• Title/Summary/Keyword: 조직병리학

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Prognostic Factors in Childhood IgA Nephropathy (소아 IgA 신병증의 예후에 관한 고찰)

  • Park Jae-Hyun;Kim Pyung-Kil;Jeong Hyeon-Joo;Choi In-Joon
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.17-23
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    • 1997
  • After the first description of IgA nephropathy by Berger in 1968, the prognosis of this disease was considered favourable. However recent studies have revealed that IgA nephropathy result in end stage renal desease in 25-30% by 20 years. Heavy proteinuria, hypertension, histological high class are regarded as poor prognostic factors. In 1996, Yagame et al reported the new histopathologic grading with a strong correlation between the grading, heavy proteinuria, high s-Cr level and renal survival. The aims of this study are to determine whether the pathological grading and other clinical parameters could contribute to predicting the outcome of this disease eventhough pediatric patients. Seventy nine patients (59 males, 20 females) with IgA nephropathy were examined. Patients were 2.08-15.17 years of age ($9.85{\pm}2.83$). The mean follow-up duration were $27{\pm}28$ months. Six of seventy nine patients progressed to chronic renal failure during the follow-up periods. High 24h urinary protein excretion at diagnosis were significantly higher in chronic renal failure patients (p<0.05). Hypertension at diagnosis were the significant associated factors in progression of chronic renal failure (p<0.05). Histological changes of IgA nephropathy in light microscopy were classified into five classes by WHO classification, four grades in Yagame's gradings. Among the seventy nine patients, 24 were as class 1, 30 as class 2, 23 as class 3; 4 as class 4, 0 as class 5 by WHO classification. 23 were classified grade 1, 31 as grade 2, 24 as grade 3, 1 as grade 4 by Yagame's grading. Among six patients who progressed to chronic renal failure, 1 clssified as class 1, 1 as class 2, 3 as class 3, 1 as class 4, 0 as class 5 by WHO Classification. 1 patients were classified as grade 1, 1 as grade 2, 3 as grade 3, 1 as grade 4 by Yagame's grading. (p>0.05) In conclusion, hypertension and heavy proteinuria at initial presentation were significantly associated with progression of chronic renal failure. The classification of WHO & Yagame's grading has no significant association with the progression of chronic renal failure in pediatric patients.

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Nodal Status of the Head and Neck Cancer Patients (두경부 암 환자의 경부 림프절 전이 분석)

  • Yang, Dae-Sik;Choi, Myung-Sun;Choi, Jong-Ouck
    • Radiation Oncology Journal
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    • v.15 no.4
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    • pp.321-329
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    • 1997
  • Purpose : It is well known that the risk of lymph nodes metastases to head and neck cancers are influenced by the location and size of the Primary tumor. as well as the degree and types of histological differentiation. However, data on the statistical analyses of lymph node metastases from the head and neck cancers among Korean Population are not available at present. In order to obtain current status of such data, we have analyzed cancer patients at the department of radiation oncology, korea universityhospital for radiation treatment. Materials and Methods : We have evaluated nine-hundred and ninetyseven (997) head and neck cancer Patients who visited to the Department of radiation oncology, between November 1981 to December 1995. After careful physical examinations and CAT scan, Patients were divided into two groups, those with positive lymph node metastases and with negative lymph node metastases. The nodal status were classified according to the TNM system of American Joint Committee on Cancer (AJCC) Besults : Four-hundred and sixteen Patients out of the 997 patients were lymph node positive $(42\%)$ and 581 patients were lymph node negative $(58\%)$ when they were first presented at the department of radiation oncelogy. According to the AJCC classification, the distribution of positive lymph node is as follow: Nl:106 $(25.5\%),\;N2a:100\;(24\%),\;N2b:68\;(16.4\%),\;N2c:69\;(16.6\%),\;3:73\;(15\%).$ respectively. The frequency of lymph node metastases according to the primary sites is as follow : larynx 283 $(28.5\%)$, paranasal sinuses: 182 $(18\%),\;oropharynx:144\;(14.5\%)\;nasopharynx:122(12\%),\;oral\;cavity\;92\;(9\%),\;hypopharynx:71\;(7\%),\;falivary\;gland:58\;(6\%)$ unknown primary:31 $(3\%),\;skin:\;14(2\%)$,. The most frequent Primary site for the positive Iymph node metastases was nasopharynx $(71\%)$ followed by hypopharynx $(69\%),\;oropharynx\;(64\%),\;oral\;cavity\;(39\%)$ The most common histologic type was squamous cell carcinoma (652/997: $65.4\%$). followed by malignant lymphoma $(109/997:11\%)$. Conclusion : Statistical results of lymph node metastases from head and neck cancer at our department were very similar to those obtained from other countries. It is concluded that the location of Primary cancer influences sites of metastases on head and neck, and stage of the primary cancer also influences the development of metastatic lesions. Since the present study is limited on the data collected from one institute. further statistical analyses on Korean cancer Patients are warrented.

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피부 병변은 닭 마렉병 진단에 결정적 단서를 제공한다

  • 조경오;박남용
    • Korean Journal of Veterinary Pathology
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    • v.6 no.2
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    • pp.101-104
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    • 2002
  • 닭의 전신장기에 림프종 발생이 특정인 마렉병(Marek's disease; MD)은 림프구성 백혈병(Lymphoid leukosis; LL)과 병리학적 소견이 매우 유사하여 감별이 요구된다. 마렉병 바이러스(Marek's disease virus; MDV)는 질병초기에서 후기에 이르기까지 모낭상피세포에 세포용해성 감염을 지속적으로 일으킨다. 세포용해성 감염이 있는 모낭상피세포는 변성내지 괴사되어 있고 핵내봉입체가 관찰된다. 또한 세포용해성 감염이 있는 모낭상피세포 바로 밑의 진피와 깃털 수질(feather pulp)내의 혈관주위에 림프구 침윤이 관찰된다. 이러한 피부병변은 MD의 특징적인 병변들로서 LL과 감별할 수 있는 결정적인 단서이다. 본 고에서는 MD에 관한 전반적인 것과 특히 MD 진단을 위한 피부병변의 유용성에 대해서 자세히 논하고자 한다. 양계산업에 문제를 야기하고 있는 림프구 증식성 종양은 크게 마렉병(Marek’s disease; MD)과 백혈병(Lymphoid leukosis; LL)이 있다. 이들 질환의 원인체들이 분리되기 전까지는 이들 질병들은 발병부위에 따라 질병명을 붙였다. 즉, 내부장기냐 근육에 발생한 것은 visceral lymphomatosis, 피부에 발생한 것은 skin leukosis, 말초신경의 병변은 poly­n neuritis, neuritis, neurolymphomatosis gallinarum, range paralyis로 불리었다. 또한 눈에 발생한 것은 blindness, gray eye, iritis, uveitis, ocular lymphomatosis라고 불리었다. 1961년에 Biggs는 이러한 림프구 증식성 질병을 마렉병과 백혈병 으로 분류하자는 제안을 하였고, 드디어 1960년대 중반에 림프구 증식성 병변 중의 일부에서 herpesvirus가 분리되어서 Biggs가 제안한 병명인 마렉병을 본격적으로 사용하게 되었다. MD는 마렉병 바이러스(Marek’s disease virus; MDV)가 원 인제로서 닭에 전염성이 강한 염증성에서 종양성의 병변을 내부장기, 피부, 근육, 안구, 중추신경계, 말초신경계 등에 일 으킨다. MDV는 림프종을 유발하기 때문에 처음에는 사람에서 림프종을 유발하는 Epstein-Bar 바이러스와 관련이 있을 것으로 생각되어 gamma-herpesvirus로 분류되었지만, MDV의 게놈 구조와 세포배양에서 빠르게 성장한다는 점 때문에 지금은 alpha-herpesvirus로 재분류 되었다. MDV는 바이러스 중화시험과 한천 겔 침강법에 의해서 3개의 혈청형으로 분류 된다. 혈청형 1은 종양원성 바이러스와 종양원성 바이러스의 계대배양에 의한 약독주가 있다. 혈청형 2는 자연적으로 발 생하는 비종양원성 닭의 MDV이고, 혈정형 3은 바종양원성 칠면조 herpesvirus (HVT)이다. 림프종을 유발하는 MDV 감염은 4개의 과정, 즉 초기 세포용해성 감염, 잠복감염, 후기 세포용해성 감염, 마지막으로 종양화로 나눌 수 있다. 감염의 경로를 보면, 흡입된 MDV는 폐의 대식세포에 감염한 후 전선 장기로 MDV를 전파 시킨다. 특히, 흉선, F냥, 비장 등의 림프구에 초기 세포용해성 감염을 일으키는데, B 림프구가 주로 감염된다. 세포용해성 감염음 방어하기 위해 몰려든 T 림프구가 활성화가 되면, T 세포도 감염되게 된다. 잠복감염은 여러 가지 사이토카인 등 을 포함한 면역반응에 의해서 일어나며, 이 때 잠복감염된 세포는 특히 혈중의 T 세포라고 한다. 혈중 MDV 감염세포 는 피부 모낭상피세포, 선장 등 상피세포 유래의 조직에 MDV를 전파 시켜서 이들 조직에서 후기 세포용해성 감염이 일어나게 한다. 후기 세포용해성 감염을 유발하는 것은 이러한 MDV가 감염된 혈중 림프구라는 증거는 혈중의 세포 외에는 감염성 바이러스가 없기 때문이다. 후기 세포용해성 감염이 있는 후 육안적 혹은 현미경적으로 검출이 가능한 림프종이 여러 장기에서 관찰된다. MDV가 감염되면 병변 발생부위에 따라서 다양한 임상증상이 발생한다. 즉 내부장기에 병변이 있을 경우는 침울, 체중감소, 산란율 저하 등이 발생하며, 신경계는 발생부위별 신경증상이 일어난다. 이러한 장기나 조직에서는 육안적으로 백색에서 회백색의 종양성 병변이 관찰된다. 말초신경에 병변이 발생한 경우에는 특히 좌골신경 및 신경총에서 호발하는데, 이들 조직은 편측성 혹은 양측성으로 종창되어 있다. 안구는 간혹 육안적으로 식별이 가능한 홍채 퇴색 및 증식 병변이 관찰된다. 피부형 MD는 특히 육용계에서 문제가 되고 있으며, 산란계의 내장형 MD가 발생한 경우에도 피부를 자세히 설펴보면 피부형 MD를 간혹 관찰할 수 있다. 피부형 MD는 모낭주위에 원형의 결절형태로 발생하는데, 이들 병변이 커지면 바로 옆의 병변과 융합 되어 큰 결절을 형성하기도 한다. (중략)

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Comparison of Size Criteria in Mediastinal Lymph Node Involvement of Adenocarcinoma of Lungs (폐 선암의 종격동 림프절 전이에 있어서 림프절 크기 기준의 비교)

  • Gu, Ki-Seon;Kuk, Hiang;Koh, Hyeck-Jae;Yang, Sei-Hun;Jeong, Eun-Taik
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.4
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    • pp.542-547
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    • 1999
  • Background: Decision in mediastinal lymph node involvement of lung cancer by CT scan is very important and valuable for the treatment planning and prognosis prediction. In general, long diameter of mediastinal lymph node more than 15mm is used as criterion of lung cancer involvement. Adenocarci-noma has a tendency of early distant metastasis and micrometastasis, so adenocarcinoma may involve lymph node earlier and cannot be detected before lymph nodes are enlarged enough. The authors tried to determine the difference between two size criteria(15mm, 10mm) in adenocarcinoma for the detection of cancer involvement. Methods: Numbers of sample are 60 cases(male 46, female 14, median age: 61.5 years). According to pathology, squamous cancer 41, large cell cancer 2, adenocarcinoma 17. According to TNM stage, I 23, III 24, IIIA 13. Results : Mean long diameter of lymph node involvement is 16.0($\pm8.0$) mm in non-adenocarcinoma group, and that of adenocarcinoma group is 12.0($\pm3.2$) mm(p<0.05). If long diameter of lymph node larger than 15mm as involvement criterion is applied, sensitivity, specificity, positive predictive index, negative predictive index, accuracy of nonadenocarcinoma group are 54%, 100%, 100%, 83%, 86%, and those of adenocarcinoma group are 43%, 90%, 75%, 69%, 71%. If long diameter of lymph node larger than 10mm as involvement criterion is applied, sensitivity, specificity, positive predictive index. negative predictive index. accuracy of nonadenocarcinoma group are 65%, 77%, 61%, 92%, 79%, and those of adenocarcinoma group are 100%, 80%, 78%, 100%, 88%. Conclusion: Long diameter of lymph node larger than 10mm is more valuable criterion as lymph node involvement in adenocarcinoma of lungs.

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Lactoferrin Sequestration and Its Contribution to Iron Deficiency Anemia in Helicobacter pylori Infected Gastric Mucosa (Helicobacter pylori 감염과 관련된 철 결핍성 빈혈에서 Lactoferrin Sequestration의 역할)

  • Moon, Kwang-Bin;Kang, Chang-Kyu;Choe, Yon-Ho;Han, Hye-Seung;Song, Sun-Uk
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.1
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    • pp.11-18
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    • 2002
  • Purpose: It is known that lactoferrin serves as a source of iron for H. pylori in gastric mucosa. This study was undertaken to investigate the relationship between lactoferrin and H. pylori infection coexistent with iron-deficiency anemia by determining the lactoferrin levels in gastric biopsy specimens, and by locating the major sites of lactoferrin expression, according to the presence or absence of iron-deficiency anemia. Methods: Fifty-five adolescents that underwent gastroduodenoscopy were divided into three groups: NL (n=19) for normal controls, HP (n=15) for patients with H. pylori, and IDA (n=21) for patients with H. pylori gastritis and coexisting iron-deficiency anemia. Histopathologic features were graded from to marked on the basis of the Updated Sydney System. The gastric mucosal levels of lactoferrin were measured by immunoassay. Immunohistochemical technique was used to allow identification of the location and quantification of the lactoferrin expression. Results: Lactoferrin levels in the antrum increased significantly, in proportion to, H. pylori density, polymorphonuclear cell infiltration, and chronic inflammation in the histologic specimens. Patients in the HP and IDA groups showed significantly increased mucosal levels of lactoferrin compared with that observed in the normal group (p=0.0001). The lactoferrin level in IDA group tended to be higher than that in the HP group (p=0.2614). The major sites of lactoferrin expression by immunohistochemistry were in glands and neutrophils within epithelium. Lactoferrin was stained weakly in NL, and strongly in HP and IDA. Conclusion: The lactoferrin sequestration in the gastric mucosa of IDA was remarkable, and this finding seems to give a clue that leads to the clarification of the mechanism by which H. pylori infection contributes to iron-deficiency anemia.

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Effects of Purgative Action with Natrii Sulfas on Bax and HSP72 Expressions of the MCAO Rat Brain (망초(芒硝)의 사하작용(瀉下作用)이 MCAO 흰쥐 뇌조직의 Bax 및 HSP72 발현에 미치는 영향)

  • Kim, Kon-Sik;Kim, Bum-Hoi;Lee, Dong-Eun;Yang, Kee-Young;Kim, Seong-Joon;Kang, Hee;Sohn, Nak-Won
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.4
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    • pp.818-824
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    • 2009
  • This study aimed to evaluate the effect of purgation therapy with Natrii sulfas, a therapy for stroke patients with constipation in the oriental medicine, on the ischemic brain damage of the rats. The ischemic brain damage was induced by the middle cerebral artery occlusion (MCAO), Natrii sulafas was administered once after the MCAO. After 48 hours, expressions of Bax, Bcl-2, c-Fos, and HSP72 on the brain tissues were observed by immunohistochemistrical methods or technique. Purgation therapy with Natrii sulfas attenuated the excess of Bax expression caused by the ischemic brain damage. It was significant statistically in the penumbra of cerebral cortex, but not in the caudate putamen, of the MCAO rats. Purgation therapy with Natrii sulfas did not attenuate the excess of Bcl-2 expression caused by the ischemic brain damage. Purgation therapy with Natrii sulfas did not attenuate the excess of c-Fos expression caused by the ischemic brain damage. Purgation therapy with Natrii sulfas attenuated the excess of HSP72 expression caused by the ischemic brain damage. It was significant statistically in the penumbra of cerebral cortex, but not in the caudate putamen, of the MCAO rats. These results suggest that purgation therapy with Natrii sulfas has a neuroprotective effect on the ischemic brain damage and an anti-apoptotic effect.

Fine Needle Aspiration Cytology of Myxoid Chondrosarcoma of Pleura -A Case Report- (점액양 연골 육종 1례의 세침 흡인 세포학적 소견)

  • Myong, Na-Hye;Cho, Kyung-Ja;Jang, Ja-June;Zo, Jae-Il;Shim, Young-Mog
    • The Korean Journal of Cytopathology
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    • v.1 no.2
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    • pp.152-157
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    • 1990
  • A 70-year-old female who was diagnosed as myxoid chondrosarcoma by fine needle aspiration of a pleural mass is described. She presented with left chest discomfort of 4 months' duration and aggravating dyspnea and chest pain for 2 months. Chest X-ray and CT scan revealed a large lobulated low density mass invading chest wall at the left pleural cavity and massive pleural fluid. Fine needle aspiration was done under the impression of mesothelioma or metastatic cancer. The aspirates from the mass were very cellular and composed of isolated or clustered forms of large plump cells. Abundant cytoplasm was blulsh opaque and the margin was rounded in the isolated cells, whereas clustered cells show ill-defined ceil borders and aggregating tendency. The nuclei were eccentric, round to ovoid, and had fine chromatin pattern and multiple small nucleoli. Cellular pleomorphism or mitotic figure was not definite. These findings were consistent with cytologic features of chondrosarcoma. Final diagnosis was confirmed as myxoid chondrosarcoma by mediastinoscopic biopsy and the tumor showed strong positivity for S-100 protein.

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Fine Needle Aspiration Cytology of Follicular Neoplasm of the Thyroid (갑상선의 여포상 종양의 흡인세포학적 소견)

  • Cho, Kyung-Ja;Jang, Ja-June
    • The Korean Journal of Cytopathology
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    • v.4 no.2
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    • pp.105-110
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    • 1993
  • The major limitation of fine needle aspiration of the thyroid is in the evaluation of follicular tumors. it may be difficult or occasionally, impossible to distinguish on a cytologic basis, between hyperplastic nodular getter, follicular adenoma and well differentiated follicular carcinoma. We reviewed cytologic presentations of 15 histologically confirmed follicular neoplasms of the thyroid. Aspiration smears of 6 follicular adenomas were cell-rich with ball-like or syncytial aggregates of monotonous follicular cells, in contrast to honeycomb-like flat sheets of adenomatous goiter Mild nuclear pleomorphism and a small visible nucleolus were noted in 2 cases, respectively. Nine cases of follicular carcinoma showed very high cellularity, irregularly shaped cell clusters, and numerous isolated tumor cells. Nuclear pleomorphism and visible nucleoli were noted in 6 and 5 cases, respectively. Another characteristic finding, entrapped endothelial cells within the ceil clusters, was noted in 7 carcinomas and 1 adenoma. The background of the smears of all follicular neoplasms was hemorrhagic, with no or scanty colloid. We confirmed that the cytologic features of follicular adenoma and carcinoma were similar in general, with subtle differences in cell morphology, but the presence of isolated tumor cells and entrapped endothelial cells was suggestive of malignancy.

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Studies on Viruses Isolated from Lilium spp. In Korea I. Broad Bean Wilt Virus and Cucumber Mosaic Virus (한국산 나리류에서 분리한 바이러스에 관한 연구 I. Broad Bean Wilt Virus 및 Cucumber Mosaic Virus)

  • Chang Moo Ung;Chung Jae Dong
    • Korean Journal Plant Pathology
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    • v.3 no.3
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    • pp.223-235
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    • 1987
  • Samples showing yellow mosaic symptom of Lilium spp. with necrotic fleck, stunting, malformation, and colour breaking were collected from lily-growing areas in the southern part of Korea. Two viruses were distinguished under a electron microscope and their host range, serological reaction, stability in sap, type of aphid transmission, and relations with cells and tissues were examined. Broad bean wilt virus (BBWV) was transmitted by sap-inoculation to 23 plant species in 8 families and by the aphid, Myzus persicae. This virus was inactivated after 10 min at 70C, at dilution of $10^{-3}$, and after 6 days at about 20C. Electron microscopic examination of purified preparation showed that the virus is spherical particle of 28nm in diameter. The virus reacted positively with BBWV-antiserum in agar gel diffusion test. In ultrathin sections of BBWV infected tissues, large aggregates or crystalline array of virus particles and vesicular body were found in the cytoplasm, vacuole, and nucleus of mesophyll cells. Cucumber mosaic virus (CMV) was transmitted by sap-inoculation. Electron microscopic examination of its purified preparation showed spherical particles of 30nm in diameter. The virus reacted positively with CMV-Y strain-antiserum in agar gel diffusion test. In ultrathin sections of CMV infected tissues, crystalline array of virus particles were found in the vacuole and a large number 0f virus particles were found in the cytoplasm and the plasmodesmata of mesophyll cells. When each of these viruses was retransmitted to Lilium tigrinum. L. concolor, and L. auratum, BBWV induced slight symtoms and colour breaking, but CMV induced yellowing mosaic or necrotic fleck.

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Protective effects of Jijang-kimchi extracts on diabetes mellitus and alcoholic liver injury in laboratory rats (랫드에서 김치가 당뇨병 및 알코올성 간 손상 예방에 미치는 효과)

  • Kim, Chang-Hyu;Park, Byung-Sung;Um, Kyung-Hwan
    • Journal of the Korean Applied Science and Technology
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    • v.37 no.5
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    • pp.1078-1087
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    • 2020
  • The current study was carried out to investigate the effect of oral administration for 30 days of the Jijang kimchi extracts on prevention of diabetes, alcoholic liver injury and reduction of blood lipids in laboratory rats with alcoholic liver injury and diabetes induced by streptozotocin. In a diabetic model animals, the blood lipid profile, ALT, and AST levels were lower in kimchi extract groups compared to DC (diabetes control) group, and blood glucose level of DCJK (DC+oral administration with Jijang kimchi extracts) group was lower than that of DCCK (DC+oral administration with commercial kimchi extracts) group. Insulin levels were increased in order of NC (normal control), DCJK > DCCK > DC groups. In alcoholic liver injury model animals, ALT, AST and bilirubin were lowed in order of AC (alcohol group received 1 bottle of soju) > ACCK (1 bottle of soju plus oral administration with commercial kimchi extracts) ACJK (AC plus oral administration with Jijang kimchi extracts) > NC groups. In the clinical pathologic findings of liver tissue, AC group was severely injured, and tended to be improved in groups eating a 1 bottle of soju plus oral administration with kimchi extracts, especially Jijang kimchi extract group. The results suggest that eating Jijang kimchi can improve insulin secretion ability while lowering blood lipid profile, blood sugar and ALT, AST, and bilirubin levles in diabetic and alcoholic liver injury model animals.