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소 간세포암의 전산화단층촬영 소견 - 조영제 증강 전후 소견의 비교검토 -
김정룡(Chung Yong Kim),이효석(Hyo Suk Lee),최병인(Byung Ihn Choi),한만청(Man Chung Han),김수태(soo Tae Kim),김주완(Chu Wan Kim),김용일(Yong Il Kim),이건욱(Kuhn Uk Lee) 대한소화기학회 1988 대한소화기학회지 Vol.20 No.3
N/A Sixty-seven lesions of small hepatocellular carcinoma in 50 patients under 5cm in diameter detected by computed tomography (CT) were reviewed to characterize the CT feature. All 50 patients were studied with a CT-9800 scanner. CT scans were obtained both before and after administration of contrast medium given by bolus injection of 120 ml of meglumine iohatlamate. CT density of the tumor was classified as hypodense, isodense, and hyperdense on the basis of the difference in density between the lesion and the surrounding liver parenchyma. Detectability of small hepatocellular carcinoma on CT scans was divided into three categioies; Good: tumor is noted, and extent of tumor is clearly defined; Fair: tumor is noted, but extent of tumor is not defined; Poor: tumor is not noted. On nonenhanced CT scans, 40 cases (60%) showed hypodense masses and 27 cases (40%) showed isodense masses whereas all cases showed hypodense masses on contrast-enhanced CT scans. On nonenhanced CT scans, 27 cases (40%) were categorized as good, 13 cases (20%) as fair, and 27 cases (40%) as poor while 65 cases (97%) were categorized as good, and 2 cases (3%) as fair on contrast-enhanced CT scans. Additional CT characteristics of small hepatocellular carcinoma were well defined margin (99%), and peripheral hyperdense rim (44%). These results suggest that contrast-enhanced CT scans are better than nonenhanced CT scans in detecting and defining the tumor, and CT might be useful for characterization of small hepatocellular carcinoma.
간내 담관암의 전산화단층촬영소견의 특징 - 간 흡충중과의 연관성을 중심으로 -
최병인(Byung Ihn Choi),박재형(Jae Hyung Park),김주완(Chu Wan Kim),김승협(Seung Hyup Kim),김원홍(won Hong Kim),한만청(Chung Yong Kim),김정룡(Eun Sil Yu),김용일(Man Chung Han),유은실(Chu Wan Kim) 대한소화기학회 1988 대한소화기학회지 Vol.20 No.1
N/A 22 patients with intrahepatic cholangiocarcinomas of the liver were examined with computed tomography (CT). Initial symptom was nonspecific such as upper abdominal discomfort or pain in majority. There was no patient with jaundice or liver cirrhosis. 13 patients (59%) showed positive skin or stool test for clonorchis sinensis. 17 patients had the peripheral type of cholangiocarcinoma and five patients had the main duct type. The tumors showed low-density rnasses in pre and postcontrast CT scan in all cases vith wide variation of homogeneity. The tumor margins were irregular in 18 patients (82%) and the degree of contrast enhancement of the tumor was minimal in 19 patients (86%). 13 patients, who had the clonorchiasis, showed mild, and diffuse dilatation r>f the intrahepatic bile duct in addition to the low-density mass. 12 patients (55%) showed extrahepatic metastasis. In peripheral type of the tumor, five patients showed fine, stippled or aggregated powderlike high-density areas in precontrast Cl scan that vere mucinous substances within the mass on pathologic section. Eleven patients showed markedly low-density masses even in postcontrast CT which corresponded to diffuse, microcystic change of the tumor on resected specimen. In main duct type, all patients showed focal ductal dilataion around the low-density mass. Intrahepatic cholangiocarcinoma should be the primary diagnostic consideration when characteristic CT findings are detected in noncirrhotic patient with clonorchiasis.
이열,전석철,임정기,박재형,김주완,Lee, Yul,Jeon, Suk-Chul,Lim, Jeong-Ki,Park, Jae-Hyung,Kim, Chu-Wan 대한영상의학회 1983 대한영상의학회지 Vol.19 No.2
The chest X-ray findings of 20 cases of pulmonary opportunistic infections were analyzed according to causative agents. The results were as follows : 1. Final diagnoses of 20 cases of opportunistic infections were tuberculosis in 6 cases, pneumocystis carinii pneumonia in 5 cases, bacterial infection in 7 cases, and fungal infection in 2 cases. 2. The underlying diseases were leukmia in 6 cases, kidney transplantation in 6 cases, lymphoma in 3 cases, nephrotic syndrome in 1 case, nasopharyngeal cancer in 1 case, multiple myeloma in 1 case, agranulocytosis in 1 case, and hypogammaglobulinemia in 1 case. 3. In tuberculosis, all the 6 cases showed severe maniferstations such as miliary tuberculosis, tuberculous pneumonia, moderately advanced tuberculosis and tuberculous pericarditis. 4. In pneumocystis carinii pneumonia, the most frequent findings were bilateral alveolar densities and peripheral field of the lung was saved in most cases. 5. In 2 cases of fungal infections bilateral multiple cavitary nodules were noted. 6. In cases of bacterial infection there were more cases of gram negative infection than gram positive and 2 cases of pseudomonas revealed bilateral multiple cavitary nodules.
이열,강흥식,박재형,김주완,Lee, Yul,Kang, Heung-Sik,Park, Jae-Hyung,Kim, Chu-Wan 대한영상의학회 1987 대한영상의학회지 Vol.23 No.1
Microcholangiography using microbarium was done for radiological observaton of the morphology of intrahepatic microbiliary system and its change after extrahepatic bile duct obstruction. Regurgitation of microbarium into the systemic circulation ws also observed. Extrahepatic bile ducts of 40 rabbits were ligated and microcholangiography was done just after ligation, after 1 day, 3 days and 5 days. Injection pressure of microbariu was 58cm H\sub 2\O in 20 rabbits and 93cm H\sub 2\O in another 20 rabbits. Histologic findings of the liver was compared with microcholangiographic findings. The results were as follows : 1. In microcholangiography, interlobular bile ducts and ductules were well noted, but bile canaliculi were ot visible. 2. After extrahepatic bile duct ligation, ductules and small interlobular bile ducts were tortuously dilated and proliferated. 3. Microbarium was regurgitated into hepatic sinusoids from a portal tract due to rupture of interlobular bile ducts or d ctules, and this was observed only in limited portions of sample tissue sections, but could be found in most of 40 rabbits. From the above results, the morphology of intrahepatic microbiliary system and its change after extrahepatic bile duct obstruction could be radiologically observed with microcholangiography, so this technique could be used for an experimental study about the biliary system.
간장 및 담도 : 간종괴의 (肝腫塊) 자기공명영상 ( 磁氣共鳴影像)
윤용범(Yong Bum Yoon),송인성(In Sung Song),김정룡(Chung Yong Kim),최병인(Byung Ihn Choi),한만청(Man Chung Han),김주완(Chu Wan Kim),박현욱(Hyun Wook Park),조장희(Zang Hee Cho) 대한소화기학회 1986 대한소화기학회지 Vol.18 No.2
N/A Seventeen liver masses including eight hepatocellu]ar carcinomas, eight hemangiomas and one simple cyst were studied by magnetic resonance imaging (MRI) with 2.0 Tesla superconductive magnet in order to evaluate the possibility of differential diagnosis between the liver masses by MRI and to analyze the optimal pulse sequence in high field magnet. Identical multislice/multiecho techniques were used in all patients of obtain Tl-and T2-weighted spin echo using TR 500, 1500, 2000 msec and TE 30, 60, 90, 120 msec. MRI could detect liver mass in all cases. Hepatocellular carcinoma tended to have ill-defined margin, inhomogeneous signal intensity, central high signal intensity area and capsule sometimes and showed iso- or high signal intensity on SE 500/30 images and high signal intensity on T2 weighted images obtained with 2000 msec TR and 30, 60, 90 msec TE. Hemangioma tended to have sharp margin, homogeneous signal intensity and no central high signal intensity area or capsule and showed iso- or low signal intensity on SE 500/30 images. Hemangioma also has high signal intensity with prolongation of TR and TE. On T2-weighted images obtained with 2000 msec TR and 60, 90, 120 msec TE, hemangiomas had significantly greater contrast between mass and surrounding liver than hepatocel]ular carcinoma. Simple cyst showed well-marginated homogeneous low signal intensity on SE 500/30 image and increased signal intensity with prolongation of TR and TE. Differentiaion between hemangioma and hepatocellulor carcinoma could possible in 17 cases and MRI may become the procedure of choice for distinguishing hemangioma from hepatocellular carcinoma and may replace the angiography for the diagnosis of hemangioma.
경피경간담배액술 (經皮經肝膽排液術) 193예에 관한 분석
최병인(Byung Ihn Choi),박재형(Jae Hyung Park),임덕(Duk Lim),한만청(Man Chung Han),한준구(Jun Koo Han),이종범(Jong Beum Lee),김주완(Chu Wan Kim) 대한소화기학회 1984 대한소화기학회지 Vol.16 No.2
N/A Percutaneous transhepatic biliary drainage has played a major role in treatment of patients with biliary tract disease, especially obstruction by malignant disease. Percutaneous transhepatic biliary drainage was perfor med 193 times in 152 patients of obstructive jaundice for recent 3 years from July, 1981 to September, 1984 at department of radiology, Seoul National University Hospital. The results were as follows: 1) The male to female ratio was 2:3:1 and the 7 th decade was the most common. 2) The causes of obstructive jaundice included 135 malignant diseases and 17 benign diseases. Malignant diseases were 61 cases of bile duct cancer, 36 cases of metastasis, 26 cases of pancreatic cancer, 6 cases of gallbladder cancer, 4 cases of ampulla Vater cancer, 1 case of duodenal cancer, and 1 case of hepatoma. Benign diseases were 10 cases of common bile duct stone, 1 case of intrahepatic stones, 4 cases of benign stricture and 2 cases of cholangitis. 3) The most common indication was palliative drainage of obstruction secondary to malignant tumor in 113 cases. 4) The overall success rate was 95%. Internal drainage was achieved in 45(24%) cases and external drainage was accomplished in 139 (76%) cases. 5) Decline in serum bilirubin level was found in 144 patients (95%) with the most rapid decline within 1 week after the procedure. 6) Acute major complication occurred in 17 cases (9%) Percutaneous transhepatic biliary drainage is a proven technique for non-operative biliary decompression and established alternative to surgery.