증례 : 예기치 못한 담낭암의 복강경 담낭절제술 후 발생한 투관침 삽입부 전이 1예

김경욱 ( Kyung Wook Kim ),김철홍 ( Cheul Hong Kim ),박재홍 ( Jae Hong Park ),이민재 ( Min Jae Lee ),양윤식 ( Yoon Shig Yang ),윤중근 ( Jung Kun Yoon ) 대한내과학회 2004 대한내과학회지 Vol.67 No.-

세침 폐생검 세포검사의 진단적 의의

김영철(Young Chol Kim),박용주(Yong Ju Park),김두섭(Doo Sub Kim),홍득민(Duk Min Hong),양윤식(Yoon Shig Yang),심원보(Won Bo Shim),윤중근(Jung Geun Yoon),김종인(Jong In Kim),이성주(Seong Joo Lee),이태원(Tae Won Lee) 대한내과학회 1991 대한내과학회지 Vol.41 No.6

N/A Seventy-five patients with either pulmonary nodules or masses that could not be confirmed with sputum examination or bronchoscopic examination underwent transthoracic fineneedle aspiration with 22 or 23 gauze needles under fluoroscopy for cytologic diagnosis. There were 51 men and 24 women, and the age range was 43-78 years old. The lesion distribution and sizes were as follow: 48 cases in the right lung, 2l cases in the left lung, 23 cases under 4 cm in size, and 52 cases over 4 cm in size. There were no meaningful correlations in lesion size or site with malignant or benign cytologic findings. Among the 46 malignant cases squamous cell carcinoma was 32 cases, large cell carcinoma 5 cases, small cell carcinoma 4cases, lymphoma 3 cases, and bronchioalveolar carcinoma 2 cases. Among the other cases, pulmonary tuberculosis was. 11 cases and lung abcess 3 cases. Among the 49 cases proven malignant after operation or follow-up by now, 46 cases were malignant at fine- needle aspiration biopsy cytology (sensitivity 93.9%), and among the 23 cases proven benign after follow up, all showed no malignancy by fine-needle aspiration biopsy cytology (specificity 100%). Three cases failed in the follow-up due to various causes. In the benign cases, there were some who had difficulty in being diagnosed with this procedure alone, but we were helped a great deal in differentiating malignancies by this procedure. Complications were minimal, but 5 cases of pneumoth-orax occurred, and 2 cases among these needed closed thoracotomy and soon improved. In conclusion, transthoracic fine-needle aspiration biopsy cytology is very helpful in diagnosing patients with lung nodules or masses that failed to be confirmed with sputum examination or bronchoscopic procedure and in differentiating a malignant state from a benign one, with minimal complications. So, active clinical trial of this procedure is recommended.

간 및 척추 전이로 나타난 원발 부위 불명의 소세포암 1예

윤기현,박찬호,한상훤,김철홍,김경욱,박재홍,이민재,양윤식,손창학 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.2

Metastatic carcinoma of unknown origin takes up approximately 2-12% of the oncology-patients evaluated, and the patients have poor response to treatment but we can expect that some proportion of theirs have good response to chemotherapy and improvement of symptoms and prolongation of survival, 96% of small cell carcinoma originates from lung and 4% originates from extrapulmonary sites(salivary glands, pharynx, larynx, G-I tract, uterine cervix etc.). We experienced a case of small cell carcinoma of unknown origin with multiple hepatic and L-spine metastases. The patient was a 68-year-old woman who had complained of lower back pain and gait disturbance for 3 months. US-guided biopsy of hepatic mass showed small cell carcinoma. She received combination chemotherapy (cisplatin and etoposide) as for small cell lung cancer and achieved partial response and improvement of symptoms.

뇌, 척추, 전립선 병변을 동반한 속립성 결핵 1예

김철홍,김경욱,박재홍,이민재,양윤식,김주인,설상영 白中央醫療院 2004 仁濟醫學 Vol.25 No.1

국내에서 폐외결핵의 유병율은 잘 알려져있지 않지만, 아직도 뇌 결핵종, 결핵성 척추염 등의 보고는 드물지 않다. 저자들은 두통을 주소로 내원한 63세의 환자가 속립성 폐결핵, 뇌 결핵종, 결핵성 척추염, 전립선 결핵을 동시에 보여, 전립선 낭종의 흡입생검상 항산균도말검사 및 배양검사상 양성으로 결핵성으로 진단하고 치료하였기에 문헌고찰과 함께 보고하는 바이다. The prevalence of the extrapulmonary tuberculosis in Korea is not well-recognized, but the number of reports about brain tuberculoma and tuberoculous spondylitis is not small. The authors experienced a case of a 63-years-old man who had visited for a headache and was diagnosed as having miliary tuberculosis with brain tuberculoma, tuberculous spondylitis and prostatic tuberculosis at the same time. Tuberculous infection was confirmed by positive AFB stain & culture of aspirates of prostatic cystic fluid. We report this case with a brief review of the references.

항 벽세포 항체 및 항 내인자 항체 양성을 보인 악성 빈형 1예

이지혁,이은아,배윤상,김병준,정찬형,문원주,양윤식,손창학 인제대학교 1998 仁濟醫學 Vol.19 No.2

저자는 위 수술의 병력이 없으며 오심 및 구토, 소화불량의 증상으로 입원한 환자에서 A형 만성 위축성 위염과 함께 항 벽세포 항체(anti-parietal cell antibody) 및 항 내인자 항체(anti-intrinsic factor antibody) 양성을 보인 악성빈혈 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. We present a case of pernicious anemia without history of gastric operation in 77 year old male. The patient suffered from nausea, vomiting, and dyspepsia. He had dysesthesia and hypoesthesia on the distal area of both arm and foot by neurologic examination. Laboratory findings were as follows: serum cobalamin 10pg/ml(normal range: 200∼1000 pg/ml), serum folate 4.64ng/ml(normal range : 3 ∼15ng/ml), anti-intrinsic factor antibody (strong positive), antiparietal cell antibody(positive), first stage of Schilling test(1.4%). The findings of peripheral blood and bone marrow were compatible with megaloblastic anemia. He was treated with intramuscular injection of hydroxocobalamin, and clinical course appeared improving process. We report this case(pernicious anemia with positive antiparietal cell antibody and anti-in-trinsic factor antibody) with a brief review of the literature.

Mitomycin-C에 의한 용혈성 요독 증후군(Hemolytic Uremic Syndrome) 1예

한상훤,김경욱,김철홍,박재홍,이민재,김구,양윤식,손창학 인제대학교 백병원 2003 仁濟醫學 Vol.24 No.1

Hemolytic Uremic Syndrome(HUS) is a clinical syndrome characterized by the presence of microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure. This syndrome spontaneously arise in a few patients with advanced cancer, but it is more commonly related to the use of certain chemotherapeutic agents. Mitomycin-C is the most common causative agent. Hemolytic uremic syndrome may be induced 4 to 8 weeks after administration of mitomycin-C, and it usually develop in clinical remission state of cancer. We report a patient who developed HUS after adjuvant chemotherapy containing mitomycin-C for gastric cancer.

폐결핵이 동반된 아급성 괴사성 임파선염 1 예

홍정표,최선희,김형권,강남욱,강창원,이은아,양윤식,오성욱,박무정,조만종,정연재 대한내과학회 1996 대한내과학회지 Vol.50 No.1

Subacute necrotizing lymphadenitis(SNL) is first described in 1972 by Kikuchi and Fujimoto independently, which has benign clinical course with characteristic histologic features. The etiology is unknown but clinical and histological features suggest an infectious agent, which has not been identified. The resemblance of lymph node lesions to those of systemic lupus erythematosus has suggested an autoimmune process. We report a case of a 24-year-old woman who presented with cervical lymphadenopathy, fever, cough and pulmonary lesion in chest x-ray. The histopathological features of the lymph nodes showed typical findings consistent with SNL and the chest lesion was diagnosed as pulmonary tuberculosis by positive sputum AFB smear.

좌심방 원발성 골육종 1 예

이용훈,최선희,심원보,강창원,박무정,정수상,양윤식,조만종,정연재 대한내과학회 1996 대한내과학회지 Vol.51 No.1

Primary tumors of the heart are rare, their morbidity is 0.0017-0.25% at autopsy. About seventy five percent of primary cardiac neoplasms are benign. Atrial myxomas are the most commonly encountered benign cardiac neoplasms. The other benign tumors are fibroma, lipomatous tumor, valvular fibroelastic papilloma, and rhabdomyoma, Malignant neoplasms are about twenty-five percent of primary cardiac neoplasms, and the majority are angiosarcoma and rhabdomyosarcoma. Most cardiac osteosarcomas are clinically mistaken for myxoma because of location in the left atrium. They are extremely rare, larger, tend to infiltrate, and very aggressive neoplasms. Histologically a variety of patterns may be encountered in addition to the osteosarcoma and immunohistochemically cardiac osteosarcomas show similar features as noncardiac osteosarcomas. The overall prognosis of patients with these tumors is dismal. But the role of surgical palliation of these lesions remains valid. Therefore, we believe that early diagnosis of cardiac sarcomas using echocardiography, as well as complete surgical excision, may improve survival. Since we have experienced one case of primary osteosaroma of the left atrium, we report this with related references.

위암을 동반한 악성 흑색극세포증 1 예

김민호,심재광,하연주,전성곤,권태경,김희승,이정회,양윤식 대한내과학회 2000 대한내과학회지 Vol.59 No.4

The new onset of acanthosis nigricans in an adult-especially when the lesions appear on mucosal membranes such as the lips, periocular areas, and anus-may be indicative of an underlying tumor. Adenocarcinoma of the gastrointestinal tract is the most common malignancy-most often cancer of the stomach. A 72 years old female had disseminated, symmetrically distributed, brownish black pigmentation and papillary hypertrophy on the intertriginous and flexural areas for 12 months, and gastric adenocarcinoma was confirmed during the evaluation of internal malignancy. The cutaneous finding of acanthosis nigricans was a significant cutaneous marker of internal malignancy in this case.(Korean J Med 59:438-441, 2000)

간 전이된 악성 부신경절종:1 예 보고

김민호,최동진,심재광,고영재,하연주,전성곤,양윤식 대한내과학회 2001 대한내과학회지 Vol.61 No.2

We report a case of malignant paraganglioma with hepatic metastases. A 70-year old woman developed huge hepatic tumor 2years after complete resection of the retroperitoneal paraganglioma. CT imaging of abdomen revealed huge hepatic masses, which had not been found previously. A needle biopsy on the liver was performed, resulting in a diagnosis of malignant paraganglioma. These tumors are usually benign but can occasionally produce local and distant metastases. Development of metastatic localizations is the only formal proof of malignancy as histology cannot distinguish between benign and malignant paragangliomas. Surgery is the basis of treament and should be performed early in the operable course. Both chemotherapy and radiotherapy could be given, but satisfactory outcomes were not obtained. We suggest that close investigations for metastasis in patient with paraganglioma, seemed benign initially, as well as periodic follow up examinations should be emphasized.(Korean J Med 61:201-205, 2001)