비골화성 섬유종 및 섬유성 피질골 결손의 새로운 진단적 소견

조재현,이기범,서정호,김대웅,김병석,Cho, Jae-Hyun,Lee, Kyi-Beom,Suh, Jung-Ho,Kim, Dae-Woong,Kim, Byoung-Suck 대한근골격종양학회 1999 대한골관절종양학회지 Vol.5 No.3

비골화성 섬유종에서 피질골 관(cortical tract)과 개구관(opening tract), 섬유성 피질골 결손에서 피질골내 병소의 존재는 두 병소의 형태학적인 중요한 특징이며, 이 질환을 진단하는데 중요한 단서로 활용될 수 있으리라 사료된다. This study was performed to document the morphologic relationships between non-ossifying fibroma (NOF) and fibrous cortical defect (FCD), as well as to determine any new diagnostic clues. Eighteen patients with 21 NOFs and 14 patients with 15 FCDs found incidentally on radiography were included. The authors prospectively performed CT, MRI, or both on all subjects. The study included size, location, sclerotic property and contour of the periphery, as well as calcification of the matrix of the lesions and the distance from the lesion to the growth plate. The morphologic characteristics were thoroughly reviewed focusing on the presence of the cortical tract in the lesions. The size of the lesion and the distance from the growth plate were not correlated with the patient' age. The presence of the cortical tract was noted in 18(85.7%) out of 21 NOFs, and 10(66.7%) out of 15 FCDs. The presence of the cortical tract was correlated with the longitudinal length of the lesion and the distance from the growth plate. The presence of the cortical tract may be one of the important characteristics in NOF and FCD, and if the diagnosis of bony lesions is obscure by radiologic finding, its exsitence may be a good indicator of diagnosis for NOF or FCD.

A Case of Kaposiform Hemangioendothelioma of the Pterygopalatine Fossa

박준은,장재원,이기범,김철호,Park, Jun Eun,Chang, Jae Won,Lee, Kyi-Beom,Kim, Chul-Ho The Korean Society for Head and Neck Oncology 2013 대한두경부 종양학회지 Vol.29 No.1

카포시형 혈관내피종은 주로 영유아기에 발생하는 혈관내피세포에서 유래하는 혈관종양이다. 성인에서도 발생할 수 있으나 발생률은 정확히 알려져 있지는 않다. 뼈 또는 연조직을 침범할 수 있으며 경계성 종양으로 알려져 있다. 모세혈관종 또는 카포시형 육종과 유사하게 혈관이 포함된 침습적이고 경계가 불분명한 결절을 형성하며, 보통 사지의 연조직이나 간, 폐에 발생하는 경우가 많다. 문헌상으로 두경부에 발생한 증례가 몇 편 보고되어 있으나, 그 중 익구개와에 발생한 경우를 보고한 경우는 없었다. 저자들은 5개월된 남아에서 익구개와에 발생한 카포시형 혈관내피종을 인터페론 알파와 수술적 절제로 성공적으로 치료하였기에 이를 문헌고찰과 함께 보고하는 바이다.

췌장의 고형성 유두상 암종의 세침흡인 세포학적 소견

조미연,이광길,이기범,정현주,정우희,Cho, Mee-Yon,Lee, Kwang-Gil,Lee, Kyi-Beom,Jeong, Hyeun-Joo,Jung, Woo-Hee 대한세포병리학회 1990 대한세포병리학회지 Vol.1 No.1

We present the cytologic features of a case of solid and papillary neoplasm of the pancreas. Cytologically, the tumor was composed of a monotonous population of polygonal cells containing eccentrically located round nuclei with one or two distinct small nucleoli and a finely stippled chromatin pattern. The tumor cells were similar to those of the islet cell tumor and showed isolated loosely aggregated and solid sheets or large cell clumps. The large cell clumps revealed a branching papillary structure containing fibrovascular central core, which is characteristic histologic feature of solid and papillary neoplasm of the pancreas. This case was confirmed by tissue examination including histochemical, immunohistochemical and electron microscopical studies. Ultrastructurally, the tumor cells contained a few membrane- bound electron dense granules.

간의 다발성 맥관근지방종 - 세침흡인 세포학적 검사로 진단한 1예 보고 -

임현이,박광화,이기범,Yim, Hyun-Ee,Park, Kwang-Wha,Lee, Kyi-Beom 대한세포병리학회 1998 대한세포병리학회지 Vol.9 No.1

Angiomyolipoma(AML) of the liver is a rare benign tumor; about 50 cases, almost solitary, have been reported. We present here a extremely rare case of multiple AML in the liver diagnosed by fine needle aspiration cytology(FNAC). Two large masses were found in a 51 year-old woman complaining of abdominal discomfort by computed tomography and several smaller masses are scattered in the liver. FNAC was performed, showing bundles of spindle shaped smooth muscle cells intermingled with mature fat cells. FNAC may be a valuable method for definitive diagnosis of hepatic AML. The diagnosis was further confirmed by histologic examination with immunohistochemical studies.

유골 골종에서 전산화 단층 촬영 유도하 경피적 핵 절제술 - 천공기 이용법 -

김병석,조재현,이기범,유청수,안재인,Kim, Byoung-Suck,Cho, Jae-Hyun,Lee, Kyi-Beom,Yu, Chung-Su,Ahn, Jae-In 대한근골격종양학회 1999 대한골관절종양학회지 Vol.5 No.1

Aspirin has usually been taken for pain relief originating in the nidus of osteoid osteoma, however it takes too long to become effective. Because of the protracted painful course and the unpredictability of regression, osteoid osteoma is usually removed. And then, the defective host bone is internally fixed by plate and screws and augumented by autogenous bone graft. However, the common intracortical location and exuberant periosteal reaction hinders the exact intraoperative localization of the nidus. The authors managed 6 patients by computerized tomography-guided percutaneous nidus excision with a relatively small skin incision, small cortical window, short operation time and no bone graft. It may be one of the best options for removal of the nidus of osteoid osteoma with certainty.

거골에 발생한 골육종 - 증례 보고 -

김병석,임호영,조재현,김태홍,이기범,Kim, Byoung-Suck,Lim, Ho-Yeung,Cho, Jae-Hyun,Kim, Tae-Hong,Lee, Kyi-Beom 대한근골격종양학회 2002 대한골관절종양학회지 Vol.8 No.3

42세 남자 환자가 우측 족관절부에 4개월 동안 증가하는 동통 및 종괴를 주소로 내원하였다. 단순 방사선 소견 및 전산화 단층 촬영 소견상 우측 거골 경부의 골내부 및 피질골 파괴소견을 보였다. 병리소견은 고악성도의 골형성 골육종이었다. 두 사이클의 수술전 항암치료에도 불구하고, 족관절부의 종괴는 커졌고 폐전이로 진행되었다. 원발 병소에 대하여 슬관절하 절단, 폐전이에 대하여 쐐기모양 폐 절제술을 실시하였고 수술후 항암치료를 시행하였으나 수술후 10개월에 폐전이로 환자는 사망하였다. A 42 year old male patient complained of increasing pain and mass around the right ankle with 4 months duration. Simple Roentgenogram and CT showed ill-defined osteolysis and cortical perforation in the neck of the right talus. The pathologic findings showed high grade osteoblastic osteosarcoma. The tumor mass of the ankle increased and pulmonary metastasis was found in spite of administrating of two cycles of preoperative chemotherapy. Below-knee amputation and open wedge pulmonary resection were performed for primary lesion and multiple pulmoanry metastasis, respectively. However, the patient died with multiple pulmonary metastasis in spite of three cycles of postoperative chemotherapy at ten months after the operation.

1 , 2 - dimethylhydrazine 으로 유발되는 대장암발생의 기전에 관한 조직 및 조직화학적 연구

이유복(Yoo Bock Lee),박찬일(Chan Il Park),이기범(Kyi Beom Lee) 대한소화기학회 1985 대한소화기학회지 Vol.17 No.2

N/A To investigate the histogenesis of colonic carcinoma, 1,2-dimethylhydrazine(DMH) was injected to Sprague-Dawley rats for 6 to 24 weeks, 20 mg/kg/week, and gross and microscopic studies of the colonic mucosa were made with special emphasis on changes of transitional mucosa(TM), such as the pattern and nature of mucin contents and epithelial dysplasia. The tunor developed in 1/10 in 6~16 weeks treated groups, 1/6 in 20 weeks and 5/6 in 24 weeks treated group. Majority of the tumors were adenocarcinomas, while a few cases of signet ring cell carcinoma wero observed in 24 weeks treated group. Histologic and histochemical changes of the remaining colonic mucosa, especially at the TM consisted of enlargement of the crypts due to goblet cell(G-C) hyperplasia with increased mucin production during 8 to 16 weeks treatment, followed by epithelial dysplasia, such as loss of polarity, nuclear hyperchromacity and reduction of the secretory function. The content of mucin increased during 8 to 16 weeks treatment and was comprised of predominantly sulfomucin, while the content, especially sulfomucin, markedly decreased as dysplastic changes progressed and was accompanied by a relative increase of sialomucin. These findings suggest that the histogenesis of colonic carcinoma takes steps of initia1 G-C hyperplasia with increased sulfomucin production and later dysplastic changes of G-C, accompanied by reduction of sulfomucin secretion and a relative increase of sialomucin.

중족골에 발생한 전이암

김병석,전미선,최진혁,조재현,이기범,김우식,안재인,Kim, Byoung-Suck,Chun, Mi-Son,Choi, Jin-Hyuk,Cho, Jae-Hyun,Lee, Kyi-Beom,Kim, Woo-Sig,Ahn, Jae-In 대한족부족관절학회 1998 대한족부족관절학회지 Vol.2 No.1

저자들은 43세된 여자 환자에서 직장암에 대하여 광범위 절제술 및 림프 절제술, 항암치료 및 방사선 치료 후, 국소 재발없이 직장암 수술 20개월 후, 좌측 족부의 제2 중족골로 전이된 전이암 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. The pulmonary metastasis and bony metastasis finally resulted from the malignant tumors as one of the inevitable problems. Among them, the bony metastasis, which frequently involved the vertebrae, pelvis, ribs, sternum, and skull, have had the frequencies over 30%. Metastasis to the distal part of the knee is rare. However, acrometastasis which occured in bones of the foot is even rarer(0.4%) and a late manifetation of a disseminated disease from the literature review. Acrometastasis should be considered in elderly patients with a history of the previous malignancy, complaint of foot pain and mass lesion. We are reporting one rectal carcinoma with acrometastasis to the second metatarsal bone.

수지 조갑하 사구종의 진단 및 치료에서 자기 공명 영상의 임상적 의미

김병석,김우식,한경진,조재현,이기범,하헌교,강신영,Kim, Byoung-Suck,Kim, Woo-Sig,Han, Kyoung-Jin,Cho, Jae-Hyun,Lee, Kyi-Beom,Ha, Heon-Kyo,Kang, Shin-Young 대한근골격종양학회 2001 대한골관절종양학회지 Vol.7 No.1

목적 : 임상적으로 수지 사구종으로 의심되는 환자의 수술전 자기 공명 영상을 시행하여, 자기 공명 영상을 이용한 진단의 유용성과 변연 절제술 후의 임상적 결과를 알아보고자 하였다. 연구대상 및 방법 : 수지 사구종을 의심하는 10례를 대상으로 수술전 문진, 이학적 검사, 단순 방사선 검사, 자기 공명 영상(9례)을 시행하였다. 수술적 치료는 변연 절제술을 시행하였으며, 수술후 병리 소견, 수술후 합병증 등을 비교 분석하였다. 결과 : 사구종으로 확진된 10례 중 호소하는 증세는 동통 10례, 압통 9례, 냉온에 대한 민감도 3례, 부종 1례였다. 자기 공명 영상 소견상 T1 강조 영상에서 저신호 강도 3례, 동신호 강도 5례, T2 강조 영상에서 고신호 강도 8례, 그리고 gadolinium 조영 증강된 영상에서는 8례 모두 조영 증가 소견을 보여 주었고, 발생 위치는 횡단면에서 정중부 6례, 외측부 5례, 조갑 외측 추벽 2례, 수지 두수 3례였고, 시상면에서 조갑상 5례, 조갑 기질 5례였다. 수술은 외측 접근법 1례, 조갑을 통한 접근법 9례를 시행하였으며, 모두 변연 절제술을 실시하였다. 수술후 전 예에서 임상 증세는 소실되었으며, 조갑 변형은 1례에서 발견되었으나, 재발은 없었다. 결론 : 수지의 사구종을 진단하는데 임상 증세는 아주 중요하나, 진단이 애매하거나 오랜 기간 동안 증세가 있어온 환자들에게서 비교적 비싼 비용을 지불하더라도 자기 공명 영상을 제한적으로 사용할 경우, 수술전 종물의 정확한 위치 확인 및 진단에 도움을 주는 방법의 하나로 생각한다. Purpose : Authors investigated the efficiency of preoperative MRI in suspicious glomus tumor and the clinical outcomes after marginal excision. Materials and Methods : In 10 cases of glomus tumors in the fingers, authors retrospectively analyzed the clinical data, including previous trauma, treatment history, preoperative symptoms, physical examination, plain radiography, MRI (9 cases), pathological findings and postoperative complications. Results : The patients had pain in 10 cases, tenderness in 9 cases, cold sensitivity in 3 cases and edema in one case. MRI showed low signal (3 cases) or iso-signal (5) intensity on T1 weighted image, high signal intensity (8) on T2 weighted image, and all the lesions were enhanced in gadolinium enhancement images. The exact locations of glomus tumors were median in 6 cases, lateral in 5, lateral fold in 2 and pulp in 3 in transverse section and nail bed in 5 cases and nail matrix in 5 in sagittal section. Marginal excision was performed by lateral approach in one case and transungual in 9 cases. Histologically, all 10 cases were composed of solid sheets of round cells interrupted by thin-walled blood vessels. Most of clinical symptoms were disappeared in all cases after operation. Nail deformity was found in one case, which was originated from nail matrix, however, there was no recurrence. Summary : Clinical symptom was the most impotant factor in diagnosis of glomus tumor in the fingers. However, preoperative MRIs were helpful in patients, who had obscure pain or prolonged clinical symptoms with suspicious glomus tumors. Preoperative MRI might be one of the most useful tools for establishing the exact diagnosis and detecting the location of glomus tumors, in spite of the relatively high expenses.

위암환자에서 예후인자로서 EGFR, p21(ras oncogene product) 및 p53의 연구

민진식(Jin Sik Min),이희대(Hy De Lee),이기범(Kyi Beom Lee),최승호(Seung Ho Choi),박찬일(Chan Il Park),노성훈(Sung Hoon Noh) 대한외과학회 1994 Annals of Surgical Treatment and Research Vol.46 No.4