• 대한두경부종양학회지
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• 제14권2호
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• pp.199-205
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• 1998

Objective: Telomerase, a specialized ribonucleoprotein polymerase associated with cellular immortality, is expressed by most malignant cells and is inactive in most normal somatic cells. The assays of telomerase activity in various tumors have provided both diagnostic and prognostic information. This study was carried out to determine whether telomerase activity could be useful in distinguishing benign and malignant thyroid diseasees. Materials & Methods: Telomerase activity was determined using Oncor $TRAP_{EZE}^{TM}ELISA$ Telomerase Detection Kit for performing PCR-based telomeric repeat amplification protocol (TRAP) assay followed by ELISA detection in both normal and tumor tissues of 23 adenomatous hyperplasias, 12 follicular adenomas, 4 follicular carcinomas, 16 papillary carcinomas, 4 Hashimoto's thyroiditises and 3 malignant lymphomas. We also examined all cases microscopically to review the status of lymphoid infiltrate. Results: Of the 62 cases, extensive lymphoid infiltrates were contained in 20 tumor tissues(4 Hashimoto's thyroiditises, 3 malignant lymphomas, 6 adenomatous hyperplasias and 7 papillary carcinomas), all of which showed positive telomerase activity. All the normal tissues without lymphoid infiltrates(n=43) did not express telomerase activity. Of 42 tumor tissues without lymphoid infiltrates, 37(88.0%) showed positive telomerase activity: 13 of 17 adenomatous hyperplasias(76.5%), 11 of 12 follicular adenomas(91.7%), 4 of 4 follicular carcinomas(100.0%) and 9 of 9 papillary carcinomas(100.0%). Conclusions: Our methods showed high sensitivity in the detection of telomerase activity and the exclusion of lymphoid infiltrates may be important in telomerase assay. In our work, the measurement of telomerase activity was not useful in distinguishing benign and malignant thyroid diseases.

• 대한두경부종양학회지
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• 제2권1호
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• pp.61-66
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• 1986

저자들은 부갑상선 선종 3 예를 입상고찰과 함께 보고하는 바이다. 부갑상선 기능 항진증이 있는 환자에서 임상증상들이 각각 서로 달랐으며 증상의 다양성과 여러기관의 침범을 볼수 있었다. 제 1 예는 심한 근 쇄약을, 제 2 예는 좌 경골의 낭포성골병변을, 제 3 예는 상복부동통, 관절통 및 정신장애를나타냈다. 전례(全例) 모두에서 骨의 광물질(鑛物質) 소실(消失) (demineralization) 을 보였고 두 예에서는 경부 종괴가 촉지 되었고 나머지 한 예만 전형적인 낭포성 섬유성 골염 (Osteitis fibrosa cystica) 을 보였다. 3 예중 2 예는 주세포 선종 (Chief cell adenoma) 이었으며 나머지 한 예는 혼합성 세포형 (mixed cell type) 이었다. 저자들은 본 질환에 대한 진단기준, 외과적 수술방법 및 수술 성공 여부 판정에 대한 지침을 제시하고저 한다.

• Advances in pediatric surgery
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• 제13권2호
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• pp.162-168
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• 2007

Adrenocortical tumors are very rare in children and the clinical course is not clearly understood. The aim of this study is to review the clinical characteristics and courses of pediatric adrenocortical tumors. The medical records of patients who underwent surgery for primary adrenal tumor at the Department of Surgery, Seoul National University hospital, from Jan. 1986 to Feb. 2006 were reviewed. There were 10 adrenocortical tumor patients; 5 had adrenocortical adenoma and 5 adrenocortical carcinoma. All of the adrenocortical adenomas presented as functioning tumors, i.e., Cushing syndrome or virilization. However, only 2 patients had functioning adrenocortical carcinoma. Median size of adenoma was 5 (3.3-6) cm, and carcinoma 12.5 (6.5-13) cm. Adenomas were smaller than 6 cm and carcinomas were larger than 6.5 cm. Surgical resection alone cured all adrenocortical adenoma patients, and they were all alive without recurrence. Three of 5 adrenocortical carcinoma patients died of tumor recurrence despite radical surgery and chemotherapy. There were 2 long-term survivals for adrenocortical carcinoma, one patient survived 10 years without recurrence until he died of newly developed osteosarcoma, and the other patient is alive without recurrence for 20 years. As the prognosis of pediatric adrenocortical carcinoma is poor, peri-operative aggressive chemotherapy is suggested in addition to radical surgery.

• 대한비뇨기종양학회지
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• 제15권3호
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• pp.137-142
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• 2017

Purpose: To examine and compare the perioperative outcomes of laparoscopic adrenalectomy (LA) and to determine its efficacy in patients with nonfunctioning adrenal adenomas (NFA) and subclinical Cushing syndrome (SCS). Materials and Methods: We retrospectively analyzed the clinical data obtained from 79 consecutive patients who underwent LA for the treatment of either NFA (n=35) or SCS (n=44) between 2011 and 2016. All patients had undergone computed tomography, as well as endocrinological tests to confirm the diagnosis prior to the adrenalectomy. The primary endpoint was improved metabolic parameters relating to diabetes, hypertension, dyslipidemia, and obesity. Results: Patients with SCS compared to those with NFA showed a higher occurrence of diabetes (29.5% vs. 11.4%), hypertension (59.1% vs. 34.3%), and dyslipidemia (43.2% vs. 14.3%). Patients with SCS showed a smaller median tumor size compared to those with NFA (2.5 cm vs. 5 cm). No significant perioperative complications ${\geq}$ Clavien-Dindo classification grade III were observed in any patient (SCS or NFA group). In terms of their metabolic profile, patients with SCS showed a significant postoperative improvement in hypertension (50.0%), diabetes (53.9%), dyslipidemia (31.6%), and obesity (29.2%). However, patients with NFA showed a postoperative improvement only in dyslipidemia (40.0%) and obesity (4.8%). Conclusions: Owing to absence of significant perioperative complications and the marked postoperative improvement in metabolic impairment, LA is a useful treatment strategy in patients diagnosed with SCS. In contrast, LA was not observed to show beneficial effects in correcting/improving the metabolic profile in patients presenting with NFA.

• Korean Journal of Ophthalmology
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• 제32권6호
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• pp.488-496
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• 2018

Purpose: This study aimed to analyze the factors influencing visual field recovery after transsphenoidal approach-tumor resection (TSA-TR) in pituitary adenoma patients with visual field defects (VFDs). Methods: We retrospectively evaluated 102 eyes of 102 patients with VFDs induced by pituitary adenomas who underwent TSA-TR between January 2010 and December 2015. All patients had been observed for more than one year. The severity of the VFD in each patient was evaluated using the mean deviation (MD) and pattern standard deviation in the most-affected eye. Clinical and demographic data such as preoperative visual acuity and visual field, age, sex, tumor volume, neurological symptoms at diagnosis, duration of symptoms, patterns of the preoperative VFD, and preoperative central VFD were investigated and analyzed for association with recovery of the visual field. Results: Recovery from VFDs occurred in 71 (69.6%) eyes after a mean period of $18.36{\pm}5.21$ months. The recovery group was younger (p = 0.003), had higher preoperative MD values (p = 0.016), and had better preoperative visual acuity (p = 0.03), compared with the non-recovery group. Preoperative central VFD (p = 0.006) and preoperative bilateral VFD (p = 0.016) were significantly less frequent in the recovery group. Multivariate logistic regression revealed that age at diagnosis (odds ratio [OR], 0.962; p = 0.022), preoperative MD (OR, 1.069; p = 0.046), preoperative central VFD (OR, 0.212; p = 0.039), and preoperative bilateral VFD (OR, 0.212; p = 0.035) were associated with visual field recovery after TSA-TR. Conclusions: Younger age, higher preoperative MD, and the preoperative abscence of central VFD or bilateral VFD were favorable factors influencing visual field recovery after TSA-TR in patients with pituitary adenomas. An understanding of the associated clinical factors may help predict visual outcomes after TSA-TR in pituitary adenoma patients with VFDs.

• International journal of thyroidology
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• 제11권2호
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• pp.123-129
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• 2018

Background and Objectives: Hypermethylation of the tumor suppressor gene RASSF1A and activating mutation of BRAF gene have been recently reported in thyroid cancers. To investigate the role of these two epigenetic and genetic alterations in thyroid tumor progression, methylation of RASSF1A and BRAF mutation were examined in thyroid tumors. Materials and Methods: During 2007 to 2017, 69 papillary carcinomas, 18 nodular hyperplasia, 3 follicular carcinomas, and 13 follicular adenomas were selected. The methylation-specific polymerase chain reaction (MSP) technique was used in detecting RASSF1A methylation and polymerase chain reaction (PCR)-single-stranded conformation polymorphism and sequencing were used for BRAF gene mutation study. Results: The hypermethylation of the RASSF1A gene was found in 84.6%, 100% and 57.9% of follicular adenomas, follicular carcinomas, and papillary carcinomas, respectively. Nodular hyperplasia showed a hypermethylation in 33.3%. The BRAF mutation at V600E was found in 60.7% of papillary carcinoma and 27.0% of nodular hyperplasia, but none of follicular neoplasms. The BRAF mutation was correlated with the lymph node metastasis and MACIS clinical stage. There is an inverse correlation between RASSF1A methylation and BRAF mutation in thyroid lesions. Conclusion: Epigenetic inactivation of RASSF1A through aberrant methylation is considered to be an early step in thyroid tumorigenesis, and the BRAF mutation plays an important role in the carcinogenesis of papillary carcinoma, providing a genetic marker.

• Journal of Korean Neurosurgical Society
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• 제62권2호
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• pp.256-262
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• 2019

Objective : Pituitary adenomas (PAs) are often detected as incidental findings. However, the natural history remains unclear. The objective of this study was to evaluate the natural history and growth pattern of untreated PAs. Methods : Between 2003 and 2014, 59 PAs were managed with clinico-radiological follow up for longer than 12 months without any kind of therapeutic intervention. Tumor volumes were calculated at initial and last follow-up visit, and tumor growth during the observation period was determined. Data were analyzed according to clinical and imaging characteristics. Results : The mean initial and last tumor volume and diameter were $1.83{\pm}2.97mL$ and $13.77{\pm}6.45mm$, $2.85{\pm}4.47mL$ and $15.75{\pm}8.08mm$, respectively. The mean annual tumor growth rate was $0.33{\pm}0.68mL/year$ during a mean observation period of $46.8{\pm}32.1months$. Sixteen (27%) PAs showed tumor growth. The initial tumor size (HR, 1.140; 95% confidence interval, 1.003-1.295; p=0.045) was the independent predictive factor that determined the tumor growth. Six patients (11%) of 56 conservatively managed non-symptomatic PAs underwent resection for aggravating visual symptoms with mean interval of 34.5 months from diagnosis. By Cox regression analysis, PAs of last longest diameter over 21.75 mm were a significant prognostic factor for eventual treatment. Conclusion : The initial tumor size of PAs was independently associated with the tumor growth. Six patients (11%) of conservatively managed PAs were likely to be treated eventually. PAs of last follow-up longest diameter over 21.75 mm were a significant prognostic factor for treatment. Further studies with a large series are required to determine treatment strategy.

• Clinical Endoscopy
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• 제55권6호
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• pp.760-766
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• 2022

Background/Aims: Endoscopic submucosal dissection (ESD) is an effective method for resecting gastric adenomas and adenocarcinomas. A significant discrepancy was observed between endoscopic and pathological sizes in samples obtained from patients undergoing ESD. This study elucidates the factors affecting size discrepancy after formalin fixation. Methods: The records of 64 patients with 69 lesions were analyzed, including 50 adenomas and 19 adenocarcinomas. Data on location, gross shape, histology, and size after fixation in formalin were collected. Results: The mean size of the resected specimen appeared to decrease after formalin fixation (37.5 mm prefixation vs. 35.8 mm postfixation, p<0.05). The mean long axis diameter of the lesions was 20.3±7.9 mm prefixation and 13.4±7.9 mm postfixation. Size differences in lesions smaller than 20 mm were significantly greater than those in lesions larger than 20 mm (7.6±5.6 mm vs. 2.5±5.8 mm, p<0.01). In multivariate analysis, a tumor size of ≥20 mm was found to be an independent factor affecting size postformalin fixation (p<0.05). Conclusions: The endoscopic size of lesions before ESD may be underestimated in tumors larger than 20 mm in size. Therefore, increased attention must be paid during ESD to avoid instances of incomplete resection.

• Journal of Gastric Cancer
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• 제1권1호
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• pp.55-59
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• 2001

Purpose: Several studies of an endoscopic mucosal resection(EMR) have been reported, but reports about benign protruding lesions that arise at the scar of EMR for early gastric cancer (EGC) or a gastric adenoma are rare. The purpose of this study was to elucidate endoscopic and histological characteristics of benign protruding lesions which arise at the scar of an EMR for EGC and a gastric flat adenoma. Materials and Methods: In 101 lesions (73 gastric flat adenomas and 28 EGCs) from 96 patients, 16 lesions developed new protruding lesions that arose at the scar of the EMR. We retrospectively analyzed the endoscopic findings of initial and protruding lesions, and several other clinical factors (H. pylori infection, eradication therapy, and proton pump inhibitor (PPI) or H2-blocker use). Results: 1. The mean duration until detection of the protruding lesion was 8.9 months ($1.5\∼27$). Protruding lesions arose at the scar of the EMR in 1 of 28 EGCs ($3.6\%$) and from 15 of 73 gastric flat adenomas ($20.5\%$). All of the patients were men. 2. With respect to the endoscopic findings, the shapes of the protruding lesions were as follows: 10 Yamada (Y) I, 4 Y-II, 1 Y-III, and 1 flat lesion. Histological examination of the protruding lesions revealed regenerating hyperplasia in 5 lesions, intestinal metaplasia in 5, and both in 6. 3. The incidence of these lesions was higher in cases of tubular adenomas with focal high-grade dysplasia than in cases of tubular adenomas without dysplasia (p<0.05). 4. The incidence of H. pylori infection was higher in patients ($81.7\%$) who developed a protruding lesion than in those ($51.8\%$) who did not develop (p=0.029); also, the incidence of use of PPI was higher in those patients (p=0.045). However, eradication therapy for H. pylori and duration of use of PPI or H2-blocker showed no difference between groups. Conclusions: It may be possible that the potential hyperplasia that may reside in normal mucosa surrounding EGC or a gastric adenoma might awaken during the healing process of the EMR ulcer and develop to benign protruding lesions. And, H. pylori and PPI might also be related to the development of the protruding lesions.

• 한국독성학회:학술대회논문집
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• 한국독성학회 2003년도 춘계학술대회 논문집
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• pp.39-40
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• 2003

Ochratoxin A (OA), a potent nephrotoxin in several species, is knownto be a renal carcinogen in animals and is implicated in the etiology of Balkan endemic nephropathy (BEN). The NTP (National Toxicology Program) classified Ochratoxin A as having clear evidence of carcinogenic activity, based on uncommon tubular adenomas and tubular cell carcinomas of the kidney and multiple fibroadenomas of the mammary gland, seen in the rat.(omitted)