Ki-1 임파종 1 예

김용진,김경재,박재복,이지현,안기성,강민모,최석문,황기석 대한내과학회 1993 대한내과학회지 Vol.45 No.4

A 60-year-old man was admitted to our hospital complaining of fever with chillness and anarexia for 12 weeks. Physical examination revealed supraclavicular lymphadenopathy and left inguinal lymphadenopathy. Abdominal CT scan showed the evidence of maked lymphadenopathy on retraperitoneal, external iliac, obturator, left inguinal, and celiac lymph nodes. A pathologic diagnosis of Ki-1(+) lymphoma was made by the biopsed supraclavicular lymph node because the node consisted of large cells with pleomorphic nuclei, scanty cytoplasm, large basophilic nucleoli, atypical vacuoli and large cells were positive for leukocyte common antigen, Ber-H2, marker, and B-cell marker.

전신성 홍반성 낭창의 임상적 고찰

신영태,김종학,장윤경,양종오,구영선,강민규,황평주,나기량,이강욱,서광선 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

The epidemiology, diagnostic criteria, clinical features, symptoms and signs laboratory findings, kidney pathology, and clinicopathologic correlation of systemic lupus erythematosus(SLE) were analyzed. The 63 patients studied were managed at the Department of Internal medicine, CNUH, from January 1983 to December 1997. Kidney biopsy was performed in 53 patients out of 63 patients with SLE. The results were as follows: 1. The ratio of male to female was 1:26. They were 12 to 71 years old and mean age was 32.1 years old. The peak age incidence was 4th decades(30%). 2. The most frequent chief complaint on admission was generalized edema. Most patients complain two or more symptoms. 3. Immunologic and renal disorders were the most frequently observed in the ARA criteria of SLE. And the positive ANA, hematologic disorder, malar rash, and arthritis, were observed in order of frequency. 4. Among the 53 patients with renal biopsy, 30 patients revealed class Ⅳ lupus nephritis(56%), class II in 12 patients(23%), class V in 8 patients(15%) and class III in 2 patients(6%). 5. The cases of lupus nephritis represented as nephrotic syndrome were high in the class IV with 68% and class V with 86%. 6. Of 30 patients who can be followed up, 5 patients resulted in death(17 % of mortality). They "were 14 to 57 years old and mean age was 28 years old. Follow up duration were from 1 month to 6 years and 3 months, and mean duration was 1 year and 1 month, but 3 cases 7. The causes of death were as follows: Two cases were due to seizure and coma resulted from CNS involvement. One was sepsis due to miliary the & pneumonia. One was dilated cardiomyopathy and heart failure due to cardiac ac involvement. And the other one was sepsis and acute renal failure resulted from cellulitis. 8. Prednisolone was used in all patients basically, and methyl-prednisolone pulse therapy, antimalarials and alkylating agents were used in some cases. In the cases of combined therapy, the activity of SLE was well controlled.

24시간 혈압 감시를 통한 만성 뇌졸중 환자에서의 야간 혈압 강하 현상의 연구

정산,이병철,유경호,정승철,김성민,권기한,황성희 대한신경과학회 1996 대한신경과학회지 Vol.14 No.4

한국의 발톱진균증 환자의 삶의 질에 관한 연구

조백기,박종갑,김형옥,김성욱,백승철,김진우,김시용,안규중,전재복,오지원,김낙인,이규석,오칠환,김수남,김상태,손숙자,신용우,김동석,이원우,권경술,서대헌,황규왕,이종석,고재경,강원형,정기양,최응호,김기홍,박석돈,강승주,함정희,명기범,김방순,구상완,김병수,원영호,김한욱,송은섭,정병수,노병인,홍창권,박장규,한지윤,김광중,구대원,김종민,김재홍,유희준,양경미 대한의진균학회 1998 대한의진균학회지 Vol.3 No.2

Background: Onychomycosis, especially toenail onychomycosis has become one of the common fungal infection and has historically been regarded as a cosmetic rather than medical problem by many patients, even by physicians. Recently, however, there are several reports that is a refractory disease which may cause a deleterious effect on patiets quality of life (QOL). Objective: The purpose of this study was to investigate the impact of toenail onychomycosis on QOL in Korea and to assess the chandes of QOL after treatment. Methods: Total 1004 patients with toenail onychomycosis which was confirmed by clinical findings and KOH preparation were were enrolled at 47 dermatologic centers in Korea, and interviewed with standardized QOL questionnaire before and after sytemic antifungal treatment. Responses to the questionnaire were scored by 5-point scale (1∼4) and averaged, and were analyzed for 5 dimensions of emotional impact, social impact, symptorn and functional impact, patients views concerning treatment, and relationship with doctor. Results: 1. Before and after treatment, the most serious impact was emotional dimension showing 1.90 and 1.30 in average score (AS), and social (AS: 1.14 and 0.83) and symptom and functional impact (AS: 1.05 and 0.92) was also affected. 2. In female rather than male, statistically more significant impact on patients QOL was observed in all dimensions. 3. After treatment, 3 of 5 dimensions were improved significantly - emotional dimension (AS : from 1.90 to 1.30), social dimension (AS: from 1.14 to 0.83), patients view concerning treatment (AS: from 1.34 to 1.02). 4. The drgree of patients satisfaction at the therapeutic effect was very high- 62.4% (immediately after treatment) and 65.8% (9 months affer initiation of treatment) of patients answered excellent or good. Conclusion: This study confirms that toenail onychomycosis has significant impact on the overall QOL of patients. Also the effect of antifungal therapy on patients QOL were watisfactory. Therefore, both doctor and patient should pay more attention to the treatment of onychomycosis. [Kor J Med Mycol 3(1): 115∼124]

Gallstone spillage caused by spontaneously perforated hemorrhagic cholecystitis.

Kim, Young Chul,Park, Mi-Suk,Chung, Yong Eun,Lim, Joon Suk,Kim, Myeong-Jin,Kim, Ki Whang WJG Press 2007 WORLD JOURNAL OF GASTROENTEROLOGY Vol.13 No.41

<P>There are occasional incidences of gallstone spillage during laparoscopic cholecystectomy, and there have been frequent reports on such a topic in the literature. To the best of our knowledge, however, there have been no reports about spilled stones caused by spontaneously perforated hemorrhagic cholecystitis. Here, we report the radiologic findings of spilled stones caused by spontaneously perforated hemorrhagic cholecystitis in a 55-year-old man.</P>

Potential Conditions Causing Impairment of Selective Hepatobiliary Enhancement of Gadobenate Dimeglumine-Enhanced Delayed Magnetic Resonance Imaging

Kim, Honsoul,Kim, Myeong-Jin,Park, Mi-Suk,Cha, Seung-Whan,Lim, Joon Seok,Yoo, Hyung Sik,Kim, Ki Whang Lippincott Williams Wilkins, Inc. 2010 Journal of computer assisted tomography Vol.34 No.1

OBJECTIVE:: To identify conditions that might impair the delayed selective hepatobiliary enhancement of gadobenate dimeglumine. MATERIALS AND METHODS:: Ninety-five gadobenate-enhanced magnetic resonance imaging studies were retrospectively and independently analyzed. The effects of selective hepatic enhancement and biliary excretion were each categorized into 3 grades according to the perceived difference of signal intensity between the liver parenchyma and portal vein, and signal intensity in the common bile duct of precontrast- and delayed-phase images.History of diffuse liver disease, liver cirrhosis, and renal disease; elevated levels of blood urea nitrogen (BUN)/creatinine (Cr), aspartate aminotransferase (AST)/alanine aminotransferase, bilirubin, and alkaline phosphatase (ALP); ascites; and splenomegaly were compared according to the grade of hepatic and biliary enhancement. RESULTS:: Diffuse liver disease (P = 0.002); cirrhosis (P < 0.001); renal disease (P = 0.022); ascites (P = 0.001); splenomegaly (P < 0.001); and elevated levels of BUN (P = 0.001), Cr (P = 0.003), AST (P < 0.001), bilirubin (P < 0.001), and ALP (P < 0.001) were factors that impaired selective hepatic enhancement. Biliary excretion was affected by the presence of liver disease (P < 0.001), cirrhosis (P < 0.001), splenomegaly (P < 0.001), ascites (P = 0.002), and elevated levels of Cr (P = 0.013), AST (<0.001), alanine aminotransferase (P = 0.001), bilirubin (P < 0.001), and ALP (P < 0.001). CONCLUSION:: Delayed selective hepatobiliary enhancement of gadobenate dimeglumine can be impaired by liver or renal disease and/or by elevated levels of bilirubin, ALP, BUN, and Cr.

Can microvessel invasion of hepatocellular carcinoma be predicted by pre-operative MRI?

Kim, Honsoul,Park, Mi-Suk,Choi, Jin Young,Park, Young Nyun,Kim, Myeong-Jin,Kim, Kyung Sik,Choi, Jin Sub,Han, Kwang-Hyub,Kim, EunJu,Kim, Ki Whang Springer-Verlag 2009 EUROPEAN RADIOLOGY Vol.19 No.7

Restaging of Rectal Cancer with MR Imaging after Concurrent Chemotherapy and Radiation Therapy.

Kim, Dae Jung,Kim, Joo Hee,Lim, Joon Seok,Yu, Jeong-Sik,Chung, Jae-Joon,Kim, Myeong-Jin,Kim, Ki Whang The Society 2010 Radiographics Vol.30 No.2

<P>In patients with rectal cancer who have received concurrent chemotherapy and radiation therapy (CCRT) before surgery, magnetic resonance (MR) imaging has low accuracy in prediction of the pathologic stage owing to overstaging or understaging. The factors related to this problem include fibrosis, desmoplastic reaction, edema, inflammation, and viable tumor nets at a fibrotic scar from a previous tumor. Preoperative diagnosis with MR imaging of histologic variants of rectal adenocarcinoma, especially mucinous adenocarcinoma, is important because these variants tend to have a poor response to CCRT. In addition, these variants manifest with high signal intensity on T2-weighted images after CCRT; this finding makes it difficult to differentiate residual tumors from remaining mucin pools. MR volumetry and functional MR imaging may be helpful in prediction and assessment of tumor response to CCRT. Awareness of post-CCRT changes helps radiologists achieve appropriate restaging of irradiated rectal cancer with MR imaging and can lead to a reduction in understaging or overstaging. It is important to obtain and compare both pre- and post-CCRT images before interpreting the post-CCRT images.</P>

Rectal Cancer: Comparison of Accuracy of Local-Regional Staging with Two- and Three-dimensional Preoperative 3-T MR Imaging.

Kim, Honsoul,Lim, Joon Seok,Choi, Jin Young,Park, Jaeseok,Chung, Yong Eun,Kim, Myeong-Jin,Choi, Eunhee,Kim, Nam Kyu,Kim, Ki Whang Radiological Society of North America 2010 Radiology Vol.254 No.2

<P>Purpose: To compare the local-regional staging accuracy of the conventional two-dimensional (2D) T2-weighted imaging protocol and of the three-dimensional (3D) T2-weighted imaging protocol for preoperative magnetic resonance (MR) imaging in rectal cancer patients. Materials and Methods: This retrospective study was approved by the institutional review board, and a waiver of informed consent was obtained. A review was conducted of 109 preoperative 3-T MR images obtained with 2D and 3D T2-weighted imaging protocols in rectal cancer patients. Two radiologists independently assessed the radiologic findings for T and N category lesions, conspicuity of tumor margin, and image quality of 2D and 3D data. Interactive multiplanar reconstruction was performed for 3D data analysis. The linear weighted kappa values for T2-weighted imaging staging results (2D and 3D data) and histopathologic staging results were calculated and compared. Wilcoxon signed rank test was performed to compare tumoral conspicuity and overall image quality. Results: T category lesion staging accuracy values for 2D and 3D data, respectively, were 66.0% and 67.0% for reviewer 1 (P = .465) and 63.3% and 56.9% for reviewer 2 (P = .402). N category lesion staging accuracy values for 2D and 3D T2-weighted images, respectively, were 64.2% and 57.8% for reviewer 1 (P = .427) and 47.7% and 62.4% for reviewer 2 (P = .666). Tumor conspicuity was better for 2D T2-weighted imaging, but no significant difference in image quality was observed. Conclusion: Preoperative MR imaging in rectal cancer patients for staging with conventional 2D and multiplanar reconstruction 3D T2-weighted imaging protocols showed no significant differences in accuracy of T and N category staging and overall image quality, as determined by degree of artifact. However, the 3D T2-weighted imaging protocol had limitations in regard to lesion conspicuity. (c) RSNA, 2010.</P>

Comparison of diffusion‐weighted mri and mr volumetry in the evaluation of early treatment outcomes after preoperative chemoradiotherapy for locally advanced rectal cancer

Kim, Young Chul,Lim, Joon Seok,Keum, Ki Chang,Kim, Kyung Ah,Myoung, Sungmin,Shin, Sang Joon,Kim, Myeong‐,Jin,Kim, Nam Kyu,Suh, Jinsuk,Kim, Ki Whang Wiley Subscription Services, Inc., A Wiley Company 2011 Journal of magnetic resonance imaging Vol.34 No.3

<P><B>Abstract</B></P><P><B>Purpose:</B></P><P>To compare diffusion‐weighted imaging (DWI) and magnetic resonance (MR) volumetry for predicting treatment outcomes of locally advanced rectal cancers with preoperative chemoradiotherapy (CRT).</P><P><B>Materials and Methods:</B></P><P>This prospective study was approved by our Institutional Review Board. Thirty‐four patients underwent three MR examinations: pre‐CRT (before CRT), early CRT (2 weeks after CRT initiation), and post‐CRT (before surgery). The tumor apparent diffusion coefficient (ADC), ADC increase rate, and volume reduction rate were compared between responders and nonresponders using three reference standards: downstaging, modified Response Evaluation Criteria in Solid Tumors (mRECIST), and tumor regression grade (TRG). For DWI and volumetry, differences between responders and nonresponders were assessed by receiver operating characteristic analysis.</P><P><B>Results:</B></P><P>The median early tumor volume reduction rate of responders, subgrouped by downstaging and mRECIST (47.97% and 53.97%, respectively), was significantly higher than that of nonresponders (20.94% and 20.36%; <I>P</I> = 0.0024 and 0.0001, respectively), but there were no significant differences in pre‐CRT ADC and early ADC increase rate using all references. When using the downstaging and mRECIST, the diagnostic performance of early tumor volume reduction rate (Az = 0.81 and 0.94, respectively) was higher than that of pre‐CRT ADC (Az = 0.55 and 0.62; <I>P</I> = 0.033 and 0.007) and early ADC increase rate (Az = 0.58 and 0.64; <I>P</I> = 0.055 and 0.01) for predicting the treatment outcome. For TRG, there were no significant differences between DWI and volumetry.</P><P><B>Conclusion:</B></P><P>Early tumor volume reduction rate at the second week after CRT initiation may be a better indicator than DWI based on the mean ADC measurements for predicting CRT treatment outcome. J. Magn. Reson. Imaging 2011;. © 2011 Wiley‐Liss, Inc.</P>