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완전발달 난류 원관 유동에서의 3T 및 7T MRI를 이용한 자기공명온도계의 적용
류형우,백승찬,김동현,이활,오석훈,황원태,You, Hyung Woo,Baek, Seungchan,Kim, Dong-Hyun,Lee, Whal,Oh, Sukhoon,Hwang, Wontae 한국가시화정보학회 2020 한국가시화정보학회지 Vol.18 No.1
Magnetic resonance thermometry (MRT) is a technique capable of measuring three-dimensional mean temperature fields by utilizing temperature-dependent shifts in proton resonance frequency. In this study, experimental verification of the technique is obtained by measuring 3D temperature fields within fully developed turbulent pipe flow, using 3T and 7T MRI scanners. The effect of the proton resonance frequency (PRF) thermal constant is examined in detail.
임상연구 : 삼차원 단층촬영을 이용한 중심정맥의 쇄골상부 도자법에 대한 해부학적 고찰
서정화 ( Jeong Hwa Seo ),이활 ( Whal Lee ),정철우 ( Chul Woo Jung ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.50 No.4
Background: The current study aimed at elucidating the anatomical basis for a supraclavicular approach for central venous catheterization using three-dimensional computed tomography (3D-CT). Methods: Retrospective review of CT images from 60 adult patients with normal body build was performed using 3D-CT reconstruction. Right-sided approach was assumed, and the skin entry point was decided as a point above the subclavian vein at the supraclavicular fossa. Measured parameters were; angles of the clavicle (Aclv) and the subclavian vein (Ascv) to the coronal plane, the distance from the clavisternomastoid angle to the skin entry point (Dse), the optimal angle of needle insertion (Ains) targeting the confluence between the internal jugular vein and the subclavian vein, the distance from the skin entry point to the confluence (Dconf), and the diameter of the confluence (Dia). Descriptive statistics were performed for the measured values. Correlation test was performed between Ascv and Aclv. Results: Measured values were; Aclv = 8.0˚, Ascv = 5.7˚, Dse = 12.5mm, Ains = 40˚, Dconf = 20.5mm, and Dia = 18.1mm. Ascv demonstrated positive correlation with corresponding Aclv (r = 0.494, P < 0.001). Conclusions: Optimal guideline for the supraclavicular approach can be provided via 3D-CT investigation. Forty degrees of needle direction to the sagittal plane and parallel to the posterior surface of the clavicle, at 1.3 cm posterior to the clavisternomastoid angle insures proper puncture of the confluence without anticipated complications. (Korean J Anesthesiol 2006; 50: 373~8)
심근경색을 가진 환자에서 호흡정지 T2강조 자기공명영상의 유용성: 지연 조영증강 영상과의 비교
최상일,강성권,유원희,임청,조중행,이활,정진욱,박재형,이경원,Choi Sang Il,Kang Sung-Kwon,Ryu Won Hee,Lim Cheong,Choh Joong Haeng,Lee Whal,Jeong Jin-Wook,Park Jae-Hyung,Lee Kyung Won 대한자기공명의과학회 2003 Investigative Magnetic Resonance Imaging Vol.7 No.2
목적 : 심근경색을 가진 환자에서 호흡정지 T2강조 자기공명영상의 유용성을 알아보고자 하였다. 대상 및 방법 : 심근 생존능을 평가하기 위하여 자기공명영상이 시행된 환자에서 지연 조영증강을 보였던 11명의 환자를 대상으로 하였다. 지연 조영증강을 보이는 심근부위와 비교하여 T2강 조영상에서 일치하는 부위를 고신호강도, 동등신호강도, 저신호강도로 나누어 분석하였으며, 정상 심근과 경색 부위의 신호강도 세기 및 통벽성 범위(transmural extent)을 측정하였다. 환자의 임상정보를 토대로 심근경색의 시기와 T2 강조영상과의 상관관계를 분석하였다. 결과 : T2강조영상에서 5명의 환자의 12분절에서 정상심근에 비하여 경색부위에 고신호강도를 보였으며, 6명의 환자의 12분절에서 저신호강도를 보였다. 경색부위의 고신호강도는 정상심근에 비하여 $175{\pm}9\%$ 이었으며, 저신호강도는 $73{\pm}5\%$ 이었다 (p < 0.05). 통벽성 범위(transmural extent)의 평가에 있어, T2강조영상에서 고신호강도 부위는 지연 조영증강을 보인 부위보다 컸으나 $(100\%\;vs.\;49{\pm}17\%)$, 저신호강도 부위는 일치하였다. T2 강조영상에서 고신호강도는 심근경색후 11일 이내에 보였고, 저신호강도는 7개월 이후에 보였다. 결론 : 호흡정지 T2 강조영상은 부종 및 섬유화 반흔 범위의 평가와 함께 심근경색의 시기를 예측하는 데에 있어 유용할 것으로 사료된다. Purpose : To evaluate the usefulness of breath-hold T2-weighted MR imaging in patients with myocardial infarction. Materials and Methods : We investigated 11 patients with myocardial infarction who shown delayed enhancement on MR imaging. Infarcted myocardium on T2-weighted MR imaging was classified as high, iso, and low signal area comparing with normal myocardium. The intensity and transmural extent of infracted myocardium was also analyzed. On the basis of clinical information, the stage of infracted myocardium on T2-weighted MR imaging was assessed. Results : It was observed high signal area in 12 segments of 5 patients, low in 12 segments of 6 patients on T2-weighted MR imaging. The high signal intensity of infarcted myocardium was shown as $175{\pm}9\%$ comparing with that of the normal myocardium, low signal intensity as $73{\pm}5\%\;(p\;<\;0.05)$. In the evaluation of transmural extent, the high signal areas on T2-weighted MR imaging were larger than infarct area on delayed enhancement imaging $(100\%\;vs.49\%{\pm}17\%)$, whereas low signal areas on T2-weighted MR imaging correlated. High signal area was visualized on T2-weighted MR imaging within 11 days, whereas low-signal area was seen after 7 months. Conclusion : Breath-hold T2-weighted MR imaging is useful in the evaluation of stage as well as edema and fibrous scar in patients with myocardial infarction.
김민혜 ( Min Hye Kim ),이서영 ( Suh Young Lee ),이승은 ( Seung Eun Lee ),김미영 ( Mi Yeong Kim ),조은정 ( Eun Jung Jo ),박창민 ( Chang Min Park ),이활 ( Whal Lee ),조상헌 ( Sang Heon Cho ),강혜련 ( Hye Ryun Kang ) 대한천식알레르기학회 2014 Allergy Asthma & Respiratory Disease Vol.2 No.5
Purpose: Delayed hypersensitivity reaction can occur in a couple of hours to several days after injection of iodine-based contrast media (ICM). ICM-related delayed type hypersensitivity is not common but increasing as rapid growth of ICM use. Nevertheless, objective data on delayed type hypersensitivity are still scarce worldwide including Korea. This study was performed to investigate the clinical features of ICM-induced delayed hypersensitivity in Korean patients. Methods: We retrospectively reviewed the electronic medical records of patients diagnosed with delayed hypersensitivity to ICM from January 2009 to December 2012 at Seoul National University Hospital and analyzed the data to identify the clinical characteristics of these patients. Results: A total of 44 cases were diagnosed as delayed-type hypersensitivity to ICM. The mean age was 54 years, and 70.5% were female. The mean number of previous ICM exposure was 3.8, and skin reactions were the most common symptoms. In 45% of patients, hypersensitivity reaction developed on the first exposure to ICM. Among the 27 patients exposed to ICM again, hypersensitivity reactions recurred in only 4 patients (14.8%). There was no difference of recurrence rate according to the use of premedication or the change in ICM. Conclusion: In this study, we observed a female predominance and a low recurrence rate in delayed hypersensitivity to ICM. Premedication and ICM change was not effective in preventing recurrence of delayed type reactions.(Allergy Asthma Respir Dis 2014;2:352-357)
급성 출혈 환자에서 N-Butyl Cyanoacrylate를 이용한 경도관 동맥색전술의 유용성
제환준 ( Hwan Jun Jae ),김상윤 ( Sang Youn Kim ),이의중 ( Eui Jung Lee ),이활 ( Whal Lee ),서길준 ( Gil Joon Suh ) 대한외상학회 2005 大韓外傷學會誌 Vol.18 No.2
Background: N-Butyl Cyanoacrylate (NBCA) is a liquid embolic material that can be useful for transcatheter arterial embolization (TAE) of acute bleeding especially in patients with coagulopathy, because it does not depend on coagulation for its therapeutic effect. The aims of this study were to evaluate the clinical efficacy and safety of TAE with NBCA in acute bleeding patients. Methods: Between August 2003 and September 2004, TAE using NBCA for acute bleeding was performed in 23 patients (16 men, 7 women; mean age, 56.5years). The causes of bleeding were gastric ulcer (n=5), postoperative bleeding (n=4), post-biopsy bleeding (n=3), postpartum bleeding (n=3), duodenal ulcer (n=2), angiodysplasia (n=2), gastric lymphoma (n=1), iatrogenic injury (n=1), CMV gastritis (n=1), stab injury of the liver (n=1). TAE was performed using 1:3 mixtures of NBCA and iodized oil. The angiographic and clinical success rate, recurrent bleeding rate, procedure-related complication and clinical outcomes were evaluated. Results: The angiographic and clinical success rate was 100% and 91.3% (21/23), respectively. There was no serious ischemic complication. Recurrent bleeding occurred in 2 patients (8.7%) and they were managed with successful second TAE (n=1) and endoscopic treatment (n=1). Nine patients (39.1%) had coagulopathy at the time of TAE and clinical success rate in this group of patients was 88.9% (8/9). Conclusions: TAE with NBCA is highly effective and safe treatment modality for acute bleeding patients, especially when the patient has a coagulopathy.