담낭 유암종

김홍용(Hong Yong Kim),고일향(Il Hyang Ko),이진호(Jin Ho Lee),김관엽(Kwan Yop Kim),류종철(Jong Cheol Ryu),차순주(Soon Joo Cha),신원창(Won Chang Shin),박태준(Tae Joon Park),최원충(Won chung Choi) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.4

Carcinoid tumors which arise from enterochromaffin cells are usually found in the appendix, ileun, bronchus and rectum. Carcinoid tumors of the biliary tract are exceedingly rare and pre-operative diagnosis is very difficult. We report a case of carcinoid tumor of the gallbladder in a 43-year-old man presenting jaundice and right upper quadrant abdominal pain as a chief complaint. A tumor of the neck of gallbladder was demonstrated with ultrasonography, computed tomography, endoscopic retrograde cholangiopan-creatography, and percutaneous cholangiography and was confirmed as carcinoid tumor at operation.

복부 자기공명영상 촬영시 장운동 억제제의 효과 : 통상적인 촬영시와의 비교 연구 Comparative Study with Conventional Technique

차순주,김정숙,김원홍,조우호,허감 인제대학교 1993 仁濟醫學 Vol.14 No.2

복부 자기공명영상술은 호흡이나 장운동 등의 움직임에 의한 조영물(artifact)에 의한 영상질의 저하가 문제시 되고 있어, 본 연구에서는 영상개선의 목적으로 부스코판을 정맥주사하여 얻은 영상과 통상적인 방법으로 얻은 영상을 비교하였으며, 그 결과 부스코판을 주사한 뒤 얻은 영상의 질이 진단을 달리 할 정도로 탁월하지는 않지만 영상개선은 이루어졌다. The magnetic resornance image is the most reliable study recently, but in the abdominal field, the favour of the study is reduced, because the motion artifact by respirations and bowel movements. We injected 20mg of Scopolanine butylbromide(Buscopan), antispasmodics which has a effect of peripheral parasymphathetic block, through the vein in arm. We chose fourteen patients randomly and got T1 wighted images (TR 500, TE 15) before and after buscopan injection. The 14 pairs of abdominal images, in five area, liver, stomach, definition between stomach and pancreas, colon and small bowel, are interpreted by five radiologists. They compared the inages after buscopan injection with the conventional imges, and rated as follow, minus 2 in definite aggrevation, minus 1 in minimal aggrevation, o in no change, plus 1 in minimal inprovement, plus 2 in definite improvement, and the scores by the five radiologist are summed, the total scores were graded as follow, the aggrevation in less than minus 2, a score from minus 2 to plus 2 is unchanged image, a score from plus 3 to 7 is minimal improvement, and definite improvement of the images is over than 7. In result, minimal improvements are 12 cases(85.7%) in the liver, 8 cases(57.1%) in the stomach, 9 cases(64.3%) in the stomach and pancreas, 11 cases(78.6%) in the colon, 10 cases(71.4%) in the small bowel, and definite improvement of the images are 2 cases(14.3%) in stomach, 1 case (7.2%) in small bowel, and no aggrevation of the images is not graded. In conclusion, the MRI after buscopan injection are improved slightly compared to conventional image, and now we recommend Buscopan injection in abdominal MRI study.

소아 장중첩증의 방사선학적 연구

차순주,김정숙,김원홍,조우호,허감,함영백,김홍동,박영일,정철영 인제대학교 1991 仁濟醫學 Vol.12 No.4 sup

개인용 컴퓨터를 이용한 교육용 의료영상 관리

차순주,김용훈,허감 인제대학교 1995 仁濟醫學 Vol.16 No.3

목적: 영상정보의 양이 한정되어 전산화가 가능한 교육용 증례를 개인용 컴퓨터를 이용하여 교육용 증례 전산화 프로그램(Casebank-GI)을 개발하고 교육용 자료를 전산화하고자 하였다. 대상 및 방법: 사용된 컴퓨터는 펜티엄이 내장된 IBM 호환기종(RAM 16 MB)의 개인용 컴퓨터이며, 영상을 디지털화하는 장치로 Overlay board와 비디오 카메라와, 보조 기억장치로 1.3 GB 용량의 광자기 디스크드라이버를 부착하여 사용하였다. 운영체계는 한글윈도우 3.1이며, 데이터 관리 프로그램은 Access 2.0를 이용하여 구성하였고 영상획득과 편집을 위한 프로그램은 Overlay board 전용프로그램과 Powerpoint를 이용하였다. 대상이 된 증례는 본원의 복부방사선 분야의 증례 중 필름 상태가 양호하며, 교육적인 가치가 있는 160개를 대상으로 하였다. 결과: Casebank-GI는 대다수의 사용자들이 별도의 교육 과정 없이 사용할 수 있도록 사용자 위주 전개 방식으로 구성하였으며 프로그램 구성 내용은 11개의 독립된 데이터베이스를 구축하고 36개 입출력 화면과 이에 연동되는 41개의 검색문, 20개의 출력양식으로 구성하였다. 총 입력된 영상수는 850 여개로 전체의 데이터양은 약 560 Mbyte이다. 참고자료는 질환별로 각종 문헌을 참조하여 다양한 항목별로 정리한 참고자료와 저자들에 의해 완성된 국내 방사선 관련 논문 색인 프로그램(KJR SEEKER)을 내장하여 국내 논문을 참조할 수 있게 하였고 데이터의 검색 방법은 증례별, 질병색인별, 방사선진단명으로 검색할 수 있게 하였다. 결론: 저자들에 의해 개발된 교육용 증례 전산화 프로그램인 Casebank-GI는 비교적 적은 투자로 큰 기술적 어려움 없이 교육용 증례들을 전산화한 결과 그 효용성이 높을 것으로 사료 되어 보고하는 바이다. Objective : The purpose of this study was to develope the program of teaching case filing system, Casebank-GI, for students and residents. Material and methods : The IBM compatable personal computer was used, which had Pentium CPU, Overaly board for digitizing of images, and 1.3 GB magnetooptical disk driver. The program tool is Access 2.0 under Windows 3.1 (Korean version) environment. The 160 cases are selected from Gastrointestinal teaching case pool. Result: Casebank-GI has 11 database, 36 screens fort data input, 41 query, and 20 output form, and 850 images from 160 cases are saved. And the program contains references of disease, and Korean Journal seraching system. Total amount of data is 560 Mbyte. Conclusion: Casebank-GI, a computerized program of teaching case filing system, is useful program for students and residents, becauase of easy manipulation and economical efficiency

장중첩증의 진단; 단순복부 엑스선촬영의 진단 신뢰도

차순주,허감 인제대학교 1991 仁濟醫學 Vol.12 No.2

소아 장중첩증의 진단법중의 하나인 단순 복부엑스선 촬영의 신뢰도를 15명의 방사선과 의사를 대상으로 조사하여 진단적 가치를 평가한 결과 단순복부엑스선 촬영은 장중첩증의 진단에 도움을 주지 못했다. Early detection of a intussusception is critical, because of higher rate in cases of early diagnosis, so various methods, such as plain abdomen radiography, colon study with Barium, and sonography, have been suggested for diagnosis of the intussusception. The plain abdomen film has played an important role of diagnosis conventionally, but the reliability of this is variable by authors. From September 1989 to December 1990, plain abdomen films of 73 cases were randomized, of which 57 intussusceptions, proven with the colon studies wrer included, and 15 radiologists interpreted. 1.The sensitivity is 64.8%(Max.82.5%, Min.43.9%), the specificity is 55%(Max. 81.3%, Min.25%). 2.The true positive rate is 54.4%, the false positive is 19.3%, the true negaive is 50%, and the false negative is 31.3% by over 60% of the interpreters. 3.Various findings were suggested by the interpreters in spite of the same films. Soft tissue masses were noted in 52.3%(Max.77.1%, Min.28.6%), small bowel obstruction in 43.9%(max.80.5%, Min.12%), ad no gas shadows in cecal pople portion in 37.7% of the cases(Max.100%, Min.3.1%).

신축 병원에서의 PACS 설치에 관한 타당성 연구

차순주,허감 인제대학교 1998 仁濟醫學 Vol.19 No.2

PACS(Picture Archiving and Communicating System)는 근래 들어 증가하는 각종 검사 및 의료 서비스 질의 개선 요구와 대형화되어 가는 병원, 및 인건비 상승 등에 의한 채산성 악화로 인한 어려운 여건을 타개할 목적으로 추진되고 있다. 이에 저자 등은 각종 통계자료와 최근 수집된 정보분석을 토대로 경제성 여부와 예측 가능한 임상 분야에서의 장단점을 분석하여 PACS 설치의 타당성을 연구하고자 하였다. 600병상 규모에서의 신축 병원이 PACS를 도입할 경우와 그렇지않을 경우의 장비 도입가의 비교 두 그룹간의 향후 5년간의 장비 운용에 발생할 비용의 비교 그리고 전술한 직접 가치 이외의 간접 가치에 대해 비교ㆍ분석하였다. 본연구결과로 PACS의 도입은 기존의 필름시스템에 비해 경제적인 것으로 판단되었으며, PACS의 간접효과는 환자에게 여러 이점을 제공할 뿐 아니라 병원에도 경제적, 교육적, 타 병원과의 경쟁력 확보에서 여러 장점을 제공한다. PACS(Picture Archiving and Communicating System) has been installed in some medical centers to solve the problems such as personal expense and lack of film file storage space, and to improve the delivery service of films from the film warehouse. We analyzed statistical data from the hospital, which has the similar number of beds and the environment to the new hospital to be built. To compare the amounts invested initially and the running cost between the PACS and the conventional film system. Although the equipment for PACS is more expensive than that used in conventional film system, PACS system will save running cost each year, and result in economic benefit. PACS will not only provide economic feasibility but also vitalize academic activity, and improve the quality of medical service. In conclusion, for a new hospital with 600 beds, we recommend PACS system.

소아 장중첩증의 초음파 소견 : 진단 신뢰도와 새로운 소견 Finding and Reliability

차순주,김정숙,허감 대한초음파의학회 1991 ULTRASONOGRAPHY Vol.10 No.2

Evaluation of Iodized Oil Distribution with Variable Flow Velocities, Vessel Diameter and Injection Rate : Experimental Study in Phantom Vessels and Implication for Embolization of Hepatocellular Carcinoma 판톰혈관을 이용한 실험적 연구

Cha, Soon Joo,Hur, Gham 인제대학교 1998 仁濟醫學 Vol.19 No.2

목적: 간암의 화학적색전에 이용되는 에치오돌의 분포도가 에치오돌의 주사속도와 혈관내의 혈류의 속도의 변화에 따라 어떻게 달라지는지 판톰혈관을 이용한 실험으로 알아보고자 하였다. 대상 및 방법: 판톰혈관은 폴리비닐수지를 이용하여 Y자형의 2개의 분지를 갖도록 만들었으며 판톰의 2개의 분지의 직경 차이에 따라 3가지 다른 판톰을 제작하였다. 혈류에 해당하는 유속은 물탱크의 높이를 60cm를 유지하여 얻었으며 에치오돌의 정량분석은 혼탁도를 비교는 방법으로 측정하였다. 결과: 판톰혈관의 분지의 직경이 같거나 크면서 혈류 빠른 경우 대부분의 에치오돌이 분포되며, 이때는 에치오돌의 주사속도나 혈류의 빠르기에 의해 영향을 받지 않지만, 판톰혈관의 분지가 작으며 혈류가 빠른 경우는 에치오돌의 주사속도가 느리면 상대적으로 많은 양의 에치오돌이 분포한다. 결론: 종양으로 가는 혈관이 작을 경우 에치오돌의 주사속도를 천천히 하면 에치오돌의 종양내 분포율을 높일 수 있다. Purpose: To evaluate the effect of injection rates, folw velocities and vessel diameters on the distribution of Ethiodol in phantom vessel. Materials & Methods: Vessel phantoms had a vifurcation into two branches. Three phantoms were constructed : in Phantom I, both branches are same in diameter, phatntom II and III had different diamerers. The oil-water mixture flowing out each branches was emulsified by a food blender. The turbidity of emulsions were compared with known density -standards. Result: When the equal or larger beanch had faster fluid sppeed, that branch received the greater volume of Ethiodol, and it was insensitive to the speeds of the fluid and the Ethiodol injection rate. When smaller branch faster fluid speed, the volume of Ethiodol received by that branch depended on phantom used, and was influenced by speed of the fluids, and Ethiodol injection rate. In particular, when the smaller branch had the faster fluid speed, decreasing the Ethiodol injection rate put relatively more Ethiodol into the smaller blanch. Conclusion: When the tymor vessels are smaller than the normal vessels, decreasing injection rates may increase the distribution of Ethiodol to the tumor

유방절제술 후 방사선치료를 받는 유방암 환자의 골스캔 추적검사에서 보이는 상부늑골에 나타난 열소의 의의: 골 전이인가?

김용훈,차순주,김정숙,조우호,김지영 인제대학교 2001 仁濟醫學 Vol.22 No.1

Purposes: This is to evaluate weather the hot uptake on upper ribs in follow-up breast cancer patients is caused by radiotherapy or metastasis. Materials and Methods: We retrospectively reviewed the medical records, bone scan and other radiological study of 37 patients with radiotherapy after mastectomy. Bone scans were reviewed by three radiologists and final decisions were reached by consensus. We were analyzed in the periods of the radiation therapy, number of and time of bone scan, time of appearance of hot uptake and duration and location of the hot uptake. Results: Hot uptake was occurred in 17 patients. The median radiation dose was 5972cGy(range 5040∼7200cGy). The median time to initial occurrence was 13 months(range 7∼21 me). Hot uptake on bone scan was not related to the amount and duration of the radiotherapy. In 9 patients, hot uptakes were disappeared, spontaneously. In 6 patients. hot up-takes were remained but decreased uptakes. One patient was proved the uptake metastasis. Conclusions: We concluded that hot uptake on upper ribs in follow-up breast cancer patient were occurred on account of radiotherapy.

골주사를 이용한 사교상 (Snake bite) 환자의 경과 관찰 2예 보고

이민재,차순주,박정국,이황복 대한핵의학회 1985 핵의학 분자영상 Vol.19 No.2

It is very difficult to check the severity and clinical course of the toxicity in snake bite patients by virtes of clinical manifestation and laboratory tests. And we observed the findings of bone sean with ggmTc-MDP in two snake bite patients. First pati nt was bitten in the right ankle with local pain and swelling. The finding of bone scan of him was increased uptake of radionuclide in the soft tissue of right leg and thigh. Others were normal findings. Second patient was bitten in the right hand. But his symptom was severe and he com- plained local pain and swelling, nausea, blurred vision, and oliguria. The bone scan findings of secand patient was; Increased uptake of radionuclide in the soft tissue of whole body. Decreased uptake in the bone tissue, Renal outline was not delineated, Follow up study 10 days after, revealed more improved findings in the scan.