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자궁목질 바른표본에서 비정형 편평세포의 p16에 대한 면역세포화학염색
김활웅,이종실,이정희,고경혁,Kim, Hwal-Woong,Lee, Jong-Sil,Lee, Jeong-Hee,Ko, Gyung-Hyuck 대한세포병리학회 2004 대한세포병리학회지 Vol.15 No.1
It was reported that the main cause of intraepithelial neoplasm and squamous cell carcinoma of the uterine cervix is human papilloma virus infection, and that the expression of p16 is increased in cells infected by human papilloma virus. We performed an immunocytochemical staining for protein p16 in 17 cases of cervocovaginal smears initially diagnosed as atypical squamous cells of undetermined significance, to know whether the staining could help the differentiation of neoplastic cells from reactive atypical cells. Of 17 smears, 6 were diagnosed finally as high grade intraepithelial neoplasm or invasive squamous cell carcinoma by follow-up biopsy and smear, and 5 of the 6 were positive for p16. Three were diagnosed as koilocytosis, and one of them was weakly positive for p16. Eight were diagnosed as reactive atypical cells, and all of them were negative for p16. We thought that immunocytochemical staining of p16 in cervocovaginal smears could help the differentiation of neoplastic cells from reactive atypical cells.
김활웅,고경혁,김철우 대한병리학회 2003 Journal of Pathology and Translational Medicine Vol.37 No.3
Sinonasal undifferentiated carcinoma (SNUC) is a rare, aggressive neoplasm arising in the nasal cavity and paranasal sinuses. We report a case of SNUC in an old woman. The tumor was located at the nasal cavity and ethmoid sinus, extending to the cranial cavity. The nasopharynx was free from the tumor. Microscopically, the tumor formed nests or sheets containing medium-sized cells with small amounts of eosinophilic cytoplasm. High mitotic rates and tumor necrosis were characteristic. There was no evidence of glandular or squamous differentiation. The tumor was focally weak positive for cytokeratin, but negative for vimentin, leukocyte common antigen, S-100 protein, chromogranin, synaptophysin and neuron specific enolase. Epstein Barr Virus EBER-1 was not detected by in situ hybridization. SNUC is a highly aggressive tumor and must be distinguished from less aggressive sinonasal neoplasms.
Vancomycin 내성 장구균의 분포 및 Vancomycin, penicillin 및 Gentamicin의 병용 효과
김활웅 ( Hal Woong Kim ),이위교 ( Wee Gyo Lee ),유기원 ( Ki Won Ryu ),김각현 ( Kag Hyu Kim ),관연식 ( Yun Sik Kwak ) 대한임상검사과학회 1998 대한임상검사과학회지(KJCLS) Vol.30 No.3
Infections caused by vancomycin-resistant enterococci (VRE) are becoming increasingly prevalent throughout the world Because of the resistance of vancomycin resistance is troublesome. The optimum drug regimen for treatment of infections due to VRE is not known Very few data have been published concerning in VRE-infected patients. The combined regimen may offer a treatment for patients infected with VRE. The IXJI1Xl8e of this study was to examine the incidence of VRE among total enterococci from clinical specimen and investigate the antimicrobial synergistic killing of clinical isolates of VRE belonging to genotypic resistance classes vanA, vanB, and vanC. A total of 1,286 enterococcal isolates from patients over a period of 12 months were screened for vancomycin resistance using brain heart infusion agar plates supplemented with 6 ug/ml, of vancomycin. The incidence of VRE among enterococcal isolates was calculated form microbiology statistics program Nine strains of VRE and 2 strains of vancomycin-susceptible enterococci were utilized in this study. Minimal inhibitory concentrations (MIC) were determined by agar dilution method Synergistic inhibition of growth was assessed by addition vancomycin, penicillin, gentamicin, or combinations of these antibiotics to cultures in the early loganthmic phase of growth Synergy was defined as a decrease in CFU/mL by at least 2 log10 after 24h compared with the effect of the most active single agent In the 12 months, the incidence of VRE was 3.2%. Among 9 strains, analyses, the frequency of uanB, uanC1, and uanC2 types was 2, 4, and 3 strains, respectively, Vancomycin-penicillin-gentamicin, and vancomycin-penicillin resulted in 2 or more logs of killing above that the most effective single agent for all vanA and vanB strains. All vanC strains were resistant to any antibiotics combination. Continued vigilance, strict enforcement of infection control, and curtailment of vancomycin use seem to be our best approaches to controlling this increasingly important problem For this purposes, accurate and timely detection of vancomycin resistance and periodic investigation for incidence is essential. Triple combination therapy and vancomycin plus penicillin regimen may be effective for the treatrrent of infections caused by vancomyin-resistant enterococci belonging to genotypic classes vanA and vanB. Further studies are needed for the new therapeutic regimen against vanC strains.
이종실,김활웅,이정희,윤희상,정운태,고경혁 대한병리학회 2003 Journal of Pathology and Translational Medicine Vol.37 No.1
Background : It has been believed that there is a pure mucus-secreting cardiac mucosa (CM), about 2 cm in length, below the gastroesophageal junction. However, recent reports suggest that CM might not be located at the most proximal portion of the stomach. The purpose of this study is to investigate the relationships between the types of proximal gastric mucosa and patients’age, sex, their condition regarding the Helicobacter pylori infection, and severity of chronic gastritis. Methods : Two pieces of mucosal tissue from the most proximal portion of the stomach and the antrum of 44 pediatric and 85 adult patients were examined using a light microscope. A rapid urease test was performed on the other antral specimen from each patient. Results : In 46 (90.2%) out of 51 patients with aged 30 or under, only the pure acid-secreting oxyntic mucosa (OM) was present at the most proximal portion of the stomach. The cardiac or mixed oxyntocardiac mucosa (OCM) increased in prevalence with age. The CM or OCM was found more frequently in patients with H. pylori infection or severe gastritis than in those without H. pylori infection or those with mild gastritis. However, there were no statistically significant differences within the same age groups. Conclusions : Although the OCM is sometimes present at the most proximal portion of the stomach, the CM is absent or rare in individuals under the age of 30. The OCM or CM increases in prevalence with age. There are no direct relationships between the type of proximal gastric mucosa and a patient’s gender, his/her condition regarding the H. pylori infection, and severity of chronic gastritis.
김우진,김활웅,화정석,정기현 대한비뇨의학회 2004 Investigative and Clinical Urology Vol.45 No.7
Purpose: The histological changes in the upper pole of excised duplex kidneys with ureterocele were reviewed and the histological variations with respect to age and ureterocele position were assessed. Materials and Methods: During the last ten years, 10 patients with duplex system ureterocele underwent an upper pole nephrectomy. A total of 10 specimens, of which 4 and 6 were diagnosed at younger than 1 year old and older than 1 year old, and 5 each involving intravesical and ectopic locations, respectively, were available for independent review by a single pathologist. Histological lesions were classified into the 5 categories; chronic interstitial inflammation, interstitial fibrosis, tubular atrophy, glomerulosclerosis and dysplasia. Each category was divided into moderate/severe histological lesions(greater than 25% involvement) and minimal/mild lesions(25% or less involvement). Results: Chronic interstitial inflammation, interstitial fibrosis, tubular atrophy, glomerulosclerosis and dysplasia in each of the specimens were graded as moderate/severe(greater than 25% involved) in 50, 50, 60, 10 and 80% of the subjects, respectively. The ureteroceles detected at an early stage were not associated with less severe upper pole histological lesions. Also, no pathological differences were observed when comparing specimens according to the ureteroceles positions. Conclusions: It appears that the histological lesions observed may not be progressive or reversible. Therefore, it is suggested that enhancement of the upper pole renal function seems unjustified in the light of the histological evidence, and the goals of clinical management should focus on preventing complications and secondary procedures. (Korean J Urol 2004;45:720-725)
김지연,김활웅,최경운,이창훈,설미영,강현정,신동훈 대한병리학회 2006 Journal of Pathology and Translational Medicine Vol.40 No.4
Background : Disturbances of the cell cycle regulatory proteins are key events underlying the development and/or progression of human malignancies. The aim of this study was to evaluate the expression of G1/S cell cycle regulatory proteins in ovarian epithelial tumor. Methods : We simultaneously evaluated the expression of cyclin D1, cyclin E, CDK4, CDK2, p16, Rb, E2F1, p53 and the Ki67 labelling index (LI) by immunohistochemical methods in 148 cases of ovarian epithelial tumor of the benign (n=47), borderline (n=29), and malignant type (n=72). Results : The expression of cyclin E, CDK2, p16, Rb, E2F1, p53 and the Ki67 LI gradually increased from the benign type, through the borderline type, to the malignant tumors. Between the borderline and malignant tumors, the increased expression of cyclin E, E2F1, and p53, and the decreased expression of Rb were significantly associated with malignancy. The reduced Rb expression and the increased E2F1 expression were correlated with the FIGO stage and the histologic grade in the malignant ovarian epithelial tumors. Conclusions : Cyclin E, E2F1, and p53 overexpressions and the loss of Rb are the important components during carcinogenesis of ovarian epithelial tumors. Our results suggest that in- creased expression of E2F1 should be considered as a new parameter for the prognosis of patients with malignant ovarian epithelial tumors.