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혈정액증의 경직상 코일을 이용한 자기공명영상 소견:경직장 초음파소견과의 비교
원제환 대한영상의학회 1996 대한영상의학회지 Vol.35 No.3
Purpose : To describe MR findngs of the seminal tract using endorectal surface coil(ECMR) in patients withhemospermia and to compare them with transrectal ultrasonography(TRU TR US). Materials and Methods : Twenty-fourpatients with hemospermia underwent MR imaging using a 1. 5T unit. T2-weighted fast spin echo axial, sagittal andcoronal images, and T1-weighted spin echo axial images were obtained using on endorectal surface coil. MR findingsin 17 patients were compared with TRUS performed by urologist. Results : Twenty-two patients(92%) demonstratedmorphological abnormalities in the prostate and the seminal tract. On ECMR, 16 hemorrhagic foci were seen in 13patients. Prostatic cysts were seen in 14 patients(8 m llerian and 6 wolffian). These cysts showed high signalintensity on T2-weighted images. On T1-weighted images, m llerian duct cysts showed low signal intensity andwolffian duct cysts showed high signal intensity. On ECMR, calculi were seen in 18 patients. Of 17 cases who hadboth ECMR and TRUS, prostatic cysts were seen in 11 on ECMR and 5 cases on TRUS (p<0.05). No hemorrhage in theseminal tract was detected on TRUS. In is cases, calculi were clearly defined on ECMR, and in 11 cases on TRUS(p<0.1). Conclusions : ECMR demonstrated various lesions in patients with hemospermia and was superior to TRUS inthe localization of hemorrhage and detection of prostatic cysts and calculi.
원제환 대한영상의학회 2021 대한영상의학회지 Vol.82 No.3
The prevalence of lower extremity disease is increasing with age. With recent technological advancements, endovascular treatment is being performed more frequently. The treatment goal of intermittent claudication is to improve walking and reduce claudication. To achieve these goals, anatomical durability and patency are important. In patients with critical limb ischemia, the lesions are diffuse and particularly severe in below-the-knee arteries. The treatment goal of critical limb ischemia is to promote wound healing and to prevent major amputation, which is evaluated by the limb salvage rate. Primary stenting using covered or bare metal stents is a widely accepted endovascular treatment. While drug-eluting technologies with or without atherectomy are widely used in the treatment of femoropopliteal disease, balloon angioplasty is the mainstay treatment for below-the-knee intervention. CT angiography provides a road map for planning endovascular treatment in patients without absolute contraindications. 하지동맥 질환의 유병률은 고연령 군에서 증가한다. 최근의 기술적 진보로 혈관 내 치료가점점 더 많은 빈도로 시행되고 있다. 간헐적 파행의 치료 목표는 보행 능력을 향상시키고 증상을 완화시키는 것이다. 이를 위해 해부학적 내구성을 높이는 것이 중요한 전략이며 개통률이 치료 평가 기준이 된다. 임계 하지허혈을 가진 환자에서는 병변이 광범위하고 특히 무릎아래동맥을 심하게 침범한다. 임계 하지허혈의 치료 목적은 상처 회복을 촉진하고 주요 절단을 예방하는데 있으며 사지 보존율이 평가의 기준이 된다. 장골동맥 협착의 치료에는 피복혹은 비피복 스텐트 삽입술이 일차적 치료로 인정된다. 대퇴슬와동맥 질환은 죽종제거술과함께 약물방출풍선 및 스텐트가 자주 사용되는 반면 무릎아래동맥 질환에서는 풍선확장술이주요 치료 방법이다. 컴퓨터단층 혈관조영술은 절대적 금기증이 없는 환자에서 혈관 내 치료계획 수립을 하는데 로드맵을 제공한다.
원제환 대한의사협회 2014 대한의사협회지 Vol.57 No.4
Cystic lymphangioma is a congenital lymphatic malformation that occurs most commonly in the head and neck. Mostlymphangiomas are asymptomatic, but progressive enlargement may cause feeding difficulty, airway, and cosmeticproblems. According to the diameter of the majority of the cysts, lymphangiomas are divided into macrocystic (>1 cm),microcystic (<1cm), or mixed types. Sclerotherapy has been recommended as a primary treatment because surgery mayresult in severe tissue defect or functional complication. OK-432 is the most widely used sclerosant. Typical complicationsinclude fever, local inflammation, pain and swelling, which can usually be controlled conservatively. Bleomycin haspotential risk of lung fibrosis, although there has been no such report in the literature. Acetic acid is a more potentsclerosant, which may be used as a secondary drug due to the risk of adjacent nerve damage in high concentration. The lesions are punctured with a 21 G needle under ultrasound guidance. In macrocystic lesions, we inserted 6-7 Fcatheters for drainage and instillation of sclerosant. While OK-432 and bleomycin are not removed, alcohol and aceticacid should be removed after indwelling for 20 minutes. Overall, an excellent response (over 90% resolution) rateof 48% was achieved. Response rate was higher in macrocystic type than microcystic type. There may be a risk ofairway obstruction due to swelling and inflammation in cervical lesions. Preventive tracheostomy or intubation maybe necessary in those lesions. In conclusion, sclerotherapy is a safe and effective for treatment of lymphangioma. It isrecommended as a first line therapy.
A Rare Case of Empyema Developed after Transarterial Chemoembolization for Hepatocellular Carcinoma
서영균,원제환,왕희정,김진우 대한영상의학회 2015 대한영상의학회지 Vol.72 No.1
A 60-year-old male patient who previously underwent transarterial chemoembolization for recurrent hepatocellular carcinoma three months ago presented to the emergency department with pleural effusion and hemoptysis. On serial review of plain radiographs and chest CT, transdiaphragmatic migration of Lipiodol from the treated area of the liver into the ipsilateral pleural cavity was demonstrated. The patient consequently developed empyema in the right thorax. Therefore, percutaneous drainage was performed. Empyema and pleural effusion regressed after 10 days of medical treatment and drainage. After that, the patient was transferred back to the local clinic upon full symptomatic recovery. Herein, we describe a rare complication of transarterial chemoembolization for hepatocellular carcinoma manifesting as an empyema secondary to the migration of the ethiodized oil content from the liver into the ipsilateral pleural cavity.