• Korean Journal of Head & Neck Oncology
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• v.13 no.1
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• pp.74-80
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• 1997

We have experienced 5 cases of unusual well differentiated thyroid carcinoma with insular component during the past 5 years. 4 cases were presented with cervical masses but I case (patient 2.) was initiallty with lung and brain metastasis. The tumors from 4 cases showed invasive growths but that of 1 cases(patient 1.) showed intrathyroidal. Total thyroidectomy and cervical lymphnode dissection(CCND or RND) was performed in 4 cases but only RND was performed in spite of mediastinal metastasis of the tumor in patient 5 under the patient's choice. During the follow-up period, we also performed radical nephrectomy and metastatectomy for the kidney and iliac bone metastasis respectively, in patint 2. Microcsopically, the tumors showed the insular growth patterns, focally(less than 50%) in 3 cases and predominantly(more than 75%) in 2 cases. And the insular componentas were combined with papillary carcinoma in 2 cases and follicular carcinoma in 3 cases. Cervical lymphnode metastases were confirmed in 4 cases. Patient 2 died of disease with metastases to lung, brain, bone and kidney, 52 months after initial therapy. Patient 1, 3 and 4 are alive and have no recurrence and distant metastasis. Patient 5 is also alive with the mediastinal metastasis. In our experience, the well differentiated thyroid carcinomas with insular component showed characteristic histologic features, aggressive behavior in initial presentation and unfavorable prognosis regardless of the percentage of the insular component.

• Journal of Korean Neurosurgical Society
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• v.29 no.9
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• pp.1195-1203
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• 2000

Objective : To confirm the efficacy of functional hemispherectomy and peri-insular hemispherotomy on treatment of intractable epilepsy. Materials & Methods : From April 1997 to February 1999, we performed 1 functional hemispherectomy and 6 peri-insular hemispherotomy in 7 consecutive patients. These procedures result in completely disconnected hemisphere while maintaining the disconnected portion of the hemisphere intact within the surgical cavity. The indications were hemimegalencephaly in 2 cases, infarction with encephalomalacia in 2, Sturge-Weber syndrome in 1, hemiconvulsion hemiplegia epilepsy syndrome in 1, cortical dysplasia with leptomeningeal cyst in 1. Mean follow-up is 15.8 months(range 8-28 months). Results : Among 7 patients, 1 patient died immediately after peri-insular hemispherotomy. Five patients became seizure free with reduced doses of medications. One patient developed rare disabling seizure with medication. In 6 patients, there were improvements in the function of the hemiparetic limbs in the postoperative phase. A 3-year-old boy with infarction and encephalomalacia died few hours after surgery due to postoperative hypothermia. Two patients required shunt after surgery. Two patients developed postoperative brain swelling but were successfully managed with conservative care. Conclusion : In conclusion, functional hemispherectomy and peri-insular hemispherotomy may provide substantial seizure control in selected cases of young hemiplegic patients with intractable epilepsy.

• Korean Journal of Head & Neck Oncology
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• v.21 no.2
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• pp.178-182
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• 2005

Insular carcinoma(poorly differentiated thyroid cancer) is defined as a aggressive, follicular-derived thyroid carcinoma with behavior intermediate between follicular/papillary and anaplastic carcinomas. It was described by Carcangiu in 1984, but its prognosis, classification and the origin is not yet clear. And preoperative fine needle aspiration cytology of insular carcinoma has not been satisfactory. We experienced a case of advanced thyroid insular carcinoma with invasion of the sternum. So we intend to present the case with a review of the related literatures.

• Journal of architectural history
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• v.20 no.6
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• pp.41-56
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• 2011

This study mainly examined the unit space (room) called 'MARI' of the private houses that were built between the 19c and the early 20c in the insular areas of southwestern sea. Generally, this region has unique historicity (restructure of the insular environment in the 17c and the 18c) and geographic environment that are different from inland regions thus the environment is presumed as a related factor to developments and structures of the private houses. 'MARI' is a noticeable space that is installed in a main building without an exception even in small 3 bedroom private houses. Its nature has location and usage distinctions in an architectural plan with similar 'MARU' of inland Jeollanam-Do. There are large crocks filled with grains at MARI. Thus, MARI is a storage room. Mostly rice and various other kinds of grains are stored in the several crocks, large and small. Many household goods are kept here as well. Another peculiar function of MARI is that this space commonly enshrines ancestral tablets of three generations. Hence, MARI takes a role of a shrine of an aristocratic house from an inland region. Considering the size of the house and space, this seems to be a very unprecedented utilization of area. MARI is located at the top (at the head of the house) on the floor plan. In other words, it is located at the space in the highest rank. The importance of ancestor worship and grains is evinced architecturally. It is really interesting fact that MARI is also located within recently built modern houses (Cheongsan Island, Joyak Island, etc.). Therefore, it can be said that the unique MARI tradition of this region has an intact continuity even today. After all, MARI has a great significance as a unique unit space of insular areas of southwestern sea that is installed in the main buildings of all houses regardless of size and shape of the houses, and their insular locations.

• The Korean Journal of Cytopathology
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• v.14 no.1
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• pp.17-21
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• 2003

Insular carcinoma of the thyroid(ICT) is an uncommon thyroglobulin-producing neoplasm, intermediate between well differentiated and anaplastic carcinoma. Only a few publications have addressed the fine needle aspiration cytologic(FNAC) findings from ICT. We experienced a case histologically diagnosed as ICT and with preoperative FNAC in a 52 - year - old woman. The FNAC displayed scanty colloid and abundant monomorphic follicular cells presented singly, in small loose aggregates, and in cohesive trabecular or acinar clusters. Intact insulae of tumor cells were also identified. Necrosis and mitosis were rare. Tumor cells showed round and monomorphic nuclei, finely granular chromatin, and inconspicuous nucleoli. When insular structure is identified in thyroid FNAC specimen, ICT should be included in the differential diagnosis. Herein we discuss and review the cytologic criteria for separation of ICT from other thyroid neoplasms.

• The Korean Journal of Cytopathology
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• v.9 no.1
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• pp.117-121
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• 1998

Cytologic features of a poorly differentiated "insular" carcinoma of the thyroid are presented. In fine needle aspiration cytology, the aspirates were highly cellular and tumor cells were arranged in loose cluster or singly dispersed on focally necrotic background. Occasional microfollicles were evident. The tumor cells had poorly defined, scanty cytoplasm and most of the nuclei were fairly uniform with coarse chromatin pattern. A few large pleomorphic cells were also noted. The cytologic findings of the present case were correlated well with the histologic findings, which showed typical insular pattern and the presence of uniform cells with occasional pleomorphism.

• The Korean Journal of Cytopathology
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• v.5 no.1
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• pp.35-40
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• 1994

A case of poorly differentiated "insular" carcinoma of the thyroid is presented and discussed with references to the literature. Un fine needle aspiration cytology of our case, the aspirates were highly cellular with tumor cells appearing as dispersed isolated cells as well as in dense clusters and syncytial formations. Occasional microfollicles containing colloid were evident. Most of nuclei were fairly uniform with considerable variability and a few showed definite atypical features. Nuclear grooving was additional features. Necrotic debris was not seen. Our cytologic findings were correlated well with histology, confirming typical insular pattern of tumor cells with the presence of occasional pleomorphic cells and papillary carcinoma-like features. With much attention to cytological features of insular carcinoma, it would be possible to diagnose a preoperative suggestive diagnosis, even though not definitive.

• The Korean Journal of Cytopathology
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• v.5 no.1
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• pp.46-51
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• 1994

Fine needle aspiration cytologic features of a case of insular carcinoma of the thyroid in a 23-year-old woman who presented a palpable neck mass is described. The aspirate showed cellular smear arranged in trabeculae, solid or loose clusters, and microfillicles in necrotic background. The tumor cells had uniform, small round, hyperchromatic nuclei. The chromatin was finely granular, and nuclear membrane was smooth. Nucleoli were not discernible. Nuclear pleomorphism was minimal. The cytoplasm was usually scanty, pale, poorly outlined, and almostly amphophilic. Sometimes paranuclear cytoplasmic vacuoles were noted. final diagnosis was confirmed by total thyroidectomy as insular carcinoma.

• Investigative Magnetic Resonance Imaging
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• v.15 no.1
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• pp.67-71
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• 2011

Purpose : To compare T2 relaxation times (T2) in the cingulate cortex, amygdaloid body, hippocampal body, and insular cortex between 1.5T and 3.0T MR imagers. Materials and Methods : Twelve healthy volunteers underwent FLAIR and CPMG imaging perpendicular to the hippocampal body at both 3.0T and 1.5T. T2 was measured in the cingulate cortex, amygdaloid body, hippocampal body, and insular cortex. The T2 relaxation time ratios of the cingulate cortex, insular cortex, and amygdaloid body to the hippocampal body were compared between 1.5T and 3.0T. Results : The mean T2 of the cingulate cortex, amygdaloid body, hippocampal body, and insular cortex at 1.5T were $109.5{\pm}3.1$, $117.0{\pm}7.1$, $114.7{\pm}2.4$, and $111.3{\pm}2.4$, respectively; $99.7{\pm}3.8$, $100.7{\pm}4.3$, $97.9{\pm}3.4$, and $96.2{\pm}2.0$, respectively, at 3.0T. Percentage changes of T2 in the cingulate cortex, insular cortex, amygdaloid body, and hippocampal body at 3.0T with respect to those at 1.5T were -8.9%, -13.5%, -14.6%, and -13.5%, respectively. The mean T2 ratios of the cingulate gyrus, insular cortex, and amygdaloid body to the hippocampal body at 1.5T and 3.0T were 0.96 and 1.02 (p = 0.003); 1.02 and 1.03 (p>0.05); 0.97 and 0.98 (p>0.05), respectively. Conclusion : T2 decrease in the cingulate cortex was less than the amygdaloid body, insular cortex, and hippocampal body at 3.0T. The mean T2 ratio of the cingulate gyrus to the hippocampal body was significantly different between 1.5T and 3.0T.

• Korean Journal of Acupuncture
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• v.38 no.3
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• pp.162-174
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• 2021

Objectives : We aimed to identify the antidepressant effect of liver tonification acupuncture treatment (ACU (LT); KI10, LR8, LU8, LR4) and four gate acupuncture treatment (ACU (FG); LI4, LR3) and its brain neural activity in the normal and chronic restraint stress (CRS)-induced mouse model. Methods : Firstly, normal mice were given ACU (LT) or ACU (FG) and the c-Fos expressions in each brain region were analyzed to examine brain neural activity. Secondly, CRS was administered to mice for 4 weeks, then ACU (LT) or ACU (FG) was performed for 2 weeks. The depression-like behavior was evaluated using open field test (OFT) before and after acupuncture treatment. Then, the c-Fos expressions in each brain region were analyzed to examine brain neural activity. Results : In normal mice, ACU (FG) regulated brain neural activities in the hypothalamus, hippocampus, and periaqueductal gray. ACU (LT) changed more brain regions in the prefrontal cortex, insular cortex, striatum, and hippocampus, including those altered by ACU (FG). In CRS-induced model, ACU (LT) alleviated depression-like behavior more than ACU (FG). Also, brain neural activities in the motor cortex area 2 (M2), agranular ventral part and piriform of insular cortex (AIV and Pir), and cornu ammonis (CA) 1 and CA3 of hippocampus were changed by ACU (LT), and those of AIV and CA3 were also changed by ACU (FG). As in normal mice, ACU (LT) resulted in changes in more brain regions, including those altered by ACU (FG) in CRS model. M2, Pir, and CA1 were only changed by ACU (LT) in depression model, suggesting that these brain regions reflect the specific effect of ACU (LT). Conclusions : ACU (LT) relieved depression-like behavior more than ACU (FG), and this acupuncture effect was associated with modulation of brain neural activities in the motor cortex, insular cortex, and hippocampus.