귀밑샘의 형질세포와 호산성 조직구를 다량 함유한 림프절외 변연부 B-세포 림프종의 세침흡인 세포검사 소견 -1예 보고-

이영석,안정석,채양석,염범우,최종상,김철환,Lee, Young-Seok,An, Jung-Suk,Chae, Yang-Seok,Yeom, Bom-Woo,Choi, Jong-Sang,Kim, Chul-Hwan 대한세포병리학회 2007 대한세포병리학회지 Vol.18 No.2

The authors present the fine needle aspiration cytology (FNAC) cytologic findings of a case of extranodal marginal zone B cell lymphoma (MZBCL), which featured abundant plasma cells and eosinophilic histiocytes arising in both parotid glands. A 49-year-old female presented with palpable masses in both parotid glands. She had been suffering from systemic lupus erythematosus and rheumatoid arthritis. The lesions were evaluated by FNAC and smears showed a small number of clusters of oncocytic cells with abundant eosinophilic granular cytoplasm and small nuclei, intermixed with small to medium-sized lymphoid cells containing round to lobulated nuclei, which suggested Warthin's tumor. Some of lymphoid cells had a plasmacytoid appearance, and some scattered large cells contained a large amount of eosinophilic cytoplasm. Bilateral superficial parotidectomy was performed and a histopathologic study indicated MZBCL with abundant plasma cells, intermixed with eosinophilic histiocytes. The presence of oncocytic cells and a mixture of lymphoid and plasma cells indicates Warthin's tumor, but the cytologic features of a relatively monotonous small to medium-sized lymphoid infiltrate suggest the possibility of MZBCL in the clinical setting of an FNAC study performed on a patient suffering from a connective tissue disease.

위에 발생한 위장관 간질성 종양의 임상병리학적 특성과 치료성적

류제석,이성렬,최새별,박성수,이주한,김승주,김종석,채양석,목영재,Ryu Je-Seock,Lee Sung-Ryul,Choi Sae-Byeol,Park Sung-Soo,Lee Ju-Han,Kim Seung-Joo,Kim Chong-Suk,Chae Yang-Seok,Mok Young-Jae 대한위암학회 2005 대한위암학회지 Vol.5 No.1

배경: 위장관 간질성 종양(GISTs)은 위장관계에 발생하는 간엽성 종양이다. 위장관 간질성 종양은 면역조직화학 검사에서 c-kit 단백 발현의 양성을 나타내며 그 임상적 경과는 매우 다양하다. 저자들은 위장관 간질성 종양의 임상병리학적 특성을 고찰하고 예후 인자를 평가하기 위하여 후향적 연구를 시행하였다. 대상 및 방법: 본 연구는 고려대학교 의과대학 외과학교실에서 1996년부터 2003년까지 위장관 간질성 종양으로 수술적 절제를 시행한 40명의 환자를 대상으로 하였다. 종양의 크기와 핵분열 정도에 따라 저위험도 집단(23예), 고위험도 집단(17예)으로 분류하였으며 두 군간 임상병리학적 특성, 면역조직화학 검사 결과 및 예후를 비교 분석하였다. 결과: 환자의 평균 연령은 $61.3\pm11.1$세이었으며 남녀비는 1:1,1이었다. 임상병리학적 소견으로는 수술 전 임상 증상이 있었던 경우와 수술 전에 조직학적으로 진단이 되었던 경우, 종양의 크기가 클수록, 핵분열이 많을수록, 종양의 성상이 궤양을 동반하거나 괴사를 보일 때, 고위험군에 포함되는 빈도가 높았다. 단변량 분석 결과, 종양의 크기, 핵분열 정도, 궤양 및 괴사 소견 그리고 내시경적 초음파 이상소견이 통계학적으로 의미가 있는 인자들로 나타났으며, 다변량 분석을 시행한 결과 핵분열 정도가 생존율에 영향을 미치는 독립적인 예후 인자로 나타났다. 관찰 기간 중 8예에서 재발하였으며 STI-571(imatinib mesylate, $Gleeveo^{R}$)을 사용한 4예는 현재까지 생존하고 있으며 사용하지 않은 4예 중 2예는 질환이 진행하는 양상을 나타내었고, 나머지 2P는 사망하였다. 결론: 위에서 기원한 위장관 간질성 종양에서 종양의 크기, 궤양 및 괴사 소견은 생존율에 영향을 주는 임상병리학적 소견이며, 핵분열 정도는 유용한 예후 인자라고 할 수 있다. STI-571은 재발 혹은 전이 환자에 있어 치료 효과를 나타내므로 술후 치료에 적용하는 것이 예후 향상에 기여하리라 생각된다. Purpose: Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms of the gastrointestinal tract. GISTs are positive for the expression of c-Kit protein at immunohistochemistry, and their clinical presentations vary. This retrospective study was performed to evaluate the clincopathologic characteristics of GISTs and to define the prognostic factors. Materials and Methods: 40 patients who underwent a complete resection of a GIST during the period $1996\~2003$ at the Department of Surgery, Korea University College of Medicine, were studied. We divided them into low- and high-risk. groups by using tumor size and mitotic count: 23 cases were low risk, and 17 were high risk. Clinicopathologic features, immunohistochemical findings, and prognoses were compared between the low- and the high-risk groups. Results: The mean age of the 40 patients was $61.3\pm11.1$years, and the male-to-female ratio was 1:1.1. There was no significant difference in age and sex between the groups. A comparative analysis revealed tumor size, mitotic count, clinical symptoms, preoperative pathologic diagnosis, ulceration, and necrosis to be variables that had statistically significant differences between the high- and the low-risk groups. In the univariate analysis, tumor size, mitotic count, ulceration, necrosis, and abnormal endoscopic ultrasound findings were associated with disease-free survival, but in the multivariate analysis, mitotic activity was the only independent factor associated with disease-free survival. 8 patients had recurrences during the follow-up period, and four of them were treated with STI-571 (imatinib mesylate, $Gleevec^{(R)}$). The treated patients have survived until now; however, two of non-treated patients died from disease progression. Conclusion: Based on this study, tumor size, ulceration, and necrosis are significant factors affecting survival, and mitotic activity may be a useful prognostic marker. STI-571 may be used in an adjuvant setting because the drug has shown anticancer activity in patients with recurrence or metastasis.

유방암에서 p53 암억제 유전자 변이에 대한 연구

류진우(Jin Woo Ryu),구범환(Bum Hwan Koo),채양석(Yang Suk Chae) 대한외과학회 1995 Annals of Surgical Treatment and Research Vol.48 No.2

위암의 성장현태와 관련된 종양인자 연구

민연기(Youn Ki Min),조성진(Seong Jin Cho),채양석(Yang Seok Chae),김승주(Seung Joo Kim),목영재(Young-Jae Mok),김종석(Chong-Suk Kim) 대한외과학회 2005 Annals of Surgical Treatment and Research(ASRT) Vol.68 No.1

이소성 췌장의 임상적 고찰

홍정훈(Jeong Hun Hong),조용걸(Yong Geul Joh),엄준원(Jun Won Um),정석인(Suk In Jung),채양석(Yang Suk Chae),배정원(Jeong Won Bae),서성옥(Sung Ock Suh) 대한외과학회 2000 Annals of Surgical Treatment and Research Vol.58 No.5

강직성 척추염 환자의 대장 병변에 관한 연구

이형호 ( Young Ho Lee ),박진호 ( Jin Ho Park ),김재선 ( Jae Sun Kim ),박영태 ( Young Tae Bak ),이창홍 ( Chang Hong Lee ),김철환 ( Chul Hwan Kim ),채양석 ( Yang Suk Chae ),송관규 ( Gwan Gyu Song ) 대한류마티스학회 1996 대한류마티스학회지 Vol.3 No.1

목적: 강직성 척추염 발병기전을 규명하려는 연구의 일환으로 한국인 강직성 척추염 환자에서 장 병변의 유무를 확인하여 강직성 척추염의 발병에 있어서 장 병변의 역할을 알아보고자 하였다. 방법: 강직성 척추염으로 진단받은 24명의 환자를 대상으로 하여 말단 회장부위를 포함한 대장 내시경 및 조직 검사를 시행하였다. 결과: 1) 대장 내시경상 강직성 척추염환자 24명중 Stage 1은 6명(25.0%), Stage 2는 1명(4.2%)으로 총 7명(29.2%)에서 병변이 관찰되었고 이중 5명은 약년형 만석 관절염으로 부터 발병되었으며, 병변위치는 6명(85.7%)은 말단 회장부위에, 1명(14.3%)은 대장에 위치하였다. 2) 조직소견상 Stage 0와 Stage 3는 단 1명도 없었으며 정상소견인 Stage 1은 10명(41.7%), 염증소견인 Stage 2는 14명(58.3%)이었으며, 장염증의 아형으로 급성형을 2명(8.3%), 만성형은 12명(50%)이었다. 3) 말초 관절염이 동반 안된 강직성 척추염 환자에서 급성형은 단 1명도 없었고 만성형은 6명(50%)이었으며, 말초 관절염이 동반된 환자에서는 급성형이 2명(16.7%), 만성형은 6명(50%)으로 말초 관절염이 동반된 환자에서 장병변이 더 많았다. 4) Sulfasalazine을 투여 받지 않은 환자에서 급성형은 1명도 없었고 만성형은 7명(58.3%)이었으며, sulfasalazine을 투여 받은 환자에서는 급성형이 2명(16.7%), 만성형은 5명(41.6%)으로 sulfasalazine 투여 유무에 따른 의의있는 장염증의 차이는 없었다(p=0.31). 결론: 강직성 척추염의 한국인 환자에서도 만성적인 장 병변의 발생 빈도가 외국의 보고와 일치하였으며 이는 한국인에서도 만성적인 장변변이 강직성 척추염의 발병기전에 중요한 역할을 담당할 가능성을 시사하는 소견이다. Objective: To investigate the frequency of gut inflammation in the ankylosing spondylitis and the role of gut lesion in the pathogenesis of the ankylosing spondylitis. Methods: Ileocolonoscopy and biopsy were performed in 24 patients with ankylosing spondylitis. Results: 1) Endoscopic lesions were observed in 7 patients (29.2%) of 24 patients and more often in the terminal ileum (6/7) than in the colon (1/7). Among 7 patients with endoscopic lesions, S patients were presented as juvenile chronic arthritis. 2) Histologic signs of gut inflammation were detected in 14 patients (58.3%). Actue lesions were seen in 2 patients (8.3%) and chronic lesions were seen in 12 patients (50%). 3) In 12 patients without the involvement of peripheral joints, acute lesion was not seen (0%), and chronic lesions were seen in 6 patients (50%). In 12 patients with the involvement of peripheral joints, acute lesions were seen in 2 patients (16.7%), and chronic lesions were seen in 6 patients(50%). Gut inflammations were more frequent in patients with the involvement of peripheral joints than in those without the involvement of peripheral joints. 4) In 12 patients without the administration of sulfasalazine, acute lesion was not seen(0%), and chronic lesions were seen in 7 patients (58.7%) In 12 patients with the administration of sulfasalazine, acute lesions were seen in 2 patients (16.7%), and chronic lesions were seen in 5 patients (41.6%). The frequency of gut lesions in patients without the administration of sulfasalazine was not different from that in patients with the administration of sulfasalazine(p<0.05). Conclusion: Gut inflammation was frequently found in patients with ankylosing spondylitis. Chronic gut inflammation could play a role in the pathogenesis of the ankylosing spondylitis.

진행성 위암의 예후에 있어서 종양맥관 형성의 의의

이창홍(Chang Hong Lee),박영태(Young Tae Bak),김진호(Jin Ho Kim),김재선(Jae Seon Kim),변관수(Kwan Soo byun),권소영(So Young Kwon),목영재(Young Jae Mok),지종대(Jong Dae Ji),김준석(Jun Suk Kim),채양석(Yang Seok Chae) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.2

N/A In spite of the application of an aggressive surgical approach and the detection of disease in an early stage, the 5-year survival rate of patients with acllvanced gastric cancer is still low. It is well known that the survival of the disease is closely related to TNM classification. But it is not sufficient enough to identify poor prognostic subgroups. Recently substantial evidence suggests that tumor angiogenesis in several types of cancer can be an independent prognostic predicto,. In this study we investigated how tumor angiogenesis in gastric cancer correlated with stage, grade of cell differentiation and survival. We highlighted the vessel by staining their endothelial cells immunocytochemicailly for factor VIII and counted thern in the most dense areas of neovascularization in 46 surgical specimens of advanced gastric cancer. The mean counts in patients with stage I, II and III were 19+- 7.31+-11 and 43+-30 respectively. But microvessel counts did not correlated significantly with grade of cell diifferentiation and survival. In conclusion, the number of microvessels per 200X fielid of light microscope in the areas of the rnost intensive neovasrularization in an advanced gastric cancer may be one predictor that reflects prognosis but needs further study whether it could be an independent prognostic predictor or not.

갑상선기능저하증에 기인한 내인성 급사 1예 보고

이정규,전지현,김민정,이규재,김한겸,조현득,채양석 大韓法醫學會 1999 대한법의학회지 Vol.23 No.2

Although it is known that hypothyroidism can cause cardiac dysfunction, it is very hard to find a case report on sudden death due to hypothyroidism. There are only two reported cases on mediline; one is about a 15-year-old girl who died suddenly of Hashimoto's thyroiditis and the other is about a 31-year-old man who also died suddenly of hypothyroidism associated with chronic lymphocytic thyroiditis. Recently we found a young woman who unexpectedly died while she was sleeping. She was diagnosed as hypothyroidism when she went to hospital about a month before she died. At autopsy there were roughly four abnormal findings; Hashimoto's thyroiditis, mild chronic active hepatitis, diverticulosis and accessory spleen. Trace of chlorpheniramine was detected in gastric remains and blood alcohol level was 0.37 percent. To our knowledge, this is the first case reporting sudden and unexpected natural death associated with hypothyroidism in Korea.

Pure Red Cell Aplasia를 동반한 흉선종

채양석,김인선,백승룡 대한병리학회 1982 Journal of Pathology and Translational Medicine Vol.16 No.2

롤러스케이트 선수의 운동상해발생과 예방에 대한 조사 연구

김동희,김도수,채양석,이하얀,김선호,조성채 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.1

The study was intended to research the fact of roller skate players injury. For the study, kinds and parts of injuries, skills to be hurted, facility, injured time, cause, remedy, mental response and protecting were investigated through 182 roller skate players. The results were as follows : 1. The injury body part was showed that leg was the highest and followed by knee and ankle. 2. In the cause of injury was showed as follows: skills on corner work, bank track with concrete, 200m distance. 3. In the general cause of injury was showed: chronic fatigue by over training. 4. In the treatment and participation period after injury outbreak were showed: treatment period was toward the inside 1 week and participation to play during the treatment. 5. To the injury prevention players responded warm up, and cool down and mental-concentration were needed. Supervisor, coach and players responded knee protector wearing was needed in elementary school players and helmet-chin protector wearing in general players. The game rule revision was not necessary and the agree and disagree for ground unity to resemble. Almost players to be like concrete ground.