간장 및 담도 : Ketoconazole 에 의한 독성간염 4예

강진경(Jin Kyung Kang),박찬일(Chan Il Park),김경희(Kyung Hee Kim),민희원(Hee Won Min),오광제(koyang Jae Oh),김형중(Hyung Jung Kim),전재윤(Jae Youn Jun),정재복(Jae Bock Jung),정우희(Woo Hee Jung) 대한소화기학회 1986 대한소화기학회지 Vol.18 No.1

N/A Ketoconazole is the broad-spectrum antifungal ageht as an imidazole-dioxolane compound which is metabolized chiefly in the liver. It is used in onychomycosis, chronic mucocutaneous candidiasis, systemic fungal infection, and vaginal candidiasis that is chronic or not healed with topical treatment. Side reactions of ketoconazole are seen in 5%~10% of all the patients medicated but most of them are mild and transient. Nausea and vomiting are the most frequent side reactions. In addition, there are abdominal pain, headache, dizziness, itching sensation, fever, photophobia, diarrhea and transient elevation of serum hepatic enzyme level. However, symptoms of hepatitis develop rarely. In 1984, Lewis and co-workers reported 33 cases of ketoconazole- induced hepatitis and this kind of hepatitis has already been reported twice in Korea. In recent time we experienced 4 cases of hepatitis which had seemed as acute or chronic hepatitis clinically, but had confirmed with peritoneoscopic liver biopsy as toxic hepatitis developed after longterm use of ketoconazole.

후복막강에 발생한 Castleman병

서정건(Jung Kun Seo),정준근(Jun Keun Jung),정준표(Jun Pyo Chung),박효진(Hyo Jin Park),전재윤(Chae Yoon Chon),지훈(Hoon Ji),김기황(Ki Hwang Kim),지훈상(Hoon Sang Chi),정우희(Woo Hee Jung) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.3

Castlemans disease is a rare, benign disorder of the lymphoid tissue, and refers ta a distinctive type of giant lymphoid hyperplasia that forms tumor-like masses in lymph nodes and, occasionally, in extranodal sites. Although the mediastinum is its the most common location, it also occurs, albeit rare, in other areas of the body, where lymph nodes are normally found. It is difficult to differentiate between Castlernans disease and other malignant lesions preoperatively. We report a case of a hyaline-vascular variant of Castlemans disease presenting as a solitary retroperitoneal mass in a 39 year old female patient. We also present the MR features, together with conventional radiologic imagings, which made it possible to diagnose Castlemans disease preoperatively, although the mass of the patient was in an unusual location, This report may provide information on differentiation between primary retroperitoneal malignancies and Castlemans disease. (Korean J Gastroenterol 1996; 28:462-468)

유방암의 조직학적 다발성

박희붕(Hee Boong Park),이희대(Hy De Lee),정우희(Woo Hee Jung),오기근(Ki Keun Oh),지훈상(Hoon Sang Chi),김병로(Byong Ro Kim),민진식(Jin Sik Min) 대한외과학회 1994 Annals of Surgical Treatment and Research Vol.47 No.2

132예의 유방보존술식 분석

형우진(Woo Jin Hyung),구자윤(Ja Yun Koo),서창옥(Chang Ok Suh),정우희(Woo Hee Jung),오기근(Ki Keun Oh),이희대(Hy De Lee) 대한외과학회 1997 Annals of Surgical Treatment and Research Vol.53 No.1

갑상샘 세침흡인 세포검사와 조직검사의 진단 일치율 및 정확도 분석 -조직학적으로 확진된 322 예에 대한 분석-

구자승,정우희,양석우,홍순원,Koo, Ja-Seung,Jung, Woo-Hee,Yang, Seok-Woo,Hong, Soon-Won 대한세포병리학회 2008 대한세포병리학회지 Vol.19 No.2

Fine needle aspiration (FNA) cytology is the decisive test in the pre-operative diagnostics of thyroid nodules. Here we share our institutional experience about thyroid aspiration and give suggestions for suspicious cytology results. Three hundred twenty-two cases in 270 patients (mean age 47.4 years, 243 women and 27 men) who underwent thyroidectomy were reviewed. Among the 322 cases, the FNA diagnosis of "positive for malignancy" was 87 cases (27.0%), "suggestive of malignancy" 30 cases (9.3%), "suspicious for malignancy" 61 cases (18.9%), "negative for malignancy" 102 cases (31.7%), and "unsatisfactory smear" 42 cases (13.0%). Eighty seven cases (100%) out of "positive for malignancy", 29 cases (96.7%) out of "suggestive of malignancy", and 39 cases (64.0%) out of "suspicious for malignancy" were papillary carcinoma (148 cases, 95.5%), or follicular carcinoma (2 cases, 1.3%), or metastatic carcinoma (1 case, 0.6%). Seventeen patients who had only negative or unsatisfactory cytology underwent thyroidectomy and nine cases (52.9%) were papillary carcinoma. We suggest that: the cytology diagnosis of "suggestive of malignancy" could be regarded as "positive for malignancy", the cytology diagnosis of "suspicious of malignancy" should be carefully correlated with clinico-radiologic manifestation, and even a negative or unsatisfactory smear should be carefully followed up.

귀밑샘에 발생한 점액 화생을 동반한 만성 경화침샘염의 세침흡인 세포소견 -증례 보고-

석재연,정우희,허상범,김진,홍순원,Seok, Jae-Yeon,Jung, Woo-Hee,Fan, Xu Xiang,Kim, Jin,Hong, Soon-Won 대한세포병리학회 2005 대한세포병리학회지 Vol.16 No.2

Chronic sclerosing sialadenitis, also known as Kuttner tumor, is a benign chronic inflammatory lesion of the salivary gland. Here, we describe a case of chronic sclerosing sialadenitis with mucinous ductal metaplasia in a parotid gland, which was confused with low-grade mucoepidermoid carcinoma on aspiration cytology.

소아의 경부 종괴에 관한 임상 및 병리학적 고찰

박희붕(Hee Boong Park),이묘경(Myo Kyung Lee),홍정(Jeong Hong),정우희(Woo Hee Jung),황의호(Eui Ho Hwang),설준희(Joon Hee Sul) 대한두경부종양학회 1993 대한두경부 종양학회지 Vol.9 No.2

Histologically proven 465 cases of neck mass in children were analized for the determination of the nature of lesions. Pathologic specimens were obtained during 10 years from January 1981 to December 1989 at Severance Hospital, Yonsei University, College of Medicine. 1) Congenital lesion was most common in neonate(80%) and congenital lesion and inflamatory disease were common in infancy and inflammatory disease was most common in more than one year old children. Thyroglossal duct cyst was most common(35.4%) disease of the congenital lesion. followed by cytic hygroma(34%) and branchial cleft remnants(29.2%). 2) Benign tumors were discovered most frequently in adolescence (55.2%) and thyroid adenoma(23.7%) and epithelial tumor(21.1%) and hemangiomas(19.7%) were most common. Most common malignant tumors were malignant lymphoma (50%) and Hodgkin's disease and were present in the older children. Metastatic cancers were very rare and their primary sites were deductable in all cases. 3) Reactive hyperplasia of lymph node was most common in inflammatory disease(23.7%). Tuberculosis lymphadenitis was more common than nonspecific lymphadenitis. 4) Bilaterality of lesion was commonly seen in malignant disease(41.7%), reactive hyperplasia of lymph node (38.85%) and metastatic disease(33.3%). Size and duration of the masses were not helpful in the differential diagnosis of the cause of the masses. Pediatric neck mass must be evaluated with its characteristics. sites, bilaterality, size and its cange, duration and patient's age but any of these alone cant not be predicted its causes without biopsy or excision. Biopsy or excision can be done with few complication but biopsy of lymph node for diagnosis is carefully made because a large number of lymph node biopsy showed no definite diagnosis in these selected cases of patients.

Conservative Surgery and Primary Radiotherapy for Early Bresst Cancer: Yonsei Cancer Center Experience

서창옥,이희대,이경식,정우희,오기근,김귀언,Suh Chang Ok,Lee Hy De,Lee Kyung Sik,Jung Woo Hee,Oh Ki Keun,Kim Gwi Eon The Korean Society for Radiation Oncology 1994 Radiation Oncology Journal Vol.12 No.3

병기 1기, 2기 유방암에서 유방보존적 수술 후 방사선치료는 기존의 유방전적출술을 대치할 수 있는 치료법으로 정립되었다. 연세암센터에서는 1991년 부터 유방보존술을 적극적으로 시행하였고 첫 3년동안 140예를 치료하였다. 목적 : 연세암센터에서 시행하고 있는 유방보존술의 적응증, 치료방침과 방사선치료 방법을 소개하고 결과 및 방사선치료의 부작용을 보고하고자 한다. 방법 : 1991년 1월부터 1992년 12월까지 연세암센터 치료방사선과에서 유방보존적수술 후 근치적 방사선치료를 받았던 64명의 조기 유방암 환자를 대상으로 하였다. 모든 환자들은 종괴 또는 병변을 포함한 부분유방절제술과 액와임파절 곽청술을 시행받은 후 방사선치료를 받았다. 방사선치료는 수술후 3-18주에 시행되었는데 선형가속기 4MV X-ray를 사용하여서 침범된 유방 전체에 4500-5040 cGy를 5-6주에 걸쳐서 조사하였고 원발 병소 주변에 전자선을 사용하여서 1-2주에 걸쳐서 1000-2000 cGy를 추가 조사하였다. 치료를 받았던 환자들의 임상적 특성과 치료방법, 방사선치료에 따르는 부작용, 재발 여부 등을 분석하였다. 결과 : 대상환자들의 연령은 23세에서 59세로 중앙값이 40세 였다. 총 64명중 T1은 27명, T2는34명 이었으며 3명은 비침윤성 암이었다. 또한 전체의 $42.2\%$인 27명은 액와임파절 침윤이 있었다. 추적 기간(6-30개월, 중앙값 14개월) 동안 1예의 유방내 재발과 2예의 원격 전이가 관찰되었는데 유방내 재발은 원발병소와 다른 사분원에 위치하여서 처음 진단에서 발견하지 못했던 유방조영술상의 미세석회화음영에서 종괴가 자랐던 예로 다시 유방전적출술을 받은 후 무병생존 중이다. 방사선치료 중 또는 추적 기간 동안 치료를 요하는 부작용으로는 1예에서만 방사선 폐렴이 있었으나 대증요법 으로 완쾌되었다. 결론 : 추적 기간이 짧기 때문에 국소재발율, 생존율, 미용효과 등의 치료 결과를 평가하기는 이르지만 조기 유방암에서 유방보존적 수술과 근치적 방사선치료는 심한 급성 또는 아급성 부작용이 없는 안전하고 편안한 치료법임을 확인할 수 있었다. 또한 국소재발율을 낮추기 위해서는 유방보존술에 적합한 환자들을 선택하기 위한 철저한 평가가 필수적임을 알 수 있었다. Breast conserving surgery and irradiation is now accepted as preferable treatment method for the patients with stage I and II breast cancer. Our institution activated team approach for breast conservation in 1991 and treated one hundred and fourty patients during the next three years. Purpose : To present our early experience with eligibility criteria, treatment techniques, and the morbidities of primary radiotherapy. Materials and Methods: Sixty four patients with early stage breast cancer who received breast conserving treatment between January 1991 and December 1992 were evaluated. All patients received partial mastectomy(wide excision to quadrantectomy) and axillary node dissection followed by radiotherapy. Total dose of 4500-5040 cGy in 5-5 1/2 weeks was given to entire involved breast and boost dose of 1000-2000 cGy in 1-2 weeks was given to the primary tumor site. Linac 4 MV X-ray was used for breast irradiation and electron beam was used for boost. Thirty five Patients received chemotherapy before or after radiotherapy. Patients characteristics, treatment techniques, and treatment related morbidities were analyzed. Results : Age distribution was ranged from 23 to 59 year old with median age of 40. Twenty-seven patients had T1 lesions and 34 patients had T2 lesions. In three patients, pathologic diagnosis was ductal carcinoma in situ. Thirty-seven Patients were N0 and 27 patients were Nl. There were three recurrences, one in the breast and two distant metastases during follow-up period(6-30 months, median 14 months). Only one breast recurrence occured at undetected separate lesion with microcalcifications on initial mammogram. There was no serious side reaction which interrupted treatment courses or severe late complication. Only one symptomatic radiation pneumonitis and one asymptomatic radiation pneumonitis were noted. Conclusions: Conservative surgery and primary radiotherapy for early breast cancer is Proven to be safe and comfortable treatment method without any major complication. Long-term follow up is needed to evaluate our treatment results in terms of loco-regional control rate, survival rate, and cosmetic effect.

췌장의 고형성 유두상 암종의 세침흡인 세포학적 소견

조미연,이광길,이기범,정현주,정우희,Cho, Mee-Yon,Lee, Kwang-Gil,Lee, Kyi-Beom,Jeong, Hyeun-Joo,Jung, Woo-Hee 대한세포병리학회 1990 대한세포병리학회지 Vol.1 No.1

We present the cytologic features of a case of solid and papillary neoplasm of the pancreas. Cytologically, the tumor was composed of a monotonous population of polygonal cells containing eccentrically located round nuclei with one or two distinct small nucleoli and a finely stippled chromatin pattern. The tumor cells were similar to those of the islet cell tumor and showed isolated loosely aggregated and solid sheets or large cell clumps. The large cell clumps revealed a branching papillary structure containing fibrovascular central core, which is characteristic histologic feature of solid and papillary neoplasm of the pancreas. This case was confirmed by tissue examination including histochemical, immunohistochemical and electron microscopical studies. Ultrastructurally, the tumor cells contained a few membrane- bound electron dense granules.

소변검사의 재검 시 세포원심분리법과 액상세포검사 $ThinPrep^{(R)}$의 효율성에 관한 비교

김현경,표주연,이윤희,정우희,김세훈,홍순원,Kim, Hyun-Kyung,Pyo, Ju-Yeon,Lee, Yoon-Hee,Jung, Woo-Hee,Kim, Se-Hoon,Hong, Soon-Won 대한세포병리학회 2007 대한세포병리학회지 Vol.18 No.1

Once diagnosed as "cell paucity"or "atypia" by the cytospin (CS) preparation, this CS preparation does not secure a precise diagnosis by repeated testing alone. Although the ThinPrep (TP) preparation is acknowledged to show increased cellularity, performing the screening tests for the cases that have enough cellularity, according to CS, raises issues for the cost-effectiveness. To obtain a more precise diagnosis through increasing the cellularity by performing TP, we selected the cases that were diagnosed as "cell paucity" or "atypia" by CS, but they required a more precise diagnosis, and the samples were processed via both CS and TP to compare the results. 11 patients diagnosed as "cell paucity" and 22 patients diagnosed as "atypia" by CS participated in this study. When the detection rate of atypical cells in both preparations with repeated urine cytology was compared, the overall detection rate of TP (16cases, 48.5%) was superior than that of CS (11cases, 33.3%), with statistical significance. The cellularity of both preparations was compared on repeated urine cytology; the general cellularity of TP (29cases, 87.9%) was higher than that of CS (20cases, 60.6%), but there was no statistical significance. Particularly, we repeated the TP for the 1 case that was diagnosed as "atypia" and we performed polyoma virus immunohistochemical staining, which confirmed polyoma virus. In conclusion, we can avoid obtaining negative diagnosis from cases with uncertain "atypia" or "cell paucity" by performing repeated TP testing.