종격동의 점액성 지방육종의 세침흡인 세포학적 소견 -1예 보고-

주희재,정순희,김호근,Joo, Hee-Jae,Jung, Soon-Hee,Kim, Ho-Geun 대한세포병리학회 1990 대한세포병리학회지 Vol.1 No.2

The cytologic findings in fine needle aspiration of a case of myxoid liposarcoma of the mediastinum are described. The smear and cell block of the aspirate revealed solid clusters with background of amorphous material and scattered single tumor cells. The clusters were moderately cellular and consisted of atypical lipoblasts in varying stages of differentiation and delicate plexiform capillaries. Good correlation was found between the histologic and cytologic findings in the fine needle aspirates. The differential diagnosis between myxoid liposarcoma and other myxoid soft tissue tumors is discussed.

퇴행성 신경초종의 세침흡인 생검에 대한 세포학적 소견

주희재,이광길,Joo, Hee-Jae,Lee, Kwang-Gil 대한세포병리학회 1990 대한세포병리학회지 Vol.1 No.2

Ancient (degenerated) schwannomas are benign tumors that display pronounced degenerative changes including cyst formation, calcification, hemorrhage, and hyalinization. The tumors are usually infiltrated by large numbers of inflammatory cells such as neutrophils, lymphocytes, siderophages, and histiocytes. They are located in deep locations such as the retroperitoneum and must be differentiated from malignant soft tissue tumors because spindle cells with nuclear atypia may be present. In the fine needle aspiration biopsy. The cytologic findings of two cases of ancient schwannoma occurring in posterior mediastinum and retroperitoneum, respectively, are described. Computerized tomographic findings of both cases showed changes of cystic degeneration or necrosis. A case occurred in retroperitoneum revealed features of destruction of vertebral body to suggest a malignant soft tussue tumor radiologically. The cytologic findings of aspiration biopsy of both tumors revealed that the tumor cells were spindle in shape with elongated nuclei. Some of tumor cells were arranged in a palisading fashion. Cell structures that resemble the Verocay bodies were observed. Some of the tumor cells showed pleomorphic bizarre nuclei, but no mitotic activity or chromatin clumping was seen. Inflammatory cells, siderophages and histiocytes were scattered in fibrillar material. These cytologic findings are important in the diagnosis of ancient schwannoma and in the differentiation of this tumor from the malignant spindle cell tumor.

Smooth Muscle Tumor of Uncertain Malignant Potential ( STUMP ) 의 임상적·병리학적 고찰

이희종(Hee Jong Lee),유희석(Hee Sug Ryu),박영한(Young Han Park),주희재(Hee Jae Joo),양성천(Seung Chun Yang),오기석(Kie Suk Oh) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.10

목적 : 본 연구는 Smooth muscle tumor of uncertain malignant potential(이후 STUMP로 표기함)을 평활근 육종과 비교하여 임상적. 병리학적으로 고찰하고, 1994년 개정된 자궁평활근종 분류법으로 재분류후 그 결과를 임상경과와 비교하여, 새로운 분류법의 실용성을 검토하였다.연구방법 : 1995년부터 1999년까지 아주대학교병원 산부인과를 내원한 환자들 중 STUMP로 진단된 11례와 평활근 육종으로 진단된 7례의 의무기록과 조직표본을 통해 임상적 병리학적 소견을 검토하였고, 1994년 Kempson과 Hendrickson에 의해 정립된 자궁평활근종의 분류법에 의해 재분류하였다.결과 : 환자의 연령분포/ 분만력/ 폐경유무/ 호르몬제재 복용 기왕력은 양군에서 유의한 차이가 없었다. 가장 흔한 임상증상은 불규칙한 자궁출혈이었고 (STUMP 54%, 평활근 육종 62%), 수술전 초음파상 악성종양이 의심된 경우는 STUMP 군에서 1례(9%), 평활근 육종군에서 2례(29%)였다. STUMP 군 2례에서는 근종 절제술만으로 치료를 종결하였고 총 18례중 나머지 환자들은 전자궁 적출술 및 선택적 자궁부속기 절제술을 시행하였으며, 모든 예에서 재발이나 전이소견은 없었다. 총 18례 중 STUMP 10례와 평활근 육종 4례는 유사분열지수가 증가된 평활근종으로, STUMP 1례는 비정형 평활근종으로, 평활근 육종 3례는 같은 진단명으로 재분류되었다.결론 : STUMP에서 유사분열지수가 증가된 평활근종(leiomyoma with increased mitotic index)으로 재분류된 종양의 환자들은 모두 양호한 임상경과를 보여 본 연구에서 자궁평활근종의 새로운 분류법은 임상경과와 일치하였다. 이 경우 임신을 원하는 여성이면 근종 절제술만으로 치료를 종결할 수 있다. 그러나 재발가능성이 적은 비정형 평활근종(atypical leiomyoma with low risk recurrence)이나 저급악성도를 갖는 평활근종(smooth muscle tumor of low malignant potential)으로 분류된 예는 악성 임상경과의 가능성이 있어, 예후에 대한 장기적인 추적조사가 필요할 것으로 본다. Objective : To evaluate clinical-pathological aspects of smooth muscle tumor of uncertain malignant potential (STUMP), comparing those of leiomyosarcomas and to reclassify them according to the revised classification of smooth muscle tumor, and to investigate the clinical value of new classification.Methods : A retrospective review of clinical and pathological characteristics of 11 cases of STUMP and 7 cases of leiomyosarcoma was done at department of obstetrics and gynecology of Ajou university hospital from 1995 to 1999. They were reclassified according to the revised classification by Kempson and Hendrickson in 1994.Results : Patients' age, parity, status of menopause, history of hormonal use were not significantly different. Vaginal bleeding was most common clinical symptom in both groups(STUMP 55%, leiomyosarcoma 63%) and sarcomatous change was suspected in 1 case of STUMPs and 2 cases of leiomyosarcomas with preoperative transvaginal sonographic examination. Two cases of STUMP were treated with myomectomy only and hysterectomy with or without salpingo-oophorectomy was performed in all cases of leiomyosarcomas and 9 cases of 11 STUMPs. No adjuvant therapy was done and none recurred. Ten cases of STUMP and four cases of leiomyosarcoma were reclassified into leiomyoma with increased mitotic index, one STUMP into atypical leiomyoma, and three leiomyosarcomas remained in the same category by revised classification.Conclusion : Such tumors reclassified into leiomyoma with increased mitotic index showed benign clinical course and the results of this study support new classification. However, atypical leiomyoma with low risk recurrence and smooth muscle tumor with low malignant potential still have possibility of malignant clinical course.

임신 제 3 분기까지 진행된 비교통성 흔적자궁각 임신 1 예

황경주(Kyung Joo Hwang),양정인(Jeong In Yang),오기석(Kie Suk Oh),김행수(Haeng Soo Kim),안은주(Eun Joo Ahn),양성천(Seong Cheon Yang),이은주(Eun Ju Lee),주희재(Hee Jae Joo) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.1

The uterus with rudimentary horn occurs as a result of a lack of development during fetal life of the middle and lower parts of one of the Miillerian ducts, in which there is a failure of fusion of the two ducts, The incidence of this uterine anomaly is rare. Many cases of rudimentary uterine horn are not discovered since they do not become involved in a pregnancy, and thus remain symptomless and uncomplicated, and the diagnosis usually being made only with pregnancy with rupture. In this presentation, we describe a case of diagnosis and management of unruptured non-communicating rudimentary uterine horn pregnancy at the third trimester. The patient diagnosed by ultrasonography and MRI, was hospitalized for further evaluation and delivery under the impression of unruptured non-communicating rudimentary horn pregnancy. A living male infant weighing 1,930 gm was delivered by cesarean section at 33+l weeks due to impending preterm labor. Some articles concerned this subject were reviewed briefly to discuss relevant method of diagnosis, treatment, and clinical characteristics.

신우 이행세포암에 동반된 방광의 도립 유두종

고동희(Dong Hee Koh),조대성(Dae Sung Cho),원용연(Yong Yeon Won),최민규(Min Kyu Choi),주희재(Hee Jae Joo),김세중(Se Joong Kim) 대한비뇨기종양학회 2003 대한비뇨기종양학회지 Vol.1 No.2

갑상선 질환(종양)에서 Cyclooxygenase-2의 발현에 대한 연구

이국종,박희붕,김지훈,정용식,주희재<SUP>1<,SUP>,소의영,Kug Jong Lee,M,D,Hee Boong Park,M,D,Ji Hoon Kim,M,D,Yong Sik Jeong,M,D,Hee Jae Joo,M,D,<SUP>1<,SUP> and Euy Young Soh,M,D 대한갑상선-내분비외과학회 2002 The Koreran journal of Endocrine Surgery Vol.2 No.2

Purpose: Thyroid tumor is one of the most common endocrine tumors, and yet little is known about its molecular process of development and progression. Cyclooxygenase (COX)- 2, the inducible form of the COX enzyme for prostaglandin synthesis, is up-regulated in gastrointestinal cancers and is a key mediator of epithelial cell growth. Regular intake of aspirin or other nonsteroidal antiinflammatory drugs (NSAIDs) is associated with a decreased incidence of colorectal, esophageal, gastric, and lung cancer. We sought to determine the involvement of COX-2 in human thyroid cancer. Methods: COX-2 protein was assayed in thyroid tissue of 64 which were inflammatory disease and benign tumor and malignant tumor with or without metastasis patients by using immunohistochemistry and Western Blot analysis. Results: COX-2 protein was not expressed in normal thyroid tissue. But COX-2 protein was expressed strongly in inflammatory tissue. Expression of COX-2 was very high in both benign and malignant tumor. There is no difference in pathology and malignant potential or existence of metastasis. Conclusion: There was no correlation between clinicopathological characteristics of thyroid tumor and intensity of COX-2 protein expression. In addition, there was no difference of expression of COX-2 between inflammatory thyroid disease and thyroid tumor. This study indicates that COX-2 protein over expression may contribute to an early event of gastric cancer development, and it further suggests that selective inhibition of COX-2 may provide a chemopreventive effect against thyroid cancer. (Korean J Endocrine Surg 2002;2:90-96)

자궁내막증 환자의 자궁내막내 성호르몬 수용체, Integrins, Cyclooxygenase의 발현과 변이 양상

김미란,박동욱,권혁찬,황경주,주희재,조동제,김세광,오기석,Kim, Mi-Ran,Park, Dong-Wook,Kwon, Hyuek-Chan,Hwang, Kyoung-Joo,Joo, Hee-Jae,Cho, Dong-Jae,Kim, Sei-Kwaug,Oh, Kie-Suk 대한생식의학회 2000 Clinical and Experimental Reproductive Medicine Vol.27 No.2

Objectives: To develop a new immunohistochemical marker system for supplementation of the Noyes histological classification of the endometrium in women of child bearing age with regular menstrual cycles, and to employ this system to evaluate pathologic factors involved in endometriosis, and thus to ascertain if it is useful in diagnosis. Materials and Methods: Endometrial biopsies were sampled from the posterior fundus of 41 (24 proliferative phases, 17 secretory phases) women with regular menstrual cycles (28-32 days), and each sample was immunohistochemically stained according to Noyes et al (1975) for determination of expression for estrogen receptor (ER), progesterone receptor (PR), integrin ${\alpha}_1$, ${\alpha}_4$, ${\beta}_3$, COX-1 and COX-2. Then, the PR, integrin ${\beta}_3$ and COX-2 which were clearly expressed in the luteal phase was with endometrial samples were obtained from 20 cases of normal patients (group 1) and 25 cases with endometriosis (group 2) after confirming the day of ovulation by sex steroid level measurements 7-8 days after ovulation Results: In the regular menstruation group the expression of ER showed a tendency to be increased in the proliferative phase and decreased in the secretory phase, and was the highest in the proliferative phase. However, PR in the stromal cells showed no change in the entire menstrual cycle while in the epithelial cells, PR reached a peak in the late proliferative phase and was almost absent in the secretory phase. Integrin (${\alpha}_1$, ${\alpha}_4$, and ${\beta}_3$ expression in the epithelial cells was absent in the proliferative phase but ${\alpha}_1$ was strongly expressed starting from the early secretory phase into the entire secretory phase. ${\alpha}_4$ was expressed strongly in the early and mid secretory phases and disappeared in the late proliferative phase, while ${\beta}_3$ appeared after the mid secretory phase and continued to be expressed until the late secretory phase. Expression in the stromal cells was weak overall and did not show any cyclic pattern. COX-1 expression was shown as a cyclic pattern in the stromal and epithelial cells and was particularly strongly expressed in the mid secretory phase of epithelial cells, and in the mid secretory and menstruation phase of stromal cells. In the endometrial epithelial cells there was strong expression during the entire cycle with stronger expression in the secretory phase compared to the prolferative phase. COX-2 was clearly expressed in the late proliferative, early and mid secretory phases in the stromal cells. No expression was observed in the proliferative phase of the epithelial cells, but which began to appear in the early secretory phase reaching a significant pattern from the mid secretory phase onwards. There was almost no expression in the stromal cells. In the cases with endometriosis showing normal endometrial maturation according to the Noyes classification, PR expression was increased while Integrin-${\beta}_3$의 expression was significantly decreased compared to the normal group. Also, COX-2 expression was slightly decreased in the stromal cells of patients with endometriosis while it was significantly increased in the stromal cells. Conclusion: Immunohistochemical markers can supplement the original Noyes classification of histological endometrial dating and therefore ascertain existing pathologic conditions. Particularly for patients with endometriosis with normally mature endometrial cells, changes in COX-2 and integrin expression patterns may assist in elucidating pathophysiologic mechanisms and therefore aid in the diagnosis of abnormal implantation conditions, and consequently determine a treatment modality.

위암의 진행과 간세포성장인자(HGF), Met 그리고 E-cadherin 발현간의 상호관계

한상욱(Sang-Uk Han),주희재(Hee-Jae Joo),이재호(Jae-Ho Lee),김욱환(Wook-Hwan Kim),조용관(Yong-Kwan Cho),김명욱(Myung-Wook Kim) 대한외과학회 1998 Annals of Surgical Treatment and Research Vol.55 No.1

자궁경부암에서 접합분자 E - cadherin 의 발현

오기석(Kie Suk Oh),주희재(Hee Jae Joo),김선영(Sun Young Kim),유희석(Hee Sug Ryu),정태영(Tae Young Chung),장기홍(Ki Hong Chang) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.2

N/A Objective: The aim of the present study was to evaluate the E-cadherin expression in normal cervical epithelium, carcinoma in situ of the cervix, and invasive carcinoma of the cervix, and to define the role of E-cadlherin expression in tumor invasion with respect to clinicopathologic parameters. Methods: We conducted immunodetection of E-cadherin in 58 cases of cervical carcinoma using immunohistochemistry in formalin-fixed, paraffin-embbeded sections, Rusults: E-cadherin expression was different between normal cervical epithelium and carcinoma in situ of the cervix, and between normal cervical epithelium and invasive carcinoma of the cervix(p<0.05). However, there was no difference in E-cadherin expression between carcinoma in situ and invasive carcinoma of the cervix. In invasive cervical carcinomas, expression of E-cadherin and the intensity of cytoplasmic E-cadherin expression did not correlate with histologic type, lymphvascular space invasion, lymph node metastasis, and stage of disease. Conclusion: It is mncluded that expression of E-cadherin is related to tumor invasion in cervical tissues, but further studies with regard toE-cadherin/catenin/cytoskeleton complex are needed to clarify the prognostic role of E-cadherin with respect to clinicopathologic parameters in invasive cervical carcinoma,

H. pylori Infection 감염과 위암 발생

한상욱,조용관,정재연,박현진,김영배,남기택,김대용,주희재,최준혁,김진홍,이기명,김명욱,함기백,Han Sang-Uk,Cho Yong-Kwan,Chung Jae-Yun,Park Hyun-Jin,Kim Young-Bae,Nam Ki-Taek,Kim Dae-Yong,Joo Hee-Jae,Choi Jun-Hyuk,Kim Jin-Hong,Lee Ki-Myung,Kim 대한위암학회 2002 대한위암학회지 Vol.2 No.2

In spite the fact that H. pylori infection might be the causative organisms of acute and chronic gastritis, peptic ulcer diseases and the definition as the class I carcinogen by WHO IARC, still debates exist about the relationship between H. pylori and gastric carcinogenesis. Epidemiological and animal studies demonstrated a link between gastric cancer and chronic infection with H, pylori, but the exact mechanism responsible for the development of gastric cancer in H. pylori-infected patients still remain obscure. In order to declare the clear association, definate evidences like that decrement in the incidence of gastric cancer after the eradication of H. pylori in designated area compared to noneradicated region or the blockade of specific mechanism acting on the carcinogenesis by H. pylori infection. The other way is to identify the upregulating oncogenes or downregulating tumor suppressor genes specifically invovled in H. pylori-associated carcinogenesis. For that, we established the animal models using C57BL/6 mice strain. Already gastric carcinogenesis was developed in Mongolian gerbils infected with H. pylori, but there has been no development of gastric cancer in mice model infected with H. pylori after long-term evaluation. Significant changes such as atrophic gastritis were observed in mice model. However, we could observe the development of mucosal carcinoma in the stomach of transgenic mice featuring the loss of TGF-beta sig naling by the expressions of dominant negative forms of type II receptor specifically in the stomach. Moreover, the incidence of gastric adenocarcinoma was significantly increased in group administered with both MNU and H. pylori infection than MNU alone, signifying that H. pylori promoted the gastric carcinogenesis and there might be host susceptibility genes in H. pylori-associated gastric carcinogenesis. Based on the assumption that chronic, uncontrolled inflammation might predispose to carcinogenesis, there have been several evidences showing chronic atrophic gastritis predisposed to gastric carcinogenesis in H. pylori infection. Although definite outcome of chemoprevention was not drawn after the longterm administration of anti-inflammatory drug in H. pylori infection, the actual incidence of atrophic gastritis and molecular evidence of chemoprevention could be obtained. Selective COX-2 inhibitor was effective in decreasing the development of gastric carcinogenesis provoked by H. pylori infection and carcinogen like in chemoprevention of colon carcinogenesis.