경피경간 담배액술 : 175예의 분석

서경진 대한영상의학회 1990 대한영상의학회지 Vol.26 No.4

Percutaneous transhepatic biliary drainage is a safe, effective and palliative means of treatment in biliary obstruction, especially in cases with malignant obstruction which are inoperable. 175 cases of transhepatic biliary drainage were performed on 119 patients with biliary obstruction from January 1985 to June 1989 at kyung-pook National University Hospital. The causes of obstructive jaundice were 110 malignant diseases and 9 benign diseases. The most common indication for drainage was pilliative intervention of obstruction secondary to malignant tumor in 89 cases. 86 cases of external drainage were performed including 3 cases of left duct approach, 29 cases of external-internal drainage and 60 cases of endoprosthesis. In external and external-internal drainages, immediate major complications(11.9%) occured, including not restricted to, but sepsis, bile peritonitis and hemobilia. Delayed major complications942.9%) were mainly catheter related. The delayed major complicatio of endoprosthesis resulted from obstruction of the internal stent. The mean time period to reobstruction of the internal stent was about 12 weeks. To improve management status, regular follow-up is required, as is education of both patients and their families as to when immediate clinical attention is mandated. Close communication amongst the varying medical specialties involved will ber necessary to provide optimal treatment for each patient.

Ehlers-Danlos 증후군 : 다발성 동맥류와 혈관 촬영의 합병증 Angiography with Complication

서경진 慶北大學校 醫科大學 1990 慶北醫大誌 Vol.31 No.3

A man with Ehlers-Danlos syndrome of the arterial type is described because of an uncommon disease of vascular systems and complications during angiography. He had multiple aneurysms at carotid, hepatic and gastric arteries. Also he suffered from carotid-cavernous fistula. The complications including hemothorax and aortic laceration developed during arteriography.

IgA 신증: WHO 분류와 형태학적 소견에 따른 반정량 점수체계와의 상관관계

서경진,김태정,이교영,심상인,최영진 대한병리학회 2009 Journal of Pathology and Translational Medicine Vol.43 No.3

Background : IgA nephropathy (IgAN) is the most common glomerulonephritis worldwide, and the clinical course of IgAN shows marked variability. Many efforts have made to histologically predict the clinical outcome. There are two methods to classify IgAN. One is mainly based on the glomerular changes, such as the WHO and the Lee and Haas classification systems. The other is a morphologic semi-quantitative scoring system, which counts the changes of the glomerular, tubulointerstitial and vascular structures, respectively. The purpose of this study is to determine whether the WHO classification properly reflects the various morphologic findings of IgAN. Methods : We analyzed 354 cases of IgAN by both the WHO classification system and the semiquantitative scoring system and evaluated the correlations of these two methods. Results : The severity of the glomerular lesions (glomerulosclerosis, capsular adhesion and mesangial matrix expansion) and the tubulointerstitial lesions (interstitial fibrosis, tubular atrophy and interstitial lymphocytic infiltration) are strongly correlated with the increase of the WHO classes of IgAN (Spearman’s rho [R] ≥0.5, p<0.05). There is a weak correlation between crescent formation and the increase of the WHO classes (R=0.3, p<0.05). Conclusions : This study shows that the WHO classification well reflects the severity of various morphologic findings and this suggests a complementary role for the semi-quantitative scoring system in classifying IgAN.

Dermatomyositis in a Patient with Cholangiocarcinoma Detected by an [18F]-Fluorodeoxyglucose Positron Emission Tomography–Computed Tomography Scan

서경진,박진균,조승철,박현경,백해운,이경분,이동수,이경훈 대한암학회 2016 Cancer Research and Treatment Vol.48 No.2

Cholangiocarcinoma with paraneoplastic dermatomyositis (DM) is extremely rare, and the whole body positron emission tomography–computed tomography (PET-CT) finding of paraneoplastic DM is rarely reported. We report a 66-year-old woman with metastatic cholangiocarcinoma, initially presented with bilateral proximal muscle uptake on PET-CT without clinical muscle symptoms. The initial interpretation of the high muscle uptake was metastasis to the muscles. However, while awaiting for chemotherapy, muscle weakness evolved and rapidly progressed. The level of creatine phosphokinase was significantly elevated. Electromyography revealed moderate myopathy, and a muscle biopsy showed degenerating myofibers with variable sizes. The diagnosis of paraneoplastic dermatomyositis was made. This case highlights that, although rare, paraneoplastic dermatomyositis can be present with cholangiocarcinoma. Also, muscle inflammation can precede the clinical muscle symptoms, and paraneoplastic DM should be considered as a possible differential diagnosis in the assessment of cancer patients who present with abnormal muscle tracer uptake in PET-CT scans.

연조직종양의 새로운 WHO 분류를 중심으로: 지방세포종, 섬유모세포성/근육섬유모세포성종, 소위섬유조직구종, 평활근종, 혈관주위종과 근골격종에 대하여

서경진,Suh, Kyung-Jin 대한근골격종양학회 2008 대한골관절종양학회지 Vol.14 No.1

연조직종양의 이해는 과거 10년 동안에 걸쳐 주요 변화와 더불어 실질적인 진보가 있었고, 이를 바탕으로 연조직종양의 새로운 분류가 WHO에 의해 2002년에 이루어졌다. 이 개정은 이전에 발표와 상당히 다른 내용의 접근을 하였고, 이 작업에 유전학과 분자생물학 그리고 임상분야의 전문가들이 참여하였다. 여기에서는 과거에 알고 있었거나 특성이 알려진 많은 종양을 포함하여 새로운 큰 변화나 작은 변화가 일어난 부분에 대해서 정리를 하였다. 이러한 내용을 연조직종양의 새로운 WHO 분류를 중심으로 지방세포종, 섬유모세포성/근육섬유모세포 성종과 소위섬유조직구종, 평활근종, 혈관주위종과 근골격종을 중심으로, 큰 변화와 작은 변화로 나누어서 설명하고 새롭게 소개되는 병명을 소개하고 정리하였다. 이 새로운 WHO의 연조직종양의 분류를 이해하여, 종양의 진단과 예후의 재현을 용이하게 하는 필수적인 지침으로 사용할 수 있을 것으로 생각된다. Soft tissue tumor classifications should be an important part of radiology, oncology and, for clinicians and pathologists, they provide diagnostic instruction and prognostic guidelines. In soft tissue tumor classification systems, the World Health Organization (WHO) classifications have become dominant, enabled by the timely publication of new 'blue books' which included detailed text and numerous good illustrations. The new WHO classification of soft tissue tumors was introduced in 2002. Because the classification represents a broad consensus concept, it has gained widespread acceptance around the globe. This article reviews the changes which were introduced the adipose tumors, fibroblastic/myofibroblastic tumors, so-called fibrohistiocytic tumors, smooth muscle tumors, pericytic tumors and skeletal muscle tumors which have been first recognized or properly classified during the past decade.

상완신경총의 영상

서경진,이정현,이경규 대한자기공명의과학회 2007 Investigative Magnetic Resonance Imaging Vol.11 No.2

상완신경총의 영상 진단은 복잡한 해부학적인 구조와 다양하게 침범하는 병들로 인해 어렵고 도전적이다. 상완신경총 영상 진단의 일차적인 목표는 외상성 손상과 비외상성 손상의구별이다. MRI의 급속경사와 전용표면코일을 이용한 적절한 공간분해능을 가진 영상기기의발전과 이를 이용한 다양한 펄스열의 개발이 상완신경총의 외상성 손상과 비외상성 손상에대한 구별에 많은 도움을 주어 정확한 진단으로 수술 여부의 결정에 이용된다. MRI는 비외상성 상완신경총 병변의 진단에 가장 좋은 영상진단이며, CT 척수강조영술은 상완신경총을침범하는 신경근견열 병변의 검사에 많이 이용된다. 그리고 일반적으로 고화질, 고해상력의MRI 가 상완신경총 비외상성병변의 진단에 일차적인 영상검사로 중요한 역할을 하고 있다.

연조직종양의 새로운 WHO 분류를 중심으로: 혈관종, 연골-골종과 불확실한분화종에 대하여

서경진,Suh, Kyung-Jin 대한근골격종양학회 2008 대한골관절종양학회지 Vol.14 No.2

연조직종양의 분류는 종양학에서 영상의학과의사와 임상을 담당하는 정형외과의사, 종양학자 그리고 병리학자의 진단과 예후의 재현을 용이하게 하는 필수적인 지침이다. 연조직종양의 이해는 과거 10년 동안에 걸쳐 주요 변화와 더불어 진보가 있었고, 이를 바탕으로 연조직종양의 새로운 분류가 WHO에 의해 2002년에 이루어졌다. 이 개정은 이전에 발표된 분류와 많은 부분에서 다른 내용의 접근을 하였고, 이 작업에는 유전학과 분자생물학 그리고 임상분야의 전문가들이 참여하였다. 여기에서는 과거에 알고 있었거나 특성이 알려진 종양을 포함하여 새로운 큰 변화나 작은 변화가 일어난 부분에 대해서 정리를 하였다. 이러한 내용의 연조직종양의 새로운 WHO 분류를 혈관종, 연골-골종 그리고 불확실한분화종을 중심으로, 큰 변화와 작은 변화로 나누어서 설명하고 새롭게 소개되는 병명을 정리하였다. 이 새로운 WHO의 연조직 종양의 분류를 이해하여, 종양의 진단과 예후의 재현을 용이하게 하는 필수적인 지침으로 사용할 수 있을 것으로 생각된다. Soft tissue tumor classifications should be an important part of radiology, oncology and, for orthopedic clinicians and pathologists, they provide diagnostic instruction and prognostic guidelines. In soft tissue tumor classification systems, the World Health Organization (WHO) classifications have become dominant, enabled by the timely publication of new blue books which included detailed text and numerous good illustrations. The new WHO classification of soft tissue tumors was introduced in 2002. Because the classification represents a broad consensus concept, it has gained widespread acceptance around the globe. This article reviews the changes which were introduced the vascular tumors, chondroid-osseous tumors and tumors of uncertain differentiation which have been first recognized or properly classified during the past decade.

Costs and clinical outcomes of patients with diffuse large B-cell lymphoma in first remission: role of PET/CT surveillance

서경진,김기환,김률,변자민,김미소,박진현,김범석,김태민,김진수,최인실,허대석 대한내과학회 2019 The Korean Journal of Internal Medicine Vol.34 No.4

Background/Aims: The role of [18F]-f luorodeoxyglucose positron emission tomography- computed tomography (PET/CT) in patients with diffuse large B-cell lymphoma (DLBCL) in first remission is unclear. Methods: Medical costs within the first 3 years of treatment completion and clinical outcomes of 118 patients with DLBCL in first remission with and without surveillance PET/CT (PET/CT [+] group [n = 76] and PET/CT [–] group [n = 42], respectively) were retrospectively analyzed. Results: In a propensity matched cohort with adjustment for International Prognostic Index risk and relapse, the PET/CT (+) group was shown to have similar medical costs as the PET/CT (–) group. Relapse-free survival (RFS) and overall survival (OS) were comparable between the two groups (median RFS not reached [NR] for both groups, p = 0.133; median OS NR, p = 0.542). Among 76 patients with surveillance PET/CT, 31 (40.8%) had findings suggestive of recurrence and 16 of these (51.6%) were later confirmed to have recurrent disease. Fifteen patients (48.4%) were confirmed to not have recurrence after follow-up CT or PET/CT evaluation (n = 10) and biopsy (n = 4). None of the patients with negative PET/CT findings had disease recurrence. Sensitivity, specificity, positive predictive value, and negative predictive value of PET/CT for detection of recurrence were 1, 0.75, 0.52, and 1, respectively. Conclusions: Surveillance PET/CT resulted in similar clinical outcomes and medical costs compared to no surveillance PET/CT. Approximately half of patients with PET/CT findings of recurrence had no recurrence after follow-up imaging and biopsy, which would not have been carried out if PET/CT had not been performed in the first place.

모낭모세포종에서 유래한 모낭모세포성 암종 - 1예 보고 -

서경진,유진영,강석진,정지한,이혜경,이교영 대한병리학회 2007 Journal of Pathology and Translational Medicine Vol.41 No.4

Trichoblastic carcinoma is a rare malignant neoplasm of follicular germ cell origin; to the best of our knowledge, only six trichoblastic carcinomas arising in trichoblastomas have appeared on the literature. We recently experienced a trichoblastic carcinoma arising in a long standing trichoblastoma. A 68-year old woman came to the hospital with a chief complaint of an ulcerated nodule on her face. The nodule, 1.1×0.9 cm with an asymmetrical configuration, had been present and unchanged for more than 20 years, however, it grew suddenly with painful burning sensation. An excisional biopsy was performed and disclosed a deeply invasive, highgrade carcinoma, which consisted of cohesive epithelial cells arranged in irregular plump or germinative cell nests of various sizes. However, at the periphery of the tumor was a benign trichoblastoma surrounded by perifollicular sheath. We believe that the present case is a trichoblastic carcinoma developed via malignant transformation of pre-existing trichoblastoma.

다골성섬유형성이상에서 발생한 골육종: 증례보고

서경진 대한자기공명의과학회 2007 Investigative Magnetic Resonance Imaging Vol.11 No.1

섬유형성이상은 골모세포의 비정상적인 분화로 정상 골수와 해면골이 미숙골과 섬유성간질로 대치되는 유전이 되지 않는 골질환이다. 섬유형성이상은 다양한 영상소견을 보이며, 일반적으로 우연히 발견되며 정밀검사가 필요하지 않다. 그러나 섬유형성이상에서 병적골절의 합병증을 보일 수 있고 드물게 악성변이의 합병증을 가진다. 다골성섬유형성이상을 가진 44세 남자환자의 대퇴골에서 방사선소견상 골피질의 파괴와 자기공명영상에서 연부조직종괴를 가진 악성변이의 소견을 보였고, 수술로 절제된 조직학적 검사에서 연골아세포골육종으로 진단 받았다.