Fixation Methods for Implantable Port Chamber: Comparative Study Using Glue, Self-stabilizing Leg and Suture Fixations in Rabbits

나형일,심형진,곽병국,김현주,이용철 대한영상의학회 2004 Korean Journal of Radiology Vol.5 No.4

OBJECTIVE: To evaluate the fixation strength and tissue reaction of the glue fixation and self-stabilizing leg fixation methods and to compare the results with those of the conventional tagging suture fixation method. MATER AND METHODS: Twelve healthy rabbits were selected and three different methods of implanting the port chamber were employed on the back of each rabbit. A total of thirty six port chambers were implanted with these three different methods, viz. the glue fixation method using tissue adhesive, the self-stabilizing leg method using a self-expandable stabilizing leg, and the suture fixation method. The fixation strength and the gross and histopathologic changes of each fixation method were evaluated at three days, one week, two weeks and four weeks after port implantation. RESULTS: The glue fixation method showed a good fixation strength, which was similar to that of the tagging suture method (pr two weeks showed cracks on the external surface, but this had no adverse effects on their function. A large amount of granulation tissue reaction was found at the bottom of the chamber (pely lower fixation strength (pexhibited equal fixation strength compared to the suture fixation, but showed cracking and a large amount of granulation tissue, whereas the fixation with a self-stabilizing leg showed weaker fixation strength. .OBJECTIVE: To evaluate the fixation strength and tissue reaction of the glue fixation and self-stabilizing leg fixation methods and to compare the results with those of the conventional tagging suture fixation method. MATER AND METHODS: Twelve healthy rabbits were selected and three different methods of implanting the port chamber were employed on the back of each rabbit. A total of thirty six port chambers were implanted with these three different methods, viz. the glue fixation method using tissue adhesive, the self-stabilizing leg method using a self-expandable stabilizing leg, and the suture fixation method. The fixation strength and the gross and histopathologic changes of each fixation method were evaluated at three days, one week, two weeks and four weeks after port implantation. RESULTS: The glue fixation method showed a good fixation strength, which was similar to that of the tagging suture method (pr two weeks showed cracks on the external surface, but this had no adverse effects on their function. A large amount of granulation tissue reaction was found at the bottom of the chamber (pely lower fixation strength (pexhibited equal fixation strength compared to the suture fixation, but showed cracking and a large amount of granulation tissue, whereas the fixation with a self-stabilizing leg showed weaker fixation strength.

중두개와의 표피양낭: 비전형적인 전산화 단층촬영 및 자기 공명 영상 소견의 증례보고

나형일,이용철,권정택,강석형,유승민,이화연,송인섭,김양수,유현 대한영상의학회 2004 대한영상의학회지 Vol.51 No.5

Intracranial epidermoid cysts usually show homogeneous hypodensity on CT scans, hypointensity on T1- weighted MR images and hyperintensity on T2-weighted MR images. Most of them arise in the cerebellopontine angle and parasellar areas. We report a case of middle cranial fossa epidermoid tumor with unusual image findings. The entire tumor mass showed inhomogeneous low density, without any enhancing solid portion on the CT scans. The lateral portion of the tumor showed homogeneous T1 low signal intensity and T2 high signal intensity. The medial portion of the tumor showed heterogeneous T1 and T2 intermediate to high signal intensity. On the gadolinium enhanced MR images, enhancement of the thickened dura was observed behind the tumor. Surgery and pathologic examination revealed the presence of an extradural epidermoid cyst. 두개내 표피양낭(epidermoid cyst)은 일반적으로 전산화 단층촬영에서는 균질한 저음영으로 관찰되며, T1 강조 자기공명영상에서는 균질한 저신호강도로 T2 강조 영상에서는 균질한 고신호강도로 나타난다. 두개내 호발 부위는 소뇌교각과 안장옆 부위이다. 저자들이 경험한 비전형적인 위치와 영상 소견을 보였던 중두개와의 표피양낭은 국내에 보고 됐던 바가 없다. 종괴 전체는 전산화 단층촬영에서 불균질한 저음영으로 관찰되었으며 내부에 조영증강이 되는 부분은 보이지 않았다. 종괴의 외측 부위는 T1 강조 자기공명 영상에서 균질한 저신호강도와 T2 강조 영상에서 고신호강도를 보였다. 종괴의 내측 부위는 T1 강조 영상과 T2 강조 영상에서 모두 불균질한 동등신호강도와 고신호강도를 보였다. 조영증강 영상에서 종괴의 뒤쪽으로 두꺼워진 뇌경막의 조영 증강 소견도 보였다. 수술과 조직검사에서 경막외 표피양낭으로 진단되었다.

흉막 삼출을 동반하지 않은 미세 흉막 전이: 전산화 단층 찰영과 초음파 소견

나형일,유승민,김양수,이화연,송인섭,심형진,곽병국,신종욱 대한초음파의학회 2004 ULTRASONOGRAPHY Vol.23 No.3

Pleural metastasis from malignancy is commonly combined with effusion. We report the ultra-sonographic and CT findings in a rare case of micro-pleural metastasis without effusion. A 34-year-old male patient with lung cancer underwent video-assisted thoracoscopic surgery (VATS),prior to open thoracotomy. VATS revealed multiple metastatic micronodules on the pleura, whichwere overlooked on the preoperative CT scan. The HRCT images and chest ultrasonogramsshowed clear evidence of pleural micro-nodules. 악성 종양에 의한 흉막 전이는 보통 흉막 삼출을 동반한다. 저자들은 흉막 삼출을 동반하지 않은 미세 흉막 전이 를 보인 드문 증례의 초음파 및 전산화 단층촬영 소견을 보고하고자 한다. 폐암을 가진 34세 남자 환자가 개흉술에 앞서서 비디오 흉강경수술을 시행 받았다. 흉강경 검사 상 수술 전 전산화 단층촬영에서 간과하였던 여러 개의 전 이 미세 결절이 흉막에서 관찰되었다. 고해상 전산화 단층촬영 영상과 흉부 초음파에서 미세 결절들이 분명하게 관찰되었다.

폐동맥을 침범한 염증성 가성종양: 증례 보고

나형일,김양수,유승민,손동섭,이화연,송인섭,이종범,김건상,유현 대한영상의학회 2004 대한영상의학회지 Vol.51 No.5

Pulmonary inflammatory pseudotumor is the most common primary lung mass seen in children, but extraparenchymal involvement is relatively rare. We report here on a case of inflammatory pseudotumor involving the mediastinum and the pulmonary artery. A 48-year-old man presented with enlargement of the right hilum on a simple chest radiograph. He had a history of exertional dyspnea for 1 year. A non-homogeneous enhancing mass was noted in the right pulmonary artery on computed tomography. Mediastinotomy and pulmonary artery angiography with a forcep biopsy revealed inflammatory pseudotumor of the mediastinum and pulmonary artery. 폐의 염증성 가성종양은 소아에 있어서는 가장 흔한 흉부 종괴이나, 상대적으로 폐 실질 외 에서 발생하는 경우는 드물다. 저자들은 폐동맥을 침범한 염증성 가성종양의 증례를 보고하고 자 한다. 48세 남자가 흉부 단순촬영 상 우측 폐문 비대의 소견을 보여 내원하였다. 과거력 상 환자는 1년간의 노작성 호흡곤란이 있었다. 전산화 단층 촬영에서 부분적인 조영 증강을 보이 는 종괴가 우측 폐동맥에서 관찰되었다. 종격동절개술과 폐동맥 혈관조영술을 통해 시행한 겸 자 생검에서 염증성 가성종양으로 진단되었다.

高等學校 平準化에 따른 能力別 學習指導 硏究 : 敎科別 移動式 編班에 의한 能力別授業을 中心으로

羅炯 건국대학교 행정대학원 1977 建國大學校 行政大學院 硏究論叢 Vol.5 No.-

뇌와 척수에 동시에 발생한 속립성 결핵: 증례 보고

성창근,나형일,유현,변준수,윤영철,서재승,김기현 대한영상의학회 2008 대한영상의학회지 Vol.59 No.5

결핵이 중추신경계(central nervous system)를 침범하는 경우는 드물며, 특히 척수를 침범하는 경우는 더욱 드물다. 항결핵제제를 복용하던 중 간헐적인 기억상실증을 보인 환자의 뇌 전산화단층촬영과 뇌 자기공명영상 그리고 척추 자기공명영상에서 작은 크기의 다발성 결절들이 관찰되었다. 속립성 결핵을 의심하였고 항결핵제제와 스테로이드 치료 후 결절들은 호전되었다. 저자들은 뇌와 척수를 동시에 침범한 속립성 결핵의 예를 경험하여 문헌고찰과 함께 증례를 보고자 한다.

기관지 동맥 색전술시 합병될 수 있는 척수 손상의 예측을 위한 펜토탈 소디움 유발검사의 임상 적용

김기현,심형진,유승훈,곽병국,나형일,송인섭,김양수,이종범 중앙대학교 의과대학 의과학연구소 2002 中央醫大誌 Vol.27 No.1

The evaluate the clinical significance of pentothal sodium provocative test for prediction of spinal cord complication in bronchial artery emobolization or chemotreatment(BAE or BACT),82 arteries of 31 patients were studies. thirty-one patients consists of twenty-two cases of pulmonary tuberculosis, senen cases of primary lung cancer,one case of merastatic lung cancer and a case of aspergilloma. 82 arteries consists of 56 bronchial arteries, 9 intercostobronchial trunks, 7 intercostal arteries, 5 intemal mammary arteries, 2 thyrocervical trunks, a inferior phrenic artery,a lateral thoracic artery and a superior thoracic artery. In allcases, selective arterial angiography was performed after arch aortography. Before infusion of embolic or chemotherapeutic agent, 2.5% water solution of pentothal sodium(ultra short-acting barbiturate) was injected. Neurologic examination was done to evaluate the spinal cord complication. There was no significant acute and delayed neurologic change in all cases. The complication and problem caused by pentothal sodium test itself were not found either. In conclusion, pentothal sodium test is easy, simple and method to prevent and predict spinal cord complication in BAE or BACT, but the accumulation of clinical experiences will be needed.

Detecting Cerebral Microbleeds on Susceptibility-Weighted MR Imaging: Comparison with the Conventional MR Imaging Sequences

성창근,변준수,유현,나형일,서재승,김기현 대한영상의학회 2009 대한영상의학회지 Vol.60 No.2

Purpose: The purpose of our study was to compare the susceptibility-weighted imaging (SWI) with the conventional MR imaging sequences for their ability to detect cerebral microbleeds. Materials and Methods: We studied 17 patients (9 men and 8 women, mean age: 58 years) with microbleeds. The gradient-recalled echo T2*-weighted imaging (GRE), the T2-weighted imaging (T2WI), the fluid-attenuated inversion recovery (FLAIR) imaging and the SWI were obtained from all the subjects. The number of microbleeds was counted on each MR imaging sequence. We also compared the number of detected microbleeds (%) of each imaging technique with that of SWI being 100%. The Friedman ANOVA Test was used for statistical analysis and a p value of less than 0.05 was considered statistically significant. Results: The number of detected mircobleeds on each imaging technique (%, mean ± standard deviation), as compared to that detected on SWI as 100%, was as follows: GRE vs. SWI (64.9 ± 19.3 vs. 100, p =0.001), T2WI vs. GRE (16.9 ± 17.7 vs. 64.9 ± 19.3, p = 0.001), and T2WI vs. FLAIR (16.9 ± 17.7 vs. 13.8 ± 17.7, p = 0.027). Conclusion: SWI demonstrates a significantly higher sensitivity for detecting microbleeds as compared to that of GRE and the other conventional MR imaging sequences.

알츠하이머병과 경도인지손상 환자에서 백질 고강도와 인지기능장애와의 연관성

윤성구,박두병,나철,이영식,민경준,한덕현,최태영,안영균,나형일,기백석 대한신경정신의학회 2009 신경정신의학 Vol.48 No.4

Objectives We investigated the relationship between periventricular and deep white matter hyperintensity and cognitive function in Alzheimer’s disease (AD) and mild cognitive impairment (MCI). Methods T2-weighted MRI scans were performed in 41 subjects with AD 38 subjects with mild cognitive impairment and 38 control subjects. Periventricular and deep white matter hyperintensities were rated on a Fazekas 0-3 scale by a medical specialist of the department of radiology blind to clinical diagnosis. Cognitive function was assessed by using Cognitive Assessment and Reference Dia-gnoses System. Results No significant differences between demographic characteristics and vascular risk factors were revealed comparing AD, MCI and controls. The frequencies of AD were significantly higher than those of MCI and normal control in Grade 2 and 3 of periventricular hyperintensity and Grade 3 of deep white matter hyperintensity. The scores of amnesia, executive function and attention were significantly lower in Grade 2 and 3 of periventricular hyperintensity than in Grade 0 and 1. The scores of attention were significantly lower in Grade 3 of deep white matter hyperintensity than in Grade 0, 1 and 2. Conclusion Periventricualr hyperintensities are associated with cognitive decline in amnesia, executive function and attention, while deep white matter hyperintensities are associated with cognitive decline in attention. T2 강조 MRI에서 보이는 백질 고강도는 반복적인 허혈 성 손상이 백질의 구조적 변화를 일으켜서 발생한다. 이와 같은 백질 고강도는 아밀로이드 혈관병증이 많이 동반되는 AD와 연관성이 있으며 백질 부위에 따라서 인지기능 저하 에 차이를 보인다. 백질은 해부 및 병리적인 차이로 뇌실주 위 백질과 심부 백질로 나뉘어지는데, 뇌실주위 백질 고강도 는 기억력 저하, 고위수행장애 및 집중력/계산력에서 인지 기능 저하를 보였으며 심부 백질 고강도는 집중력/계산력에 서 인지기능 저하를 보였다.