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- 저자 : 김종재 ( Chong Jai Kim ) (검색결과 24 건)
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김민영,김대연,안효섭,김종재,김인원,정성은,이성철,박귀원,김우기,Kim, Min-Young,Kim, Dae-Yeon,Ahn, Hyo-Seep,Kim, Chong-Jai,Kim, In-One,Jung, Sung-Eun,Lee, Seong-Cheol,Park, Kwi-Won,Kim, Woo-Ki 대한소아외과학회 1997 소아외과 Vol.3 No.2
Hepatoblastoma is a rare pediatric malignancy which frequently presents at an advanced un resectable stage. With the neoadjuvant chemotherapy, improved resectability and survival have been reported. Twenty children with biopsy proven hepatoblastoma were treated during the period between January 1987 and June 1995. Median age at diagnosis was 13 months(2 months to 7 year and 10 months), and 13 were male. Histologic profile was 13 epithelial(5 fetal, 4 mixed, 1 embryonal, 3 undetermined), and 5 mixed mesenchymal and epithelial and 2 of undetermined type. Chemotherapy effectively reduced the tumor volume($p$=0.008), and was able to convert 7 out of 9 initially unresectable cases(78%) to resectable ones. Twelve radical and 2 palliative operations were done with or without adjuvant chemotherapy. The Median follow up period was 33 months and the median survival was 26 months. The group with curative resection had a 61.1% 5 year survival rate, but none of palliative resection group survived more than 13 months($p$=0.0001). In univariate analysis for prognostic factors revealed, large tumor size at diagnosis and abscence of thrombocytopenia were associated with poor survival, but these differences were not statistically significant. Histological pure fetal type did not mean a better prognosis. Even with a recent neoadjuvant chemotherapy, the strategy should be focused on the radical resection as early as possible.
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소아의 만성 B형 간염: 새로운 병리조직학적 분류와 임상 소견의 상관 분석
이선영,고재성,김종재,장자준,서정기,Lee, Seon-Young,Ko, Jae-Sung,Kim, Chong-Jai,Jang, Ja-June,Seo, Jeong-Kee 대한소아소화기영양학회 1998 Pediatric gastroenterology, hepatology & nutrition Vol.1 No.1
Objective: Chronic hepatitis B infection (CHB) occurs in 6% to 10% of population in Korea. In ethinic communities where prevalence of chronic infection is high such as Korea, transmission of hepatitis B infection is either vertical (ie, by perinatal infection) or by close family contact (usually from mothers or siblings) during the first 5 years of life. The development of chronic hepatitis B infection is increasingly more common the earlier a person is exposed to the virus, particularly in fetal and neonatal life. And it progress to cirrhosis and hepatocellular carcinoma, especially in severe liver damage and perinatal infection. Histopathology of CHB is important when evaluating the final outcomes. A numerical scoring system which is a semiquantitatively assessed objective reproducible classification of chronic viral hepatitis, is a valuable tool for statistical analysis when predicting the outcome and evaluating antiviral and other therapies. In this study, a numerical scoring system (Ludwig system) was applied and compared with the conventional histological classification of De Groute. And the comparative analysis of cinical findings, family history, serology, and liver function test by histopathological findings in chronic hepatitis B of children was done. Methods: Ninety nine patients [mean age=9 years (range=17 months to 16 years)] with clinical, biochemical, serological and histological patterns of chronic HBV infection included in this study. Five of these children had hepatocelluar carcinoma. They were 83 male and 16 female children. They all underwent liver biopsies and histologic evaluation was performed by one pathologist. The biopsy specimens were classified, according to the standard criteria of De Groute as follows: normal, chronic lobular hepatitis (CLH), chronic persistent hepatitis (CPH), mild to severe chronic active hepatitis (CAH), or active cirrhosis, inactive cirrhosis, hepatocellular carcinoma (HCC). And the biopsy specimens were also assessed and scored semiquantitatively by the numerical scoring Ludwig system. Serum HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc (IgG, IgM), and HDV were measured by radioimunoassays. Results: Male predominated in a proportion of 5.2:1 for all patients. Of 99 patients, 2 cases had normal, 2 cases had CLH, 22 cases had CPH, 40 cases had mild CAH, 19 cases had moderate CAH, 1 case had severe CAH, 7 cases had active cirrhosis, 1 case had inactive cirrhosis, and 5 cases had HCC. The mean age, sex distribution, symptoms, signs, and family history did not differ statistically among the different histologic groups. The numerical scoring system was correlated well with the conventional histological classification. The histological activity evaluated by both the conventional classification and the scoring system was more severe as the levels of serum aminotransferases were higher. In contrast, the levels of serum aminotransferases were not useful for predicting the degree of histologic activity because of its wide range overlapping. When the histological activity was more severe and especially the cirrhosis more progressing, the prothrombin time was more prolonged. The histological severity was inversely related with the duration of seroconversion of HBeAg. Conclusions: The histological activity could not be accurately predicted by clinical and biochemical findings, but by the proper histological classification of the numerical scoring system for the biopsy specimen. The numerical scoring system was correlated well with the conventional histological classification, and it seems to be a valuable tool for the statistical analysis when predicting the outcome and evaluating effects of antiviral and other therapies in chronic hepatitis B in children. 연구목적: 만성 B형 간염의 간조직 소견은 진단 및 예후의 평가 뿐아니라 치료여부의 결정 및 치료효과의 평가를 위해서 중요하고, 이는 좀 더 객관적, 구체적, 포괄적으로 새롭게 분류할 필요성이 있다. 우리나라 소아의 만성 B형 간염의 빈도는 높을 것으로 추정되는데 아직 이에 대한 병리조직학적 고찰은 거의 없는 상태이다. 이에 저자들은 점수로 평가한 최근의 반정량적 분류 방법(Ludwig 분류법)을 전통적으로 이용되어온 De Groute의 분류법과 비교하여 연관성을 밝히고, 반정량적 분류법이 좀 더 객관적으로 예후를 예견하고 형태학적 변화를 감시하는 유용한 방법임을 소개하고자 하였다. 대상 및 방법: 서울대학교병원 소아과에 입원하여, 간조직 생검을 받은 만성 B형 간염 환아 99명을 대상으로 병리조직 소견과 병록지 고찰을 시행하였다. B형 간염 표식자로는 HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc(IgG, IgM), HDV를 방사면역측정(radioimmunoassay)을 이용하여 검사하였다. 간생검조직은 전통적인 De Groute의 병리조직학적 분류법과 병리조직학적 변화를 문맥강 및 문맥강 주변의 염증(Portal/Periportal activity), 간소엽 내 염증(Lobular activity), 섬유화(Fibrosis)로 나누어 각각의 정도를 0에서 4로 점수화(Numerical scoring)한 Ludwig의 체계에 따라 분류하였다. 두가지 분류법 간의 연관성과, 병리조직 소견에 따른 빈도, 연령 및 성별 분포, 임상적 특징, 생화학적 및 혈청학적 검사 소견을 비교 조사하였다. 또한 간세포암 5례는 따로 분류하여 임상적 고찰을 시행하였다. 결 과: 1) 총 99례 중 남아 83례, 여아 16례였고, 연령별 분포는 1년 5개월에서 16년 4개월까지였으며, 평균연령은 9.4세였다. 병리조직형별 연령 및 성별분포에는 차이가 없었다. 2) 병리조직형별 분포는 정상 조직 소견 2례, 만성 소엽성 간염 2례, 만성 지속성 간염 22례, 경도 만성 활동성 간염 40례, 중등도 만성 활동성 간염 19례, 고도 만성 활동성 간염 1례, 간경변을 동반한 만성 활동성 간염 7례, 간경변증 1례, 간세포암 5례였다. 두가지 분류법은 높은 연관성을 보였으나 간경화의 경우는 연관성이 떨어져서, 간조직내 염증과 섬유화는 따로 분리하여 평가하거나, 섬유화의 중량이 필요함을 알 수 있었다. 3) 간세포암을 제외한 94례 중 66례(70%)가 신체검사에서 우연히 발견된 경우였으며, 2례는 전신 부종이 주소로서 B형 간염과 관련된 막성 사구체 신염이 동반되어 있었다. 그 외는 비특이적인 간염증상을 주소로 내원하여 진단되었다. 내원시 임상 증상으로는 이피로성, 식욕부진, 오심, 구토, 복통, 복부팽만, 체중감소, 발열, 진한 소변색, 황달, 비출혈, 부종, 혈뇨 등이 있었고, 이학적 소견으로는 간장비대, 비장비대, 우측 상복부통이 있었다. 병리조직형별 임상증상, 이학적 소견 및 그 빈도에는 차이가 없었다. 4) 총 99례 중 가족력상 어머니에 B형 간염의 병력이 있는 경우가 54례, 아버지가 12례, 형제들의 경우가 25례 있었으며, 그 외의 동거 가족에서 가족력이 있는 경우는 17례 있었고, 가족력이 없는 경우는 28례였다. 가족 중 간경화가 있는 경우는 9례였고, 간세포암도 2례에서 있었다. 어머니가 만성 활동성 간염으로 사망한 례가 1례 있었고, 형제가 전격성 간염으로 사망한 경우도 1례 있었다. 병리조직형별 가족력의 차이는 없었다. 5) 간기능 검사소견을 보면, AST와 ALT의 평균은 각각 $151{\pm}158$ U/L, $215{\pm}221$ U/L이고, 병리조직형별로는 조직 염증소
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김기환 ( Ki Hwan Kim ),이지영 ( Ji Young Rhee ),이재경 ( Jae Kyung Lee ),조화영 ( Hwa Young Cho ),임석아 ( Seock Ah Im ),박규주 ( Kyu Joo Park ),김종재 ( Chong Jai Kim ) 대한내과학회 2008 대한내과학회지 Vol.75 No.2
Primitive neuroectodermal tumor (PNET) is frequent in children and adolescents, but rare in adults. Most of the extraosseous Ewing`s sarcoma or PNET occur in the soft tissues of the extremities, the paravertebral region, and the pelvic cavity. PNET in the gastrointestinal tract is uncommon. We report herein a case of PNET arising from the jejunum in a 38-year-old woman. She presented with anorexia, nausea, vomiting, and weight loss. Abdominal computed tomography revealed a mass in the small bowel with obstruction. She had a small bowel segmental resection, from which PNET was diagnosed. Multi-agent chemotherapy comprised of vincristine, adriamycin, cyclophophamide, ifosfamide, and etoposide (VAC/IE) was administered for 1 year. The treatment was well-tolerated. She remains alive and continues to be disease free 30 months postoperatively. (Korean J Med 75:237-241, 2008)
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정현정(Hyeon Jeong Jeong),김정화(Jeong Hwa kIM),박중신(Joong Shin Park),김장한(Jang Han Kim),오수영(Soo Young Oh),문정빈(Jeong Bin Moon),김미하(Mi Ha Kim),김종재(Chong Jai Kim),전종관(Jong Kwan Jun),윤보현(Bo Hyun Yoon),이현순(Hyun S 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.10
Congenital nephrotic syndrome is a rare condition of poor prognosis which develops at birth or within the first year of life. It is characterized by significantly increased maternal serum alphafetoprotein(AFP) and amniotic fluid AFP in the early second trimester. Occasionally affected children have been reported but we have no prenatally-diagnosed case in Korea. We report a case of congenital nephrotic syndrome of Finnish type, with a brief review of literature, that was diagnosed prenatally by maternal serum AFP, amniotic fluid AFP and family history. This case was terminated at 21 weeks of gestation and confirmed by autopsy with placentomegaly, microcystic tubular dilatation on light microscopy, the effacement of the foot processes of the epithelial basement membrane on electron microscopy.
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김종재,김용일,김우호,지제근,채승완,팽성숙,최기영 대한소화기학회 2000 대한소화기학회지 Vol.35 No.4
Background/Aims: The solid-pseudopapillary tumor of the pancreas occurs predominantly in young women, and most of them seem to be benign. The histogenesis of this tumor remains unclear. In this study, we reviewed the clinicopathologic findings and immunohistochemical staining pattern of eleven cases of solid-pseudopapillary tumor of the pancreas. Methods: Eleven cases of solid-pseudopapillary tumor of the pancreas were reviewed and immunohistochemistry with 12 antibodies was performed. Two cases were examined by electron microscopy. Results: All of the cases were female with a mean age of 27.9 years. Grossly, tumors were well demarcated multinodular mass with solid, cystic and hemorrhagic pattern and the mean diameter was 7.7 cm. Histologic examination showed that uniform cells formed solid sheets, and loss of cohesion produced pseudopapillae. Immunohistochemically, the all cases were reactive for vimentin and neuron specific enolase. Three cases expressed progesteron receptor, two cases expressed cytokeratin, and one case expressed alpha-1 antitrypsin. None of the cases showed expression of estrogen receptor, chromogranin, synaptophysin, lipase, epithelial membrane antigen, carcinoembryonic antigen or p53 protein. Conclusions: The solid-pseudopapillary tumor of the pancreas is possibly originated from pluripotent stem cells, but lacks definite evidences of endocrine or exocrine differentiation.
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金宗才 中央醫學社 1993 中央醫學 Vol.58 No.1
The incidence of gunshot injuries is much lower in Korea when compared with those of western countries, because one is prohibited from having firearms. But, sporadic cases of gunshot injuries are encountered chiefly in the army and the police. The range of fire is divided into ; 1) Contact gunshot wounds 2) Loose contact gunshot wounds 3) Close range gunshot wounds 4) Long range gunshot wounds according to the tissue appearances around the entrance, and these are affected in turn by gas, flame, smoke, gunpowder, bullets, and muzzle. The major problem in the investigation of gunshot injuries lies in the discrimination of homicide, suicide, and accidents, and the factors that should be considered in the investigation of gunshot injuries include 1) The scene of death 2) Examination of clothes and hands 3) Location of wounds 4) Range of fire 5) Multiplicity of guns 6) Detection of fire.
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