of lung cancer were analyzed. Results: Lung cancers with coexisting pulmonary TB were located predominantly in the upper lobes (82.4%). The mean diameter of the mass was 5.3 cm, and most tumors (n=42, 82.4%) had a lobulated border. Calcification within the tumor was seen in 20 patients (39.2%), and cavitation in five (9.8%). Forty-two (82.4%) had mediastinal lymphadenopathy, and more than half the tumors (60.8%) were at an advanced stage [IIIB (n=11) or IV (n=20)]. The average delay in diagnosing lung cancer was 11.7 (range, 1-24) months, and the causes of this were failure to observe new nodules masked by coexisting stable TB lesions (n=8), misinterpretation of new lesions as aggravation of TB (n=5), misinterpretation of lung cancer as tuberculoma at initial radiography (n=4), masking of the nodule by an active TB lesion (n=3), and subtleness of the lesion (n=1). Conclusion: Most cancers concurrent with TB are large, lobulated masses with mediastinal lymphadenopathy, indicating that the morphologic characteristics of lung cancer with coexisting pulmonary TB are similar to those of lung cancer without TB. The diagnosis of lung cancer is delayed mainly because of masking by a tuberculous lesion, and this suggests that in patients in whom a predominant or growing nodule is present and who show little improvement of symptoms despite antituberculous or other medical therapy, coexisting cancer should be suspected.

• Clinical and Experimental Pediatrics
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• 제52권4호
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• pp.458-463
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• 2009

목 적 : 뇌갈림증은 연질막 표면에서 외측 뇌실까지 대뇌 피질이 갈라져 열구를 이루며 회색질로 둘러 싸여 있는 드문 대뇌 기형으로서 본 연구에서는 국내 소아에서 발생한 뇌갈림증 환아의 임상양상, 방사선 소견에 대해 전반적으로 고찰하여 질환의 특징을 알아보고자 하였다. 방 법 : 2005년 1월부터 2007년 12월까지 세브란스 어린이 병원과 영동 세브란스 병원 소아과에 방문 및 입원 치료한 뇌갈림증 환자 13예의 환아를 대상으로 의무 기록을 후향적으로 고찰하였다 결 과 : 진단 시의 연령은 0-30개월 사이로 평균 연령은 $9.08{\pm}9.61$ 개월이었고, 남녀비 3.33:1로 남아에서 호발 하였다. 뇌갈림증은 일측성이 8예(61.5%), 양측성이 5예(38.5%)였고, 개방형이 4예(30.8%), 폐쇄형이 5예(38.5%), 개방형과 폐쇄형 모두 보이는 혼합형이 4예(30.8%)였다. 모든 환아에서 다른 뇌기형이 동반되었는데 투명 중격 결손이 9예(69.2%), 거미막 낭종이 4예(30.8%), 시신경 형성 부전이 4예(30.8%), 대뇌 피질 형성부전이 4예(30.8%), 뇌실 확장이 3예(23.1%), 뇌량 무형성이 1예(7.7%) 순이었다. 운동장애는 편측 근력 약화는 모든 유형에서 관찰되었고 편마비는 4예에서 사지마비는 3예에서 관찰되어 열구의 유형과 운동 장애의 정도의 상관관계는 알아 볼 수 없었다. 발달 지연이 모든 환아에서 조사되다. 간질 발작은 13예의 환아 중 7예(53.8%)에서 발병하였는데 일측성에서 5예, 양측성에서 2예로 조사되었고 그 중 난치성 간질은 3예(42.8%)였다. 결 론 : 우리나라 소아에서 뇌갈림증의 임상 양상과 신경영상 소견은 열구의 위치, 유형 및 동반기형에 따라 매우 다양하게 나타났다. 뇌갈림증의 조기 진단과 간질 발생에 대한 주의 깊은 관찰이 반드시 필요하며 이와 관련된 보다 많은 환자군을 대상으로 하는 심도 있는 연구가 장기적으로 이루어 져야 할 것이다.