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골반내에 발생한 Proximal-type 유상피성 육종 1예
길준철,이상수,전병화,김성훈,손우석,목정은,박양순,강길현 대한부인종양 콜포스코피학회 2003 Journal of Gynecologic Oncology Vol.14 No.4
유상피성 육종은 매우 드문 악성 연조직 육종으로, 전형적인 경우들은 주로 젊은 남성의 수부, 전완부와 같은 신체의 원위부에 피하 혹은 심재성 피부 종괴로 발생하며, 조직학적 소견상 적은 비정형성을 나타내는 유상피성 세포와 방추형 세포의 증식에 의한 다발성 결절 형태의 배열을 보인다. 최근에 전형적인 유상피성 육종과 조직학적 유사성을 가지나 더 공격적인 형태인 proximal-type 유상피성 육종이 보고되었으며, proximal-type은 전형적인 유상피성 육종에 비하여 현저한 유상피성 세포의 발현과 매우 심한 비정형성을 나타내며, 세포가 매우 크고, 소포성 핵과 뚜렷한 핵소체를 보이며, 자주 rhabdoid 세포의 양상을 띈다. 임상적으로는 전형적인 형태에 비하여 호발 연령이 조금 늦고, 주로 체간부에, 특히 골반, 회음부, 생식기 등과 같은 심부에 발생하고, 더욱 공격적인 양상을 나타낸다. 저자들은 13세 소녀에서 원발부위를 알 수 없는, 골반내에 발생한 proximal-type 유상피성 육종 1예를 경험하여, 문헌 고찰과 함께 보고하는 바이다. Epithelioid sarcoma is a rare malignant soft-tissue sarcoma with an unknown histiogenesis, typically presenting as a subcutaneous or deep dermal mass lesion in the distal portions of the extremities of young adults. Recently, a more aggressive, so-called 'proximal-type' epithelioid sarcoma has been reported. In contrast to conventional epithelioid sarcoma, the proximal type is characterized by a predominantly large cell epithelioid cytomorphology, marked cytologic atypia, and frequent occurrence of rhabdoid features in most patients. Proximal-type epithelioid sarcoma has a predilection for appearing in the genitalia, especially the vulva, penis, pelvis and buttocks. Also this lesion appears to be somewhat more aggressive or at least metastasizes earlier than the conventional epithelioid sarcoma. We report a 13-year-old girl who presented with a buge mass filling the pelvic cavity which was painful, hard and fixed on palpation, and was radiologically diagnosed as a malignant germ cell tumors on the CT scan. The mass was surgically excised and pathologically proved to be an proximal-type epithelioid sarcoma of unknown origin.
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문점용 ( Jum Yong Moon ),길준철 ( Jun Chul Gil ),조덕주 ( Duk Joo Jo ),김성훈 ( Sung Hoon Kim ),이상수 ( Sang Su Lee ),목정은 ( Jung Eun Mok ) 대한주산의학회 2002 Perinatology Vol.13 No.1
무심 쌍태아는 일란성 쌍태아의 1%, 전체 임신 35000건 중 하나의 발생률을 보이는 매우 희귀한 기형이다. 무심 쌍태아는 태반에 혈관 문합이 존재하여 정상 쌍태아로부터 무심 쌍태아로 역류된 피에 의존해 살아가는 기생적 존재이다. 그 결과 정상 쌍태아는 심부전, 태아사망, 양수과다증과 그와 관련된 많은 합병증이 발생하며, 50~75%의 높은 사망률을 보인다. 저자들은 정상 쌍태아의 자궁내 사망과 동반된 무심 쌍태아 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. The acardiac twin is very rare congenital malformation of monozygotic multiple gestations affecting 1% of monozygotic twins, or 1 in 35000 births. The acardiac twin has a parasitic existence and depends on the donor twin for its blood supply via placental anastomoses and retrograde perfusion of the acardiac umbilical cord. Acardiac twin places the normal twin at risk for high output cardiac failure and in utero fetal death and may lead to polyhydramnios and its related complications. The mortality rate is reported to be between 50% and 75% for the normal twin. We recently experienced a case of acadius anceps with a normal twin death in uterus, so present with a brief review of the literature.
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이상수,정영훈,조덕주,목정은,길준철,문점용,오유섭 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.9
A 17-year-old primigravida, who had an elective abortion in the second trimester of pregnancy in a local clinic, was transferred to our hospital in state of status epilepticus. During the last 2-hr period immediately prior to admission the patient had an unknown number of generalized convulsions together with intermittent episodes of vomiting. Despite the administration of anticonvulsants and sedatives her condition was one of wild agitated response to stimuli, alternating with deep coma. After a tentative diagnosis of dilutional hyponatremia, she was given hypertonic saline solutions in addition to anticonvulsant therapy. Fourteen hours after her seizure, the patient was awake, alert, and cheerful but totally amnescent about the previous period. This case of severe water intoxication associated with an infusion of oxytocin reported here may serve as a reminder of the potential hazards of a widely used procedure, and of the precautions which must be observed.
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김성훈 ( Kim Seong Hun ),이상수 ( Lee Sang Su ),전병화 ( Jeon Byeong Hwa ),길준철 ( Gil Jun Cheol ),손우석 ( Son U Seog ),목정은 ( Mog Jeong Eun ),이은혜 ( Lee Eun Hye ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.3
Foreign bodies retained in the peritoneal cavity rarely are documented, owing to medical, legal, and other reasons. A retained surgical sponge in the peritoneal cavity may cause symptoms both in the early postoperative period as well as months or years after the original operation. Among the complications reported following retention of surgical pads and sponges are obstruction, peritonitis, adhesions, abscess formation, erosion into the gastrointestinal lumen, and extrusion via the rectum. Erosion of a surgical sponge into the bowel is uncommon. We report a 33-year-old women in whom retained surgical sponge eroded into the small bowel and produced unusual radiologic findings and complications.
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