유방암 환자에서 종양조직내 Collagenase 활성도와 골스캔과의 비교

김창근(Chang Guhn Kim),최시성(See Sung Choi),김현정(Hyun Jeong Kim),김선구(Seon Gu Kim),임형근(Hyung Guhn Lim),노병석(Byung Suk Roh) 대한핵의학회 1996 핵의학 분자영상 Vol.30 No.3

N/A Purpose: It has been known that the activity of extracellular matrix degradative enzymes such as collagenase correlate well with the metastaic potential of various tumor cells in experimental study. This study was aimed at comparing the activities of type IV collagenase with bone scan findings in patients with breast cancer. Materials and Methods: We retrospectively correlated bone scan findings with the results of immunohistochemical staining for 92kDa, 72kDa type IV collagenase in 28, and 30 patients with metastatic breast cancer, respectively, as well as 23, and 27 patients with primary breast cancer, respectively. The immunohistochemical staining was performed with tissue specimens obtained from primary or metastatic breast tumor lesions. The amounts of the enzyme were graded from 0 to 4 and scored by multiplication metastasis was also scored from 1 to 5 with increasing probability. Results: There was a significant difference in enzyme scores between patients with and without metastasis. In patients with primary breast cancer group, the frequency of patients with enzyme score of less than 170 were 96%(26/27) and 100%(26/26) with 92kDa and 72kDa collagenase, respectively. In contrast, in patients with metastatic breast cancer group, the frequency of patients with enzyme score of more than 200 were 93%(28/30) and 87%(26/30) with 92kDa and 72kDa collagenase, respectively. All patients with each enzyme score of less than 170 show no active bony metastasis, however, there were variable bone scan findings in patients with each enzyme score of more than 200. Conclusion: Bone scan is useful to confirm, localize or follow up of bony metastasis in patients with each enzyme scores of more than 200. Acitve metastatic lesions were hardly seen on the bone scintigraphy in patients with collagenase scores of less than 170.

신경세포 이주장애 환아의 임상소견과 뇌자기공명 영상 소견과의 상관관계

오광수(Kwang-Soo Oh),최시성(See-Sung Choi) 대한소아신경학회 1998 대한소아신경학회지 Vol.5 No.2

목적 : 신경세포 이주장애는 태생 2-5개월에 뇌실주의 신경세포가 피질쪽으로 이주하여 신경세포층을 형성하는 과정의 이상으로 생기는 선천성발달이상으로 결함의 형태학적 특징에 따라 피질이형성증, 편평뇌증, 분열뇌증, 이소성회백질, 거대뇌증 등으로 분류한다. 최근 MRI의 도입으로 이의 진단이 보다 용이하고 난치성 간질의 한 원인으로 많은 연구가 되고 있다. 본 연구자들은 신경세포 이주장애로 진단된 환아의 임상적 소견을 분석하고 MRI 소견과의 상관관계를 알아보고자 본 연구를 시행하였다. 대상 및 방법 : 1992년 2월부터 1997년 7월까지만 5년 5개월 동안 원광대학병원 소아과에 내원하여 뇌자기공명 영상 촬영을 시행한 환아중에서 신경세포 이주장애로 진단되었던 환아 20례를 대상으로 성별 연령별 분포, 임상소견, 뇌파소견, MRI상 병변의 분류 및 병소의 분포를 분석하고, 병소의 분포에 따른 임상증상의 특징과의 상관관계를 연구하였다. 결과 : 1) 총 20례 중 활택뇌증 9례(45%)이 가장 많았고, 피질 이형성증이 7례(35%), 분열뇌증과 이소성회백질이 각각 2례(10%)이었다. 2) 뇌자기공명 영상 소견상 병소의 위치는 양측이 12례(60%)로 일측의 8례(40%)보다 많았으며, 활택뇌증 9례 모두 양측성이었고 피질 이형성증 7례 중 6례에서 일측성이었으며, 분열뇌증과 이소성회백질은 각각 1례씩 일측성과 양측성 이상 소견을 보였다. 3) 동반된 이상소견은 20례 중 18례에서 출현하였으며 투명중격의 무발생이 4례(20%)로 가장 많았고, 신경세포 이주장애의 분류상 2가지 병변이 공존한 경우가 3례에서 있었다. 4) 임상증상은 경련이 17례(85%)로 가장 많았고, 발육장애 10례(50%), 언어지연 5례(25%), 운동장애 3례(15%), 그리고 주의력결핍 및 과잉행동증후군이 1례 있었다. 5) 신경세포 이주장애 환아의 경련의 형태는 정신경련이 12례(60%), 국소 경련이 5례(25%), 혼합된 경련이 2례(10%)에서 나타났다. 6) 뇌파소견은 16례에서 시행하여 이상소견은 11례(68.7)었으며, 초점성 극파 또는 예파가 3례(18.8%), 전반적인 극파 또는 예파가 1례(6,2%)에서 관찰되었고, 초점성 서파는 1례(6.2%), 전반적인 서파 3례(31.5%), 전반적인 극파 및 서파의 혼합이 2례(12.5%)에서 관찰되었다. 7) 침범된 병소의 범위와 임상증상간의 관계는 양측성의 병변이 있는 환아에서 발육장애가, 일측성의 병변이 있는 환아에서 발육장애가, 일측성의 병소를 가지고 있는 환아에서 운동장애의 빈도가 통계적으로 유의하게 높았다.(p=0.0007, p=0.04) 결론 : 신경세포 이주장애 환아의 주된 증상은 경련이 가장 많았고, 발육장애, 언어지연 및 운동장애의 순이었다. 뇌자기공명 영상 소견상 침범된 병변범위가 양측성인 경우에 발육장애와 일측성인 경우에 운동장애의 출현빈도가 통계적으로 유의하게 높았다. Beginning in the eighth week of fetal life the neuroblasts migrate from the midline to the periphery to form the gray matter of the cerebral cortex. Abnormalities of cell migration are characterized by ectopic location of neurons in the cerebral cortex. This broad group of anomalies include lissencephaly, schizencephaly, cortical dysplasia, gray matter heterotopia, and unilateral hemimegalencephaly. The purpose of this study was to correlate clinical data with anatomic data, which was evaluated by brain magnetic resonance imaging characteristics that are most useful in predicting clinical course. Methods : The clinical records, EEG, and MRI findings of 20 patients with neuronal migration disorders were retrospectively reviewed. Results : The 20 patients with neuronal migration disorders consisted of 11 with lissencephaly, 7 with cortical dysplasia, 2 with heterotopia, and 2 with schizencephaly. Clinically, seizure was the most common symptom in 85%, next developmental delay in 50%, and then delayed speech in 25%, motor deficit 15% in order. The main associated brain anomalies included absence of septum pellucidum in 20%, periventricular leukomalacia in 15%, and corpus callosal agenesis in 15% of patients. Bilateral involvement of lesion in MRI was 60%, comparing to unilateral lesion in 40% of the patients. The most common involed lobes was frontoparietal region. An abnormality of EEG examination was showed in 11 cases of patients(68.7%). Patients with diffuse, bilateral lesion in MRI findings of neuronal migration disorders had significantly developmental delay than those with unilateral lesion(p=0.0007). Patients with unilateral lesion had significantly motor deficit than those with bilateral lesion(p=0.04), Conclusion : Seizures were the most common symptoms among neurological manifestations of neuronal migration disorders. Statistically significant correlations of delayed development with bilateral lesion and motor deficit with unilateral lesion were found.

초음파상 비전형적 소견을 보이는 간혈관종의 적혈구 표지 스캔소견

김창근(Chang Guhn Kim),원종진(Jong Jin Won),이지영(Ji Young Lee),이경수(Kyoung Soo Lee),김찬수(Chan Soo Kim),최시성(See Sung Choi) 대한핵의학회 1992 핵의학 분자영상 Vol.26 No.2

N/A We evaluated the scintigraphic findings of sonographically atypical hemangioma, that is, a hypoechoic or heterogeneously hypoechoic nodule which contains hypoechoic areas more than 40% of the volume, and compared it with those of sonographically typical hemangioma in 26 patients with 31 nodules. Sonographically atypical hemangioma were 13 in 11 patients and sonographically typical hemangioma were 18 the 15 patients. Dynamic blood flow, planar and SPECT blood pool imaging was performed. In atypical hemangioma, increased blood pool activity was seen in 11 of 13 nodules on SPECT and in 10 of 13 nodules on planar image and increased blood flow was seen in 4 of 13 nodules on dynamic blood flow study. No significant difference in detecting increased blood pool activity between sonographically atypical and typical hemangioma. In conclusion, Tc-99m-red blood cell SPECT is as useful in diagnosis of sonographically atypical hemangioma as in typical hemangioma and can be used as a confirmatory or complementary study.

간 허혈성괴상의 CT소견에 대한 실험적 연구 : 간실질 및 피막의 경시적 변화와 병리조직의 비교 Changes of CT Findings of Liver Parenchyama and Capsule with Time Lapse Correlated with Histopathology

김창근,김강득,최시성,정선관,노병석,원종진 圓光大學校 醫科學硏究所 1994 圓光醫科學 Vol.10 No.1-2

In order to evaluate CT findings with time and to confirm the capsular structure correlating with its histopathologic findings, we experimentally induced ischemic necrosis of liver in 20 rabbits. Incision of the abdomen was performed under anesthesia. Ligation of hepatic artery, portal vein and hepatic duct of right inferior posterior lobe of the liver after injection of macroaggregated albumin into right inferior posterior portal vein in order to prevent from developing collateral circulation as possible. Precontrast and postcontrast enhanced CT images were obtained at 1. 2. 4 days and 1, 2. 4. 6 weeks after induction of ischemic necrosis. Necrotic area in the liver showed homogeneous low density compared to normal liver, and no contrast enhancement after contrast material administration, and marked volume loss with time. CT attenuation value of necrotic area at 1 day(36.7±6.4 M±SD, Hounsfield unit) approached to two third of that of normal liver(56.3±7.3) and showed no significant change until two weeks but increased significantly after four weeks. On contrast enhanced CT images, capsular structure was obsereved as a high density rim along the liver surface of the necortic area in 8 of 15 cases. From the first day on, homogenous ischemic or coagulation necrosis was observed but rarely findings of edema, hemorrhage and cystic change were observed on histopathologic specimen. In all of the histologic samples taken from 10 cases during th 2nd to 6th week, fibrous thickening with rich vascularity was observed along the surface of the necrotic area. In conclusion, ischemic necrosis of the liver showed homogeneous low density and no contrast enhancement. CT attenuation value of necrotic area increased significantly with time associated with markedly decrease in volume. Capsular structure attributed to the hypertrophy of the liver capsule and rich vascularity within it.

골다공증성 대퇴골 골절의 위험인자 평가

정선관,박성훈,김혜원,이영환,윤권하,최시성,노병석,원종진 圓光大學校 醫科學硏究所 2007 圓光醫科學 Vol.22 No.1

MR Imaging of Intradural Spinal Lipoma : A Case Report 1예 보고

Choi, See-Sung,Lee, Jong-Deuk,Juhng, Seon-Kwan,Roh, Byung-Suk,Kim, Chang-Guhn,Won, Jong-Jin 圓光大學校 醫科學硏究所 1996 圓光醫科學 Vol.12 No.2

아주 드물게 발생하는 경막내 척추 지방종이 흉추부에서 발생한 1예를 보고한다. 자기공명영상은 시상면에서 종양의 상부와 하부 범위를 분명하게 보여 주었으며, 또한 종양과 척수와의 관계도 잘 나타내주었다. A case of intradural spinal lipoma in thoracic region is presented. MR imaging clearly showed the upper and lower extent of the tumor on the sagittal images. The relation of the tumor to the cord was also well shown.

혈관촬영에 이용된 비이온성 조영제가 T-임파구아군에 미치는 영향

이경수,최시성,노병석,정선관,김창근,원종진,전창덕,정헌택 圓光大學校 醫科學硏究所 1993 圓光醫科學 Vol.9 No.1-2

Several investigators have shown that the radiographic contrast media have the ability to influence different biologic systems in blood. However, the influence of contrast media on the subpopulations of T-lymphocyte is scarcely investigated. The immune response, including the production of immunoglo-bulin by B cells, is controlled in part by regulatory signals exchanged between functionally heterogenous subpopulations in the T-cell compartment. To evaluate the influence of contrast media on the subpopulations of T-lymphocyte, the author studied the change of T-lymphocyte subpopulations in peripheral blood of 12 patients, before and after injection of Iopromide (Ultravist® in vivo during angiography. T-lymphocyte subpopulations were analyzed by flow cytometer. In general, lymphocyte, Anti-CD_3^+, Anti-CD_4^+, Anti-CD_8^+, Anti-CD_45R^+, and Anti-CD_4^+/Anti-CD_8^+ ratio statistically were not decreased by Iopromide. In conclusion, our results suggest that human immune system is not influenced by Iopromide during angiography.

전산화 단층촬영을 이용한 신손상의 평가

노병석,최시성 圓光大學校 醫科學硏究所 1991 圓光醫科學 Vol.7 No.1-2

The diagnosis and appropriate management of patents with renal trauma have remained controversal. From February 1987 to December 1990, we evaluated with 43 CT of sustaining renal trauma. Computed tomography provides the most precise anatomical detail of renal injuries as well as valuable information regarding other retroperitoneal and intra-abdominal structures, often resulting in the identification of associated and unsuspected injury. Except 3 cases - severe fracture, shattered kidney with disrupted fragments, renal pedicle injury-, all cases of blunt renal trauma treated conservatively. By precise CT staging and interventional procedure, the main management of renal trauma changed from surgical treatment to conservative management.

Gianturco형 금속 스텐트를 이용한 하지 혈관협착의 치료

박양규,원종진,최시성,노병석,소병준,채권묵 대한혈관외과학회 1991 Vascular Specialist International Vol.7 No.1

Four lesions with artherosclerotic stenosis or occlusion of the iliac and superficial femoral arteries were treated with modified Gianturco expandable metallic stents. The vessel lumen was restored with the combined use of dilation with undersized balloon and subsequent stent insertion. Clinical symptoms improved in all patients, and no technical failure occurred. Doppler anklebrachial index studies were preformed in three cases, and in all three cases the indexes improved after stent placement. During the follow up of 5 months, all arteries remained patent. Longterm follow up and more clinical experience will be necessary to evaluate the efficacy of this stent.

흰쥐에서 Iodine-131-Iododeoxyadenosine 의 생체분포 및 유방암 영상화에 관한 연구

김혜원,원종진,최시성,이현철,김창근,김선구,Yang, David J,이강무,민병철,이종덕,Kim, E Edmund 대한핵의학회 1998 핵의학 분자영상 Vol.32 No.4

Purpose: I-131 labeled (2'-deoxy-2-iodo-β-D-arabinofuranosyl) adenine (IAD) may be involved in DNA synthesis during active proliferation of tumor cells. We conducted this study to find out the biodistribution of IAD and its feasibility for scintigraphic tumor imaging. Materisls and Methods: Tosyl acetyl-adenosine was dissolved in acetonitrile, and I-131-NaI was added and heated to synthesize IAD. Female Fisher 344 rats innoculated with breast tumor cells were injected witb 0.27 MBq of IAD. Rats were sacrificed at 0.5, 1, 2, 4, 24h and the % of injected dose per gram of tissue (%ID/g) was determined. For scintigraphy, rats bearing breast cancer were administered with 1.11 MBq of IAD and imaging was perforrned after 2 and 24h. Then, rat body was fixed and rnicrotomized slice was placed on radiographic film for autoradiography, Results: %ID/g of tumor wa.' 0.74 (0.5h), 0.73 (1h), 0.55 (2h), 0.38 (4h), and 0.05 (24h), respectively. At 1h after injection, %ID/g of tumor was higher than that of heart (0.34), liver (0.42), spleen (0.47), kidney (0,69), muscle (0.14), bone (0.33) and intestine (0.51). However, %1D/g of tumor was lower than blood (1.06), lung (0.77), and thyroid (177.71). At 4h, %ID/g of tumor in comparison with other tissue did not change. Tumor contrast expressed by tumor to blood ratio was 0.69 and tumor to muscle ratio was 5.11 at 1h. However, these ratios did not improve through 24h. On autoradiogram and scintigraphy at 2 and 24 hour, the tumor was well visualized. Conclusion: This results suggest that Ial) may have a potential for tumor scintigraphy. However, further work is needed to improve localization in tumor tissue. (Korean J Nucl Med 1998;32:374-81)