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위 신경초종 보고 - 병리학적 , 면역조직화학적 및 초미세구조적 관찰
장미수(Mee Soo Chang),김용일(Yong Il Kim) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.4
Neurilemmoma of the stomach is a rare controversial neoplasm which requires extensive studies to clarify its nature from stromal tumor or leiornyoma. This paper describes the pathologic, immunohistochemical and ultrastructural characteristics of neurilemmoma of the stomach from a 52-year-old woman. The tumor was a 2.2cm, well circumscribed submucosal mass located in the anterior wall of midbody. Microscopically, the cells were made up of fasciculating bundles of spindle cells featured with benign nuclear atypia and peripheral lymphoid cell cuffing. The tumor cells revealed a diffuse strong immunoreactivity to S-100 protein and vimentin, but were negative to desmin and smooth muscle actin, and focal positive reaction to glial fibrillary acidic protein. Peripheral lymphoid cuffing was suggested an immune reaction against the tumor tissue. Ultrastructurally, rnany tumor cells showed a number of thin e]ongated and interdigitating dendritic- like cell processes, distinct uniform basal laminae, frequent cellular attachments and microfila- ments. The findings supported the schwannian nature of the tumor, and the focal positive immunoreactivity for GFAP indicates the possibility of focally modified schwann cell. (Korean J Gastroenterol 1996;28:556 - 560)
간의 파골세포모양 거대세포 종양의 세침흡인 세포학적 소견
박찬식,김지은,장미수,Park, Chan-Sik,Kim, Ji-Eun,Chang, Mee-Soo 대한세포병리학회 1999 대한세포병리학회지 Vol.10 No.1
Osteoclast-like giant cell tumor of the liver is an extremely rare malignancy with poor prognosis. To our knowledge, 5 cases have been reported in English literatures, but there was no report about fine needle aspiration cytologic(FNAC) features. We experienced a case of osteoclast-like giant cell tumor of the liver obtained by computed tomography(CT)-guided FNAC and needle biopsy. The cytologic findings mimicked slant cell tumor of the bone. A large hepatic mass of the left lobe with abdominal wall invasion was found by CT in a 46- year-old female complaining of epigastric pain. The FNAC showed moderately cellular smears consisting of osteoclast-like giant cells and mononuclear cells, which were individually scattered or intermingled in clusters. The osteoclast-like giant cells had abundant cytoplasms and multiple small round nuclei with fine chromatin and distinct nucleoli. The mononuclear cells had moderate amount of cytoplasm and relatively bland-looking oval nuclei with single small nucleoli. All of the cytologic features recapitulated the histologic findings of bland-looking osteoclast-like multinucleated giant cells evenly dispersed throughout the background of mononuclear cell. The immunohistochemical study showed positive reaction for CD68 and vimentin, but negative for cytokeratin in both osteoclast-like slant cells and mononuclear cells.
위장관 ( 胃腸管 ) : 장관 폴립증 - 28 장관 절제예에 대한 임상 및 병리학적 분석 -
김용일(Yong Il Kim),장미수(Mee Soo Chang) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.1
N/A A clinicopathologic analysis of 28 surgically resected intestinal polyposis was made in view of associated carcinomatous change and rationale for surgical intervention. Included were 13 cases of familial adenomatous polyposis, 3 multiple colnnic adenomas, 1 Gardner's syndrome, 6 juvenile polyposis and 5 Peutz-Jeghers syndrome. The carcinoma was associated in 11 of 13 familial adenomatous polyposis (85%) and the adenomacarcinoma sequence was supported by the carcinomatous change within the adenomas in 8 cases (62%). Multiple synchronous carcinomas were found in 7 cases, and one of them illustrated early malignant transformation of adenomas. The extent of surgical resection was interpreted irrelevant in four cases, of which two cases of familial adenomatous polyposis received Miles operation because of insufficient preoperative study. In the remaining two cases (one juvenile polyposis and another Peutz-Jeghers syndrome), unnecessary extensive resection with sacrifice of anal sphincter was done. The source for such sacrifice of anal sphincter were attributed either to misinterpretation of mixed hyperplastic-adenomatous features in juvenile polyposis to familial adenomatous polyposis on frozen section examination, or to inadequate preoperative diagnostic workup in Peutz-Jeghers syndrome (misinterpreted as familial adenomatous polyposis).
악하선관으로 연결되는 주설하관을 가진 설하선과 이에 발생한 선양낭성암종 1례
문성중(Sung Joong Moon),정영호(Young Ho Jung),장미수(Mee-Soo Chang),진홍률(Hong-Ryul Jin) 대한두경부종양학회 2006 대한두경부 종양학회지 Vol.22 No.2
Tumors rarely arise in the sublingual salivary glands. They should be considered malignant until proved otherwise. Adenoid cystic carcinoma is most commonly encountered malignant tumor of the sublingual gland. We report a case of adenoid cystic carcinoma arising from the sublingual gland. Moreover, the sublingual gland had anatomic variation of main duct(Bartholin’s duct) which is connected to Wharton’s duct.
대장암의 병리학적 특성 - 절제 대장암 872예에 대한 분석 -
김우호(Woo Ho Kim),김용일(Yong Il Kim),장미수(Mee Soo Chang) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.1
This study was undertaken to characterize the pathologic features of the carcinomas of the large intestine among Koreans. A total of 872 consecutive cases of surgically resected large intestine carcinomas operated at Seoul National University Hospital during a perioid of 8 and 8/12 years from 1981 to 1989 were investigated according to the Korean Guideline for Colo-Rectal Cancer Study. The results were summarized as follow: 1) The male to female ratio was 1.3:1(498 males and 374 females). The age at the time of resection ranged from 17 to 86 years, and the highest peak was in the 6th decade. 2) The topographic incidence order of the carcinomas were 256 cases(30%) in the upper rectum; 229(27%) in the lower rectum; 103(12%) in the ascending colon; 102(12%) in the sigmoid colon. 3) Moderately differentiated adenocarcinoma was found in 56%, well differentiated adenocar- cinoma in 24%, and poorly differentiated adenocarcinoma in 6%. Mucinous carcinoma and signet-ring cell carcinoma comprised 8.3% and 1.5%, respectively. 4) The average size of the tumors was 5.2 +- 2.9 cm. Applying the Borrmann classification to the colo-rectal carcinomas, the order of the frequency was type II(366 cases), type lll(298 cases) and type I (144 cases). 5) Early colon cancer was found in 15 cases(1.8%). The stage of the colo-rectal cancer showed a preponderance of Dukes Astler-Coller C2 lesions; 375(44%) were in C2, 319(37%) in B2, 95(11%) in Bl, 40(5%) in D, 17(2%) in Cl, and 6(1%) in A. In 20 cases of anal cancer, 11 were Boman stage B2 and the remaining 9 were stage C. 6) There were 16(1.8%) cases with multiple primary carcinornas, of which 12(1.4%) were synchro- nous and 4(0.46%) metachronous. 7) In 83 cases(9.5%), the colo-rectal polyps including 73 cases(8.4%) of neoplastic polyps were associated. The majority of them were tobular adenomas(59 cases). 8) Familial polyposis with cancer was found in 7 cases(0.8%) and their age ranged from 29 to 58 years. Of them, 4 cases were multiple carcinomas, and all of 7 cases showed one or more cancers in the rectum. 9) Adenoma-carcinoma sequence was histologically confirmed in 32 of 872 carcinomas(3.7%). The above data were compared and discussed with those from domestic and western literatures.
황색육아종성 담낭염 수술 후 지속적인 CA 19-9 상승으로 진단된 담관암 1예
황상연 ( Sang Youn Hwang ),김준석 ( Joon Suk Kim ),정지봉 ( Ji Bong Jeong ),김지원 ( Ji Won Kim ),김병관 ( Byeong Gwan Kim ),이국래 ( Kook Lae Lee ),안영준 ( Young Joon Ahn ),장미수 ( Mee Soo Chang ) 대한소화기학회 2010 대한소화기학회지 Vol.55 No.6
Xanthogranulomatous cholecystitis (XGC) is an unusual and destructive inflammatory process that is characterized by thickening of the gallbladder (GB) wall with a tendency to adhere to neighboring organs. XGC is often mistaken for GB carcinoma, and the frequency of the coexistence of these two lesions is approximately 10%. Therefore, in case of severe XGC, there is chance of either overlooking the carcinoma or other significant lesions. CA 19-9 is commonly measured in the serum of patients with hepatobiliary malignancies. Although CA 19-9 can be elevated in benign conditions such as cholestasis, pancreatitis, tuberculosis, thyroid disease etc., malignancy should be considered at first in setting of its significant and persistent elevation. We report a case of a 62-year-old man who showed continuously rising level of CA19-9 over 2000 U/mL after cholecystectomy for xanthogranulomatous cholecystitis and finally was diagnosed as cholangiocarcinoma by short-term follow up. (Korean J Gastroenterol 2010;55:404-409)
혐기성 세균 Prevotella 침습성감염증의 임상적 특징과 예후
윤지열 ( Ji Yeol Yoon ),추은주 ( Eun Ju Choo ),최상호 ( Sang Ho Choi ),김미나 ( Mi Na Kim ),김남중 ( Nam Joong Kim ),김양수 ( Yang Soo Kim ),우준희 ( Jun Hee Woo ),류지소 ( Ji So Ryu ),장미수 ( Mee Soo Chang ) 대한내과학회 2003 대한내과학회지 Vol.64 No.3
목적 : Prevotella species는 Bacteroides 등과 함께 침습성 혐기성감염의 주요한 원인균이다. 저자들은 3차진료 기관인 대학병원에 입원한 환자들을 대상으로 Prevotella 침습성 감염증의 임상적 특성과 예후 및 예후 인자 등을 살펴보고자 본 연구를 시행하였다. 방법 : 병원전산프로그램을 이용하여 1997년 1월부터 2000년 12월까지 서울아산병원에 입원한 환자들의 혈액, 흉수 및 복수 배양검사결과를 조사하였고 이중 Prevot Background : Prevotella species is one of the major microoranism responsible for invasive anaerobic bacterial infection. This study was performed to investigate the clinical characteristics and outcome of invasive Prevotella infection in a University affi
김영훈 ( Young Hoon Kim ),정지봉 ( Ji Bong Jeong ),주세경 ( Sae Kyung Joo ),최민영 ( Min Young Choi ),이국래 ( Kook Lae Lee ),장미수 ( Mee Soo Chang ),안영준 ( Young Joon Ahn ) 대한내과학회 2013 대한내과학회지 Vol.85 No.2
We herein report a case of large cell neuroendocrine carcinoma (NEC) of the gallbladder confirmed by laparoscopic surgery. A 60-year-old male was HBsAg-positive. Abdominal computed tomography showed a 2.5 × 2.5 cm enhancing polypoid mass in the gallbladder and multiple masses in liver segments 4 and 5 that enhanced in the arterial phase and washed out in the delayed phase. Liver biopsy findings showed only poorly differentiated morphology. A laparoscopic operation was performed for diagnosis of the masses because curative resection seemed impossible to perform, which showed unusual findings of either hepatocelluar carcinoma or gallbladder cancer. Therefore, laparoscopic liver biopsy and cholecystectomy were performed. The final pathologic results of the masses showed large cell NEC of the gallbladder with liver metastasis. Central bisegmentectomy and extensive lymph node dissection were ultimately performed. The patient was still alive 16 months after diagnosis. (Korean J Med 2013;85:183 187)