• Journal of The Korean Ophthalmological Society
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• v.59 no.11
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• pp.1071-1076
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• 2018

Purpose: To report a case of immunoglobulin G4 (IgG4)-related ophthalmic disease associated with adult xanthogranulomatous disease. Case summary: A 38-year-old male with a history of cholecystectomy visited our clinic for bilateral periorbital swelling. Histopathology of the orbital biopsy showed diffuse infiltration of foamy histiocytes with Touton giant cells and lymphoid follicles, with a diagnosis of adult-onset xanthogranuloma. After excisional biopsy, he was treated with azathioprine and prednisolone. Four years after treatment, he again visited the clinic due to bilateral, yellowish eyelid masses. Serological examinations were all nonspecific findings, except for elevation of IgG and IgG4 levels. Magnetic resonance imaging showed bilateral symmetric soft tissue enlargement with slightly heterogeneous T1/T2 isosignal intensity, with contrast enhancement at the superolateral aspect of extraconal spaces. Excisional biopsy and blepharoplasty were performed. Immunohistochemical sections showed that the IgG4+/IgG plasma cell ratio was 10-20% and the IgG4 plasma cell count was 22/high power field (HPF). His past sections of 2013 from the pathology department were again stained and showed that the IgG4+/IgG plasma cell ratio was 40-50% and the IgG4 plasma cell count was 59/HPF. Thus, he was definitely diagnosed with IgG4-related ophthalmic disease. Conclusions: If there is recurrent eyelid swelling, IgG4-related ophthalmic disease should be considered as a differential diagnosis. And the patient with adult xanthogranulomatous disease can be diagnosed with IgG4-related ophthalmic disease.

• Tuberculosis and Respiratory Diseases
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• v.41 no.4
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• pp.339-353
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• 1994

Background : The p53 gene codes for a DNA-binding nuclear phosphoprotein that appears to inhibit the progression of cells from the G1 to the S phase of the cell cycle. Mutations of the p53 gene are common in a wide variety of human cancers, including lung cancer. In lung cancers, point mutations of the p53 gene have been found in all histological types including approximately 45% of resected NSCLC and even more frequently in SCLC specimens. Mutant forms of the p53 protein have transforming activity and interfere with the cell-cycle regulatory function of the wild-type protein. The majority of p53 gene mutations produce proteins with altered conformation and prolonged half life; these mutant proteins accumulate in the cell nucleus and can be detected by immunohistochemical staining. But protein overexpression has been reported in the absence of mutation. p53 protein overexpression or gene mutation is reported poor prognostic factor in breast cancer, but in lung cancer, its prognostic significance is controversial. Method : We investigated the p53 abnormalities by nucleotide sequencing, polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP), and immunohistochemical staining. We correlated these results with each other and survival in 75 patients with NSCLC resected with curative intent. Overexpression of the p53 protein was studied immunohistochemically in archival paraffin- embedded tumor samples using the D07(Novocastra, U.K.) antibody. Overexpression of p53 protein was defined by the nuclear staining of greater than 25% immunopositive cells in tumors. Detection of p53 gene mutation was done by PCR-SSCP and nucleotide sequencing from the exon 5-9 of p53 gene. Result: 1) Of the 75 patients, 36%(27/75) showed p53 overexpression by immunohistochemical stain. There was no survival difference between positive and negative p53 immunostaining(overall median survival of 26 months, disease free median survival of 13 months in both groups). 2) By PCR-SSCP, 27.6%(16/58) of the patients showed mobility shift. There was no significant difference in survival according to mobility shift(overall median survival of 27 in patients without mobility shift vs 20 months in patients with mobility shift, disease free median survival of 8 months vs 10 months respectively). 3) Nucleotide sequence was analysed from 29 patients, and 34.5%(10/29) had mutant p53 sequence. Patients with the presence of gene mutations showed tendency to shortened survival compared with the patients with no mutation(overall median survival of 22 vs 27 months, disease free median survival of 10 vs 20 months), but there was no statistical significance. 4) The sensitivity and specificity of immunostain based on PCR-SSCP was 67.0%, 74.0%, and that of the PCR-SSCP based on the nucleotide sequencing was 91.8%, 96.2% respectively. The concordance rate between the immunostain and PCR-SSCP was 62.5%, and the rate between the PCR-SSCP and nucleotide sequencing was 95.3%. Conclusion : In terms of detection of p53 gene mutation, PCR-SSCP was superior to immunostaining. p53 gene abnormalities either overexpression or mutation were not a significant prognostic factor in NSCLC patients resected with curative intent. However, patients with the mutated p53 gene showed the trends of early relapse.

• The Korean Journal of Zoology
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• v.35 no.2
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• pp.173-182
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• 1992

흰쥐에 Spirometro rrinoce측 제3기 유충(고충 sparganum)이 감염되었을때 유충에서 생성된 성장호르몬 유사물질이 흰쥐 성장에 미치는 영향을 조사하기 위하여, 감염 기일이 경과에 따라 흰쥐의 뇌하수체와 유충의 체내에서 성장호르몬 분비세포를 면역조직화학염색으로 검색하였다. 유충의 표피와 표피성 근육층 및 근질 근육층에서 면역반응성을 띄는 성장 호르몬이 동정되었으며 감염시기의 경과에 따라 성장호르몬 분비세포의 수가 점차 증가하였다. 이와는 대조적으로 흰쥐의 뇌하수체에서는 성장호르몬 분비세포의 수가 감염 기일의 경과에 따라 정상대조군에 비하여 점차 감소 하였으며, 감염후 3개월이 경과되면 다시 증가하여 정상대조군의 수준으로 회복되었다. 또한 유충에 감염된 기일의 경과에 따른 횐쥐의 혈중 성장호르몬 농도변화를 dot-ELISA 방법으로 추정한 결깍 정상대조군의 성장호르몬의 양과 유의한 차이는 없었다. 결론적으로 유충의 체내에서 생성된 성장호르몬 유사물질이 전이숙주인 흰쥐의 성장을 유도할 것으로 사료된다.

• Clinical and Experimental Pediatrics
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• v.51 no.1
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• pp.73-77
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• 2008

Purpose : p16 gene, mapped to the 9p21 chromosomal region, has emerged as a candidate tumor suppressor gene in human neoplasm. It is an inhibitor of cyclin-dependent kinase and inhibits Rb phosphorylation. In a variety of tumors including childhood acute lymphoblastic leukemia (ALL), deletion and/or mutation of the p16 gene has been found. Despite their high frequency, the prognostic importance of p16 alterations is still controversial in ALL and has been reported to be either unfavorable or similar to that of other patients. We studied the correlation between loss of p16 protein confirmed by immunohistochemical staining and clinical outcomes of patients diagnosed as ALL. Methods : We performed an immunohistochemical staining for p16 protein in 74 cases of bone marrow biopsy slide initially diagnosed as ALL between January 1998 and December 2006. We reviewed the clinical manifestations, laboratory findings, treatment outcomes retrospectively. Results : Of 74 slides, 12 were negative for p16 protein. Seven were males and 5 were females with a median age at diagnosis was 5.8 (1.3-18.8) years. Initial WBC were 17,225 $(500-403,300)/{\mu}L$. By immunologic surface marker analysis, 7 patients were early pre-B CALLA (+) and 5 patients were T-cell ALL. Two patients of intermediate risk group had relapsed and died. Three patients had family history of breast cancer. Four patients died and overall survival rates were $53.5{\pm}18.7%$. Conclusion : Loss of p16 protein is supposed to be an independent risk factor of childhood ALL associated with poor outcomes. In clinical setting, the clinician must take into account p16 status, not only at the genomic but also at the protein level. Further clinical experience on thoroughly investigated cases will help a better understanding between p16 status and clinical outcomes.

• Advances in pediatric surgery
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• v.19 no.2
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• pp.108-121
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• 2013

목적 Pheochromocytoma of the Adrenal gland Scaled Score (PASS) 시스템과 면역화학염색 등을 통한 갈색세포종 및 부교감신경절종의 악성화 예측인자가 제시되고 있으나 명확한 병리학적 또는 분자생물학적 예측인자는 밝혀진 바 없다. 본 연구에서는 임상적, 병리학적 분석을 통해 갈색세포종 및 복강내 부교감신경절종의 악성화 예측인자를 확인하고자 하였다. 대상 및 방법 1990년 1월부터 2010년 12월까지 서울대학교어린이병원에서 수술적 절제 후 병리학적으로 갈색세포종 및 복강내 부교감신경절종으로 확진된 20명의 18세 이하 소아 환자를 대상으로 임상적 특징을 분석하였고, PASS 시스템에 따른 병리 슬라이드 판독하였다. 세포활성도를 반영한다고 알려진 유전자에 대한 항체 중 Ki-67, p53, bcl-2, mdm-2, cycline D1, p21, p27을 이용해 면역 화학검사를 한 후 결과를 확인하였다. 결과 20명의 환자 중 갈색세포종은 14명, 복강내 부교감신경절종은 6명이었다. 악성화는 각각 4명, 3명에서 관찰되었다. 혈관 침범, 주변부 지방조직 침습, 세포분열 증가가 통계적으로 유의한 악성화 예측인자였으며(각각 p=.007, .031, .031), 갈색세포종만 분석하였을 때도 통계적으로 유의하였다(각각 p=.033, .003, .019). PASS 시스템은 악성화를 예측하는데 있어 통계적으로 유의하지 않았으며, 혈관 침범, 주변부 지방조직 침습, 세포분열 증가를 항목으로 하여 새롭게 만든 병리 스코어 시스템은 악성 환자군과 양성 환자군 사이에 통계적으로 유의한 차이를 보였다(p< .001). 악성과 양성 질환 사이의 면역화학염색 결과에서 유의한 차이는 없었다. 결론 소아에서 갈색세포종 및 복강내 부교감신경절종의 악성화 예측인자로 혈관 침범, 주변부 지방조직 침습, 세포분열 증가를 이용할 수 있다. 소아에서 PASS시스템으로 악성화를 예측할 수 없었으나, 새로운 병리스코어 시스템으로 악성 환자군을 예측할 수 있었다. 면역화학검사 결과 세포 활성도를 반영하는 인자들은 악성화를 예측할 수 없었다.

• Clinical and Experimental Reproductive Medicine
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• v.30 no.4
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• pp.309-316
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• 2003

연구목적: 스테로이드 계통의 에스트로겐 호르몬은 막 수용체와 결합하고 DNA에 부착되어, 자궁조직에서 발현되는 많은 유전자들의 발현 양상을 조절하는 것으로 알려져 있다. 본 연구에서는 난소를 제거한 생쥐 모델을 이용하여 에스트로겐에 의해 조절되는 전사 관련 유전자(transcription factor)들을 동정하고, early up-regulation gene으로 확인된 Fos related antigen (Fra1과 Fra2) 유전자의 발현 양상을 RT-PCR과 면역염색방법으로 살펴보았다. 연구재료 및 방법: 난소 절제술을 시행한 생쥐에 에스트로겐을 피하주사하고 2, 4, 6, 12시간 간격으로 자궁조직을 적출하였다. 대조군으로는 sesame oil만을 주사한 후 2시간째에 수획한 자궁조직을 사용하였으며, 시간대별로 채취한 자궁조직(n=4)에서 RT-PCR을 수행하였다. RT-PCR을 통해 early response gene으로 확인된 Fra1과 Fra2에 대한 에스트로겐의 영향을 살펴보기 위해 estrogen receptor antagonist인 ICI 182, 780을 주사하여 유전자 발현 양상의 변화를 살펴보았다. 또한, 자궁조직내에서의 단백질 발현 부위를 관찰하기 위해 면역조직화학염색을 실시하였다. 결 과: 생쥐 자궁조직에서 에스트로겐에 의해 발현 양상의 변화가 확인된 유전자는 early up-regulation genes (CREB2, Fra-1, 2, GATA5), late up-regulation gene (E2F1), no response genes (CREB1, ATF1, GLI3, E2F3), down-regulation genes (GLI2, E2F5, GATA-2, 3, 6) 등으로 구분할 수 있었다. 그 중 early up-regulation genes에 해당하는 Fra1과 Fra2 유전자는 ICI 182, 780에 의해 그 발현이 유의하게 감소되는 것을 확인하였다(p < 0.01). 이들 단백질은 생쥐 자궁조직의 상피세포층, 기질층, 근육층에서 고루 발현되었으며, 특히 근육층에서 강한 염색정도를 관찰할 수 있었다. 결 론: 이상의 결과를 통해 Fra1과 Fra2 유전자의 발현은 에스트로겐에 의해 조절됨을 알 수 있었으며, 이들의 강한 발현이 자궁조직의 근육층에서 관찰되어 이들의 기능에 대한 연구가 필요할 것으로 생각된다.

• Korean Journal of Acupuncture
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• v.25 no.1
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• pp.155-164
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• 2008

목 적 : 본 연구의 목적은 양릉천 침 처치 시 C57BL/6 생쥐의 중뇌 흑질에 위치한 도파민성 신경세포 사멸 억제 효과를 조직화학 염색법을 이용하여 Tyrosine hydroxylase(TH)와 laminin의 발현으로 관찰하고자 한다. 실험방법 : 실험에 이용한 동물은 C57BL/6 생쥐로, 매일 25mg/kg의 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)를 5일간 주사하였고, 매일 MPTP 주사한 뒤 2시간 후에 양릉천에 침치료를 시행하였으며 MPTP 주사를 종료한 뒤 침치료는 7일동안 계속 시행하였다. 마지막 MPTP 주사 7일 후에 동물을 희생하여 뇌를 적출하고 고정하였다. 침효과를 확인하기 위해 Thyrosine hydroxylase(TH), laminin의 발현 변화 정도를 조직염색화학법으로 이용하여 확인하였다. 각 그룹간의 유의성 검증은 one-way ANOVA를 이용하였다. 결 과 : 도파민성 신경세포 선택적인 신경독소인 MPTP에 대한 양릉천 침처치에 의한 신경보호 효과를 도파민신경세포의 표지자인 TH 발현을 면역화학조직염색법으로 관찰하였다. 대조군에 비해 MPTP 처치 군의 신경세포 사멸이 유의적으로 감소하였고(P <0.05), MPTP + 침처치 군에서 증가되는 양상을 확인하였다 (P <0.05). 또한 도파민성 신경세포내에 존재하는 laminin의 발현정도 역시 대조군보다 MPTP 처치 군에서 유의적으로 감소하였고, MPTP + 침처치 군에서 증가되는 양상을 확인하였다 (P <0.05). 결 론 : MPTP에 의한 도파민성 신경세포 손상에 대한 양릉천 침처치의 신경보호 효과는 세포외 기질중의 하나인 laminin의 발현 정도를 조절하여 비롯되는 것으로 사료된다.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.74-81
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• 2008

Background: Fascin is an actin-bundling protein that induces membrane protrusions and it increases cell motility in various transformed cells. Esophageal cancer is one of the most lethal malignancies, and it exhibits extensive local invasion or frequent regional lymph node metastasis even after curative surgery. We investigate the expression of fascin by performing immunohistochemistry to evaluate the clinical characteristics and prognostic significance of its expression in esophageal cancer patients. Material and Method: Immunochemistry for fascin was performed on 76 tumor samples from 76 patients who underwent esophageal cancer operations. The expression levels of fascin in the 76 esophageal cancer tissues were compared with those in the corresponding normal esophageal epithelium. The fascin-positive samples were defined as those showing more than 75% of fascin-positive cells. Result: Overall, a fascin positive expression was detected in 39 (51.3%) out of the total 76 cases. The tumors with positive fascin expression tended to more frequently show a higher stage (p=0.030), and a higher T-factor (p=0.031). The prognosis of the fascin negative group was significantly better than that of the fascin positive group (p=0.004). Multivariate analysis revealed that lymphovascular invasion and the fascin expression were independent prognostic factors. Conclusion: Fascin was expressed in 513% of the esophageal cancer tissues and a positive expression of fascin was associated with more advanced tumor progression and recurrence. Our study suggests that the fascin expression may be an independent prognostic factor for an unfavorable clinical course few those patients suffering with esophageal cancer.

• Journal of Chest Surgery
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• v.40 no.2 s.271
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• pp.114-121
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• 2007

Background: Apoptosis plays a crucial role in carcinogenesis, as well as in development and tissue homeostasis. Terminal deoxyribonucleotidyl transferase mediated neck end labelling (TUNEL) and in situ nick end labelling (ISEL) have been used to investigate the apoptosis in tissues. Since the introduction of the M30 monoclonal antibody to overcome drawbacks of TUNEL and ISEL, the apoptosis in various tumors, with the exception of pulmonary carcinomas, has been studied. In this study, attempts were made to examine the correlation of apoptosis in non-small cell carcinomas, using both M30 and the expression of p53 protein, with the clinicopathological factors. Material and Method: Forty five patients with surgically resected non-small cell carcinomas were included. Immunohistochemical staining with M30 and p53 monoclonal antibody were peformed, and their expressions compared with the clinicopathological features. The overall survival time and recurrence-free survival time were calculated, and the factors influencing the survival time analyzed using a univariate analysis. The effects of the expression stati of M30 and p53 on the risks of cancer related to both death and recurrence were evaluated using a multivariate analysis. Result: The p53 positive group had many more M30 positive cells than the p53 negative group (p53 positive group; $61.7{\pm}26.8$ cells vs. p53 negative group; $45.6{\pm}29.6$ cells, p=0.005) and significantly more p53 positive patients showing at least 10 positive cells (apoptotic index, $Al{\ge}1$) on M30 staining (p53 positive group; 52.4% (11/21) vs. p53 negative group 16,7% (4/24), p=0.025). In the univariate analysis, the survival times in relation to smoking (pack-year), performance status (PS) and Al showed significant differences. The multivariate analysis demonstrated the relative risk (R.R) of cancer death increased almost 7.5-fold (R.R 7.482; 95% Cl $1.886{\sim}29.678$; p=0.004) and the risk of recurrence almost 3,8-fold (R.R 3.795; 95% Cl: $1.184{\sim}12.158$; p=0.025) in the high Al (${\ge}1$) compared to the low Al (<1) group. There was no prognostic effect of p53 expression on the survival time or risk of cancer death and recurrence. Conclusion: In non-small cell lung carcinomas, M30 immunohistochemistry was an excellent method for analyzing apoptosis; the high apoptotic index could be an adverse prognostic predictive factor.

• Journal of Veterinary Clinics
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• v.31 no.5
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• pp.407-411
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• 2014

A 12-year-old castrated male Pekingese dog was presented with weakness, exercise intolerance, and an episode of coughing started 2 weeks earlier upon presentation. Physical examination revealed a grade II/VI left systolic heart murmur. Echocardiographic examination revealed a pericardial effusion and a mass at the heart base located beside the left atrium. The mass beside the left atrium was also visible on the thoracic radiograph after drainage of the pericardial effusion. An aortic body tumor was definitely diagnosed based on postmortem histopathological examination and immunohistochemical staining for specific markers. The dog lived 234 days after diagnosis with only medical management and without recurrence of the pericardial effusion.