The impact of pathologic differentiation (well/ poorly) and the degree of Ki-67 index in patients with metastatic WHO grade 3 GEP-NECs.

Kim, Seung Tae,Lee, Su Jin,Lee, Jeeyun,Park, Joon Oh,Park, Young Suk,Lim, Ho Yeong,Kang, Won Ki Grune & Stratton 2017 Journal of clinical oncology Vol.35 No._suppl15

<P> e15686 </P><P> Background: Herein, we investigated the impact of pathologic differentiation (well or poorly differentiated) in metastatic grade 3 GEP-NEC patients receiving etoposide and platinum-based therapy. Simultaneously, we evaluated a more exact Ki67 index cut-off point to select patients with grade 3 GEP-NEC who might benefit from etoposide plus platinum (EP)-based therapy. Methods: Among patients pathologically diagnosed with metastatic grade 3 GEP-NECs at Samsung Medical Center between June 2013 and March 2016, 31 GEP-NEC patients receiving etoposide and platinum-based therapy were included in this study. Results: Primary sites included 13 foregut-derived GEP-NECs [stomach (n = 4), duodenum (n = 4), and pancreas (n = 5)] and 2 hindgut-derived GEP-NECs of the rectum. Sixteen unclassified GEP-NECs originated from 7 gall-bladder (GB), 6 liver and 3 unknown primary sites. According to pathologic differentiation, 14 patients had well differentiated and 17 had poorly differentiated grade 3 GEP-NECs. Between well differentiated and poorly differentiated grade 3 GEP-NECs, there was a significant difference in the distribution of Ki67 index. There was no significant difference of treatment efficacy between well and poorly differentiated grade 3 GEP-NECs (RR; 35.7% vs. 41.2%, p = 0.525). Tumor response to EP occurred in 5 of 7 patients with Ki67 > 60% and 7 of 24 with Ki67≤60%, which was significantly different (RR; 71.4% vs. 29.2%, P = 0.043). There was no significant difference in PFS according to pathologic differentiation (well differentiated vs. poorly differentiated) and Ki67 index ( > 60% vs ≤60%). Conclusions: Grade 3 GEP-NECs could be morphologically classified into well and poorly differentiated NETs. Additionally, among grade 3 GEP-NECs, there was a significant difference in ranges of Ki67 index between well and poorly differentiated NECs. Higher levels ( > 60%) of Ki67 index might be a predictive marker for efficacy of EP as a standard regimen in grade 3 GEP-NECs. </P>

Comparison of Proliferative Activity in Each Histological Subtypes of Benign and Atypical Intracranial Meningiomas by PCNA and Ki-67 Immunolabeling

최승진,장은덕,권성오,계대곤,박춘근,이상원,강준기,Choi, Seung Jin,Chang, Eun Deok,Kwon, Seung Oh,Kye, Dae Kon,Park, Choon Keun,Lee, Sang Won,Kang, Joon Ki The Korean Neurosurgical Society 2000 Journal of Korean neurosurgical society Vol.29 No.9

목 적 : 양성 뇌수막종에 비하여 이형성 및 악성 뇌수막종이 나쁜 임상적인 예후 및 양상을 보이는 것은 잘 알려져 있으나, 양성 뇌수막종에 있어서 각각의 병리조직학적 아형에 따른 생물학적 양상의 차이에 대해서는 잘 알려지지 않거나 일부 논란이 되고있다. 본 연구에서는 이형성 뇌수막종 및 양성 뇌수막종의 각각의 병리조직학적 아형에 따른 증식능의 차이여부를 알아보고자 PCNA와 Ki-67표지지수를 분석하였다. 방 법 : 본원에서 뇌수막종으로 수술을 시행하여 얻은, 재발을 보여 재수술을 시행한 2례를 포함하여, 파라핀에 포매시킨 27개의 조직을 대상으로 병리학적인 증식능을 분석하기 위해, PCNA에 대한 단일항체 및 MIB-1 단일항체를 이용한 면역조직화학적 염색을 시행하였다. 조직학적 분류상 meningothelial type이 8례, transitional type이 9례, fibroblastic type이 5례였으며, 이형성 수막종이 5례였다. 결 과 : PCNA표지지수의 평균값은 양성 수막종에서 meningothelial type이 $4.82{\pm}5.10%$, transitional type이 $9.01{\pm}4.25%$, fibroblastic type이 $5.66{\pm}5.32%$를 보였으나 이형성 수막종에서는 $27.62{\pm}19.67%$의 높은 지수를 나타냈고, Ki-67 표지지수의 평균값은 양성 수막종의 아형에서 각각 $0.43{\pm}0.85%$, $0.44{\pm}1.08%$, $0.24{\pm}0.18%$를 보이고, 역시 이형성 수막종에서는 $0.84{\pm}0.59%$의 높은 지수를 보였다. 즉, 양성 수막종에서 각각의 아형에 따른 PCNA 및 Ki-67 표지지수는 통계학적으로 의미있는 차이는 없었으나(p>0.05), 이형성 수막종에서는 의미있는 높은 표지지수를 보여(p<0.05) 양성 수막종에서 보다 높은 증식능을 보임을 알 수 있었다. 결 론 : PCNA 및 Ki-67 표지지수를 이용한 증식능의 비교결과, 양성 뇌수막종에서는 각각의 아형에 따른 생물학적 양상이나 예후는 차이가 없을것으로 생각되나, 이형성 수막종에서는 높은 증식능을 보여 이에 대한 예후를 예상할 수 있을것으로 생각되며, 또한 이러한 표지지수가 병리조직학적으로 양성과 이형성의 감별에 많은 도움이 될것으로 사료된다. Objective : The clinical prognosis and biological behavior of atypical and especially malignant meningiomas are well known to be worse than benign meningioma, but the degree of biological aggressiveness in each classical subtypes of benign meningioma is controversy. This study was performed to see whether there is a difference in the proliferative activity between each different histological subtypes of benign meningioma as well as atypical meningioma. Methods : Paraffin-embedded surgical specimens of 27 meningiomas, including two recurrent tumors, were studied to evaluate proliferative activity by immunohistochemical method with monoclonal antibodies to proliferating cell nuclear antigen(PCNA) and MIB-1. The specimens consisted of 8 cases of meningothelial, 9 cases of transitional, 5 cases of fibroblastic subtypes and 5 cases of atypical meningiomas. Results : Mean PCNA labeling indices of meningothelial, transitional and fibroblastic meningiomas were $4.82{\pm}5.10%$, $9.01{\pm}4.25%$ and $5.66{\pm}5.32%$, but that of atypical meningiomas was $27.62{\pm}19.67%$, noting a higher value compared to all three subtypes of benign meningiomas. Mean Ki-67 labeling indices of the above 3 subtypes were $0.43{\pm}0.85%$, $0.44{\pm}1.08%$ and $0.24{\pm}0.18%$, and that of atypical meningiomas was also revealed to be of higher value ($0.84{\pm}0.59%$). PCNA and Ki-67 labeling indices were not statistically different between histological subtypes of benign meningioma(p>0.05), but the differences of both immunolabeling between benign and atypical meningiomas were statistically significant(p<0.05). Conclusion : Immunolabeling of PCNA and Ki-67 in intracranial meningiomas reveals no prognostic difference between meningothelial, transitional and fibroblastic subtypes in classical benign meningiomas by measuring expression of PCNA and Ki-67, but it seems to be helpful in differentiating benign and atypical meningioma, later showing more proliferative activity and biological aggressiveness.

[P350] A case of adenoid type basal cell carcinoma on philtrum : Very rare histopathological variant

( Won Choi ),( Kyoung Geun Lee ),( Byoung Yong Koh ),( Ki Bum Myung ),( Seung Hyun Cheong ),( Hyung Jin Hahn ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

Basal cell carcinoma (BCC) has been described as the most common malignant skin tumor usually seen in head and neck region. It has various histological variants and constitues about 65% of epithelial tumors. Known variants of BCC include as cystic, nodular, adenoid, morpheaform and miscellaneous forms. Of these, adenoid type BCC is regarded as a low grade malignancy compared to other types. A recent study reported the adenoid BCC incidence of 1.3%. Adenoid type of BCC has no site predilection and have been reported at various sites including forehead, inner canthus of eye, chin, trunk and extremities. A 78-year-old woman presented with a slow growing, pigmented, 0.8cm sized nodule located on the philtrum for seven years, along with an ulcerative hemorrhagic erosion lesion and rolled up edges. Skin biopsy specimens were taken by punch biopsy. Multiple cyst-like structures with strands of basaloid cells presenting with lacelike pattern, and mucoid-patterned stroma were seen. On immunohistochemical staining, SMA, CK19, C-kit were found negative while CD 10, CK5/6, p63 and p53 were positive. Also, Ki-67 was 70 %. After 18 days, excisional biopsy with skin-fat composite graft was taken from philtrum and left side of cheek. Thereafter, patient was diagnosed with adenoid BCC based on histological finding and was treated with wide biopsy with skin-fat composite graft for cosmetic aspect. Herein we report a rare case of adenoid BCC.

Ki-67 Expression Gives Additional Prognostic Information on St. Gallen 2007 and Adjuvant! Online Risk Categories in Early Breast Cancer

Jung, So-Youn,Han, Wonshik,Lee, Jong Won,Ko, Eunyoung,Kim, Eunkyu,Yu, Jong-Han,Moon, Hyeong-Gon,Park, In Ae,Oh, Do-Youn,Im, Seock-Ah,Kim, Tae-You,Hwang, Ki-Tae,Kim, Sung-Won,Noh, Dong-Young Springer - Society of Surgical Oncology 2009 Annals of Surgical Oncology Vol.16 No.5

[P349] A case of squamous cell carcinoma arising from epidermal cyst on buttock

( Won Choi ),( Kyoung Geun Lee ),( Byoung Yong Koh ),( Ki Bum Myung ),( Seung Hyun Cheong ),( Hyung Jin Hahn ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

Epidermal cysts are common benign tumor of the skin. They are slow growing, round, firm intradermal or subcutaneous tumor and occur most commonly on the trunk, face and scalp. Interestingly, when an epidermal cyst ruptures and its contents are released into the dermis, foreign body reaction occurs. As a result, multinucleated giant cells may form a keratin granuloma and lead to a pseudocarcinomatous hyperplasia, which is thought to be a stimulant of squamous cell carcinoma (SCC) formation. From a review of the literature, malignant transformation of epidermal cysts is very rare and its incidence rate is known to be 0.011 -0.045%. An 82-year-old woman presented with painful, 2cm-sized subcutaneous nodule on left buttock for two years. Excisional biopsy specimens were taken from the skin lesion on buttock. In microscopic view, numerous keratinous materials were released from ruptured cysts. The specimen was consisted of well-differentiated squamous cells with atypical nucleus and mitotic figures. In mid dermis, horn pearl and the numerous multinucleated giant cells were also seen. On immunohistochemical staining, CK5/6 were positive. Also, Ki-67 and p53 were largely confined to basal portion of epithelium. The patient was diagnosed with a rare case of SCC arising from epidermal cyst based on histological finding and was later treated with complete excisional biopsy. Herein we report a rare case of SCC arising from epidermal cyst.

역내외 현물환, 선물환 및 NDF 거래에 의한 원화 가치 가격발견에 관한 연구

빈기범 ( Ki Beom Binh ),이상민 ( Sang-min Lee ),이원섭 ( Won Seop Lee ) 한국파생상품학회(구 한국선물학회) 2016 선물연구 Vol.24 No.2

본 연구에서는 Hasbrouck(1995, 2002)의 정보공헌도(information share) 기법을 이용하여 역내 외환시장의 원/달러 현물환율과 선도환율, 역외 통화시장의 원/달러 NDF 환율의 장기적 공통추세를 중심으로 한 상호 가격발견의 동학을 분석한다. 분석 결과는 다음과 같다. 첫째 NDF 시장에 비해 역내 외환시장에서의 현물환이나 선물환이 주도적인 가격발견의 기능을 하고 있다. 둘째, 원화 가치는 글로벌 위기시 국내외 정보에 더욱 민감해지는데, 위기의 시기에 있어 NDF의 가격발견 역할이 증대된다. 하지만, 역내 시장의 가격발견상 역할과 비중을 능가하지는 못한다. 결국, NDF 시장이 이른바 왝더독(wag the dog)을 촉발시키는 요인으로 보기 어렵다. 이러한 결과는 NDF 시장에 대한 부정적 인식과 시각을 지닌 시장 참여자나 정책당국자가 참고할 필요가 있다. 나아가, NDF 시장이 원화에 대한 24시간 거래를 가능케 하고, 역내 외환시장의 현물환율이나 선물환율에 대한 가격발견 기능이 있다는 것은 역내 외환 시장에서 주요 환율 지표 결정에 있어 불확실성을 줄이는 역할을 하고 있는 것을 시사한다. Using Hasbrouck`s (1995, 2002) information share method, we examine the mutual price discovery dynamics among Won/Dollar spot, forward, and NDF exchange rates in on- and off-shore FX markets. Our findings include : (i) During the entire period, the mutual price discovery between on-shore FX market and off-shore NDF market are significantly led by on-shore Won-Dollar spot and forward exchange rates. (ii) Within the period around the global crisis, NDF exchange rates have mutual influence on the price discovery, which is expecially greater than the any other period. The results show Won-Dollar spot exchange rate fluctuations during the global crisis are greatly affected by external factors of the international financial markets. Not only that, but off-shore NDF trading promptly reflects the price information of KRW on the factors.

법률서비스 조직의 내부품질이 직원 및 고객의 만족도와 충성도에 미치는 영향: 서비스-수익 체인(S-PC) 모델을 중심으로

이상기(Lee, Sang-Ki),구자원(Gu, Ja-Won) 한국경영교육학회 2020 경영교육연구 Vol.35 No.1

[연구목적] 본 연구는 법률서비스 조직의 내부품질이 직원 및 고객의 만족도와 충성도에 미치는 영향을 분석하고, 그에 따른 시사점을 찾기 위하여 실증분석을 수행하였다. [연구방법] 본 연구를 위하여 서비스-수익 체인 모델을 활용하였으며, 183명의 변호사, 변리사, 기타 전문가들을 대상으로 설문을 수행하였으며, 분석을 위하여 SPSS와 AMOS 버전 25를 사용하였다. [연구결과] 실증분석 결과 서비스제공 준비수준은 직원만족도, 직원층성도, 고객충성도에 정(+)의 영향을 보였고, 고객만족도에는 유의미한 영향을 보이지 않았다. 내부서비스 품질은 직원만족도, 직원충성도, 고객만족도, 고객충성도 모두 유의미한 영향을 갖지 않는 것으로 나타났다. 서비스 생산성 및 품질은 고객만족도와 고객충성도에 정(+)의 영향을 미치는 것으로 나타났고, 직원만족도 및 직원충성도에는 유의미한 영향을 보이지 않았다. 서비스가치 전달은 고객만족도에 정(+)의 영향을 갖는 것으로 분석되었지만, 직원만족도, 직원충성도, 고객충성도에는 유의미한 영향을 갖지 않는 것으로 나타났다. 직원만족도와 고객충성도는 경영성과에 정(+)의 영향을 보였고, 직원충성도와 고객만족도는 경영성과에 영향을 미치지 않는 것으로 나타났다. [연구의 시사점] 본 연구에서는 선행연구에서 제시되는 내용과는 일부 다른 결과가 도출되었다. 이것은 법률서비스 및 서비스 제공자의 특수성에 기인한 것으로 판단된다. S-PC 모델이 단일 모델로 모든 성과경로를 설명하는 데에는 한계가 있다고 지적한 선행연구의 내용과 부합한다. S-PC 모델의 장점과 한계를 같이 이해하고, 산업과 기업(조직)의 특수성을 고려한 추가적인 검토가 함께 전략에 반영되어야 한다고 제시한다. [Purpose] This study conducted empirical analysis to analyze the impact of internal quality of legal service organization on employee and customer satisfaction and loyalty, and to find any implications accordingly. [Methodology] The Service-Profit Chain model was used to carry out this empirical study. For this study, 183 responses from lawyers, patent attorneys, customs agents, para-legals, patent technology experts, and legal support staffs were analyzed. A total of 20 hypotheses were set up and tested to verify. [Findings] As a result of the empirical analysis, the level of readiness for service provision had a positive effect on employee satisfaction, employee loyalty, and customer loyalty, but not on customer satisfaction. In terms of internal service quality, it had no meaningful effect on employee satisfaction, employee loyalty, customer satisfaction, and customer loy2alty. Service productivity and quality were found to have a positive effect on customer satisfaction and customer loyalty, but not on employee satisfaction and employee loyalty. Service value delivery had a positive effect on customer satisfaction, but did not have a meaningful effect on employee satisfaction, employee loyalty, and customer loyalty. Employee satisfaction and customer loyalty had a positive effect on operational performance, however employee loyalty and customer satisfaction did not affect operational performance. [Implications] This study has shown some different results from those generally understood due to the characteristics of the service and the propensity of the service provider. The research results are consistent with the findings of previous studies, which point out that the S-PC model, as an integrated single model, has limitations in explaining all performance path. This study explains the limitations of the S-PC model and suggests that additional considerations should be taken into account in the service strategy, while taking advantage of the merits as an integrated model and at the same time taking into account the specificity of each industry or organization.

A case of atypical Spitz nevi

( Kyoung Geun Lee ),( Won Choi ),( Joon Soo Lim ),( Seung Hyun Cheong ),( Ki Bum Myung ),( Hyung Jin Hahn ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1

Spitzoid melanocytic lesions may be broadly categorized into Spitz nevi, atypical Spitz tumor (AST), and spitzoid melanomas. Atypical Spitz nevi, also known as AST is rare spitzoid melanocytic proliferations with an uncertain malignant potential and described as conventional Spitz nevi with 1 or more atypical features with indeterminate biological potential. It has clinical features of larger size (>6 mm), irregular borders, irregular topography, or ulceration. Threre are no definite histologic diagnostic criterias among spitzoid melanocytic proliferations, but asymmetry, ulceration, pagetoid melanocytosis, lack of maturation, deep mitoses, and atypia are distinct findings of atypical Spitz nevi. A 2-year-old man presented with several months of pigmented nodule on right knee. Skin biopsy from right knee showed spitzoid melanocytic proliferation from the epidermis to the reticular dermis. Melanocytes arranged in nests were epithelioid with abundant eosinophilic cytoplasm. Each cells showed uniform pleomorphism and mitosis, but there were no atypical mitosis. Few kamino bodies in epidermis and outlier cells in reticular dermis were also detected. Immunohistochemical study revealed positive of HMB-45, S-100, P16 and Ki-67 over 30 percent. We report a case of atypical spitz nevi and distinguishing features of spitzoid melanocytic proliferations through literature review.

소화불량(消化不良)과 과심상(過心傷)의 상관성(相關性)에 대(對)한 고찰(考察) -스트레스, 기울(氣鬱), 비병증(脾病證)의 평가(評價)를 통(通)해-

김진성,윤상협,류봉하,류기원,이상욱,Kim, Jin-Sung,Yoon, Sang-Hyub,Ryu, Bong-Ha,Ryu, Ki-Won,Lee, Sang-Wook 대한한방내과학회 2004 大韓韓方內科學會誌 Vol.25 No.4

Background & Object : Dyspepsia for which no organic causes are disclosed is referred to as functional dyspepsia. Functional dyspepsia is here studied in connection with a biopsychosocial model. From the aspect of individual response to external environment, in connection with stress response, functional dyspepsia is studied by both the psychology department and the internal medicine departments. The disease is taken as approachable from the aspect of internal injury due to seven emotions and stress as differentiated by Oriental medicine. Materials and Methods : Targeted at 223 patients underwent medical checks and endoscopy at Kangnam Korean Hospital, Kyunghee University. They agreed to join this clinical experiment. Stress response inventory, GARS (global assessment of recent stress scale), GSRS (gastrointestinal symptom rating scale), diagnostic scores for Ki-depression, and Spleen Disease Differentiation of Syndromes were all measured and evaluated. The test group was comprised of functional dyspepsia patients. The control group was comprised of nonsymptomatic chronic gastritis patients who were found to suffer from chronical gastritis in endoscopy and thus could be diagnosed with functional dyspepsia if symptoms would arise, but did not complain of subjective symptoms. Results showed these corelations: Functional dyspepsia patients were found to have more serious Ki-depression compared to nonsymptomatic chronic gastritis patients. The more serious Ki-depression the more serious the dyspepsia symptoms. The higher the stress response inventory the more serious the dyspepsia. Deficiency of spleen Eum, and Deficiency and Sinking of spleen Gi were found to coincide with serious Ki-depression.

Development of a T-DMB Monitoring System

Kyung-Taek Lee1,Ki-Won Kwon,Yong-Suk Park,Sung-Jun Kim,Jong-Ho Paik 대한전자공학회 2008 ITC-CSCC :International Technical Conference on Ci Vol.2008 No.7

With the start of T-DMB service, diverse multimedia broadcasting services became available in the high-speed mobile environment. In addition to high-quality digital radio (audio) and television (video), diverse data services, such as Dynamic Label Segment (DLS), JPEG Slideshow (SLS), Broadcast Web Site (BWS), Traffic and Travel Information (TTI), interactive service using Binary Format for Scenes (BIFS), and Visual Radio, are being serviced. Currently, there is an increase in demand in the market for T-DMB monitoring system that can support all the data service available. In this paper, we present T-DMB monitoring systems that can simultaneously decode 6 services of different format within the two ensemble, through suitable algorithms and multi-thread techniques.