선상 편평상피세포암

장홍준(Hong Zoon Jang),이근수(Geun Soo Lee),김종민(Jong Min Kim),이종주(Chong Ju Lee) 대한피부과학회 1990 대한피부과학회지 Vol.28 No.3

We report a case of adenoid squarnous cell carcinoma occurred in a 64-year-old male. The patient had a single, centrally ulcerated nodule with an indurated border on the superior helical rim of the left ear. The histopathologic finding showed a squamous cell carcinoma infiltrating der mis as multiple gland-like structures. The wall of gland-like structure was composed of one to several cell layers and the lumen was filled with dyskeratotic, acantholytic cells. (Kor J Dermatol 28(3): 381 384, 1990)

점액낭종의 임상 및 병리조직학적 고찰

장홍준(Hong Zoon Jang),박혜림(Hye Rim Park),안규중(Kyu Joong Ahn),김종민(Jong Min Kim),이종주(Chong Ju Lee) 대한피부과학회 1990 대한피부과학회지 Vol.28 No.6

Mucoceles usually occur as solitary, asymptomatic, translucent, and dome-shaped cysts containing clear viscous fluid on lower lip or oral mucosa. The authors reviewed the clinical and histopathological findings in 33 patients with mucocele and attempted to clarify the difference between the histopathologic types (retention and extravasation). The results were summarized as follows. 1. Age distribution was from 2 to 53 years and mean age was 21.4 years. Male to female ratio was 1.2:1(18 males.15 females). 2. Histopathologic type was classified. 4 cases(12.1%, mean age.17.3 years) were retention type, 19 cases(57.6%, mean age.'21.5 years) mixed type, and 10 cases(30.3 %, mean age.20.9 years) extravasation type. Among 19 mixed types, 13 cases were retention dominant and 6 cases extravasation dominant. 3. Durations from the onset to the diagnosis could be clarified in 16 cases. Those were below 1 year in 14 cases(87.5% ) and below 3 years in 16 cases all. Mean duration was 9.4 months. 4. The sites of involvement were lower lip(72.7%), tongue(24.3%), and oral mucosa(3.0%), in decreasing order of frequency. 5. The visited departments were otolaryngology(72.7%), dentistry(12.1%), plastic surgery(9,1%) and dermatology(6.1%), in decreasing order of frequency. 6. In the histopathologic observation, surface epithelium was observed in 25 cases (75.8%), cyst in 23 cases(69.7%), granlation tissue in 29 cases(87.9%), mucin in 28 cases(84.8%), surrounding salivary glands in 20 cases(60.6%) and foamy macrophages in 32 cases(97.0% ), 7. Special stains(PAS, D-PAS, and alcian blue at pH2.5 and 0.4) for the mucin were performed in 10 cases. The results were compatible with sialomucin. (Kor J Dsrmatol 28(6):747 757, 1990)

Ito 저색소증

이근수,장홍준,서연림,안규중,김종민,이종주 ( Geun Soo Lee,Hong Zoon Jang,Yeon Lim Suh,Kyu Joong Ahn,Jong Min Kim,Chong Ju Lee ) 대한피부과학회 1990 대한피부과학회지 Vol.28 No.5

A Case of Hypomelanosis of lto Geun Soo Lee, M.D., Hong Zoon Jang, M.D., Yeon Lim Suh*, M.D., Kyu Joong Ahn, M.Dl., Jong Min Kim, M.D., Chong Ju Lee, M.D. Departments of Dermatology and Pathology*, Clooege of Medicine, Hallym University Seoul, Korea We report a case of hypomelansis of Ito developed in a 6-year-old male patient. He had numberous bizarre, hypopigmented streaky macules on the left side of the chest, and upper arm. The histopathologi findings demonstrated that hypopigmented areas contained slightly decreased basal pigmentation with decreased content of intracellualr melanin in keratinocytes and melanocytes and revealed neither inflammatory changes nor dropping of melanin granule into the dermis. The electron microscopic finding showed decreased number of melanosomes, incomplete melaniztion, and cytoplasmic vacuoles in keratinocytes and melanocytes. Extra-cutaneous alterations were not found.

모기질종의 임상 및 병리조직학적 소견에 관한 연구

장홍준,백용관,김종민,손진희 ( Hong Zoon Jang,Yong Gwan Baik,Jong Min Kim,Jin Hee Sohn ) 대한피부과학회 1997 大韓皮膚科學會誌 Vol.35 No.4

Background: Pilomatricoma is a rare benign follicular tumor in Orientals. Objective : Clinical and histopathological features of the tumor were analyzed. Methods: The medical records and histopathological slides of 19 tumors from 17 patients with pilomatricoma were studied. Results : The morphology of the tumors were divided into 3 groups :1) elevated, uniform nodules(16 cases), 2) elevated, multilobulated nodules(2 cases), and 3) non-elevated, uniform nodules (1 case). Histologically, the tumors were composed of shadow cells, transitional cells, basaloid cells and squamous cells. Changes of the stroma within the tumors and the stroma overlying the tumors included vascular dilatation, RBC engorgement and infiltration of inflammatory cells. Changes of the epidermis overlying the tumors were found in 14 cases and included hyperkeratosis(14 cases), follicular plugging(2 cases), epidermis invagination(5 cases) and acanthosis nigricans-like change(3 cases). Conclusion: Clinically, pilomatricomas manifested as either a solitary nodule or two nodules. Histologically, several tumors showed palisading of basaloid cells, retraction spaces, lymphoid follicles and acanthosis nigricans-liike epidermal changes in addition to the classic features of pilomatricoma. (Kor J Dermatol 1997;35(4): 693-701)

Comparative Analysis of the Patients with Spontaneous Thalamic Hemorrhage with Concurrent Intraventricular Hemorrhage and Those without Intraventricular Hemorrhage

Nam Taek Min,Jang Ji Hwan,Kim Seung Hwan,Kim Kyu Hong,Kim Young Zoon 대한의학회 2021 Journal of Korean medical science Vol.36 No.1

Background: This study aimed to compare the characteristics of patients with spontaneous thalamic hemorrhage (STH) accompanied by intraventricular hemorrhage (IVH) with those of patients without IVH. Methods: The medical records of consecutive patients with STH admitted to our institute between January 2000 and December 2018 were reviewed retrospectively. The laboratory and radiological results, mortality, and functional recovery were compared between the STH patients with IVH and those without IVH. Results: Among 2,389 patients with spontaneous intracerebral hemorrhage, 233 (9.8%) patients were included in this study. Concurrent IVH was detected in 159 (68.2%) patients with STH, and more frequently in those with body mass index ≥ 25, Glasgow Coma Scale score of 3–8, underlying disease, family history of stoke, posterior/medial/global location of hematoma, ventriculomegaly, large volume of hemorrhage, and midline shift ≥ 5 mm. The 3-month mortality was 25.8% and 8.1% (P = 0.039), the rate of good functional recovery at 6 months was 52.2% and 31.0% (P = 0.040), and incidence of delayed normal pressure hydrocephalus (NPH) at 12 months was 10.8% and 24.5% (P = 0.062) in the STH patients with IVH and those without IVH, respectively. At 12 months, delayed NPH developed in 28 of 47 (59.6%) patients who received external ventricular drainage (EVD)-based treatment, 5 of 45 (11.1%) patients who underwent endoscopic evacuation-based treatment, and 8 of 45 (17.8%) patients who underwent other surgeries. Conclusion: Concurrent IVH is strongly associated with mortality in patients with STH. Delayed NPH may develop more frequently in STH patients with IVH who were treated with EVD.

Stent-assisted Coil Embolization of Petrous ICA in a Teenager with Neurofibromatosis

Sang Hyuk Lee,Young Zoon Kim,Ji Hwan Jang,Kyu Hong Kim 대한뇌혈관외과학회 2015 Journal of Cerebrovascular and Endovascular Neuros Vol.17 No.3

We herein report on a patient with a cerebral aneurysm located at the petrous portion of the internal carotid artery (ICA). An 18-year-old male, previously diagnosed with neurofibromatosis, was referred to our emergency service complaining of severe headache, pulsatile tinnitus, nausea, and vomiting which occurred suddenly. Neuro-radiological studies including computed tomography and magnetic resonance imaging of the cerebral artery showed a large aneurysm arising from the petrous segment of the left ICA. He was treated with a neuro-interventional technique such as intra-arterial stenting and coil embolization for the aneurysm. Several days after the interventional treatment, his symptoms were resolved gradually except for a mild headache. Symptomatic unruptured aneurysm at the petrous portion of the ICA is rare, and our patient was treated successfully using a neuro-intervention technique. Therefore, we describe a case of a petrous aneurysm treated with endovascular coils without compromising the ICA flow, and review the literature.

례악성 송과체 종양의 연수막 파종과 유사한 발현을 가진 송과체 세포종 환자에서 발생한 유방암의 종양성 뇌수막염 -증례보고-

장지환 ( Ji Hwan Jang ),김규홍 ( Kyu Hong Kim ),양근영 ( Geun Young Yang ),김영준 ( Young Zoon Kim ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2012 대한뇌종양학회지 Vol.11 No.1

Neoplastic meningitis is a relatively rare, but serious late-stage complication of brain metastasis from systemic cancer. A 37-year-old woman presented with complaints of altered mentation, nausea and vomiting. Computed tomography (CT) and magnetic resonance imaging of brain revealed a patchy enhancement with gadolinium contrast of leptomeninges over the cerebral convexities and in basilar cistern, insulae, all the recesses, and ventricular walls. By neuroendoscopy, we performed third ventriculostomy and biopsy of pineal mass, which revealed a histopathologically-pure pineocytoma. The unexpected observation of cells floating in the ventricle was consistent with adenocarcinoma. In systemic work up, Cancer Antigen (CA) 15-3 was markedly increased in serum, and multiple enhanced masses were found in the breast, lung, axial lymph node, and vertebrae on positron emission tomography-CT. Ultrasonography-guided biopsy of breast mass suggested poorly differentiated adenocarcinoma. Herein, we report a rare case of neoplastic meningitis of breast cancer in the patients with a pineocytoma.

Diffusion-weighted imaging-positive lesions following endovascular treatment for ruptured and unruptured aneurysms: Its incidence according to antithrombotic drugs

Lee Sang Hyuk,Kim Seung Hwan,Jang Ji Hwan,Kim Young Zoon,Kim Kyu Hong,남택민 대한뇌혈관외과학회 2022 Journal of Cerebrovascular and Endovascular Neuros Vol.24 No.3

Objective: Microembolic infarcts are frequently observed on diffusion-weighted imaging (DWI) following endovascular treatment. We investigated DWI-positive lesions and symptomatic ischemic complications (SICs) in patients with ruptured and unruptured aneurysms following coiling and the relationship between DWI-positive lesions and antithrombotic drugs. Methods: Between January 2016 and December 2020, 83 patients underwent DWI within 48 h following endovascular treatment for ruptured (n=30) and unruptured (n=53) aneurysms. Results: The overall rate of DWI-positive lesions was 55.4%. There were no significant differences in the occurrence rate (45.3% vs. 43.3%, p=1.000) and the number of lesions (2.7±4.6 vs. 4.0±5.3, p=0.237) between unruptured and ruptured aneurysms. SIC occurred more frequently in patients with ruptured aneurysms than unruptured ones (20.0% vs. 1.9%, p=0.015). The cutoff value of DWI-positive lesions for predicting SIC was 5 (sensitivity 100%, specificity 78.9%). The procedure time was significantly longer in patients with DWI-positive lesions ≥5 than those with DWI-positive lesions <5 (104.1±43.8 vs. 85.1±30.8 min, p=0.030). Patients with DWI-positive lesions <5 were more frequently observed in the postprocedural heparinization group than in the no heparinization group (85.7% vs. 58.5%, p=0.012). Conclusions: The incidence of DWI-positive lesions did not differ significantly between the ruptured and unruptured aneurysms. However, SIC occurred more frequently in patients with ruptured aneurysms. Longer procedure time is a risk factor for DWI-positive lesions, and postprocedural heparinization seems to reduce the incidence of DWI-positive lesions.

Recent Trends in the Withdrawal of Life-Sustaining Treatment in Patients with Acute Cerebrovascular Disease : 2017–2021

Seung Hwan Kim,Ji Hwan Jang,Young Zoon Kim,Kyu Hong Kim,Taek Min Nam 대한신경외과학회 2024 Journal of Korean neurosurgical society Vol.67 No.1

Objective : The Act on Life-Sustaining Treatment (LST) decisions for end-of-life patients has been effective since February 2018. An increasing number of patients and their families want to withhold or withdraw from LST when medical futility is expected. This study aimed to investigate the status of the Act on LST decisions for patients with acute cerebrovascular disease at a single hospital. Methods : Between January 2017 and December 2021, 227 patients with acute cerebrovascular diseases, including hemorrhagic stroke (n=184) and ischemic stroke (n=43), died at the hospital. The study period was divided into the periods before and after the Act. Results : The duration of hospitalization decreased after the Act was implemented compared to before (15.9±16.1 vs. 11.2±18.6 days, p=0.127). The rate of obtaining consent for the LST plan tended to increase after the Act (139/183 [76.0%] vs. 27/44 [61.4%], p=0.077). Notably, none of the patients made an LST decision independently. Ventilator withdrawal was more frequently performed after the Act than before (52/183 [28.4%] vs. 0/44 [0%], p<0.001). Conversely, the rate of organ donation decreased after the Act was implemented (5/183 [2.7%] vs. 6/44 [13.6%], p=0.008). Refusal to undergo surgery was more common after the Act was implemented than before (87/149 [58.4%] vs. 15/41 [36.6%], p=0.021) among the 190 patients who required surgery. Conclusion : After the Act on LST decisions was implemented, the rate of LST withdrawal increased in patients with acute cerebrovascular disease. However, the decision to withdraw LST was made by the patient’s family rather than the patient themselves. After the execution of the Act, we also observed an increased rate of refusal to undergo surgery and a decreased rate of organ donation. The Act on LST decisions may reduce unnecessary treatments that prolong end-of-life processes without a curative effect. However, the widespread application of this law may also reduce beneficial treatments and contribute to a decline in organ donation.

Impact of the Coronavirus Disease Pandemic on Patients with Head Injuries in South Korea

남택민,Do-Hyung Kim,Ji Hwan Jang,Young Zoon Kim,Kyu Hong Kim,Seung Hwan Kim 대한신경외과학회 2022 Journal of Korean neurosurgical society Vol.65 No.2

Objective : The coronavirus disease 2019 (COVID-19) pandemic is affecting the characteristics of patients with head injuries. This study aimed to evaluate the effect of the COVID-19 pandemic on patients with head injuries at a regional emergency medical center in South Korea. Methods : From April 2019 to November 2020, 350 patients with head injuries were admitted to our hospital. The study period was divided into the pre-COVID-19 (n=169) and COVID-19 (n=181) eras (10 months each). Patients with severe head injuries requiring surgery (n=74) were categorized into those who underwent surgery (n=41) and those who refused surgery (n=33). Results : Head injuries in pediatric patients (<3 years) were more frequent in the COVID-19 era than in the pre-COVID-19 era (8.8% vs. 3.6%, p=0.048). More patients refused surgery in the COVID-19 era than in the pre-COVID-19 era (57.9% vs. 30.6%, p=0.021). Refusal of surgery was associated with old age (67.7±14.5 vs. 52.4±19.1, p<0.001), marital status (married, 84.8% vs. 61.0%, p=0.037), unemployment (42.4% vs. 68.3%, p=0.034), COVID-19 era (66.7% vs. 39.0%, p=0.021), and lower Glasgow coma scale scores (6.12±3.08 vs. 10.6±3.80, p<0.001). Multivariable logistic regression analysis revealed that refusal of surgery was independently associated with old age (adjusted odds ratio [OR], 1.084; 95% confidence interval [CI], 1.030–1.140; p=0.002), COVID-19 era (adjusted OR, 6.869; 95% CI, 1.624–29.054; p=0.009), and lower Glasgow coma scale scores (adjusted OR, 0.694; 95% CI, 0.568–0.848; p<0.001). Conclusion : We observed an increased prevalence of head injuries in pediatric patients (<3 years) during the COVID-19 pandemic. Additionally, among patients with severe head injuries requiring surgery, more patients refused to undergo surgery during the COVID-19 pandemic.