재발 유두상갑상선암의 외과적 치료에 있어 중앙경부탐색의 의의

홍석준(Suk Joon Hong),류진숙(Jin Sook Ryu),송영기(Young Kee Shong),안일민(Il Min Ahn) 대한외과학회 2001 Annals of Surgical Treatment and Research Vol.60 No.2

각막내피세포의 증식 및 손상의 회복에 대한 ROCK 억제제 Y-27632의 효과

김경환,정진권,류진숙,고아영,김미금,위원량,Kyeong Hwan Kim,Jin Kwon Chung,Jin Suk Ryu,MS,Ah Young Koh,BS,Mee Kum Kim,Won Ryang Wee 대한안과학회 2013 대한안과학회지 Vol.54 No.3

Purpose: To investigate the effect of ROCK inhibitor Y27632 on the human corneal endothelial cell proliferation in vitro and in vivo. Methods: Using corneal endothelial cells isolated and cultured from human donor cornea, we compared the effect of Y27632 (10 μM ) on the proliferation in vitro by flow cytometry analysis. For the evaluation of the effect of Y27632 (10 mM) in vivo, corneal thickness and wound area were analyzed for the corneal endothelial wound rabbit model induced by transcorneal freezing. Results: Ki67 positive cells were increased in the Y27632 group (9.1 ± 4.1 %) than the control group (8.0 ± 5.9 %), whereas annexin V positive cells in the Y27632 group (2.9 ± 1.0 %) were decreased compared to the control group (4.2 ± 2.2 %). However these were not statistically significant. Wound area after Y27632 application in animal model is concerned, the control group showed significant smaller area (45.6 ± 0.6 mm2) compared to the Y27632 group (49.3 ± 0.8 mm2; p = 0.029, Mann-Whitney U test), however, these were not significantly different from the baseline. Corneal thickness was not different between the two groups. Conclusions: Different from other reports for the effect of Y27632, no significant effect on the proliferation in vitro and wound healing in vivo, regarding human corneal endothelial cell, were found in this study.

면역억제제를 복용 중인 환자에서 안구표면 편평상피세포암의 안구 내 침범 1예

박은우(Eu Noo Bak),류진숙(Jin Suk Ryu),곽상인(Sang In Khwarg),오주연(Joo Youn Oh) 대한안과학회 2016 대한안과학회지 Vol.57 No.3

목적: 면역억제제를 복용 중인 환자에서 발생한 안구표면 편평상피세포암의 안구 내 침범에 대한 임상적, 조직학적 소견과 치료 경과에 대해 보고하고자 한다. 증례요약: 신장이식 후 17년간 면역억제제를 복용 중인 59세 남자 환자가 재발하는 우안 결막의 하얀 병변을 주소로 내원하였다. 병변의 절제적 생검 후 절제부위에 mitomycin C 점적 및 양막이식술을 시행하였다. 조직학적 검사상 편평상피세포암으로 확인되었다. 당시 시행한 안와 전산화 단층촬영검사상 특이소견은 관찰되지 않았다. 술 후 6개월간 Interferon alpha 2b 안약을 점안하였다. 술후 1년째 우안 결막 병변이 재발하여 절제적 생검과 mitomycin C 점적, 반복적 냉응고요법, 양막이식술을 시행하였다. 같이 시행한 안와 전산화 단층촬영검사에서 우안 내측에 1.9 cm의 고밀도 종괴가 관찰되어 편평상피세포암의 안구 내 침범으로 진단하고 우안안와내용물제거술을 시행하였고, 조직학적 검사상 편평상피세포암으로 확인되었다. 결론: 면역억제제 복용 환자에서 발생한 안구표면 편평상피세포암은 빠르게 다른 부위로 침범할 수 있음을 고려할 때 수술적 완전절제 후에도 적극적인 경과 관찰이 필요하다. Purpose: To report a case of ocular surface squamous cell carcinoma with intraorbital extension in a patient with renal transplantation and long-term immunosuppressive therapy. Case summary: A 59-year-old Korean male presented with a whitish mass in the medial limbus and conjunctiva of the right eye. The patient had undergone renal transplantation 17 years prior due to lupus nephritis and was on systemic immunosuppression with daily prednisolone (10 mg), tacrolimus (5 mg), and mycophenolate sodium (720 mg). The complete excision of the mass was performed and mitomycin C application and amniotic membrane transplantation on the excised area were combined. Histopathological examination revealed the mass was squamous cell carcinoma. There were no abnormal findings on the orbit computed tomography (CT). The patient was additionally treated with topical interferon alpha 2b 6 months postoperatively. One year later, a mass recurred at the same site in the right eye. The complete excision of the mass, mitomycin C application, cryotherapy, and amniotic membrane transplantation were performed. Orbit CT showed a 1.9 cm-sized intraorbital mass involving the medial rectus of the right eye. The orbital exenteration was performed and the intraorbital mass was histologically proven to be squamous cell carcinoma. Conclusions: Ocular surface squamous neoplasia in patients with renal transplantation and long-term immunosuppressive therapy should be monitored closely for the possibility of orbital invasion.

재발유두상갑상선암의 외과적 치료에 있어 FDG-PET의 유용성

정동환(Dong Hwan Jung),류진숙(Jin Sook Ryu),문대혁(Dae Hyuk Moon),송영기(Young Kee Shong),안일민(Il Min Ahn),홍석준(Suk Joon Hong) 대한외과학회 2001 Annals of Surgical Treatment and Research Vol.60 No.5

부갑상선기능항진증 환자에서 Tc-99m MIBI 부갑상선 신티그라피를 이용한 병소 국소화

문대혁,류진숙,이희경,김재승,홍승모,홍석준,신중우,공경엽 대한핵의학회 1999 핵의학 분자영상 Vol.33 No.2

Purpose: This study was performed to evaluate the diagnostic usefulness of double-phase Tc-99m MIBI parathyroidism scintigraphy with single photon emission computed tomography (SPECT) in patients with hyperparathyroidism. We also evaluated the relationship between Tc-99m MIBI uptake and oxyphil cell contents in parathyroid glands. Materials and Methods: The subjects were 28 parathyroid glands of 10 patients who underwent Tc-99m MIBI parathyroid scintigraphy and parathyroidectomy for clinically suspected hyperparathyroidism. Early and delayed pinhole images were obtained at 15 minutes and 2 hours after injection of Tc-99m MIBI, and SPECT images were followed. The weight and oxyphil cell contents of parathyroid of tissue were obtained from pathologic specimen, and the scintigraphic findings were compared with histopathology. Results: In surgical histopathology, 6 parathyroid adenomas and 9 parathyroid hyperplasias were confirmed. The sensitivity, specificity, and positive predictive value of early and delayed images were 46.7% (7/15), 76.9% (10/13), 70% (7/10) and 667% (10/15), 92.3% (12/13), 90.9% (10/11), respectively. SPECT image detected an additional small hyperplasia. The sensitivity, specificity, and positive predictive value of combined interpretation of early and delayed images with SPECT were 733% f11/15), 100% (13/13), 100% (11/11). The sensitivity was 100% (6/6) for aenoma, whereas that was 555% (5/9) for hyperplasia. Both adenomas and hyperplasias showed significantly increased oxyphil cell contents compared with normal parathyroid glands (p<0.0001), but the oxyphil cell content and weight were not significantly different between adenomas and hyperplasias. Conclusion: Double-phase Tc-99m MIBI parathyroid scintigraphy with SPECT is useful for lesion localization m patients with hyperparathyroidism. Although both adenoma and hyperplasia have increased oxyphil cell content, the sensitivity is high in adenoma, but low in hyperplasia.

갑상선 분화암 환자의 경과 관찰에서 수술전·후 혈청 갑상선글로불린 측정의 유용성

이성진,원종철,김하영,한정희,이은주,김상욱,류진숙,문대혁,홍석준,안일민 대한내분비학회 2000 Endocrinology and metabolism Vol.15 No.4·5

131I 스캔 음성 분화 갑상선 암에서 FDG-PET 의 임상적 이용 : 수술 후 병리 소견과의 비교 분석 An Evaluation Compared with Pathologic Findings

이은주,이성진,문대혁,류진숙,정준기,안일민,소영,홍석준,송헌호,김하영,이철룡 대한내분비학회 1999 Endocrinology and metabolism Vol.14 No.3

Background: FDG-PET has been suggested to have a supplementary role in localizing recurred sites of differentiated thyroid carcinoma. This study was performed to show whether FDG-PET is feasible as an alternative diagnostic modality for patients with I-131 scan negative thyroid carcinoma by verification of post-surgical pathology findings. Methods: Eighteen patients of papillary thyroid carcinoma (M:F=4:14, age 41±16 year) who had total thyroidectomy and I-131 ablation therapy were included. All patients showed negative I-131 scan on therapeutic dose but they were suspected as disease recurrence because of elevated serum Tg or anti-Tg Ab during follow-up periods. FDG-PET was performed, and then cervical lymph node dissection on either side or both sides of the neck was done according to FDG-PET results. Results: A total of 77 cervical lymph node groups were dissected in 18 patients; internal jugular chain 49, spinal accessory 9, jugulodigastric 5, anterior jugular 4, paratracheal 3, supraclavicular 2, and oters 5. Forty eight lymph node groups revealed metastatic papillary carcinoma on pathology and their largest diameter ranged from 0.4 to 7.0cm (1.2±0.7cm). All patients had at least one malignant lymph node group. FDG-PET detected 37 among 48 malignant lymph nodes (sensitivity 77%), and their count ratio ranged 1.7-31.1 (6.1±6.3). Among the 30 malignant lymph nodes less than 1cm, FDG-PET detected 20 lymph nodes. Of the 29 lymph node groups without malignant cells, FDG-PET was also negative in 24 groups (specificity S3%). Positive predictive value of FDG-PET on I-131 scan negative differentiated thyroid carcinoma was 88%; negative predictive value was 69%. Conclusion: FDG-PET has been confirmed as a valuable diagnostic modality to detect cervical lymph nodes of differentiated thyroid carcinoma who are suspicious for recurrence but with negative I-131 scan, by pathologic findings (J Kor Soc Endocrinol 14:520-530, 1999).

재발성 대장암 진단에서 PET(Positron Emission Tomography)의 유용성

박인자,유창식,김희철,이강홍,류진숙,하현곤,김진천 대한대장항문학회 2004 Annals of Coloproctolgy Vol.20 No.2

갑상선 분화암 환자의 경과 관찰에서 수술 전 , 후 혈청 갑상선글로불린 측정의 유용성

원종철,이은주,이성진,문대혁,김상욱,류진숙,안일민,홍석준,한정희,김하영 대한내분비학회 2000 Endocrinology and metabolism Vol.15 No.4

Background: Thyroglobulin (Tg) measurement is primarily used to monitor patients with well differentiated thyroid carcinomas (WDTC) for tumor recurrence. We evaluated the correlations between fold responses of thyroglobulin levels and TNM stages (and MACIS scores) at recurrent group. Also correlations between preoperative Tg levels and Tg (on or off replacement) levels at the time of recurrence were evaluated. Postoperative Tg levels between recurrent and non-recurrent groups were analyzed for the use of assessing risk of recurrence. Methods: One hundred twenty five cases of WDTC who had total thyroidectomy and (131)I remnant thyroid ablation were finally included in this study. After optimal TSH stimulations ($gt;30 μIU/mL), (131)I whole body scan (WBS) was performed. We interpreted as a recurrence only when abnormal findings on the (131)I WBS were detected. Preoperative, immediate postoperative and follow-up Tg tlevels were regularly measured. Results: Difference of preoperative Tg levels between recurrent an non-recurrent groups was not significant (27.5±4.2 ng/mL vs. 16.0±10.9 ng/mL). Also differences of immediate postoperative Tg (on or off replacement) levels between two groups was not significant (2.4±3.8 ng/mL vs. 3.6±3.l ng/mL, 33.4±4.8 ng/ml vs. 24.5±4.8 ng/mL, respectively). Tg levels on replacement at 24 months after surgery between recurrent and non-recurrent groups were significantly different (2.2±4.8 ng/mL, 15.9±6.5 ng/mL, p$lt;0.001) and also Tg levels off replacement between recurrent and non-recurrent groups were significantly different (4.0±6.6ng/mL vs. 49.4±9.3 ng/mL, p$lt;0.001). Fold responses between recurrent and non-recurrent groups were significantly different (2.0±3.1 ng/mL, 5.0±4.1 ng/mL, p=0.009). Fold responses between recurrent and non- recurrent groups were significantly different according to TNM stages (p=0.002) but not different according to MACIS scores. Preoperative Tg levels were correlated Tg (on or off replacement) levels at the time of recurrence (p=0.02, r=0.4: p$lt;0.0espectively). Sensitivity, specificity, accuracy of Tg levels over 2 ng/mL on replacement were 95%, 73%, 84% but those of Tg levels over 7 ng/mL off replacement were 83%, 70%, 77%. Conclusion: Fold responses may predict prognosis of WDTC. Small postoperative increase in serum Tg levels may indicate a large increase of tumor mass in cases of normal or low preoperative Tg levels. Tg levels over 2 ng/mL on replacement or 7 ng/mL off replacement during follow-up may suggest the recurrence of WDTC (J Kor Soc Endocrinol 15:542-553, 2000).

감염의 진단에 있어 Tc-99m Ciprofloxacin의 유용성

배인규,최선영,김양수,이미숙,오승준,류진숙,류지소,이희경,우준희 대한감염학회 2001 감염 Vol.33 No.2

Background : For the evaluation of infectious or inflammtory disease, Tc-99m HMPAO WBC scan has been used. But techniques involving radiolabelled leukocytes scan were difficult, and have failed to distinguish between bacterial infection and non-bacterial inflammation. To overcome this difficulty, we evaluated Tc-99m Ciprofloxacin in clinically suspected bacterial infection. Methods : We used this agent for 31 patients who had suspected sites of infection. And then we compared the imaging results of these patients with those of radiolabelled leukocyte scan. Results : There was no adverse effect. 29 patients was involved for the interpretation. Infective spondylitis was the most common suspected disease (41%). Bacteriologic culture was positive in 10 patients. The most common organism was meticillin-susceptible S. aureus (5 cases). The sensitivity and specificity of Tc-99m Ciprofloxacin was 83.3% and 66.6%, and those of Tc-99m HMPAO WBC was 62.5% and 83.3%, repectively. For the diagnosis of infective spondylitis the sensitivity of Tc-99m Ciprofloxacin was 80.0% and that of Tc-99m HMPAO WBC was 40.0%. Conclusion : Tc-99m Ciprofloxacin shows relatively high sensitivity and specificity. Tc-99m Ciprofloxacin was superior to Tc-99m HMPAO WBC for the diagnosis of infection in axial skeleton. (Korean J In-fect Dis 33:128∼132, 2001)