• The Korean Journal of Pain
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• 제19권2호
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• pp.207-212
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• 2006

Background: The epidural injection technique is a commonly used intervention in the management of chronic spinal pain, which has the advantage of delivering various drugs, such as local anesthetics or steroids, in higher concentrations to the inflamed nerve root. A guidewire-reinforced epidural catheter was introduced through a Tuohy needle during the caudal epidural procedure, with a catheter threaded into the affected nerve roots and the spread-pattern of contrast agents observed under fluoroscopy. Methods: Sixty-seven patients with low back pain, who showed evidence of a herniated nucleus pulposus on magnetic resonance imaging, were included. All patients received fluoroscopically guided caudal epidural injections, with the guidewire-reinforced epidural catheter introduced through a Tuohy needle and threaded either to the right or left side toward the target nerve roots. After confirming the catheter tip position at the affected nerve root, 2 ml increments of contrast agents (up to 6 ml) were injected, and their corresponding AP fluoroscopic views were obtained. Three radiologists reviewed all the radiographic findings and measured the proportion of the area of contrast spread at the side of target nerve roots. Results: Greater proportion of the area of contrast spread was observed at the side of the target nerve roots (P < 0.0001). At each level of contrast injection (2-⁣, 4- ⁣ and 6 ml), more than 70% of the spread of contrast dye was observed at the side of the target nerve roots in 85%, 70%, and 55% of cases, respectively. Conclusions: The combination of a caudal epidural injection and use of a guidewire-reinforced epidural catheter significantly enhances the target specificity, as revealed by the selective spread of contrast dye at the side of target nerves.

• Asian Pacific Journal of Cancer Prevention
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• 제15권12호
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• pp.5089-5095
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• 2014

Background: As a common and essential contrast medium at present, gadobenate dimeglumine has shown better performance than some other agents when applied to Breast Magnetic Resonance Imaging Screening (Breast MRI Screening). Nevertheless, reports on the diagnostic performance of these two mediums (gadobenate dimeglumine and gadopentetate dimeglumine) are not completely consistent. Objective: To assess the diagnostic value of gadobenate dimeglumine and gadopentetate dimeglumine for Breast MRI Screening in patients suffering from breast cancer and to provide more convinced evidence to guide clinical practice in terms of appropriate contrast agents. Data Sources and Review Methods: Original articles in English and Chinese published before January 2013 were selected from available databases (The Cochrane Library, PUBMED, EMBASE, Chinese Biomedical Literature Database, Chinese Scientific Journals Full-text Database, Chinese Journal Full-text). The criteria for inclusion and exclusion were based on the standard for diagnosis tests. Meta-Disc software (Version 1.4) was used for data analysis. Then, the area under curve (AUC) of SROC and the spearman rank correlation of sensitivity against (1-specificity) were calculated. Results: Total of 17 researches involving 1934 patients were included. The pooled sensitivity of gadobenate dimeglumine and gadopentetate dimeglumine were 0.99 (0.97, 1.00) and 0.93 (0.88, 1.00) respectively. The pooled specificity for these two contrast agents were 0.924 (0.902, 0.943) and 0.838 (0.817, 0.858) respectively, and the AUC of SROC curve were 0.9781 and 0.9215 respectively. Conclusions: Gadobenate dimeglumine can be regarded as a more effective and feasible contrast medium for Breast MRI Screening. At least 5% differences in diagnostic performance are usually considered as clinically relevant.

• 한국산학기술학회논문지
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• 제15권8호
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• pp.5124-5130
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• 2014

조영제의 희석률 변화에 따른 신호강도를 분석하여 조영증강 자기공명혈관조영검사 시 점도와 삼투압에 따른 부작용을 최소화하고 신호강도를 높여 영상의 질을 향상시키고자 하였다. 연구방법은 조영제가 혈관에 주입되면 혈액과 희석되어 mol 농도가 변화되고, 그에 따라 신호강도의 변화를 일으킴에 착안하여 phantom을 제작하였다. phantom 결과를 바탕으로 임상실험은 2013년 11월부터 2014년 1월까지 조영제를 희석한 군(30명)과 희석하지 않은 군(30명)으로 구분하여 뇌혈관의 신호강도를 비교하였다. 연구결과, 조영제 mol 농도 변화에 따른 phantom의 신호강도는 0.0125mmol부터 급격히 증가하다 20mmol에서 최고점을 이룬 후 200mmol부터 평형을 이루었다. 임상실험에서도 조영제를 희석하여 검사한 영상의 신호강도가 모두 높게 나타나, 1000mmol 조영제 사용에 비해 500mmol로 희석하여 사용함이 최고점인 20mmol에 근접하여 우수함을 알 수 있었다. 결론적으로 조영제를 희석하여 사용함으로써 점도와 삼투압을 저하시키고, 영상의 질을 향상시킬 수 있었으므로 임상적용의 유용성이 높다고 할 수 있다.

• 한국자기학회지
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• 제16권1호
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• pp.102-106
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• 2006

이 연구의 목적은 약물의 분리나 약물전달 시스템에 이용 할 수 있도록 마그네타이트 나노 입자의 표면을 개질, 즉 생체적합성, 저독성의 특성을 갖는 키토산을 이용하여 키토산이 피복된 나노 크기의 자성체 입자를 제조하는 것이다. 본 연구에서는 음향화학법을 적용한 공침 기술을 이용, 균일한 마그네타이트 나노 입자를 합성하였다. 계면활성제인 올레인산을 가하여 입자간의 응집을 막았다. 물과 계면활성제의 농도비 R=[물]/[계면활성제]를 조절하여 평균크기가 2nm에서 9nm인 마그네타이트 입자를 선택적으로 합성하였다. 이 방법을 통하여 합성된 마그네타이트 나노 인자를 염기성 수용액에 분산시켰다. 초음파를 조사하면서 키토산 용액을 서서히 가하여 마그네타이트 나노 입자의 표면을 키토산으로 피복하였다. 이때 키토산의 농도가 증가할수록 입자가 수 나노미터 크기씩 증가하는 것을 입도 분석기와 원자 현미경 관찰을 통해서 확인 할 수 있었다. 합성된 마그네타이트 분말과 키토산이 피복된 마그네타이트 나노 입자 모두 실온에서 초상자성을 보이는 것으로 나타났다.

• Bulletin of the Korean Chemical Society
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• 제34권10호
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• pp.2900-2904
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• 2013

We present the synthesis and characterization of DTPA-bis(histidylamide) (1a), DTPA-bis(aspartamide) (1b), and their gadolinium complexes of the type $[Gd(L)(H_2O)]$ (2a:L = 1a; 2b:L = 1b). Thermodynamic stabilities and $R_1$ relaxivities of 2a-b compare well with Omniscan$^{(R)}$, a well-known commercial, extracellular (ECF) MRI CA which adopts the DTPA-bis(amide) framework for the chelate: $R_1$ = 5.5 and 5.1 $mM^{-1}$ for 2a and 2b, respectively. Addition of the Cu(II) ion to a solution containing 2b triggers relaxivity enhancement to raise $R_1$ as high as 15.3 $mM^{-1}$, which corresponds to a 300% enhancement. Such an increase levels off at the concentration beyond two equiv. of Cu(II), suggesting the formation of a trimetallic ($Gd/Cu_2$) complex in situ. Such a relaxivity increase is almost negligible with Zn(II) and other endogenous ions such as Na(I), K(I), Mg(II), and Ca(II). In vivo MR images and the signal-to-noise ratio (SNR) obtained with an aqueous mixture of 2b and Cu(II) ion in an 1:2 ratio demonstrate the potentiality of 2 as a copper responsive MRI CA.

• Korean Journal of Radiology
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• 제22권9호
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• pp.1547-1554
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• 2021

Objective: We aimed to investigate whether repeated intravascular administration of iodinated contrast media (ICM) or gadolinium-based contrast agents (GBCAs) within a short interval was associated with an increased risk of post-contrast acute kidney injury (PC-AKI). Materials and Methods: This retrospective study included 300 patients (mean age ± standard deviation, 68.5 ± 8.1 years; 131 male and 169 female) who had undergone at least one ICM-enhanced perfusion brain CT scan, had their baseline and follow-up serum creatinine levels available, and had not undergone additional contrast-enhanced examinations 72 hours before and after a time window of interest were included. The study population was divided into three groups: single-dose group and groups of patients who had received multiple contrast administrations in the time window of interest with the minimum contrast repeat interval either within 4 hours (0-4-hour group) or between 4 to 48 hours (4-48-hour group). Multivariable logistic regression analysis was conducted to evaluate the association between AKI and repeated ICM administrations. A similar supplementary analysis was performed including both ICM and GBCA. Results: When ICM was only considered ignoring GBCA, among 300 patients, 207 patients received a single dose of ICM, 58 had repeated doses within 4 hours (0-4-hour group), and 35 patients had repeated doses between 4 to 48 hours (4-48-hour group). Most patients (> 95%) had a baseline estimated glomerular filtration rate (eGFR) of ≥ 30 mL/min/1.73 m². AKI occurred in 7.2%, 13.8%, and 8.6% of patients in the single-dose, 0-4-hour, and 4-48-hour groups, respectively. In the 0-4-hour and 4-48-hour groups, additional exposure to ICM was not associated with AKI after adjusting for comorbidities and nephrotoxic drugs (all p values > 0.05). Conclusion: Repeated intravascular administrations of ICM within a short interval did not increase the risk of AKI in our study patients suspected of acute stroke with a baseline eGFR of ≥ 30 mL/min/1.73 m².

• Investigative Magnetic Resonance Imaging
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• 제5권1호
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• pp.33-37
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• 2001

목적 : 자성 자기공명조명제의 효율을 결정하는데는 상자성물질의 물분자 결합위치에 구속되어 있는 물분자와 자유 물분자사이의 물분자 교환율이 매우 중요한 역할을 담당한다. 따라서 본 연구에서는 $^{17}O-NMR$기법을 사용하여 현재 상용화 되어 있는 Gd 자기공명조영제 및 최근 간특이성 자기공명조영제로 제안되고 있는 Gd-EOB-DTPA의 물분자 교율을 측정하고자 하였다. 대상 및 방법 본 연구에 사용된 조영제는 Gd-DTPA, Gd-DTPA-BMA, Gd-DOTA, Gd-EOB-DTPA 이며 여기에 Isotech 사의 5% $^{17}O$로 치환된 증류수를 혼합하여 사용하였다. 결과적인 시료의 pH는 buffer용액을 사용하여 pH=7로 고정하였으며 다양한 온도에서 Bruker-600 (14.1 T, 81.3 MHz)모델의 NMR장비를 사용하여 측정하였다. 에코열 24개의 Carr-Purcell-Meiboom-Gill (CPMG) 펄스 시권스를 사용하여 $^{17}O$의 스핀-스핀 이완시간(T2)을 측정하고 이렇게 얻어진 T2 데이터는 최소자승법을 이용하여 Solomon-Bloembergen방정식에 fitting시켜서 최종적으로 각 조명제의 물분자 교환율을 계산하였다. 결과 : 측정된 각 조영제의 물분자 교환시간은 300k의 온도에서는 Gd-DTPA의 경우 0.427, Gd-DTPA-BMA의 경우 $1.99{\;}{\mu}s$, Gd-DOTA의 경우 $0.27{\;}{\mu}s$, Gd-EOB-DTPA의 경우 $0.11{\;}{\mu}s$로 나타났으며 이러한 물분자 교환시간은 온도에 따라 변화함을 알았다. 물분자 교환시간의 온도 의존성은 모든 조영제에서 지수함수의 형태로 나타났으나 조영제에 따라 온도가 올라감에 따라 물분자 교환시간이 감소하는 감소율에서는 차이를 나타내었다. 결론 : 상자성 조영제의 relaxation enhancement 기전을 이해하는데는 물분자 교환율에 대한 정보가 매우 중요하며 이러한 물분자 교환율을 정확히 측정하는데는 $^{17}O-NMR$기법이 매우 유용함을 알 수 있었다.

• The Korean Journal of Pain
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• 제10권2호
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• pp.214-219
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• 1997

Background: Epidural neural blockade with local anesthetics combined with steroids has been in clinical trials for patients with low back pain. But pain treatment of low back pain remains somewhat problematic. Many patients with low back pain have epidural fibrosis and adhesions proved with magnetic resonance imaging(MRI) examination. These findings might play an important role in the origin of back pain. Present study was aims to investigate the effect of epidural adhesiolysis in patients with low back pain. Methods: We investigated 76 patients suspected with epidural fibrosis and adhesion was suspected. Nerve pathology was demonstrated and epidural fibrosis suspected or proved with MRI examination. 17G needle specially designed by Racz was inserted at sacral hiatus and catheter was inserted untill its tip was located at lesion site under fluoroscopic guidance. Injection of contrast dye was achieved and prospected spread of agents. Injection of 0.25% bupivacaine, triamcinolone, and 10% hypertonic saline via catheter were carried out daily for 3 days. Evaluation included assessment of pain relief (Numerical Rating Scale; NRS) post-epidural adhesiolysis 3 days, 1 week, and 3 months. We also looked for complication of epidural adhesiolysis. Results: Statistical analysis(Friedman nonparametric repeated measures test and Dune's multiple comparison test) demonstrated NRS was significantly less during 3 months after epidural adhesiolysis(P<0.05). Especially, there is a extremely significance in post-epidural adhesiolysis 3 days (P<0.001). Only four patients reported any complications the most common symptom among three persistent headache but disappeared after a few months without residual sequelae. Conclusion: We conclude epidural adhesiolysis is a safe and effective method of pain therapy for low back pain with proven lumbo-sacral fibrosis and adhesion. A direct visualization by epiduroscopy may be more useful to the resulting functional changes after epidural adhesiolysis.

• 대한의용생체공학회:의공학회지
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• 제41권6호
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• pp.228-234
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• 2020

Superparamagnetic iron oxide nanoparticles (SPIONs) are approved by the Food and Drug Administration (FDA) in the United States. SPIONs are used in magnetic resonance imaging (MRI) as contrast agents and targeted delivery in nanomedicine using external magnet sources. SPIONs act as an artificial peroxidase (i.e., nanozyme), and these reactions were highly stable in various pH conditions and temperatures. In this study, we report a nanozyme ability of the clustered SPIONs (CSPIONs) synthesized by the oil-in-water (O/W) method and coated with biocompatible poly(lactic-co-glycolic acid) (PLGA). We hypothesize that the CSPIONs can have high sensitivity toward H2O2 derived from the reaction between a fixed amount of glucose and glucose oxidase (GOX). As a result, CSPIONs oxidized a 2,2'-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid) diammonium salt (ABTS) commonly used as a substrate for hydrogen peroxidase in the presence of H2O2, leading to a change in the color of the substrate. We also utilized a colorimetric assay at 417 nm using various glucose concentrations from 5 mM to 1.25 μM to validate β-D-glucose detection. This study demonstrated that the absorbance value increases along with increasing the glucose level. The results were highly repeated at concentrations below 5 mM (all standard deviations < 0.03). Moreover, the sensitivity and limit of detection were 1.50 and 5.44 μM, respectively, in which CSPIONs are more responsive to glucose than SPIONs. In conclusion, this study suggests that CSPIONs have the potential to be used for glucose detection in diabetic patients using a physiological fluid such as ocular, saliva, and urine.

• Advances in nano research
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• 제1권3호
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• pp.159-169
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• 2013

A preparation method for gadolinium compound (GdC) nanoparticles coated with silica ($GdC/SiO_2$) is proposed. GdC nanoparticles were prepared with a homogeneous precipitation method at $80^{\circ}C$ using $1.0{\times}10^{-3}$ M $Gd(NO_3)_3$, 0.5 M urea and $0-3.0{\times}10^{-4}$ M ethylenediarinnetetraacetic acid disodium salt dihydrate (ETDA) in water. As a result of preparation at various EDTA concentrations, GdC nanoparticles with a size as small as $40.5{\pm}6.2$ nm, which were colloidally stable, were prepared at an EDTA concentration of $2.0{\times}10^{-4}$ M. Silica-coating of the GdC nanoparticles was performed by a St$\ddot{o}$ber method at $35^{\circ}C$ using $1.0-10.0{\times}10^{-3}$ M tetraethylorthosilicate (TEOS), 11 M $H_2O$ and $1.5{\times}10^{-3}$ M NaOH in ethanol in the presence of $1.0{\times}10^{-3}$ M GdC nanoparticles. Performance of preparation at various TEOS concentrations resulted in production of $GdC/SiO_2$ particles with an average size of $106.1{\pm}11.2$ nm at a TEOS concentration of $5.0{\times}10^{-3}$ M. The gadolinium (Gd) concentration of $1.0{\times}10^{-3}$ M in the as-prepared $GdC/SiO_2$ particle colloid solution was increased up to a Gd concentration of 0.2 M by concentrating with centrifugation. The core-shell structure of $GdC/SiO_2$ particles was undamaged, and the colloid solution was still colloidally stable, even after the concentrating process. The concentrated $GdC/SiO_2$ colloid solution showed images of X-ray and magnetic resonance with contrast as high as commercial Gd complex contrast agents.