설하선에 발생한 고립성 섬유종 1예

금윤섭,김기영,임근혜,김정규 대한이비인후과학회 2008 대한이비인후과학회지 두경부외과학 Vol.51 No.3

Solitary fibrous tumor, a mesenchymal neoplasm that arises most commonly from the pleura of the lung, has been described in a variety of extrapleural sites including the abdominal cavity, soft tissue, upper respiratory tract and rarely in head and neck region. We present a rare case of solitary fibrous tumor that occurred in the sublingual gland. A 52-year old woman presented with a painless mass in the left side of the floor of mouth. The tumor was well-demarcated and easily dissected, and it showed highly cellular areas of spindle cells with pattern-less architecture alternating with hypocellular areas. The tumor cells were positive for CD34 but negative for cytokeratins and S-100 protein. During the 12 months of follow-up, there was no recurrence of tumor growth. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:286-8)

백서 간의 재관류 손상에서 단기간 허혈전처치의 효과 : Interleukin-1α와 Nuclear Factor-κB 발현

금윤섭,이수경,김선주,곽은경,박지영,박태인,배한익,손윤경,서인수 대한병리학회 2002 Journal of Pathology and Translational Medicine Vol.36 No.4

Background : A short period of ischemia and reperfusion, called ischemic preconditioning, protects various tissues against subsequent sustained ischemic insult. Apoptosis of hepatocytes and sinusoidal endothelial cells are a critical mechanisms of injury in the ischemic liver. Because nuclear factor-κB (NF-κB) has a significant role in the cell survival, we hypothesized that ischemic preconditioning protects by inhibition of apoptosis through the expression of NF-κB, induced by interleukin-1α (IL-1α), which is known for enhancement of its transcription and activation. Methods : We induced ischemia and reperfusion on rat liver, and performed in situ terminal deoxyribonucleotidyl transferase-mediated dUTP nick end labelling assay and polymerase chain reaction for IL-1α mRNA and NF-κB mRNA. Results : Apoptosis of hepatocytes and sinusoidal endothelial cells, assessed by in situ TUNEL assay, was significantly reduced with preconditioning. The expression of IL-1α mRNA and NF- B mRNA are seen on discrete monoclonal bands around 344 and 356 base pairs, in comparison with normal rat liver, but, there was no significant difference between the ischemia-reperfusion group and the preconditioning group. Conclusions : We suggest that ischemic preconditioning confers dramatic protection against prolonged ischemia via inhibition of apotosis through the expression of IL-1α inducing NF-κB and its activation. However, we need further study in the activity of NF-κB, such as nucleotide shift assay, because the activity of NF-κB is regulated by binding of the inhibitory protein, I κB.

전립선암에서 PTEN과 Ki-67 발현의 임상적 의의

강일,금윤섭,박관규,김덕윤,박재신 대한비뇨의학회 2009 Investigative and Clinical Urology Vol.50 No.6

Purpose: Phosphatase and tensin homolog (PTEN) is a novel tumor suppressor gene located at chromosome 10q23. Ki-67 antigen is a human nuclear protein that is expressed in all active parts of the cell cycle. We evaluated the significance of PTEN and Ki-67 expression in prostate cancer and investigated the relation of this expression with clinico- pathological factors in prostate cancer. Materials and Methods: Initially, we did two kinds of immunohistochemical staining for PTEN and Ki-67. Immunohistochemical staining was performed on 75 formalin-fixed paraffin-embedded cancer specimens. Staining on paraffin blocks from prostate carcinomas was compared with that for adjacent normal prostate. Stainings were considered positive if nuclear staining was seen. Positive stainings were analyzed with the patient's clinico-pathological findings. Statistical analysis was performed by using chi-square test with p<0.05 considered significant. Results: PTEN was expressed in 65 (86.6%) of 75 specimens. Ki-67 was expressed in 63 (84.0%) of 75 specimens. The staining scores of the tumor cells for PTEN and Ki-67 were higher than those of the adjacent normal cells (p<0.05). The staining scores for PTEN were negatively correlated with the serum prostate-specific antigen (PSA) level and Gleason score, but this was not statistically significant (p>0.05). PTEN expression was negatively correlated with lymph node or distant metastases (p<0.05). Ki-67 was positively correlated with the serum PSA level, the Gleason score, and metastases (p<0.05). Conclusions: PTEN and Ki-67 staining correlated well with Gleason score and PSA level in prostate cancer. These could be a possible predictor of prostatic neoplasms. Purpose: Phosphatase and tensin homolog (PTEN) is a novel tumor suppressor gene located at chromosome 10q23. Ki-67 antigen is a human nuclear protein that is expressed in all active parts of the cell cycle. We evaluated the significance of PTEN and Ki-67 expression in prostate cancer and investigated the relation of this expression with clinico- pathological factors in prostate cancer. Materials and Methods: Initially, we did two kinds of immunohistochemical staining for PTEN and Ki-67. Immunohistochemical staining was performed on 75 formalin-fixed paraffin-embedded cancer specimens. Staining on paraffin blocks from prostate carcinomas was compared with that for adjacent normal prostate. Stainings were considered positive if nuclear staining was seen. Positive stainings were analyzed with the patient's clinico-pathological findings. Statistical analysis was performed by using chi-square test with p<0.05 considered significant. Results: PTEN was expressed in 65 (86.6%) of 75 specimens. Ki-67 was expressed in 63 (84.0%) of 75 specimens. The staining scores of the tumor cells for PTEN and Ki-67 were higher than those of the adjacent normal cells (p<0.05). The staining scores for PTEN were negatively correlated with the serum prostate-specific antigen (PSA) level and Gleason score, but this was not statistically significant (p>0.05). PTEN expression was negatively correlated with lymph node or distant metastases (p<0.05). Ki-67 was positively correlated with the serum PSA level, the Gleason score, and metastases (p<0.05). Conclusions: PTEN and Ki-67 staining correlated well with Gleason score and PSA level in prostate cancer. These could be a possible predictor of prostatic neoplasms.

구불창자에서 발생한 횡문근모양 샘암종- 1예 보고 -

오훈규,조창호,금윤섭 대한병리학회 2008 Journal of Pathology and Translational Medicine Vol.42 No.1

Colorectal adenocarcinoma with rhabdoid features is extremely rare and only two cases have been previously reported. We report here on a case of colorectal adenocarcinoma with prominent rhabdoid features in a 69-year-old female. The specimen was an ulcerative mass from the sigmoid colon, and it measured 3.5×3 cm. Microscopic examination of the tumor showed mostly rhabdoid cells that had eccentrically located large nuclei and foci of glandular formation. A transitional area from the poorly differentiated adenocarcinoma to the rhabdoid tumor was also noted. Immunohistochemical studies showed strong reactivity of the glandular forming cells for pan-cytokeratin, and the cells were occasionally positive for vimentin. The cells with rhabdoid features were diffusely positive for vimentin and focally positive for pan-cytokeratin. These results suggested that the cells with rhabdoid features originated from dedifferentiated primary adenocarcinoma. Since colorectal adenocarcinoma with rhabdoid features is highly aggressive and unresponsive to conventional therapy, making the preoperative diagnosis is important to facilitate the treatment.

외상에 의한 심실중격 열창 : 1증례 보고

박태인,채종민,금윤섭,곽정식 大韓法醫學會 1999 대한법의학회지 Vol.23 No.2

Blunt chest trauma may cause a variety of cardiac injuries, such as cardiac contusion, congestive heart failure due to myocardial injury or disruption of intracardeac structues, and more severely, instantaneous death. Traumatic rupture of the interventricular septum secondary to blunt chest trauma is extremely rare. Rupture of the interventricular septum may occur almost immediately after injury or many days later. The most common site of rupture is in the muscular portion of the septum near the apex. The exact mechanism of ventricular septal rupture in blunt trauma is unknown but it is thought to occur by external compression of the heart between the sternum and the vertebrae or as a result of extreme changes in intrathoracic pressure during sudden deceleration. We report an autopsy case of intraventricular septum rupture due to blunt chest trauma. A comatous 28-year-old male was admitted to emergency room after blunt chest trauma by unidentified object. He was treated with supportive care but expired two days later. The autopsy findings were as follows. The dead boy was slightly slender. External wound and patterned bruise were not present. In submentopbic incision, both pleural fluid(right 700ml, left 450ml) and ascites(400ml) were noted. The posterior wall of left ventricle showed hemorrhage measuring 1cm in diameter. On opening the heart, there was interventricular septum rupture measuring 3.5cm in length. Other cardiac structures were unremarkable. On ligh microscopic examination, endothelial cell was not seen in ruptured portion and both lung showed severe congestion and edema.

완전 절제된 IB 비소세포암에서 재발의 예후인자로의 장측늑막 침범

김석,박기성,금윤섭,이섭,배지훈,현대성 대한흉부외과학회 2009 Journal of Chest Surgery (J Chest Surg) Vol.42 No.5

배경: 완전 절제된 IB 비소세포암에서 항암요법의 반드시 필요한가에 대한 여러 보고가 있다. 그래서 본 연구는 완전 절제된 IB 비소세포암 환자에서 재발에 관여하는 예후인자를 찾고 항암요법의 필요성을 알아보았다. 대상 및 방법: 1997년부터 2006년까지 모두 48명의 환자를 후향적으로 조사하였다. 전체생존율과 무병생존율을 위해 Kaplan-Meier method를 사용하였고 단변량 분석은 log rank, 다변량 분석은 Cox 회귀모형을 사용하였다. 결과: 추적중앙값은 48개월, 5년 전체생존율은 55.9%, 5년 무병생존율은 48.6%였다. 단변량 분석에서 장측늑막과 임파혈관침범이 재발에 유의한 인자였고, 다변량분석에서는 장측늑막침범이 예후인자였다. 또한 장측늑막, 임파혈관 침범 중 한 개 이상의 경우, 없는 경우와 비교하여 전체 생존율에서 의미 있는 차이가 있었다. 결론: 장측늑막침범은 재발 및 생존에 관여하는 불량한 예후인자이며, 항암요법이 필요한 환자를 선택할 때 도움 되는 인자로 생각된다. Background: Several trials have reported on whether adjuvant chemotherapy for resected stage IB non-small cell lung cancer is needed. The aim of our study was to investigate prognostic factors for recurrence to help identify patients who should receive adjuvant chemotherapy. Material and Method: We reviewed the cases of 48 stage IB non-small cell lung cancer patients between 1997 and 2006. Disease-free survival and overall survival rates were calculated by the Kaplan-Meier method. Univariate analysis was performed with the log rank test and multivariate analysis was done using Cox’s proportional hazard model. Result: The median follow-up time was 48 months. The overall survival rate was 55.9%, and the disease-free survival rate was 48.6%. Of 8 variables, two factors, visceral pleural invasion and lymphovascular invasion, were prognostic factors of disease-free survival (univariate analysis). Visceral pleural invasion was a significant prognostic factor in multivariate analysis, and overall survival in compared one or more variable such as visceral pleural invasion or, and lymphovascular invasion with the other variables. Conclusion: Visceral pleural invasion was identified as a poor prognostic factor and it may help select which patients will benefit from adjuvant chemotherapy in addition to more comprehensive follow-up.

심장사르코이드증에 의한 급사: 1예 보고

이수경,김선주,금윤섭,박태인,이상한,채종민,곽정식 대한병리학회 2003 Journal of Pathology and Translational Medicine Vol.37 No.5

Sarcoidosis is a systemic granulomatous inflammation with an unknown cause. The commonly involved sites are the lymph nodes, lungs, skin, eyes, and heart. Although cardiac involvement in sarcoidosis is rarely detected clinically, it is reported in 20-50% of autopsied sarcoidosis patients. Cardiac involvement is one of the most severe conditions of sarcoidosis and may cause sudden death. We report a case of a sudden death due to a massive cardiac sarcoidosis in a 43-year-old man. The microscopic examination revealed an extensive noncaseating granulomatous inflammation in the mediastinal lymph nodes and the heart with no evidence of myocyte necrosis. A special stain and molecular study excluded the possibility of other causes such as fungi or mycobacterium. The authors concluded that the cause of death was attributed to arrhythmia due to a cardiac sarcoidosis with massive involvement of the conduction system.

갑상선 종괴로 촉지된 흉선종의 세침흡인 세포학적 진단 - 2예 보고 -

김동자,박지영,금윤섭,박태인,손윤경,Kim, Dong-Ja,Park, Ji-Young,Kum, Yoon-Seup,Park, Tae-In,Sohn, Yoon-Kyung 대한세포병리학회 2000 대한세포병리학회지 Vol.11 No.1

Thymoma is the most common anterior mediastinal tumor in adults. Rarely, it is presented as the anterior neck mass, commonly located in the anterolateral aspect of the neck or adjacent to the thyroid. We experienced two cases of fine needle aspiration cytology of thymoma, mimicking thyroid mass. The first case was an ectopoic cervical thymoma in a 31-year-old female. The fine needle aspiration cytology was misinterpreted as reactive hyperplasia of lymph node. But the histologic diagnosis was thymoma, predominantly lymphocytic type. The second case was an invasive thymoma in a 66-year-old female, who complained a large anterior neck mass. The fine needle aspiration cytology revealed biphasic population of some clusters of epithelial cells and scattered lymphocytes. The cytologic diagnosis was thymoma and was confirmed as invasive thymoma after the biopsy. Therefore, when the cytologic feature of anterior neck mass shows the both lymphocyte and epithelial component, the differential diagnosis should Include the possibility of thymoma.

간성상세포의 활성에서 siRNA를 이용한 TGF-β1의 전사조절

오훈규,김경현,금윤섭,조창호,박재복,박관규 대한병리학회 2009 Journal of Pathology and Translational Medicine Vol.43 No.6

Background : The cytokine-induced activation of hepatic stellate cells (HSC) plays a major role in liver fibrosis. Quiescent HSCs undergo phenotypic transformation called “transdifferentiation” in response to viral, chemical or immune insults to the liver. The cytokine TGF-β1 plays a key role in progressive liver fibrosis. Since small interfering RNA (siRNA) is a powerful tool for silencing gene expression post-transcriptionally, the present study aimed to determine whether synthetic TGF-β1 siRNA down-regulates the expression of the TGF-β1 gene in immortalized and activated rat HSCs (HSC-T6s). The study examined whether synthetic TGFβ1 siRNA prevents rat HSCs activation and extracellular matrix (ECM) production. Methods : TGF-β1 siRNA or a control (pU6) siRNA was added to HSC-T6 culture media. We then performed RT-PCR and western blot analyses for TGF-β1 and ECM components (fibronectin, type-I collagen, and TIMP-1). Results : TGF-β1 siRNA significantly down-regulated expression of TGF-β1 mRNA and protein and attenuated mRNA and protein expressions of type-I collagen, fibronectin, and TIMP-1, as compared to the control. Conclusions : TGF-β1 siRNA can effectively down-regulate the expression of TGF-β1 in rat HSC, resulting in significant inhibition of HSC activation and of ECM production. These data indicate that synthetic TGF-β1 siRNA can be a useful treatment modality to prevent liver fibrosis. Background : The cytokine-induced activation of hepatic stellate cells (HSC) plays a major role in liver fibrosis. Quiescent HSCs undergo phenotypic transformation called “transdifferentiation” in response to viral, chemical or immune insults to the liver. The cytokine TGF-β1 plays a key role in progressive liver fibrosis. Since small interfering RNA (siRNA) is a powerful tool for silencing gene expression post-transcriptionally, the present study aimed to determine whether synthetic TGF-β1 siRNA down-regulates the expression of the TGF-β1 gene in immortalized and activated rat HSCs (HSC-T6s). The study examined whether synthetic TGFβ1 siRNA prevents rat HSCs activation and extracellular matrix (ECM) production. Methods : TGF-β1 siRNA or a control (pU6) siRNA was added to HSC-T6 culture media. We then performed RT-PCR and western blot analyses for TGF-β1 and ECM components (fibronectin, type-I collagen, and TIMP-1). Results : TGF-β1 siRNA significantly down-regulated expression of TGF-β1 mRNA and protein and attenuated mRNA and protein expressions of type-I collagen, fibronectin, and TIMP-1, as compared to the control. Conclusions : TGF-β1 siRNA can effectively down-regulate the expression of TGF-β1 in rat HSC, resulting in significant inhibition of HSC activation and of ECM production. These data indicate that synthetic TGF-β1 siRNA can be a useful treatment modality to prevent liver fibrosis.

폐쇄성 담관질환에서 관찰되는 담소관증식의 기원에 관한 면역조직화학적 연구

성현정,안병철,이재태,금윤섭,박재복,박관규 대한병리학회 2009 Journal of Pathology and Translational Medicine Vol.43 No.2

Background : The relationship between bile duct proliferation and portal fibrosis in obstructive liver diseases remains unclear. The purpose of this study is to analyze the relationship between hepatic stellate cells (HSC), hepatocytes and bile ductule proliferation in obstructive liver disease using immunoreactivity for α-SMA (α-smooth muscle actin), CK7, and CK19. Methods : We used 20 human tissue samples with hepatic fibrosis due to intrahepatic stones and liver cirrhosis. Immunohistochemical staining was performed using the streptavidin-biotin method. Results : Proliferations of bile ductules at the periphery of the hepatic lobules, and diffuse HSC activation in the perisinusoidal spaces were observed in all cases. Immunoreactivity of the hepatocytes for CK7 and CK19 suggested a possible phenotypic transformation into bile duct epithelium during fibrogenesis. Immunohistochemical-analyses of α-SMA expression profiles showed that intralobular HSCs and some hepatocytes underwent early phenotypic changes, and that the accumulation of collagen coincides with that of α-SMA-labeled myofibroblasts around portal/septal ductular structures. Conclusions : Our results showed the possibility of a phenotypic transformation of hepatocytes into bile ductular epithelium. It is suggested that hepatocytes might play a role in bile ductule proliferation in obstructive liver disease.