CpG Island Methylation According to the Histologic Patterns of Early Gastric Adenocarcinoma

최준정,조미연,정소영,갈릴미아잔,김현수 대한병리학회 2011 Journal of Pathology and Translational Medicine Vol.45 No.5

Background: Although the importance of aberrant DNA methylation in the development of gastric adenocarcinoma has been described, the mechanism of pathogenesis has not been revealed yet. We quantitatively analyzed methylation of four CpG islands and one repetitive DNA element, according to the histologic features of adenocarcinoma with precursor lesions. Methods: We divided the cases as adenocarcinoma with intestinal type precursors (type A, n=19 cases) and adenocarcinoma with diffuse type precursors (type B, n=19 cases). We micro-dissected tumor cells and matched non-neoplastic gastric mucosa from the hematoxylin and eosin-stained slides. Results: A total of 20 CpG sites of long interspersed nucleotide element-1 (LINE1), RAR-related orphan receptor alpha (RORA), Kruppel-like factor 7 (KLF7), mutL homolog 1 (MLH1), MINT25, and CD133 were analyzed. Methylation was determined by bisulfate-pyro-sequencing, and hypomethylation of LINE1 and CD133 was noted in the tumors, compared to the levels in the non-neoplastic gastric mucosa (p=0.014 and p=0.015, respectively). A statistically different methylation pattern of CpG sites at CD133 and KLF7 was noted only in type B lesions, compared to that in matched non-neoplastic gastric mucosa (p=0.027 and p=0.043, respectively). Conclusions: Given that aberrant methylation occurs in a relatively early phase of carcinogenesis, different patterns of methylation may determine the carcinoma phenotype. However, further large-scale study is required to clarify the significance of this difference.

Value of Additional Immunocytochemical Stain for Cytokeratin in the Diagnosis of Leptomeningeal Involvement of Metastatic Carcinoma

최준정,김세훈 대한병리학회 2011 Journal of Pathology and Translational Medicine Vol.45 No.5

Background: The purpose of this study was to describe potential pitfalls in the diagnosis of metastatic adenocarcinoma in cerebrospinal fluid (CSF) and to suggest additional work in association with cytokeratin immunocytochemistry for the proper diagnosis, especially in the specimens with low cellularity. Methods: We collected 267 cytologic specimens of CSF from patients, who were diagnosed over a 9-month period. Each of the individual samples were divided into half the sample size and processed via both, ThinPrep (TP) with Papanicolau stain and cytocentrifugation-based preparation (cytospin, CP) with immunocytochemical stain for cytokeratin. Results: Amongst the 267 cases, 45 cases from 22 patients were diagnosed to be positive for metastasis adenocarcinoma in CSF. TP with Papanicolau stain showed satisfactory cytomorphology when compared with specimen of CP preparation and cytokeratin immunocytochemical staining. All the TP processed cases belonged to satisfactory/superior categories based on the assessment of technical artifact, which potentially helps in decreasing diagnositc errors. However, in 10 out of 45 cases, diagnostic atypical cells were present only in one of the two slides. Conclusions: Immunocytochemical stain for cytokeratin along with TP processed specimen helps in decreasing potential diagnostic errors in the cytological diagnosis of metastatic carcinoma in CSF specimen.

Mini-review: Eosinophils, a Useful Diagnostic Clue in Surgical Neuropathology

최준정,김세훈,김태승 고신대학교(의대) 고신대학교 의과대학 학술지 2012 고신대학교 의과대학 학술지 Vol.27 No.2

Eosinophils are one of the polymorphonuclear granulocytes derived from bone marrow stem cells, and they contain many small cytoplasmic granules that stain bright red with eosin or brick-red with Romanowsky staining. Eosinophilic infiltration is also present in various human central nervous system (CNS) diseases such as parasitic infection, transverse myelitis, vasculitis, Langerhans cell histiocytosis, glioblastoma and etc... Due to the morphologic and functional characteristics, the presence of eosinophils in certain lesions may provide useful diagnostic clues in the right clinical setting. Consideration of this finding may facilitate the diagnosis of CNS pathologic lesions, especially in a small specimen such as a stereotactic biopsy.

R. A. Fisher 의 실험계획법의 방법론적 고찰

최준정 ( Joon Cheong Choi ) 한국경제학회 1959 經濟學硏究 Vol.7 No.1

The design of experiment can be defined as a method of sampling. It has been employed and developed in the Rothamsted Experimental Station for agriculture as a technique of agricultural experiment in the later nineteenth century and was elaborated and introduced by R.A. Fisher into the field of study where experiments are done. In earlier days, the random sampling method has exclusively been used in the Pearsonian descriptive statistical method but the achievements of Fisher made it clear that the discriptive method is very imperfect one. That is to say, in the Pearsonian system, the descriptive method holds so long as the universe were to be homogeneous. In the practical case, however, the universe we are always facing with is, in most cases, not homogeneous but heterogenous and under these circumstances we can hardly grasp the characteristics of the phenomena by means of descriptive method with any precision. Henceforth the method of inductive statistics was deviced and developed. The industive statistics has something in its theoretical construction quite different from that of descriptive statistics. As, in many practical cases, the universe is constituted from heterogeneous elements, the precision can be expected to be improved if we classify the heterogenous universe into a number of homogeneous strata, and select sampling from this group than to select it at random from the universe. On this account, we are obliged to be in need of the universe. When we classify the universe into a number of strata and the frequency of observation is apportioned to these strata, the number of samples selected is hoped to be proportionate to the size of the universe. The main theme of this paper is to examine the above-said technique of sample design in sampling method. The design of experiment of R. A. Fisher, in effect, is the core in the problems of modern statistic`s and Fisher`s achievements in this field is a monumental contribution to the systematication of statistics together with the analysis of variance and these theory of estimation. It constitutes the theoretical backbone of inductive statistics together with Neyman-Pearsonian Theory of testing hypothesis. Modern statistics (industive statistics) is originated from the classical works Gosset and in developed through E.S. Pearson J. Neyman to R.A. Fisher and the studies in the theory and application of its method is enriched and refined by the works of E.S. Pearson, J. Neyman and A. Wals. As the application of the design of experiment is to the field of the control of experiment and mass production, it is an inevitable outcome that Fisher`s design of experiment came to qualify the methodology of control.

Medullary Thyroid Carcinoma Presenting as a Predominantly Cystic Mass on Ultrasonography: A Case Report

김자영,최준정,김아현,문희정,김은경,곽진영,김명현 대한초음파의학회 2012 ULTRASONOGRAPHY Vol.31 No.1

Most medullary thyroid carcinomas show suspicious malignant features such as hypoechogenicity, a spiculated margin and/or intranodular calcifications, which are well known features of papillary carcinoma. We report here on a case of medullary carcinoma that was seen as a predominantly cystic thyroid mass on ultrasonography. This type of case is not common in the literature and we discuss the way to diagnose a medullary thyroid carcinoma.

Expression of Organic Anion Transporting Polypeptides in an H-Ras 12V Transgenic Mouse Model of Spontaneous Hepatocellular Carcinoma

김한솔,최준정,유대열,최혜진 연세대학교의과대학 2021 Yonsei medical journal Vol.62 No.7

Purpose: Expression of organic anion transporting polypeptides (OATPs) 1B1/1B3 in hepatocellular carcinoma (HCC) induces aparadoxical enhancement of gadoxetic acid on liver magnetic resonance imaging (MRI). We examined the expression profile ofOATPs with regard to tumor differentiation in a genetically modified H-Ras 12V mouse model of spontaneous HCC that undergoesmultistep hepatocarcinogenesis with minimal inter-individual variation. Materials and Methods: Tumor nodules were harvested from transgenic H-Ras 12V mice. Hematoxylin and eosin-stained slideswere examined for tumor differentiation and high-grade pathological components (tumor necrosis, thickened trabeculae, or vascularinvasion). Immunohistochemistry of OATP 1B1/1B3 was performed, and OATP expression was assessed. Results: We examined well-differentiated HCCs (n=59) in which high-grade pathological components were absent (n=49) or present(n=10). Among the well-differentiated HCCs without high-grade pathological components (n=49), OATP expression was negative,weak positive, and moderate positive in 23, 17, and nine cases, respectively. Among the well-differentiated HCCs with highgradepathological components (n=10), OATP expression was negative, weak positive, and moderate positive in one, two, andseven cases, respectively. The ratio of positive OATP 1B1/1B3 expressing tumors was higher in HCCs with high-grade pathologicalcomponents than in those without high-grade pathological components (p=0.004). Conclusion: Our findings support those of previous clinical studies that have reported the frequent appearance of gadoxetic acidenhancedMRI in moderately differentiated HCC.

전이성 대장암종에서 Osteopontin 및 MMP-1의 유전자 발현 변화 및 연관 임상 소견 검증

김호근,최준정,김상겸,박전한,김남규 대한병리학회 2010 Journal of Pathology and Translational Medicine Vol.44 No.3

Background : Metastasis is one of the most important characteristics of cancer in terms of its impact on patient survival. Unfortunately, identification of altered genes during tumor metastasis is limited. Methods : Using high-throughput microarrays containing 19K spotted human oligonucleotides, gene expression of primary and matched metastatic colon cancer were compared in previous study. Although DNA microarray analysis did not demonstrate complete classification of primary and metastatic carcinoma, 80 differentially expressed genes were identified. Among these, expression of osteopontin, matrix metalloproteinase-1 (MMP-1) and serpin A1 was assessed using immunohistochemistry in a validation set containing 43 pairs from tissue microarrays. Results : The expression of osteopontin was significantly higher in metastatic carcinoma than in primary carcinoma, as indicated by mRNA expression. The expression of MMP-1 was significantly lower in metastatic carcinoma. Expression of serpin A1 was not correlated with the microarray results. Conclusions : Osteopontin and MMP-1 expression successfully classified primary and metastatic colorectal carcinomas and further studies on their clinical application is encouraged.

Thymolipoma in a 13-year-old Korean girl

박수진,백지영,최준정,김경원,김명준,김규언,손명현 대한소아청소년과학회 2010 Clinical and Experimental Pediatrics (CEP) Vol.53 No.1

Thymolipoma is a rare benign tumor of anterior mediastinum. Most patients are asymptomatic with incidental finding of the tumor during a diagnostic workup of other medical problems. We present a case of 13-year-old girl with anterior mediastinal thymolipoma, surgically removed after an incidental diagnosis.

항호중구 세포질 항체 음성인 Churg-Strauss 증후군 1예

이승범,강희철,최준정 대한가정의학회 2010 Korean Journal of Family Medicine Vol.31 No.4

Churg-Strauss syndrome is a rare primary vasculitis called allergic granulomatosis angiitis. There is a substantial overlap of symptoms or signs between different vasculitides, so that a diagnosis of any vasculitis can be determined by a combination of clinical symptoms and laboratory tests. We report a case of a 54-year-old woman who had bronchial asthma, eosinophilia, peripheral polyneuropathy, pulmonary infiltrate, maxillary sinusitis, and extravascular eosinophilic infiltration on skin biopsy. So she was diagnosed as having Churg-Strauss syndrome, but she was antineutrophil cytoplasmic antibodies-negative on immunologic study. She had fever and showed cardiac involvement that was presented as cardiomegaly and pulmonary edema at chest radiography and left ventricular hypertrophy on electrocardiography. After steroid therapy, general condition and skin manifestation were rapidly improved. Churg-Strauss 증후군은 드문 원발성 혈관염으로 알레르기-육아종성 혈관염으로 알려져 있다. 여러 가지 혈관염들은 중복되는 특성이 많기 때문에 감별진단은 임상소견과 검사소견을종합하여 이루어진다. 저자들은 54세 여자 환자로 기관지 천식, 호산구 증가, 다발성 신경병증, 폐침윤, 부비동염 그리고 피부 조직검사상 혈관외 호산구 침윤을 보인 Churg-Strauss 증후군 1예를 보고한다. 환자는 면역혈청검사에서 항호중구 세포질 항체(antineutrophil cytoplasmic antibodies, ANCA)는 음성이었으며, 발열을 동반하고 흉부방사선 검사에서 심비대와 폐부종이 관찰되고 심전도에서 좌심실 비대 소견을 보였다. 환자는 스테로이드 치료로 증상이 빠르게 호전되었다.

Poorly Differentiated Thyroid Carcinoma with Gross Internal Jugular Vein Invasion and Multiple Lung Metastases

이용문,박재현,최준정,배금석,강성준 대한갑상선학회 2015 International Journal of Thyroidology Vol.8 No.1

A rare case of poorly differentiated thyroid carcinoma (PDTC) with gross intraluminal invasion to the internal jugular vein whose clinical manifestation was multiple lung metastases is described. A 66-year-old man was referred to the outpatient clinic of the Department of Internal Medicine, hemato-oncology subdivision for multiple lung nodules found by his regular health check-up. These lung nodules showed variable sizes with irregular shapes, and typical distributions throughout the parenchyma, which were consistent with metastatic nodules. Ultrasonography revealed a 4.5 cm sized hypoechoic mass with irregular shape in his left thyroid lobe and a huge thrombus in the left internal jugular vein. PDTCs associated with gross intraluminal invasion to the great cervical vein and multiple lung nodules as their first clinical manifestation are extremely rare. We would emphasize the importance of preoperative detailed evaluation of the disseminated disease by ultrasonography in suspected patients.