난소 기형종 수술 전 미성숙 기형종을 감별하기 위한 자기공명 영상 소견

최주혁 ( Joo Hyuk Choi ),동서연 ( Seo Yun Tong ),김민정 ( Min Jeung Kim ),박종섭 ( Jong Sup Park ),임용택 ( Yong Taik Lim ),김진홍 ( Jin Hong Kim ),나성은 ( Sung Eun Rha ),김미란 ( Mee Ran Kim ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.7

목적: 난소의 기형종 환자에서 미성숙 기형종을 감별하기 위한 자기공명촬영의 소견을 알아보고자 한다. 연구 방법: 1995년 1월 1일부터 2005년 12월 31일까지 가톨릭대학교 의과대학 강남성모병원 산부인과에서 기형종으로 수술 받은 환자들을 대상으로 의무기록과 수술기록, 병리결과를 검토하였다. 결과: 기형종으로 진단 받은 환자는 787명, 성숙기형종은 773명(98.2%), 미성숙 기형종은 14명 (1.8%)였다. 미성숙 기형종으로 진단 받은 환자 중 수술 전 진단된 경우는 10예, 수술 후 조직검사로 확인한 예는 4예 (28.6%)였다. 미성숙 기형종 환자의 MRI 영상진단에서는 고형질 부분에 많은 수의 낭성 구조와 지방질로 보이는 고신호 강도의 부분 (punctuate foci)이 특징적으로 관찰되었다. 본 증례들에서는 출혈이나 괴사, 전이를 보이는 경우는 관찰되지 않았다. 결론: 비교적 어린 나이에 진단되는 미성숙 기형종의 수술 전 진단은 환자의 가임력을 보존하기 위한 수술 방법을 결정하는데 중요하며, 이를 위해서는 수술 전 정확한 진단이 필수적이다. MRI에서 미성숙 기형종은 비교적 특징적인 소견을 보인다. Objective: The purpose of this study was to differentiate immature from mature ovarian teratomas, using magnetic resonance (MR) imaging and to evaluate the MR imaging appearance of immature teratomas. Methods: The patients with pathologic diagnosis of ovarian teratomas between January 1995 and December 2005 were restrospectively reviewed for clinicopathologic characteristics. Results: Of the 787 patients studied, 773 (98.2%) patients were mature cystic teratomas and 14 (1.8%) patients were immature teratomas. Ten patients with immature teratoma (71.4%) were diagnosed preoperatively and 4 patients (28.6%) were diagnosed postoperatively. Preoperative MRI was performed in 4of 14 patients surgically proved immature teratomas. At MR imaging, the immature teratomas characteristically have a large, irregular solid component containing coarse calcifications and numerous variable-sized cysts. Small punctuate foci of fat help diagnosing these tumors. Conclusion: Preoperative MR imaging are relatively specific in the detection of immature teratomas. This suggests that preoperative MR imaging is helpful in differentiating immature from mature ovarian teratomas.

간암에서 좋은 결과를 예상하고 치료를(TACE, RFA, OP/LT, Cyber knife 등) 하였으나 조기 재발한 간암 증례 : 고주파 열치료 후 조기재발과 폐 및 뇌전이를 보인 원발성 간세포암 1예

김진동 ( Jin Dong Kim ),권정현 ( Jung Hyun Kwon ),배시현 ( Si Hyun Bae ),최종영 ( Jong Young Choi ),윤승규 ( Seung Kew Yoon ),이영준 ( Young Jun Lee ),나성은 ( Sung Eun Rha ),천호종 ( Ho Jong Chun ),최병길 ( Byung Gil Choi ),이해 대한간암연구회 2009 대한간암학회지 Vol.9 No.-

Radiofrequency ablation (RFA) is the preferred method of local ablation for patients with small (<3 cm sized) hepatocellular carcinoma (HCC) when surgical resection cannot be applied. If RFA procedure is sufficiently completed, it provides lower local tumor recurrence, and longer overall as well as disease-free survival. We experienced a case of early stage HCC which recurred at 2 months after successful RFA procedure, and rapidly metastasized to lung and brain.

간암에서 좋은 결과를 예상하고 치료를(TACE, RFA, OP/LT, Cyber knife 등) 하였으나 조기 재발한 간암 증례 : Milan기준에 합당한 간암에서 간이식 후 재발 1예

우현영 ( Hyun Young Woo ),김진동 ( Jin Dong Kim ),권정현 ( Jung Hyun Kwon ),배시현 ( Si Hyun Bae ),최종영 ( Jong Young Choi ),윤승규 ( Seung Kew Yoon ),나성은 ( Sung Eun Rha ),변재영 ( Jae Young Byun ),천호종 ( Ho Jong Chun ),최 대한간암연구회 2009 대한간암학회지 Vol.9 No.-

Liver transplantation is curative therapy for hepatocellular carcinoma especially if ,within Milan criteria, 4 year survival and recurrence-free survival was reported to be 85% and 92%, respectively. Herein we report a patient who experience rapid recurrence following living donor liver transplantation (LDLT) for hepatocellular carcinoma within Milan criteria. A 52 year-old-men patient with known liver cirrhosis associated with hepatitis B virus was admitted for the treatment of hepatocellular carcinoma (HCC). Abdominal CT revealed two nodules less than 3 cm in right hepatic lobe. After single session of transcatheter arterial chemoembolization (TACE), the patient underwent LDLT. After seven months following transplantation, recurrent HCC was detected on transplanted liver with concurrent metastatic nodule in lung. Although TACE and metastsectomy were performed for recurrent intrahepatic mass and lung metastasis, recurrent HCC showed rapid progression and patient died of progressive tumor after 10 months following LDLT.

The Scarlet Letter에 나타난 Hawthorne의 상징주의에 관한 연구

나성은 건국대학교 1997 대학원 학술논문집 Vol.44 No.-

Nathaniel Hawthorne, a literary writer of New England, was researching an understanding of the truth concerning the human heart. He regarded the depths of human nature as his literary entity, and in The Scarlet Letter used his artistic talent to explore the psychological influence of guilt upon human beings. "Romance"was his vehicle to grasp the truth of human psychology and thus, at the end, the reader. The Scarlet Letter, his most remarkable literary product, is the masterpiece that conveys his profound and penetrating insight into human psychology. A number of symbols found in this literary work communicate the depth of this work and his understanding of the human spirit. "Color symbolism,""symbolism of light and darkness,""the symbol of the scarlet letter 'A',""The symbol of nature,"and the chiaroscuro effect flowing in the first part of the work are used among other things, all leading to the culmination of his romance. The symbolism in the work implies many things. First of all, the scarlet letter "A"is the mysterious symbol which invites infinite interpretations, just as in the story its picture appears in various forms. The letter "A"originally stands for the word adultery. But it also stands for the words,"Abel, affection, Angel, art, atonement, ascension, Alpha, America, the original sin of Adam, and Dimmesdale's first name, Arthur." In this work, Hawthorne employs not only the use of various colors but also the effects of light and darkness in order to depict the characters and Nature. The sharp contrast between light and darkness, particularly, contributes to the striking effect to the description of the truth of human nature, as expressed all through this work. In The Scarlet Letter,"light"stands for "life, a clean conscience, the whiteness of the soul, love, sinlessness, Nature's sympathy, good, the approval of God and Nature, happiness, Grace, exposure, revelation, infinite purity, truth, health, and the spiritual Light of Revelation.""Darkness"stands for "sin, evil, hatred, death, hell,concealment, God's Punishment, revenge, and cruelty." The colors which are employed in this literary work are diverse. Among them the main featured colors are "red"and "black." "Red"stands for "sin, passion, adultery, and the deep heart of Nature,"and "black"represents "evil, sin, inauspiciousness"and express emotions such as "sadness, sorow, unhappiness."The colors of "green, yellow, brown,"the colors as we often find in Nature, are also used for representing the beauty of vivid Nature. As moral and psychological concepts, the light and darkness used in the literary work stand for "moral good"and "moral evil,"projecting the mental aspects of the characters and their deepest inner world. The contrasting colors also symbolize both "natural good"and"natural evil"as they are used in describing the appearance of characters and nature. This novel, a tale of human fragility and sorrow, is a tale which begins with the contrast between the tone of the red rose, a sweet moral blossom, and the gloomy tone of the cell, the black flower of a civilized soviety, and which ends up with the contrast between the tones of"Sables"and "Gules"in the last chapter of the novel. Readers may say that this literary work is indeed the work of"symbolic romance,"as it begins with, and ends with symbols.

이식 신의 사구체 여과율 측정에서 정확한 감쇄 보정을 위한 신장 깊이 대표값 설정

오순남,김성훈,나성은,정용안,이성용,유이령,손형선,정수교 대한핵의학회 2002 핵의학 분자영상 Vol.36 No.4

http://www.haansoft.com/cgi-bin/matroom3_0/mat_view.pl?idx=9418&matid=10Purpose: To measure reliable glomerular filtration rate by using the representative values of transplanted renal depths, which are measured with ultrasonography. Materials and Methods: We included 54 patients (26 men, 28 women), with having both renal scintigraphy and ultrasonography after renal transplantation. We measured GFR with Gates' method using the renal depth measured by ultrasonography, and median and mean ones in each patient. We compared GFR derived from ultrasonography-measured renal depth with GFR derived from median and mean renal depths. The correlation coefficients were obtained among GFR derived from ultrasonography-measured renal depths, median and mean renal depths under linear regression analysis. We determined whether GFR derived from median or mean renal depth could substitute GFR derived from ultrasonography-measured renal depth with Bland-Altman method. We analyze the expected errors of the GFR using representative renal depth in terms of age, sex, weight, height, creatinine value, and body surface. Results: The trasplanted renal depths range from 3.20 cm to 5.96 cm. The mean value and standard deviation of renal depths measured by ultrasonography are 4.09±0.65 cm in men, and 4.24±.078 cm in women. The median value of renal depths measured by ultrasonography is 4.36 cm in men and 4.14 cm in women. The GFR derived from median renal depth is more consistent with GFR derived from ultrasonography-measured renal depth than GFR derived from mean renal depth. Differences of GFR derived from median and ultrasonography-measured renal depth are not significantly different in the groups classified with creatinine value, age, sex, height, weight and body surface. Conclusion: When median value is adapted as a representative renal depth, we could obtain reliable GFR in transplanted kidney simply. (Korean J Nucl Med 2002;36;271-6)