경추 추간판 탈출증의 유형별 자기공명영상 소견

김함겸 대한방사선과학회(구 대한방사선기술학회) 2000 방사선기술과학 Vol.23 No.2

방사선 관련업무 종사자의 개인피복에 관한 연구

김함겸,안규동,이병국 순천향대학교 산업의학연구소 1997 순천향산업의학 Vol.3 No.1

For the purpose of measurement of level of radiation exposure by employees working in fields related to radiation the analysis had been made on the level of radiation exposure for a total of 1875 employees working in radiation related field at 10 university hospitals in Seoul, 6 university hospitals in rural areas, 16 private hospitals (health centers), 5 research agencies, 10 military hospitals, 10 research institutes of industry and 5 firms for non-destructive test works from January 1995 to December 1995 for one year. The result of analysis of radiation exposure for a total of 518 employees working in the field of radiation at university hospitals in Seoul area for the purpose of measurement of radiation exposure based on characteristics of the employees working the the field related to radiation showed the following status: 1. The level of radiation exposure of the employees working in the field related to radiation on the basis of agencies was 6.55-1.89 mSv which is below the level of 20 mSv/y being recommended as average annual reference level for 5 years from International Commitee of Radiation Protection(ICRP). 2. In terms of sequence of exposure level the non-destructive testing firms were highest followed by university hospital, military hospital, general hospital, private hospital(health center), research institute of industry and other research institutes with lesser exposure than preceding ones in this sequence. 3. In terms of difference in exposure by people with different jobs among medical specialist, resident, radiotechnologist,nurse and other visitors to radiation section residents showed highest level of exposure followed by radiotechnologist, nurse and medical specialist with lesser exposure than preceding one in the same sequence. 4. In terms of age levels such as 50s, 40s, 30s and 20s it was revealed that people in their 20s were most exposed to radiation followed by people in 30s, 40s and 50s with lesser exposure than preceding one the same sequence. 5. Result of measuring radiation exposure level by different department such as department of radiology, therapeutic radiology, nuclear medicine and department of clinics and pathology showed that department of radiology had highest level of radiation exposure with 2.83-1.22 mSv followed departments with lesser exposure such as department of nuclear medicine, clinics and pathology etc. and therapeutic radiology. 6. The result of measuring employees at different functions such as general radiography room, computed tomography(CT Room), angiography room and fluoroscopy room, indirect radiography, portable radiography and operation room showed that level of radiation exposure was 9.05-1.25 mSv. Employees for indirect radiography, portable radiography and operation rooms showed highest level of radiation exposure and it is followed by general radiography room, angiography, and fluoroscopy and computed tomography room with lesser degree of radiation exposure than preceding one in the same sequence.

체외충격파쇄석술을 이용한 총담관 및 췌관 결석의 치료

김함겸,손순룡,이원홍 대한방사선과학회(구 대한방사선기술학회) 1998 방사선기술과학 Vol.21 No.1

요추 추간판 탈출증의 유형별 자기공명영상 소견

김함겸 대한방사선과학회(구 대한방사선기술학회) 1999 방사선기술과학 Vol.22 No.1

뇌혈관 질환의 자기공명영상(MRI) 적용에 대한 고찰

김함겸 中央醫學社 1993 中央醫學 Vol.58 No.6

The role of MRI has been already proved about the Intracranial disease. Accordingly, the medical significance lies on the diagnosis of functional and celluar - pathological change rather than that by morphological change achived by the existing CT or X-ray. So, we hereby analize the image in application of MRI to the patient with cranial blood vessel disease and exam ine early the change of hemorrhage by Brain Infarction and Cranial Hemorrhage and also consider the exposed lesion at the Tl Weighted Image and T2 Weighted Image. 1. Parenchymal Hemorrhage 2. Brain Infarction 3. Aneurysm 4. AVM

19) 요추 추간판 탈출증의 유형별 자기공명영상소견

김함겸 대한방사선사협회 1999 대한방사선사협회지 Vol.25 No.1

열공성 뇌경색 환자-대조군에서 신경행동검사의 수행 평가

김함겸,박수경,이건세,김형수,김화선,장성훈,Kim, Ham-Gyum,Park, Sue-Kyung,Lee, Kun-Sei,Kim, Hyeoug-Su,Kim, Wha-Sun,Chang, Soung-Hoon 대한예방의학회 2003 예방의학회지 Vol.36 No.3

전체 뇌졸중의 $15{\sim}20%$를 차지하고 있는 열공성 뇌경색(lacunar infarction)은 최근 뇌경색형 뇌졸중의 증가와 더불어 그 중요성이 점차 증가하고 있는데, 1년 이내 뇌경색이 재발되거나 노인, 고혈압 및 초기 신경학적 이상과 같은 감수성 인자가 있는 경우 뇌경색 재발과 혈관성 치매 발생 위험이 있어 삼차예방적 측면에서의 적절한 처치가 필요한 질병이다. 그렇지만 열공성 뇌경색은 증상이 없거나 경미한 경우가 상당히 많아 환자 자신이 치료의 중요성을 느끼지 못할 뿐 아니라 의사들도 환자의 경미한 신경학적 이상을 인지하지 못하여 처치의 당위성에 대해 설득력있는 근거를 제시할 수 없어 적절한 처치가 미비한 상황이다. 본 연구는 신경학적 자각 증상은 없지만 MRI상 열공성 뇌경색으로만 진단된 환자군이 MRI상 이상소견이 관찰되지 않는 대조군에 비하여 신경행동 검사상 차이가 관찰될 것이라는 가설을 구명하고자 하였다. 따라서 뇌졸중의 증상 및 증후 없이 두개골 외상 혹은 두통, 경부강직 등과 같은 신경학적 이상으로 MRI를 촬영한 대상자 중에서 다른 이상 없이 열공성 뇌경색으로만 진단될 환자군과 특별한 이상 소견이 없는 것으로 진단된 대조군에서 WHO의 NCTB(neurobehavioral core test battery)검사의 일부와 Perdue pegboard score검사를 시행하였고, 그 결과 대조군에 비해 환자군의 신경행동 이상이 평균 및 가장 빠른 단순반응시간 검사를 제외한 5개 검사에서 관찰되었다. 본 검사의 결과는 자각 증상이 없거나 경미한 증상을 호소하는 열공성 뇌경색 환자들의 차후 필요한 검사의 선별과 삼차 예방적 측면에서 처치의 근거로서 활용될 수 있을 것이다. 또한 자각 증상이 없거나 경미한 증상이 있지만 진찰상 신경학적 이상 증후를 거의 찾을 수 없는 대상자에서 MRI검사 필요성의 근거를 확인하고자 하는 대상자에게 이용될 수 있을 것으로 사료된다. Objectives : We carried out tests for neurobehavior by using WHO-NCTB (neurobehavioral core test battery) and Perdue pegboard score test to identify differences between lacunar infarction cases and controls. Methods : Among the subjects who underwent MRI between February 2001 and March 2002 in a university hospital located in Seoul and who were diagnosed only as lacunar infarction without any intracranial disease, 46 patients were selected as cases (male: 21, female: 25). Controls were selected who had no cerebrovascular disease on MRI by matching age (5 years), gender, and education (2 years) in a ratio of 1:1 , Among WHO-NCTB, the following 5 tests and Perdue pegboard score test were used to categorize the study subjects: digit and symbol matching, simple reaction time, Benton visual retention, digit span, and Pursuit aiming test, Results : Among the above 6 tests of neurobehavior, lacunar infarction cases showed lower score than controls except for the simple reaction time test. As the controlling variables of multivariate analysis in the stepwise regression analysis, the followings were selected due to their significant association: age, education, BMI, gender, drinking, exercise, add systolic blood pressure. From multivariate regression analysis, there was significant difference (p<0.05) between lacunar infarction cases and controls in digit and symbol matching, Benton visual retention, digit span, pursuit aiming, and Perdue pegboard score test, but not in the score of simple reaction time test. Conclusions : We suggest that the above 5 tests for neurobehavior, with the exception of the simple reaction time test, might be used as the basis for recommendation of further treatment and other neurological tests by the earlier defection for neurological abnormality in lacunar infarction.

HRCT의 임상적용

김함겸 中央醫學社 1994 中央醫學 Vol.59 No.1

THI를 이용한 방사선사의 건강수준 평가

김함겸,김화선 대한방사선과학회(구 대한방사선기술학회) 2001 방사선기술과학 Vol.24 No.2

이황화탄소중독에 대한 자기공명영상소견

김함겸 中央醫學社 1995 中央醫學 Vol.60 No.8

The Carbon disulfide(CS2) is colorless liquid which is very strong in volatility. It is used for manufacturing Artificial silk, Cellophan and Carbon tetrachloride and also as an agent for fumigation. The clinical condition, which may be appeared due to intoxication of Carbon disulfide, is very diverse, and if it is exposed in high concentration for long time to Central nerve system, it may cause acute or sub acute encephalopathy due to the toxicity specially influenced on Central Nerve system. The clinical conditions of headache, dizziness, fatigue and memory disturbance may be shown. Now the writer has gained Brain Sectional Image by using Magnetic Resonance Imaging : MRI with subjects of patients who have been exposed to Carbon disulfide for a certain period and then has analyzed the comments to be resulted in the following : 1. Multiple infarction : 34% 2. Sinusitis : 30% 3. negative study : 28 % The equipment used in this connection was Hitachi MR Imaging system(MRP-20) and protocol was Fov=240 mm, matrix=256 X 256, Average 2-3, Slice thickness 7.5 mm, TR/TE 400-600/20-3msec(T1WI), TR/TE 2000/80-100 msec(T2WI), TR/TE 2000/30-40msec(PDWI).