경복정맥 간내문맥-간정맥 단락술의 교정

염현규 대한영상의학회 1997 대한영상의학회지 Vol.36 No.3

급성 담낭염전의 방사선학적 소견: 증례 보고

김성훈,김종열,염현규 대한영상의학회 2004 대한영상의학회지 Vol.51 No.3

Torsion of the gallbladder is a rare and acute abdominal condition. Even with the recent advances in radiologic imaging modalities, it is difficult to make a correct preoperative diagnosis of gallbladder torsion. We recently experienced a case of gallbladder torsion at the body portion in which an accurate preoperative diagnosis could be made on the gray scale and by using color Doppler ultrasonography. We report the imaging and operative findings with particular emphasis on the ultrasonographic“ whirlpool sign”. 급성 담낭염전은 급성 복증을 일으키는 매우 드문 질환이다. 영상진단 방법이 발달한 최근까지도 수술전에 정확한 진단을 하기가 어려운 것으로 알려져 있다. 저자들은 우상복부 통증으로 내원한 87세 여자 환자에서 초음파 및 전산화단층촬영으로 수술전에 진단을 할 수 있었던 한 예를 경험하였기에 이에 영상소견을 수술 소견과 비교하여 보고하며 특히 초음파에서 보인 와류증후를 강조하여 보고하고자 한다.

다낭성 종괴로 나타난 대망 기원의 위장관 외 간질종양: 증례 보고

고은숙,배경수,전경녀,김재수,유진종,염현규,이종실 대한영상의학회 2004 대한영상의학회지 Vol.51 No.5

Extragastrointestinal stromal tumor (EGIST) has been reported to occur only rarely, and the cases of this disease appearing as cystic masses are also known to be very infrequent. Along with a review of the related articles, we report here on a case of EGIST arising from the omentum that was seen as a multiloculated large cystic mass with multiple thick septa and a solid component. 위장관외 간질종양(extragastrointestinal stromal tumor, EGIST)은 드문 것으로 보고되어 있으며 낭성 종괴로 나타나는 빈도 또한 매우 낮다. 저자들은 대망에 생긴 커다란 낭성 종 괴로 내부에 격막과 고형성분이 보이는 EGIST를 경험하였기에 문헌고찰과 함께 보고하고자 한다.

고립 골낭 : 스테로이드 주사후 방사선학적 소견의 변화

김건우,서경진,박일형,김경호,전경녀,김용선,이상권,염현규,이종민,김용주,강덕식 경북대학교 의학연구소 1999 경북대학교병원의학연구소논문집 Vol.3 No.1

목 적 : 고립골낭내 스테로이드 주사후 방사선학적 소견의 변화와 임상적 의의를 알아보고자 하였다. 대상 및 방법 :단순촬영, 컴퓨터단층촬영(CT) 및 자기공명영상(MRI)을 시행하고 수술로 진단된 고립골낭 중 골낭내에 스테로이드(methylpredinisolone acetate, MPA)를 주사한 12예를 대상으로 하여 후향적으로 방사선학적 변화를 조사하였다. 전례에서 MPA를 1회에 80-200mg을 1--7회까지 골낭내에 주사하였다. 추적 검사기간은 3-50개월(평균 20개월)이었으며, 추적검사로 전례에서 단순촬영과 4예에서 CT를 시행하였다. 결 과 : 고립골낭의 병소에 MPA 주사후 단순촬영 소견의 변화는 낭내 방사선 음영의 증가 10예, 골낭크기의 감소 7예, 골낭주위 얇아진 피질의 두께 증가 8예, 그리고 이중윤상형 음영을 보인 경우가 4예였다. CT 소견의 변화는 CT를 시행한 4예 모두에서 낭내 방사선 음영의 증가. 골낭 크기의 감소와 이중윤상형 음영이 보였으며, 12예 전 예에서 동통의 감소가 관찰 되었다. 결 론 : 고립골낭의 스테로이드 주사후 대부분 임상과 방사선학적으로 치유의 변화를 보여 효과적인 치료 방법으로 생각되며 단순촬영과 CT에서 이중윤상형 음영이 보이는 전 예에서 치유 과정을 보여 이중윤상형 음영은 치료 효과와 예후를 예측하는 요소로 생각된다. Purpose : To evaluate radiographic changes and clinical effects after the injection of steroid injec-tion into simple bone cyst Materials and Methods : We analyzed plain radiographic and CT findings after the injection of steroid (methylprednisolone acetate, MPA) into simple bone cyst. Twelve patients were involved eight were males and four were females, and their ages ranged from 6 to 41 years. They were treated from one to seven times with an intracystic injection of MPA, 80-200mgs per injection. All patients were evaluated by plain film, and four by CT, and the mean follow-up period was 20 months. Results : Postinjection plain radiographic findings were as follows : increased internal radiodensity (n= 10), smaller cyst (n=8), cortical thickening (n=7), and radiodensity of double rings pattiern (n=4). CT findings were as follows : increased internal attenuation (n=4), smaller cyst (n=4) and radiodensity of double ring pattern along the cyst wall (n=4). All patients improved clinically and radiologically, especially those with radiodensity of double ring pattern. Conclusion : The injection of steroid into simple bone cyst is an effective treatment. A new radio-Graphic finding after injection is radiodensity of double ring pattern along the cyst wall, and we believe that this indicates progression of the healing process.

복수를 동반한 간경변증에서 뇌혈류저항의 증가

김성국,김종렬,최용환,정준모,전성우,권영오,이응주,탁원영,염현규 대한간학회 1999 Clinical and Molecular Hepatology(대한간학회지) Vol.5 No.1

Background/Aims : Portal hypertension in cirrhosis is associated with a hyperdynamic circulation, which is characterized by hypervolemia, high cardiac output, arterial hypotension and low peripheral vascular resistance. These circulatory abnormalities are thought to be secondary to a splanchnic arteriolar vasodilation related to the increase in portal pressure. Studies assessing regional hemodynamics in patients of cirrhosis with ascites have shown vasoconstriction in the renal circulation and in peripheral vascular territory. This study was designed to assess the cerebral vascular resistance in cirrhotic patients with ascites. Methods : The resistive index in the middle cerebral artery and in a renal interlobar artery were measured by Doppler ultrasonography in 12 cirrhotic subjects without ascites, 23 cirrhotic subjects with ascites, and 8 healthy subjects. The arterial blood pressure and plasma renin and norepinephrine concentration, which reflect the activity of the renin-angiotensin and sympathetic nervous systems respectively, were also measured. Results : The resistive index in the middle cerebral artery were significantly higher in cirrhotic patients with ascites (0.58±0.04, mean standard deviation) than in cirrhotic patients without ascites (0.53±0.02, P$lt;0.01) and in control subjects (0.50±0.05, P$lt;0.01). The resistive index in the middle cerebral artery showed direct correlation with renal resistive index (r = 0.52, P$lt;0.01), plasma renin activity (r = 0.44, P$lt;0.01) and norepinephrine (r = 0.33, P$lt;0.05). The resistive index in the middle cerebral artery showed an inverse correlation with mean arterial pressure (r = -0.59, P$lt;0.01). Conclusion : The results suggest that in patients of cirrhosis with ascites, independent of the amount of ascites, there is a cerebral vasoconstriction which is related with the arterial hypotension and the overactivity of vasoconstrictor systems. (Korean J Hepatol 1999;5:33-42)

췌장 가성 낭종의 수술적 치료와 경피적 배액술의 비교

김준우(Jun Woo Kim),황윤진(Yoon Jin Hwang),윤영국(Young Kook Yun),염현규(Hun Kyu Ryeom),김용주(Yong Joo Kim) 대한외과학회 1997 Annals of Surgical Treatment and Research Vol.53 No.1

담도 질환에서 자기공명영상 담도췌관조영술과 내시경적 역행성 담도췌관조영술의 비교

정준모,김현수,하승수,박재홍,이종협,조창민,박수영,권영오,탁원영,정민규,김성국,최용환,염현규 대한소화기내시경학회 2001 Clinical Endoscopy Vol.22 No.3

Background/Aims: This study was performed to evaluate the diagnostic accuracy and clinical applications of magnetic resonance cholangiopancreatography (MRCP) compared with endoscopic retrograde cholangiopan - creatography (ERCP). Methods: Prior to carrying out ERCP, MRCP was performed on 71 patients and the two examinations were compared using a double blank test, Results: The results revealed that 15 patients had choledocholithiasis, 4 gall bladder stones, 28 cholangiocarcinomas, 12 pancreatic head cancers, 2 ampulla of Vater cancers, 1 gall bladder cancer with ductal invasion, 4 other benign diseases and 5 normal conditions. For the patients with choledocholithiasis, the values of MRCP's sensitivity, specificity and accuracy were 100%, 9S.2% and 98.6%, respectively, and those of ERCP's were all 100%, For the patients with malignant obstructions, the values of MRCP's sensitivity, specificity and accuracy were 90.7%, 100% and 94.4%, respectively, and the values of ERCP's were 95.3%, 92.9% and 94.4%. Conclusions: These data show that MRCP has a rather high sensitivity, specificity and accuracy in the diagnosis of the biliary tract system, and therefore MRCP can be substituted for ERCP in the aspect of diagnosis.

간의 국소 결절성 과형성 1예

김성국,이영두,이승엽,최용환,박언휘,탁원영,조창민,배한익,염현규,권영오,정준모 대한간학회 2000 Clinical and Molecular Hepatology(대한간학회지) Vol.6 No.4

Focal nodular hyperplasia (FNH) is a rare benign hepatic tumor occurring predominantly in women of childbearing age. Generally oral contraceptive is not associated with FNH but might accentuate the vascular abnormalities which may cause the lesion to enlarge and, very rarely, to rupture. FNH is typically asymptomatic and seldom bleeds. Often it is incidentally observed during imaging procedures performed for some other reasons. The histologic feature of FNH is characterized by areas of localized growth of mature hepatocytes and septal fibrosis. Surgical resection is seldom required because of the benign nature of the lesion and its lack of significant complication. We experienced a case of focal nodular hyperplasia without liver cirrhosis confirmed by surgical resection and histologic examination. in a 47-year-old man..(Korea J Hepatol 2000;6:524-529).

비신생물성 질환에 대한 췌십이지장 절제술의 안정성 및 수술 후 삶의 질에 대한 평가

은영아(Young A Eun),김상걸(Sang Geol Kim),윤혁진(Hyuk Jin Yun),김종렬(Jong Yeol Kim),김갑철(Gab Chul Kim),염현규(Hyun Kyu Ryeom),김성희(Sung Hi Kim),황윤진(Yun Jin Hwang),윤영국(Young Kook Yun) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.73 No.1

Purpose: Pancreaticoduodenectomy for mass-like lesions that are suspicious of malignancy sometimes reveals only nonneoplastic disease, especially in those cases where adequate tissues for biopsy are unavailable. In this study, we evaluated the outcomes and quality of life (QOL) after pancreaticoduodenectomy for treating nonneoplastic disease. Methods: The clinical data of 28 patients who underwent pancreaticoduodenectomy for nonneoplatic disease and trauma from Jan. 1992 to Feb. 2006 were reviewed retrospectively. The QOL was evaluated using the FACT-Hep questionnaire. The patients who underwent laparoscopic cholecystectomy for benign gallbladder disease were utilized as the control group. Results: 13.8% (28/203) of all the pancreaticoduodenectomized patients had nonneoplatic disease and trauma. Male patients were predominant (25/28) and all the trauma patients were male. The mean age was 48 (23∼72) years old. The indications for surgery included lesions suspicious for malignancy (16 cases), pancreaticoduodenal artery aneurysm (1 case), and pancreatoduodenal injury (11 cases). The histologic findings of the nonneoplastic lesions revealed benign inflammation of the bile duct (6 cases), chronic pancreatitis (8 cases), pancreatic pseudocyst (1 case), and fibrosis of the Ampulla of Vater (1 case). No surgical mortality occurred. However, the trauma patients group had higher morbidity (72.7% Vs 23.5%, respectively, P=0.01) and a longer hospital stay (68.0 days Vs 32.6 days, respectively, P=0.02) after surgery compared to the nonneoplastic disease patient group. The QOL of the patient who underwent pancreaticoduodenectomy for nonneoplatic disease was not different from that of the control group. Conclusion: Since pancreaticoduodenectomy for nonneoplastic disease was safe and the QOL of the patients was acceptable, it should be performed more often when malignancies can not be excluded from the differential diagnosis.

간 14 : 복수를 동반한 간경변증에서 뇌혈류저항의 증가

전성우(S . W . Jeon),조재현(J . H . Cho),권혁만(H . M . Kwon),금민수(M . S . Geum),최정일(J . I . Choi),권영오(Y . O . Kweon),김성국(S . K . Kim),최용환(Y . H . Choi),정준모(J . M . Chung),김종열(J . Y . Kim),염현규(H . G . Ryeom) 대한소화기학회 1998 대한소화기학회 추계학술대회 Vol.1998 No.-