Wilm’s tumor의 放射線治療

장기현 ( Kee Hyun Chang ) 국군의무사령부 1977 대한군진의학학술지 Vol.8 No.2

38% Lipiodol을 사용한 상악동 점막 기능 검사법에 의한 상악동염의 X-선 진단 -단순 X-선 촬영과의 비교를 중심으로-

장기현 ( Kee Hyun Chang ),김병근 ( Byoung Geun Kim ) 국군의무사령부 1979 대한군진의학학술지 Vol.10 No.1

실험 개에서 Rb - 82 심근 Dynamic PET 영상을 이용한 국소 심근 혈류 예측의 기본 모델 연구

고창순(Chang Soon Koh),이명철(Myung Chul Lee),정준기(June Key Chung),이동수(Dong Soo Lee),서정돈(Joung Don Seo),정재민(Jae Min Jeong),곽철은(Cheol Eun Kwark),장기현(Kee Hyun Chang),강건욱(Keon Wook Kang),황은경(Eun Kyung Hwang) 대한핵의학회 1995 핵의학 분자영상 Vol.29 No.1

N/A This study investigates a simple mathematical model for the quantitative estimation of regional myocardial blood flow in experimental canine coronary artery thrombosis using Rb-82 dynamic myocardial positron emission tomography. The coronary thrombosis was induced using the new catheter technique by narrowing the lumen of coronary vessel gradually, which finally led to partial obstruction of coronary artery. Ten Rb-82 dynamic myocardial PET scans were performed sequentially for each experiment using our 5, 10% and 20 second acquisition protocol, respectively, and three regions of interest were drawn on the transaxial slices, one on left ventricular chamber for input function and the other two on normal and decreased perfusion segments for the flow estimation in those regions. Single compartment model has been applied to the measured sets of regional PET data, and the rate constants of influx to myocardial tissue were calculated for regional myocardia1 flow estimates with the three parameter fits of raw data by the Levenberg-Marquardt method. The results showed that, (1) single compartment model suggested by Kety-Schmidt could be used for the simple estimation of regional myocardial blood flow, (2) the calculated regional myocardial blood flow estimates were dependent on the selection of input function, which reflected partial volume effect and left ventricular wall motion, and (3) mathematically fitted input and tissue time activity curves were more suit-able than the direct application of the measured data in terms of convergence.

측두엽 간질에성 발작기 뇌관류 SPECT의 간질병소 국소화 성능

고창순(Chang Soon Koh),이명철(Myung Chul Lee),정준기(June Key Chung),이동수(Dong Soo Lee),김은실(Eun Sil Kim),장기현(Kee Hyun Chang),이상건(Sang Kun Lee),정천기(Chun Kee Chung) 대한핵의학회 1995 핵의학 분자영상 Vol.29 No.3

N/A Anterior temporal lobectomy has become a widely used resective surgery in patients with medically intractable temporal lobe epilepsies. Prerequisites of this resection include the accurate localization of the epileptogenic focus and the determination that the proposed resection would not result in unacceptable postoperative memory or language deficits. The purpose of this study was to evaluate the performance of ictal SPECT compared to MRI findings for localization of epiletogenic foci in this group of patients. 11 patients who had been anterior temporal oral lobectomy were evaluated with ictal 99m-Tc-HMPAO SPECT and MRI. MRI showed 8/11(73%) concordant lesion to the side of surgery and ictal SPECT also showed 8/11(73%) concordant hyperperfusion. In 3 cases with incorrect or nonlocalizing findings of MRI, ictal SPECT showed concordant hyperperfusion. In 2 cases confirmed by pre-resectional invasive EEG, MRI showed bilateral and contralateral lesion but ictal SPECT showed concordant hyperperfusion. 3 delayed injection of ictal SPECT showed discordant hyperperfusion. Thus, ictal SPECT was a useful method for localizing epileptogenic foci in temporal lobe epilepsies and appeared complementay to MRI.

신피질성 간질에서 발작기 99mTc - HMPAO 뇌혈류 SPECT의 간질병소 국소화 성능

고창순(Chang Soon Koh),이명철(Myung Chul Lee),정준기(June Key Chung),이동수(Dong Soo Lee),김은실(Eun Sil Kim),현인영(In Young Hyun),장기현(Kee Hyun Chang),이상건(Sang Kun Lee) 대한핵의학회 1995 핵의학 분자영상 Vol.29 No.4

N/A The epileptogenic zones should be localized precisely before surgical resection of these zones in intractable epilepsy. The localization is more difficult in patients with neocortical epilepsy than in patients with temporal lobe epilepsy. This study aimed at evaluation of the usefulness of ictal brain perfusion SPECT for the localization of epileptogenic zones in neocortical epilepsy. We compared the performance of ictal SPECT with MRI referring to ictal scalp electroencephalography (sEEG). Ictal Tc-99m-HMPAO SPECT were done in twenty-one patients. Ictal EEG were also obtained during video monitoring. MRI were reviewd. According to the ictal sEEG and semiology, 8 patients were frontal lobe epilepsy, 7 patients were lateral temporal lobe epilepsy, 2 patients were parietal lobe epilepsy, and 4 patients were occipital lobe epilepsy. Ictal SPECT showed hyperperfusion in 14 patients(67%) in the zones which were suspected to be epileptogenic according to ictal EEG and semiology. MRI found morphologic abnormalities in 9 patients(43%). Among the 12 patients, in whom no epileptogenic zones were revealed by MR1, ictal SPECT found zones of hyperperfusion concordant with ictal sEEG in 9 patients(75%). However, no zones of hyperperfusion were found in 4 among 9 patients who were found to have cerebromalacia, abnormal calcification and migration anomaly in MRI. We thought that ictal SPECT was useful for localization of epileptogenic zones in neocortical epilepsy and especially in patients with negative findings in MRI.

두경부악성종양에서의 전산화단층촬영의 진단적 가치 -비인두업성종양을 중심으로-

이열,서창해,장기현,Lee, Yul,Suh, Chang-Hae,Chang, Kee-Hyun 대한방사선종양학회 1984 Radiation Oncology Journal Vol.2 No.1

The CT findings of 46 cases of nasopharyngeal cancer were analyzed and compared with clinical tumor staging. They are composed of 28 cases $(61\%)$ of squamous cell carcinoma, 13cases $(28\%)$ of undifferentiated carcinoma, 4 cases $(9\%)$of lymphoma and 1 case $(2\%)$ of adenoid cystic carcinoma. The results were as follows : 1. The most common CT findings of nasopharyngeal cancers are air·way asymmetry including obliteration of Rosenmuller fossa, orifice of Eustachian tube and asymmetric obliteration of parapharyngeal fat. 2. Other involved anatomic sites are carotid sheath area, oropharynx, paranasal sinuses especially sphenoid sinus, cervical lymph nodes, nasal cavity and skull base or middle cranial fossa. 3. CT does significantly influence on the tumor staging of the nasopharynx cancers, but has a definite value in evaluating deep tissue invasion of the cancers especially to parapharyngeal space or carotid sheath area. 4. CT seems to be essential for staging work-up, estimating the prognosis, and assessing the effect of radiotherapy of the nasopharyngeal cancer because it clearly shows the whole extent of the tumors including deep tissue invasion.

강의평가 도구의 타당도와 신뢰도에 관한 연구

채수진(Su-Jin Chae),장기현(Kee-Hyun Chang),강흥식(Heung-Sik Kang),김우선(Woo-Sun Kim) 한국의학교육학회 2002 Korean journal of medical education Vol.14 No.2

Purpose: The aim of this study was to analyze the instruction evaluation questionnaires that have been used by the Department of Radiology, Seoul National University College of Medicine, 2001, and to determine a means to improve them. Methods: This study used (1) a factor analytic technique to identify the instructional factors that determine the correlation between all pairs of the evaluation items. (2) A procedure known as Cronbach s alpha, which allows the internal consistency of the instruction evaluation items to be estimated. (3) A correlation method to compare the instruction evaluation score results among the students, residents, peer faculties and the faculty itself. Results: The results were summarized as follows: First, the Instruction Evaluation Questionnaire included 12 items, 6 comprising a teaching method connected with the lecturer factor and the other 6 a teaching method connected with the teaching resource factor. Second, the Cronbach s α index was found to be 0.91s. This indicates the high reliability of the items of the questionnaire for the instruction evaluation. Third, it was found that the correlation between the evaluators was very low (r=.345). In particular, the average score of the peer faculties was 3.33, which was lower when compared with the average score of other evaluators. Conclusion: There is no concordant opinion regarding the evaluation items that should be used in an instruction evaluation in a Medical College. However, the instruction evaluation items should consider various factors connected with the teaching and learning activity. There is a need to elaborate on the contents of the evaluation items in order that the instruction evaluation items be more reliable and have a greater validity.

뇌양미충증에 대한 전산화단층촬영소견

임덕,최병인,홍성모,장기현,Lim, Duk,Choi, Byung-Ihn,Hong, Sung-Mo,Chang, Kee-Hyun 대한영상의학회 1983 대한영상의학회지 Vol.19 No.1

Cysticercosis, like other parasitic disease, is still endemic in many parts of the world, and is not infrequently found in Korea. The authors reviewed CT findings of 54 cases of the cysticercosis involving the central nervous system which were proven by pathology and clinical findings. The results are as follows: 1. Male to female retio is 3 : 1 and the most prevalent age group is the fifth decade. The most common sympton is seizure(56%). 2. Involved areas in the brain are parenchymal(66%), intraventricular(15%), leptomeningeal(40%) and the mixed(15%). 3. Pre-contrast CT findings are the round low density in 46 cases(85%), multiple pin-point calcification in 18 cases(33%), variable degrees of hydrocephalus in 20 cases(37%) and peripheral edematous change in 8 cases(15). 4. Post-enhancement CT findings are complete or partial wall enhancement in 28 cases(50%), nodular enhancement in 18 cases(32%) and pin-point enhancement in 10 cases(18%) which represents the enhancement of the scolex per se. Basal cisternal enhancement is seen in one case, which is very unusual finding of cysticercosis cellulosae.

우리나라 의료윤리교육의 현황과 발전방향: 누가 무엇을 어떻게 가르치고 평가할 것인가?

최은경 ( Eun Kyung Choi ),장기현 ( Kee Hyun Chang ),김수연 ( Soo Youn Kim ),권복규 ( Ivo Kwon ),김옥주 ( Ock Joo Kim ) 한국의료윤리학회 2006 한국의료윤리학회지 Vol.9 No.1

This study examines the current status of ethics education in medical schools in Korea and addresses the following questions: "Who teaches medical ethics?" "What is taught?" and "How is it taught?" The study also surveys opinions on the questions of "Who should teach medical ethics?" "What should be taught?" and "How should it be taught?" From March to May 2006, a questionnaire was developed and sent to educators of medical ethics in Korea. Out of the 41 medical schools that received the questionnaire, 37 (90.2%) replied. Thirty six medical schools provide ethics education as part of their regular curricula; 28 schools (75.7%) offer independent courses in medical ethics, while 6 schools provide integrated/special lectures in medical schools. Thirty three medical schools (80.5%) reported teaching ethics in only one year of their curriculum, while the remaining 8 medical schools reported teaching ethics in 2 or more years. Two medical schools provided ethics courses in 5 years. Most schools offer ethics courses in the second or third year of medical schools, and 8 schools (21.6%) provide instruction in ethics in two or more medical courses. With respect to the question of who teaches, in 25 schools (67.6%) only one professor teaches medical ethics, while in the remaining 12 schools there are two or more instructors. Thirty schools do not have a full-time faculty member for medical ethics education. With respect to the question of what is taught, the most common content areas are ``ethical concepts,`` ``the ethics of death and dying,`` ``reproductive ethics,`` and ``doctor-patient relationships.`` As for the question of how it is taught, the most common methods are lectures (34 schools, 91.9%), group discussions (24 schools, 64.9%), and case studies. The majority of respondents indicated that current medical ethics education in Korea fails to meet the goals and standards of ethics education. The principal causes of this, according to respondents, are as follows: 1) an insufficient allocation of time for ethics education; 2) the lack of qualified instructors; and 3) the lack of recognition and support for the importance of ethics education in medical schools. As for the question of who should teach medical ethics, most of the educators believe that a team consisting of ethicists, clinicians, medical humanists, lawyers, and specialists is most suitable. Respondents ranked the following as the most important content areas: 1) ``ethical concepts``; 2) ``doctor-patient relationships``; 3) ``human rights and doctors.`` The ranking reveals a continuing stress on the conceptual and theoretical bases for medical ethics. Concerning teaching methods, most respondents replied that the best method is small group discussion, although it is impractical due to the lack of teaching faculty. At a workshop where these results were discussed, educators of medical ethics expressed a need, given the lack of resources and professional personnel in Korea, to build a network to share resources and information for the betterment of ethics education in Korea.

슬관절 이중조영촬영술 -연골판손상을 중심으로-

이손영 ( Son Yong Lee ),장기현 ( Kee Hyun Chang ),이기철 ( Ki Chul Lee ) 국군의무사령부 1978 대한군진의학학술지 Vol.9 No.1