• 대한두경부종양학회지
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• 제23권1호
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• pp.41-45
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• 2007

A 60 years old female patient presented with $8{\times}6\;cm$ sized painless oval mass in the left parietal region. She had left lobectomy of thyroid gland 10 years ago. Cranial CT, MRI, FGD PET-CT showed a solid mass which invaded left parietal bone. After embolization, craniectomy with tumor excision was performed. Histological examination revealed metastatic follicular cancer originated thyroid gland, with vascular and dura invasion. Postoperatively, neck CT showed right thyroid multiple nodules and right level III multiple lymph node enlargement. Thyroid function test was normal, but level of thyroglobulin was high (72ng/ml). So she had right lobectomy of thyroid gland with lymph node dissection under a diagnosis of follicular carcinoma. But histological examination revealed adenomatous hyperplasia and not lymph node metastasis. After operation, she received radioiodine therapy of 150mCi and then the level of thyroglobulin normalized (8.4ng/ml). The patient is under follow-up since she had operation 4 months ago.

• 대한수의학회지
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• 제9권2호
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• pp.7-18
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• 1969

Researches to determine the infectious status on the pancreatic fluke, Eurytrema pancreaticum(Janson 1889) Looss, 1907, were made into several slaughter hauses at four different districts through seven years from 1963 to 1969. The infection rate showed 2962 positive of 5974 heads (49.6%) of cattle at the Seoul first slaughter hause in Seoul, 881 positive of 1021 heads (86.3%) in Cheju, and six(6) positive of 56 heads (11.1%) at Suwon, 58 positive of 306 heads(19.0%)at Joenju. The infection rate 53.1%, (2907 positive heads of total 7357 heads exammed) is the representative infection rate at the cattle eurytremiasis in Korea. It showed little variation through a year and was increased as compared with those of the past period, from 1915 to 1945. Fecal examinations in order to find out the local distribution of the pancreatic fluke were conducted on cattle, sheep, and goats raised in four districts, showing two(2) of 269 heads (0.7%) in Kyonggi-do, 41 of 212 heads (19.3%) in Cheju-do, and negative in both Chungnam-do and Joenbuk-do. When an artificial infection wss performed on rabbits and goats with metacercaria of the pancreatic fluke, Parenchyma of their pancreas were degenerated and the ducts were dilated. When cattle and sheep were infected naturally, the pancreatic ducts were also dilated, the wall was thickened, and adenomatous and epithelial hyperplasia was appeared. The conclusion, putting the foregoing pathological changes, has been arrived at chronic hyperplastic pancreatitis in the eurytremiasis of cattle, sheep, goats and rabbits.

• 대한두경부종양학회지
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• 제13권1호
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• pp.16-23
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• 1997

Although normal thyroid epithelial cells do not constitutively express HLA-DR antigen, their expression in wide spread within thyroid glands obtained from the human with autoimmune thyroid disease and with many neoplastic thyroids. We have, therefore, studied immunohistochemically with regard to the expression of HLA-DR antigen of thyroidectomy specimens from 50 patients of various thyroid diseases with use of paraffin-embedded tissue. One or two sections from each case were stained with commercially available mouse monoclonal antibody for class II HLA-DR antigen(HLA-DR/Alpha, DAKO) and examined by semiquantitative counting system for thyrocytes, neoplastic thyrocytes and other cells expressing HLA-DR antigen. All patients with lymphocytic thyroiditis(2/2) and diffuse hyperplasia(Graves' disease)(5/5), most patients with Hashimoto's disease(9/ll) expressed HLA-DR antigens in thyrocyte with abundant HLA-DR expressing lymphocytic infiltrates with lymph follicle formation in its vicinity or adjacent to the lesion. Most patients with papillary carcinoma(9/1l) had HLA-DR antigen detected in malignant thyrocytes ; while follicular carcinoma(0/3) and follicular adenoma(0/5) did not have detactable HLA-DR immunoreactivity. Adenomatous goiter(3/7) had HLA-DR antigen detected focally in lesser than half cases. Conversely, in four papillary carcinomas and three adenomatous goiters, HLA-DR expression of thyrocytes was found in the absence of HLA-DR expressing lymphoid infiltrates. In such cases therefore other factors more than thyroid autoimmunity must be causative for HLA-DR immunoreactivity. The results of this study indicate as follows. 1) The expression of HLA-DR on thyrocytes involved in autoimmune reactions appeared to be secondary to cytokine release from associated lymphocytic infiltrates. 2) Thyrocytes in thyroid lesions with equal degrees of lymphocytic infiltration without HLA­DR expression exhibited no HLA-DR immunoreactivity. 3) In neoplastic thyrocytes, most papillary carcinoma(9/11) exhibited detactable HLA-DR expression, while follicular carcinoma/adenoma(0/3/0/5) exhibited no detactable HLA-DR immunoreactivity which suggest the existence of divergent mechanisms inducing and modulating HLA-DR expression of different types of neoplastic thyrocytes.

• Asian Pacific Journal of Cancer Prevention
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• 제16권5호
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• pp.1925-1928
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• 2015

Background: To investigate whether CT findings can predict the invasiveness of persistent cancerous pure ground glass opacity (pGGO) by correlating the CT imaging features of persistent pGGO with pathological changes. Materials and Methods: Ninety five patients with persistent pGGOs were included. Three radiologists evaluated the morphologic features of these pGGOs at high resolution CT (HRCT). Binary logistic regression was used to assess the association between CT findings and histopathological classification (pre-invasive and invasive groups). Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance of diameters. Results: A total of 105 pGGOs were identified. Between pre-invasive (atypical adenomatous hyperplasia, AAH, and adenocarcinoma in situ, AIS) and invasive group (minimally invasive adenocarcinoma, MIA and invasive lung adenocarcinomas, ILA), there were significant differences in diameter, spiculation and vessel dilatation (p<0.05). No difference was found in air-bronchogram, bubble-lucency, lobulated-margin, pleural indentation or vascular convergence (p>0.05). The optimal threshold value of the diameters to predict the invasiveness of pGGO was 12.50mm. Conclusions: HRCT features can predict the invasiveness of persistent pGGO. The pGGO with a diameter more than 12.50mm, presences of spiculation and vessel dilatation are important factors to differentiate invasive adenocarcinoma from pre-invasive cancerous lesions.

• 대한두경부종양학회지
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• 제23권1호
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• pp.32-36
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• 2007

Background and Objective：A post-operative hypertrophic scar of the anterior neck is the leading complaint of the patients who underwent conventional thyroid surgery. In order to minimize the post-operative scar of the anterior neck, we performed thyroidectomy via axillary approach using operating microscope and a specialized retractor to determine technical feasibility. Patients and Methods：From January 2005 to December 2006, we performed thyroidectomy via axillary approach under operating microscope(f=400mm, ${\times}2.5$；OPMI $pico^{(R)}$；Zeiss, Germany) for benign unilateral nodule in 25 cases(all female, average age 34.5yrs). Under general anesthesia less than 7cm of skin incision was made in the axilla of ipsilateral side. A subcutaneous tunnel went over the pectoralis major muscle and the clavicle, and then through the sternocleidomastoid muscle and sternothyroid muscle was excised. The area around the thyroid was sufficiently dissected, and then a retractor designed for exposure via axillary approach was placed within the tunnel and under operating microscope thyroidectomy was performed. Results：There were 17 cases of thyroid nodulectomy and 8 cases of subtotal lobectomy. The mean average operative time was 102.64minutes. Postoperative complications included one case of postoperative bleeding, one case of temporary vocal cord paralysis, two cases of delayed wound healing, two cases of paresthesia of shoulder and arm, and two cases of hypertrophic scar of the axilla. Postoperative histopathology includes 17 cases of adenomatous hyperplasia, six cases of cyst, and two cases of follicular adenoma. For all cases hospitalization period was two days. Conclusion：Thyroidectomy via axillary approach under operating microscope has a good cosmetic advantage without a post-operative scar of the anterior neck. The procedure is simple due to direct vision using operating microscope, easy to identify important structures by magnifying them, and therefore surgical time can be reduced.

• Parasites, Hosts and Diseases
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• 제32권1호
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• pp.13-18
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• 1994

간흡충은 담관내에 기생하면서 만성적 감염의 결과 최종적으로 담관암을 유발시키는 것으로 알려져 왔다. 실험동물에서 간흡충의 감염만으로는 담관암이 발생하지 않으며, 어떠한 외적 혹은 내적 발암성의 물질들과 병합하여 담관암이 형성하는 것으로 보고된 바 있다 본 실험은 햄스터에서 간흡충의 감염과 dimethylnitrosamine(DMN)의 병합작용으로 담관암이 발생되었다는 모델을 이용하여 "발암기전의 2단계이론" 상에서 간흡충의 역할을 밝혀보고자 하였다. 총 90마리의 햄스터를 15 마리씩 6군으로 나누었다. $DMN{\;}{\rightarrow}{\;}CS$군의 햄스터에서는 먼저 15 ppm의 DMN을 4주 동안 음수 투여하고, 1주 후에 간흡충을 15마리씩 인공감염시켰다. 그리고 5주 후에 piaziquantel로 간흡충을 치료하였다 $CS{\;}{\rightarrow}{\;}DMN$군에서는 먼저 간홉충을 감염시키고 5주 후에 praziquantel로 치료하였으며 1주 후부터 DMN을 4주동안 투여하였다. DMN + CS군에서는 DMN과 간흠충을 동시에 투여하였으며 4주 후에는 DMN을 제거하였다. DMN군과 CS군은 각각 DMN과 간흡충만을 투여하였고 대조군은 아무것도 투여하지 않았다. 모든 실험동물은 13주 후에 부검하였으며 조직병리학적인 방법으로 간장을 검경하여 진단하였다. 실험결과 담관암은 $DMN{\;}{\rightarrow}{\;}CS$군에서 3마리, DMN + CS군에서 11마리가 발생하였으며 나머지 군들에서는 암이 발생하지 않았다. 본 실험으로 2단계 발암기 전상에서 간흡충은 담관암발생을 촉진하는 효과를 보였음을 알수 있었다.

• Parasites, Hosts and Diseases
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• 제31권1호
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• pp.21-30
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• 1993

간흡충은 담관암 발생의 원인적 요소로 알려졌다. 그러나 간흡충이 담관암을 일으키는 병리 기전은 자세하게 알려져 있지 않다. 본 연구는 15 ppm의 dimethylnitrosamine(DMN)을 먹는 물로 투여한 햄스터에 간흡충을 감염시켜 담관암의 발생여부를 알아보고 담관암의 병리조직학적 변화를 관찰하고자 하였다. DMN을 투여하고 간흡충을 감염시킨 챔스터에서 11주 후에 8마리 중 6마리가 육안적 혹은 조직학적으로 담관암(cholangiocarcinoma)의 소견을 보였으며 나머지 2마리는 담관종(cholangiofibroma)으로 진단할 수 있었으나 부분적으로 악성적인 모습도 관찰 할 수 있었다. 담관암의 병리조직학적 소견은 담관상피세포가 선종상 혹은 유두상의 증식을 나타내고 높은 이형성을 보였으며 점액세포화생과 괴사소를 보이고 있었다. DMN 만을, 혹은 간흡충만을 투여하거나 감염시킨 햄스터들에서는 담관암이 전혀 발생되지 않았다. 본 .실험은 DMN을 투여한 햄스터에 간흡충감염으로 담관암이 발생하는 과정에서 DMN과 간흡충의 협동작용(synergism)을 보여준 것으로 추정한다.

• 대한두경부종양학회지
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• 제9권1호
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• pp.16-24
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• 1993

During 7 years, from Jan. 1986 to Dec. 1992, authors studied 208 cases of the surgically managed thyroid nodules at the Department of General Surgery, Han Kang Sacred Heart Hospital and obtained the following results. 1) Among the total 208 cases, male to female ratio was 1:11.2 in benign thyroid diseases and 1:9 in malignant thyroid diseases. The benign disease was prevalent between second and forth decade comparing with malignant disease between third and fifth decade. 2) The most common duration of illness was 3 months(26.0%). 3) Palpable neck mass was the most common chief complaint(100%). Palpitation. fatigue, and sweating were common complaints in patient with benign disease, and fatigue, palpitation, and sweating in malignant disease in decreasing order of frequency. 4) 55.8 % of lesions were in right lobe, 33.2% in left lobe, 5.8% in diffuse type, 4.8% in bilateral lobes, and 0.5% in isthmus. 5) The most common size of nodule was between 2.0cm and 3.9cm in diameter, which consisted of 55.1% of benign disease and 48.0% of malignant disease. 6) 86.5% of thyroid function test showed euthyroidism, 10.1% hyperthyroidism, and 3.4% hypothyroidism. 7) Thyroid scanning of 176 patients revealed cold nodules in 92.5% of benign diseases and in 92.9% of malignant diseases. 8) The most common benign disease was adenomatous hyperplasia(62.7%), and the most common malignant disease was papillary adenocarcinoma(80.0%). 9) Fine needle aspiration cytology was performed in 91 cases, and it showed 69.0% of sensitivity, 90.3% of specificity, and 83.5% of accuracy. 10) Frozen biopsy was performed in 109 cases. and it showed 93.9% of sensitivity, 100.0% of specificity, and 98.2% of accuracy. 11) The most commonly performed operation was unilateral lobectomy(including unilateral lobectomy with isthmectomy)(79.1%) in benign disease. and total thyroidectomy(62.0%) in malignant disease. 12) Postoperative complication showed 5 cases of wound infection (2.4%), 3 cases of transient hypoparathyroidism(1.4%), 3 cases of transient hoarseness(1.4%), 2 cases of postoperative bleeding(1.0%), 1 case of permanent hypoparathyroidism(0.5%), 1 case of permanent hoarseness(0.5%), and 1 case of postoperative pneumonia (0.5%).

• 대한두경부종양학회지
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• 제20권2호
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• pp.128-134
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• 2004

Background and Objectives: Angiogenesis is the process of new blood vessel development from preexisting vessel. Angiogenenesis has been considered to be essential for the growth and expansion of a solid tumor. Vascular endothelial growth factor (VEGF), known as one of the most important vascular permeability factors, induces proliferation of endothelial cells, stiumulates angiogenesis, and increases vascular permeability. Several recents reports have documented that VEGF overexpression is associated with poor clinical outcomes in many maligmancies. The aims of this study were to determine whether microvessel density and VEGF expression are related to clinicopathologic factors such as age, sex, tumor size, tumor stage, and prognostic factors and to evaluate the relationship between VEGF expression and angiogenesis in benign and malignant thyroid tumors. Materials and Methods: The subjects were 65 patients (27 with papillary carcinoma, 27 with adenomatous hyperplasia, 11 with follicular adenoma) who underwent thyroidectomy from 1995 to 2001. Imuunohistochemistry was used to detect VEGF expression and microvessel density (MVD) in paraffin-embedded thryoid tumor specimens. Results: The intensity of the VEGF expression did not show stastically difference between benign and malignant thyroid tumors. There was no apparent correlation between VEGF expression and age, tumor size, T stage or scores of the AGES, AMES and MACIS systems. The neo-microvessel density was higher in the maligant tumor than the benign tumors. Also, higher neo-microvessel density was associated with metastases of the lymph nodes and scores of the AMES and AGES systems. Conclusion: Our results suggest that neo-microvessel vessel density may be a significant prognostic factor in the thyroid papillary carcinoma. But the VEGF expression does not appear to be an significant independent prognostic factor for thyroid papillary carcinoma.

• Parasites, Hosts and Diseases
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• 제31권1호
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• pp.13-20
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• 1993

간흡충에 감염되었을 때 나타나는 조직병리학적 소견의 변화로는 담관 직경이 확장되고 담관벽이 비후되며, 담관 상피층에 선종성 증식과 배세포 화생이 관찰되었다. 치료 후에는 이러한 변화 중에서 화생이 소실되나 선종성 증식은 상당히 완화되어 잔존하고 담관벽의 비후는 지속된다. 이러한 형태학적인 변화는 선종성인 특징이 있어 어떠한 분비기능이 예상되었다. 이 연구에서는 특히 소장의 분비물이 담관 점막층에서 분비되는가를 확인하고자 하였다. 간흡충 피낭유충을 300개씩 8마리의 토끼에 감염시킨 후, 14주에 프라지관텔로 치료하여 구층 후 6개월 및 1년에 간을 적출하고, 파라핀 포매하여 절편을 만들어 분비물에 대하여 면역조직화학법을 시행하였다. Gastrln과 secretin은 정상토기의 간내 담관 및 감염된 담관에서 나타나지 않았다. Serotonin은 비감염 간 내 담관에서는 관찰되지 않았으나, 감염 대조군의 담관상퍼층에서 몇 개의 양성 세포가 관찰되었다. 그러나 치료 후 6개월에는 관찰되지 않았다. 또한 휜쥐에 100개씩 간흡충 피낭유충을 감염시키고 증식된 상피 층에서 소장 미소응모막 효소의 활성을 관찰한 바, alkalinephosphatase의 활성이 감염군에서 대조군과 같은 정도로 관찰되 었으나 sucrose, trehalase, lactate, leucine annnopeptidase의 활성은 나타나지 않았다. 이 결과를 통하여 간흡충 감염시에 증식된 담관상피에 소수의 serotonin 분비세포가 있음을 관찰하였고 다른 소장의 분비기능은 생기지 않음을 확인하였다. 이 serotonin을 포함한 세포는 비만세포로 추정된다.