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위 인환세포 암종에 관한 점액 조직화학적 및 초미세구조적 연구
공경엽(Gyoung Yub Gong),설미영(Mee Young Sol),이선경(Sun Kyung Lee) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.2
N/A The mucin histochemical and ultrastructural studies in signet ring cell carcinoma of stomach were performed for the purpose of investigating phenotypic expression of tumor cells and its histogenesis. The specirnens used in this study were 57 cases of gastric sig- net ring cell carcinoma (12 cases of early cancer and 45 cases of advanced one) which were obtained by gastrectomy during 1990-1991 in Pusan National University Hospital. The specimens were studied with the mucin histochemical stainings of paradoxical concanavalin A, galactose oxidase-Schiff sequence, sialidase galactose oxidase-Schiff reac- tion and periodate borohydride technique/potassiurn hydroxide/periodic acid Schiff proce- dure, and transmission electron microscopic examination. This study disclosed that cancer cells of the signet-ring cell carcinoma could be classified into gastric type (pyloric gland cell type and surface mucous cell type) and intestinal type (small and large bowel goblet cell types, and intestinal absorptive type). Among 57 cases of gastric carcinoma examined, 37 cases(64.9%) consisted of gastric type cells, 3 cases(5.7%) and 17 cases(29.3%) were com- posed of intestinal type cells and rnixed cell population, respectively. There was no statis- tically significant difference in frequency among mucous cell types on the aspect of the site of origin. In 12 cases of early carcinoma, there were 9 cases of pure gastric (75.0%) and 3 cases of mixed type cells(25.0%). In 45 cases of advanced carcinoma, there were 28 cases of gastric(62.2%), 3 cases of intestinal(6.7%), and 14 cases of mixed type cells (31.1 %). According to the result, intestinal type cells were more prevalent in advanced cases than early ones. On the basis of this study it is suggested that gastric signet ring cell carcinoma arises in the nonmetaplastic gastric mucosa while intestinal type cells were developed by intestinal metaplasia within the signet-ring cell carcinoma during advancement of the lesion.(Korean J Gastroenterol 1994; 26: 239 250)
자궁경부질 도말 검사 정도 관리과정으로서의 세포 및 조직진단의 비교 분석과 10% 무작위 재선별과의 비교 분석
윤길숙,허주령,손경희,김온자,공경엽,Yoon, Ghil-Suk,Huh, Joo-Ryung,Son, Kyung-Hee,Kim, On-Ja,Gong, Gyung-Yub 대한세포병리학회 1998 대한세포병리학회지 Vol.9 No.2
Although the success of the Papanicolaou test as a screening tool of cervical cancer is evident, there still exists $2{\sim}5%$ of discrepancy rate by both human and machine. To improve the qualilty of cervico-vaginal cytology, the authors compared cervicovaginal smear with cervical biopsy diagnoses, and analysed the causes of discrepancies. Among 30,922 cervicovaginal smears from June 1996 to April 1997 at our hospital, there were 271 cases of cervicovaginal smear with subsequent cervical punch or LEEP cone biopsies within several months. The biopsies and smears from a total of 98 discordant cases were reviewed. The discrepancy was attributed to sampling errors in 43 cases(43.9%), and to cytologic diagnosis in 49 cases(50.0%). Among these, 43 cases were interpretative errors(categories A;19, B;16 and C;8) whereas six cases were screening errors(categories B:2 and C:4). Among cervical biopsy cases, errors were present in four. As for 10% random rescreening, cytotechnologists reviewed 3,196 of 30,922 smears during the same period, There were 43 cases of screening error(categories A;27, B;16). Cytologic/histologic correlation was superior to 10% random rescreening of negative cases. The most effective method for quality improvement in cervicovaginal cytology was to implement both quality control(rescreening) and qualify assurance(cytologic/histologic correlation) programs.
세포 병리 자문 재판독의 진단 불일치에 관한 연구: 서울아산병원의 경험
박소형,노재윤,조경자,공경엽,조영미,강신광,Park, So-Hyung,Ro, Jae-Y.,Cho, Kyung-Ja,Gong, Gyung-Yub,Cho, Yong-Mee,Khang, Shin-Kwang 대한세포병리학회 2008 대한세포병리학회지 Vol.19 No.2
Background : Second opinion diagnosis of outside pathology slides is a common practice for efficient and proper patient management. We analyzed cytology slides from outside hospitals submitted for a second opinion diagnosis to determine whether the second opinion diagnosis had any influence on patient care. Methods : We reviewed 1,153 outside cytology slides referred to Asan Medical Center for second opinions from January, 2007, to December, 2007. All cases were categorized into three groups; no diagnostic discrepancy, minor diagnostic discrepancies (no impact on the management), and major diagnostic discrepancies (significant impact on the management and subsequent follow-up). Results : The thyroid was the most common organ system (933 cases, 80.9%), Forty cases (3.6%) belonged to the major diagnostic discrepancy group and 149 cases (12.8%) to the minor discrepancy group. For validation of second opinion diagnoses in major discrepancy cases, subsequent biopsy or surgical resection specimens and clinical information were reviewed, which were available in 29 cases. The second opinion diagnoses resulted in alteration of clinical management in 21 of 29 cases. Conclusion : For all referred patients, second opinion diagnosis is important and mandatory for appropriate patient care.
자궁경부 세포검사에서 기존 도말과 AutoCyte PREP의 비교
장재정,김정선,조경자,강신광,남주현,공경엽,Jang, Jae-Jung,Kim, Jung-Sun,Cho, Kyung-Ja,Khang, Shin-Kwang,Nam, Joo-Hyun,Gong, Gyung-Yub 대한세포병리학회 2002 대한세포병리학회지 Vol.13 No.1
This study was designed to compare the performance of liquid-based preparation from the AutoCyte PREP with the conventional cervicovaginal smear in masked split-samples. In randomly selected 840 cases, the conventional smear was always prepared first, and the AutoCyte PREP used the resldual cells on the collecting device. Parallel AutoCyte PREP slides and matched conventional smears were screened in a blind fashion. All abnormals and 10% random normal cases were reviewed by two pathologists in a blind fashion. The Bethesda System was used for reporting the diagnosis and specimen adequacy. The diagnoses from the two methods were agreed exactly in 767(91.3%) of 840 cases. The AutoCyte PREP demonstrated a 25% overall improvement in the detection of squamous intraepithelial lesion(SIL). The ratio of ASCUS to SIL was decreased as 0.45 compared with 1.00 of conventional smear. The AutoCyte PREP produced excellent cellular preservation and superior sensitivity for detection of atypical cells as compared to the conventional smear. It makes us to be able to subclassify ASCUS into from WNL to HSIL. We thought that the AutoCyte PREP method might contribute to increase the detection rate of abnormal cells than conventional methods.
직장암에서 (99m)Tc-항CEA 항체 F(ab`)₂분절을 이용한 수술전 방사면역신티그라피 및 방사면역지침수술에 관한 기초연구
류진숙(Jin Sook Ryu),김진천(Jin Choen Kim),김창남(Chang Nam Kim),공경엽(Gyung Yub Gong),이희경(Lee Kyung Lee) 대한핵의학회 2000 핵의학 분자영상 Vol.34 No.3
N/A Purpose: This prospective study was performed to evaluate the usefulness of preoperative radioimmu-noscintigraphy and intraoperative scintimetric examination (radioimmunoguided surgery: RIGS) using (99m)Tc-anti-CEA F(ab')₂, fragment. Materials and Methods: Nineteen patients with rectal cancer underwent preoperative whole body planar scintigraphy at 4 hours after injection of (99m)Tc-anti-CEA F(ab')₂, fragment and SPECT imaging at 18 hours. Surgical operation was performed at 24 hours after injection. During laparotomy, radioactivities from intraabdominal viscera were measured by gamma probe. The radioac-tivities from excised tumor and lymph nodes were also measured and compared with pathology. Results: All nineteen patients were confirmed to have adenocarcinomas in the rectum. Twenty-seven of 97 excised lymph node groups had metastasis and 2 patients had liver metastasis in pathology. Preoperative radioim- munoscintigraphy detected primary tumors in 11 patients (sensitivity 55% ) and it couId not detect any lymph nodes or liver metastasis. All patients showed high radioactivity in the kidneys, liver, spleen, and major vessels in intraoperative measurement by gamma probe, and tumor activity was not discriminated from background activity. However, ra4ioactivity from excised tumor was higher than normal rectum (T/B ratio; 3.47±2.25). When excised lymph node activity/background activity ratio >1,5 was considered as positive criteria of metastasis, sensitivity, specificity, positive and negative predictive values were 78.6%, 73.9%, 55.0% and 89.5%, respectively. Conclusion: Radioimmunoscintigraphy using (99m)Tc-anti-CEA F(ab')₂. has no additional value for preoperative staging and use of early RIGS using (99m)Tc-anti-CEA F(ab')₂is inappropriate. For early RIGS using (99m)Tc labeled antibodies in rectal cancer patients, further development of more specific antibodies and methods to reduce background activity are needed. (Korean J Nucl Med 2000;34:243-51)
췌관경 소견이 특징적이었던 Mucinous Ductal Ectasia 2예
김해경,김명환,이성구,유병무,민영일,박효숙,공경엽,김연석,정성애,명승재,서동완 대한소화기내시경학회 1996 Clinical Endoscopy Vol.16 No.4
We report two cases of mucinous ductal ectasia of the pancreas which showed characteristic pancreatoscopic findings. They also showed characteristic duodenoscopic findings such as patulous ampullary orifice and mucus leakage from the papilla, and underlying pathology was hyperplasia in one case and adenoma in the other case, The insertions of pancreatoscope into the main pancreatic duct were easy without previous sphincterotomy and whitish frog egg-like mucosa was noted in one case and finger-like papillary projection was noted in the other case.
김해경,김명환,서동완,윤광희,유병무,민영일,공경엽,이재균,최재원,김연석,명승재,송병철,신은석 대한소화기내시경학회 1998 Clinical Endoscopy Vol.18 No.1
Biliary Papillomatosis is an extremely rare pathologic entity. Only about 40 cases of intrahepatic or diffuse intra- and extrahepatic papillomatosis have been described since the first report in 1959 by Caroli. Although this is a histologically benign lesion, its course is unfavaurable because of its tendency to extend to the entire biliary tract, high recurrence rate following local excision and the probability of progression to malignancy. We described herein a case of biliary papillomatosis associated with diffuse bile duct dilatation. The patient, a 59-year-old male, was admitted to our hospital because of right upper abdominal pain and weight loss. Cholangiogram revealed multiple round filling defects in common hepatic duct with intrahepatic bile duct dilatation. The patient underwent Whipple's operation with right lobectomy. Grossly, multiple small pin-head sized polypoid masses were seen in common bile duct, common hepatic duct and right intrahepatic duct. Microscapically, papillary epithelial hyperplasia with moderate cellular atypia was seen and there was no evidence of stromal invasion. He is healthy with a follow-up for 7 months.
이정희,류진숙,공경엽,김기수,홍석준,송영기 대한내분비학회 1998 Endocrinology and metabolism Vol.13 No.4
The origins of medullary carcinoma and papillary carcinoma of thyroid are embryologically different. We report a case of simultaneous occurrence of medullary carcinoma and papillary carcinoma of the thyroid in the same thyroid gland. In this case, the occurrence of the two tumors may be a coincidence, does not have embryological or genetical significance (J Kor Soc Endocrinol 13:634-639, 1998).