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        • KCI등재

          면역세포화학 염색법과 전자 현미경검사를 통한 뇌하수체 선종의 특징

          김태승,박찬일,최인준,허갑범,이현철,임승길,김현만,이은직,안광진,정윤석,양우익,이규창,윤도흠,정상섭,박용구,김경래 대한내과학회 1992 대한내과학회지 Vol.43 No.2

          Background: The development of immunocytochemistry and the application of electron microscopy improved the knowledge of the pathology and classification of the pitutiary adenomas. We investigated the characteristics of the pituitary adenomas examined by the immunocytochemistry and electron microscopy. Methods: 44 patients with the pituitary adenomas were investigated, using immunocytochemical techniques in paraffin-embedded tissue, and electron microscopy in fresh tissue. Results: The mean age was 38±13 years, and the ratio of male to female was 1: 2.4 and 18 were prolactinomas, 8 acromegalies, 3 acromegalies with hyperprolactinemia, 3 Cushing`s diaseases, 3 FSH secreting adenomas, 1 TSH secreting adenomas, and 6 nonfunctioning adenomas among 44 patients. The agreement between serum prolactin and prolactin immunocytochemistry was 77.3% if the serum prolaetin level to predict lactotrope adenoma was above 50ng/ml; however, the agreement was 93,2% if the serum prolatin level above 100ng/ml. The serum levels of prolactin and growth hormone in sparsely granulated lactotrope and somatotrope adenomas were 1149.6, 109.5ng/ml, respectively, which were higher than those (129.6, 35.9ng/ml) of densely granulated ones. Immunocytochemical and electron microscopic analysis revealed that thirteen were lactotrope adenomas (12 sparsely granulated, and 1 densely granulated), 9 somatotrope adenomas (6 sparsely granulated and 3 densely granulated), 6 gonadotrope, 4 corticotrope (3 symtomatic and 1 silent), 1 mixed somatotrope and lactotrope, 1 mammosomatotrope, 1 thyrotrope, and 9 null cell (6 nononcocytic, and 3 oncocytic) adenomas. Conclusion: The immunocytochemistry, permitting the visualization of intracellular hormones in the tissue of the pituitary adenoma, made exact histologic diagnosis. So, we have known whether the cause of hyperprolactinemia was lactotrope adenoma or functional hyperprolactinemia due to PIF inhibition. And it was also possible to diagnose silent corticotrope adenoma and gonadotrope adenoma which had no apparent clinical manifestation. Electron microscopic examination of the pituitary adenoma diagnosed by immunocytchemistry showed ultrastructrural characteristics of the adenoma cells containing each hormones, Accordingly, we could subclassify the pituitary adenoma. However, the identification of the adenomas with somewhat similar ultrastrutural features such as null cell, gonadotrope, and thyrotrope adenoma, may be facilitated by immunocytochemistry. Accordingly, both immunocytochemistry and electron microscopy are necessary for the identification and characterization of the pituitary adenomas.

        • KCI등재

          전신성 홍반성 낭창 환자 혈청내 항뇌신경세포 항체에 관한 연구

          김태승,홍천수,조상래,박중원,남동호 대한내과학회 1992 대한내과학회지 Vol.43 No.4

          Background: Neuropsychiatric disorders caused by lupus activity occur during the course of the illness in about 50% of patients with systemic lupus erythematosus (SLE). And neuropsychiatric disorder is a poor prognostic sign and frequent cause of death in lupus patients. Recently some evidences suggest that autoantibodies directed against neuronal cell may have pathogenic significance in neuropsychiatric lupus. The present study was undertaken to characterize further nature of antineuronal antibody in SLE sera and to prove the association between antineuronal antibody and neurapsychiatric disorders in lupus. Methods: Sera from 61 patients with SLE (female 58, male 3) and 20 health control were examined for IgG antineuronal antibody by indirect immunofluorescence method using the frozen section of human brain (cortical portion of parietal lobe), Absortion experiments with 10 sera of high antineuronal antibody titer (≥1:10) by cardiolipin, asialoGM1, CNS neurofilament, myelin basic protein, ceramide and galactocerebroside were done to evaluate cross-reaction between purifed protein and lipid antigens and fluorescent IgG antineuronal antibody. Results: Fluorescent lgG antineuronal antibody was detected in 64% (39/61) of SLE patients and 5% (1/20) in health control, 3 types of fluorescent patterns of neuronal staining were observed. Those were homogenous pattern (21 cases), ring pattern (3 cases) and mixed pattern (18 cases). SLE patients with neuropsychiatric disorders had high titer (≥l:10) of fluorescent IgG antineuronal antibody more frequently than those without neuropsychiatric disorders (14/29, 48% vs 4/32, 12.5%; p$lt;0.05). Lymphocyte counts of the peripheral blood in SLE patients with neuropsychiatric disorders were significantly lower than those of SLE patients without neuropsychiatric disorder (788/㎣ vs 1453/㎣; p$lt;0.05). Absorption experiments showed the significant changes in immunofluorescent patterns or immunofluorescent grades by asialo GM1, CNS-neurofilament and cardiolipin. Conclusion: IgG antineuronal antibody was high titer in neuropsychiatric lupus and absorption experiment suggested the cross-reactivity of antineuronal antibody with cardiolipin, asialo GM1, CNS-neurofilament.

        • 소아에서 다발성으로 나타난 저등급 골육종 - 1예 보고 -

          김태승,박용욱,Kim, Tai-Seung,Park, Yong-Wook 대한근골격종양학회 2009 대한골관절종양학회지 Vol.15 No.2

          저등급 골육종은 전형적 골육종에 비해 발생 빈도가 훨씬 드물고, 호발 연령도 전형적 골육종에 비해 높은 것으로 나타나 있다. 본 교실에서는 12세 여아에서 좌측 경골, 대퇴골 경부 및 간부, 그리고 좌측 비구에 발생한 다발성 저급성 골육종 1예를 경험하였다. 본 증례는 예외적으로 소아에 발생하였고, 그리고 다발성 소견을 나타내어 동시성(synchronous) 혹은 이시성(metachronous) 전이의 양상을 띠고 있었다. 더욱이 저급성 골육종은 일반적으로 느린 성장 과정을 보이기 때문에, 본 증례에서 보이는 전이의 양상에 대해서는 희귀하여 문헌고찰과 함께 보고하는 바이다. Low grade central osteosarcoma is an rare variant of conventional osteosarcoma and generally occurs in older age than conventional. We experienced a case of low grade osteosarcoma occurred in a 12 years old female. Moreover, it occurred multifocally in left tibia, left femoral neck and midshaft, and left acetabulum. We could not sure whether it was from synchronous or metachronous metastasis. Usually the low grade osteosarcoma progresses very slowly. But, despite this case was low grade osteosarcoma with very indolent progression, furthermore, it showed synchronous or metachronous metastasis. So we report this unusual case with review of literature.

        • 우측 둔부를 침범한 위장관 간질 종양 - 1예 보고 -

          김태승,황건성,김기천,박문향,Kim, Tai-Seung,Whang, Kuhn-Sung,Kim, Ki-Chun,Park, Moon-Hyang 대한근골격종양학회 2007 대한골관절종양학회지 Vol.13 No.2

          위장관이외의 장소에서 위장관 간질 종양(Gastrointestinal stromal tumor, GIST)이 발생하는 경우는 매우 드물기 때문에 일차적 병소가 아닌 전이 병소로 진단되는 경향이 있다. 이에 본 저자들은 25세 남자에서 좌측 둔부 중둔근, 소둔근에서 발생한 위장관 간질 종양이 복부의 일차 병소없이 인접한 장골 및 천골을 침범한 1례를 경험하였다. 이에 위장관외 간질종양(Extragastrointestinal stromal tumor, EGIST)이라는 진단명과 함께 보고하고자 한다. Gastrointestinal stromal tumor (GIST) occurring outside the gastrointestinal tract is uncommon. When GIST is found outside the gastrointestinal tract, it has greater possibility to be diagnosed with metastatic lesion from other primary focus. But it rarely occurs in extragastrointestinal tract primarily, and then even outside abdomen. We experienced one case of GIST occurred from right buttock area of 25 year-old man. We could not find out the primary focus in abdomen. The tumor was developed inside gluteus medius and minimus and extended to pelvic inner area destroying iliac bone and adjacent sacrum. Here, we report the case of GIST with terminology of extragastrointestinal stromal tumor (EGIST).

        • KCI등재
        • 역분화 방골성 골육종 - 증례 보고 1 례 -

          김태승,송상준,최일용,Kim, Tae-Seung,Song, Sang-Jun,Choi, Il-Yong 대한근골격종양학회 1998 대한골관절종양학회지 Vol.4 No.1

          Parosteal osteosarcoma is characterized as a densely ossifying lesion, usually occurring on the surface near the metaphyses of a long bone. The histological pattern is a well- differentiated mature bone trabeculae with a hypocellular spindle-cell stroma. The cytological details are those of a low-grade malignant lesion. The natural history of this lesion is indolent local growth, late invasion of the underlying bone, and infrequently, distant metastasis. However, there is a significant risk of eventual dedifferentiation into a high-grade lesion. We report here-a case of parosteal osteosarcoma dedifferentiated into a high-grade lesion, which occurred in the left distal femur of a 40-years-old woman, and discuss the experience in detail.

        • KCI등재

          Charcot-Marie-Tooth 병에서 시행한 양측성 범거골관절 고정술 - 1예 보고 -

          김태승,강석근,Kim, Tai-Seung,Kang, Suk-Keun 대한족부족관절학회 2001 대한족부족관절학회지 Vol.5 No.2

          Cavovarus deformities of both feet in 28 years old female patient with Charcot-Marie-Tooth disease were treated by one-staged pantalar arthrodesis. Excellent results were achieved at 6 years after surgery. She could walk without brace or stick and she was satisfied with the result of one-staged pantalar arthrodesis. One-stage pantalar arthrodesis is an effective method of treatment for cavovarus deformity of foot in Charcot-Marie-Tooth disease.

        • 사지 및 체간에 발생한 양성 연부조직 종양의 발생 분포

          김태승,서경원,김태진,Kim, Tai-Seung,Seo, Kyoung-Won,Kim, Tae-Jin 대한근골격종양학회 1999 대한골관절종양학회지 Vol.5 No.1

          1984년 2월부터 1997년 11월까지 한양대학교 의과대학교 정형외과학교실에서 경험한 양성 연부조직 종양 중 병리조직학적으로 확진된 총 230례에 대하여 임상적으로 분석하여 다음과 같은 결과를 얻었다. 1. 양성 연부조직 종양중 결절종(26.5%)이 가장 많았고, 혈관종(19.6%), 지방종(17.0%), 슬와낭종(13.0%), 신경초종(7.0%)의 순으로 발생하였다. 그리고, 임파관종(3.9%), 섬유종증(3.0%), 사구종(3.0%), 신경 섬유종(2.2%), 평활근종(0.9%), 색소 융모결절성 활막염(0.9%), 점액종(0.9%), 외상성 신경종(0.9%), 황색종(0.4%), 활액막성 연골종증(0.4%), 골화성 근염(0.4%)이 발생하였다. 2. 종양의 분포 연령은 비교적 전 연령층에 걸쳐 고르게 발생하였다. 이 중 혈관종과 임파관종은 20세 이전에 호발하는 경향을 보였다. 3. 성별 분포는 남자 98례, 여자 132례로 여자에게 약 1.3배 많았으나, 슬와낭종과 신경초종은 남자에게 호발하였다. 4. 15세 이하의 소아에서는 혈관종, 결절종, 임파관종, 지방종의 순으로 발생하였고, 16세 이상의 성인에서는 결절종, 지방종, 슬와낭종, 혈관종의 순으로 발생하였다. 5. 발생 부위는 하지(60.0%)에 호발하였고, 상지(35.2%), 체간(4.8%)의 순으로 발생하였다. 6. 크기가 1cm 미만인 종양은 결절종, 사구종, 혈관종, 임파관종의 순으로 발생하였고, 1-5cm인 종양은 결절종, 혈관종, 슬와낭종, 지방종, 신경초종의 순으로 발생하였다. 5cm 이상인 종양은 지방종, 혈관종, 임파관종, 결절종의 순으로 발생하였다. 7. 모든 환자는 절제술로 치료받았고, 국소 재발은 22례(9.6%)에서 나타났으며 혈관종이 12례로 가장 많았다. 재발율은 외상성 신경종, 색소 융모결절성 활막염, 신경 섬유종, 섬유종증, 혈관종의 순으로 나타났다. The authors reviewed and analyzed the pathologically confirmed 230 cases of benign soft tissue tumors which had been treated at Department of Orthopaedic Surgery in Seoul Hospital, Hanyang University College of Medicine from February 1984 to November 1997. The following results were obtained. 1. The most common benign soft tissue tumors was ganglion(26.5%) followed by hemangioma(19.6%), lipoma(17.0%), Baker's cyst(13.0%) and neurilemmoma(7.0%) in decreasing order of incidence. 2. Benign soft tissue tumors were found evenly distributed over all age group. Hemangioma and lymphangioma were usually found to occur before 20 years old. 3. Female was affected about 1.3 times more common. But, Baker's cyst and neurilemmoma occurred most frequently in male. 4. In children, the most common benign soft tissue tumors was hemangioma followed by ganglion, lymphangioma, and lipoma. In adult, ganglion, lipoma, Baker's cyst, hemangioma were common. 5. The lower extremity was the predominant site of occurrence(60.0%). 6. Benign soft tissue tumors were taken by excision. Local recurrences were developed in 22(9.6%) out of 230 cases, especially in hemangioma.

        • 섬유성 골 이형성증의 치료

          김태승,양문승,조재림,Kim, Tai-Seuug,Yang, Mun-Seung,Cho, Jae-Lim 대한근골격종양학회 1996 대한골관절종양학회지 Vol.2 No.1

          The results of treatment of eighteen lesions of fibrous dysplasia which of them seventeen lesions were treated with surgery were reviewed at the Department of Orthopedic Surgery, College of Medicine, Hanyang University Hospital. We studied to evaluate the functional clinical results and the recurrence according to the type of disease, grafted bone, methods of treatment and location of lesion. We treated sixteen patients(five males and eleven females) and their mean age was 22.6 years. There was no association with skin pigmentation or dysfunction of endocrine system. Twelve patients had a monostotic pattern and four patients had a polyostotic pattern. Twelve lesions were treated with curettage and bone grafting and four lesions in the proximal femur were treated by internal fixation with curettage and bone grafting. One lesion was treated by en-bloc resection. There were eleven satisfactory results in twelve monostotic lesions and there were four satisfactory results in five polyostotic lesions, but the recurrence were four cases, respectively. The two unsatisfactory results were seen in two patients treated by autografting, but there were three recurrence of four lesions in autografting only, one of five in autografting and allografting, four of eight in allgrafting or xenografting. Four of six lesions in upper extremity were recurred after curettage and bone grafting and five of them showed satisfactory results. In pelvic and lower extremity lesions, the recurrence were occurred in two lesions after curettage and bone grafting and in two lesions after internal fixation and bone grafting. The recurrence does not always provide an unsatisfactory functional results and the recurrence showed higher rate in radiologic pattern of ground glass appearance with-out marginal sclerotic rim, but the recurrence according to grafted bone showed similar rates. Curettage and bone grafting is adequate for a symptomatic lesion and firm internal fixation is needed for a lesion in proximal femur. In use of grafted bone, xenograft or allograft may be preferable to autograft because of the disadvantage of autografting like a increased blood loss, prolonged operation times, etc.

        • 말초 신경에 발생한 신경 내 결절종: 2예 보고

          김태승,조영훈,백승삼,김성재,Kim, Tai-Seung,Jo, Young-Hoon,Paik, Seung-Sam,Kim, Sung-Jae 대한근골격종양학회 2013 대한골관절종양학회지 Vol.19 No.2

          말초 신경에 발생하는 결절종은 일부 보고된 바는 있으나, 발생 빈도는 드문 것으로 되어있으며 발생 부위는 비골 신경이 가장 흔한 것으로 보고되고 있다. 이외에도 요골 신경, 척골 신경, 정중 신경, 좌골 신경, 경골 신경 및 후 골간신경에 발생한 경우도 보고되고 있다. 저자들은 내측 족저 신경에 발생한 신경 내 결절종 1예와 총 비골 신경에 발생한 신경 내 결절종 1예를 신경학적 후유증 없이 치료하여 이를 보고하고자 한다. Ganglion cysts that occurred within sheaths of peripheral nerves have been documented in literatures, but it is relatively rare condition. The peroneal nerve is the most common site of involvement. Other reported sites of involvement are the radial, ulnar, median, sciatic, tibial and posterior interosseous nerves. We report a case of the intraneual ganglion cyst within peroneal nerve and another case of the intraneural ganglion cyst within a medial plantar nerve that were successfully excised without neurologic complication.

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