• Journal of Chest Surgery
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• 제32권8호
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• pp.726-731
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• 1999

목적 및 배경: 세포사를 조절하는 암유전자 산물인 bcl-2 단백과 암억제유전자 산물인 p53 단백은 암의 발생 에 관여하는 것으로 알려져 있다. 최근 종양 조직내에서 bcl-2 단백 및 p53 단백의 발현과 종양의 악성도 및 예후와의 관련성에 대한 연구가 활발하게 진행되고 있으나 흉선종에서의 연구는 미흡한 실정이다. 대상 및 방법: 1984년부터 1997년까지 고신대학교 복음병원 흉부외과에서 수술 치험한 흉선상피종 중 병리 조직의 보관이 비교적 양호하고 병록 기록지가 충실한 30례를 대상으로 Rosai씨 분류법 및 Masaoka 병기와 중증근 무력증의 동반 여부에 따라 분류하고 종양조직을 이용하여 면역조직화학 검사를 시행하여 각 분류에 따른 bcl-2 단백과 p53 단백의 발현율, 그리고 bcl-2 단백과 p53 단백의 발현간에 상관관계를 조사하였다. 결과: bcl-2 단백은 비침습성 흉선종에는 발현된 경우가 없었고 침습성 흉선종 10례 중 3례(30%), 흉선암 11례 중 8 례(61.5%)에서 발현되어 악성도가 높을수록 발현율이 높게 나타났다(p=0.021). p53 단백은 비침습성 흉선종에 서 1례(14.3%), 침습성 흉선종 5례(50%), 흉선암 8례(61.5%)에서 발현되어 악성도가 높을수록 발현율이 높아 지는 경향을 보였으나 통계학적 유의성은 없었다(p=0.126). 17례의 흉선종의 Masaoka 병기(1기 5례, 2기 7례, 3기 2례, 4a기 3례)에 따른 bcl-2 단백은 1기와 4a기에서는 발현 예가 없었고, 2기 1례(14.3%), 3기 2례(100%) 에서 발현되어 병기가 진행할 수록 높은 발현율을 보였고(p=0.011), p53 단백은 1기 1례(20%), 2기 2례 (28.6%), 3기 2례(100%), 4a기 1례(33.3%) 발현되어 p53 단백 역시 병기가 진행할 수록 발현율이 높아지는 경 향을 보였으나 통계학적 유의성은 없었다(p=0.229). 중증근무력증의 동반 여부와 bcl-2단백, p53 단백의 발현 과는 무관하였다. bcl-2 단백과 p53 단백의 발현간의 상관관계는 bcl-2 단백과 p53 단백의 발현이 일치하는 경우가 23례(76.7%), 불일치하는 경우가 7례(23.3%)로 상관관계가 있는 것으로 나타났다(kappa치=0.525). 결 론: 흉선상피종 조직내 bcl-2 단백의 발현은 종양의 악성도를 반영하는 것으로 나타났고 p53 단백은 종양의 악성도와 관련이 없는 것으로 나타났다. 그럼에도 두 단백의 발현간에 상관관계가 있는 것으로 나타나 이의 규명을 위해서는 향후 p53 단백의 유전자 변이와 두 단백의 발현과 환자의 생존율과의 상관관계에 대한 연 구가 요할 것으로 사료된다.

• Journal of Chest Surgery
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• 제18권4호
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• pp.849-854
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• 1985

We have experienced 50 cases of mediastinal tumors and cysts from March, 1979 to August, 1985 at Kyung Hee University Hospital. The results of this cases analysis were as followings; 1. Of all 50 mediastinal tumors and cysts, 26 patients were male and 24 patients were female. There was no sex preference. The age distribution was from 27 months to 64 years, and mean age was 33.5 years old, and also no age preference. 2. The most common mediastinal tumor was benign cysts [12 cases], which comprise 24% of all mediastinal tumors and cysts. The second common mediastinal tumor was teratoma [9 cases-18%], and followed by thymic tumors and tuberculous granuloma [7 cases-14% each], neurogenic tumors [5 cases-10%], and other tumors [10 cases-20%]. 3. The anterior mediastinum was most common tumor location, and followed by middle, superior, and posterior. 4. All 9 teratomas were developed at anterior mediastinum, and 4 of 5 neurogenic tumors were developed at posterior mediastinum. Thymomas were developed at anterior and superior mediastinum. The bronchogenic cysts had no predilection of location. 5. The most common chief complaint at admission was chest pain or discomfort [23 cases-46%], and followed by cough with or without sputum, and exertional dyspnea. Asymptomatic patients were only 7 patients [24%]. 6. Of all 50 cases, 38 cases [76%] received radical tumor resection, 7 mediastinoscopic biopsy, 3 explo thoracotomy and biopsy, and 1 neck mass biopsy. 7. There were 2 hospital deaths, one of which was a patient who suffered malignant thymoma and Myasthenia Gravis. The patient received radical tumor excision, but died at 7th POD. The other patient was a patient with malignant transformation of the benign cystic teratoma. The operative mortality was 4%.

• Advances in pediatric surgery
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• 제14권1호
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• pp.83-87
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• 2008

Accessory cervical thymic tissue has been rarely reported. However, it should be included in the differential diagnosis of neck masses in children, along with branchial anomalies, lymph nodes and other tumors. This lesion occurs along the descending line of the thymus between the angle of mandible and superior mediastinum. A 2-month-old infant presented with an asymptomatic left sided neck mass. MRI revealed a well defined homogeneous mass in the deep lobe of left parotid gland. At operation, an easily identified soft tissue mass was found in the left submandibular area, measuring $3{\times}1.5cm$. It was completely excised. Microscopic examination revealed normal thymic tissue.

• 약학회지
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• 제59권4호
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• pp.164-169
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• 2015

In the present study, we determined the effect of $18{\beta}$-glycyrrhetinic acid ($18{\beta}$-GA) in the mice model bearing xenografts of HT-29 human colon cancer cell line. Data from the cytotoxicity assay displayed that $18{\beta}$-GA induced cell death in HT-29. The cytotoxicity was enhanced as the $18{\beta}$-GA treatment was prolonged. In case of 72 hrs treatment, $LD_{50}$ of $18{\beta}$-GA was approximately $90{\mu}M$, and the efficacy at $100{\mu}M$ of $18{\beta}$-GA appeared to be equivalent to that of doxorubicin at $1{\mu}M$. Based on the in vitro data, we tested the anti-tumor effect of $18{\beta}$-GA in thymic mice (Balb/c strain). Xenograft tumors were generated by subcutaneous injection of HT-29 ($3{\times}10^6cells/mouse$) to mice and the mice were treated intraperitoneally with $18{\beta}$-GA ($50{\mu}g/time/mouse$) every other day for 4 times. The tumor volumes were measured for a period of 14 days. Data displayed that the $18{\beta}$-GA treatment reduced the tumor volumes (P < 0.05) as compared to control mice. However, this activity was demolished when athymic mice (Balb/c nu/nu) were used instead of thymic mice. This observation appeared that T lymphocyte played an important role in the anti-tumor activity. In conclusion, our results indicate that $18{\beta}$-GA has anti-tumor activity in HT-29 tumor-bearing mice, which may be associated with T cells.

• Tuberculosis and Respiratory Diseases
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• 제51권3호
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• pp.281-288
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• 2001

저자들은 운동성 호흡곤란과 경부 림프절 종대로 내원한 환자의 전종격동에서 발견된 편평상피세포암에 대한 면역조직화학 염색 검사상 cytokeratin 13에는 양성이고 CD5와 cytokeratin 7에는 음성이었지만 임상적, 방사선학적, 수술적 소견, 그리고 조직학적 소견을 바탕으로 흉선암에 준해 치료한 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Korean Journal of Radiology
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• 제20권4호
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• pp.671-682
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• 2019

Objective: To investigate whether computed tomography (CT) and fluorine-18-labeled fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) may be applied to distinguish thymic epithelial tumors (TETs) from benign cysts in the anterior mediastinum. Materials and Methods: We included 262 consecutive patients with pathologically proven TETs and benign cysts 5 cm or smaller who underwent preoperative CT scans. In addition to conventional morphological and ancillary CT findings, the relationship between the lesion and the adjacent mediastinal pleura was evaluated qualitatively and quantitatively. Mean lesion attenuation was measured on CT images. The maximum standardized uptake value (SUVmax) was obtained with FDG-PET scans in 40 patients. CT predictors for TETs were identified with multivariate logistic regression analysis. For validation, we assessed the diagnostic accuracy and inter-observer agreement between four radiologists in a size-matched set of 24 cysts and 24 TETs using a receiver operating characteristic curve before and after being informed of the study findings. Results: The multivariate analysis showed that post-contrast attenuation of 60 Hounsfield unit or higher (odds ratio [OR], 12.734; 95% confidence interval [CI], 2.506-64.705; p = 0.002) and the presence of protrusion from the mediastinal pleura (OR, 9.855; 95% CI, 1.749-55.535; p = 0.009) were the strongest CT predictors for TETs. SUVmax was significantly higher in TETs than in cysts (5.3 ± 2.4 vs. 1.1 ± 0.3; p < 0.001). After being informed of the study findings, the readers' area under the curve improved from 0.872-0.955 to 0.949-0.999 (p = 0.066-0.149). Inter-observer kappa values for protrusion were 0.630-0.941. Conclusion: Post-contrast CT attenuation, protrusion from the mediastinal pleura, and SUVmax were useful imaging features for distinguishing TETs from cysts in the anterior mediastinum.

• Journal of Chest Surgery
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• 제22권2호
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• pp.272-289
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• 1989

Benign lung tumors compose a heterogeneous group of solid growths that present variations in clinical features, depending on whether the origin is within the bronchus on lung parenchyma or from visceral pleura. Benign tumors of the lung are relatively uncommon, and series are to be found in the literature and the classification of benign tumors of the lung continues to be controversial because of disagreement concerning the origin and prognosis of many common lesions. We adopt Liebows original classification but excluded bronchial adenoma which no longer considered as benign tumor and added pulmonary A-V fistula and congenital cystic adenomatoid malformation. We analyzed 61 cases of benign tumors which were composed of 16 original Korean cases and 45 cases which were reported on journal of Thoracic & Cardiovascular Surgery. The results were. [1] Incidence; Of 61 cases, chondromatous hamartoma was 2 cases [41 %], congenital cystic adenomatoid malformation 10 cases [16.4 %], pulmonary A-V fistula 5 cases [8.1 %], sclerosing hemangioma 4 cases [6.5 %], teratoma, plasma cell granuloma & mesothelioma were 3 cases [4.9%], Castlemans disease 2 cases [3.3%], and mucous gland adenoma, paraganglioma, and leiomyoma 1 case [1.6 %]. [2] Age & Sex distribution; Male 30 cases and female 31 cases. Mean age was 31.4 years old. [3] Main symptom; was coughing, 32.8%, and no symptom, 24.6%. [4] Sixty eight percentage of chest film showed mass density, and 4 cases showed calcification, 2 cases had lobulation. [5] Size of mass was large and multiple mass was 2 cases. Endobronchial tumors were 9 cases, 14.9 %. [6] Three cases of endobronchial tumor were preoperatively diagnosed by bronchoscopy and 2 cases of pulmonary A-V fistula were diagnosed by pulmonary arteriography. [7] Seven cases, 11.5%, had associating diseases such as bronchogenic cyst, thymic cyst, Schwannoma, situs inversus, bronchiectasis and bronchogenic carcinoma. [8] Minor resection such as excision 8i: wedge resection were 15 cases, 26.2 %, and 6 cases, 75.4 %, of lobectomy were performed including 5 cases of pneumonectomy 5 cases had. [9] Postoperative complications; One case, 1.6 %, expired due to respiratory insufficiency. Two cases had re-operation due to bleeding and hemoptysis.

• Journal of Chest Surgery
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• 제55권2호
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• pp.126-142
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• 2022

Background: Thymic epithelial tumors (TETs) are rare, and information regarding their surgical outcomes and prognostic factors has rapidly changed in the past few decades. We analyzed surgical treatment practices for TETs and outcomes in terms of overall survival (OS) and freedom from recurrence (FFR) during a 13-year period in Korea. Methods: In total, 1,298 patients with surgically resected TETs between 2000 and 2013 were enrolled retrospectively. OS and FFR were calculated using the Kaplan-Meier method and evaluated with the log-rank test. Prognostic factors for OS and FFR were analyzed with multivariable Cox regression. Results: A total of 1,098 patients were diagnosed with thymoma, and 200 patients were diagnosed with thymic carcinoma. Over the study period, the total number of patients with surgically treated TETs and the proportion of patients who underwent minimally invasive thymic surgery (MITS) increased annually. The 5-year and 10-year survival rates of surgically treated TETs were 91.0% and 82.1%, respectively. The 5-year and 10-year recurrence rates were 86.3% and 80.0%, respectively. The outcomes of surgically treated TETs improved over time. Multivariable Cox hazards analysis for OS, age, tumor size, and Masaoka-Koga stage were independent predictors of prognosis. The World Health Organization classification and tumor-node-metastasis (TNM) staging were also related to the prognosis of TETs. Conclusion: Surgical treatment of TETs achieved a good prognosis with a recent increase in MITS. The M-K stage was the most important prognostic factor for OS and FFR. The new TNM stage could also be an effective predictor of the outcomes of TETs.

• Journal of Chest Surgery
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• 제30권1호
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• pp.55-60
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• 1997

본 인제대학교 의과대학 서을 백병원 흉부외과학교실에서는 1987년 9월 부터 1995년 12월까지 원발성 종격동 종양의 진단하에 수술을 시행한 40례를 대상으로 하여 임상적 고찰을 하였다. 관찰 대상은 남자 18례와 여자 22례로 연령은 Vll에서 68세까지 였으며 평균 )4.1세였다. 종양의 진단시 증상은 흉통(12.5%), 기침(12.5%), 호흡곤란(7.5%) 경부종괴(7.5%), 흉부불쾌감(5.0%) 등이었다. 진단은 모든 예에서 단순 흉부엑스선 사진과 흉부 전산화단층촬영을 실시하였고 5례 에서는 자기공명영상을 시행하였다. 경피적 침생검은 22례에서 시행하여 16례에서 조직학적 진단을 얻었다(민감도 72.7%). 종양의 위치별 분포는 전상부 종격동 24례(60.0%), 후부 종격동 14례(35.0%), 중부 종격동 2례(5.0%)였다. 종양의 종류는 흉선종 11례(27.5%), 신경성종양 10례(25.0%), 배아세포종 7례(17.5%), 낭종 8례(20.0%), 거대 림프 절비대(Castleman's disease) 2례(5.0%), 방추세포육종 1례(2.5%) 그리고 림프종 1례(2.5%), 였다. 악성 종양은 5례로 침습성 흉선종 3례, 방추세포육종 1례, 림프종 1례였다. 치료는 양성의 모든 예와 악성종양 3례에서 완전절제하였고, 2례는 수술이 불가능하였다. 수술후 사망은 없었고 합병증은 창상피열, 성대마비, 어깨강직이 각각 1례씩 있었다.

• Tuberculosis and Respiratory Diseases
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• 제56권1호
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• pp.103-108
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• 2004

저자들은 44세 여환에서 흉부 단순 촬영상 심장비대로 오인되어 순환기내과로 전원된 환자에서 흉선지방종으로 진단 후 수술적제거로 치료한 환자 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.