• 한국방사선학회논문지
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• 제17권3호
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• pp.385-392
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• 2023

카롤리병은 섬유낭성 간질환이다. 상염색체 열성 장애로 담관의 선천적 다발성 확장이 특징이다. 카롤리병을 진단하는 방법으로 전산화단층촬영, 자기공명영상 검사, 담관 조영술, 초음파 검사가 있다. 전산화단층촬영검사는 섬유다낭성 간 질환을 감지하고 구별하는데 필수적이며, 간 내 담관의 확장을 판별하는 데 유용하다. 하지만 조영제를 사용함으로써 일어날 수 있는 부작용에 대한 인지가 필요하다. 자기공명영상검사는 대표적으로 자기공명담췌관조영술 방법을 이용한다. 비침습적 검사로 환자의 고통을 경감할 수 있고, 담췌관부의 해부학적 구조와 병변 유무를 쉽고 빠르게 관찰이 가능하다. 담관 조영술은 비대해진 담관 전체에 걸친 여러 낭성 확장을 직접 시각화할 수 있는 효과적인 진단 방법이다. 하지만 이 시술 또한 침습적인 시술이므로 진단이 아닌 치료 목적으로 권장된다. 초음파 검사는 전산화단층촬영과 유사한 소견을 확인할 수 있다. 간동맥 뿌리는 기존의 그레이 스케일 초음파에서 증명하기 쉽지 않다. 하지만 관 내 혈관 뿌리를 가진 확장된 담관을 묘사할 수 있을 뿐만 아니라 관 내 색상 도플러 신호를 쉽게 식별할 수 있다는 점에서 임상적 가치를 갖고 있다. 최근엔 영상진단의 발전으로 전산화단층촬영 검사, 자기공명영상 검사, 담관 조영술, 초음파 검사 등으로 조기 진단이 가능해졌다. 조기 진단을 통해 치료 후에 장기적인 예후가 개선될 수 있도록 영상 진단 발전에 더욱 기여하고자 각 검사별 카롤리병에 대하여 어떠한 양상이 나타나는지 고찰하였다

• Archives of Plastic Surgery
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• 제38권3호
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• pp.251-256
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• 2011

Purpose: A nasolabial cyst is a rare non-odontogenic, soft-tissue, developmental cyst arising anywhere on the face inferior to the nasoalar region. It is thought to arise from either epithelial remnants trapped along the lines of fusion during the development of face or the remnants of the developing nasolacrimal duct. This study examines various features of nasolabial cysts with bony involvement to provide a basis for correct diagnosis and treatment. Methods: Eight cases of nasolabial cyst treated in Soonchunhyang Hospital between March 2002 and July 2010 were examined in terms of their clinical features and radiological and histological findings. Seven patients underwent surgical excision of the cyst via an intraoral, sublabial approach. One underwent incision and drainage. Results: Our eight patients were seven women and one man. The most frequent symptoms and signs were facial deformity and swelling of the nasolabial fold. Computed tomography (CT) showed a well-circumscribed cystic mass lateral to the pyriform aperture. Seven cases had erosive lesions on CT, and the intraoperative findings were consistent with a nasolabial cyst with a bony defect. Typical histopathological findings showed that these cysts were most frequently lined with respiratory epithelium with ciliated columnar cells and cuboid cells. No patient developed complications or recurrences. Conclusion: A nasolabial cyst is often unrecognized or confused with other intranasal masses, including fissural and odontogenic cysts, midface infections, or swelling in the nasolabial area. Therefore, a careful clinical and radiological evaluation should be preformed when considering the differential diagnosis. We present eight patients with nasolabial cysts treated via a gingivobuccal approach with excellent functional and cosmetic results.

• Childhood Kidney Diseases
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• 제11권2호
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• pp.299-305
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• 2007

HWW(Herlyn-Werner-Wunderlich) 증후군은 중복자궁, 일측성 폐쇄질 및 동측 신장 무형성을 보이는 비뇨생식기계의 선천성 기형으로 매우 드문 질환 중 하나이다. 대부분 초경 이후 발생하는 월경통이나 복강내 종물등으로 발견되지만, 본 증례는 소아에서 반복되는 요로 감염과 현미경적 혈뇨로 인해 진단된 경우이다. 복부 초음파 검사에서 일측 신무형성이나 중복 자궁의 소경이 보일 때는 이러한 뮬러관 기형의 가능성을 염두에 두어야 보다 빠른 진단이 가능하고, 환자의 고통 또한 중여줄 수 있을 것이다. 특히 반복되는 요로 감염시에도 단순한 감염 치료보다 정밀검사를 항상 염두에 두어야 할 것이다.

• 대한수의학회지
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• 제39권6호
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• pp.1197-1209
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• 1999

Twenty-one dogs(male 11 heads, female 10 heads) which were about 16 months ($16.3{\pm}3.5$) old and 10kg($10.1{\pm}2.0$) body weight, were allotted randomly into four groups as follows. Group I consisted of five dogs whose muscles were operated for sham muscle injuries. Group II consisted of seven dogs treated for cystic duct obstruction. Group III consisted of five dogs treated for the union fracture model. Group IV consisted of five dogs treated for the non-union fracture model. Radiographical and histological observations were carried out to determine bone alkaline phosphatase(BALP) and total alkaline phosphatase(TALP) values of each group for 20 weeks after the treatments with the condition of new bone formation. And also the applicability of percentage of BALP values to TALP (B/T) was studied after BALP was compared respectively with TALP. The level of TALP was increased without any relation to bone formation in group II, and all levels of BALP and B/T were increased in group III. The mean of B/T was high in statistical significance, due to varied levels of B/T and BALP. The changes of rates of B/T were significantly increased only in the case of the active new bone formation in group III, union fracture model. It was recognized that the mean values of B/T were statistical significant of the high applicability of the B/T ratio as an index of bone formation.

• 대한생식의학회:학술대회논문집
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• 대한불임학회 2003년도 제45차 추계학술대회
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• pp.21-30
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• 2003

As a result of the technological advance provided by intracytoplasmic sperm injection (ICSI) in 1992, the evaluation and treatment of the infertile male has changed significantly. Many men who were previously thought to be irreversibly infertile have the potential to initiate their own biologic pregnancy. However, not all men having impaired semen parameter are ideal candidates for ICSI for numerous reasons including a lack of addressing the underlying problem causing the male infertility, unknown genetic consequences, and cost-effectiveness issues. In this era of ICSI, the fundamental approach to the male with suspected subfertility is unchanged and is based on a history, physical examination, and focused laboratory testing. The urologist should approach the patient with an intent to identify remediable causes of subfertility given the specific clinical situation. For instance, should a gentleman have his varicocele repaired or vasectomy reversed, or should he proceed directly with ICSI? If no factors can be improved in a timely manner, then ICSI should be considered using the available sperm. Examples of recent advances include the diagnosis and treatment of ejaculatory duct obstruction, indications and techniques for performing testis biopsy, and technique for sperm harvesting. In addition, potential genetic causes of male subfertility should be diagnosed and discussed with the patient. Cystic fibrosis gene mutation, karyotype abnormallities, and Y-chromosome microdeletions all have recently been identified as causative for male infertility in otherwise phenotypically normal men. With recently evolved diagnostic and therapeutic techniques now available for the infertile couple, even the most severe male factor problems in patients previously considered irreversibly infertile are now potentially treatable. The physician should be aware of the availability and limitations of these new and exciting reproductive technologies because they will allow him to provide timely and more effective therapy for the infertile couple. An understanding of these advances by all physicians is important as we progress into the $21^{st}$ century

• 대한기관식도과학회지
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• 제14권2호
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• pp.31-37
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• 2008

Background and Objectives: In most cases of benign neck cysts, surgical excision has been considered as treatment of choice. However, sometimes complete excision is very difficult, and recurrences has been occured due to insufficient surgery frequently. In this point of view, non-surgical treatment has been attempted with sclerosing agents such as picibanil(OK-432). In this study, we evaluated the efficacy of picibanil sclerotherapy for benign neck cysts. Materials and methods: We retrospectively reviewed 53 patients(27 males, 26 females) who had undergone sclerotherapy with picibanil for benign neck cysts such as ranula, lymphangioma, thyroglossal duct cyst and branchial cyst. Information was gathered with respected to age, sex, number of injections, side effect and outcome of treatment. All patients were treated with intralesional aspiration of cystic contents and injection of picibanil, and followed on neck ultrasonography or neck CT. Results: 53 patients received sonoguided sclerotherapy using picibanil(OK-432). 31 patients(41.3%) showed total shrinkage, near total shrinkage(more than 90% of volume) in 7 patients(9.3%), marked shrinkage(more than 70%) in 5 patients(6.6%) and partial shrinkage(less than 70%) in 17 patients. 15 patients(20%) reaveled no response and 8 patients showed recurrences with repeated sclerotherapy. The side effects of therapy were observed by symptoms such as fever, localized pain and odynophagia. However, these complications disappeared after several days in all cases. Conclusions: We recognized that picibanil(OK-432) sclerotherapy for benign neck cyst is a safe and effective procedures as a primary treatment before considering surgery.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제2권2호
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• pp.262-266
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• 1999

Obstruction of the extrahepatic bile ducts is the most common cause of conjugated hyperbilirubinemia in early infancy. More than 90% of such obstructive lesions are accounted for by extrahepatic biliary atresia. A rare lesion is obstruction of the common duct by impacted, thickened secretions and bile. Bile plug syndrome is defined as extrahepatic obstruction of the bile ducts by bile sludge in term infants without anatomic abnormalities, congenital chemical defects of bile, or hepatocellular lesions. Obstruction of extrahepatic ducts by plugs of biliary material apperas to be due to the inspissation and precipitation of bile and mucus within the lumen of the ducts. Cholestasis and precipitation of bile develop in association with abnormal composition of bile in cystic fibrosis, hepatocellular damage, prolonged erythroblastic jaundice, altered biliary dynamics with total parenteral nutrition, gut dysfunction, diuretic therapy, exchange transfusions and perinatal hemolysis. In those cases, the term inspissated bile syndrome is used. The clinical and laboratory findings in bile plug syndrome are identical to those observed in biliary atresia and choledochal cyst. The diagnosis can be suspected based on the findings of clinical and laboratory examinations together with hepatobiliary imaging, ultrasonography, radionuclide scan and liver biopsy. We experienced a case of spontaneous resolution of bile plug syndrome in a 4-year-old girl. We report this case with brief review related literatures.

• 대한병리학회지
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• 제52권6호
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• pp.378-385
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• 2018

Background: BRCA1-associated protein 1 (BAP1) mutations are frequently reported in clear cell renal cell carcinoma (ccRCC); however, very few studies have evaluated the role of these mutations in other renal cell carcinoma (RCC) subtypes. Therefore, we analyzed BAP1 protein expression using immunohistochemistry in several RCC subtypes and assessed its relationship with clinicopathological characteristics of patients. Methods: BAP1 expression was immunohistochemically evaluated in tissue microarray blocks constructed from 371 samples of RCC collected from two medical institutions. BAP1 expression was evaluated based on the extent of nuclear staining in tumor cells, and no expression or expression in <10% of tumor cells was defined as negative. Results: Loss of BAP1 expression was observed in ccRCC (56/300, 18.7%), chromophobe RCC (6/26, 23.1%), and clear cell papillary RCC (1/4, 25%), while we failed to detect BAP1 expression loss in papillary RCC, acquired cystic disease-associated RCC, or collecting duct carcinoma. In ccRCC, loss of BAP1 expression was significantly associated with high World Health Organization (WHO)/International Society of Urological Pathology (ISUP) grade (p=.002); however, no significant correlation was observed between loss of BAP1 expression and survival in ccRCC. Loss of BAP1 expression showed no association with prognostic factors in chromophobe RCC. Conclusions: Loss of BAP1 nuclear expression was observed in both ccRCC and chromophobe RCC. In addition, BAP1 expression loss was associated with poor prognostic factors such as high WHO/ISUP grade in ccRCC.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제27권1호
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• pp.62-70
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• 2024

Purpose: Choledochal cysts are congenital anomalies that occur as localized cystic or fusiform dilatations of the biliary tree. Reflux and stasis of pancreatic enzymes in the biliary duct may relate to the development of intestinal metaplasia which might be an important factor related to the carcinogenesis of choledochal cyst, thus the expression of beta-catenin in the metaplastic epithelium might be associated with malignant transformation of choledochal cyst epithelium. Methods: This study was conducted at a tertiary care pediatric center between October 2014 and March 2017. Forty patients were evaluated for epithelial lining, mural ulceration, fibrosis, inflammation, and metaplasia. Results: Out of 40, 12 cases (30.0%) were the infantile age group and 28 cases (70.0%) were in the classic pediatric group. Ulceration was classified as grade 0 (14 cases, 35.0%), grade 1 (17 cases, 42.5%), or grade 2 (nine cases, 22.5%). Inflammation was classified as grade 0 (2 cases, 5.0%), grade 1 (26 cases, 65.0%), or grade 2 (12 cases, 30.0%). Fibrosis was classified as grade 0 (five cases, 12.5%), grade 1 (11 cases, 27.5%), grade 2 (17 cases, 42.5%), or grade 3 (seven cases, 17.5%). Metaplasia was noted in five (12.5%) out of 40 cases. All choledochal cysts with metaplasia showed beta-catenin nuclear positivity on immunohistochemistry and were followed up. Conclusion: This study emphasizes the importance of detailed histopathological examination and documentation of metaplastic changes. Metaplasia was associated with beta-catenin nuclear positivity. These findings suggest a potential role for beta-catenin as a marker of metaplastic changes in choledochal cysts.

• Clinical Endoscopy
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• 제56권5호
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• pp.650-657
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• 2023

Background/Aims: Endoscopic ultrasound gallbladder drainage (EUS-GBD) is gaining attention as a treatment method for cholecystitis. However, only a few studies have assessed the outcomes of permanent stenting with EUS-GBD. Therefore, we evaluated the clinical outcomes of permanent stenting using EUS-GBD. Methods: This was a retrospective, single-center cohort study. The criteria for EUS-GBD at our institution are a high risk for surgery, inability to perform surgery owing to poor performance status, and inability to obtain consent for emergency surgery. EUS-GBD was performed using a 7-Fr double-pigtail plastic stent with a dilating device. The primary outcomes were the recurrence-free rate of cholecystitis and the late-stage complication-avoidance rate. Secondary outcomes were technical success, clinical success, and procedural adverse events. Results: A total of 41 patients were included in the analysis. The median follow-up period was 168 (range, 10-1,238) days. The recurrence-free and late-stage complication-avoidance rates during the follow-up period were 95% (38 cases) and 90% (36 cases), respectively. There were only two cases of cholecystitis recurrence during the study period. Conclusions: EUS-GBD using double-pigtail plastic stent was safe and effective with few complications, even in the long term, in patients with acute cholecystitis.