本態性高血壓症의 病因에 對한 體質 및 環境的 硏究

朴錫璉 최신의학사 1974 最新醫學 Vol.17 No.9

These studies were undertaken to examine constitutional pressor responses, personal characters (temperaments and emotions), noxious emotional stimuli, salt-intake, ageing factors and other cont?ributing factors relating to the etiology of essential hypertension. Therefore the mechanisms of essential hypertension were investigated from constitutional and environmental viewpoints. The results, were as follows; 1. Essential hypertension is a product of interaction between intrinsic or genetic factors and ext?rinsic or environmental factors. 2. The intrinsic factors include both pressor constitutional responses to life stresses and pressor personal characters, and the extrinsic factors both pressor emotional stimuli and high salt-intake. To put it in the concrete; a) The greater pressor constitutional responses to life stresses become, b) the more traits of pressor personal characters are possessed, c) the greater the intensity, length and frequency of pressor emotional stimuli become, and d) the more salt one intakes, the more easily essential hypertension will develop. However, when the extrinsic factors are weak while the intrinsic factors are strong and vice versa, essential hypertension may develop. 3. Middle age period as an ageing factor provides fundamental basis for the development of essen?tial hypertension. Above-mentioned five factors are considered as the most important determinants in the initiation of essential hypertension. As a minor helping factor, overweight helps to elevate blood pressure. 4. Essential hypertension is a clinical entity which results from the disharmony of cardibfascular responses derived from the overactivity of the cephalic-sympathetic N. system evoked by daily, strong, long-standing pressor emotions of middle-aged persons with congenital sympathico--dominant constitution. 5. Early essential hypertension once formed gradually progresses to sustained hypertension through superimposition of structural changes in resistance vessels, atherosclerosis and .renal' pressor substan?ces, namely renin-angiotensin-aldosterone etc. 6. I advocate the "Predisposition-Inducement ; .Theory" as one which explains the etiology and mechanisms of essential hypertension.

Mucinous Tubular and Spindle Cell Carcinoma of KidneyOccurring in a Patient with Pulmonary Adenocarcinoma

박석연,강경훈,노재윤,제니퍼블랙,정진수,이강현,홍은경,박원서 대한병리학회 2008 Journal of Pathology and Translational Medicine Vol.42 No.1

Mucinous tubular and spindle cell carcinoma (MTSCC) is a rare type of kidney tumor that has only been recently described. Furthermore, a case of MTSCC associated with a simultaneous lung cancer in the same patient has never been reported in the literature. In this paper, we describe a kidney tumor that was detected during staging work-up in a 72-year-old lung cancer patient. The kidney tumor was removed and shown to exhibit histological and immunophenotypic features of MTSCC, completely distinct from the pulmonary adenocarcinoma. In addition, this case was unique because it was characterized by neuroendocrine differentiation as well as p53 and Ki-67 overexpression in tumor cells. Therefore, we report a case of MTSCC diagnosed in a patient with pulmonary adenocarcinoma and describe the detailed histologic and immunohistochemical features of MTSCC. Mucinous tubular and spindle cell carcinoma (MTSCC) is a rare type of kidney tumor that has only been recently described. Furthermore, a case of MTSCC associated with a simultaneous lung cancer in the same patient has never been reported in the literature. In this paper, we describe a kidney tumor that was detected during staging work-up in a 72-year-old lung cancer patient. The kidney tumor was removed and shown to exhibit histological and immunophenotypic features of MTSCC, completely distinct from the pulmonary adenocarcinoma. In addition, this case was unique because it was characterized by neuroendocrine differentiation as well as p53 and Ki-67 overexpression in tumor cells. Therefore, we report a case of MTSCC diagnosed in a patient with pulmonary adenocarcinoma and describe the detailed histologic and immunohistochemical features of MTSCC.

東·西醫學의 接木 東洋性理學의 理氣陰陽說에 對한 西醫學的 照明

朴錫璉 최신의학사 1994 最新醫學 Vol.37 No.2

Ecological and Epidemiological Studies on the Etiology and Pathogenesis of Essential Hypertension

Park, Syuk Ryun 최신의학사 1976 最新醫學 Vol.19 No.4

本態性高血壓症의 病因은 아직 不明이다. 筆者는 本症은 사람과 環境과의 相互作用에 依한 하나의 合作産物로 推定하여 왔다. 따라서 本硏究는 사람과 環境의 兩面에서 그 關與因子를 索出하교 그 發生機序를 考察하지 않으면 안된다고 믿는 바이다. 本硏究는 個體의 植物神經性體質, 昇壓反應, 性格, 有害情緖刺戟, 食鹽攝取量, 加齡因子 및 其他 本症의 原因에 關與된다고 考慮되는 因子들을 調査 檢討함으로써 本症의 發生機序를 生態學的 및 疫學的 見地에서 考察한 것이다. 1) 本態性高血壓症은 人類日常生活에 있어서 個體의 體質的素地와 環境因子와의 相互作用에 依한 하나의 合作産物로 看做한다. 2) 體質的素地는 交感神經緊張優越性體質과 昇壓性格의 兩者이고 環境因子는 昇壓情緖刺戟과 食鹽의 慢性過剩攝取의 兩者이다. 3) 體質的素地와 昇壓環境因子가 强大할수록, 敷衍하면 a) 交感神龍緊張優越性醴質의 素地를 많이 간직할수록, b) 昇壓性格의 素地를 많이 간직할수록, c) 昇압情緖刺戟이 强하고 길게 또는 자주 來襲할수록, 그리고 d) 食鹽을 長期間 過剩攝取할수록 本態性高血壓症은 容易하계 發生한다고 믿는 바이다. 그러나 때에는 體質因子가 弱하더라도 環境因子가 强할때 또는 이와 反對 境遇에도 本症은 發生할 可能性을 지니고 있는 것이다. 4) 中年期라는 加齡因子는 本症發生에 基盤的礎石을 提供한다. 以上 5個因子는 本症發生에 가장 重要한 決定因子가 된다. 其他 體重增加는 血壓上昇을 도와주는 하나의 補助因子가 될 수 있다. 5) 本症은 昇壓體質素地를 지닌 中年期의 사람에서 日常生活에서의 强하고 긴 또는 자주 返覆 來襲되는 昇壓情緖刻戟에 依한 過大한 stress 反應의 結果 交感神經-副腎髓質軸의 發動에서 오는 catecholamines, 腎細小動脈의 收縮 또는 交感神經의 直接刻戟에서 오는 renin-angiotensin-aldosterone 및 腦下垂體-副腎皮質軸을 通한 鑛質 corticoids의 過多放出等에 依한 持續的 神經-體液性變化로 發生되는 하나의 疾患群이다. 이 때 食鹽의 慢性過剩攝取는 stress에 依한 昇壓反應度를 增强하는 하나의 昇壓補助因子가 될 수 있다. 6) 一旦 始發된 初期高血壓症은 그 後 返覆 來襲되는 stress反應, 末梢細小動脈의 適應性肥大, arteriosclerosis와 atherosclerosis, 및 腎細小動脈硬化에서 由來되는 renin-angiotensin-aldosterone 放出等의 加重에 依하여 惡性循環이 成立되르 血壓은 上昇一路를 거듭하게 된다. 以上의 結果에 依하여 本症의 病因으로 多因子的 一元論으로서의 "素地-誘因"說(假說)을 主張하는 바이다.

Tumor lysis syndrome after nivolumab monotherapy for extensive-stage small cell lung cancer

정병진,박석연,이영주 대한내과학회 2018 대한내과학회 추계학술대회 Vol.2018 No.1

The Clinical Impact of Capmatinib in the Treatment of Advanced Non–Small Cell Lung Cancer with MET Exon 14 Skipping Mutation or Gene Amplification

최원영,박석연,이영주,임근영,박민정,이건국,한지연 대한암학회 2021 Cancer Research and Treatment Vol.53 No.4

Purpose Capmatinib, an oral MET kinase inhibitor, has demonstrated its efficacy against non–small cell lung cancer (NSCLC) with MET dysregulation. We investigated its clinical impact in advanced NSCLC with MET exon 14 skipping mutation (METex14) or gene amplification. Materials and Methods Patients who participated in the screening of a phase II study of capmatinib for advanced NSCLC were enrolled in this study. MET gene copy number (GCN), protein expression, and METex14 were analyzed and the patients’ clinical outcome were retrospectively reviewed. Results A total of 72 patients were included in this analysis (group A: GCN ≥ 10 or METex14, n=14; group B: others, n=58). Among them, 13 patients were treated with capmatinib (group A, n=8; group B, n=5), and the overall response rate was 50% for group A, and 0% for group B. In all patients, the median overall survival (OS) was 20.2 months (95% confidence interval [CI], 6.9 to not applicable [NA]) for group A, and 11.3 months (95% CI, 8.2 to 20.3) for group B (p=0.457). However, within group A, median OS was 21.5 months (95% CI, 20.8 to NA) for capmatinib-treated, and 7.5 months (95% CI, 3.2 to NA) for capmatinib-untreated patients (p=0.025). Among all capmatinib-untreated patients (n=59), group A showed a trend towards worse OS to group B (median OS, 7.5 months vs. 11.3 months; p=0.123). Conclusion Our data suggest that capmatinib is a new compelling treatment for NSCLC with MET GCN ≥ 10 or METex14 based on the improved survival within these patients.

췌장의 샘꽈리세포낭종 - 화생성 골화를 동반한 1예보고 -

김백희,박석연,김보미,강경훈 대한병리학회 2007 Journal of Pathology and Translational Medicine Vol.41 No.3

Acinar cell cystadenoma (ACA) is a very rare cystic lesion of the pancreas. The lining epithelium of ACA is morphologically identical to acinar cells of the pancreas. It is uncertain whether ACA is a benign neoplasm or cystic transformation of acinar glands but it is worthy to consider ACA in the differential diagnosis of other cystic neoplasms of the pancreas. We report here a 25-year old-woman who was operated on for a cystic mass of the pancreas. Grossly, a multilocular cystic mass containing clear serous fluid was observed. There was no communication between the cysts and the pancreatic ducts. Microscopically, cysts of various size were lined by columnar, cuboidal or flattened epithelial cells with a few foci of pseudostratification. The cells had granular apical cytoplasm and basally located nuclei with minimal atypia, the same as normal acinar cells. Metaplastic ossification was noted in the stroma. Immunohistochemically, the lining epithelium was positive for cytokeratin 7, antitrypsin and antichymotrypsin.

A Case of Metastatic Plexiform Fibrohistiocytic Tumor with Good Response to Pazopanib

이혜린,김준혁,박석연,최원영 대한내과학회 2020 대한내과학회 추계학술대회 Vol.2020 No.1

Low Grade Chondrosarcoma Presenting as Progressive Valgus Limb Deformity in a Growing Period

강현귀,박원서,박석연,Kang, Hyun Guy,Park, Weon Seo,Park, Seog Yun The Korean Musculoskeletal Tumor Society 2014 대한골관절종양학회지 Vol.20 No.1

성장기 인접 성장판에 영향을 주어 하지의 외반 변형을 보이는 대퇴골 종양이 발견되었다. 골간에 긴 골수내 종양은 성장판 근처의 골간단에서 격막에 의해 나누어졌으며 병리 검사상 저등급 연골육종으로 진단 되었다. 성장기 점진적 하지 변형이 골종양의 성장판 영향에 따른 증상일 수 있다. A femoral bone tumor causing a valgus deformity by affecting the growth plate was found. Long intramedullary diaphyseal tumor was separated by septum at the metapysis. Low grade chondrosarcoma was confirmed diagnosed by pathologists. Progressive limb deformity can be a sign of bone tumor in growing period.

상부 요로상피세포암종에서 Twist의 발현이 환자의 무병생존에 미치는 영향 및 종양 등급과의 연관성

김동일,윤선옥,박석연,김보미,강경훈,문경철 대한병리학회 2007 Journal of Pathology and Translational Medicine Vol.41 No.5

Epithelial-mesenchymal transition (EMT) is critical for morphogenesis during embryonic development and is also implicated in the conversion of early-stage tumors into invasive malignancies. Recently, Twist has been identified to play an important role in EMTmediated metastatic progression of several types of human cancer. The present study examined the expression of Twist and evaluated its clinicopathologic significance in urothelial carcinoma of upper urinary tract. Methods : Immunohistochemical staining for Twist expression was performed on 70 upper urinary tract urothelial carcinomas (UUT-UCs) using tissue microarray. Results : Immunohistochemical staining for Twist was positive in 31/70 cases (44.3%) of UUT-UCs. Twist expression was associated with high-grade and advanced-stage (ISUP grade, p<0.01; stage, p=0.045). The patients with Twist positive-tumors revealed lower disease free survival rate than those with Twist negative-tumors (p<0.01). The overall survival for patients with Twist positive-tumors was slightly worse than the patients with Twist negative- tumors, but the difference was not statistically significant (p=0.12). Conclusion : Our results suggest that Twist is a novel marker for advanced UUT-UC.