위에 생긴 이소성 췌장의 진단에 있어 경구 조영제로 물을 사용한 후 조영증강 역동적 CT의 가치

조준식,신경숙 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.2

To describe the usual and unusual CT findings of heterotopic pancreatic of the stomach and to evaluate the usefulness of dynamic contrast-enhanced CT with water as an oral contrast agent in diagnosing heterotopic pancreas We retrospectively reviewed CT findings in 10 patients with pathologically proved gastric heterotopic pancreas by operation (n=9) or endoscopic resection (n=1). In three patients, conventional CT with diluted Gastrografin solution as an oral contrast agent was performed. In seven patients, two-phase dynamic CT scans after ingestion of 600-800 ml of water were obtained in the early phase and equilibrium phase. Dynamic CT findings of heterotopic pancreas were correlated with histopathologic findings. All 10 heterotopic pancreatic rests were detected with conventional CT or dynamic CT. In seven cases who underwent dynamic CT after ingestion of water, highly enhanced mucosal layers overlying the lesions were identified and all lesions were well delineated in the submucosal layer In four of these seven cases, heterotopic pancreas showed high enhancement similar to that of adjacent normal pancreatic enhancement in the early phase of dynamic CT. The usual CT findings of gastric heterotopic pancreas were oval-shaped submucosal masses (<3cm) in the gastric antrum. The unusual CT findings were infiltrating heterotopic pancreas into the muscle layer in one, cystic dilatation of heterotopic pancreatic ducts in two, and malignant change with mucin secreting cystadencoarcinoma in one. Gastric heterotopic pancreas usually showed oval-shaped submucosal masses (<3cm) in the gastric antrum with high enhancement similar the that of pancreatic enhancment in the early phase of dynamic CT. Our results suggest that contrast-enhanced dynamic CT after ingestion of water may be helpful in diagnosing gastric heterotopic pancreas.

풍선확장술을 이용한 간내 잔류담석의 경피적 제거술 : Percutaneous Management with Balloon Dilatation and Stone Extraction

조준식,송창준 충남대학교 의과대학 지역사회의학연구소 1992 충남의대잡지 Vol.19 No.1

Recurrent pyogenic cholangitis is frequently relapsed with residual intrahepatic stones and biliary strictures after surgical treatment. Percutaneous removal of residual intrahepatic stones is an effective alternative for second operation which has a high mortality and morbidity. However, the successful extraction of intrahepatic stones may be difficult because of a high frequency of associated biliary strictures. We evaluated the effectiveness of percutaneous balloon dilatation in six patients who were difficult to extract residual intrahepatic stones due to biliary strictures. Balloon dilatation using angioplasty balloon catheter was performed via a T-tube tract. In four of six patients, balloon dilatation was successful and partially successful in two patients due to reccurence of stricture. Stone extraction was complete in three patients, incomplete in two patients, and failed in one patient. The reason of incomplete removal and failure were large sized stones and impacted stones in the intrahepatic ducts. There was no complication. In conclusion, percutaneous balloon dilatation is an effective procedure for extraction of residual intrahepatic stones associated with intrahepatic biliary strictures.

진행위암의 수술전 병기결정에서 문맥기 나선식 CT의 유용성 : Usefulness of Helical CT during the Portal Venous Phase

조준식,신경숙 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.2

The purpose of this study was to evaluate the effect of helical CT during the portal venous phase after oral ingestion of water in the preoperative staging of advanced gastric carcinomas. Of the patients underwent helical CT scanning for preoperative staging of gastric carcinoma, 70 patients with pathologically proved advanced gastric carcinomas were selected in this study. The patients ingested 600-800m1 of water as a oral contrast agent before CT scanning. A total 130150ml of nonionic contrast material was administered at the rate of 4ml/s. We obtained portal venous phase images at 60 s and equilibrium phase images at 3 min after the start of bolus administration of intravenous contrast material. Two-phase CT findings were prospectively evaluated and correlated with histopathologic findings according to TNM classification. The primary tumors were detected on CT scans in 69 (98.5%) of 70 cases. The accuracy of CT for T staging was 74.3% (52 of 70 cases). T staging was understaged in 13 cases (18.6%) and overstaged in five (7.1%). The accuracy for N staging was 67.1% (47 of 70 cases). N staging was understaged in 16 cases (22.9%) and overstaged in seven (10%). Our results suggest that helical CT during the portal venous phase can improve the accuracy of CT in the preoperative staging of advanced gastric carcinomas.

급성 폐쇄성 담관염의 치료에서 경피적 담배액술의 역할

조준식,김충현 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2

Acute obstructive cholangitis may manifest clinically from mild to severe suppurative form. Percutaneous biliary drainage (PBD) provide alternative for nonoperative biliary decompression in acute obstructive cholangitis. We analyzed our experience of PBD in 35 patients with acute obstructive cholangitis. The underlying diseases were 26 maliganant tumors and 9 benign diseases. Acute suppurative cholangitis occurred in 11 of 35 patients and the causes were 6 benign disases due to bile duct stone and 5 maliganant tumors. PBD was performed succssfully in 32 of 35 patients, 29 patients were managed effectively, partial success in 3 patients, and failed in 3 patients as a result of septic shock and biliary-portal venous fistula. Palliative PBD for advanced malignant tumor underwent in 19 patients and preoperative PBD underwent in 13 patients. Successful surgery after effective biliary decompression was performed in 12 of 13 patients who underwent preoperative PBD. This analysis suggest that PBD is initial treatment of choice for acute suppurative cholangitis and can be performed safely in acute obstructive cholangitis for palliative or preoperative management.

복부농양 및 액체저류의 경피적 카테타 배액술

조준식 충남대학교 의과대학 지역사회의학연구소 1988 충남의대잡지 Vol.15 No.2

Percutaneous catheter drainage using a combination of US, CT and fluoroscopic guidance has become the treatment of choice for various abdominal abscesses and fluid collections. It is an important alternative to surgical treatment because of its high success rate, low mortality rate and low complication. The Author analyzed the results of percutaneous catheter drainage in 30 patients with abdominal abscesses and fluid collections at Chungnam National University Hospital from May 1986 to Aug. 1988. The results were as follows: 1. Successful drainage of the collection with avoidance of operation was achieved in 24/30 (80%) patients and partial success in 3 patients among 6 failures and recurrences 2. There were 2 failures and 4 recurrence and these were due to phlegmon, organized tissue, multiplicity, fistulae, or underlying tumor. 3. Comlication was minor in most cases 4. The overall, complete and partial success rate was 90%, failure rate was 6.7% and recurrent rate was 13.3%.

플렉서블 실리콘 박막 태양전지 기술

조준식 한국공업화학회 2010 한국공업화학회 연구논문 초록집 Vol.2010 No.1

위암에 의한 간 전이의 CT 진단에 있어 조영제의 급속 정맥주사방법을 이용한 문맥기 역동적 CT의 유용성 : Usefulness of Bolus Dynamic CT During Portal Phase

조준식,송창준,김종철,이병철 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

Purpose : We evaluated the usefulness of dynamic CT during portal phase with faster injection rate of contrast material in detecting hepatic metastases from gastric cancers. Subjects and Methods : We retrospectively analyzed two-phase dynamic CT findings (portal phase and equilibrium phase) in 17 patients with pathologically proven gastric cancers and hepatic metastases. In 13 patients, a total of 150ml of nonionic contrast material was administered with a power injector at a flow rate of 5ml/sec for 30 sec, and two-phase images were obtained at 45-70 sec (portal phase) and 2-4 min (equilibrium phase) after the start of bolus injection. In four patients, two-phase dynamic CT with spiral technique was performed with the same method. Results : In cases of metastases less than 1 cm in diameter, 65 lesions were detected in the portal phase that showed clearly defined hypodense lesions in highly enhanced hepatic parenchyma. Whereas, only nine (14%) lesions were detected in the equilibrium phase and the remaining 56(86%) lesions showed isoattenuation. In cases of metastases more than 1 cm in diameter, 37 lesions were detected in the portal phase that showed clearly defined hypoattenuations. whereas, the images of equilibrium phase showed isoattenuation in five (14%), mixed attenuation in three (8%), and hypoattenuation in 29 (78%). The lesions detected in the equilibrium phase showed poorly defined hypodense lesions and tended to decrease in size due to peripheral enhancement of lesions. Conclusion : Dynamic CT during portal phase with faster injection rate of IV contrast material is an useful technique in detecting hepatic metastases from gastric cancers, particularly small lesions less than 1 cm in diameter.

AERI를 이용한 MetOp/IASI 위성 온습도 프로파일의 비교 검증

조준식,구태영,신진호,이종호 한국기상학회 2015 한국기상학회 학술대회 논문집 Vol.2015 No.4

낭변성을 일으킨 장간막부신경절종:증례 보고

조준식,신경숙,노승무,강대영,Jo, Jun-Sik,Sin, Gyeong-Suk,No, Seung-Mu,Gang, Dae-Yeong 대한영상의학회 2003 대한영상의학회지 Vol.49 No.3

부신외의 부신경절종은 드물며, 대부분 교감신경쇄를 따라 대동맥주위에 위치한 부신경절조직이 풍부한 Zuckerkandl 기관에서 발생한다. 그러나 정상 부신경절조직이 Zuckerkandl 기관의 상부경계가 되는 장간막근에도 존재할 수 있으며, 장간막에서도 매우 드물게 부신경절종이 생길 수 있다.저자들은 장간막에서 기원하여 낭변성을 일으킨 부신경절종 1예의 전산화단층촬영소견과 병리조직소견을 보고한다. Extra-adrenal abdominal paragangliomas are rare. Most arise from the organs of Zuckerkandl, involve large concentrations of paraganglionic tissue, and are located in the para-aortic space along the sympathetic chain. Published reports have, however, described normal paraganglionic tissue at the root of the mesentery which serves as the superior limit of the organs of Zuckerkandl, and mesenteric paraganglioma is very rare. We report a case of paraganglioma with cystic degeneration arising from the mesentery.

1992년도 춘계 학술강연 및 발표대회 개요 - 재료강도 ( 발표 22 ) : 기계합금화로 제조된 Ni 기 초내열합금의 고온거동

조준식,권숙인 대한금속재료학회 ( 구 대한금속학회 ) 1992 대한금속재료학회 학술대회 개요집 Vol.1992 No.1