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혈액투석을 위한 내경정맥 도관 삽입 중 발생한 상대 정맥 증후군
길욱현 ( Gil Ug Hyeon ),송호철 ( Song Ho Cheol ),백정선 ( Baeg Jeong Seon ),김진수 ( Kim Jin Su ),조근종 ( Jo Geun Jong ),이지인 ( Lee Ji In ),남유정 ( Nam Yu Jeong ),최의진 ( Choe Ui Jin ),장윤식 ( Jang Yun Sig ) 대한신장학회 2004 Kidney Research and Clinical Practice Vol.23 No.2
Most cases of superior vena cava (SVC) syndrome are secondary to malignant disease and subacute in their presentation. However, the exponential increase in use of indwelling central venous catheters and cardiac pacemakers over the last two decades has resulted in more patients with SVC syndrome. Internal jugular vein cannulation has become the preferred approach for temporary hemodialysis catheter placement following the reports of an increased in cidence of subclavian vein stenosis due to subclavian vein catheterization. We describe a patient who developed SVC syndrome after internal jugular vein catheterization. The patient had been swollen the left arm intermittently due to left central vein stenosis for 1 year and experienced balloon angioplasty and stent insertion for three times. We diagnosed the SVC syndrome through the both subclavian venography, which revealed complete obstruction of the left brachiocephalic vein with extensive collateral circulation and mild stenosis of the distal right internal jugular vein. Resolution of the clinical SVC sydrome occurred after catheter removal. (Korean J Nephrol 2004;23(2):349-352)
최근형 ( Geun-hyung Choi ),김태형 ( Tae-hyung Kim ),이미애 ( Mi-ae Lee ),박완철 ( Wan-cheol Park ),조길영 ( Gil-young Cho ),박제철 ( Je-chul Park ) 한국환경기술학회 2008 한국환경기술학회지 Vol.9 No.4
본 연구에서는 음식물쓰레기의 장기 혐기성소화 시 독성으로 작용하는 암모니아의 영향에 대하여 조사하였다. 실험에 사용된 음식물쓰레기의 BOD<sub>5</sub> 및 CODcr 농도는 59,100mg/L 및 155,700mg/L였고, CODcr/BOD<sub>5</sub> 비는 2.7이었다. 운전결과, BOD<sub>5</sub> 및 CODcr 제거효율은 체류시간 80일에서 95.8% 및 87.0%를 보였다. 또한, 체류시간 80일의 경우 암모니아 농도가 3,500mg/L까지 높아졌음에도 혐기성 미생물에는 아무런 영향이 없는 것으로 보아 독성을 유발하는 한계농도도 높아진 것으로 판단된다. This study was conducted to analyze the effect of ammonia which causes a poisonous reaction with respect to the long-term anaerobic digestion for food waste. BOD<sub>5</sub> and CODcr concentrations of food waste in the experiment were 59,100mg/L and 155,700mg/L. The ratio of CODcr/BOD<sub>5</sub> was 2.7. As operation results, the removal efficiencies of BOD<sub>5</sub> and CODcr at 80 day retention time showed 95.8% and 87.0%, respectively. Also, extended acclimation period made the level of toxic limit concentration heighten such that with 80 day retention time, even 3,500mg/L of ammonia concentration does not affect to anaerobic microorganism.
대한간학회지 제8차 춘계학술대회 초록집 : 포스터 전시 ; 사산과 관련된 원발성 담즙성 간경변증 1예
오길찬 ( O Gil Chan ),박상훈 ( Park Sang Hun ),임해성 ( Im Hae Seong ),송진영 ( Song Jin Yeong ),박철희 ( Park Cheol Hui ),한태호 ( Han Tae Ho ),박현주 ( Park Hyeon Ju ),이동근 ( Lee Dong Geun ),김종혁 ( Kim Jong Hyeog ),박충기 ( 대한간학회 2002 Clinical and Molecular Hepatology(대한간학회지) Vol.8 No.2(S)
간에 단일 종괴 형태로 나타난 특발성 과호산구 증후군 치험
오길찬 ( O Gil Chan ),박상훈 ( Park Sang Hun ),백승훈 ( Baeg Seung Hun ),박철희 ( Park Cheol Hui ),한태호 ( Han Tae Ho ),이동근 ( Lee Dong Geun ),연종은 ( Yeon Jong Eun ),김종혁 ( Kim Jong Hyeog ),변관수 ( Byeon Gwan Su ),박충기 ( 대한소화기학회 2004 대한소화기학회지 Vol.43 No.1
Hypereosinophilic syndrome is characterized by persistent blood eosinophilia of 1,500/㎣ or more in the absence of known causes and multiorgan dysfunction by eosinophil-related tissue damage. In Korea, some cases of hypereosinophilic syndrome with hepatic involvement have been described with prolonged benign clinical courses. Most of them were diffuse or multifocal lesions in imaging studies, and any case presenting as a large single mass lesion has not been described. Herein we report a case of hypereosinophilic syndrome with hepatic involvement in a 48-year-old woman who presented with a giant single mass. By abdominal CT scan, a lobulated well-margined heterogenous mass lesion was detected in the left lateral segment of the liver. Liver biopsy revealed severe eosinophilic infiltration and centrilobular necrosis of hepatocytes. The lesion completely disappeared after steroid administration for eleven months. (Korean J Gastroenterol 2004;43:61-65)
부재철(Jae Cheol Boo),한영길(Young Gil Han),이현진(Hyun Jin Lee),임근교(Geun Gyo Im),김순배(Soon Bae Kim) 대한CT영상기술학회 2011 대한CT영상기술학회지 Vol.13 No.2
I. Purpose This study aimed to determine the clinical effectiveness of dual energy imaging by comparative analysis with reference to the HU values measured from 140 kVp, 80 kVp, and mixing images with a ratio of 7 : 3 between them in normal myocardium and myocardial perfusion defect regions. This idea of comparative evaluation is based on the characteristics of dual energy that the HU values from the images from SP-DECT (adenosine stress cardiac perfusion CT using dual energy) vary with energy changes in X-ray caused by the increase or decrease of contrast agents. II. Meterial and Methods Subjects were patients who underwent dual source cardiac CT from September 14, 2009 to August 20, 2010 and were found to be with coronary artery disease. Each of them completed SP-DECT. Out of the images acquired, we used the images that were suspected to be with perfusion defect (PD) as a result of comparison With cardiac MRI and coronary angiography. They were sorted into stress-induced PD (SPD, N: 32) and myocardial infarction (MI, N: 31) by using our judgment. Next, measurement of HU values was made using ROIs in the PD site and normal myocardium adjacent to it. The size of each ROI was chosen as large as possible within the measurement areas and the number of ROIs was determined to be more than 2 to be averaged. For comparative evaluation, standard deviations of the means were calculated. III. Result The group means of standard deviations were 9.35 for MI and 27.53 for the SPD group, and in relation to the MI group, the mean of standard deviations of normal myocardium was 47.17, while in relation to the SPD that was 50.38. Our one way ANOVA analysis with SPSS (version 12.0, SPSS Inc, Chicago, IL, USA) of the data classified into three groups: SPD, MI, and normal myocardium (normal as against each of the SPD and MI groups) found that there were significant differences among the three groups, with p-value being .000(p<0.05). The Scheffe post hoc test also showed significant differences among the three groups, with p-value being .000(p<0.05). IV. Conclusions The results of this study of patients who underwent SP-DECT and were suspected to be with PD showed that, in terms of the mean of standard deviations of the HU values acquired, there were significant differences among the groups of adenosine stress induced PD, MI, normal myocardium. This suggests that at the time of the perfusion examination, contrast agents increase in the ascending order of normal myocardium, SPD, and MI. Differently phrased, given that contrast agents travel through blood vessels and blood flow in normal myocardium is considered to be normal, it can be interpreted that blood flow in the SPD group is worse than normal, but better than in the MI group. Another implication is that with these values a quantification analysis is feasible. In short, SP-DECT will be useful in increasing the accuracy of perfusion evaluation of ischemic heart disease in that it allows for more diverse imaging presentations by using characteristics of dual energy in relation to contrast agents, thereby making available comparative evaluation of images and facilitating quantitative analysis. 목적 Dual energy를 이용한 adenosine stress cardiac peifusion CT(SP-DECT) 검사에서 조영제의 증강정도에 따라 X-ray의 에너지 변화에 의한 영상의 HU값이 변화되는 특성을 이용하여 140 kVp, 80 kVp와 두영상을 혼합(7:3)한 mixing image의 정상심근과 myocardial perfusion defect부위의 HU값을 비교 측정하여 진단적 유용성을 알아보고자 한다. 대상 및 방법 연구대상은 2009년 09월 14일부터 2010년 8월 20일까지 dual source cardiac CT검사를 받은 환자 중 coronary artery disease가 있는 환자를 SP-DECT검사를 시행하였고 cardiac MRI와 coronary angiography와 비교해 perfusion defect(PD)가 있다고 판명된 영상을 사용하였다. 그 중 판독상에 stress에 기인한 PD(SPD, N:32)와 myocardial infarction(MI, N:31)로 분류하여 PD가 있는 부위와 인접한 정상심근에 ROI를 이용해서 각각의 HU수치를 측정하였다. ROI크기는 측정부위가 벗어나지 않는 정도에서 최대한 크게 하였고 최소 2부위 이상 측정하여 평균을 구하였다. 그리고 평균의 표준편차를 계산하여 비교 평가하였다. 결과 MI의 표준편차의 평균은 9.35이고 MI에 대한 normal myocardium의 표준편차의 평균은 47.17이였다. 그리고 SPD는 27.53이고 SPD의 normal myocardium은 50.38이였다. 그리고 두 집단의 전체 normal myocardium과 SPD, MI로 분류하여 SPSS(version 12.0, SPSS Inc, Chicago, IL, USA)를 이용하여 One way ANOVA로 분석한 결과 p value값이 .000(p<0.05)으로 나와 유의한 차이가 있는 것으로 나타났다. 그리고 Scheffe 사후검증결과 normal myocardium, SPD, MI 모두 p value값이 .000(p<0.05)으로 세 집단간 모두 유의한 차이가 나타났다. 결론 본 연구 결과 SP-DECT를 시행하고 PD가 있는 환자 중 adenosine stress에 기인한 PD와 MI, 그리고 normal myocardium간에는 HU수치의 표준편차 값이 유의한 차이를 보였으며 이것은 perfusion검사 당시 normal myocardium, SPD, MI 순서로 조영제가 증강이 되는 것을 의미한다. 즉 조영제는 혈류를 따라 가기 때문에normal myocardium의 혈류가 정상이라고 했을 때 SPD는 정상심근 보다는 혈액의 흐름이 잘 안 된다고 볼 수 있고 MI 보다는 혈액의 흐름이 잘된다고 할 수 있을 것이다. 그리고 이러한 값들을 가지고 정량적인 수치화도 기능할 것이다. 결론적으로 SP-DECT는 조영제에 대한 dual energy의 특성을 이용하여 여러 영상을 제공해 줌으로써 그 영상들을 서로 비교 평가 할 수 있고 보다 객관적인 정량화가 가능하다는 점에서 ischemic heart disease의 관류평가에 유용한 도움을 줄 수 있을 것이라 사료된다.