• Title/Summary/Keyword: surgical pathology

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A Case of Late Presentation of Congenital Cystic Adenomatoid Malformation of the Lung (14세 여아에서 발견된 선천성 낭종성 선종성 기형 1예)

  • Lee, Myung In;Sohn, So Hee;Lee, Dae Joon;Ha, Dong Yul;Jee, Young Koo;Lee, Kye Young;Kim, Keun Youl;Choi, Young Hi;Cho, Jeong Hi;Seo, Pil Weon;Kim, Sam Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.805-811
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    • 1996
  • Congenital cystic adenomatoid malformation of the Lung(CCAM) is characterized by anomalous fetal development of terminal respiratory structures, resulting in an adenomatoid proliferation of bronchiolar elements and cystic formation. CCAM was first described and differentiated from other cystic lung disease in the English literature by Ch'in and Tang in 1949. CCAN is a rare, potentially lethal form of congenital pulmonary cystic disease and the salient features of lesion are an irregular network of terminal respiratory bronchiole-like structures and macrocysts variably lined by pseudostratified ciliated columnar epithelium and simple cuboidal epithelium. Adult presentation of CCAM of the lung is so rare that only 9 cases have been reported in the literature of date. The pathogenesis of CCAM remains disputed and reseachers have variously proposed that the lesion represents a developmental anomaly, hamartoma, or a fonn of pulmonary dysplasia. Van Dijk and Wagenvoort divided CCAM into three subtypes : cystic, intermediated, and solid. These correspond to types I, II, and III of Stocker. In adults, the evaluation of cystic or multi cystic lung disease requires consideration of a differential diagnosis including the acquired lesions of lung abscess, cavitary neoplasm or inflammatory mass, bullous disease, bronchiectasis, and postionflammatory pneumatocele. Congenital lesions such as sequestration, bronchopulmonary-foregut anomalies, and bronchogenic cyst are also encounted. The definitive treatment for CCAM is complele removal of the involved lobe. Panial lobectomy leads to multiple complications, including severe post-operative infection. We report a case of CCAM in a 14-year-old female presentated with a pneumothorax and large bullae, who was treated by surgical remove of the involved lobe.

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Effects of Electrical Stimulation on the Nucleolar Organizer Region in Keratinocyte of Wounded Skin in Rat (전기자극이 흰쥐 창상 표피세포의 핵소체형성부위에 미치는 영향)

  • Lee Jae-Hyoung;Jekal Seung-Joo;Park Seung-Teack
    • The Journal of Korean Physical Therapy
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    • v.12 no.1
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    • pp.1-7
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    • 2000
  • The purpose of this study was to determine the effect of microamperage electrical stimulation on the number of argyrophilic nucleolar organizer region (AgNOR) in rat skin. Twenty four male Sprague-Dawley rats were divided into electrical stimulation and control group. Bach animals hair on the back was removed. The electrical stimulation group received an positive rectangular positive electrical stimulation with $500{\mu}A$, while the control group was given the same treatment without electricity. The rats were sacrificed at 4 and 7 day of stimulation, respectively. The biopsy specimens were fixed in formalin, embedded in paraffin and stained with silver nitrate. The AgNOR were counted using a light microscope and computerized image analysis system and calculated as the mean number of AgNOR per nucleus in the epidermal keratinocyte. In control skin, the mean AgNOR count of epidermal keratinocyte at 4 and 7 day were 1.67 and 1.72, whereas electrical stimulated rat had mean AgNOR counts of 2.0 and 2.14, respectively. A Student's t-test showed a significantly higher mean AgNOR number at 4 ana 7 day in the electrical stimulated rats than control rats (p<0.05). The microamperage electric current stimulation increased the epidermal AgMOR expression in incisional wound skin. These results suggest that the microamperage electrical stimulation may promote migration and proliferative activity of epidermal keratinocyte in surgical wound.

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External validation of IBTR! 2.0 nomogram for prediction of ipsilateral breast tumor recurrence

  • Lee, Byung Min;Chang, Jee Suk;Cho, Young Up;Park, Seho;Park, Hyung Seok;Kim, Jee Ye;Sohn, Joo Hyuk;Kim, Gun Min;Koo, Ja Seung;Keum, Ki Chang;Suh, Chang-Ok;Kim, Yong Bae
    • Radiation Oncology Journal
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    • v.36 no.2
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    • pp.139-146
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    • 2018
  • Purpose: IBTR! 2.0 nomogram is web-based nomogram that predicts ipsilateral breast tumor recurrence (IBTR). We aimed to validate the IBTR! 2.0 using an external data set. Materials and Methods: The cohort consisted of 2,206 patients, who received breast conserving surgery and radiation therapy from 1992 to 2012 at our institution, where wide surgical excision is been routinely performed. Discrimination and calibration were used for assessing model performance. Patients with predicted 10-year IBTR risk based on an IBTR! 2.0 nomogram score of <3%, 3%-5%, 5%-10%, and >10% were assigned to groups 1, 2, 3, and 4, respectively. We also plotted calibration values to observe the actual IBTR rate against the nomogram-derived 10-year IBTR probabilities. Results: The median follow-up period was 73 months (range, 6 to 277 months). The area under the receiver operating characteristic curve was 0.607, showing poor accordance between the estimated and observed recurrence rate. Calibration plot confirmed that the IBTR! 2.0 nomogram predicted the 10-year IBTR risk higher than the observed IBTR rates in all groups. High discrepancies between nomogram IBTR predictions and observed IBTR rates were observed in overall risk groups. Compared with the original development dataset, our patients had fewer high grade tumors, less margin positivity, and less lymphovascular invasion, and more use of modern systemic therapies. Conclusions: IBTR! 2.0 nomogram seems to have the moderate discriminative ability with a tendency to over-estimating risk rate. Continued efforts are needed to ensure external applicability of published nomograms by validating the program using an external patient population.

Experience of Biliary Atresia-Long-term Survival (담도 폐색증 환자의 수술 치험 22례 와 장기 생존율)

  • Choi, Kyung-Hyun;Yoo, Jung-Jae;Shin, Yeon-Myung;Hur, Bang;Park, Jae-Sun
    • Advances in pediatric surgery
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    • v.13 no.2
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    • pp.135-143
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    • 2007
  • Biliary atresia (BA) is an uncommon neonatal surgical disease that has a fatal outcome if not properly treated. The survival rates of the patients with native liver after Kasai's operation in countries outside Japan are not so good. We reviewed the results of 22 cases of biliary atresia treated in Kosin University Hospital between October 1987 and March 2001. There were 13 males and 9 females aged from 21 to 106 days (mean 52 days). There were 3 cases of Type I (13.6%), and 3 of Type II (13.6%), and 16 Type III (72.7%). The operative methods were resection of the common bile duct remnant and cyst followed by Roux-en-Y hepaticojejunostomy in 3 cases for Type I BA; Kasai I in 15 cases, Kasai II in 1 case, and Ueda's operation in 3 cases for Types II and III BA. There was no death within the first 30 days after operation. We were able to follow 21 of the 22 patients (95.4%) for more than 5 years. The actual 5 year survival rate (YSR) was 40.9%. One Type I case received a living-related liver transplantation at 6 years of age because of the multiple intrahepatic stones and liver cirrhosis. Five YSR after biliostomy group (Kasai II and Ueda op.) was 75 % (3/4) while that of Kasai I was 20% (3/15). One case had no bile duct in the resected fibrotic plaque on microscopic review and died 8 months after Kasai I operation, would have been a strong candidate for early liver transplantation. From the above result, our conclusions are as follows; (1) early liver transplantation should be considered for cases of no bile duct after pathologic examination of the resected specimen, (2) measures to prevent postoperative cholangitis and prevention of postoperative liver cirrhosis are needed, (3) liver transplantation program should be available for failed cases.

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Clinical Experience of 3T Breast MRI in Detecting the Additional Lesions in Breast Cancer Patients (유방암 환자에서 추가 병변 평가를 위한 3 테슬러 유방자기공명영상의 임상적 경험)

  • Lee, Ji-Hye;Kim, Sung-Hun;Kang, Bong-Joo;Choi, Jae-Jeong;Lee, Ah-Won
    • Investigative Magnetic Resonance Imaging
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    • v.14 no.2
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    • pp.121-125
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    • 2010
  • Purpose : The purpose of this study was to evaluate the diagnostic accuracy of 3.0-T breast MRI for detecting additional breast cancer soon after the initial diagnosis of breast cancer. Materials and Methods : From March to June 2009, 101 patients recently diagnosed breast cancer underwent breast MRI and surgery. Parameters analyzed on MRI were total extent of tumor, suspicious findings of multifocal, multicentric, or contralateral cancer. The diagnosis of MRI-detected cancer was confirmed by means of biopsy or surgical specimen evaluation after the localization. Results : MRI showed 37 additional suspicious findings in 34 patients. Twenty nine findings were true-positive (29/37, 78.4%), including 16 cases of multifocality, 11 cases of multicentricity and 2 cases of contralateral cancer. Among these cancers, 13 (44.8%) were ductal carcinoma in situ (DCIS) and 16 (55.1%) were infiltrating cancer. Eight findings were false-positive (8/37, 21.6%) including 6 cases of benign disease and 2 cases of high-risk lesions. Conclusion : In women with recently diagnosed breast cancer, 3.0-T MR imaging showed additional suspicious findings in 33.7%. The sensitivity and specificity for detecting additional breast cancer was 100% and 89.3%, respectively.

A Case of Bronchial Artery Aneurysm Presenting with Massive Hemoptysis (대량 객혈이 발생된 기관지 동맥류 1예)

  • Choi, Hyo-Jin;Ok, Kyung-Sun;Jung, Sung-Mo;Lee, Young-Min;Kang, Yun-Kyung;Jin, Jae-Youg;Jin, Sung-Lim;Lee, Hyuk-Pyo;Choi, Soo-Jeon;Yum, Ho-Kee
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.1
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    • pp.86-91
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    • 2002
  • A bronchial artery aneurysm(BAA) is rare, and has an unclear etiology. However, it may be caused by congenital abnormalities and acquired diseases like as bronchiectasis, tuberculosis, and other infections. The pathogenesis of a bronchial artery dilatation and the formation of an aneurysm results in an increase in the systemic blood flow to the chronic inflammatory pathologic lungs such as bronchiectasis or tuberculosis. It can be divided into the mediastinal and intrapulmonary BAA according to their location. The most common symptom is hemoptysis. Chest computed tomography and bronchial artery angiography may be used for a diagnosis. Treatment is mainly by a surgical resection of the aneurysmal artery. However, when patient is unstable due to massive hemoptysis or recurrent hemoptysis, bronchial artery embolization is useful. Here, we experienced a case of a bronchial artery aneurysm presenting as a massive hemoptysis.

Successful Pulmonary Resection Combined with Chemotherapy for the Treatment of Mycobacterium avium Pulmonary Disease : A Case Report (내과적 치료와 함께 폐절제술을 시행하여 균음전에 성공한 Mycobacterium avium 폐질환 1례)

  • Koh, Won-Jung;Kwon, O Jung;Kang, Eun Hae;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Kim, Kwhanmien;Lee, Nam Yong;Han, Joungho;Kim, Tae Sung;Lee, Kyung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.6
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    • pp.621-627
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    • 2003
  • The Mycobacterium avium complex (MAC) is the most common pathogen causing nontuberculous mycobacterial pulmonary disease. Despite the introduction of newer, more effective agents for the treatment of MAC, such as clarithromycin, the response to drug therapy in MAC pulmonary disease remains poor, and often frustrating. When MAC pulmonary disease has not been successfully eradicated using drug treatment alone, surgical management is still recognized to play a significant role. A case of MAC pulmonary disease, in a patient whose MAC disease was successfully treated by pulmonary resection, following the failure of drug therapy containing clarithromycin, is reported. To our knowledge, this is the first case report in Korea that the patient underwent a pulmonary resection for the treatment of MAC pulmonary disease.

A Case of Solitary Fibrous Pleura Tumor Associated with Severe Hypoglycemia: Doege-Potter Syndrome

  • Jang, Jong Geol;Chung, Jin Hong;Hong, Kyung Soo;Ahn, June Hong;Lee, Jae Young;Jo, Jae Ho;Lee, Dong Won;Shin, Kyeong Cheol;Lee, Kwan Ho;Kim, Mi Jin;Lee, Jung Cheul;Lee, Jang Hoon;Lee, Jae Kyo
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.2
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    • pp.120-124
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    • 2015
  • Solitary fibrous tumor of the pleura (SFTP) is a rare primary intrathoracic tumor that arises from mesenchymal tissue underlying the mesothelial layer of the pleura. It usually has an indolent clinical course. The hypoglycemia that accompanies SFTP was first described by Doege and Potter independently in 1930, hence the eponym Doege-Potter syndrome (DPS). The incidence of DPS is reported to be ~4%. In this report, we present a typical case of DPS that was cured through complete surgical resection.

A Case of Tuberculous Pericardial Abscess Mimicking Thymic Carcinoma (악성 흉선종으로 오인된 결핵성 심낭농양 1예)

  • Park, Ji-Young;Park, Seung-Ah;An, Young-Hwan;Jang, Gil-Su;Kim, So-Yeon;An, Jeung-Sun;Hong, Eun-Young;Lim, Soo-Young;Kim, Kun-Il;Seo, Jin-Won;Park, Sung-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.4
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    • pp.347-351
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    • 2011
  • We report here an unusual case of pericardial tuberculoma that was misdiagnosed as thymic carcinoma on an imaging study. A 48-year-old woman was referred for evaluation of an anterior mediastinal mass. Computed tomography (CT) scans of the chest displayed cystic masses mimicking thymic carcinoma at the anterior mediastinum. Pericardiotomy and surgical drainage of the cystic masses were done, and pathologic examination of the excised pericardial specimen showed a chronic granulomatous inflammation with necrosis, compatible with tuberculosis. Acid-fast bacilli were also identified in the specimen. After treatment with anti-tuberculosis drugs and steroids, the patient showed clinical improvement. Although tuberculous pericarditis usually presents as pericardial effusion or constrictive pericarditis, it can also present as a pericardial mass mimicking thymic carcinoma on CT. Therefore, we suggest that tuberculous pericardial abscess should be included in the differential diagnosis of a mediastinal mass in Korea, with intermediate tuberculosis prevalence.

Arthroscopic Evaluation on Intra-Articular Pathology in Recurrent Shoulder Dislocation Aged Over 40 Years (40세 이상 재발성 견관절 탈구 환자에서 관절내 병변에 대한 관절경적 연구)

  • Min, Woo-Kie;Kim, Ju-Eun;Cho, Hwan-Seong;Kim, Poong-Taek;Jeon, In-Ho
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.215-220
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    • 2009
  • Purpose: This study is to analyze the prevalence of various intra-articular lesions in patients with traumatic recurrent anterior dislocation of shoulder over 40 years and suggest clinical implications for treatment. Materials and Methods: We retrospectively studied 16 cases that underwent surgical treatment for recurrent anterior dislocation of shoulder from January 2001 to May 2009. There were 9 males and 7 females, and the mean age was 52.7years. We carried out arthroscopic exam for all patients based on standard protocol, which included labrum, capular lesion, cuff, bony lesions. Results: All 16 cases showed Hill-Sachs lesion, 3 patients (19%) had bony Bankart lesion, 6 patients (38%) had labral tear. Capsular tear were found 15 patients (94%). Twelve (75%) had ruptured supraspinatus and 5 (31%) had subscapularis tear. Only one (6%) had SLAP lesion. Conclusion: There was relatively higher incidence of capsular and rotator cuff tears in patients over age 40 years. Preoperative planning to address these lesions is highly recommended.