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Fanconi 증후군으로 발현한 Chinese Herb Nephropathy 1예
원혜성,조인정,유승현,유민아,류동열,김승정,강덕희,최규복,윤견일,성순희 이화여자대학교 의과학연구소 2007 EMJ (Ewha medical journal) Vol.30 No.2
A unique type of rapidly progressive interstitial fibrosis of the kidney, the Chinese Herb Nephropathy (CHN) has been reported in Belgian woman after intake of Chinese herbs. CHN contains several characteristics that include variable clinical features from progressive renal failure to Fanconi's syndrome, histologic finding of extensive interstitial fibrosis, high risk of urothelial malignancy. We are reporting a case of33 year-old female patient who was diagnosed as CHN. The patient visited our hospital with symptoms of nausea. Laboratory investigation showed metabolic acidosis with normal anion gap, hypokalemia, hypophosphatemia, proteinuria, glycosuria consistent with Fanconi's syndrome. She took Chinese herbs for slimming 4 months before. Renal biopsy showed the features of tubular cell injury with interstitial edema, accompanied by interstitial fibrosis on following biopsy, compatible with Chinese Herb Nephropathy. After 5 months, her renal function was progressed rapidly, therefore peritoneal dialysis was started. This case shows that we should consider Chinese herb as a cause of renal failure.
자연유산된 초기 임신에서 태반 영양막 Apoptosis의 변화
원혜성,이주학,남주현,김암,이인식,박은주,이필량,유혜경,허주령,김봉희 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.6
목적 : 임신 초기에 자연유산된 환자에서 태반 영양막 apoptosis[programmed cell death]의 변화 정도를 알아봄으로써 apoptosis가 초기 자연유산의 병태생리에 어떤 역할을 하는지 추론해보고자 한다. 방법 : 임신 제 1기에 건강한 임신이었으나 환자의 개인적인 이유로 선택적 자궁 소파술을 시행받았던 22명과 계류 유산 또는 blighted ovum의 진단하에 자궁 소파술을 시행받았던 27명으로 부터 태반을 얻었다. Hematoxylin & eosin 염색과 terminal deoxyuridine triphosphate nick end labeling[TUNEL]을 한 후, 5000개 이상의 세포를 400배 배율의 현미경하에서 관찰하여 apoptosis된 세포의 빈도를 구하였다. 통계적 검정을 위해서 Mann-Whitney U test와 Spearman rank correlation을 적절하게 사용하였다. 결과 : 선택적 자궁 소파술을 받았던 군과 자연유산된 군 각각에서 apoptosis의빈도와 임신 주수와는 서로 상관관계가 없었다. 자연유산된 군에서의 apoptosis의 빈도[중앙값;0.23%, 벙위;0-0.46%]는 선택적 자궁 소파술을 시행받았던 군의 빈도[중앙값;0.09%, 범위;0-0.28%]보다 유의하게 증가하였다.[p$lt;0.05]. 영약막 전체에서 보인 apoptosis중 융합세포영양막에서 일어난 apoptosis의 빈도는 자연유산된 군에서 선택적 자궁 소파술을 받았던 군보다 유의하게 증가하였다[23.5 -1.0% 대 12.0 -1.3%;mean -standard error of mean][p$lt;0.05]. 결론 : 영양막[특히 융합세포영양막]의 apoptosis는 자연유산의 병태생리 기전에 특정의 역할을 할 것으로 판단된다. Objective : Our purpose was to investigate whether trophoblastic apoptosis is related with early pregnancy losses. Methods : Placentas were collected from 22 uncomplicated first-trimester pregnancies undergoing elective surgical abortion for social reason and from 27 women of first-trimester pregnancy loss. Hematoxylin & eosin staining and terminal deoxyuridine triphosphate nick end labeling[TUNEL] were used to identify apoptosis. Over 5,000 cells were exmined at a magnification of x400. Mann-Whitney U test and Spearman rank correlation were used for statistical analysis. Results : There were no cerrelations between the incidence of apoptotic trophoblasts and gestational age in each of the control and failing pregnancies. The incidence of apoptosis was significantly higher in failing pregnancies[median 0.23%, range 0.0% to 0.46%]than in uncomplicated pregnancies[median 0.09%, range 0% to 0.28%][p$lt;0.05]. Apoptotic cells were detected in both syncytiotrophoblast and cytotrophoblasts. However, the relative incidence of apoptosis in syncytiotrophoblast comparing to that in cytotrophoblasts was increased significantly in failing pregnancies than in control pregnancies[23.5 -1.0% vs 12.0 -1.3%:mean -standard error of mean][p$lt;0.05]. Conclustion : Trophoblastic apoptosis, especially that of syncytiotrophoblast, may play a certain role in the phthophysiology of early pregnancy losses.
원혜성,맹이소,채현석,김형근,조영석,강진형,장홍석,유미령 거트앤리버 소화기연관학회협의회 2012 Gut and Liver Vol.6 No.2
Background/Aims: The purpose of this study was to investigate the malignant potential of aberrant crypt foci (ACF) by measuring the multiplicity of crypts and lectin expression in the early and late stages of 1,2-dimethylhydrazine (DMH)-induced colon carcinogenesis. Methods: Six-week-old Wistar rats were injected subcutaneously with DMH for 27 weeks. We classified ACF according to the number of crypts per ACF as a few crypts (≤3 crypts, FC ACF) or numerous crypts (≥4 crypts, NC ACF). Immunohistochemistry was used to evaluate lectin expression. Results: In the early stage, FC ACF (590/1,902, 31.0%) occurred more frequently than NC ACF (35/449, 7.8%); whereas in the late stage, NC ACF (176/449, 39.2%) occurred more frequently than FC ACF (324/1,902, 17.0%). The number of ACF peaked at 15 to 20weeks. The ratio of NC/FC ACF increased gradually during carcinogenesis. The expression of both UEA1 and PNA was higher in NC ACF than FC ACF. Lectin expression increased in the late stage compared with the early stage. Conclusions:The expression of lectin was higher in NC ACF and ACF in the late stage. Therefore, ACF with higher multiplicities in the late stage may have more malignant potential in DMH-induced colon carcinogenesis.
PTEN Mutation Identified in Patient Diagnosed with Simultaneous Multiple Cancers
원혜성,장은덕,나세정,황인용,이동수,유선형,김용석,김정수 대한암학회 2019 Cancer Research and Treatment Vol.51 No.1
PTEN hamartoma tumor syndrome is a spectrum of disorders characterized by unique phenotypic features including multiple hamartomas caused by mutations of the tumor suppressor gene PTEN. Cowden syndrome and Bannayan–Riley–Ruvalcaba syndrome are representative diseases, and both have several common clinical features and differences. Because PTEN mutations are associated with an increased risk of malignancy including breast, thyroid, endometrial, and renal cancers, cancer surveillance is an important element of disease management. We report a germline mutation of the PTEN (c.723dupT, exon 7) identified in a young woman with a simultaneous occurrence of breast cancer, dermatofibrosarcoma protuberans, and follicular neoplasm. This case suggests that it is critical for clinicians to recognize the phenotypic features associated with these syndromes to accurately diagnose them and provide preventive care.