Age-Related Macular Degeneration (AMD): Current Concepts in Pathogenesis and Prospects for Treatment

신옥란,김영훈 한국조직공학과 재생의학회 2013 조직공학과 재생의학 Vol.10 No.4

Age-related macular degeneration (AMD) is a degenerative disease of the eye that has been a subject of numerous studies in pathogenesis as well as clinical research in treatment owing to its notoriety as the leading cause of irreversible blindness in the elderly. Genetic studies have elucidated various pathways related to inflammation that contribute to AMD development such as those of the complement system, coagulation system, and the immune system. The current standard of treatment in AMD is inhibition of neovascularization using anti-vascular endothelial growth factor antibodies, which is effective in wet AMD. Furthermore, the absence of screening methods or preventive measures for AMD poses yet another challenge. Stem cell therapy now holds great promise for various diseases, and AMD may well be one of the earliest diseases such treatment modality may be employed, considering the unique characteristics of the eye as a localized and immune-privileged organ.

결막에 발생한 CK20 음성, CK7 양성 Merkel세포암종 - 짧은 증례 보고 -

신옥란,신정하,박재영,김현승,이교영 대한병리학회 2010 Journal of Pathology and Translational Medicine Vol.44 No.6

Merkel cell carcinoma (MCC) is an uncommon but potentially aggressive neuroendocrine carcinoma of the skin. It typically develops on sun-exposed areas of the head and neck, particularly the eyelid, periorbital region, and extremities. We report a case of unusually located MCC, presenting as a conjunctival mass, which has only been reported once in the English literature. An 83-year-old male presented with a 0.8 × 0.7 cm sized mass protruding from the lower fornix of the right conjunctiva. The mass was excised. The tumor was located in the submucosa without connection to the overlying mucosa. Light microscopic findings showed a carcinoma with undifferentiated small round cells and the presence of cytokeratin (CK AE1/3, CK7) and neuroendocrine markers. We established a diagnosis of MCC. As reported in the literature, the majority of MCCs are positive for CK20 but negative for CK7. But, this case showed an uncommon cytokeratin immunohistochemical profile of positive for CK7 and negative for CK20, suggesting a new immunophenotypic MCC variant.

유두상 신세포암에서 관찰된 세포질 내 호산성 방울- 1예 보고 -

신옥란,박재영,이혜경,이용석,한창희,강성학,이교영,최영진 대한병리학회 2006 Journal of Pathology and Translational Medicine Vol.40 No.6

Eosinophilic cytoplasmic globules may be seen in a variety of neoplastic and nonneoplastic conditions and are most often associated with alpha-1-antitrypsin deficiency, several pathologic liver conditions and yolk sac tumors. A few cases of eosinophilic cytoplasmic globules in renal cell carcinoma have been reported but there has only been one report of papillary type. We report another case of papillary renal cell carcinoma with eosinophilic cytoplasmic globules, which is similar to a Mallory body but with different properties.

폐에 발생한 말초 T 세포 림프종의 세침흡인 세포학적 소견 - 1예 보고 -

신옥란,이연수,강창석,김병기,심상인,정은선,Shin, Ok-Ran,Lee, Youn-Soo,Kang, Chang-Suk,Kim, Byung-Kee,Shim, Sang-In,Jung, Eun-Sun 대한세포병리학회 1999 대한세포병리학회지 Vol.10 No.2

Primary non-Hodgkin's lymphoma of the lung is rare among extranodal lymphomas. The most common form is low grade B-cell type originated from the mucosa-associated lymphoid tissue (MALT) of the lung and primary peripheral T cell lymphoma of the lung is extremely rare. We recently experienced a case of fine needle aspiration cytology of primary peripheral T cell lymphoma of the lung in a 39-year-old male patient. The cytologic smears revealed some sheets of reactive epithelial cells, epithelioid histiocytes, and numerous polymorphous population of lymphoid cells composed of small and intermediate sized lymphoid cells and mature lymphocytes. Lymphoid cells were slightly larger than normal mature lymphocytes and showed significant irregularity of nuclear membrane. The internal nuclear structure was marked by chromatin clumping, clear parachromatin areas, and inconspicuous nucleoli. Histopathologically, atypical small lymphocytes infiltrated in the interstitium and alveolar sac. By the immunohistochemical study and molecular biologic study of gene rearrangement, the T cell clonality of atypical lymphoid cells was confirmed.

가성육종성 변형을 보이는 병합형 간세포-담관암 - 1예 보고 -

신옥란,박재영,이혜경,최영진,김기환,구영미,임근우 대한병리학회 2006 Journal of Pathology and Translational Medicine Vol.40 No.4

Combine hepatocellular-cholangiocarcinoma with pseudosarcomatous features is a rare primary liver tumor. We report a 46-year-old man who is a carrier of HBV and has presented intermittent severe abdominal pain on right upper quadrant for 6 days. Tumor markers, alpha-fetoprotein, CEA and CA19-9 were within normal ranges. Abdominal computed tomogram revealed a large heterogeneous mass in the posteroinferior segment of right liver without associated biliary dilatation and conglomerated, enlarged portocaval and peripancreatic lymph nodes. Right hepatectomy was performed with local lymph node dissection. The tumor, measuring 7.5×5.5 cm showed an ill demarcated round to oval shape and a variegated whitish yellow solid cut surface with necrosis. Microscopically, the tumor consisted of three components, hepatocellular carcinoma, cholangiocarcinoma and undifferentiated sarcomatoid tumor cells. Immunohistochemically, hepatocellular carcinoma portion reacted positively with alpha-fetoprotein, cholangiocarcinoma portion reacted positively with bile duct-type cytokeratins (cytokeratin 7 and 19) and EMA. The pseudosarcomatous portion reacted with bile duct type cytokeratins and EMA. These findings suggested that pseudosarcomatous tumor cells may be with closely, associated primitive stem cells that can differentiate into the ductal epithelium.

뇌동맥류에서 용적묘사 기법을 이용한 3차원 전산화단층혈관조영술: 3차원 디지털감산혈관조영술과 비교

신옥란,서정진,이은주,윤웅,정용연,정태웅,김재규,박진균,강형근 대한영상의학회 2004 대한영상의학회지 Vol.50 No.6

Purpose: The author compared three-dimensional computed tomographic angiography with combined volume rendering technique (3D-CTA VR) with three-dimensional digital subtraction angiography (3D-DSA) in the detection and characterization of intracranial aneurysms, in order to assess the diagnostic capability of 3DCTA VR. Materials and Methods: This study included 50 patients with suspected intracranial aneurysm who underwent both 3D-CTA VR and 3D-DSA, and who were subsequently confirmed as having aneurysms by intracranial operation or other neurointerventional procedures. The detectability and the characteristics of the aneurysms, such as their aneurysmal neck, direction, and vasospasm of the adjacent vessels, were evaluated retrospectively. Results: Sixty-five intracranial aneurysms were detected through surgery or other interventional procedures. 3D-DSA was more sensitive (96.92%) than 3D-CTA VR in the detection of the aneurysms. All of the aneurysms that were more than 3mm in size were detected with both techniques. 3D-DSA failed to reveal one posterior communicating artery aneurysm, while 3D-CTA VR missed three aneurysms. The aneurysmal necks were clearly visualized in 58 of 61 aneurysms (95.1%) on 3D-CTA VR, but all of the aneurysmal necks(100%) were clearly identified on 3D-DSA. Conclusion: 3D-CTA combined with VR technique showed good sensitivity for the depiction of intracranial aneurysms greater than 3 mm in size, and its usefulness in characterizing the aneurysms for surgical or endovascular treatment planning was equal to or less than that of 3D-DSA. 목적: 뇌동맥류가 의심된 환자의 뇌동맥류의 평가에서 용적묘사(volume rendering, VR) 기법 을 이용한 3차원 전산화단층혈관조영술(three-dimensional Computed Tomographic angiography, 3D-CTA)의 유용성을 3차원 디지털감산혈관조영시술(three dimensional subtraction angiography, 3D-DSA)과 수술 및 신경 중재적 시술소견과의 비교를 통해 평가하고자 하였 다. 대상과 방법: 뇌동맥류가 의심되어 3D-CTA의 VR기법과 고식적 혈관조영술과 3D-DSA를 함 께 시행하여 중재적 시술 혹은 수술소견을 통해 뇌동맥류로 확진된 50명의 환자를 대상으로 하였다. 두 명의 방사선과 의사가 각각의 영상에서 뇌동맥류를 진단하였고, 뇌동맥류를 발견한 경우 뇌동맥류의 위치, 크기, 경부, 방향을 판단하여 두 가지 기법과 수술및 신경 중재적 시술 소견과의 일치정도를 후향적으로 비교 분석하였다. 결과: 수술 혹은 중재적 시술에서 모두 65예의 뇌동맥류를 발견할 수 있었고 3D-CTA의 VR 기법상 총 61예(93.85%)의 뇌동맥류를 발견할 수 있었으며 3D-DSA에서 65예 중 63예 (96.92%)를 발견할 수 있었다. 3D-CTA의 VR기법과 3D-DSA에서 발견 못했던 2개의 뇌동 맥류는 후교통동맥과 중대뇌동맥의 2 mm의 뇌동맥류였다. 경부모양 확인이 가능하였던 경우 는 3D-CTA의 VR기법에서 61예중 58예(95.1%), 3D-DSA상 전부(63예중 63예, 100%)로 3D-DSA가 약간 더 우수하였으며, 뇌동맥류의 방향은 3D-CTA의 VR 기법이나 3D-DSA에 서 각각 발견된 경우는 의무 기록지의 수술 및 중재적 시술소견과 일치하였다. 결론: 3D-CTA의 VR기법은 뇌동맥류의 치료전 진단에 있어서 3D-DSA의 역할을 완전히 대 체 할 수 없지만 비침습적인 방법으로 뇌동맥류의 발견, 크기 및 경부의 모양, 방향에 대하여 정확하게 파악할 수 있으며 뇌동맥류 주위 혈관상태를 평가할 수 있어 수술 및 중재적 혈관치 료를 위한 계획 수립에 중요한 정보를 제공할 수 있는 유용한 방법이라고 생각한다.

지방색전증과 동반된 폐포자충 폐렴 - 1예 보고 -

이성학,신옥란,이은정,이교영 대한병리학회 2009 Journal of Pathology and Translational Medicine Vol.43 No.4

Pneumocystis jirovecii is an atypical fungus that causes severe pneumonia in immune compromised patients. While Pneumocystis jirovecii pneumonia (PCP) is more commonly diagnosed in individuals who have HIV infection, it can occur in individuals with other forms of immunosuppression. Fat embolism most commonly develops after orthopedic injuries, but it has also been reported after other forms of trauma such as severe burns, closed-chest cardiac massage, and liposuction. Overlap in the clinical presentation of these diseases has not yet been reported. We report here on a case of PCP with fat embolism in 52-year-old female patient who had no obvious risk factors for HIV infection. Even if risk factors for HIV or other forms of immunosuppression are not present, PCP can also be seen in patients who present with fat embolism, and the clinical presentation of both conditions can overlap.

선천성 전치골동

김희연,신옥란,장은덕,윤병일,정문수,정윤석,한창희 대한비뇨의학회 2007 Investigative and Clinical Urology Vol.48 No.8

A Review of 5 Cases of Apocrine Carcinomas of the Breast

장은덕,신옥란,이은정,서학준,김기환,김지일,안창혁,김정수,오세정,박우찬,송병주,정상설 대한외과학회 2004 대한외과학회 학술대회 초록집 Vol.2004 No.10

Vibrio cholerae non O1/O139에 의한 장염 1예

이혜경,신옥란,이동건,채현석,김진택,강창석 대한진단검사의학회 2004 Annals of Laboratory Medicine Vol.24 No.6

Vibrio cholerae non-O1/O139 strains are the organisms that are biochemically indistinguishable from V. cholerae but do not agglutinate in Vibrio cholerae O1 and O139 antisera. V. cholerae non-O1/O139 strains are associated with gastroenteritis and extraintestinal infections such as bacteremia, peritonitis and wound infections. Gastroenteritis by V. cholerae non-O1/O139 is uncommon in Korea. We isolated V. cholerae non-O1/O139 from a stool specimen of a one year-old female with diarrhea and high fever. (Korean J Lab Med 2004; 24: 386-8) 저자들은 고열과 설사를 주소로 내원한 12개월 여자 환아의 변배양에서 Vibrio. cholerae non O1/O139 균주를 분리하여 동정결과를 간단한 문헌고찰과 함께 보고하는 바이다.