방사선과 영역에서 Personal Computer의 이용(I) -심혈관촬영실 업무의 전산화-

한만청 대한영상의학회 1985 대한영상의학회지 Vol.21 No.2

Recently, information that clinicians should know to perform the daily practice increase so rapidly that appropriate use of computer system is needed to handle the large amount of informations efficiently. But little is known about which system is appropriate to use or how much can we do with personal computer. Authors describe the experience in developing computer management and data storage system for cardiovascular radiology section in Seoul National University Hospital with APPLE II personal computer and report the experience which we got during recent one year. The results are as follows : 1. Authors describe the data input format for cardiovascular radiology section in Seoul National University Hospital. 2. Authors can get various sums, average and count of data collected during one month's clinical trial(202 cases) in an hour using our system. 3. Authors suggest that we can computerize the unite as large as 3,000 to 10,000 examinations per year using personal computer w th two 5 1/4" floppy disk system if length of record is adequately modified. 4. But for more efficient use of accumulated data(Database), authors recommend the use of large external memory device, such as hard disk.disk.

동맥 디지털 감산현관조영술의 임상정 응용

한만청 대한영상의학회 1984 대한영상의학회지 Vol.20 No.1

Though intravenous digital subtraction angiography (IV DSA) has several advantages over conventional angiography in diagnosis and follow up of various vascular disease, it also has several undesirable problems such as large volume of the contrast medium and inferior image quality compared to conventional angiography. So recently intrarterial digital subtraction angiography (IA DSA) was introduced for better image quality using small amount of contrast medium. The authors had good clinical results IA DSA which was made in 20 patients with our own system, SRM-11 developed by cooperation of Departments of Radiology and Medical engineering, Seoul National University Hospital. Intraarterial digital substraction angiography was found to have several advantages over conventional angiography : (a) small amount of contrast medium, (b) reduced need for selective arterial catheterization. (c) lower film cost, (d) shortened examination time, (e) ability to obtain a "road map", and (f) easier detection of contrast medium. Also IA DSA has several advantages over IV DSA: (a) less dependency on cardiac output, (b) far less vessel overlapping, (c) reduction in patient motion through less painful procedure by reduced volume of contrast media and shorter imaging time.ging time.

부신의 전산화단층촬영

한만청 대한영상의학회 1979 대한영상의학회지 Vol.15 No.2

Conventional radiography of the adrenal glands are too often unsatisfactory. It is well known that the whole body computed tomography is very useful in identifying retroperitoneal pathology. The authors intended to present normal data of adrenal glands for preparation of basis for interpretation of abnormalities. We reviewed CT scans of 30 cases without evidence of adrenal disease and 4 cases of adrenal lesions. The results are as follows; 1. There were 16 male and 14 female patients, and their ages ranged from 10 to 70 years. 2. On CT, both glands were shown in 23 (76%), the right in 24 (80%) and the left in 26 (86%). 3. Most of the right adrenal gland was linear or comet in shape in the apex, and partly‘inverted V’in the base. 4. The right adrenal had length of 2.4$\pm$0.8cm, width of 2.6$\pm$0.8cm and thickness of 0.6$\pm$0.1cm. The left adrenal, 2.5$\pm$0.7cm, 2.4$\pm$0.5cm and 0.7$\pm$0.1cm respectively. 5. In 2 cases of Cushing's syndrome, CT demonstrated grossly enlarged, smooth-conto red adrenal glands with convex borders. 6. In the case of cortical adenoma, CT showed the mass of homogeneous low density as a result to high total fat content. 7. In pheochromocytoma, CT showed relatively large mass with low density.

심맥관촬영술 자험 1120례에 관한 고찰

한만청 대한영상의학회 1978 대한영상의학회지 Vol.14 No.2

The cardiovascular angiography is one of the confirmative diagnositc procedure in all cardiovascular diseases as well as in various neoplastic and inflammatory diseases of other organs. Authors analyzed total 1120 cases of cardiovascular angiography that were studied in last seven years, from August 1971 to July 1978, at the Department of Radiology, Seoul National University Hospital. The results were as follows: 1. Among the 1120 cases, 707 patients were male and 413 cases were female. The age distribution was from one month to 69 years, but slightly more than 50% of all cases were in 10 to 39 years of age. 2. Among the 1718 angiographic studies, the cardiac angiography was 401, thoracic aortography 227, abdominal aorta and its branches 753, extremity arteriography 106, and venography including venacavography 169 cases. 3. The most frequent angiographic diagnosis was Tetralogy of Fallot (142 cases), and mitral insufficiency (69), Buerger's disease (59), hepatoma (52), Takayas arteritis (39), left to right cardiacshunt (39), aortic insufficiency (36), renal cell carcinoma (25), combined mitral and aortic insufficiency (19), and aortic aneurysm (19), in order of frequency. 4. During this period, total 29 failure of cardiovascular angiographic study were described. The causes were failure of arterial puncture (5 cases), cardiac arrhythmia (5), vascu ar tortuousity (4), severe side reaction to the contrast media (3), catheter rupture (1) and others including mechanical factors (11). 5. Eleven cases of major complications were noted. Four patients died during study or within 12 hours angiographic study, and the mortality rate was 0.36%. The first case was rupture of aortic aneurysm, second was cardiac camponade due to myocardial perforation in Tetralogy of Fallot patient, third was pulmonary embolism in right atrial myxoma patient and the last was retroperitoneal extravasation of contrast media in Tetralogy of Fallot with chronic renal failure patient. Other ajor complications were thrombosis of femoral artery (3), intraarterial knotting of catheter (2), renal artery embolism (1) and cutting of guide wire tip (1). 6. Among the 1120 cases, correct diagnosis was possible in 968 cases and the diagnostic accuracy was 86.4%. Of the 29 confirmed misdiagnoses, 10 representative cases were presented. 7. The angiocardiogphy is a relatively safe and accurate diagnostic procedure in all cardiovascular diseases as well as other neoplastic and inflammatory diseases.

일반연제 : 나선식 CT 를 이용한 간세포암의 진단 : 동맥기 및 지연기 스캔의 상대적 효용성

한만청,김정룡,최병인,이효석,한준구,최대섭,조재민 대한소화기학회 1994 대한소화기학회지 Vol.26 No.2

경피경폐담관조영술

한만청 대한영상의학회 1978 대한영상의학회지 Vol.14 No.2

Percutaneous Tranthepatic Cholangiography (P.T.C.) is the most valuable diagnostic technique to differentiate surgical jaundice from hepatocellular jaundice and to search the cause of the obstructive jaundice. P.T.C. using 23G Chiba needle has a high success rate in not only surgical jaundice cases but also medical problems of the liver and has a low risk. Authors present the clinical and P.T.C. findings of 189 cases which were experienced in last 5 years, from July 1973 to August 1978, at the Department of Radiology. Seoul National University Hospital. The summerized results were as follows: 1. Among the 189 cases, male was 133 cases and female was 56 cases, and the male to female sex ratio was 2 : 1. 2. The most frequent P.T.C. diagnosis was common bile duct stone (55 cases), and common bile duct cancer (54), pancreatic cancer (33), Cancer of Ampulla Vater (7), sclerosing cholangitis (5), clonorchiasis (4), gall bladder cancer (3), gall bladder stone (3), metastasis (3), hep toma (3), C.B.D. stone, other (5), and normal (14), in decreasing order. The sum of three main diseases, C.B.D. stone, other (5), and normal (14), in decreasing order. The sum of three main diseases, C.B.D. cancer and pancreatic cancer, was 75% of all cases. 3. The overall success rate of P.T.C. was 92.6%, and the diagnostic accuracy of P.T.C. was 86.9%. 4. Confirmed 19 cases of misdiagnosis was including 5 cases of gall bladder cancer, 4 of pancreatic cancer, 3 of common bile duct cancer, 2 of common bile duct stone, and others 5. All 4 cases of pancreatic cancer was misdiagnosed as common bile duct cancer. 5. Barium swallowing after P.T.C. was very useful in differential diagnosis of obstructive jaundice giving informations such as relative position of stomach, position of Ampulla Vater and the distance from Ampulla Vater to the obstruction site. 6. major complication such as hemoperitoneum, bile peritonitis, septicemia and severe hypotension was occurred in 6.5% of all P.T.C. case . 7. P.T.C. using fine Chiba needle was a very useful and informative diagnostic procedure in differential diagnosis of obstructive jaundice from hepatocellular jaundice and the nature of obstructive lesions.

방사선과 영역에서 Personal Computer의 이용

한만청 대한영상의학회 1984 대한영상의학회지 Vol.20 No.3

Recently data about performances in radiology department tend to increase rapidly and appropriate use of computer system is needed to monitor various jobs including schedulling of the patient, reporting of radiologic examination and film library management. The authors describe experiences in computerizing several jobs of radiology department using Apple 11 personal computer during last year, and our experiences suggest that with appropriate software and peripheral devices, personal computer can handle relatively large amount of informations about a certain functions in radiology department. The authors also put emphasis on the point that meticulous characterization and cocumentation of data is mandatory for effective use of computer system and should be done by radiologist who use or want to use or want to use computer system.

행동적방사선과학

한만청 대한영상의학회 1978 대한영상의학회지 Vol.14 No.2

In 1967, Dr. A. Margulis opened a new era in diagnostic radiology introducing the concepts of interventional radiology as a new subspeciality of diagnostic radiology, we prefer to call this active radiology, though. Examples of therapeutic, active radiological procedures carried out by radiologists, at the department of radiology, Seoul National University Hospital, are presented. They comprise a case of extraction of residual common bile duct stone through the T-tube, a case of common bile duct recannalization through the T-tube in common bile duct cancer patient, cases of intraarterial epinephrine infusion in massive gatrointestinal bleeding, a case of Gelfoam embolization of hepatic artery in bleeding hepatoma, percutaneous translumbar pyelography and nephrostomy in patients of obstructive renal diseases, a cases of percutaneous transhepatic cholangiography and drainage in inoperable obstructive javndice patient, two cases of atrioseptostomy with the Rashkind baloon cathete in patients of complete transposition of great vessels, and 215 cases of reduction of colonic intussusception with barium enema.

두경부질환에서의 디지탈감산혈관조영술

한만청 대한영상의학회 1985 대한영상의학회지 Vol.21 No.3

Eighty-eight patients who presented with a variety of head and neck symptoms were examined with intravenous or intraarterial digital subtraction angiography(IV or IA DSA), using the DSA equipment developed by Seoul National University Hospital. A grading system was used to evaluate the ability of DSA to answer specific diagnostic questions. Diagnostic information without need of further study was obtained in 71% with IV DSA, in 86% with aortic arch DSA and in 81% with selective arterial DSA, showing a total of 79% of diagnostic accuracy with DSA. It is concluded that IV DSA is useful in the evaluation of the cervical carotid and vertebral arterial disease, and pituitary mass lesion, while IA DSA is useful in the evaluation of most of the intracranial lesions, spinal arteriography and intra-arterial embolization. DSA is both an accurate and safe imaging modality in the study of head and neck diseases.

신세포암의 동맥조영촬영에 관하 연구

한만청 대한영상의학회 1978 대한영상의학회지 Vol.14 No.1

The significancy of renal arteriography in the diagnosis and management of patients with renal cell carcinoma has been well established since dos Santos introduced translumbar aortography in 1929. Selective renal arteriography with epinephrine injection is excellent diagnostic tool in differentiation of intrarenal masses, especially between renal cell carcinoma and simple renal cyst. The arteriographic findings of 21 cases of confirmed renal cell carcinoma, with their clinical findings, are reviewed. The brief results are as follows: 1. Incidence of renal cell carcinoma is more common in male : male to female ratio is 15 : 6, and the peak age incidence is 6th to 7th decades (67%). 2. Numerous metastatic nodules are demonstrated in chest PA film in total 5 cases of patients. In IVP studies, 90% of cases are showing various abnormal findings such as calyceal deformity, nonfunctioning, delayed functioning and displacement of kidney. 3. The characteristic arteriographic finding is demonstration of abnormal tumor vessels (96%), and the other important findings were hypervascularity (86%), vascular displacement (76%), vascular pooling (67%), intrarenal A-V shunt (57%) and arterial encasement (57%) in order. The collateral veins such as ovarian vein and retroperitoneal veins are demonstrated in 3 cases and intraluminal filling defects in the inferior vena cava or renal vein are noted in total 3 cases of patient. In one case, there is no evidence of tumor vessels, and preoperative angiographic diagnosis was simple renal cyst. 4. Epinephrine study were performed in 12 cases of patient. Mild to marked enhancement of tumor vessels after epinephrine injection is demonstrated in 6 cases, and in other 4 cases, the epinephrine effects are questionable. But in 2 cases, well demonstrated tumor vessels in no epinephrine study are disappeared in epinephrine study due to constriction of proximal normal intrarenal arteries. 5. Selective renal arteriography is one of the most e fective and accurate procedure in the diagnosis of renal cell carcinoma.