약시 환자에서 스펙트럼 빛간섭단층촬영을 이용한 망막신경섬유층의 분석

박찬금(Chan Keum Park),김수진(Su Jin Kim) 대한안과학회 2016 대한안과학회지 Vol.57 No.10

목적: 원시성 굴절부등 단안 약시 환자들을 대상으로 스펙트럼영역 빛간섭단층촬영을 이용하여(spectrum domain optical coherence tomography, SD-OCT) 유두주위망막신경섬유층의 두께와 안축장/시신경유두면적 비, 망막면적/시신경유두테 면적 비, 시신경유두 관련 지표들을 측정하여 약시안과 정상안 사이에 구조적 차이를 분석하였다. 대상과 방법: 원시성 굴절부등 단안 약시를 진단 받은 30명의 환자를 대상으로 SD-OCT를 이용하여 유두주위망막신경섬유층의 두께와 시신경유두지표들을 측정한 후 약시안과 비약시안 간 차이를 비교 분석하였다. IOL Master?潁? 이용하여 안축장과 추정 망막면적을 구한 뒤 각각 시신경유두면적과 시신경유두테 면적으로 나눈 지표를 두 군 사이에 비교하였다. 결과: 유두주위망막신경섬유층은 비측 구역에서 비약시안에 비해 약시안의 두께가 유의하게 두꺼웠다(p=0.010). 시신경유두 관련 지표들 중에서는 유두용적이 약시안에서 비약시안에 비해 유의하게 작게 나타났다(p=0.021). 굴절이상에 따른 망막신경섬유층의 두께변화는 관련이 없는 것으로 나타났다. 시신경유두테 면적과 유두주위망막신경섬유층 사이에는 유의한 양적 선형관계가 관찰되었다 (rho=0.426, p=0.005). 결론: 원시성 굴절부등 단안 약시 환자에서 SD-OCT 분석상 약시안의 비측 구역의 유두주위망막신경섬유층이 비약시안에 비해 두꺼워져 있는 결과가 관찰되었다. 유두용적을 제외한 시신경유두 관련 지표들은 약시안과 비약시안 사이에 유의한 차이가 없었다. <대한안과학회지 2016;57(10):1631-1639> Purpose: To determine whether retinal nerve fiber layer (RNFL) thickness and optic nerve head parameters differ in the amblyopic and normal fellow eyes of hyperopic anisometropic amblyopic patients using spectral domain optical coherence tomography (SD-OCT). Methods: This study included 30 patients with hyperopic anisometropic amblyopia; patient eyes were divided into 30 anisometropic amblyopic eyes and 30 normal fellow eyes. RNFL thickness, disc area, rim area, average cup-to-disc ratio, and cup volume were obtained using SD-OCT. Axial length was obtained using the IOL Master??, and the interocular differences between group were analyzed. Results: Nasal quadrant RNFL thickness of amblyopic eyes was significantly thicker than that of normal fellow eyes in amblyopic patients (p = 0.010). Among optic nerve parameters, cup volume of amblyopic eyes was significantly smaller than that of normal fellow eyes (p = 0.021). No significant relationship between refractive error and RNFL thickness was observed, and a significant positive linear relationship was observed between neural rim area and RNFL thickness (rho = 0.426, p = 0.005). Conclusions: SD-OCT analysis of hyperopic anisometropic amblyopic eyes demonstrated a significant increase in nasal RNFL thickness compared to fellow non-amblyopic eyes. No optic nerve head parameters except cup volume showed significant change. J Korean Ophthalmol Soc 2016;57(10):1631-1639

소아의 대퇴골 원위부 골단에 발생한 혈관종

김태승,이창훈,박찬금,Kim, Tai-Seung,Lee, Chang-Hoon,Park, Chan-Keum 대한근골격종양학회 2010 대한골관절종양학회지 Vol.16 No.1

골성 골단에서 발생하는 혈관종은 극히 드물어서 그 보고를 찾아보기가 쉽지 않다. 우측 슬관절부 동통과 굴곡 구축을 주소로 내원한 5세 환아로 단순 방사선 및 자기공명영상 소견상, 대퇴골 원위부 골단 및 근위부 경골에서 병변을 보였으며, 생검한 결과 혈관종으로 진단되었다. 8년간 추시 관찰하였으며, 대퇴골 원위부 골단에 발생한 혈관종은 치유되었으며, 경골 근위부 골단에 발생한 병변도 치료없이 자연적으로 소실되었다. 또한, 하지 길이의 단축이나 슬관절 기능 장애는 발생하지 않았다. A hemangioma occurred in the bony epiphysis is extremly rare. A 5-year-old boy visited to our hospital with pain and flexion contracture on the right knee. MRI showed some lesions scattered in the epiphysis of the distal femur and the proximal tibia. Biopsy specimen from the distal femoral epiphysis revealed pathologic findings compatible with hemangioma. On 8 years follow-up, the lesion in the distal femoral epiphysis had been cured, and those in the proximal tibial epiphysis were spontaneously disappeared without surgery. The scanogram shows no leg length discrepancy and angular deformity. We reports a rare case of hemangioma occurred in the bony epiphysis with the results of 8 year follow-up with the review of literatures.

소아에서 성장호르몬 치료 중 발생한 특발유두부종과 결합된 가성유두부종

이희철(Hee Chul Lee),박찬금(Chan Keum Park) 대한안과학회 2020 대한안과학회지 Vol.61 No.12

목적: 성장호르몬 치료 중 특발유두부종과 결합된 가성유두부종이 발생한 소아 환자 1예를 보고하고자 한다. 증례요약: 특별한 기저질환이 없는 11세 여아가 3개월간 성장호르몬 치료를 받고 발생한 일시적 시야흐림, 암순응 장애 및 무기력감을 주소로 타원에 내원하였다. 이학적 검사상 20/20에서 20/25로의 시력저하와 안저검사에서 양안에 유두부종이 발견되었고, 즉시 성장호르몬 치료를 중단하였다. 4주 후, 본원에 방문하였을 때 안저검사상 유두부종은 양안에 비슷한 정도로 관찰되었고 우안의 경미한 적록 색각이상만 보였다. 성장호르몬 투여로 인한 특발유두부종과 결합된 가성유두부종을 의심하였고, 성장호르몬 투여 중단을 지속하며 유두부종에 대하여 경과 관찰하기로 하였다. 결론: 성장호르몬 치료 중 안저검사상 양안 유두부종이 관찰되어, 성장호르몬 치료를 중단하였고, 4주 후 시력장애는 호전되었지만 경도의 유두부종과 결합된 가성유두부종이 그대로 남아있는 환자를 보고하는 바이다. Purpose: We report a case of pseudopapilledema combined with idiopathic papilledema in a pediatric patient receiving growth hormone treatment. Case summary: An 11-year-old girl without any underlying disease presented with bilateral transient visual obscurations, a dark-adaptation disorder, and helplessness that developed while she had been on growth hormone therapy for 3 months at a local clinic. Reduced visual acuity (from 20/20 to 20/25) was observed on physical examination and bilateral optic disc edema on fundus examination, growth hormone was immediately discontinued. Four weeks later, fundus examination revealed papilledema of both eyes with mild red-green dyschromatopsia. Recombinant growth hormone-associated idiopathic papilledema combined with pseudopapilledema was suspected. Although growth hormone, had been discontinued, we scheduled further observation of the papilledema. Conclusions: Papilledema was observed on fundus examination during growth hormone treatment and four weeks after discontinuation thereof. The symptoms improved, but mild papilledema combined with pseudopapilledema remained.

두경부 편평 세포암에서 예후인자로서의 p53 발현

정승원(Seung Won Jeong),이형석(Hyung Seok Lee),박철원(Chul Won Park),박용욱(Yong Wook Park),박찬금(Chan Keum Park),장세진(Se Jin Jang),태경(Kyung Tae) 대한두경부종양학회 2001 대한두경부 종양학회지 Vol.17 No.2

Objectives: The p53 tumor suppressor gene encodes a nuclear transcription factor that is critical regulator of cell growth and proliferation through its action in cell-cycle checkpoint control. The wide variety of stressful stmuli which include DNA damage, hypoxia, heat shock, metabolic changes activate the p53 protein, which in turn drives a series of events that culminate either in cell cycle arrest or apoptosis. Mutations of the p53 gene is the most common genetic alteration in human cancer. This gene is altered in approximately 40-60% of head and neck cancers. Whereas the wild-type form of the p53 protein plays a central role in cell-cycle control in response to DNA damage, most of the mutant forms are unable to do so. The high levels of p53 protein expression in tissues are related to the increased cellular proliferative activity and may be associated with the poor clinical outcome. To determine whether the expression of the p53 protein has prognostic significance and is associated with patterns of treatment failure in head and neck squamous cell carcinoma (HNSCC), We analyzed p53 overexpression in 40 cases of HNSCC. Materials and Methods: Immunohistochemical analysis with a monoclonal antibody (DO7) specific for p53 protein was used to detect expression of the protein in formalin-fixed, paraffin-embedded tumor samples from 40 HNSCC. We evaluated p53 protein expression and analyzed the relationship between the p53 overexpression and age, sex, primary tumor site, stage, survival rate, recurrence. All reported P values resulted from two-sided statistical tests. Results: Overexpression of p53 was detected in 20 cases(50%) among 40 cases of HNSCC. The p53 overexpression was not associated with age, sex, primary tumor site, stage, recurrence and survival rate. Conclusions: In our results, p53 was not significant prognostic factor in HNSCC. Based on many previous studies, It is evident that p53 has a certain role in tumorigenesis of HNSCC. So, the further study is needed to evaluate the prognostic significance of p53 in HNSCC.

호산구성 봉와직염의 임상 및 병리 조직학적 연구

김은경,박찬금,이중달 대한병리학회 1995 Journal of Pathology and Translational Medicine Vol.29 No.3

폐장의 원발성 악성 혈관 외피 세포종

홍은경,박찬금,이중달,강정희 대한병리학회 1992 Journal of Pathology and Translational Medicine Vol.26 No.1

가성림프종으로 오인된 식도의 원발성 림프종 1예

정숙금,고영혜,박찬금,이중달 대한병리학회 1995 Journal of Pathology and Translational Medicine Vol.29 No.3

균상 식육종에서 발생한 Ki-1 양성 대형세포 림프종 1예

노영석,김윤석,박찬금 대한피부과학회 1999 大韓皮膚科學會誌 Vol.37 No.5

Mycosis fungoides(MF) is a cutaneous T-cell lymphoma of low-grade malignancy characterized by the proliferation of small to medium-sized cerebriform lymphoid cells confined to the skin. It usually shows favorable prognosis, but morphologic transformation occurs in some cases and is often associated with a more aggressive clinical course. Herein we report a case of Ki-1 positive large cell lyrnphoma (Ki-1 LCL) which developed in the plaque stage of mycosis fungoides. Although the lesions responded well to low-dose methotrexate therapy and there was no evidence of local or systemic recurrence until now, continuous follow-up is needed because the prognosis of transformed MF is known to be poor compared with primary cutaneous Ki-1 LCL. We also discussed the differential diagnosis of primary cutaneous Ki-1 positive lymphoproliferative disorders.