• 대한세포병리학회지
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• 제7권2호
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• pp.122-133
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• 1996

This is a retrospective review of fine-needle aspiration cytology(FNAC) smears of 153 cases of thyroid disease performed during August 1989 to July 1995, which were confirmed histologically following surgical operations. FNAC results showed 63 cases(41.2%) of adenomatous goiter, 45 cases(29.4%) of papillary carcinoma, 29 cases(19.0%) of follicular neoplasm, 4 cases(2.6%) of follicular variant of papillary carcinoma, 4 cases(2.6%) of Hashimoto's thyroiditis, 4 cases(2.6%) of $H\ddot{u}rthle$ cell neoplasm, 2 cases(1.3%) of medullary carcinoma and one case(0.7%) each of subacute thyroiditis and of anaplastic carcinoma. The overall accuracy of cytological diagnosis was 83.7%. These data strongly suggest thyroid FNAC is a reliable preoperative diagnostic tool, but FNAC has been less valuable in the diagnosis of follicular lesions than any other disease of the thyroid. Adenomatous goiter was not infrequently interpreted as follicular neoplasia that requires surgery for diagnostic conformation and vice versa. The following findings are considered to be compatible with follicular neoplasm: 1) microfollicles, 2) nuclear grooving, 3) irregularity of nuclear membrane, and 4) irregular arrangement or crowding of follicular cells in groups. The FNAC criteria of adenomatous goiter are as follows: 1) atrophic follicular cells, 2) presence of macrophages, 3) abundant colloid, and 4) large follicles. It is recommended that aspiration of thyroid lesions in order to analyse with critical clinico-pathological approach and surgery is considered only for nodules that are clinically suspicious or unresponsive to hormone therapy or when a diagnosis of follicular neoplasm is made.

• 대한두경부종양학회지
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• 제10권2호
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• pp.102-105
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• 1994

The indolent course of most thyroid papillary carcinomas, even the presence of regional lymph node metastasis, make them unique among human malignant head and neck cancers. Age, sex, extracapsular invasion and anaplastic change are known to be correlated with prognosis. The purpose of this study is to clarify the significance of DNA content analysis as a prognostic factor. Twenty five thyroid papillary carcinomas were possible to be examined by flow cytometric analysis using fresh surgical specimens and three nodular hyperplasias and seven follicular adenomas were included as control group. The results were as follows: l) All of twenty five thyroid papillary carcinomas showed diploidy. 2) S-phase fraction was $1.94{\pm}2.77%$ in normal control group and $2.60{\pm}2.66%$ in papillary carcinoma group. The proliferation index was $8.44{\pm}3.89%$ in normal control and $7.70{\pm}3.63%$ in papillary carcinoma group with even low value. 3) Age, sex, extracapsular spread and lymph node metastasis showed no significant difference. In conclusion, low proliferative activity of thyroid papillary carcinomas are thought to be related with good prognosis.

• Journal of Chest Surgery
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• 제3권1호
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• pp.31-38
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• 1970

This is a report of three cases of successful embolectomy in peripheral arteries. First case was the patient who received a mitral commissurotomy 8 months ago. In that time, there was no evidence of left atrial thrombosis. He showed an embolism in the middle portion of left brachial artery without complaining of any ischemic pain. Embolectomy was performed 15 days after disappearance of radial pulse and resulted in no return of radial pulse postoperatively. Second case was a case of an embolism in lower portion of right brachial artery. She complained severe ischemic pain and cyanosis in the right forearm and fingers. She was also in the beginning state of cardiac failure, which was suspected from her hypertension associated with cardiomegaly and arrythmia Embolectomy was performed 17 hours after onset of acute pain. Immediate full pulsation of radial artery was obtained after embolectomy and the acute ischemic symptoms subsided gradually. Third case was an embolism in superior mesenteric artery which occured 24 hours after pneumonectomy for right bronchogenic carcinoma and the patient suddenly complained diffuse abdominal colicky pain. 7 hours after attack of abdominal pain. embolectomy with extensive reset ion of the small intestine was performed with uneventful recovery and without complication, such as short bowel syndrome, postoperatively. Histopathologically, the embolus was consisted of a tissue of anaplastic cell carcinoma, which was identical to the tumor of the resected right lung. Histological findings of other emboli of first and second case were old thrombus.

• Journal of Chest Surgery
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• 제15권3호
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• pp.278-284
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• 1982

As of today, the frequency of primary lung cancer is one of the improved problems in modern medicine and is increasing rapidly year by year. This study dealed with 138 cases of primary lung cancer proved by histopathologic examination in Thoracic & Card iovascular Surgery Dept. of N.M.C. from Sept. 1966 through June 1981. The majority of patients belong to 5th and 6th decade. Ratio between male and female was 3.7: 1. Initial symptoms were cough, blood tinged sputum, hemoptysis, chest pain, dyspnea and duration of symptoms before admission was within 6 months [60%] and 12 months [78%]. Histopathologically, 64 cases [61%] of them were the squamous cell carcinoma, 21 cases [15%] were the adenocarcinoma, 20 cases [14.8%] were the anaplastic carcinoma. Fifty-six cases were resectable: 43 cases were subjected to pneumonectomy and 13 cases were to lobectomy. The remaining 82 cases were nonresectable, but exploratory thoracotomy was performed in 22 cases of them. Among 56 resected cases, 33 cases were radically operated and 17 cases were subjected to palliative operation and 6 cases were subjected to extended operation. [Concomitant pericardium resection in 1 case and concomitant chest wall resection in 5 cases]. Surgical mortality was 10.7% and causes of death were aspiration of contralateral lung, respiratory insufficiency, postop. empyema with B.P.F, cardiogenic failure. This study analysed the cancer stage between preop clinical T.N.M. stage and postop. T.N.M. stage in 78 cases; resectable 56 cases and non-resectable 22 cases.

• Tuberculosis and Respiratory Diseases
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• 제75권5호
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• pp.181-187
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• 2013

The emergence of new therapeutic agents for non-small cell lung cancer (NSCLC) implies that histologic subtyping and molecular predictive testing are now essential for therapeutic decisions. Histologic subtype predicts the efficacy and toxicity of some treatment agents, as do genetic alterations, which can be important predictive factors in treatment selection. Molecular markers, such as epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) rearrangement, are the best predictors of response to specific tyrosine kinase inhibitor treatment agents. As the majority of patients with NSCLC present with unresectable disease, it is therefore crucial to optimize the use of tissue samples for diagnostic and predictive examinations, particularly for small biopsy and cytology specimens. Therefore, each institution needs to develop a diagnostic approach requiring close communication between the pulmonologist, radiologist, pathologist, and oncologist in order to preserve sufficient biopsy materials for molecular analysis as well as to ensure rapid diagnosis. Currently, personalized medicine in NSCLC is based on the histologic subtype and molecular status. This review summarizes strategies for tissue acquisition, histologic subtyping and molecular analysis for predictive testing in NSCLC.

• 대한두경부종양학회지
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• 제12권1호
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• pp.8-15
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• 1996

When thyroid carcinoma invades the larynx or trachea, the proper treatment is needed because of significant morbidity and mortality due to airway obstruction. Hemoptysis and dyspnea are the result of intraluminal extension of the tumor and call for immediate investigation with endoscopic examination and CT. If the thyroid carcinoma with extracapsular spread invades only outer perichondrium of the tracheal or laryngeal cartilage, the shaving operation would be sufficient, but if the tumor invades the cartilage or if there is intraluminal invasion, it is mandatory to remove partial or total part of some aerodigestive tract structures. We retrospectively analyzed 14 surgical cases of the thyroid cancer with laryngotracheal invasion(12 papillary carcinomas and 2 anaplastic carcinomas) at the Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital. The analysis was focused on clinical manifestation, pathologic findings, types of management and results. Survival result was not adequately analyzed due to some recently operated cases.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8271-8279
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• 2016

Background: Hepato-carcinogenesis is multifaceted in its molecular aspects. Among the interplaying agents are altered gap junctions, the proteasome/autophagy system, and mitochondria. The present experimental study was designed to outline the roles of these players and to investigate the tumor suppressive effects of curcumin with or without mesenchymal stem cells (MSCs) in hepatocellular carcinoma (HCC). Materials and Methods: Adult female albino rats were divided into normal controls and animals with HCC induced by diethyl-nitrosamine (DENA) and $CCl_4$. Additional groups treated after HCC induction were: Cur/HCC which received curcumin; MSCs/HCC which received MSCs; and Cur+MSCs/HCC which received both curcumin and MSCs. For all groups there were histopathological examination and assessment of gene expression of connexin43 (Cx43), ubiquitin ligase-E3 (UCP-3), the autophagy marker LC3 and coenzyme-Q10 (Mito.Q10) mRNA by real time, reverse transcription-polymerase chain reaction, along with measurement of LC3II/LC3I ratio for estimation of autophagosome formation in the rat liver tissue. In addition, the serum levels of ALT, AST and alpha fetoprotein (AFP), together with the proinflammatory cytokines $TNF{\alpha}$ and IL-6, were determined in all groups. Results: Histopathological examination of liver tissue from animals which received DENA-$CCl_4$ only revealed the presence of anaplastic carcinoma cells and macro-regenerative nodules. Administration of curcumin, MSCs; each alone or combined into rats after induction of HCC improved the histopathological picture. This was accompanied by significant reduction in ${\alpha}$-fetoprotein together with proinflammatory cytokines and significant decrease of various liver enzymes, in addition to upregulation of Cx43, UCP-3, LC3 and Mito.Q10 mRNA. Conclusions: Improvement of Cx43 expression, nonapoptotic cell death and mitochondrial function can repress tumor growth in HCC. Administration of curcumin and/or MSCs have tumor suppressive effects as they can target these mechanisms. However, further research is still needed to verify their effectiveness.

• 대한두경부종양학회지
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• 제30권2호
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• pp.53-61
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• 2014

Background and Objectives : Anaplastic thyroid carcinoma(ATC) is a rare but highly aggressive thyroid malignancy that is associated with an extremely poor survival despite the best multidisciplinary care. BRAF(V600E) mutation is detected in about a quarter of ATC, but unlike its high treatment response to selective BRAF inhibitor (PLX4032) in metastatic melanoma, the treatment response of ATC is reported to be low. The purpose of this study is to investigate the innate resistance mechanism responsible for this low treatment response to BRAF inhibitor and its effect on epithelial-mesenchymal transition(EMT). Materials and Methods : Two ATP cell lines, 8505C and FRO were selected and treated with PLX4032 and its drug sensitivity and effects on cell migration and EMT were examined and compared. Further investigation on the changes in signals responsible for the different treatment response to PLX4032 was carried out and the same experiment was performed on both orthotopic and ectopic xenograft mouse models. Results : FRO cell line was more sensitive to PLX4032 treatment compared to 8505C cell line. The resistance to BRAF inhibition in 8505C was due to increased expression of EGFR. Effective inhibition of both EGFR and p-AKT was achieved after dual treatment with BRAF inhibitor(PLX4032) and EGFR inhibitor(Erlotinib). Similar results were confirmed on in vivo study. Conclusion : EGFR-mediated reactivation of the PI3K/AKT pathway and MAPK pathway contributes to the relative insensitivity of BRAF(V600E) mutant ATC cells to PLX4032. Dual inhibition of BRAF and EGFR leads to sustained treatment response including cell invasiveness.

• Radiation Oncology Journal
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• 제36권2호
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• pp.103-113
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• 2018

Purpose: Anaplastic thyroid cancer (ATC) is a rare tumor with a lethal clinical course despite aggressive multimodal therapy. Intensity-modulated radiotherapy (IMRT) may achieve a good therapeutic outcome in ATC patients, and the role of IMRT should be assessed. We retrospectively reviewed outcomes for ATC treated with three-dimensional conformal radiotherapy (3D-CRT) or IMRT to determine the optimal treatment option and explore the role of radiotherapy (RT). Materials and Methods: Between December 2000 and December 2015, 41 patients with pathologically proven ATC received RT with a sufficient dose of ${\geq}40Gy$. Among them, 21 patients (51%) underwent surgery before RT. Twenty-eight patients received IMRT, and 13 received 3D-CRT. Overall survival (OS) and progression-free survival (PFS), patterns of failure, and toxicity were examined. Results: The median follow-up time for survivors was 38.0 months. The median and 1-year OS and PFS rates were 7.2 months and 29%, 4.5 months and 15%, respectively. Surgery significantly improved the prognosis (median OS: 10.7 vs. 3.9 months, p = 0.001; median PFS: 5.9 vs. 2.5 months, p = 0.007). IMRT showed significantly better PFS and OS than 3D-CRT, even in multivariate analysis (OS: hazard ratio [HR] = 0.30, p = 0.005; PFS: HR = 0.33, p = 0.005). Significantly higher radiation dose could be delivered with IMRT than 3D-CRT ($EQD2_{10}$ 66 vs. 60 Gy, p = 0.005). Only 2 patients had grade III dermatitis after IMRT. No other severe toxicity ${\geq}grade$ III occurred. Conclusion: Patients with ATC showed better prognosis through multimodal treatment. Furthermore, IMRT could achieve favorable survival rates by safely delivering higher dose than 3D-CRT.

• 대한암한의학회지
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• 제23권1호
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• pp.23-32
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• 2018

ALK 변이는 비소세포성 폐암에서 차지하는 비율은 높지 않지만 비소세포성 폐암의 발생률이 높기 때문에 환자 수는 적지 않다. ALK 저해제인 Crizotinib은 환자들의 무진행 생존을 평균 대략 4개월 정도 연장시키고 증상을 완화시키며 항암 치료를 받는 것에 비교하여 삶의 질을 향상시키는 치료성과를 거두었다. 하지만 약물 내성 발현은 주요 한계이며 여전히 ALK 변이 비소세포성 폐암 환자의 예후가 불량하므로 내성을 극복하고 지속적인 치료 반응을 유도하여 치료율을 상승시키기 위한 연구가 필요하다. 현재 폐암치료 한약제제인 삼칠충초정과 2세대 EGFR TKI 제제인 Afatinib의 동시 사용 시 상승효과가 나타난다는 연구결과는 보고되어 있지만 ALK 저해제인 Crizotinib과의 병용 치료와 관련한 연구는 시행된 바가 없었다. 본 증례는 삼칠충초정과 Crizotinib의 병용 투여를 통해 종양 크기의 불변 및 삶의 질 개선과 Crizotinib의 내성 억제 가능성 등을 보인 점에서 의의가 있으나 대조군이 없는 1례에 불과하여 Crizotinib의 단독 효과일 가능성을 배제할 수 없는 한계를 지닌다. 따라서 향후 삼칠충초정과 Crizotinib의 병용투여에 대한 추가적인 연구 및 임상시험을 통해 더욱 객관적인 효과 판정이 필요할 것으로 사료된다.