1.Radiological Intervention for Renovascular Hypertension.
Journal of the Korean Society for Vascular Surgery 2000;16(1):161-164
No abstract available.
Hypertension, Renovascular*
2.Intrauterine Infection as a Cause of the Neonatal Pulmonary Injury and Bronchopulmonary Dysplasia.
Jin Haeng CHUNG ; Jeong Wook SEO
Korean Journal of Pathology 2000;34(6):431-436
The pathogenetic role of intrauterine infection to the neonatal pulmonary injury and bronchopulmonary dysplasia was assessed by studying the interleukin-6 (IL-6) level in the umbilical cord blood and the early morphologic changes of the neonatal lung. Patients were grouped into bronchopulmonary dysplasia (4 cases), chorioamnionitis without chronic lung injury (4 cases), and 6 cases without morphologic evidence of chronic lung injury or placental inflammation. IL-6 level of umbilical cord blood was higher in babies with bronchopulmonary dysplasia (17.7 pg/ml) compared to those with chorioamnionitis (4.7 pg/ml) or those with morphologically normal lung and placenta (6.2 pg/ml). Morphologic parameters of neonatal pulmonary injury were hyaline membrane, terminal bronchiole inflammation, terminal bronchiole regeneration, alveolar collapse and fibroblastic proliferation. Bronchiolar regeneration was the most peculiar feature seen in the lung with bronchopulmonary dysplasia. Alveolar collapse and interstitial fibroblastic reaction were commonly seen in bronchopulmonary dysplasia. The postnatal age at death was higher in those with bronchopulmonary dysplasia, although the occurrence of the morphologic changes was related with the chronicity of those lesions. These findings suggest that intrauterine infection is an aggravating factor for the neonatal pulmonary injury and bronchopulmonary dysplasia, although the early stage of the lung injury is not a definitive indicator for the progressive pulmonary damage leading to the bronchopulmonary dysplasia.
Bronchioles
;
Bronchopulmonary Dysplasia*
;
Chorioamnionitis
;
Cytokines
;
Female
;
Fetal Blood
;
Fibroblasts
;
Humans
;
Hyalin
;
Hyaline Membrane Disease
;
Infant, Newborn
;
Inflammation
;
Interleukin-6
;
Lung
;
Lung Injury*
;
Membranes
;
Placenta
;
Pregnancy
;
Regeneration
3.Slow flow and mural thrombus in aortic diseases: Spin-echo MR findings and their differentiation.
Jin Wook CHUNG ; Jae Hyung PARK ; Man Chung HAN
Journal of the Korean Radiological Society 1993;29(3):395-401
In order to evaluate the ability of spin-echo MR imaging to differentiate slow flow from mural thrombus in aortic diseases, we reviewed the spin-echo MR images of 13 patients with intraaortic thrombus documented by CT (N=11) or aortography (N=2). Six patients had aortic aneurysms and seven had aortic dissection. Intraaortic mural thrombi were accompanied by flow-related intraluminal signal of various patterns and extents in all 13 patients. On 10 gated MR studies, slow flow regions showed even-echo rephasing phenomenon (N=8), interslice variation of signal intensities of the intraluminal signal (N=7) and flow-related ghost artifact (N=2). However, these MR flow phenomena were obscured on two of three non-gated studies. Seven of 13 intraaortic thrombi remained hyperintense on T2-weighted second-echo images. In these circumstances, a hypointense boundary layer between slow flow and mural thrombus, which was caused by either 'boundary layer dephasing phenomenon' of slow flow or 'paramagnetic T2 shortening' of fresh clot at the edge of mural thrombus, was useful in discriminating the area of slow flow from that of mural thrombus. Proper interpretation of spin-echo MR images may obviate the need for phase display imaging or gradientecho imaging in differentiating slow flow and mural thrombus.
Aortic Aneurysm
;
Aortic Diseases*
;
Aortography
;
Artifacts
;
Humans
;
Magnetic Resonance Imaging
;
Thrombosis*
4.Slow flow and mural thrombus in aortic diseases: Spin-echo MR findings and their differentiation.
Jin Wook CHUNG ; Jae Hyung PARK ; Man Chung HAN
Journal of the Korean Radiological Society 1993;29(3):395-401
In order to evaluate the ability of spin-echo MR imaging to differentiate slow flow from mural thrombus in aortic diseases, we reviewed the spin-echo MR images of 13 patients with intraaortic thrombus documented by CT (N=11) or aortography (N=2). Six patients had aortic aneurysms and seven had aortic dissection. Intraaortic mural thrombi were accompanied by flow-related intraluminal signal of various patterns and extents in all 13 patients. On 10 gated MR studies, slow flow regions showed even-echo rephasing phenomenon (N=8), interslice variation of signal intensities of the intraluminal signal (N=7) and flow-related ghost artifact (N=2). However, these MR flow phenomena were obscured on two of three non-gated studies. Seven of 13 intraaortic thrombi remained hyperintense on T2-weighted second-echo images. In these circumstances, a hypointense boundary layer between slow flow and mural thrombus, which was caused by either 'boundary layer dephasing phenomenon' of slow flow or 'paramagnetic T2 shortening' of fresh clot at the edge of mural thrombus, was useful in discriminating the area of slow flow from that of mural thrombus. Proper interpretation of spin-echo MR images may obviate the need for phase display imaging or gradientecho imaging in differentiating slow flow and mural thrombus.
Aortic Aneurysm
;
Aortic Diseases*
;
Aortography
;
Artifacts
;
Humans
;
Magnetic Resonance Imaging
;
Thrombosis*
5.In vivo Pharmacokinetics of Adriamycin after Hepatic Arterial Chemo-Embolization with Adriamycin-Lipiodol Emulsion.
Myung Jin CHUNG ; Jae Hyung PARK ; Jin Wook CHUNG
Journal of the Korean Radiological Society 2001;44(4):461-465
PURPOSE: To analyse the parameters of in vivo pharmacokinetics such as absorption, distributionin , and excretion of adriamycin patients with hepatocellular carcinoma, and investigate the stagnation of adriamycin, in the liver. MATERIALS AND METHODS: Five patients in whom hepatocellular carcinoma was diagnosed and who were admitted for transhepatic chemoembolization were involved in this study. Fifty mg of adriamycin was mixed with 2.5 mL of water-soluble contrast material and 12 -15 mL of lipiodol, and the emulsion was injected into a selected tumor-supplying artery using a 3-F catheter. Between 1 minute and 72 hours after chemoembolization, peripheral blood samples were then obtained, and from these the blood concentration curve of adriamycin was calculated and applied to a two-compartment model. Using the model, several pharmacokinetic parameters were estimated. RESULTS: The volume of the central and the peripheral compartment was 45 L and 4090.6 L, respectively. 75.14% of adriamycin was delivered to the liver directly, and the absorption rate constant was 2.448/hr. Distribution clearance was 969.3 L/hr, and excretion and metabolic clearance was 136.4 L/hr. CONCLUSION: Using a two-compartment model, the in vivo pharmacokinetics of adriamycin after hepatic arterial chemoembolization were successfully analyzed. On the basis of the parameters determined, it may be concluded that in these five patients, adriamycin remained in the liver in much greater quantities and for longer. Index words : Liver neoplasms Liver neoplasms, chemotherapeutic embolization Chemotherapy, regional
Absorption
;
Arteries
;
Carcinoma, Hepatocellular
;
Catheters
;
Doxorubicin*
;
Drug Therapy
;
Ethiodized Oil
;
Humans
;
Liver
;
Liver Neoplasms
;
Pharmacokinetics*
6.Hrombosed Aortic Dissections and Aortic Aneurysms: MRI Findings and Differential Diagnosis.
Jin Wook CHUNG ; Jae Hyung PARK ; Man Chung HAN ; Gi Seok HAN ; Yong Kyu YOON
Journal of the Korean Radiological Society 1994;30(5):853-858
PURPOSE: MRI is known to be an effective imaging modality of the aorta and its role is steadily increasing in the evaluation of acquired aortic diseases including aortic dissections and aortic aneurysms. However, differentiation of the aortic dissections with thrombosed false lumen from the aortic aneurysm with mural thrombus in MRI has not been easy. Therefore, the authors tried to find the characteristic MR featrses which would to differentiate the two diseases. MATERIALS AND METHODS: MR images of 6 patients with thrombosed aortic dissection and 7 patients with thrombosed aortic aneurysms were reviewed retrospectively and compared in regand to shape and extent of thrombus, dimension of aorta, and luminal flow signal. RESULTS: Thrombosed aortic dissections showed sharply demarcated crescent shaped aortic wall thickening of even thickness involving long segment of the aorta, whereas thrombosed aortic aneurysms showed irregular aortic wall thickening of uneven thickness localized in the short dilated segment of the aorta. Characteristically aortic aneurysm with mural thrombus showed eccentric intraluminal slow flow signal. In contrast to the signal void of the true lumen in aortic dissections, the residual lumen of the aortic aneurysm with mural thrombus revealed intraluminal signal due to slow flow. CONCLUSION: Familiarity to these MRI findings of thrombosed aortic dissections and aortic aneurysms may lead to the accurate differential diagnosis in majority of cases.
Aorta
;
Aortic Aneurysm*
;
Aortic Diseases
;
Diagnosis, Differential*
;
Humans
;
Magnetic Resonance Imaging*
;
Phenobarbital
;
Recognition (Psychology)
;
Retrospective Studies
;
Thrombosis
7.Transarterial chemoembolization through collateral vessels in hepatocellular carcinoma.
Ji Hye KIM ; Joon Koo HAN ; Jin Wook CHUNG ; Jae Hyung PARK ; Man Chung HAN
Journal of the Korean Radiological Society 1993;29(6):1220-1228
We performed 70 proceudres of transarterial chemoembolization (TAE) through extrahepatic collateral vessels (n=27) or parasitic feeders (n=18) in 45 hepatocellular carcinoma patients. The collaterals developed after interruption of the hapatic artery due to repeated TAE(n=17), surgical ligation(n=7) and primary celiac occlusion (n=3). Radiologic findings suggesting the existence of parasitic or collateral supply for hepatocellular carcinoma were 1) a focal defect of Lipiodol retention on CT or plain film after TAE via the hepatic artery, 2) dilated and tortuous vessels around the mass on angiography, 3) persistent elevation of the level of serum alpha fetoprotein or continuous clinical symptoms in spite of sufficient devascularization of the tumor via the hepatic artery, and 4) radiological findings of direct invasion into adjacent organ. The sites of the catheter placement were the inferior phrenic artery (n=19), omental branches (n=16), periportal collaterals (n=6), pancreaticodenal arcade (n=3), gastroduodenal artery (n=3), internal mammary artery (n=2), intercostal artery (n=2), lateral thoracic artery (n=1), bronchial artery(n=1), and colic branches(n=1). Masses feeded by the inferior phrenic and chest wall collaterals were usually located at the dome area of the liver, and the omental and gastroduodenal collaterals developed in the masses located at the inferior tip of the liver. After TAE via collateral vessels, 37 patients underwent follow-up study. In 18 cases(48%), the tumor favorably responded to TAE. Specific complications of collateral TAE were epigastric soreness (n=10), severe shoulder pain (n=4), and embolization of the spinal artery during embolization through the intercostal artey (n=1). In conclusion, various extrahepatic collaterals are important alternative or additional routes for effective chemoembolization in patients with advanced hepatoma, and early recognition of the parasitic supply and the effort to perform TAE via collaterals is very important for effective management of the patients with the hepatoma.
alpha-Fetoproteins
;
Angiography
;
Arteries
;
Carcinoma, Hepatocellular*
;
Catheters
;
Colic
;
Ethiodized Oil
;
Follow-Up Studies
;
Hepatic Artery
;
Humans
;
Liver
;
Mammary Arteries
;
Shoulder Pain
;
Thoracic Arteries
;
Thoracic Wall
8.Transjugular intrahepatic portsystemic shunt.
Jae Hyung PARK ; Joon Koo HAN ; Jin Wook CHUNG ; Man Chung HAN
Journal of the Korean Radiological Society 1992;28(3):393-398
As a new interventional procedure for the control of variceal bleeding, a portosystemic shunt can be established with the installment of metallic stent through the transjugular approach. In order to evaluate the clinical usefulness of the procedure, transjugular intrahepatic portosystemic chunt procedure were performed in 5 patients with variceal bleeding due to liver cirrhosis. The metallic stents were mainly a self expandable Wallstent(Schneider, Switzerland). An 8 to 10 mm shunt was formed by the insertion of the stent and balloon dilatation after puncture of the proximal portal vein from the right or middle hepatic vein. The patency of the shunt was proven by portography after the procedure. The portal pressure measured in 3 patients before and after the procedure improved with decrease from 31 mmHg to 25 mmHg. The procedure failed in 1 patient due to preexsisting portal vein thrombosis. During the follow-up period from 1 month to 4 months, shunts were patent in all 4 patients. However, hepatic encephalopathy occured in one patient one week following the procedure. Though the follow-up period was not long enough for full evaluation. We found the transjugular intrahepatic portosystemic shunt was a safe and effective procedure for the control of variceal bleeding by lowering the portal pressure. For the appropriate application for this procedure, the optimal size of the shunt and optimal degree of the resultant decompression are yet to be determined in the future.
Decompression
;
Dilatation
;
Esophageal and Gastric Varices
;
Follow-Up Studies
;
Hepatic Encephalopathy
;
Hepatic Veins
;
Humans
;
Liver Cirrhosis
;
Portal Pressure
;
Portal Vein
;
Portasystemic Shunt, Surgical
;
Portography
;
Punctures
;
Stents
;
Venous Thrombosis
9.Carbon Dioxide Digital Subtraction Angiography in Percutaneous Sclerotherapy of Venous Hemangiomas.
Jae Hyung PARK ; Jin Wook CHUNG ; Heung Sik KANG ; Man Chung HAN
Journal of the Korean Radiological Society 1997;37(2):219-224
PURPOSE: To investigate the usefulness of carbon dioxide digital subtraction angiography (CO2-DSA) in direct puncture sclerotherapy of venous hemangiomas involving extremities. MATERIALS AND METHODS: Direct puncture sclerotherapy was performed in 12 patients with venous hemangioma of extremities. After direct puncture of the hemangiomas, 30-50 cc of CO2 was manually injected and digital subtraction angiograms were obtained. If draining vein was visualized, a tourniquet was applied at the proximal site to compress the draining veins. There after, radiopaque embolic materials such as 1:3 mixture of Lipiodol and absolute ethanol or ethanolamineoleate-Lipiodol-Avitene (microfibrillar collagen hemostat) mixture were slowly injected under the fluoroscopic guidance. RESULTS: Rapid injection of large amount of a CO2 enabled the visualization of wide areas of venous hemangiomas in 11 patients. Draining veins were reliably demonstrated in 10 patients and pulmonary embolism of embolic materials was effectively prevented by proximal tourniquet application. Because of radiolucent nature of CO2 retained in hemangiomas, we could clearly identify the distribution of radiopaque embolic materials under fluoroscopy. Retained CO2 also could be used as a guide for additional multiple puncture of hemangiomas. There was no systemic symptoms or complications related to CO2-DSA. CONCLUSION: CO2-DSA is a convenient, safe and useful angiographic technique in direct puncture sclerotherapy of hemangiomas involving extremities.
Angiography, Digital Subtraction*
;
Carbon Dioxide*
;
Carbon*
;
Collagen
;
Ethanol
;
Ethiodized Oil
;
Extremities
;
Fluoroscopy
;
Hemangioma*
;
Humans
;
Pulmonary Embolism
;
Punctures
;
Sclerotherapy*
;
Tourniquets
;
Veins
10.A Serial MR Imaging of Myocardial Infarction with Non-Surgical Animal Model.
Myung Kwan LIM ; Jae Hyung PARK ; Hwal LEE ; Jin Wook CHUNG ; Dong Soo LEE ; June Key CHUNG ; Young Hi CHOI
Korean Circulation Journal 1998;28(11):1861-1872
Objectives: The purpose of study is to evaluate serial MR imaging of myocardial infarction using non-surgical model of myocardial infarction after percutaneous transcatheter coronary arterial embolization in dogs. MATERIALS AND METHODS: We evaluated serial pre- and post-contrast MR images with Gd-DTPA (gadolinium-diethylenetriamine-pentaacetic acid) of heart of the eleven mongrel dogs (immediate group (n=3), one week group (n=3), three weeks group (n=5)) after making non-surgically induced myocardial infarction. We confirmed the infarct with TTC staining and microscopically. The location and extents of the myocardial infarction were correlated. RESULTS: A total of 24 MR images were archived; 11 images of the immediate post-embolic period, 8 images of one-week follow-up, and five of 3-week follow-up images. Comparing with the signal intensity of normal myocardium, immediate post-embolic MR images showed low or iso signal intensities (SI) of the infarct area on T1-weighted images (T1WI) and high SI on T2-weighted images (T2WI). No contrast enhancement with Gd-DTPA was made in all cases of the immediate post-embolic MRI. One-week and 3-week follow-up MR images showed low or iso SI on T1WI and slight high or iso SI on T2WI. Contrast enhancement images in both one-week and 3-week follow-up MRI showed denser enhancement of infarct area in one-week follow-up. The myocardial wall thinning was seen in 5 of eight dogs after one week and in 3 of five after 3 weeks. CONCLUSION: In non-surgical animal models of myocardial infarction, MR images showed low or iso SI on T1WI, and high SI on T2WI in various stages, and contrast enhancement was maximum after one week and gradual decrease to 3 weeks. The myocardial wall thinning was seen in one-to 3-week follow-up MR images.
Animals*
;
Dogs
;
Follow-Up Studies
;
Gadolinium DTPA
;
Heart
;
Magnetic Resonance Imaging*
;
Models, Animal*
;
Myocardial Infarction*
;
Myocardium