조기에 재발한 미세낭종성 뇌수막종 -증례보고-

하동원 ( Dong Won Ha ),김세혁 ( Se Hyuk Kim ),신용삼 ( Yong Sam Shin ),안영환 ( Young Hwan Ahn ),윤수한 ( Soo Han Yoon ),조기홍 ( Ki Hong Cho ),조경기 ( Kyung Gi Cho ),임현이 ( Hyun Yee Lim ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2005 대한뇌종양학회지 Vol.4 No.2

We report a case of microcystic meningioma which showed unusual radiological findings resembling malignant tumor. A 44-year-old woman presented with generalized tonic clonic seizure and right hemiparesis. Computed tomography and magnetic resonance images showed a mass at left frontal, parasagittal area with septa-like enhancement and surrounding edema. 201Tl SPECT showed focal uptake in mass lesion which suggests the malignant tumor. The histopathological findings of this tumor revealed to be a microcystic meningioma and Ki-67 labeling index was 3.8. Although the mass was a subtype of meningioma, it showed a early recurrence 10 months after grossly total resection because of high proliferative index. We suggest that the biological behaviour in addition to morphologic classification should be considered in the management of benign brain tumor, such as meningioma.

Clinicopathological and molecular analysis of multinodular and vacuolating neuronal tumors of the cerebrum

Choi, Euno,Kim, Seonk-Ik,Won, Jae-Kyung,Chung, Chun Kee,Kim, Seung Ki,Choi, Seung-Hong,Choi, Seongmin,Han, Bome,Ahn, Bokyung,Im, Sun-Wha,Park, Sung-Hye Elsevier 2019 Human pathology Vol.86 No.-

<P><B>Summary</B></P> <P>Multinodular and vacuolating neuronal tumor (MVNT) of the cerebrum is a recently recognized rare neuronal tumor, and its pathogenesis is unclear. We analyzed 7 cases of histologically typical MVNT: 6 were adults (mean age, 43.0 years [range, 23-56 years]) and 1 was a child (age, 10 years). The most common symptoms were seizures (n = 4) and headache (n = 2). The tumors were supratentorial (temporal, 5; frontal lobes, 2) in origin as reported. Vacuolated tumor cells were robustly positive for α-INA and Olig2 and at least partly positive for synaptophysin and MAP2, but negative for Neu-N, nestin and CD34. GFAP and vimentin were expressed in reactive astrocytes but not in tumor cells. Negative results were obtained for p53, IDH-1, BRAF<SUP>V600E</SUP>, H3 K27M, EGFR, Lin28A, and L1CAM. ATRX, BRG1, INI-1, and TMHH were retained. The Ki-67 labeling index was very low (<1%), and pHH3 revealed no mitotic figure. Ultrastructural features of tumor cells were comparable with those of immature neuronal cells, with several intracytoplasmic myelin-like autophagosomes and pericellular vacuolization. No <I>IDH1</I>/<I>IDH2</I> and <I>BRAF</I> <SUP> <I>V600E</I> </SUP> mutations were found upon direct sequencing. Whole-exome sequencing revealed <I>FGFR2</I>-<I>ZMYND11</I> gene fusion in 1 case. After gross total resection, all patients were alive without seizures. There was no tumor recurrence during an average period of 68 months (range, 23-101 months). The analysis of 7 typical cases of MVNT suggested that these lesions may be clonal tumors because <I>FGFR2</I>-<I>ZMYND11</I> fusion was found (1 case).</P> <P><B>Highlights</B></P> <P> <UL> <LI> “MVNT” of the cerebrum is a recently recognized rare epileptogenic neuronal tumor. </LI> <LI> Whole-exome sequencing revealed <I>FGFR2</I>-<I>ZMYND11</I> gene fusion in one of our MVNT cases. </LI> <LI> The tumor cell is robustly positive for α-INA and Olig2, but negative for Neu-N. </LI> <LI> Ultrastructurally, tumor cells have autophagolysosomes with pericellular vacuolization. </LI> <LI> There was no tumor recurrence during an average period of 68 months. </LI> </UL> </P>

소아 알레르기비염의 경제적 부담 평가를 위한 다기관 조사

공도연 ( Do Youn Kong ),김경원 ( Kyung Won Kim ),김우경 ( Woo Kyung Kim ),민택기 ( Taek Ki Min ),박용민 ( Yong Mean Park ),안재억 ( Jae Ouk Ahn ),양현종 ( Hyeon Jong Yang ),염혜영 ( Hye Yung Yum ),윤혜선 ( Hae Sun Yoon ),전유훈 ( 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2012 소아알레르기 및 호흡기학회지 Vol.22 No.2

목적: 알레르기비염의 유병률은 전 세계적으로 급격히 증가하고 있으며, 그에 따른 경제적 부담도 증가하고 있다. 그러나, 소아 알레르기 질환이 미치는 경제적 부담에 관한 국내 연구는 제한적이어서 소아 알레르기비염이 환자와 그 가족에게 미치는 경제적 부담을 산출하고자 본 연구를 진행하였다. 방법: 2008년 7월 1일부터 9월 31일까지 서울시 6개 2-3차 의료기관을 방문한 18세 이하 소아 알레르기비염 환자 및 보호자를 대상으로 설문 조사를 진행하였다. 설문을 통해 직접 의료비 (병·의원 진료비, 및 약제비 한방 진료비 및 약제비, 보완/대체요법비), 직접비의료비 (교통비, 환경개선비), 그리고 간접비용 (월 평균 노동 손실)을 조사하였고 그 결과를 질환의 중증도 및 유병 기간에 따라 분석하여 그 차이를 비교하였다. 결과: 모집된 262명의 대상 중 174명(66.4%)이 남자였고, 평균 연령은 6.54세였다. 대상군의 연간 평균 직접 의료비는 177만 원이었고 직접비 의료비는 57만 원이었다. 비록 통계학적 유의성은 없었지만, 알레르기비염의 중증도가 증가할수록 직접 의료비가 증가하는 경향을 보였고, (P=0.053) 유병 기간 또한 직접 의료비의 증가와 유의한 양의 상관 관계를 보였다. (R=0.195, P=0.002) 대상 환자 보호자의 약 17%가 아이의 알레르기비염으로 인해 직장에 결근 또는 조퇴를 경험한 것으로 조사되어 사회적 간접비용을 미루어 생각할 수 있었다. 결론: 알레르기비염이 미치는 경제적 부담은 질환의 중증도가 심할수록, 그리고 유병 기간이 길수록 증가하며, 이는 특히 한방 진료 및 치료비와 보완/대체요법비의 증가에 기인한 것으로 조사되었다. 따라서 알레르기비염으로 인한 경제적 부담을 줄이기 위해서는 환자와 보호자를 대상으로 근거 중심의 치료를 할 수 있도록 지속적이고 체계적인 교육이 필요할 것으로 사료된다. Purpose: The prevalence of allergic rhinitis is rapidly increasing and results in relatively high socio-economic burden on their family and community. However, studies on the economic burden of pediatric allergic rhinitis in Korea are limited. Therefore, we conducted this study to investigate the impact of pediatric allergic rhinitis on economic burden. Methods: Two hundred sixty two children with allergic rhinitis were enrolled in 6 secondary or tertiary medical centers in Seoul from July to September, 2008. We collected data of the economic burden of allergic rhinitis (direct medical costs, direct nonmedical costs, and indirect costs) by face to face questionnaire survey. We compared the economic burden according to the severity and the duration of allergic rhinitis. Results: The mean age of subjects was 6.54 years, and male were 174 (66.4%). Direct medical costs (10,000 Korean Won/yr) were 177.75, and direct nonmedical costs were 57.92. Although, there was no statistical significance, direct medical costs showed increasing trends in severe allergic rhinitis. (P=0.053) In addition, direct medical costs were positively correlated with duration of allergic rhinitis.( R=0.195, P=0.002). About 17% of the parents who care the allergic rhinitis children experienced the work absence due to their child s illness. Conclusion: The economic burdens of allergic rhinitis were positively correlated with the severity and duration of illness. Particularly costs for alternative medicine including oriental medicine` were related with severity and duration allergic rhinitis. Therefore, special efforts for education with evidence based treatment strategy are necessary to decrease the economic burden of allergic rhinitis.

Long-term postresection prognosis of primary neuroendocrine tumors of the liver

Jay Jung,Shin Hwang,Seung-Mo Hong,Ki-Hun Kim,Chul-Soo Ahn,Deok-Bog Moon,Tae-Yong Ha,Gi-Won Song,Yo-Han Park 대한외과학회 2019 Annals of Surgical Treatment and Research(ASRT) Vol.97 No.4

Purpose: Primary hepatic neuroendocrine tumor (PHNET) is a very rare neoplasm, requiring strict exclusion of metastasis from possible extrahepatic primary sites for its diagnosis. Methods: We reviewed our clinical experience of 13 patients with primary hepatic NET who underwent liver resection from January 1997 to December 2015. Results: The mean age of the 13 patients (8 males and 5 females) was 51.1 ± 12.8 years; the most common clinical manifestation was vague, nonspecific abdominal pain (n = 9). Of them, 11 patients underwent preoperative liver biopsy, 7 of which correctly diagnosed as neuroendocrine tumor (NET). Ten patients underwent R0 resection, and 3 underwent R1 resection. Diagnosis of PHNET was confirmed both immunohistochemically and by absence of extrahepatic primary sites. All tumors were single lesions, with a mean size of 9.6 ± 7.6 cm and a median size of 4.3 cm; all showed positive staining for synaptophysin and chromogranin. During a mean follow-up period of 95.1 ± 86.6 months, 7 patients died from tumor recurrence, whereas the other 6 remain alive to date, making the 5-year tumor recurrence rate 56.0% and the 5-year patient survival rate 61.5%. When confined to R0 resection, 5-year recurrence and survival rates were 42.9% and 70.0%, respectively. Univariate analysis showed that Ki-67 proliferative index was the only risk factor for tumor recurrence. Conclusion: PHNET is a very rare tumor with no specific clinical features, and its final diagnosis depends primarily on pathology, immunohistochemistry, and exclusion of metastasis from other sites. Aggressive surgical treatment is highly recommended for PHNET because of acceptably favorable postresection outcomes

Systemic administration of low dosage of tetanus toxin decreases cell proliferation and neuroblast differentiation in the mouse hippocampal dentate gyrus

Bing Chun Yan,In Hye Kim,Joon Ha Park,Ji Hyeon Ahn,Jeong-Hwi Cho,Bai Hui Chen,Jae-Chul Lee,Jung Hoon Choi,Ki-Yeon Yoo,Choong Hyun Lee,Jun Hwi Cho,Jong-Dai Kim,Moo-Ho Won 한국실험동물학회 2013 Laboratory Animal Research Vol.29 No.3

In the present study, we investigated the effect of Tetaus toxin (TeT) on cell proliferation and neuroblast differentiation using specific markers: 5-bromo-2-deoxyuridine (BrdU) as an exogenous marker for cell proliferation, Ki-67 as an endogenous marker for cell proliferation and doublecortin (DCX) as a marker for neuroblasts in the mouse hippocampal dentate gyrus (DG) after TeT treatment. Mice were intraperitoneally administered 2.5 and 10 ng/kg TeT and sacrificed 15 days after the treatment. In both the TeT-treated groups, no neuronal death occurred in any layers of the DG using neuronal nuclei (NeuN, a neuron nuclei maker) and Fluoro-Jade B (F-J B, a high-affinity fluorescent marker for the localization of neuronal degeneration). In addition, no significant change in glial activation in both the 2.5 and 10 ng/kg TeT-treated-groups was found by GFAP (a marker for astrocytes) and Iba-1 (a marker for microglia) immunohistochemistry. However, in the 2.5 ng/kg TeT-treated-group, the mean number of BrdU, Ki-67 and DCX immunoreactive cells, respectively, were apparently decreased compared to the control group, and the mean number of each in the 10 ng/kg TeT-treated-group was much more decreased. In addition, processes of DCX-immunoreactive cells, which projected into the molecular layer, were short compared to those in the control group. In brief, our present results show that low dosage (10 ng/kg) TeT treatment apparently decreased cell proliferation and neuroblast differentiation in the mouse hippocampal DG without distinct gliosis as well as any loss of adult neurons.

Cell proliferation and neuroblast differentiation in the rat dentate gyrus after intrathecal treatment with adipose-derived mesenchymal stem cells.

Choi, Jung Hoon,Chung, Jin Young,Yoo, Dae Young,Hwang, In Koo,Yoo, Ki-Yeon,Lee, Choong Hyun,Yan, Bing Chun,Ahn, Jin Ok,Youn, Hwa Young,Won, Moo-Ho Kluwer Academic/Plenum Publishers 2011 Cellular and molecular neurobiology Vol.31 No.8

<P>Mesenchymal stem cells (MSC) have emerged as a new therapeutic tool for a number of clinical applications, because they have multipotency and paracrine effects via various factors. In the present study, we investigated the effects of adipose-derived MSC (Ad-MSC) transplantation via intrathecal injection through the cisterna magna on cell proliferation and differentiation of endogenous stem cells in the hippocampal dentate gyrus (DG) using Ki-67 (a marker for proliferating cells), and doublecortin (DCX, a marker for neuroblasts). The transplanted Ad-MSC were detected in the meninges, not in the hippocampal parenchyma. However, the number of Ki-67-immunoreactive cells was significantly increased by 83% in the DG 2 days after single Ad-MSC injection, and by 67% at 23 days after repeated Ad-MSC treatment compared with that in the vehicle-treated group after Ad-MSC transplantation. On the other hand, the number of DCX-immunoreactive cells in the DG was not changed at 2 days after single Ad-MSC injection; however, it was significantly increased by 62% 9 days after single Ad-MSC injection. At 23 days after repeated Ad-MSC application, the number of DCX-immunoreactive cells was much more increased (223% of the vehicle-treated group). At this time point, DCX protein levels were also significantly increased compared with those in the vehicle-treated group. These results suggest that the intrathecal injection of Ad-MSC could enhance endogenous cell proliferation, and the repeated Ad-MSC injection could be more efficient for an enhancement of endogenous cell proliferation and differentiation in the brain.</P>

The 18p11.22 locus is associated with never smoker non-small cell lung cancer susceptibility in Korean populations.

Ahn, Myung-Ju,Won, Hong-Hee,Lee, Jeeyun,Lee, Seung-Tae,Sun, Jong-Mu,Park, Yeon Hee,Ahn, Jin Seok,Kwon, O Jung,Kim, Hojoong,Shim, Young Mog,Kim, Jhingook,Kim, Kwhanmien,Kim, Yeul Hong,Park, Jae Yong,Ki Springer-Verlag 2012 HUMAN GENETICS Vol.131 No.3

<P>The proportion of never smoker non-small cell lung cancer (NSCLC) in Asia is about 30-40%. Despite the striking demographics and high prevalence of never smoker NSCLC, the exact causes still remain undetermined. Although several genome wide association (GWA) studies were conducted to find susceptibility loci for lung cancer in never smokers, no regions were replicated except for 5p15.33, suggesting locus heterogeneity and different environmental toxic effects. To identify genetic loci associated with susceptibility of lung cancer in never smokers, we performed a GWA analysis using the Affymetrix 6.0 SNP array. For discovery GWA set, we recruited 446 never smoking Korean patients with NSCLC and 497 normal subjects. We tested association of SNPs with lung cancer susceptibility using the Cochran-Armitage trend test. For validation, 39 SNPs were selected from the top 50 SNPs and five additional SNPs were selected in the DAB1 gene region which showed significant associations in the GWA analysis. The validation SNPs were genotyped in an independent sample including 434 patients and 1,000 controls. Among the 44 validation SNPs, two SNPs (rs11080466 and rs11663246) near the APCDD1, NAPG and FAM38B genes in the 18p11.22 region were replicated. P value of rs11080466 was 1.08 10(-6) in the combined sets (2.68 10(-5) in the discovery set and 2.60 10(-3) in the validation set) and odds ratio was 0.68 (0.58-0.79). We observed similar association for rs11663246. Our result suggests the 18p11.22 region as a novel lung cancer susceptibility locus in never smokers.</P>

A study on the topological derivative-based imaging of thin electromagnetic inhomogeneities in limited-aperture problems

Ahn, Chi Young,Jeon, Kiwan,Ma, Yong-Ki,Park, Won-Kwang Institute of Physics 2014 Inverse problems Vol.30 No.10

Influence of Epidural Steroid Injection on Adrenal Function

Won Shik Shin,Dong Ki Ahn,김명진,조경준,고영록 대한정형외과학회 2019 Clinics in Orthopedic Surgery Vol.11 No.2

Background: Spinal diseases are self-limited or non-progressive in many cases. Epidural steroid injection (ESI) is a common nonsurgical treatment option for spinal pain. Despite concerns about complications of repeated steroid injection, few studies reported on the adrenal function of spine disease patients undergoing surgery after ESI. We investigated the influence of preoperative multiple ESIs on adrenal function in spine surgery patients. Methods: This was a retrospective study with prospective data collection. Those who underwent elective spinal operations and had a history of multiple ESIs from January to June 2017 were selected as a study group. Those who underwent knee arthroplasty and did not have a history of ESI and any kind of steroid injection in other areas during 6 months before surgery were selected as a control group. Demographic data were compared to assess homogeneity between groups. We assessed the preoperative serum cortisol level (SCL) to compare the basal adrenal function between groups. Also, we assessed the elevation of SCL postoperatively to evaluate the adrenal response to the surgical stress in each group. For subgroup analysis, we divided all patients into normal (7–28 μg/dL) and subnormal groups according to SCL and analyzed risk factors of adrenal suppression with multivariate logistic regression test. Results: There were 53 patients in the study group and 130 in the control group. Age and sex were homogeneous between groups. There was significant intergroup difference in preoperative SCL (10.4 ± 4.8 μg/dL in the study group vs. 12.0 ± 4.2 μg/dL in the control group; p = 0.026).The postoperative day one SCL was 11.6 ± 5.0 μg/dL in the study group without significant increase from the preoperative level (p = 0.117), whereas the increase was significant in the control group with a postoperative level of 14.4 ± 4.4 μg/dL (p < 0.001). Among all patients, the SCL was subnormal in 18 patients and within the normal range in 165. Spine surgery was the independent risk factor irrespective of age and sex (odds ratio, 3.472; p = 0.015). Conclusions: Our results suggest that concern should be raised about the influence of preoperative multiple ESIs on adrenal suppression in spine surgery patients.

Effect of Outlier Elimination on the 99th Percentile Upper Reference Limits of High-Sensitivity Cardiac Troponin I Assays Based on a Strictly Selected Healthy Reference Population

Ahn Sunyoung,Kim Hyun-Ki,Lee Woochang,Chun Sail,Min Won-Ki 대한진단검사의학회 2022 Annals of Laboratory Medicine Vol.42 No.3

Background: We established high-sensitivity cardiac troponin I (hsTnI) 99th percentile upper reference limits (URLs) for the Centaur XPT High-Sensitivity Troponin I assay (Centaur hsTnI; Siemens, Erlangen, Germany) and Atellica IM High-Sensitivity Troponin I assay (Atellica hsTnI; Siemens) and assessed the effect of outlier elimination. Methods: The reference population comprised 380 men and 387 women, satisfying the strict systematic reference population criteria. After reference population verification by the N-terminal pro-B-type natriuretic peptide (NT-proBNP) assay, 99th percentile URLs for Centaur hsTnI and Atellica hsTnI were calculated before and after outlier elimination. Results: The 99th percentile URL for Centaur hsTnI was 60.4 (men, 74.7; women, 57.5) ng/L and that for Atellica hsTnI was 59.6 (men, 75.2; women, 55.1) ng/L. After the elimination of 61 (8.0%) outlier samples in Centaur hsTnI and 58 (7.6%) in Atellica hsTnI, the 99th percentile URLs were 13.5 ng/L (men, 15.3 ng/L; women, 11.9 ng/L) and 13.4 ng/L (men, 15.5 ng/L; women, 12.9 ng/L), respectively, significantly lower than those before outlier elimination. The CVs at the 99th percentile URLs were 5.2% and 3.5%, respectively. The measurable fractions among the reference population were 91.5% and 93.4%, respectively. Performance evaluation of Atellica B-type natriuretic peptide (BNP), Atellica NT-proBNP, Centaur hsTnI, and Atellica hsTnI showed outstanding results. Conclusions: The Korean hsTnI 99th percentile URLs calculated in this study were significantly lower after outlier elimination than before. Centaur hsTnI and Atellica hsTnI meet the “Guideline acceptable” and “Level 3 (second generation, high sensitivity)” requirements, satisfying international standards.