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권우철,김영주,이영한,리원연,김명순 연세대학교의과대학 2006 Yonsei medical journal Vol.47 No.3
The effectiveness of percutaneous embolotherapy in cases of hemoptysis due to pulmonary tuberculosis from increasing severity of lung parenchymal injury was compared. The pattern of pleural involvement, as seen on chest radiography and angiography, were comparatively analyzed in 230 patients who were available for follow-ups from March 1992 to December 2003. Chest radiography findings were classified into 4 types based on levels of complicated lesions and pleural involvement. Angiography findings were divided into 4 groups based on the level of blood supply to lesions. Early hemostasis with respect to radiographic group were as follows: Type I- 92% (73/79), Type II- 80% (52/65), Type III- 70% (42/60), and Type IV- 56% (52/92); there was an average success rate of 73% (219/296), and continued hemostasis was found in 80% of Type I patients (62/77), 77% of Type II patients (41/53), 62% of Type III patients (25/40), and 45% of Type IV patients (27/60), with an average long- term hemostatic rate of 67% (155/230). Increasing severity of pleural involvement and associated complications correlated with increasing development of systemic collateral arteries other than the bronchial artery. The severely increased circulation in systemic collateral arteries makes it difficult to predict good hemostatic results following embolization. Therefore, we recommend aggressive treatment, such as surgical intervention, after embolization in such instances.
권우철 한국재난정보학회 2018 한국재난정보학회 학술대회 Vol.2018 No.11
우리나라의 화학 산업은 국가생산·수출의 핵심을 담당하는 기반산업이며, 전자, 자동차 등의 산업과 밀 접하게 연관되는 핵심 산업이다. 특히, 우리나라 수·출입 물동량의 90% 이상을 담당하고 있는 해운항만을 통해 화학물질의 물류가 대부분 이루어지고 있다. 화학물질 사고는 텐진항 사고 사례에서도 보여주듯이 폭발적 분출로 짧은 시간에 큰 피해가 발생하므로, 예방이 가장 중요하고, 사고 시 신속하고도 유효한 대응조치가 필요하다. 따라서 본 연구에서는 항만 안전 관리제도, 운영상황 등을 살펴보고, 항만 내 화학물질의 안전관리 개선방안을 제시하였다.
경동맥의 초고속 조영증강 자기공명혈관조영술 : 경동맥과 경정맥의 식판별에 대한 시간 조정변수의 최적화
권우철 대한영상의학회 1998 대한영상의학회지 Vol.39 No.5
Purpose : To investigate the optimal delay and acquisition time for discrimination of the arterial from the venous phase in ultrafast 3D contrast-enhanced MR angiography of the carotid artery. Materials and Methods : We reviewed the MR angiographic findings of 233 patients in whom carotid stenosis and cerebrovascular disease were suspected. On the basis of delay and acquisition time they were divided into four groups. In the first three, contrast material was injected manually, and after the optimal time, mechanical injection was used for the last group. On the basis of signal intensity of the carotid artery, image quality was graded in four steps. Discrimination of the arterial from the venous phase was graded in three steps, based on the degree of venous enhancement. Results : The best grade of image quality was 70% in the first group, 85% in the second, and 95% in the third. In discrimination of the arterial-venous phase, the most definite grade was 50% in the first group, 62%in the second, and 75% in the third. Between manual and mechanical injection groups, there was no significant difference in image quality and discrimination of the arterial-venous phase.Conclusion : These results suggest that for ultrafast 3D contrast-enhanced MR angiography of the carotid artery, with manual injection of contrast material, 8-second delay time and 7-second acqusistion time are optimal..
권우철,이영한,이명섭,김영주,성기준,김명순,용석중,정순희 대한영상의학회 2006 대한영상의학회지 Vol.54 No.2
목적: 진행성 거대종괴성 섬유화의 진단에 있어서 관류 CT의 유용성에 대해 알아보고자 하였다. 대상과 방법: 진행성 거대종괴성 섬유화 환자 13명의 20개의 병변에 대하여 관류 CT 소견을 후향적으로 분석하였다. 역동적 관류 CT 영상 자료를 얻기 위해서 16열 다중 검출기 CT를 사용하였고 다중 나선식 획득방식으로 조영 전 영상과 조영제 주입 후 15초, 30초. 45초, 60초, 90초, 120초, 180초, 300초에 촬영하여 원천 영상을 얻었다. 관류 CT는 Volume map과Washout map을 구현하여 육안적 분석으로 점수를 산정하였으며 폐암 20예의 관류 CT와 비교하였다. 결과: Volume map은 20예 중 19예에서 세 명의 관찰자 모두 중 관류 또는 저 관류이었으며Washout map에서도 19예의 중간 또는 약한 washout이였다. 세 명의 관찰자간 일치도는 통계학적으로 유의하게 높은 수치를 보였다(kappa 값 >0.818, p<0.01). PMF 군은 Volume map에서의 고 관류와 Washout map에서의 강한 washout은 모두 1예(5%)씩인데 반하여 폐암 군에서는 각각 19예(95%)와 14예(70%)이었고, Chi-Square 검정 결과 두 군간에 통계학적 차이를 보였다(χ2=32.129, p<0.01). 결론: PMF에서 역동적 CT를 이용한 관류 영상(Volume map과 Washout map)은 폐암과의 감별진단에 유용한 방법이다. Purpose: We wanted to evaluate the usefulness of perfusion CT for the diagnosis of progressive massive fibrosis. Materials and Methods: We retrospectively analyzed the perfusion CT images of 20 lesions that showed progressive massive fibrosis in 13 patients. Using 16 channel multi-detector CT, a dynamic study was performed with the multiple spiral acquisition technique at 0 (precontrast), 15, 30, 45, 60, 90, 120, 180, and 300 seconds after contrast injection. The perfusion image was reformatted using these source images; it was scored on the volume map and washout map by visual inspection and then compared with 20 lesions of lung cancer. Results: The volume map showed either middle or low perfusion for 19 among the 20 lesions. The washout map also showed a weak or moderate washout pattern. The kappa values (>0.818) for the inter-reader agreement reached statistical significance (p<0.01). High perfusion on the volume map was seen in 1 case (5%) in the PMF group and in 19 cases (95%) in the lung cancer group. Intense washout on the washout map was seen in 1 case (5%) in the PMF group and in 14 cases (70%) in the lung cancer group. There was a significant difference between the two groups (χ2=32.129, p<0.01). Conclusion: Perfusion CT consisting of the volume map and washout map can be a useful method for the differential diagnosis between PMF and lung cancer.