유두주위게실은 담석의 발생 및 재발에 영향을 주는 위험인자로 보고된 바 있다. 하지만 유두주위게실이 내 시 경 역 행 담 췌 관 조 영 술 ( e n d o s c o p i c r e t r o g r a d e cholangiopancreatography) 시행 중 선택적 담관 삽관의 성공률에 영향을 주는지에 대해서는 논란의 여지가 있다. 다만, 실제 임상에서는 유두주위게실로 인해 선택적 담관 삽관이 어려운 경우가 분명히 존재하며, 이를 해결하기 위한 다양한 방법이 보고되었다. 본고에서는 생검겸자를 이용해 선택적 담관 삽관에 성공한 증례를 보고하고자 한다.

초음파 내시경 검사는 내시경 선단에 달린 초음파 탐지자를 이용하여 위장관 내에서 초음파를 이용하여 주변 장기를 관찰하는 검사다. 초음파 내시경을 이용하면 췌장을 고해상도로 실시간 관찰하면서 병소에 대한 조직 검사가 가능하다. 초음파 내시경 유도하 조직 검사는 지난 20여 년간 초음파 내시경 및 세침의 발전과 해부학적 구조의 이해 및 내시경을 통한 조직 검사 술기 등의 발전으로 췌장 질환에 대한 기본적인 비수술적 조직 검사가 되었다. 본고에서는 최근에 발표된 유럽 및 국내 가이드라인에서 언급하고 있는 내시경 초음파 유도하 조직 검사의 췌장 병변에서의 활용 기준과 다양한 종류의 조직 세침의 특성에 따른 선택, rapid on site evaluation, stylet 및 음압의 사용, fanning technique 등 검사에서 고려할 사항 및 조직 검체 처리 방법, 합병증 및 교육에 대해서 간략히 기술하였다.

Although fine-needle aspiration biopsy (FNAB) has been widely accepted as a valuable tool for differential diagnosis of head and neck tumors, the diagnostic value of FNAB in the management of salivary gland tumors has been questioned. This case report presents a patient with mucoepidermoid carcinoma of parotid gland diagnosed as pleomorphic adenoma by FNAB and discusses the pitfalls in the diagnosis of malignant salivary gland tumors.

The present study was to assess the in vitro viability and sexing rate of bovine embryos. Blastocysts were harvested on day 7～9 day after insemination(in vitro and in vivo), and the sex of the embryos was examined using the LAMP method. Embryo cell biopsy was carried out in a 80 μl drop Ca2+, Mg2+ free D-PBS and, biopsied embryos viability were evaluated after more 12 h culture in IVMD culture medium. The formation of recovered embryo to expanded and hatching stages had ensued in higher of sexed embryo in vivo than in vitro (100% vs. 89%, p<0.05), and in vitro, the rates of degeneration after sexing were significantly (p<0.05) higher in vitro than in vivo(11% vs. 0.0%). The rates of the predicted sex were female 61% vs. 56%, and male 39% vs. 44% in vivo and in vitro, respectively. The rates of survival following different biopsy methods were seen between punching and bisection method in vivo and in vitro (100% vs. 89% and 100% vs, 78% respectively). Biopsy method by punching was significantly (p<0.05) higher than bisection between produced embryos in vivo and in vitro. The present data indicate that with microblade after punching for embryo sexing results in high incidence of survivability on development after embryo biopsy. It is also suggested that LAMP-based embryo sexing suitable for field applications.

수정란의 성 판별은 유전적으로 우수한 유전형질을 보유하고 있는 소의 수정란을 성 판별하므로서 희망하는 성의 송아지를 생산할 수 있으며, 부가가치가 높은 수정란을 확보할 수 있는 기술이다. 수정란의 손상을 최소화하면서 할구를 biopsy하는 기술을 개발하고, 간단하고 빠른 시간에 성 판별이 가능한 Loop-mediated isothermal amplification방법으로 수정란을 성 판별을 실시한 결과는 다음과 같다. 1. 한우 체내 수정란의 성비는 암

This study was carried out to determine the factors on achieving good viability of embryos biopsied fur sexing, to investigate pregnancy rate following embryo transfer(ET) with sexed embryos, and to confirm the accuracy for the calves bort following ET with sexed embryos by polymerase chain reaction(PCR). To investigate viability of Hanwoo embryos after biopsy for sexing, fresh and frozen/thawed embryos were biopsied according to different developmental day of blastocysts, different stage of blastocysts, and different biopsy grade and the embryos themselves were incubated for 2 hours in TCM199 after microsection to be evaluated morphologically for recovery as blastocyst. The results obtained were as follows : 1. The rate of oocytes cleaved in vitro and the rate of blastocyst of the cleaved oocytes were 52.5% and 21.6%, respectively. The rate of blastocyst on day 8 was 11.2%, denoting the highest rate during whole culture period posterior to in vitro fertilization(IVF) 2. After biopsy for sexing, the viability rate of blastocyst on day 7, 8 and 9 was 75.0%, 88.4%, and 100.0%, respectively and the viability of early, mid, and expanded blastocyst after biopsy was 75.0%, 88.9%, and 91.1%, respectively The viability rate of fresh and frozen/thawed embryos was 89.9%, 71.4%, respectively. And the viability of expanded, hatching, and hatched blastocyst of frozen/thawed embryos was : 75.0%, 75.0%, and 50.0%, respectively. The viability of embryos according to biopsy grade of 10∼20%, 21∼30%, and 31∼40% was 85.7%, 91.5%, and 71.4%, respectively. 3. Pregnancy rate after transfer with biopsied embryo between flesh and frozen/thawed embryos was 22.6% and 20.0%, respectively. 4. In comparison between sex by PCR method and sex of calves born after embryo transfer, the accuracy of sex deterimination was 92.3% (12/13).

The possible use of micromanipulative biopsy and PCR of the biopsied embryonic cells was tested to produce sexed bovine embryos in practical terms. By micromanipulation and PCR techniques, higher survival rate and accurate sexing of demi-embryos were btained. Bovine oocytes matured and fertilized in vitro were co-cultured with bovine oviductal epithelial cell (BOEC) monolayer in USU-6 medium supplemented with 15% FBS, and the embryos of 37% (327/885) were developed to blastocysts. Among 111 blastocysts produced by invitro, only 7 (6.3%) embryos were found unable to determine their sex, probably due to the loss of cells, since no PCR product was found from those cells. All the remaining 104 (93.7%) demi-embryos survived micromanipulation and demonstrated male-specific product or bovine-specific product alone suggesting that correct sexing of the sample. Forty-three point one percent(25/58) of manipulated and cryopreserved demi-embryos after thawing were survived. Final verification of the sexed embryos is necessary to make sure the same sex in fetus and newborn calf upon embryo transfer. The established sexing method on a large number of bovine embryos from previous and this study suggests that this a could be used practically in the field.

수정란이식의 주변기술인 초기배의 미세조작및 성 판정은 가축의 경우, 경제 형질의 유전적 개량에 크게 기여하였다. 본 연구는 미세조작 biopsy와 PCR에 의한 체외생산 소 초기배의 급속. 정확한 성 판정 기법을 확립하기 위해 실시하였다. 체외성숙 및 체외수정에 의해 생산된 소수정란은 소 난관상피세포와 공배양을 통해 8-세포부터 배반포시시까지 체외발생시킨 후 미세조작 biopsy에 이용되었다. 미세조작 biopsy 과정중에 약간의 형태적인 손상이 관찰되

Tuberculosis (TB) is still a significant public health problem in Korea. In many cases, it is not easy to diagnose TB. A 13-year-old male patient was admitted for left chest pain for 6 months period. Chest radiography done two months ago during the school screening revealed a pleural effusion in the left lung. All cultures were negative, and 3 sputum samples and his pleural fluid sample tested negative for Acid-fast bacilli. There was no evidence of a malignant effusion. A pleural fluid examination revealed features suggestive of an empyema. Thick and yellowish pus was drawn out. Pleural fluid analysis presented White blood cell 5,200/mm3, and neutrophil-dominant with 60% of neutrophil. In an effort to attain a diagnosis, a video-assisted thoracoscopy procedure was performed with pleural drainage and biopsies. Active chronic granulomatous pleuritis was found through pleural biopsies. He was responsive to treatment and received 6 months of anti-TB therapy with complete clinical resolution. If the clinical picture is in confusion, pleural biopsy is occasionally indicated to diagnose TB pleuritis.

본 연구는 일반적인 간 초음파영상에서 형태학적인 분류인 간 표면, 간 가장자리, 간 실질을 점수체계로 이용하여 간 조직검사 결과의 경미한 섬유화(F1), 중증도 섬유화(F2), 심한 섬유화(F3) 및 간병변(F4)으로 나 눈 섬유화 단계와 비교하여 유용성을 알아보고자 하였다. 결론적으로 일반적인 초음파 검사는 경미한 섬유 화(F1)~심한 섬유화(F3)를 검출할 수 있는 민감한 예측 인자로 간 가장자리>간 실질>간 표면으로 나타났으 며, 간경변(F4)를 검출할 수 있는 예측인자로는 간 실질>간 표면>간 가장자리로 나타났다. 일반적인 초음파 검사에서 각각의 변수가 아닌 3가지 변수조합을 활용한다면 간 섬유화 정도와 진행 상태를 평가하는데 더 유용할 것으로 사료된다.

유방암에 관한 사회적인 관심이 증가되고 있는 가운데 진단의 가장 기본이 되는 검사는 유방 X선 촬영 과 유방 초음파 검사이다. 특히 유방 미세석회화는 조직학적 진단을 필요로 하며 유방 미세석회화 조직검사를 시행하고 있다. 이에 미세석회화 진단에 기본이 되는 X선 유도 하 조직검사(needle localized open biop sy)와 초음파 유도 하 조직검사(sono guided core needle biopsy)를 분석하여 평가하고자 한다. 유방 미세석회화를 주소로 내원한 환자에서 확대 촬영을 시행한 241예를 대상으로 X선 유도 하 조직검 사(needle localized open biopsy)와 초음파 유도 하 조직검사(sono guided core needle biopsy)의 연령대 별 분 포와 병소의 위치를 분석하고 확대촬영 시행 후 이루어진 검사를 분류해서 X선 유도 하 조직검사와 초음 파 유도 하 조직검사의 빈도를 분석하고 악성과 양성의 결과를 확인 하였다. 그 결과 X선 유도 하 조직검 사(needle localized open biopsy)가 64예(26.6%)로 초음파 유도 하 조직검사(sono guided core needle biopsy) 1 2예(4.9%)에 비해 5.4배 높은 것으로 나타났다. 초음파 장비의 발달과 입체정위 흡입법(stereotactic vacuum-assisted biopsy)등의 발달로 미세석회화의 조직 학적 진단방법이 다양해지고 있지만, 각각 검사의 특성과 한계점을 고려해 볼 때 X선 유도 하 조직검사(ne edle localized open biopsy)가 유방 미세석회화 병변에서는 정확한 조직학적 진단을 제공한다고 사료된다.

Rectal melanoma is extremely rare. Its histologic variability and difference in immunohistochemical (IHC) expression may hinder the correct diagnosis. Seventy-three years old Korean woman complained of bloody stool and found a 2cm sized rectal pedunculated polyp on colonoscopy. There was some disparity in IHC expressions as well as cytological morphology between biopsy and surgically resected specimen. When strong immunoreactivity of S-100 is encountered in anorectal lesion with unusual morphology, multiple IHC analysis and high suspicion of anorectal melanoma could lead to correct diagnosis.

Acute tubular necrosis (ATN) is a syndrome of intrinsic renal injury secondary to ischemic or toxic causes without parenchymal damages and usually non-oliguria. A 20-year old man presented with acute renal failure preceded by 2 days of watery diarrhea. He had been anuria for 48hr with intravenous fluid therapy. Oliguria persisted for 10 days and he required hemodialysis support for 6 days before renal recovery. He denied the use of any regular medication and any intravenous drug use. Renal biopsy revealed severe ATN. Histopathologic findings were marked desquamation of proximal tubular epithelial cells with intact distal tubules and normal glomeruli. We report an unusual case of ATN with anuria and clinically severe features.