폐에 발생한 원발성 인환세포암종 - 2예 보고 -

김동자,이숙희,손윤경,Kim, Dong-Ja,Lee, Sook-Hee,Sohn, Yoon-Kyung 대한세포병리학회 1997 대한세포병리학회지 Vol.8 No.1

Signet ring cell carcinoma is a variant of adenocarcinoma and has been rarely reported in the lung as a primary site. Recently, we experienced two cases of primary signet ring cell carcinoma in the lung without any other extrapulmonary lesion. Sputum cytology was performed and the tumor cells which have eccentrically located nuclei and abundnat mucinous cytoplasm were dispersed in diffuse sheets. On resected specimen, the signet ring cells occupied about $50{\sim}80%$ of all tumor cell nests. Histochemical staining revealed that the mucin produced by tumor cells was mostly carboxylated acid mucins. Ultrastructurally, the tumor cells contained variable sized membrane-bound mucin granules with weak central osmilophilic density and showed numerous surface microvilli, which represented that tumor cells arose from bronchial epithelial cells. In general, this tumor has diffusely infiltrative nature and the prognosis is fatal due to widespread metastasis before clinical discovery.

에크린 땀샘종의 세침흡인 세포소견 -1예 보고-

김동자,Kim, Dong-Ja 대한세포병리학회 2005 대한세포병리학회지 Vol.16 No.2

Eccrine spiradenoma is a rare adnexal tumor of the skin and its cytomorphology has seldom been described in literature. To evaluate the cytologic features and diagnostic pitfalls of eccrine spiradenoma, we report a case of 33-year-old male whose clinical presentation was a painful subcutaneous mass at the right preauricular area. Fine needle aspirates revealed tight clusters of multilayered, uniform, cuboidal cells arranged around hyalinized perivascular spaces. Some epithelial cells showed tubules or rosette formations. The background showed scattered, naked nuclei. The histologic findings confirmed the eccrine spiradenoma. The recognition of peculiar cytologic features and clinical correlation could be helpful in the diagnosis of skin adnexal tumors.

갑상선 종괴로 촉지된 흉선종의 세침흡인 세포학적 진단 - 2예 보고 -

김동자,박지영,금윤섭,박태인,손윤경,Kim, Dong-Ja,Park, Ji-Young,Kum, Yoon-Seup,Park, Tae-In,Sohn, Yoon-Kyung 대한세포병리학회 2000 대한세포병리학회지 Vol.11 No.1

Thymoma is the most common anterior mediastinal tumor in adults. Rarely, it is presented as the anterior neck mass, commonly located in the anterolateral aspect of the neck or adjacent to the thyroid. We experienced two cases of fine needle aspiration cytology of thymoma, mimicking thyroid mass. The first case was an ectopoic cervical thymoma in a 31-year-old female. The fine needle aspiration cytology was misinterpreted as reactive hyperplasia of lymph node. But the histologic diagnosis was thymoma, predominantly lymphocytic type. The second case was an invasive thymoma in a 66-year-old female, who complained a large anterior neck mass. The fine needle aspiration cytology revealed biphasic population of some clusters of epithelial cells and scattered lymphocytes. The cytologic diagnosis was thymoma and was confirmed as invasive thymoma after the biopsy. Therefore, when the cytologic feature of anterior neck mass shows the both lymphocyte and epithelial component, the differential diagnosis should Include the possibility of thymoma.

산전 진단된 후복막강내 Fetus in Fetu

김건중 ( Kim Geon Jung ),이창재 ( Lee Chang Jae ),김소희 ( Kim So Hui ),김동자 ( Kim Dong Ja ),강인구 ( Kang In Gu ),박학열 ( Park Hag Yeol ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.10

Fetus in fetu is a very rare congenital abnormality in which one vertebrate fetus is enclosed within the abdomen of another fetus. With advancing ultrasound imaging technique, a few case of prenatal diagnosis is reported recently. A case of fetus in fetu

난관수종액이 생쥐 배아발달에 미치는 영향

박준철,김정아,김동자,배진곤,김종인,이정호,Park, Joon-Cheol,Kim, Jeong-A,Kim, Dong-Ja,Bae, Jin-Gon,Kim, Jong-In,Rhee, Jeong-Ho 대한생식의학회 2010 Clinical and Experimental Reproductive Medicine Vol.37 No.2

목 적: 난관수종액내의 사이토카인 농도를 측정하고, 사이토카인 농도가 다른 난관수종액을 이용하여 생쥐 배아 발생에 미치는 영향을 비교하고자 하였다. 연구방법: 난관수종액은 자궁난관 조영술에서 난관수종이 진단되어 복강경을 통한 난관 절제술을 시행하는 경우 난관 절제술 전에 난관으로부터 채취한 다음 3,000 rpm에서 10분간 원심분리시킨 후 상층액만을 $-20^{\circ}C$에서 보관하였다. 난관수종액의 사이토카인의 조성 및 농도를 확인하기 위하여 interleukin (IL)-$1{\alpha}$, IL-$1{\beta}$, IL-2, IL-4, IL-6, IL-8, IL-10, tumor necrosis factor (TNF)-$\alpha$, interferon (IFN)-$\gamma$, vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), monocyte chemotactic protein (MCP)-1 등을 ELISA 방법으로 측정하였다. 기본 배양액에 난관수종액을 5%, 10%, 30%의 비율로 첨가하여 각 군별로 배반포로의 발달을 관찰하였다. 결 과: 난관수종액내에서 IL-$1{\alpha}$, IL-$1{\beta}$, IL-2, IL-4, IL-6, IL-8, IL-10, TNF-$\alpha$, IFN-$\gamma$, VEGF, EGF, MCP-1가 검출되었으며, 그 농도에 있어서는 큰 차이를 보였다. 정상 혈청 농도에 비하여 난관수종액-1은 IL-6, IL-10이 증가되어 있었고, 난관 수종액-2는 IFN-$\gamma$, MCP-1 및 VEGF가 증가되어 있었다. 각 난관수종액의 Th1/Th2 비는 HSF-1의 경우 IFN-$\gamma$:IL-10이 3.69로 정상인 데 비하여 HSF-2의 경우 IFN-$\gamma$:IL-10이 61.14로 크게 증가되어 있었다. 난관수종액을 포함하지 않는 배양액에서는 배반포기 발달률은 76.7%이었고, 난관수종액-1군은 74%로 대조군과 차이를 보이지 않았지만, 난관수종액-2군의 경우 27.7%로서 대조군 및 난관수종액-1군과도 유의한 차이를 보였다. 난관수종액-1의 경우 난관수종액 농도에 따른 차이는 없었으며, 난관수종액-2군의 경우 농도에 증가함에 따라 배반포로의 발달이 감소하기는 하였지만 통계적으로 유의하지는 않았다. 결 론: 난관수종액마다 사이토카인의 조성이 다르며 이에 따라 생쥐 배아발달에 미치는 영향이 다를 수 있다. 염증성 사이토카인이 증가된 난관수종액이 배아발달에 악영향을 미칠 것으로 추정된다. 특정 사이토카인에 의한 작용을 규명하기는 위해서는 향후 지속적인 연구가 필요할 것으로 생각된다. Objective: The aim of this study was to measure the concentrations of cytokines contained in the hydrosalpingeal fluid and to evaluate the effect on the mouse embryo development with the different cytokine concentration. Methods: The hydrosalpingeal fluids (HSF) were collected during the surgery for hydrosalpinx which was confirmed by hysterosalphingogram. The cytokines in HSF including interleukin (IL)-$1{\alpha}$, IL-$1{\beta}$, IL-2, IL-4, IL-6, IL-8, IL-10, TNF-$\alpha$, Interferon-$\gamma$ (IFN-$\gamma$), vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), monocyte chemotactic protein-1 (MCP-1) were measured by ELISA method. HSF were added up to culture media with 5%, 10%, and 30% concentrations. The blastulation rates were compared. Results: IL-$\alpha$, IL-$1{\beta}$, IL-2, IL-4, IL-6, IL-8, IL-10, TNF-$\alpha$, IFN-$\bamma$, VEGF, EGF, and MCP-1 were detected, but the concentrations were different from each sample. IL-6 and IL-10 were increased in HSF-1 group, and IFN-$\gamma$, MCP-1, VEGF were increased in HSF-2 compared with normal serum range. The Th1/Th2 ratio of HSF-2 (IFN-$\gamma$:IL10) was highly elevated to 61.64, compared with that of HSF-1 (3.69). The blastulation rate was significantly decreased in HSF-2 group (27.7%) compared those of the HSF-1 group (74%) and control group (76.7%). It showed the trend that the blastulation rate was decreased depending on the concentration HSF of culture media in HSF-2 group, but it was not statistically significant. Conclusion: The composition and concentration of cytokines in each HSF were different, and increased proinflammatory cytokines in HSF might be associated with poor embryonic development. Further study will be needed about the effect of each cytokines in HSF.

COVID-19 상황에서 일 개 대학의 실시간 화상 온라인 시험에 대한 성별, 연령, 시험응시지역에 따른 만족도 분석

여상희(Sanghee Yeo),김동자(Dong Ja Kim) 학습자중심교과교육학회 2021 학습자중심교과교육연구 Vol.21 No.23

목적 코로나-19 상황에서 대면시험이 불가하게 됨에 따라 실시간 온라인 평가를 실시하게 되었다. 이 연구의 목적은 대학원생을 대상으로 실시한 실시간 화상으로 진행한 온라인 학생평가에 대한 학생만족도를 분석하고자 한다. 방법 연구대상은 대구소재의 한 의과대학 대학원 61명이며, 온라인 시험을 실시한 과목은 총 3 과목이다. 온라인 시험에 대한 만족도 평가는 13문항으로 구성된 설문지를 개발하여 온라인으로 시행하였다. 시험진행은 학생들이 화상강의를 받았던 웹엑스로 하였다. 학생들은 웹엑스로 온라인 시험링크를 받아서, 미리 접속하고 있다가 동시에 시험을 시작하고 동시에 시험을 종료하였다. 시험응시 환경의 세팅은 학생 본인이 직접 시험을 응시하는 것이 확인되도록 본인의 모습이 촬영되도록 핸드폰이나 태블릿을 설치하도록 하였다. 부정행위에 대한 예방책으로 시험 진행과정은 녹화하였다. 결과 설문에 응답한 59명(96.7%)을 분석한 결과, 54명(91.5%)의 학생은 기술적 문제가 없이 온라인 시험이 원활히 진행되었다고 하였다. 30명(51.4%)의 학생은 온라인 시험이 익숙하지 않아 심적으로 부담된다고 응답하였으며, 25명(42.4%)의 학생은 온라인 시험방법에 익숙하지 않음으로 인해 성적에 영향을 줄까봐 우려한다고 하였다. 전반적인 평가에서는 대면시험보다 온라인 시험을 선호하였다. 온라인 시험 시에 우려되는 점으로는 네트워크 등의 기술적인 문제로 인해 시험진행 과정에서 차질이 있을까봐 우려된다는 의견이 가장 높았고(45명, 76.3%), 부정행위에 대한 우려(26명, 44.1%), 시험문제가 쉬워져 변별도가 낮아질 것을 우려하는 의견(5명, 8.5%)이 있었다. 결론 실시간 온라인 평가를 시행해 본 결과, 원거리에서 온라인으로 수강하는 학생이 많은 대학원 수업에서 온라인 평가를 시행하는 것은 인터넷 네트워크가 안정적으로 보장된다면 권장할 만하다. 다만 부정행위에 대한 우려를 경감시키기 위해 온라인 시험감독이 가능하도록 시험환경을 세팅할 필요가 있다. 향후 팬데믹 상황에서 온라인 교육의 지속성을 고려해 볼 때 온라인 시험에 대한 시도, 대비 및 노하우를 쌓아갈 필요가 있다고 판단한다. Objectives As COVID-19 put a halt to face-to-face tests, online assessment became compulsory. This study aims to analyze the evaluations of real-time online student assessment and student satisfaction for graduate students from different parts of the country who have taken online courses. Methods The participants of the study were 61 students from A Medical School, and a total of three courses were selected for the online tests. Students were given a survey with 13 questions developed by the author to evaluate their satisfaction levels on online tests. To conduct the online tests, students first logged onto WebEx, on which they received online lectures, to access the link to the test which was given over WebEx chat. Results it was found that 54(91.5%) students responded that they had no technical issues during the test. Thirty(51.4%) students responded that they felt psychologically pressured as they were not used to taking online tests, and 25(42.4%) students responded that they were concerned that online tests would affect their grades as they are not used to taking tests online. Among the concerns for online tests, the issue about which the students were most concerned was the possible technical issues such as network issues that may lead to a setback during the tests (45 students, 76.3%), followed by cheating (26 students, 44.1%), and failure to guarantee distinction among the student levels as questions on the test may be too easy (5 students, 8.5%). Conclusions It was concluded that online assessments would be worth considering for graduate school classes where a number of students take the course online from a distance, given that there is a stable Internet network. As there are concerns that students may cheat, it is necessary to set up the testing environment appropriately to supervise the tests online.

배란 유도 후 발생한 난관쌍태 임신

박준철 ( Joon Cheol Park ),김동자 ( Dong Ja Kim ),배진곤 ( Jin Gon Bae ),김종인 ( Jong In Kim ),이정호 ( Jeong Ho Rhee ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.10

Twin tubal ectopic pregnancy is rare. Especially the live twin tubal ectopic pregnancy is extremely rare, just 10 cases have been reported until now. There were 9 cases of live twin tubal pregnancy after spontaneous conception and one case after IVF cycle. This is the first report of live twin tubal ectopic pregnancy after ovulation induction with clomiphene citrate. A 31-year-old woman, nulligravida complained of primary infertility and irregular menstruation. After ovulation induction with clomiphen citrate, β-hCG was 1566 mIU/mL on missed period of 5 weeks 4 days. On 6+1 weeks, β-hCG was elevated to 3446 mIU/mL and transvaginal ultrasound revealed two separated gestational sacs, each containing yolk sac in the left tube. The variable dose of methotrexate therapy was tried using 1 mg/kg of methotrexate and 0.1 mg/kg of leukovorin. These were injected alternatively for 8 days. On 7(+3) weeks, β-hCG was elevated to 8,029 mIU/mL and transvaginal ultrasound revealed two fetal poles with heart beat in each gestational sacs. Laparoscopic salpingectomy was performed. The diagnosis was confirmed by the operative finding and also in the pathologic report. It is needed that careful ultrasonographic examination especially in the case of ovulation induction or IVF-ET. Methotrexate treatment in twin tubal pregnancy was usually failed. There was only one successful report by the direct injection of methotrexate to the fallopian tube combined with single intramuscular injection. Further research for dosage or route of administration will be needed.

초음파로 산전 진단된 가슴붙은 쌍둥이

정선욱 ( Sun Wook Jung ),김동자 ( Dong Ja Kim ),박준철 ( Joon Cheol Park ),이정호 ( Jeong Ho Rhee ),김종인 ( Jong In Kim ) 대한주산의학회 2004 Perinatology Vol.15 No.4

The estimated incidence of conjoined twins is one in 50,000 births, however, over 60% are stillborn, making the observed incidence around one per 200,000 live-births. Thoracopagus is the most common variety of conjoined twins accompanying with congenital heart disease 75%, fusion of alimentary tracts 50%, single external biliary tract 25%. Approximately 90% of thoracopagus conjoined twins are not candidates for surgical separation due to the high degree of cardiac union and the complexity of cardiovascular anomalies. With improvement in prenatal diagnosis and routine ultrasound monitoring of pregnancies, these cases are more commonly being diagnosed prenatally. Accurate diagnosis of the shared anatomy and associated malformations is crucial for counseling of the affected families regarding outcome as well as planning potential postnatal surgical separation. We experienced a case of thoracopagus with single conjoined heart that was diagnosed by ultrasonography at 15 weeks of gestation in 33 years old woman. So we present this case with a brief review of literatures.

임신과 병발한 Hirschsprung`s disease 산모의 정상분만

장보승 ( Bo Seung Chang ),김승찬 ( Seung Chan Kim ),윤영은 ( Young Eun Youn ),박미선 ( Mi Sun Park ),박옥랑 ( Ok Rang Park ),김동자 ( Dong Ja Kim ) 대한산부인과학회 2005 Obstetrics & Gynecology Science Vol.48 No.10

신경내분비적 분화가 포함된 자궁의 악성혼합 뮬러리안 종양

송준백 ( Jun Baek Song ),김준홍 ( Jun Hong Kim ),박옥랑 ( Ok Rang Park ),김주경 ( Ju Kyeong Kim ),김태상 ( Tae Sang Kim ),김동자 ( Dong Ja Kim ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.1

Malignant mixed mullerian tumor (MMMT) of the uterus are uncommon tumor and highly malignant containing epithelial and stromal components which is classified as homologous or heterologous based on the nature of sarcomatous component. It is highly malignan