충수돌기에 국한된 크론병 2 예

이건(Gun Lee),장영운(Young Woon Chang),김수영(Su Young Kim),한요셉(Yo Seb Han),김영희(Yong Hee Kim),김교영(Gou Young Kim),이동근(Dong Keun Lee),동석호(Seok Ho Dong),김효종(Hyo Jong Kim),김병호(Byung Ho Kim),이정일(Jung Il Lee),이주희(J 대한소화기학회 2001 대한소화기학회지 Vol.38 No.5

Granulomatous appendiceal disease is uncommon. Since the first report by Meyerding in 1953, about 150 cases of presumed isolated appendiceal Crohn's disease have been documented worldwide. However, none of appendiceal Crohn's disease has been reported in Korea. We experienced 27-year-old woman and 42-year-old man with isolated appendiceal Crohn's disease, which was diagnosed after surgical operation. It was presumed as acute appendicitis with periappendiceal abscess preoperatively. The pathologic finding of appendectomy specimen showed transmural inflammation with giant cell and lymphocyte infiltration, and non-caseous epitheloid granuloma. (Korean J Gastroenterol 2001;38:381-384)

완치된 결핵환자에서 발생한 Mycobacterium szulgai 폐질환

최재호 ( Jae Ho Choi ),이은정 ( Eun Jung Lee ),김은영 ( Eun Young Kim ),김현수 ( Hyun Soo Kim ),박지영 ( Ji Young Park ),이종후 ( Jong Hoo Lee ),유지홍 ( Jee Hong Yoo ),최천웅 ( Cheon Woong Choi ),김교영 ( Gou Young Kim ),정상완 ( 대한결핵 및 호흡기학회 2012 Tuberculosis and Respiratory Diseases Vol.72 No.1

Mycobacterium szulgai is a rare nontuberculous mycobacterium found in Korea. It is an opportunistic pathogen and is usually isolated from patients with a history of alcoholism, chronic pulmonary disease, or an immunocompromising condition. We present here a case of M. szulgai isolated from a patient with a history of pulmonary tuberculosis. A 54-year-old man was admitted with dyspnea and febrile sensation. He had a history of pulmonary tuberculosis which occurred 30 years earlier and treatment with anti-tuberculosis medication. His chest computed tomography scan showed cavitary consolidation in both upper lungs. A sputum acid-fast bacilli (AFB) smear was positive and anti-tuberculous medication was started. However, a polymerase chain reaction for mycobacterium tuberculosis was negative and anti-tuberculous medication was stopped. M. szulgai was isolated on 3 separate sputum and bronchial wash fluid AFB cultures. He was treated with clarithromycin, rifampicin, and ethambutol. After 1 month, a sputum AFB smear and culture became negative and no additional M. szulgai were isolated during a 16-month treatment.

Telangiectatic Osteosarcoma Arising in a Rib

성지연,김교영,류창우,김대현,박용구,Sung, Ji-Youn,Kim, Gou-Young,Ryu, Chang-Woo,Kim, Dae-Hyun,Park, Yong-Koo The Korean Musculoskeletal Tumor Society 2008 대한골관절종양학회지 Vol.14 No.2

혈관확장골육종은 골육종의 드문 아형이다. 늑골은 일반적인 골육종뿐만 아니라 혈관확장골육종에서도 흔치 않은 발생부위이다. 이 종양은 경화된 부분이 없이 혈액이나 괴사된 종양조직을 포함하는 단일성 또는 다발성 낭성 공간으로 구성되므로 다른 양성 낭성 병변과의 감별을 위해 주의 깊은 관찰이 필요하다. 그러므로 늑골이 혈관확장골육종의 호발 부위는 아니지만 일차적인 감별진단에 혈관확장골육종을 포함시키는 것이 중요하다. 늑골에서 발생한 혈관 확장골육종과 일차성 골육종에 관한 기존 보고, 혈관성골육종의 감별진단과 드문 부위에 발생한 골육종의 임상적 특징에 관한 문헌고찰과 함께, 늑골에서 발생한 혈관확장골육종 1예를 보고하는 바이다. Telangiectatic osteosarcoma is a rare variant of osteosarcoma. The rib is an uncommon primary site for conventional osteosarcoma, and even more for telangiectatic osteosarcoma. Because this tumor consists of single to multiple cystic cavities that contain blood or necrotic tumor with no appreciable areas of sclerosis, careful observation is needed to differentiate this malignancy from other benign cystic lesion. Therefore primary differential diagnosis including telangiectatic osteosarcoma is important, although rib is not the predilection site of telangiectatic osteosarcoma. We present a case of telangiectatic osteosarcoma arising in a rib. We reviewed the literature concerning telangiectatic osteosarcomas and primary osteosarcomas arising from the rib. The differential diagnosis of telangiectatic osteosarcoma and clinical features of osteosarcomas arising from unusual locations were discussed.

Usefulness of E-Cadherin Expression in Malignant Effusion

임성직,김교영,김윤화,박용구,양문호,원남희,이주희,Lim, Sung-Jig,Kim, Gou-Young,Kim, Youn-Wha,Park, Yong-Koo,Yang, Moon-Ho,Won, Nam-Hee,Lee, Ju-Hie The Korean Society for Cytopathology 1999 대한세포병리학회지 Vol.10 No.2

체강액 내의 악성 종양세포와 중피세포의 구분이 종종 어려우나 환자의 치료나 종양의 임상기 결정에 큰 영향을 미치기 때문에 정확히 감별하는 것이 매우 중요하다. E-cadherin은 상피세포에서 표현되는 유착단백질이다. 본 연구에서는 체강액의 세포학적 검사에서 악성세포의 표지자로서 E-cadherin의 유용성을 알아보기 위하여 세포검사후 조직검사로 진단을 확인한 33예를 대상으로 체강액으로부터 만든 세포 블록에 대하여 E-cadherin에 대한 면역세포화학염색을 시행하였다. 33 예의 세포학적 진단은 선암종 25예, 비정형세포 8예였다. 선암종으로 진단하였던 25 예중 21예(84%)에서 E-cadherin 에 양성이었다. 비정형세포라고 진단하였던 8예중 6예에서 음성이었으며 양성으로 염색된 2예는 조직학적 검사로 전이성 암종임을 확인하였다. 반응성 중피세포나 염증세포는 모두 음성이었다. 민감도와 특이도는 각각 84%와 75%였다. 결론적으로 E-cadherin은 체강액에서 악성 종양세포와 반응성 중피세포와의 구분에 유용한 보조적인 표지자이다. The usefulness of E-cadherin immunostaining as a marker of malignancy in the body fluids was investigated in the present study. Thirty-three histologically proven cases of cell blocks from the pleural, peritoneal, and pericardial fluids were studied by immunocytochemistry for E-cadherin antibody using LSAB method. These cases were cytologically diagnosed as adenocarcinoma (25 cases) and atypical cells (8 cases). Tumor cells showed strong positive membranous staining for E-cadherin antibody in 21 out of 25 cases (84%) of adenocarcinoma. E-cadherin staining was not found in 6 of 8 cases of suspicious maligancy. The sensitivity and specificity were 84% and 75%, respectively. Reactive mesothelial cells and Inflammatory cells scattered were all negative. In conclusion, E-cadherin is an useful adjunctive marker to distinguish reactive mesothelial cells from the carcinoma cells in the body fluids.

점액성 세관 방추세포 신장암종의 압착도말 세포소견 - 1예 보고 -

원규연,김교영,임성직,김현철,전승현,Won, Kyu-Yeoun,Kim, Gou-Young,Lim, Sung-Jig,Kim, Hyun-Cheol,Jeon, Seung-Hyun The Korean Society for Cytopathology 2008 대한세포병리학회지 Vol.19 No.2

The recent WHO classification has recognized mucinous tubular and spindle cell carcinoma (MTSCC) as a distinct entity of renal cell carcinoma, exhibiting a mixed pattern of tubules and a surrounding spindle cell proliferation within a myxoid stroma, with low-grade nuclear features. A 51-year-old woman had an incidentally discovered renal mass. Radiologic examination revealed a large, well defined mass in the lower pole of the right kidney; a right radical nephrectomy was performed. Imprint cytologic smears from fresh surgical specimens showed cellular, cohesive clusters with thick, broad trabecular arrangements and branching structures. On high power fields, the tumor was composed of round-to-oval low-grade nuclei with vesicular chromatin and small nucleoli. The tumor cells had indistinct borders and pale, eosinophilic cytoplasm, In some areas, round-to-elongated tubular structures and spindle cell patterns were noted. Chronic inflammatory cell infiltration was noted, along with a mucinous back-ground and occasional psammoma bodies. Neither significant cytologic atypia nor mitosis was seen.

림프절에 발생한 랑게르한스 세포 조직구증의 세침흡인 세포소견 -1예 보고-

김민정,김교영,조현이,정동해,김나래,하승연,Kim, Min-Jung,Kim, Gou-Young,Cho, Hyun-Yee,Chung, Dong-Hae,Kim, Na-Rae,Ha, Seung-Yeon 대한세포병리학회 2007 대한세포병리학회지 Vol.18 No.1

Langerhans cell histiocytosis (LCH) is a pleomorphic disease entity characterized by local or disseminated atypical Langerhans cells (LCs) found most commonly in bone, lungs, mucocutaneous structures and endocrine organs. Among different sites, unifocal disease confined to a lymph node (LN) is rare. We report a case of LCH confined to a LN in a 38-year-old male who presented with a 2 cm-sized cervical mass. The fine needle aspiration (FNA) smears of cervical LN showed high cellularity having isolated LCs with contorted nuclei and nuclear grooves mixed in multinucleated giant cells, small lymphocytes and eosinophils. Charcot-Leyden crystals were also seen, as were a few dendritic-like cells and intranuclear inclusions. Confirmation of LCH was made by histopathologic studies, positive reactions for S-100 protein and CD1a immunohistochemical staining and by the demonstration of Birbeck granules on electron microscopy. The differentials to be considered include dermatopathic lymphadenitis, sinus histiocytosis with massive lymphadenopathy, Hodgkin's lymphoma and malignant histiocytosis. The characteristic cytomorphologic pattern of LCH in a LN FNA smear plays an important role in suggesting the diagnosis of LCH.

백서의 아킬레스 건 봉합 후 Hyaluronate-Carboxymethyl cellulose가 조직 유착에 미치는 영향

이정희,정비오,김교영,Lee, Jung-Hee,Jeong, Bi-O,Kim, Gou-Young 대한족부족관절학회 2009 대한족부족관절학회지 Vol.13 No.1

Purpose: The purpose of this study was to evaluate the effect of Sodium hyaluronate-Sodium carboxymethyl cellulose (HA-CMC) on tissue adhesion after tenorrhapy in tenotomized Achilles tendon of the Sprague-Dawley rat. Materials and Methods: Twenty-eight legs of 14 Sprague-Dawley rat were used in study. After tenotomy of the Achilles tendons, tenorrhaphies were performed. Simple tenorrhaphy without any other procedures were performed on the left Achilles tendons (control group), and additional HA-CMC injections were done prior to the tenorrhaphy on the right Achilles tendons (HA-CMC group). Gross and histological examinations were made to identify differences between the two groups, 1, 2, 6, 8, 10, 12 and 14 weeks respectively. Results: Distinct decrease in granulation tissues and adhesions were seen in the HA-CMC group during gross inspection at 6 and 8 week after the operation. On histological analysis of the HA-CMC group, although increased infiltrations of inflammation cells were observed during 1 week, less adhesion were seen at 6, 8 and 10 weeks after the operation. In HA-CMC group, superior healing processes were seen at 6, 8 and 10 weeks and less fibrotic changes, compared to control group, were seen at 2 and 6 weeks. Conclusion: Prevention of adjacent tissue adhesion was made possible through decrease in collagen deposition and fibrosis by injecting HA-CMC before tenorrhaphy of Achilles tendon. Also, histologically faster healing process of the collagen fibers within the Achilles tendon was observed.

마이코플라즈마 폐렴균 감염에 의한 결절성 홍반; 조직병리학적 소견과 병인론의 고찰

주희영 ( Hee Young Ju ),김교영 ( Gou Young Kim ),최선희 ( Sun Hee Choi ) 대한소아감염학회 2016 Pediatric Infection and Vaccine Vol.23 No.1

결절성 홍반은 소아에서 가장 흔한 피하지방층의 염증으로 하지의 압통을 동반한 결절을 특징으로 한다. 이 질환은 다양한 원인에 의해 발생되지만 공통된 조직소견을 보여준다. 저자들은 임상적 소견 및혈청학적 방법으로 마이코플라즈마 폐렴균에 의한 결절성 홍반을 진단하였고 조직병리적인 접근을 통해 결절성 홍반의 면역병인에 대해 고찰해 보았다. 조직병리소견은 제 4형 면역반응 염증을 보였으며 이는 다양한 원인에 의한 결절성 홍반의 발생 기전을 이해하는데 도움을 줄 것이다. Erythema nodosum (EN) is a painful skin disease characterized by erythematous tender nodules located predominantly over the extensor aspects of the legs. Various etiological factors, including infection, drug administration, and systemic illness have been implicated as causes of EN. Mycoplasma pneumoniae is one of rare infectious agents to cause EN in children. We report a case of a 7-year-old boy with context of respiratory illness and skin lesions with arthralgia. From stepwise approaches, IgM antibody against M. pneumoniae was positive with titers of 12.18, consistent with respiratory infection of M. pneumoniae and histopathology showed findings of septal and lobular inflammation without vasculitis consistent with EN. In addition, we reviewed the pathogenesis of this disease based on our case and the previous reports.

류마티스관절염 환자에서 TNF-α 억제제 사용 후 발생한 백반증 1예

송란 ( Ran Song ),김소미 ( So Mi Kim ),이상훈 ( Sang Hoon Lee ),이연아 ( Yeon Ah Lee ),홍승재 ( Seung Jae Hong ),조희령 ( Hee Ryung Cho ),김교영 ( Gou Young Kim ),양형인 ( Hyung In Yang ) 대한류마티스학회 2012 대한류마티스학회지 Vol.19 No.4

As the usage of biologics for rheumatic diseases increases, such as rheumatoid arthritis and ankylosing spondylitis, various cutaneous adverse events are also being increasingly reported. We experienced a case of development of vitiligo during a TNF-α antagonist therapy in a 22-year-old woman with rheumatoid arthritis. The patient was presented with vitiligo lesions on the dorsum of both hands after 1 month of treatment with etanercept. Vitiligo improved with topical tacrolimus ointment and excimer laser treatment without the discontinuation of etanercept. No clearly defined mechanism for vitiligo induced by TNF-α antagonist exits. However, considering that vitiligo is an autoimmune disorder, the development of this skin lesion in association with the TNF-α antagonist could be explained by a paradoxical induction of the autoimmune process.

병합치료 후 소실된 비소세포폐암 Gemcitabine 병발 신증후군

이은정 ( Eun Jung Lee ),이재진 ( Jae Jin Lee ),문주영 ( Ju Young Moon ),유지홍 ( Jee Hong Yoo ),최천웅 ( Cheon Woong Choi ),김이형 ( Yee Hyung Kim ),김교영 ( Gou Young Kim ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.5

Nephrotic syndrome has been reported to accompany a malignancy. Since the first case of the nephrotic syndrome associated with extra-renal malignancy was reported in 1922, only a few cases of nephrotic syndrome accompanying other malignancies have been reported. Previous reports on such cases indicated a pattern of improvement in nephropathy as malignancy improved. But the cases of resolved nephropathy with aggravated cancer have scarcely been documented. Here we report a case of a 69 year-old male with nephrotic syndrome accompanying non-small cell lung cancer, whose proteinuria was normalized after chemotherapy while his cancer was aggravated.