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Mn-DPDP가 간의 자기공명영상과 양자자기공명분광에 미치는 영향
배인영,서창해,정원균,조순구,Bae, In-Yeong,Seo, Chang-Hae,Jeong, Won-Gyun,Jo, Sun-Gu 대한영상의학회 2002 대한영상의학회지 Vol.46 No.4
목적: Manganese dipyridoxyl diphosphate(Mangafodipir trisodium, Teslascan, Nycomed, 이하 Mn-DPDP)가 간의 자기공명영상(이하 MRI)과 양자 자기공명분광(이하 MRS)에 미치는 대상과 방법: 시험관연구로서, 4.7 테스라자기공명영상기기를 이용하여 다양한 농도의 지질용액에 Mn-DPDP를 가하기전과후에 MRS 스펙트럼을 얻어 1.3 ppm 지질피크의 변화를 보았다. 생체연구로서, 가토간조직의 망간함량변화를 알아보기 위해 Mn-DPDP(10 $\mu$mol, 1ml/kg) 를 가토에 주사하기 전과 주사 후 10분, 20분, 30분, 1시간, 2시간, 4시간, 24시간에 간조직을 원자흡광분광분석기로 분석하였다. 같은 시간에 T1-강조영상을 얻어 간의 신호강도를 구하고 상대적조영증강정도를 계산하였으며, MRS스펙트럼을 얻어 각 대사산물들의 피크면적을 구하고 이를 지질피크면적으로 나눈 상대비를 계산하여 간조직의 망간함량변화와 비교하였다. 결과: 시험관내 연구에서 Mn-DPDP는 1.3 ppm의 지질피크를 억제하는 효과를 보였다. 간조 직의 망간함량은 Mn-DPDP 주사 후 차츰 증가하여 20분에 최고에 도달하고 점차 감소하여 24시간에 정상수준에 도달했다. Mn-DPDP 주사 후 T1-강조영상에서 간조직의 신호강도변 화는 간조직의 망간함량변화와 유사한 형태를 보였다. MRS에서 Mn-DPDP 주사 후 1.3 ppm의 지질피크면적은 간조직의 망간함량과 역으로 변했다. 결론: Mn-DPDP는 MRI의 T1-강조영상에서 간의 조영증강효과를 보이고, MRS에서는 1.3 ppm의 지질피크를 감소시키며 이는 간조직의 망간함량변화와 잘 일치하였다. Purpose: To determine the influence of manganese dipyridoxyl diphosphate (Mn-DPDP) on MRI and proton MRS. Materials and Methods: In an in-vitro study designed to determine changes in the lipid peak at 1.3 ppm, 4.7T MR equipment was used to obtain proton MR spectrographic images of a lipid solution of varying concentration, with and without Mn-DPDP. Before; at 10, 20, and 30 minutes; and at 1, 2, 4, and 24 hours after the IV injection of Mn-DPDP (10${\mu}$mol, 1ml/kg), the concentration of Mn in liver tissue was measured by atomic absorption spectrometry. At the same intervals, T1-weighted MR images were obtained, the signal intensity of the liver was thus determined, and the relative enhancement ratio was calculated. MRS of rabbit liver was performed serially at the same intervals, and the peak areas of metabolites, as well as their peak areas relative to lipids, were calculated. The findings were correlated with tissue Mn concentration. Results: At 1.3 ppm with Mn-DPDP, MRS showed that the peak area of the lipid had decreased. Tissue Mn concentration increased just after Mn-DPDP injection and peaked after 20 minutes, decreasing to a level within the normal range after 24 hours. Serial changes in the signal intensity of the liver, as seen at MRI, showed similar pattern to that of Mn concentration. There was reverse correlation between serial change in the peak area of lipids at 1.3 ppm and Mn concentration after Mn-DPDP injection. Conclusion: At T1-weighted MR imaging, the injection of Mn-DPDP led to the enhancement of liver tissue, and at MRS, the lipid peak at 1.3 ppm decreased. There was close correlation between these effects and tissue Mn concentration.
서창균,김상현,이승현,윤태승,박재호,임정근 啓明大學校 醫科大學 2002 계명의대학술지 Vol.21 No.1
Systemic lupus erythematosus (SLE) is an autoimmune disease associated with variable symptoms in many organs. Involvement of central nervous system in SLE is a relatively common complication. However, transverse myelitis is a rare and late complication of SLE and its prognosis is very poor, resulting in death or severe neurologic sequelae. We report a case of transverse myelitis who was diagnosed as SLE before the onset of neurologic symptoms. Transverse myelitis was diagnosed, based on the clinical presentation and MRI findings. This patient indicated that transverse myelitis could be a relatively early manifestation of SLE. We treated the patient with pulse methyprednisolone followed by cyclophosphamide. However, the treatment did not improve clinical condition of the patient.
김상현,서창균,조호찬,이승현,윤태승,허지안,조주연,박재호 啓明大學校 醫科大學 2002 계명의대학술지 Vol.21 No.1
Statin이 혈중 근효소에 미치는 영향을 알아보기 위하여 이 연구를 시행하였으며, cerivastatin을 사용한 환자 군에서 다른 statin 사용 군보다 의미 있는 CK 및 AST치의 상승을 보였다(p<0.05). 또한 CK가 기준치보다 3배 이상 증가된 환자도 cerivastatin을 사용한 환자 군에서는 발생하였으나, 다른 statin 사용 군에서는 발생하지 않았다(p<0.05). Hypercholesterolemia is firmly established as a risk factor for the development of atherosclerosis. Cerivastatin is a third generation statin, a synthetic HMG-CoA reductase inhibitor which lowers plasma cholesterol level by inhibiting endogenous cholesterol synthesis. It has also been reported that cerivastatin is relatively well tolerated and has a low incidence of adverse effects. It has been also reported that less than 1% of the patients treated with cerivastatin experienced clinically significant elevation of muscle enzymes. The purpose of this study was to investigate the effect of cerivastatin on serum muscle enzymes. The patients with primary hypercholesterolemia were treated with statin at least 4 weeks in Keimyung University Dongsan Medical Center. We compared the effect of Cerivastatin treatment (group A, 33 patients) on changes of muscle enzymes including creatine kinase (CK), aspartate transaminase (AST) and lac-tate dehydrogenase (LDH) with other statin treatment group (group B, 46 patients). The group A produced statistically significant elevation of CK and AST (p<0.05) after treatment with cerivastatin when compared to the group B. More than three fold elevation of CK level was developed only in the group A (p=0.02). These results indicate that cerivastatin induces higher incidence of muscle enzymes elevation than other statins.