내시경적 점막절제술로 치험한 식도 과립상 세포종 1례

강혁주,김성욱,최석진,이중현,장재식,서영범,윤병구,박건욱,김성자,김용섭,강승완,이구,양창헌,이창우,김욱년,이광헌,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

과립상 세포종은 Schwann 세포 기원으로 생각되며 인체에 비교적 드물게 발생한다. 과립상 세포종은 전신 어느 곳에서나 발견될 수 있으나 주로 혀, 구강, 피부 혹은 유방 등에서 호발하며 드물게 위장관에서 발견된다. 위장관에서는 식도에서 가장 호발하며 다음으로 위, 대장 순이다. 과립상 세포종은 대부분, 특히 위장관에서는 양성이며 소수의 악성 병변이 보고되었다. 이러한 이유와 함께 수술 전의 진단이 어렵기 때문에 과립상 세포종에 대한 근본적인 치료는 현재까지 외과적 절제술이다. 최근에 시도되는 치료방법들로는 내시경적 레이저 치료, 용종절제술, 내시경적 점막 절제술 등이 있다. 저자들은 상부 소화관 내시경검사를 시행하여 식도 과립상 세포종을 진단하고 내시경적 점막 절제술을 시행하여 합병증 없이 퇴원하여 현재 재발없이 경과 관찰중인 1례를 경험하였기에 보고하는 바이다. Granular cell tumors, which occur infrequently, are probably of Schwann cell origin. They can occur almost anywhere in the body but usually affect the tongue, oral cavity, skin, or breasts and are rarely found in the gastrointestinal tracts. The esophagus is the most frequent gastrointestinal site, followed by the stomach and the colon. Granular cell tumors are generally benign, especially in the gastrointestinal tract, some malignant lesions have been reported. For this reason, and also because preoperative diagnosis is difficult, the standard treatment for granular cell tumor has until now been surgical excision. In recent years, other therapeutic methods is endoscopic laser therapy (ELT), polypectiomy, endoscopic mucosal resection (EMR). We report a case of esophageal granular cell tumor which was diagnosed by an endoscopy and managed using an endoscopic mucosal resection without complication.

치근단낭과 육아종의 디지털방사선학적 비교연구

이건일,진연화 大韓口腔顎顔面 放射線學會 1999 Imaging Science in Dentistry Vol.29 No.1

The purpose of this study was to investigate whether a radiometric analysis of radicular cysts and periapical granulomas is useful in the differential diagnosis. In this experiment, twenty-nine periapical radiographs of the radicular cyst and those periapical granuloma were used. The periapical radiography was taken by intraoral paralleling device. The X-ray film was digitized and digitally filtered to reduce film-grain noise. We estimated density difference of the inner/outer area, roundness or circularity, bone profile or scan line of the margin and cumulative percentage frequency curve of radicular cyst & periapical granuloma. The obtained results were as follows; 1. The differences in density between ROIs of inner and outer area of radicular cysts were smaller than those of periapical granulomas. 2. The equivalent circular diameter was over 6.3mm, there was significant difference between periapical cyst and periapical granuloma. 3. In differential diagnosis of radicular cyst and periapical granuloma using bone profile, sensitivity, specificity and accuracy were considerable high(0.83, 0.86, 0.86) respectively. 4. Cumulative percentage frequency curve of the radicular cyst was closer to the pseudo-pixel value of 50 than average curve, whereas periapical granuloma was closer to that of 0. Hence we conclude that digital radiometric features might be useful in the differential diagnosis between radicular cyst and periapical granuloma.(J Korean Oral Maxillofac Radiol 1999:29:239-252)

계수공제영상의 비선형 대조도 증강효과에 관한 연구

이건일,진연화 大韓口腔顎顔面放射線學會 1997 Imaging Science in Dentistry Vol.27 No.2

This study was performed to demonstrate the effect of linear or nonlinear contrast enhancement on subtraction images. Three different textures were radiograped on dental film. The first radiograph was taken without the presence of and object. the second, which showed trabucular bone, was taken of the molar area of a human. the third radiograph was taken of the coronal part of molars. Each film was digitized into a 1312 x 1024 pixel x 8 bit depth matrix by means of a Nikon 35 mm film scanner(LS-3510AF, Japan) with fixed gain and internal dark current correction to maintain constant illumination. The scanner was interfaced to a Macintosh LC Ⅲ computer(Apple Computer, Charlotte, N.C.). This resulted in three pairs of images, including different textures-plain, bone and enamel. Digital regular, linearly and nonlinearly enhanced subtraction was performed. Computer software was used to simulate lesions in the shape of a 2D-Gaussian curve on each of a pair of images. The each subtraction images were presented in a random sequence to two groups of 10 observers(students and dentists). ROC analysis was used to compare observer performance. The following results were obtained; 1. All of LCE subtraction, equalized subtraction and regular subtraction images of plain texture were diagnosed the best by far. 2. The data revealed a significant LCE effect in both the student group and the expert group. 3. Clinical expertise was a helphul factor for the observers in this study.

구강 편평세포암종에서 E-cadherin 및 β-catenin 발현의 변화 : Correlation with Histologic Features and p53 Expression

서진건,권창석,박진배,윤혜경,김우형,이희철 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.4

Objective : Altered expression of cell adheion molecules is associated with biologic behavior of tumor. The aim of this study is to evaluate the expression pattern of E-cadherin, β-catenin and p53 protein according to histologic grade and invasion pattern of squamous cell carcinoma of the oral cavity and the relationship between E-cadherin, β-catenin and p53 protein expression. Methods and Material : The materials were fifty seven cses of squamous cell carcinoma, and clinicl parameers such as age, sex, tumor location, stage and recurrence were recorded. Histologic review was done based on histologic grade and invasion pattern(nodular vs infiltrative). Immunohistochemical stains for E-cadherin and β-ca tenin were interpreted based on staining pattern as los of membranous expression and cytoplasmic expression and p53 protein expression was defined as positive if more than 10% of nuclei were reactive. Statistical analysis between E-cadherin, β-catenin and p53 protein expressions and histologic grade and invasion pattern and the relationship between E-cdherin, β-catenin and p53 protein expressions were perfomed. Results : There wa positive correlation between higher histologic grade and infiltrative pattern. Loss of membranous expression and cytoplasmic expression of E-cadherin were noted in 33.3% and 57.9%, respectively, and loss of membranous expression of E-cadherin showed increaing tendency in poorly differentiated carcinomas, however, there was no significant difference of cytoplasmic expression rate of E-cadherin according to histoogic grade. Altered expression of E-cadherin was more frequent in poorly differentiated carcinomas. Loss of membranous expression and cytoplasmic expression of E-cadherin were more frequent in carinomas with infiltrative pattern than in carcinomas with nodular pattern, but their diferences were not significant, Loss of membranous expression and cytoplasmic expression of β-catenin were observed in 19.3% and 80.7%, respectively. Loss of membranous expression of β-catenin howed no positive correlation according to histologic grade and invasion pattern, but cytoplasmic expression rate of β-catenin was higher in poorly differentiated carcinomas and in carcinomas with infiltrative pettern. p53 protein expression rate was 45.6%, and showed invreasing tendency in poorly differentiated carcinomas, but no significant relationship with invasion pattern. There was an inverse relationship of loss of membranous expression and cytoplasmic expression of E-cadherin and β-catenin. Altered expression of E-cadherin was related to cytoplasmic expression of β-catenin, however, there were no significant relationship between altered expressions of E-cadherin and β-catenin and p53 protein expression. Conclusion : In squamous cell carcinomas of the oral cavity, altered expression of E-cadherin and β-catenin was more frequent in poorly differentiated carcinomas and in carcinomas with infiltrative pattern and there was positive correlation betwween altered expression of E-cadherin and β-catenin. These findings suggest that altered expressions of E-cadherin and β-catenin may have a role in the development of squamous cell carcinomas with aggressive biologic behavior. but altered explosions of E-cadherin and β-catenin. These findings suggest that altered expressions of E-cdherin and β-catenin my have a role in the development of squmaous cell carcinomas with aggressive biologic behavior. But altered expression of E-cadherin and β-catenin might not be related to p53 protein expression. Further study on genetic mutation related to altered expression of E-cadherin and β-catenin will be needed

소아기 외과계질환의 통계적 관찰

정용헌,이재호,이건수,서종진 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2

Child is not little man but rather a father of man. Children are faced to surgical and medical problems reqiring various specialists. Authors analized 1126 pediatric surgical in-patients of Chung-nam National Univ. Hospital from Jan. to Dec. 1988 by departments, age, sex, duration of admission and types of diseases in order to get the information for management of children’s hospital. The results are as follows: 1. Absolute numbers of in-patients by departments are above 200 in general surgery and opthalmology, between 100-199 in plastic surgery, ENT, chest surgery and below 99 in urology and neurosurgery. 2. Male to female ratio as a whole is 1.8:1, male dominant. 3. Duration of admission within 1 week was of 55% as a whole, 87% in ENT, 85% in ophthalmology, 13% in orthopedic surgery. 4. Average duration of admission was 10.8 days as a whole, 4.6 days in ENT, 5.1 in ophthalmology, 29.7 days in orthopedic surgery, and variable by types of diseases. 5. The most frequent disease by departments was hernia in general surgery, fracture in orthopedic surgery, cerebral contusion in neurosurgery, ventricular septal defect in chest surgery, strabismus in ophthalmology, tonsillitis & adenoiditis in ENT.

고정밀 연삭기용 주축시스템 설계

편영식,이건범,박정현,요꼬이 요시유끼,여진욱,안건준,곽철훈 한국공작기계학회 2003 한국생산제조학회지 Vol.12 No.3

Any one of the high precision spindle systems and guide way systems, the high stiffness of structure, the error compensation during assembly, high accuracy control system is inevitable technology for development of high precision machine tools. Especially, among these, design of spindle system is one of the most important technologies leading high precision of machine tool and high quality of manufactured products. A high speed and high precision spindle system which will be used for final machining of ferrule, is designed considering the effect of heat, cutting torque, cutting force, and work-piece materials. The detailed design and analysis process are presented.

Rituximab treatment for autoimmune limbic encephalitis in an institutional cohort

Lee, Woo-Jin,Lee, Soon-Tae,Byun, Jung-Ick,Sunwoo, Jun-Sang,Kim, Tae-Joon,Lim, Jung-Ah,Moon, Jangsup,Lee, Han Sang,Shin, Yong-Won,Lee, Keon-Joo,Kim, Soyun,Jung, Keun-Hwa,Jung, Ki-Young,Chu, Kon,Lee, Sa Ovid Technologies (Wolters Kluwer) - American Acad 2016 Neurology Vol.86 No.18

<P>Objective: To determine efficacy and safety of rituximab treatment as a second-line immunotherapy treatment for autoimmune limbic encephalitis (ALE) and to determine factors associated with functional improvement and favorable outcome following rituximab treatment. Methods: We recruited 80 patients with ALE who were treated with rituximab as a second-line immunotherapy from the Korea Autoimmune Synaptic and Paraneoplastic Encephalitis Registry and reviewed 81 patients without rituximab as a control. We grouped patients according to the detection or type of antibodies; in addition, we evaluated clinical, laboratory, first-line immunotherapy, and rituximab treatment profiles and defined main outcomes as improvements on the modified Rankin Scale (mRS) score and a favorable mRS score (0-2) at the last follow-up. Results: Functional improvement occurred more frequently in the rituximab group compared to the control group. In the rituximab group, 30 (37.5%) patients had synaptic autoantibodies, 15 (18.8%) in the paraneoplastic autoantibodies, and 35 (43.8%) were antibody-negative. The effect of rituximab was the same regardless of autoantibody status. Additional monthly rituximab therapy and partial response to first-line immunotherapies were associated with mRS score improvements, as well as favorable mRS scores. mRS scores of 4-6 as the worst neurologic status predicted an unfavorable mRS score. There were no reported serious infusion-related or infectious adverse effects of rituximab. Conclusions: Rituximab is effective and safe as a second-line immunotherapy for ALE, regardless of autoantibody status. Additional monthly rituximab therapy might potentiate the efficacy of rituximab. Classification of evidence: This study provides Class IV evidence that rituximab improves mRS scores for patients with autoimmune limbic encephalitis who fail first-line therapy.</P>

Tocilizumab in Autoimmune Encephalitis Refractory to Rituximab: An Institutional Cohort Study

Lee, Woo-Jin,Lee, Soon-Tae,Moon, Jangsup,Sunwoo, Jun-Sang,Byun, Jung-Ick,Lim, Jung-Ah,Kim, Tae-Joon,Shin, Yong-Won,Lee, Keon-Joo,Jun, Jin-Sun,Lee, Han Sang,Kim, Soyun,Park, Kyung-Il,Jung, Keun-Hwa,Jun Springer-Verlag 2016 Neurotherapeutics Vol.13 No.4

<P>A considerable portion of autoimmune encephalitis (AE) does not respond to conventional immunotherapies and subsequently has poor outcomes. We aimed to determine the efficacy of tocilizumab, an anti-interleukin-6 antibody, in rituximab-refractory AE compared with other treatment options. From an institutional cohort of AE, 91 patients with inadequate clinical response to first-line immunotherapy and following rituximab were retrospectively reviewed. Patients were grouped according to their further immunotherapy strategies. Thirty (33.0 %) patients were included in the tocilizumab group, 31 (34.0 %) in the additional rituximab group, and 30 (33.0 %) in the observation group. Outcomes were defined as the favorable modified Rankin Scale scores (aecurrency sign2) at 1 and 2 months from the initiation of each treatment strategy and at the last follow-up. Favorable clinical response (improvement of the modified Rankin Scale scores by aeyen 2 points or achievement of the mRS scores aecurrency sign 2) at the last follow-up was also analyzed. The tocilizumab group showed more frequent favorable mRS scores at 2 months from treatment initiation and at the last follow-up compared with those at the relevant time points of the remaining groups. The majority (89.5 %) of the patients with clinical improvement at 1 month from tocilizumab treatment maintained a long-term favorable clinical response. No serious adverse effects of rituximab or tocilizumab were reported. Therefore, we suggest that tocilizumab might be a good treatment strategy for treating AE refractory to conventional immunotherapies and rituximab. The tocilizumab-mediated clinical improvement manifests as early at 1 month after treatment initiation.</P>

LAG-3 and TIGIT protein expressions in cutaneous melanoma and their relationship with PD-1 tumor-infiltrating lymphocytes

( Keon Hee Lee ),( Woo Jin Lee ),( Ye Jin Lee ),( Myoung Eun Choi ),( Kyung A Yun ),( Chong Hyun Won ),( Mi Woo Lee ),( Jee Ho Choi ),( Sung Eun Chang ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2

Background: Lymphocyte activating gene 3 (LAG-3) and T cell immunoglobulin and ITIM domain (TIGIT) are emerging important checkpoint proteins. Objectives: We evaluated LAG-3 and TIGIT protein expression patterns and correlation with programmed death-1 (PD-1) expression, and determined their effects on clinicopathological characteristics and biological responses in melanoma. Methods: Diagnostic tissue from 124 cases of melanoma was evaluated by immunohistochemistry for LAG-3, TIGIT, and PD-1 expression. Clinicopathological features and survivals were analyzed according to the expression of LAG-3, TIGIT, and PD-1. Results: LAG-3 and TIGIT expression on TILs was significantly correlated with that of PD-1 expression, and was also significantly associated with negative prognostic factors: deeper Breslow thickness, lymph node involvement, and advanced stage of disease. However, PD-1 expression was not associated with clinicopathological variables, which are a prognostic index. High expression of either LAG-3 or TIGIT was associated with worse survivals. High expression of PD-1 was not predictive for survivals, but expression of LAG-3 or TIGIT predicted worse survivals in patients with high expression of PD-1. Conclusion: Expression of LAG-3 and TIGIT represents an independent unfavorable prognostic factor in cutaneous melanoma, which suggests the therapeutic value of combined immune checkpoint blockade in melanoma.

Progression of Cerebral White Matter Hyperintensities and the Associated Sonographic Index

Lee, Woo-Jin,Jung, Keun-Hwa,Ryu, Young Jin,Lee, Keon-Joo,Kim, Jeong-Min,Lee, Soon-Tae,Chu, Kon,Kim, Manho,Lee, Sang Kun,Roh, Jae-Kyu Radiological Society of North America 2017 Radiology Vol. No.