• The Journal of the Korean bone and joint tumor society
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• v.6 no.4
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• pp.163-167
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• 2000

Aneurysmal bone cyst(ABC) is a benign lesion and generally occurs in the long bones and vertebral column. ABC of the rib is an uncommon entity. We reported a case of ABC originating in the left first rib. The patient was a 19-year-old woman and presented with palpable mass on the shoulder. Chest X ray and MRI showed a large expansile mass, with multiple cystic areas, arising from the left first rib and bulging out into retroclavicular and paravertebral soft tissue, so the lesion was initially misdiagnosed as a soft tissue malignant tumor destructing adjacent rib. On histological examination, the mass, which was surrounded by a peripheral band of mature trabecular bone, consisted of multiple anastomosing cavernous blood channels separated by fibrous septa that containing osteoid, myxochondroid material and osteoclast-type giant cells.

• Tuberculosis and Respiratory Diseases
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• v.56 no.1
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• pp.18-28
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• 2004

Background : Many diseases like lung cancer and tuberculosis can involve cervical lymph node. Fine needle aspiration cytology(FNAC) was known as a useful screening test for the evaluation of enlarged lymph node. But the usefulness and limitations of FNAC according to disease category or physical characteristics of lymph node were not yet fully established. Methods : Retrospective analysis of three hundred forty two adult patients who performed FNAC due to enlarged cervical lymph nodes at the Seoul Municipal Boramae Hospital during the period from January 1999 to December 2002 and final diagnosis could be made by surgical biopsy, microbiology or clinical observation. Results : Among the 342 cases, 176(51.5 %) were finally diagnosed as benign nature ncluding reactive hyperplasia, Kikuchi's disease and acute suppuration. Eighty eight(25.7 %) were diagnosed as tuberculous lymphadenitis, 66(19.3 %) as metastasis, and 12(3.5 %) as lymphoma. Tuberculosis, metastasis, and lymphoma all showed significantly larger diameter, longer duration of lymph node enlargement. There were higher frequency of supraclavicular involvement in the cases of tuberculosis and metastasis. The overall diagnostic sensitivity of FNAC was 88.0 %, and 88.6 % in benign nature lesion, 77.3 % in tuberculosis, 90.1% in metastasis and 58.3 % in lymphoma. The diagnosis of tuberculosis was made by FNAC in 68 cases (77.3 %) among 88 cases. Lung cancer(43.9 percent) was most frequent cause of cervical lymph node metastasis. Diagnostic sensitivity of FNAC was significantly lower in the supraclavicular than other cervical lymph node(80 % vs. 91.3 %) and not correlated with disease nature, node size or number. Conclusion : Though FNAC was a reliable screening test for enlarged cervical lymph node enlargement, the diagnostic sensitivity was low in the case of lymphoma or when the enlarged lymph node was located at the supraclavicular area.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.4
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• pp.309-316
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• 2009

Purpose: F-18 FDG can be accumulated in the liver, bowel, kidney, urinary tract, and muscles physiologically. The aim of this study was to evaluate the clinical value of dual time point 18F-FDG PET /8 imaging for the differentiation of the colonic focal uptake lesions. Materials and Methods: One hundred thirty two patients (M:F = 77:55, Age 62.8$\pm$11.6 years) underwent $^{18}$F-FDG PET/CT at two time points, prospectively: early image at 50-60 min and delayed image at 4-4.5 hours after the intravenous injection of $^{18}$F-FDG. Focally increased uptake lesions on early images but disappeared or shifted on delayed images defined a physiological uptake. For the differential evaluation of persistent focal uptake lesions on delayed images, colonoscopy and histopathologic examination were performed. SUVmax changes between early and delayed images were also compared. Results: Among the 132 patients, 153 lesions of focal colonic uptake were detected on early images of $^{18}$F-FDG PET/CT. Of these, 72 (47.1%) lesions were able to judge with physiological uptake because the focal increased uptake disappeared from delayed image. Among 81 lesions which was showed persistent increased uptake in delayed image, 61 (75.3%) lesions were confirmed as the malignant tumor and 14 (17.3%) lesions were confirmed as the benign lesions including adenoma and inflammatory disease. Remaining 6 (7.4%) lesions were confirmed as the physiological uptake because there was no particular lesion in the colonoscopy. In the malignant lesions, the calculated dual time point change for SUVmax ($\Delta$%SUVmax) was 20.8$\pm$18.7%, indicating a significant increase in SUVmax between the two point (p<0.01). In contrast, the change in SUVmax for the non-malignant lesions including benign lesions and physiological uptake was -13.7%$\pm$24.2%. For the differentiation of the malignant and non-malignant focal colonic uptake lesions, $\Delta$%SUVmax was the most effective parameter, and the cut-off value using -5% provided the best sensitivity, specificity, and accuracy. Conclusion: The dual time point $^{18}$F-FDG PET/CT imaging with SUVmax change evaluation could be an important noninvasive method for the differentiation of malignant and benign focal colonic uptake lesions including physiologic uptake.

• Investigative Magnetic Resonance Imaging
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• v.17 no.3
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• pp.224-231
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• 2013

Purpose : To evaluate the potential effects of background parenchymal enhancement of MR imaging in diagnosed breast cancer patients on the rate of additional biopsy and resultant cancer yield. Materials and Methods: 322 patients who were diagnosed with breast cancer and had undergone breast MR imaging were included in this study. Two radiologists reviewed the MRI for degree of background parenchymal enhancement and additional suspicious lesions described as BI-RADS category 4 or 5 on radiologic reports. Biopsy was done for these lesions, pathology reports were reviewed to calculate the cancer yield. Results: Background parenchymal enhancement of MR imaging in a total of 322 patients were classified as minimal degree 47.5%, mild degree 28.9%, moderate degree 12.4% and marked degree 11.2%. Among these 332 patients, MR imaging of 70 patients showed additional suspicious malignant lesions described as BI-RADS category 4 or 5, and consequently, 66 patients underwent biopsy. Biopsy rates in those with minimal or mild background parenchymal enhancement and those with moderate and marked background parenchymal enhancement were 19.9% and 22.3% (p-value 0.77) respectively. Cancer yields in those with minimal or mild background parenchymal enhancement and those with moderate and marked background parenchymal enhancement were 6.5% and 5.2% (p value 0.88) respectively. Both these results did not show stastically significant difference between the two groups. Conclusion: The degree of background parenchymal enhancement in MR imaging of breast cancer patients did not significantly impact additional biopsy rates or cancer yields.

• Journal of Korean Society for Atmospheric Environment
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• v.4 no.1
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• pp.58-70
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• 1988

대기오염이 건강에 미치는 영향의 유무를 알아보고 그 영향의 정도를 반영해 줄 수 있는 지표의 개발을 목적으로 우리나라 전역을 서울, 대도시, 중소도시, 농어촌 등 4개 지역으로 구분하고 의료보험대상자 3,922,027명에 대한 호흡기질환 외래수진률을 지역별로 비교해 보았다. 조사대상 질환군으로서는 다음 7가지의 호흡기질환을 채택하기로 하였다. 1) 결핵성 질환 2) 호흡기 및 흉곽내장기의 악성신생물 3) 급성호흡기 감염 4) 폐염 및 인플루엔자 5) 만성폐색성 폐질환 및 유사증 6) 진폐증 및 외인성의 기타 폐질환 7) 상기도의 기타질환 상기 질환으로 인한 외래수진에 관한 정보는 1983년 1월 1일 부터 12월 31일 사이에 제출된 보험의료비 청구서에 나타난 자료를 이용하여 수집하였으며, 그 분석을 통해 다음과 같은 결론을 얻었다. 1) 지역별 연간종합외래수진률을 비교해 본 결과 농촌지역에서 가장 낮은 수준을 나타내고 있는 질환은 조사대상 7개 호흡기질환군중 다음 4개 질환군이 해당되고 있다. (1) 결핵질환 (2) 호흡기 및 흉곽내장기의 악성 신생물 (3) 상기도의 기타질환 (4) 진폐증 및 외인성의 기타 폐질환 한편 이 종합외래수진률이 가장 높은 지역은 대도시 지역으로서 5가지 호흡기질환군의 수진률이 다른 지역에 비해 훨씬 높게 나타나 있다. 이와같은 결과는 의료보험환자들의 "외래수진률"을 이용하여 대기오염과 건강과의 관련도를 측정할 수 있는 "대기오염 - 건강" 지표의 개발이 가능할 것임을 뒷받침해 주고 있다. 그러나 가장 오염도가 높다고 예상되는 서울지역에서의 외래수진율이 대도시 지역보다 높지 않다는 것은 오염도와 외래수진률과의 관계에서 일관성있는 결과를 보여주지 못하고 있음을 뜻하는데 과거의 자료로서는 외래수진률만 가지고 대기오염과 건강과의 관계를 표시해주는 지표로 삼기에는 미흡함을 알 수 있다. 2) 월별 외래수진률의 경향을 보면 거의 모든 호흡기질환군에서 계절적인 특이성을 나타내지 못하고 있다. 단 이 경우도 농촌지역이 연중 계속 최하위를 유지하고 있는 질환군이 7개 대상질환군 중에 4개군에 달하고 있다. 3) 보험환자들의 "외래수진률"은 아직은 미흡한 점이 있으나 앞으로 "대기오염 - 건강" 지표로서 개발 활용할 가치는 있다고 볼 수 있으며 서울, 대도시, 중소도시, 농어촌 등 4개 지역에 대한 월별 외래 수진률을 다음 4가지 질환군에 대하여 계속 관측하여 그 경향을 분석할 것을 권장한다. (1) 호흡기 및 흉곽내장기의 악성 신생물 (ICD. 160-165) (2) 급성호흡기 감영 (ICD. 460-466) (3) 폐염 및 인플루엔자 (ICD. 480-487) (4) 만성폐색성 폐질환 및 유사증 (ICD. 490-496) 4) 외래수진률은 진료방식 즉, 투약기간의 장단등으로 인한 통원 (通院) 빈도 차이의 영향을 받게 되므로 지역별 병 $\cdot$ 의원의 보험환자 진료방식에 대한 비교검토가 요구된다.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.2
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• pp.207-212
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• 2016

Irritation fibroma is a common hyperplastic lesion of the oral mucosa that can occur in response to chronic irritation or trauma. This report presents an unusual case of irritation fibroma associated with ectopic eruption of the maxillary left central incisor in a patient with Angelman syndrome. Considering the patient's medical history and cooperative ability, excisional biopsy under intramuscular sedation using midazolam was performed. The patient exhibited successful healing without lesion recurrence. It is important to perform histopathological examination followed by excisional biopsy, because other benign or malignant tumors may mimic the clinical appearance of an irritation fibroma.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.6 no.2
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• pp.129-139
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• 2003

Purpose: The aim of the study was to evaluate the long-term outcome of glycogen storage disease (GSD) type 1 with particular reference to hepatic adenoma and hepatocellular carcinoma, and to analyze risk factors affecting the development of hepatic adenoma in GSD type 1. Methods: Forty-three GSD type 1 patients (31 males and 12 females, mean age $13.9{\pm}6.4$ years) were analyzed retrospectively. Hepatic adenoma was detected on abdominal USG and diagnosed on histologic examination. Clinical profiles were compared between patients with hepatic adenoma (n=16) and age-matched controls without hepatic adenoma (n=16). Results: 1) Of 43 GSD type 1 patients, 16 (37.2%) had hepatic adeoma. Hepatic adenoma was detected at the age of mean $14.2{\pm}4.1$ years (range: 7.9~25.7 years). Fourteen (87.5%) adenomas were multiple at detection. 2) Comparison of the clinical profiles between adenoma group and non-adenoma group revealed that age at first introduction of uncooked cornstarch treatment was significantly late in adenoma group compared with non-adenoma group ($9.1{\pm}5.2$ years vs. $3.0{\pm}1.8$ years, p=0.003). Portocaval shunt surgery was performed in 11 (68.8%) patients in adenoma group and 3 (18.8%) in non-adenoma group (p=0.004). Hepatic adenoma developed mean $5.8{\pm}4.2$ years after shunt operation. 3) One patient was diagnosed as hepatocellular carcinoma at the age of 25.7 years. Conclusion: Hepatic adenoma is an important late complication of GSD type 1 with the risk of malignant transformation. Early introduction of cornstarch therapy with strict metabolic control is needed to prevent the development of hepatic adenoma in GSD type 1.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.1
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• pp.65-69
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• 2011

Purpose: Normal pancreas has low uptake rate in $^{18}F$-FDG PET scan. However, it is possible to diagnose malignancy of pancreatic cancer which has high uptake rate. Many studies approve a high prevalence of diabetes in pancreatic cancer and if the blood glucose level (BGL) is over the normal range, FDG uptake will be decreased and there will be inconvenience for patients from the delay time to reduce the high BGL or could cause difficulty to arrange the schedule. Therefore, we studied the relation of BGL and image quality in pancreatic cancer on PET. Materials and Methods: A hundred patients had PET scan. The prevalence of pancreatic cancer and diabetes were evaluated using SPSS ver. 17. The fasting BGL of patients were examined and sorted as diabetes mellitus (DM) group and Non-DM group. For the evaluation, patients were divided into 3 groups (Non-DM, DM; BGL${\geq}7.0mmol/L$, and DM; BGL<7.0 mmol/L). The ROI was drown on Liver and Lung for the PET imaging analysis. Results: Fifty three male and forty seven female were in the patients. The average age was $60.1{\pm}13.5$. There were 36 patients (male: 22, female: 14, 36%) who had pancreatic cancer with DM. There were 15 patients who showed over 7.0 mmol/L in their fasting BGL and 85 patients who showed under 7.0 mmol/L in their fasting BGL. Among the Non-DM, DM; BGL${\geq}7.0mmol/L$, and DM; BGL<7.0 mmol/L, there was not a statistical significance (p>0.05). Conclusion: The prevalence of pancreatic cancer was comparatively high in this study. If the fasting BGL was slightly over the normal BGL, we believe it will not give a severe disturbance when the patients have PET scan. Furthermore, the examination schedule doesn't need to change and the inconvenience from the delay of patients preparation will be reduced.

• Radiation Oncology Journal
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• v.14 no.4
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• pp.291-297
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• 1996

Purpose : This study was performed to evaluate survival, failure patterns, and prognostic factors of MMR patients after radiation therapy. We also discussed the need for chemotherapy. Materials and Methods : A retrospective analysis was done for 23 patients with MMR who were treated with radiation therapy from June 1985 to November 1992. There were 19 male and 4 female patients, The patients' age ranged from 17 to 71 years (median 39 years). Systemic symptoms including fever, weight loss, or malaise were found in $30\%$ of the patients. The nasal cavity was most frequently involved No patients had nodal involvement at diagnosis. There were 2 patients with distant metastasis at presentation. Radiation therapy was delivered five times a week, 1.8 Gy daily, total $45\~54$ Gy (median 50.4 Gy) using 6 MV X-ray No patients received chemotherapy as initial treatment. Results : Overall 5-year and 10-year survival rates were $52.4\%$ and $44.1\%$, respectively. Seventy Percent(12/17) of the patients achieved complete response to radiotherapy, and $29.4\%$ (5/17) achieved partial response. The Patients with complete response showed a better 5-year survival rate than those with partial response ($66.9\%$ vs. $20\%$. p=0.004). Symptom duration before diagnosis, the presence of systemic symptom, and the number of primary sites had no influence on survival. The patterns of failure were as follows: local failure(1), failure in adjacent site(1), local and distant failure(1) distant metastasis(2). and conversion to malignant lymphoma(1). We could not find factors associated with the patterns of failure. Conclusion : The most important facto associated with survival was the response to radiotherapy. Seventeen percent of the patients had distant metastasis, and the salvage after distant metastasis was not successful. However. about $50\%$ of the patients could achieve long-term survival with local radiation therapy alone. Therefore, chemotherapy of MMR should be done after a prospective randomized study for the factors associated with distant metastasis.

• Journal of Chest Surgery
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• v.41 no.2
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• pp.239-246
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• 2008

Background: Aortic surgery for high risk patients has high mortality and morbidity rates, and the necessity of performing aortic surgery in cancer patients is questionable because of their short life expectancy. Endovascular repair of aneurysm repair can be considered for high risk patients and cancer patients because it has relatively lower invasiveness and shorter recovery times than aortic surgery does. Especially, percutaneous endovascular stent graft treatment is more useful for high risk patients because it does not require general anesthesia. Material and Method: From July 2003 to September 2007, twelve patients who had inoperable malignancy or who had a high risk of complication because of their combined diseases during aortic surgery underwent endovascular aortic aneurysm repair. he indications for endovascular repair were abdominal aortic aneurysm in 5 patients, descending thoracic aortic aneurysm in 6 patients and acute type B aortic dissection in one patient. The underlying combined disease of these patients were malignancy in 3 patients, respiratory disease in 6 patients, old age with neurologic disease in 6 patients, Behcet's iseae in one patient and chronic renal failure in one patient. Result: Stent grafts were inserted percutaneously in all cases. There were 4 hospital deaths and there were 3 delayed deaths during the follow-up periods. There were no deaths from aortic disease, except one hospital death. There were several complications: a mild cerebrovascular accident occurred in one patient, acute renal failure occurred in 2 patients and ischemic bowel necrosis occurred in one patient. Mild type I endoleak was observed in 2 patients and type II endoleak was observed in a patient after stent graft implantation. Newly developed type I endoleak was observed in a patient during the follow-up period. Conclusion: Percutaneous endovascular stent graft insertion is relatively safe procedure for high risk patients and cancer patients. Yet it seems that its indications and its long term results need to be further researched.