소아 급성 신우신염환아의 색도플러 초음파 검사의 유용성

김은미,권귀향,이혜경,홍현숙,최득린 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.1

Purpose: Urinary tract infections are common in childhood and are most frequent in those under 1 year of age. In these children, however, differentiation of the pyelonephritis from cystitis is clinically difficult. We investigated the utility of color doppler image ultrasound in the diagnosis of acute pyelonephritis(APN) in children. Results were compared with renal cortical scintigraphy using 99mTC-DMSA. Materials and Methods : 99mTc-DMSA SPECT and color doppler ultrasound were performed within 1 week intervals in 14 patients with clinically suspected APN. (aged 4months to 15years: mean 6.1 year, 7 girls and 7boys). Urine culture was considered positive if greater than 100.000 colonied of a single organism were isolated. CDI was performed with 3.5NHz convex linear probe Ultramark 9(ATL., Bothell, Washington, USA) following a standard gray scale sonogram of the kidneys. Renal cortical scintigraphy was performed with 99mTc DMSA SPeCT(PRISM 2000, Picker, USA), Axial, coronal, both sagittal pinhole images were obtained 1.5-2 hour after 1mCi isotope was injected. Renal scan was considered to be abnormal and indicative of APN when there was a focal, wedged shaped defect in radionuclide accumulation extending from the periphery of the kidney to centrally or if there was diffuse abnormality in renal tubular function. Renal scarring was defined when defects were shallow lesions along the periphery of the kidney with evidence of volume loss, or if they could be shown from prior examination to pre-date of the acute episode. The color doppler image were interpreted to be consistent with APN if there was decrease flows in the renal cortex. Results: Of the 28 kidneys were examined, renal scan showed 5 cases of abnomal findings, 3 cases were APN, 2 cases were chronic scarring. Two fo the three cases of APN showed decreased blood flow on CDI and positive culture, for a sensitivy 67%. Two cases of renal scarring due to grade V bilateral vesicoureteral reflux show decreased blood flow at right upper pole kidney on CDI, however DMSA scan had diffculties finding the new lesion due to underlying irregularity of scarred kidney. Color doppler US correctly identified 4 of 5 renal poles with APN and 21 of 23with no APN including 2 patients with false positive. The DMSA scan was used as the standard of comparison the study; the CDI has a sensitivity 67%, specificity 84%, positive predictive value 33%, negative predictive value 95%. 84% The lesion showed decreased blood flow and on one follow up case increased blood flow. The presence of prior renal scarring made interpretation of asymmetric vascularity difficult on DMSA, the use of CDI may increase the diabnostic sensitivity of sonography in pediatric pyelonephritis.

신장이식전후 정맥디지탈감산 혈관조영술의 방사선학적 고찰

최득린 대한영상의학회 1986 대한영상의학회지 Vol.22 No.2

Renal IV DSA was applied to evaluate 15 potential renal donors and 14 examinations of 12 renal allograft recipients. We evaluate the angiographic acute or chronic rejection, alteration of renal size after transplantation, excretion time of the contrast media and pre, post DSA serum creatinine level. DSA is a safe, easily performed, outpatient prodecure and useful in evaluation and distinguishing status of surgical anastomosis, intrarenal vasculatures. arterial excretion time and rejection phenomenon.

X線 造影劑 注入量이 白鼠腎에 미치는 影響의 實驗的 硏究

崔得麟 고려대학교 의과대학 1984 고려대 의대 잡지 Vol.21 No.1

The clinical use of contrast media continue to increase at an enormous rate with new development in diagnostic modalities. Although reports of the contrast media in roentgenography producing acute renal impairment have increased, the pathogenesis is unclear. Predisposing factors include advanced age, previous renal insufficiency, diabetes mellitus, dehydration, multiple myeloma, cardiac disease and hyperuricemia. The author emphasize recent information concerning the pathophysiology of nephrotoxic acute renal impairment produced by radiocontrast media available nowadays and aminoglyconside antibiotics-Gentamycin, which administered subcutaneously twice daily for 10 days. 350 rats (Weight 180-200gm) classified into 3 group, dehydrate group, hydrate group and Gentamycin induced renal impaired group. The author injected small dose, proper dose and massive dose respectively and then took IVP and enforced nephrectomy for histologic examination whether tubular damages or not. The results were summarized as follows: 1. Incidence of contrast induced nephrotoxicity. 1) Dehydrate group Histologic changes developed in 29 rats among 125 rats with overall incidence of 23.2%. Ideal dose without nephrotoxicity ranges from 0.5ml to 1.5ml/㎏. 2) Hydrate group Histologic changes developed in 26 rats with overall incidence of 20.8%, lower than dehydrate group. Ideal dose without nephrotoxicity ranges from 0.5ml to 1.5ml/㎏. 3) Gentamycin treated group Histologic changes developed in 37 rats among 80 rats with overall incidence of 46.3%, 13 rats died with dosage of 5.0ml/㎏, motality rate of 52%. Proper dose range from 1.5ml and under 2.5ml/㎏. 2. Intravenous pyelography 1) Dehydrate group All rats showed good nephrogram and pyelogram during 5 minutes to 30 minutes. No evidence of visualization of large intestine even after 12 hours or 24 hours. 2) Hydrate group Good nephrogram and pyelograms were taken at 5 minutes to 30 minutes with dosage of 0.5ml to 1.5ml/㎏. 3) Gentamycin treated group Poorly visualized nephrogram taken at 30 minutes to 60 minutes. 12hours delayed film showed contrast filled large intestine, possibly due to extrarenal excretion because of renal impairment. 3. Histologic findings. There were variable findings including interstitial hemorrhage between renal cortex and medulla, eosinophilic proteinous round material in the distal convoluted tubules, hydropic degeneration of proximal convoluted tubules and toxic necrosis of proximal convoluted tubules with focal degeneration.

담낭의 경구조영술 1, 005 예를 통한 형태와 담석과 Biliary dyskinesia 에 관한 고찰

최득린 대한영상의학회 1980 대한영상의학회지 Vol.16 No.1

Oral cholecystography has been proved useful and widely used as screening method in the gallbladder disease. The material consist of 1, 005 cases including 411 males and 591 females of oral cholecystography performed at Soon Chun Hyang Medical College Hospital during the last two years from 1977 to 1979. The authors analyzed relationship of gallbladder shape to cholelithiasis and biliary dyskinesia. The results obtained are as follows : 1. Among 1,005 cases, 414 cases were male and 591 cases were female. The female was predominant than the male and highly affected between 41-50 years of age. 2. Shape of the gallbladder was classified into the 9 type ; most popular type was pear type. 3. Incidence of gallstone was more common in septated and folding type than others. 4. Male to female ratio of gallstone was 54 ; 84 of total 138 cases, and peak age was 41 to 60 years (65.2%). 5. In 138 gallstone cases. opaque stones were 65 cases(47.1%) and nonopaque stones were 73 cases (52.9 ). 6. The emptying rate of gallbladder was faster in the male than the female, and faster in the older are group over 51 years than the younger age group below 30 years. Average emptying rate was 41.8%. 7. Biliary dyskinesia was predominant between the age of 31-40(37.3%), We classified the biliary dyskinesia into 3 types ; hyperkinetic dyskinesia, hypotonic dyskinesia and hypertonic dyskinesia. Most prevalent type was hypotonic dyskinesia. 24 cases(47.1%).

심장질환의 디지탈감산조영술

최득린 대한영상의학회 1986 대한영상의학회지 Vol.22 No.2

DSA was done in 133 examinations of 128 patients during 2 years consist of 9 examination of IV DSA and 124 examination of selective cardian DSA after cardiac catheterization. Open heart surgerywas perfomed in 90 patients and 12 patients showed discrepancy between pre-and post operative diagnosis, showing a total 86.7% of diagnostic accuracy with DSA. We experienced the significant reduction in dose of contrast media , 30-40% of dose of conventional cardiac angiogrpahy. It is concluded that DSA I useful in the evaluation of septal defects, valvular disease and other congenital heart disease. DSA is an accurate simple and safe method in evaluating of cardiac diseases.

무릎관절의 골 관절염 : 방사선 촬영술과 자기공명 영상의 비교 Comparison of Radiography and MR Imaging

최득린 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1

상하지의 방사선학적 검사를 이용한 개인식별에 관한 연구

최득린,김대호,이혜경,권귀향,김기정 내무부 국립과학수사연구소 1992 國立科學搜査硏究所年報 Vol.24 No.-

진행 위암에서 분화도에 따른 표준섭취계수의 차이 : 18F-FDG PET-CT의 분석

최득린 순천향대학교 의학연구소 2009 Journal of Soonchunhyang Medical Science Vol.14 No.3

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안정성과 불안정성 박리성 골연골염의 감별에서 자기공명 양상소견 : 자기공명영상 기준의 재평가

최득린 순천향의학연구소 2008 Journal of Soonchunhyang Medical Science Vol.14 No.1

Objective: To assess the radiographic and MR features of osteochondritis dissecans(OCD) in the knee, ankle and elbow and reappraise the criteria for differentiating stable and unstable OCD by using MRI. Materials and Method: The author retrospectively reviewed 16 cases of OCD who had correlative arthroscopy or arthrotomy. There were 15 patients with an average age of 18 years(12-41 years). The author analysed age, location, shape, signal intensity, articular cartilage, subchondral bone, abnormal fluid collection and displacement of OCD if any. Results: 12 cases in femoral condyle(7 in MFC and 5 in LFC), 2 cases in medial talar dome and 2 cases in capitulum. Stable OCD were present in 4(25%) and ubstable OCD in 12(75%)of 16 cases. Radiography showed poor correlation with arthrography and 7 cases were understaged. MRI proved accurate in discriminating stable(4 of 4 cases) versus unstab1e(12 of 12 cases) OCD. Conclusion: The author conclude that high signal intensity line between OCD and underlying bone, defect of articular cartilage and subchondral bone cyst, displacement of fragment(if any) on T2WI of MRI are strongly suggestive findings of unstable OCD. MRI is very sensitive method of detecting instability of OCD and can predict arthroscopic findings accurately.

영·유아의 先天性 十二指腸 閉塞에 관한 考察 : annular pancreas, duodenal diaphragm and duodenal obstructing band

崔得麟,金基廷 순천향대학교 1983 논문집 Vol.6 No.1

The causes of obstruction of duodenum are duodenal atresia, annular pancreas, duodenal diaphragm, obstructing duodenal band(Ladd's band) and duodenal duplication cysts. We exprienced annular pancreas, duodenal diaphragm and Ladd's band with partial or complete duodenal obstruction. Annular pancreas is an anomaly of the ventral pancreas and probably due to the persistence of the left ventral bud. We present these cases based on clinical and radiological fingings with review of some literatures.