Clinical implication of methionyl-tRNA synthetase (MRS) expression in non-small cell lung cancer; usefulness of diagnostic marker

조은나,김은영,정지예,김아름,서은영,장윤수 대한결핵 및 호흡기학회 2015 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.120 No.-

Objectives: Aminoacyl-tRNA synthetases (ARSs) are essential enzymes which catalyze ligation of amino acids to their cognate transfer RNAs. Methionyl-tRNA synthetase (MRS) is one of the ARS class 1 family initiating translation by transferring Met to initiator tRNA, suggesting import role in tumor growth. Phosphorylated MRS by mitogen-activated protein kinase seems to serve as a protective mechanism against reactive oxygen species mediated damage. In view of the points listed above, MRS can be deduced to be related to cancer growth and drug resistance. We evaluated clinical implication of MRS and usefulness as a diagnostic marker in Non-small lung cancer (NSCLC) using immunohistochemical (IHC) staining. Methods: A total of 118 cases of curatively resected stage I NSCLC underwent IHC staining and survival analysis using Log Rank Test were performed. Results: IHC expression strength was analyzed using the scoring system devised according to the intensity and frequency of MRS staining. In the normal lung, MRS expression score were weaker than NSCLC which MRS expression varying the intensity score 0 to 9 and 37 out of 118 (31.4%) presented strong IHC intensity over 6 mainly observed in the cytoplasm (79 out of 118, 66.9%). When clinicopathological features evaluated, female NSCLC showed higher MRS expression (P=0.071). There was no difference in disease-free survival or overall survival according to the MRS expression (P=0.945, 0.625). Conclusion: MRS to be expressed more in the NSCLC than in normal lung tissue. However, MRS did not present correlation with NSCLC prognosis.

Anastomotic Airway Complications after Lung Transplantation

조은나,백효채,함석진,김송이,장윤수 연세대학교의과대학 2015 Yonsei medical journal Vol.56 No.5

Purpose: Anastomotic airway complications are a major cause of morbidity and mortality after lung transplantation (LTx). In this study, the authors identified types and clinical outcomes of airway complications after LTx. Materials and Methods: All bronchial anastomotic complications were analyzed in a total of 94 LTx cases involving 90 recipients who underwent surgery between July 2006 and May 2014. Fifteen LTx cases (14 recipients) with incomplete medical records for fiberoptic bronchoscopy (FBS) and three cases underwent heart-lung transplantation (HLT) were excluded. Postoperative FBS at 24–48 hours, 1, 3, 6, and 12 months, and then yearly after the transplantation were performed. Results: A total of 76 LTx cases (75 recipients) were analyzed. The mean age of the recipients was 49.55 years (range, 18–71 years), and 38 (49.4%) were male. Twenty-one out of 76 cases (27.6%) experienced early anastomotic complications, and 12 (15.8%) presentedlate anastomotic complications. The early anastomotic airway complications presented in various forms: stenosis, 1 case; narrowing, 1; necrosis & dehiscence, 3; fistula, 4; granulation, 10; and infection, 2. Late complications almost entirely presented in the form of bronchial stenosis; five recipients showed stenosis at the anastomosis site, and one of them showed improvement afterballooning. Five others were found to have stenosis at the bronchus intermedius, distal to the anastomosis site. Three of these patients showed improvement after ballooning or bronchoplasty. Conclusion: By serial surveillance via FBS after LTx, we detected anastomotic airway complications in 42.9% of cases, which were successfully managed with improved clinical outcomes.

A Rare Case of Primary Thymic Adenocarcinoma Mimicking Small Cell Lung Cancer

조은나,박혜성,김태훈,변민광,김형중,안철민,장윤수 대한결핵및호흡기학회 2015 Tuberculosis and Respiratory Diseases Vol.78 No.2

Primary thymic adenocarcinoma is a very rare malignancy of the anterior mediastinum with no standardized treatment. A 36-year-old male patient presented with hoarseness over the past 3 months. A chest computed tomography (CT) scan showed an infiltrative mass to the proximal vessels and aortic arch in left upper mediastinum (4.1×3.1×5.4 cm). Brain magnetic resonance imaging (MRI) showed focal lesions, suggesting metastasis in the left frontal lobe. A thoracoscopic biopsy of the mediastinal mass confirmed a primary thymic adenocarcinoma forming a glandular structure with atypia of tumor cells. The patient received four cycles of systemic chemotherapy, consisting of etoposide and cisplatin, with concurrent radiotherapy (6,000 cGy/30 fractions) to the mediastinal lesion and the metastatic brain lesion (4,200 cGy/12 fractions). A follow-up chest CT scan and brain MRI showed a decrease in the size of the left upper mediastinal mass and brain lesion. We report a rare case of the primary thymic adenocarcinoma with a literature review.

증례 : 호흡기 ; CT 유도하 경피적 흉부 세침흡인생검 후 발생한 뇌 공기색전증 1예

조은나 ( Eun Na Cho ),박희진 ( Heejin Park ),김혜원 ( Hae Won Kim ),장윤수 ( Yoon Soo Chang ),김형중 ( Hyung Jung Kim ),안철민 ( Chul Min Ahn ),변민광 ( Min Kwang Byun ) 대한내과학회 2013 대한내과학회지 Vol.85 No.4

고립성 폐결절의 진단을 위해 경피적 흉부 세침흡인생검을 하는 경우 기흉이나 혈흉, 공기색전증 등의 합병증 발생빈도가 유의하게 증가하는 환자군을 확인하여 시술을 진행하는 동안 활력징후 및 임상양상을 주의 깊게 관찰하여야하며 공기색전증의 임상양상을 보일 경우 즉각적인 진단과 6시간 내의 빠른 고압산소치료를 시행하여야 한다. 이전의 증례보고와 비교하였을 때 본 증례는 세침흡인생검 시행 시합병증의 발생위험도 예측에 따른 환자 관찰과 임상증상에 중점을 둔 진단 및 빠른 고압산소치료가 좋은 치료 결과를 내는 방법임을 보여주고 있다. Low-dose thoracic computed tomography (CT) for the early diagnosis of lung cancer detects many solitary pulmonary nodules. Fine needle aspiration biopsy (FNAB) is the diagnostic method used most commonly in the diagnosis of solitary pulmonary nodules. Cerebral air embolism is a rare, fatal complication of FNAB. Hyperbaric oxygenation therapy within 6 hours of the event ensures a good prognosis with cerebral air embolisms. We present a case of cerebral air embolism that occurred during CT-guided lung FNAB biopsy that was treated with hyperbaric oxygenation within 6 hours. The patient recovered completely from the neurological deficit and had a favorable long-term outcome. (Korean J Med 2013;85:416-419)

EGFR Mutation G719C at Exon 18 in NSCLC

한우람,지수연,조은나,곽현정,유문빈,조혜제,김철수,이종화 대한내과학회 2019 대한내과학회 추계학술대회 Vol.2019 No.1

전전뇌증 1예

김미희,양수진,조은나,박소양,안현숙,최원영 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.11

전전뇌증은 태생기 전뇌의 게실화의 실패로 인한 전두부의 기형복합체이다. 전전뇌증의 조기 산전 진단은 심한 증도를 밝혀내고, 예후를 예상하고, 그 예후 및 심한 정도에 따라 적절한 치료를 결정하기 위해 중요하다. 최근 고해상 초음파의 발달로 임신 초기에 전전뇌증을 가진 태아의 발견이 가능해졌다. 우리는 산전에 진단된 무엽성 전전뇌증 1예를 초음파 및 부검 소견과 함께 보고하는 바이다. Holoprosencephaly is a complex abnormality of the forebrain that is postulated to derive from a failure in the diverticulation of the embryonic prosencephalon. Early antenatal diagnosis of holoprosencephaly is important to find out its severity, to predict its prognosis and to determine proper treatment according to its prognosis and severity. With recent development of high resolution ultrasonography, it is possible to detect a fetus with holoprosencephaly at early antenatal period. We report a case of alobar holoprosencephaly, diagnosed antenatally with its sonographic and autopsy finding.

임신 18 주의 자궁파열 1 예

양수진(Su Chin Yang),조은나(Eun Na Cho),박소양(So Yang Park),김미희(Mi Hee Kim),김병점(Pyung Jum Kim) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.2

Spontaneous uterine rupture during the second trimester of pregnancy is a rare obstetric emergency. When a patient presents with acute abdominal pain and signs of hemorrhagic shock, a number of differential diagnoses must be considered. Early diagnosis and proper management is necessary to decreased the high maternal and fetal morbidity and mortality associated with rupture of uterus. We present a case of spontaneous rupture of the uterus in the 18th week of pregnancy with a brief review of literatures.

TP-52 : Thematic Poster ; LSL-Kras G12D 마우스 폐암 모델에서 Proteasome Inhibitor와 Pemetrexed 병합의 치료 효과

박희진,김은영,신정아,조은나,변민광,안철민,김형중,장윤수 대한결핵 및 호흡기학회 2013 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.116 No.0

KRAS의 활성 돌연변이는 전체 암의 약 30%에서 발견되고 국내 폐암 환자의 약 5%에서 발견된다. KRAS 활성 돌연변이를 가진 암종증은 기존 항암 치료에 저항성이 높은 것으로 알려져 있어 새로운 치료 방법이 필요하다. 이에 연구자들은 pemetrexed 와 proteasome 억제제의 조합이 Ras/Raf/MAPK 기전이 활성화되어 있는 KRAS 활성 돌연변이를 가지고 있는 폐암에서 암세포의 고사를 강화시키고 약제내성을 극복하는데 도움이 되는 가를 확인하고자 하였다. LSL-KRAS G12D 마우스 hetero 모델을 생후 8주째에 1*108 PFU adenoCre virus 흡입시킨 후 8주간 사육 하였다. 대조군과 Pemetrexed (100 mg/kg)및 bortezomib (0.7 mg/kg) 단독투여군 그리고 두 약제의 병용투여군으로 randomization 한 뒤, BIW 로 4주간 복강 투여 후 4주간 경과 관찰한 뒤 안락사 하여 tumor volume 및 tumor area 를 관찰하였다. 자연사할 때 까지 경과관찰 한 쥐는 약 40주 생존하였으며 전체 폐 면적 중 암종증이 차지하는 비율은 33.3±6.64%. 대조군의 경우는 4.6±0.46%, Pemetrexed 단독 투여군은 5.4±1.54%, bortezomib 단독 투여군은 5.1±1.17%, 병용투여군은 13.2±2.65% 였다. 대조군과 단독군, 단독군 간에서의 암 면적은 통계학적으로 유의하지 않았으며 (P=1.000, one-way ANOVA) 병용투여군의 암면적비율은 타 군과 비교해서 유의한 증가를 보였다 (p=0.001, one-way ANOVA). 이의 원인 확인 위해 시행한 병리학적 소견상 병용투여군에서 crystal laden macrophage 가 침윤되어 있는 것이 전 폐야에서 관찰되었다. LSL-KRAS G12D 마우스 모델에서 Proteasome 억제제와 pemetrexed 와의 병용투여는 단독 투여 군에 비해 오히려 효과가 저하되었고 이에 병합요법은 적절하지 않은 것으로 사료된다. 또한 병용투여군에서 관찰된 macrophage 의 손상의 기전을 찾기 위해 연구가 필요하다.

조기 위암에서 전이성 림프절과 감별이 필요하였던 관외형 위장관 기질종양 1예

박정수,박효진,김종원,윤선옥,박형순,김지현,윤영훈,조은나 대한소화기내시경학회 2010 Clinical Endoscopy Vol.41 No.5

Gastric adenocarcinoma may coexist with tumors of other histological types. The synchronous occurrence of gastric adenocarcinoma and gastrointestinal stromal tumor (GIST) has rarely been reported in the literature. It is still not known whether such an association represents an incidental coexistence or indicates a similar pathogenesis in the simultaneous development of tumors of different histological types. Here we report a case of an exoluminal GIST that was confused with a metastatic lymph node in early gastric cancer. 위 선암은 다른 조직학적 분류를 가지는 종양과 동시에 발생하는 경우가 있으며, 유암종, 점막연관림프종, 평활근육종, 위장관 기질종양 등을 동반할 수 있는 것으로 알려져 있다. 이러한 동시 발생하는 종양에 대해서는 드물게 보고하고 있으나 병태생리에 대해서는 아직 확립된 이론이 없어 이에 대한 연구가 필요하다. 저자들은 조기 위암의 병기 결정을 위해 시행한 복부전산단층촬영에서 작은그물막에 전이성 림프절과 감별이 필요한 종양 소견을 보여, 조기 위암에 대한 내시경 점막하 박리술 시행 후 복강경하 종양절제술 결과 관강외 위장관 기질종양으로 진단한 1예를 경험하였기에 문헌고찰과 함께 보고한다.

자궁경관임신에서 Methotrexate 치료 후 소파술을 시행한 보존적 치료

강은주(E . J . Kang),김현진(H . J . Kim),김미희(M . H . Kim),조은나(E . N . Cho),김현주(H . J . Kim) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.8

N/A Objective : To evaluate the safety and efficacy of intramuscular methotrexate injection followed by dilatation and curettage (D & C) for the treatment of ectopic cervical pregnancy. Method : Nine patients with cervical pregnancy were treated alternately with four doses of intramuscular methotrexate (1.0 mg/kg) and four doses of intramuscular folinic acid (0.1 mg/kg). On the seventh day after treatment, patients were measured for level of serum β-hCG (human chorionic gonadotropin) and underwent ultrasounds. According to the result, additional dose of MTX or curettage were done. Serum β-hCG and ultrasound were checked every week until the level of serum β-hCG and the finding of ultrasound had been normalized. Results : Eight patients showed normal level in serum β-hCG and normal finding in ultrasound after the methotrexate/folinic acid therapy followed by D & C. One of nine patients showed increase by double concentrations in serum β-hCG after the MTX/Folinic acid treatment. After intraamnionic injection of MTX, serum β-hCG titer was decreased in this case. One week later, D & C was performed. No patient was experienced severe complications. All patients who had wanted a subsequent pregnancy were conceived. Conclusion : These results suggest that methotrexate/folinic acid therapy followed by D & C is safe and effective as a primary therapy for ectopic cervical pregnancy.