유방 섬유낭성 질환의 세포학적 진단의 분류 - 세포학적 소견에 의한 등급점수표의 이용에 대한 제안 -

윤혜경,김찬환,주종은,강신광,Yoon, Hye-Kyoung,Kim, Chan-Hwan,Joo, Jong-Eun,Khang, Shin-Kwang 대한세포병리학회 1994 대한세포병리학회지 Vol.5 No.2

Fine needle aspiration biopsy has been proved as a safe, accurate and cost-effective diagnostic modality in palpable breast lesions. Cytologically, fibrocystic disease can be classified into 3 categories as nonproliferative breast disease, proliferative breast disease without atypia, and proliferative breast disease with atypia. This terminology for fine needle aspirates is compatible with that of diagnostic histopathology. Cytologic differentiation of nonproliferative disease from proliferative breast disease is important, since the risk of cancer development in cases of atypical hyperplasia is 4-5 times higher than that of general population. Twenty five fine needle aspirates of fibrocystic disease confirmed by subsequent histopathology were re-evaluated and classified into 3 categories depending on their architectural and nuclear features. In addition, these aspirates were scored according to the cytologic grading system, devised by Masood et al. and based on six cytologic criteria. Concordance rates between cytomorpholgic diagnosis and cytologic diagnosis using the cytologic criteria grading system and histologic diagnosis were 88% and 92%, respectively.

미완결 발병연령에 근거한 연관성 추세 검정법의 비교

윤혜경,송혜향,Yoon, Hye-Kyoung,Song, Hae-Hiang 한국통계학회 2008 응용통계연구 Vol.21 No.6

발병연령과 이에 관련되었다고 의심되는 좌위와의 연관성이 실제로 존재하는 경우에 유전자형 정보에 따라 발병연령(age of onset) 분포의 추세가 뚜렷하게 나타난다. 그러나 연관성 검정에서 주로 채택하고 있는 발병연령의 상한연령(cutoff age)을 제한하는 표본추출은 유전자형에 따른 여러 군의 미완결 자료의 분포가 다름을 초래하게 되며, 이러한 미완결 분포 차이는 발병연령의 추세 검정에 있어 효율성을 낮추는 원인이 된다. 일반적으로 두 군의 경우에 그 대책으로써 윌콕슨(Wilcoxon) 통계량보다는 미완결 자료의 분포가 다름에 영향을 덜 받는다고 알려진 로그순위(log-rank) 통계량을 사용한다. 본 논문에서는 로그순위 통계량 적용을 유전자형에 따른 여러 군의 경우로 확장하여 Jones와 Browley (1989)에 언급된 일반화 로그순위 추세 검정통계량(generalized log-rank statistic for trend)을 제안하며, 연관성 연구에서 이 검정통계량과 여러 다른 추세 검정통계량의 효율성을 모의실험으로 알아본다. The genetic association test on age of onset trait aims to detect the putative gene by means of linear rank tests for a significant trend of onset distributions with genotypes. However, due to the selective sampling of recruiting subjects with ages less than a pre-specified limit, the genotype groups are subject to substantially different censored distributions and thus this is one reason for the low efficiencies in the linear rank tests. In testing the equality of two survival distributions, log-rank statistic is preferred to the Wilcoxon statistic, when censored observations are nonignorable. Therefore, for more then two groups, we propose a generalized log-rank test for trend as a genetic association test. Monte Carlo studies are conducted to investigate the performances of the test statistics examined in this paper.

여성형 유방의 세침흡인 세포학적 소견 - 14예에 대한 고찰 -

윤혜경,박설미,주종은,Yoon, Hye-Kyoung,Park, Seol-Mi,Joo, Jong-Eun 대한세포병리학회 1994 대한세포병리학회지 Vol.5 No.2

Fine needle aspiration cytologic findings in 14 cases of gynecomastia are described. General cytomorphologic features resemble those of fibrocystic disease in women than those of fibroadenoma. Among the cytologic parameters, three-dimensional structure of epithelial cell clusters, presence of micronucleoli and irregularities of nuclear size and shape are suggestive of epithelial proliferative activity. In audition, 4 cases are proliferative breast disease without atypia and 10 cases are nonproliferative breast disease depending on cytologic criteria grading system.

유방 선근상피종의 세침흡인 세포학적 소견 - 섬유선종과의 비교 -

윤혜경,정수진,강미선,Yoon, Hye-Kyoung,Jung, Soo-Jin,Kang, Mi-Seon The Korean Society for Cytopathology 1998 대한세포병리학회지 Vol.9 No.1

유방에 발생한 선근상피종은 드문 양성 종양으로 세침흡인 세포학적 소견이 잘 알려져 있지 않다. 저자들은 조직소견상 관상 선근상피종으로 확진된 23세 여자의 좌측 유방종괴의 세침흡인 세포학적 특징과 전형적인 유방 섬유선종과 비교하여 감별점을 찾아보았다. 세침흡인 세포학적 소견상 흡인된 양이 많아 높은 세포학적 밀도를 보였으며, 배경에는 풍부한 나핵 세포와 점액성 물질이 관찰되었다. 상피세포의 군집의 크기는 작거나 중간 정도였으며, 느슨한 응집성을 보였고, 소수의 촘촘한 응집성을 보이기도 하였다. 상피 세포의 핵은 둥글고 비교적 균일하였으며, 작은 핵소체는 가끔 발견되었으나 핵의 비정형성이나 유사분열상은 관찰되지 않았다. 근상피세포들이 풍부하게 관찰되었으며 응집성이 좋은 상피세포 군집의 변연부를 따라 배열하기도 하였다. 기질 조직은 흡인된 양이 적었으며 섬유성 양상이었다. 전형적인 섬유선종과 구별되는 선근상피종의 세포학적 특징은 응집성이 덜한 상피세포 군집, 불분명한 군집의 변연부, 상피세포의 작은 덩어리가 미만성으로 관찰되는 점과 적은 양의 섬유조직성 기질조직이었다. Adenomyoepithelioma is an uncommon benign tumor of the breast. We present the fine needle aspiration cytologic features of adenomyoepithelioma in a 23 year-old Korean women, initially diagnosed as fibroadenoma. Aspiration cytologic findings of the left breast mass revealed high cellularity, small to medium sized, less cohesive epithelial clusters, rich naked cells and amorphous materials on background. The epithelial cells were round and uniform with no cytologic atypia or mitosis. Myoeplthelial cells were conspicuous with peripheral rimming along the epithelial clusters. Small amount of fibrotic stromal tissues were observed. Distinguishing features from typical fibroadenoma are less tight epithelial clusters, dyscohesive epithelial cell aggregates, more abundant naked cells and scant stromal tissue fragments.

유방 염증성 질환의 세침흡인소견

윤혜경,박설미,강미선,양영일,김찬환,Yoon, Hye-Kyoung,Park, Seol-Mi,Kang, Mi-Sun,Yang, Young-Il,Kim, Chan-Hwan 대한세포병리학회 1995 대한세포병리학회지 Vol.6 No.2

Fine needle aspiration of the breast is an important diagnostic tool in malignant lesions, but is also useful in differentiation of inflammatory breast diseases mimicking carcinoma clinically and radiologically. Recently, the authors have experienced eight biopsy-proven cases of chronic inflammatory diseases of the breast, which consisted of 4 cases of duct ectasia, 2 cases of fat necrosis, and a case of tuberculous mastitis and granulomatous mastitis respectively. Their cytologic features mainly based on the components and the relative frequency of inflammatory cells were evaluated for differential diagnosis of chronic inflammatory breast diseases. The results are as follows; 1. In cases of duct ectasia, varying amount of neutrophils, mononuclear leukocytes, histiocytes and multinucleated giant cells were intermixed with benign epithelial cell clusters. 2 Abundant fat tissue fragments were diagnostic for fat necrosis. Histiocytes and mononuclear cells were main components but not rich, and neutrophils and giant cells were infrequently observed. 3. Characteristic granulomas composed of epithelioid cells, mononuclear leukocytes and Langhans' type giant cells and lymphocytic infiltrates were conspicuous in tuberculous mastitis, and occasionally neutrophils, necrotic materials and epithelial cell clusters were found 4. In granulomatous mastitis, epithelioid cell granulomas were also noted but numerous neutrophils and histiocytes were intermingled within or outside the granulomas.

타액선 종양의 세포자멸사 및 세포자멸사 연관 표지자 발현

윤혜경(Hye Kyoung Yoon),강미선(Mi Seon Kang),이재우(Jae Woo Yi),김상효(Sang Hyo Kim) 대한두경부종양학회 2006 대한두경부 종양학회지 Vol.22 No.1

Objectives: The salivary gland tumor shows heterogeneity in histologic patterns and biological behavior. The aim of this study is to elucidate the relationships between apoptosis and expressions of apoptosis-related factors(bcl-2, bax, M30), p53 and MIB-1 in the salivary gland tumors. Methods: Immunohistochemical stains for apoptosis-related factors, p53 and MIB-1 and TUNEL study for apoptosis were performed in 46 cases of salivary gland tumors 02 benign and 34 malignant). Results: Twenty(43.5%) of 46 cases showed positive reaction for apoptosis, and the expression rates of bcl-2, bax, M30, p53 and MIB-1 were 85.3%, 68.8%, 65.9%, 39.1% and 26.1%, respectively. A significant difference between benign and malignant tumors was only noted in MIB-1 expression(p=0.0167). In malignant tumors, apoptosis showed no significant relationships to expressions of apoptosis-related factors. There were inverse relationships between p53 and bcl-2 expression(p=0.0375), and between M30 and MIB-1 expressions(p=0.0379). No significant differences of apoptosis, bcl-2, bax, M30, p53 and MIB-1 expression rates according to the tumor size, lymph node status, recurrence and survival were found. Conclusion: In the development of benign and malignant salivary gland tumors, apoptosis might be associated, however, apoptosis and expressions of apoptosis-related factors seemed to be not reliable prognostic factors in malignant salivary gland tumors.

폐, 종격동 및 뇌를 침범한 방추세포형 혈관내피종

윤혜경 ( Hye Kyoung Yoon ),김환태 ( Hwan Tae Kim ),김인호 ( In Ho Kim ),이봉춘 ( Bong Choon Lee ),강창일 ( Chang Il Kang ) 대한결핵 및 호흡기학회 1993 Tuberculosis and Respiratory Diseases Vol.40 No.3

고학력 경력단절 여성의 직업진로 탐색 경험 분석

윤혜경(Yoon Hye Kyoung) 한국평생교육학회 2008 평생교육학연구 Vol.14 No.1

본 연구에서는 그간 선행연구에서 밝혀지지 않았던 고학력 중장년 여성들의 직업진로 탐색 과정을 가시화하고, 그 맥락을 여성주의ㆍ평생교육적 관점에서 해석하였다. 첫째, ‘고학력 중장년 여성들의 직업진로 탐색 경험은 암중모색(暗中摸索)의 과정’임을 알 수 있었다. 이들의 직업진로 탐색과정을 직업교육 참여경험 중심으로 분석한 결과, 3단계로 유형화될 수 있었으며, 다수의 직업교육에 참여하였으나 3단계인 직업진로 결정단계까지 도달하지 못한 사례들이 다수 발견되었다. 또한 각 단계별로 직업교육 활용 양상도 상이하게 나타났다. 이 결과는, 수강생의 진로탐색 수준에 따라 교육요구가 다름을 고려하여 진로탐색단계별로 차별화된 교육 프로그램, 구직지원책을 제공해야 함을 시사한다. 둘째, ‘고학력 중장년 여성들의 직업정보 취득을 위한 사회적 경로가 부재’한 것으로 나타났다. 이들의 직업정보 취득 경로는 3가지 하위범주로 분류되었고 극히 개인적ㆍ제한적ㆍ간접적 맥락에서 직업정보를 취득하고 있는 것으로 밝혀졌다. 이에 본 연구는 고학력 중장년 여성들에게 직업교육이 인생구조 전환, 새로운 진로 탐색을 지원하는 교육이 되어야 한다는 데 대한 이해가 필요하며, 평생교육적 차원에서 ‘진로상담-직업교육-구직지원’이 연계되는 통합적 직업교육체제를 구축하여 이들의 학습권을 보장해야 함을 주장 하였다. The purpose of this study is to analyze how highly educated women explore a new vocational career in their middle age and participate in the education to get a job. Adopting the qualitative approach with a purposeful sampling, a series of in-depth interviews were carried out with thirteen highly educated middle-aged women, who have participated in vocation education program to find a job. The aspect of vocational career search is as follows. Career search for them is , groping in the dark" in a way since it involves a number of trial-and-errors due to lack of social support system. The exploration for the vocational career can be categorized into the following three phases based on the experiences in the vocation education. First, they become aware of the significance of initiating searching process out of home. Second, they take a variety of vocation education without a particular career in mind. In third phase, they decide an occupation and intensively obtain the knowledge and skills related to that occupation. These phases do not appear in this order to all the interviewees and they are in different phases. And they use vocation education with different purposes on each phases. Different educational needs of the learners in different phases should be taken into account when organizing the classes. In addition, some measures should be taken for individuals who experience confusion in the first and second phases and give up the search without advancing to the third phase. Majority of the interviewees obtain information on employment mostly from acquaintances, the internet and mass media in limited fashions rather than from vocation education institutions. It is a significant problem that there is a lack of information delivery modalities providing useful employment information meeting the needs of highly educated women. Based on the aforementioned results analysis, I make several suggestions for the vocation education of the highly educated middle-aged women. First, we should try to understand the needs and desire of women to alter the life structure. Also, the values or missions of women"s vocation education need to be reestablished in the context of life-long education. Their desire for the employment should not be regarded as narcissistic focusing only on the self-development but should be recognized as a right of learners trying to fulfill the necessities in life. Second, integrated education system should be established to help women find a new course of life even after adulthood since the search for a new vocational career should be open to all ages in this aging society. To achieve the goal, education for the humanities/to know oneself), occupation counseling, training for occupational skills and employment-support system should be accompanied. Consequently, re-structuring of the institutions for the life-long education to support employment in a narrow sense and the search for a direction of life through self-reflection in a broad sense is necessary.

백서의 척추간 신경공 협착증 모델에서 Lipo-Prostaglandin E1의 정주효과

윤혜경 ( Hye Kyoung Yoon ),이평복 ( Pyung Bok Lee ),한진수 ( Jin Soo Han ),박상현 ( Sang Hyun Park ),이승윤 ( Seung Yoon Lee ),김양현 ( Yang Hyun Kim ),김용철 ( Yong Chul Kim ),이상철 ( Sang Chul Lee ) 대한통증학회 2007 The Korean Journal of Pain Vol.20 No.1

무증상성 요이상을 동반한 사구체신염 환아의 임상 및 병리학적 분석

성익호,윤혜경,정우영,Sung Ick-Ho,Yoon Hye-Kyoung,Chung Woo-Yeong 대한소아신장학회 1997 Childhood kidney diseases Vol.1 No.2

목적 : 경피적 신생검에 의해 사구체신염으로 진단된 환아들 중 무증상성 요이상을 주소로 하였던 환아들을 대상으로 이들을 다시 단독 단백뇨군, 단독 혈뇨군, 혈뇨와 단백뇨를 동시 에 나타내는 군으로 세분한 후 이들 각각에서의 사구체신염의 종류와 발생빈도를 분석하였다. 방법 : 1986년 1월부터 1996년 12월 사이에 인제의대 부산백병원 소아과에 입원하여 신질환이 의심되어 초음파 유도하에 Tru-cut needle을 이용하여 경피적 신생검을 시행한 환아들 중에서 사구체신염으로 진단된 15세 이하의 환아 310례 중 무증상성 요이상을 동반하였던 134례를 대상으로 하였다. 환아들의 임상양상은 의무기록을 중심으로 후향적으로 분석하였다. 결과 : 1) 전체 환아 310명 중 무증상성 요이상을 동반하였던 환아는 134명으로 전체의 43.2%를 차지하였다. 2) 무증상성 사구체신염 환아 중 원발성 사구체신염은 95명, 속발성 사구체신염은 39명으로 원발성 사구체신염이 더 많았으며, 원발성과 속발성 사구체신염의 발생 비는 2.44:1이었다. 이를 빈도순으로 살펴보면 IgA 신증이 26.9%로 가장 많았고, 다음으로 알레르기 자반증성 신염이 17.9%, 미세병변을 보인 경우가 17.2%, thin GBM disease가 12.7%, B형 간염 바이러스와 연관된 사구체신염이 6.0%, 연쇄상구균 감염 후 사구체신염이 3.0%, 막증식성 사구체신염과 메산지움 증식성 사구체신염이 각각 2.2%, Alport 증후군이 1.5%, fibrillary 신염이 0.7%의 순이었고, 어느 곳에도 분류되지 못한 경우가 9.7%를 차지하였다. 3) 단백뇨와 혈뇨를 동시에 동반한 군에서의 사구체신염의 분포를 보면 IgA 신증이 34.6%, 알레르기 자반증성신염이 19%, 미세병변을 보인 경우가 17.7%, thin GBM disease가 8.9%, B형 간염 바이러스와 연관된 사구체신염이 6.3%, 연쇄상구균 감염후 사구체신염이 3.6%, 메산지움 증식성 사구체신염과 막증식성 사구체신염 그리고 Alport 증후군이 각각 1.2%를 차지하였다. 4) 단독 혈뇨군에서의 사구체신염의 분포를 보면 thin GBM disease가 19.6%. IgA 신증과 알레르기 자반증성 신염이 각각 17.6%, 미세병변을 보인 경우가 11.8%, B형 간염 바이러스와 연관된 사구체신염과 막증식성 사구체신염 그리고 메산지움 증식성 사구체신염이 각각 3.9%, 연쇄상구균 감염 후 사구체신염과 Alport 증후군 그리고 fibrillary 신염이 각각 2.0%를 차지하였다. 5) 단독 단백뇨군은 4례 였는데 미세병변을 보인 경우가 3례, B형 간염 바이러스와 연관된 사구체신염이 1례를 차지하였다. 결론 : 혈뇨와 단백뇨를 동시에 동반하였던 군이 79례로 58.9%, 단독 혈뇨군이 51례로 38.1%, 단독 단백뇨군이 4례로 3%를 차지하여 혈뇨와 단백뇨를 동시에 동반한 군이 가장 많았다. 전체적인 사구체신염의 발생빈도를 살펴보면 IgA신증, 알레르기 자반증성 신증, 미세병변을 보인 경우, thin GBM disease순이었고, 혈뇨와 단백뇨를 동시에 동반한 군에서는 IgA 신증이, 단독 혈뇨군에서는 thin GBM disease가 가장 많았다. Purpose : To evaluate the prevalence and clinical manifestations of various glomerulonephritis(GN) in children with asymptomatic urinary abnormalities, a clinicopathological analysis of 134 biopsied cases which were subdivided into 3 groups of proteinuria with hematuria, isolated hematuria and isolated proteinuria was done. Methods : We conducted retrospective study with review of histopathologic findings and clinical manifestations of the 134 cases with asymptomatic urinary abnormalities diagnosed by percutaneous renal biopsy which were done between January 1986 and December 1996 at department of pediatrics, Pusan Paik hospital. Results : 1) The proportion of children with asymptomatic urinary abnormalities was 43.2% of all biosied cases. 2) Among these, primary GN were 95 cases and secondary GN were 39 cases, it's ratio was 2.44:1. As a whole, the most common pathologic diagnosis was IgA nephropathy(IgAN, 26.9%), which was followed by $Henoch-Sch\"{o}nlein$ purpura nephritis(HSPN, 17.9%), minimal change lesion(MC, 17.2%), thin GBM disease(12.7%), Hepatitis B associated glomerulonephritis(HBGN, 6.0%), poststreptococcal glomerulonephritis(PSAGN, 3.0%), mesangial proliferative glomerulonephritis(MesPGN, 2.2%), membranoproliferative glomerulonephritis (MPGN, 2.2%), Alport syndrome (1.5%) and Fibrillary nephritis(0.7%). 3) In proteinuria with hematuria, the most common pathologic diagnosis was IgAN(34.6%), which was followed by HSPN(19%), MC(17.7%), thin GBM disease(8.9%), HBGN(6.3%), PSAGN(3.6%), MesPGN(1.2%), MPGN(1.2%) and Alport syndrome(1.2%). 4) Major causes of isolated hematuria were thin GBM disease(19.6%), IgAN(17.6%), HSPN(17.6%), MC(11.8%). 5) Isolated proteinuria was due to of 3 cases of MC and 1 case of HBGN. Conclusion : The prevalence of glomerulonephritis with asymptomatic urinary abnormalities in children were 43.2% of all biopsed cases. When these children were subdivided into 3 groups, proteinuria with hematuria was accounted 58.9%(79 cases) and then isolated hematuria was 38.1%(51 cases), isolated proteinuria was only 3%(4 cases) respectively. The most common pathologic diagnosis was IgA nephropathy in patient with proteinuria and hematuria, and thin GBM disease in patient with isolated hematuria.