Yoon Yang Jung

Protective Effect of Phosphatidylcholine on Lipopolysaccharide-Induced Acute Inflammation in Multiple Organ Injury

Soybean polyunsaturated phosphatidylcholine (PC) is thought to exert anti-inflammatory activities and has potent effects in attenuating acute renal failure and liver dysfunction. The aim of this study was to investigate the effects of PC in protecting multiple organ injury (MOI) from lipopolysaccharide (LPS). Six groups of rats (N=8) were used in this study. Three groups acted as controls and received only saline, hydrocortisone (HC, 6 mg/kg, i.v.) or PC (600 mg/kg, i.p.) without LPS (15 mg/kg, i.p.) injections. Other 3 groups, as the test groups, were administered saline, HC or PC in the presence of LPS. Six hours after the LPS injection, blood and organs (lung, liver and kidney) were collected from each group to measure inflammatory cytokines and perform histopathology and myeloperoxidase (MPO) assessment. Serum cytokines (TNF-α, IL-6 and IL-10) and MPO activities were significantly increased, and significant histopathological changes in the organs were observed by LPS challenge. These findings were significantly attenuated by PC or HC. The treatment with PC or HC resulted in a significant attenuation on the increase in serum levels of TNF-α and IL-6, pro-inflammatory cytokines, while neither PC nor HC significantly attenuated serum levels of IL-10, anti-inflammatory cytokine. In the organs, the enhanced infiltration of neutrophils and expression of ED2 positive macrophage were attenuated by PC or HC. Inductions of MPO activity were also significantly attenuated by PC or HC. From the findings, we suggest that PC may be a functional material for its use as an anti-inflammatory agent.

Correlation of AR, EGFR, and HER2 Expression Levels in Prostate Cancer: Immunohistochemical Analysis and Chromogenic In Situ Hybridization

Purpose The androgen receptor (AR) plays a central role in prostate cancer. Evidence from several groups indicates that epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor 2 (HER2) may enhance AR activity in prostate cancer cell lines. This study was designed to investigate the protein expression of AR, EGFR, and HER2 and to determine whether the EGFR and HER2 genes are amplified in prostate cancer tissues. Materials and Methods The protein expression levels of AR, EGFR, and HER2 in a tissue microarray block of 66 prostate cancer samples were investigated by immunohistochemical analysis and chromogenic in situ hybridization was used to determine whether the EGFR and HER2 genes were amplified in these tissues. Results The AR and EGFR proteins were expressed in 59.1% and 40.9% of prostate cancers, respectively, but their expression levels were not significantly associated with clinicopathologic factors. Of the cases in which tissues were negative for EGFR protein expression, 69.2% were positive for AR protein expression; however, AR protein expression was significantly reduced (44.4%) in tissues in which EGFR protein was expressed. HER2 expression was detected in only 1 case (1.5%). No amplification of the EGFR or HER2 genes was found in prostate cancer specimens. Conclusion This study was limited by small number of subjects, but it can still be inferred that the expression levels of the AR and EGFR proteins are inversely correlated in prostate cancer patients. The potential utility of EGFR and HER2 as prognostic factors or therapeutic targets warrants further study.

A Pilot Study Evaluating Liquid-Based Fine Needle Aspiration Cytology of Breast Lesions: A Cytomorphological Comparison of SurePath® Liquid-Based Preparations and Conventional Smears

Objective: Fine needle aspiration cytology (FNAC) is recommended by the World Health Organization as a diagnostic method for breast lesions. The morphological interpretation of liquid-based preparations (LBPs) remains a diagnostic challenge due to considerably altered cytomorphology. The aim of the current study was to compare cytomorphological characteristics of SurePath® (SP)-based LBP and conventional smear (CS) in breast FNACs. Study Design: The study included 77 benign and 60 malignant breast FNACs obtained by both SP and CS, all with tissue confirmation. Cases analyzed with both preparations were reviewed and compared, focusing on 10 cytomorphological features. Results: SP aspirates demonstrated notable cytomorphological alterations. Among them, a prominent three-dimensional configuration of cell clusters and frequent and conspicuous nucleoli were the most prominent characteristics of SP compared with CS. Overall diagnostic performances were comparable but were slightly lower for SP than CS (diagnostic accuracy of two reviewers; 87.6 and 90.5% for SP vs. 91.2 and 92.7% for CS, respectively). Conclusion: Although the reviewer should be aware of distinctive cytomorphological alterations, the SP technique is reliable for the evaluation of breast lesions with the advantage of easy interpretation and a diagnostic accuracy equivalent to CS.

Application of chemokine CXC motif ligand 12 as a novel diagnostic marker in preoperative fine-needle aspiration biopsy for papillary thyroid carcinoma.

Objectives: A panel composed of three immunomarkers, cytokeratin 19, HBME-1 and galectin-3, is recommended for improving the accuracy of diagnosing papillary thyroid carcinoma (PTC), but the results are sometimes inconsistent and difficult to interpret. We used immunocytochemistry to assess the utility of chemokine CXC ligand 12 (CXCL12) as a novel diagnostic marker for PTC employing paraffin-embedded cell blocks. Methods: We analyzed the expression of CXCL12 using immunocytochemical staining in 82 cases of thyroid lesions (47 PTCs and 35 thyroid lesions other than PTC). To determine the optimal cut-off value for the assessment of CXCL12 positivity, we used receiver operating characteristics (ROC). Results: ROC curves showed that the optimum diagnostic cut-off was 10% (area under the curve 0.950, 95% confidence interval 0.891-1.008), with exclusive CXCL12 expression in PTC compared to other thyroid lesions (p < 0.001). In total, more than 90% of the PTCs were associated with CXCL12 immunohistochemical staining, while only up to 11.4% of thyroid lesions other than PTC were positive for CXCL12. The follicular variant PTC showed 90% CXCL12 expression compared to 10.5% positivity in follicular neoplasm. Conclusion: Our findings indicate that CXCL12 may be an effective supplementary diagnostic marker for PTC in preoperative fine-needle aspiration cytology using the cell block method.

Characteristic tumor growth patterns as novel histomorphologic predictors for lymph node metastasis in papillary thyroid carcinoma

The aim of this study was to investigate the efficaciousness of histological tumor growth patterns in the prediction of lymph node metastasis (LNM) in papillary thyroid carcinoma (PTC). All combinations of infiltrative tumor border, lateral tubular growth, and intraglandular dissemination were assessed for their ability to predict LNM in 229 patients. In addition, we analyzed their predictive value within subgroups based on the tumor size and number of tumor nodules. Each tumor growth pattern was significantly associated with LNM, as 11 of the 12 combinations of these 3 patterns were found to be independently predictive of LNM (P < .05). Similar results were observed in both univariate and multivariate logistic regression analyses of PTCs, grouped according to the tumor size and number of tumor nodules. This study has shown that histological features suggestive of invasive tumor growth, including infiltrative tumor border and lateral tubular growth, may be used as independent predictive factors of LNM in PTC, and can improve treatment and follow-up strategies for PTC.

Influence of Exposure to Extremely Low Frequency Magnetic Field on Neuroendocrine Cells and Hormones in Stomach of Rats

Extremely low frequency magnetic fields (ELF-MF) have the ability to produce a variety of behavioral and physiological changes in animals. The stomach, as the most sensitive part of the neuroendocrine organ of the gastrointestinal tract, is crucial for the initiation of a full stress response against all harmful stress. Thus, the purpose of this study was to examine whether ELF-MF stimuli induce changes in the activity of neuroendocrine cells, considering their involvement in endocrine or paracrine effect on surrounding cells. The exposure to ELF-MF (durations of 24 h and 1 or 2 weeks, 60 Hz frequency, 0.1 mT intensity) altered the distribution and occurrence of gastrin, ghrelin and somatostatin-positive endocrine cells in the stomach of rats. The change, however, in the secretion of those hormones into blood from endocrine cells did not appear significantly with ELF-MF exposure. Comparing with sham control, ELF-MF exposure for 1 and 2 week induced an increase in BaSO(4) suspension propelling ratio of gastrointestinal tract, indicating that ELF-MF affects gastrointestinal motility. Our study revealed that ELF-MF exposure might influence the activity of endocrine cells, an important element of the intrinsic regulatory system in the digestive tract. The pathophysiological character of these changes and the mechanism responsible for neuroendocrine cell are still unclear and require further studies.

Significance of Subcategory Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance Showing Both Cytologic and Architectural Atypia in Thyroid Aspiration Cytology

Objective: The Bethesda System for Reporting Thyroid Cytopathology is now widely used as the standard reporting system for fine-needle aspiration cytology (FNAC). Recently, several studies have attempted to subcategorize the atypia of undetermined significance (AUS)/follicular lesion of undetermined significance (FLUS) category. We aimed to analyze the significance of a subcategory of AUS/FLUS showing both cytologic and architectural atypia (AUS/FLUS-C&A). Study Design: From April 2011 to May 2014, 18,091 patients underwent FNAC at Samsung Medical Center. For those patients we analyzed the clinical significance of the subcategory AUS/FLUS-C&A. Results: One hundred and sixty-three patients were diagnosed as AUS/FLUS-C&A. Of 71 cases with subsequent histologic confirmation, 47 (66.2%) were diagnosed with papillary thyroid carcinoma (PTC). Of the 47 PTC cases, 32 (68.1%) were follicular variant-PTC. A significant difference in the PTC rate (58.3 vs. 82.6%) and PTC size (average: 1.8 and 0.9 cm) was noted between circumscribed lesions and infiltrative lesions on ultrasonography. Conclusion: We demonstrated that the subcategory of AUS/FLUS-C&A has considerable clinical implications and one should be aware of the cytological and ultrasonographic features.

Epidural intracranial metastasis from benign leiomyoma: A case report with literature review

Uterine leiomyomas are benign tumors of smooth muscle oriin believed to result from a clonal proliferation of uterine smooth uscle tissue [1]. They are the most common gynecologic tumors iagnosed in women of reproductive age, and the most common ndication for hysterectomy. Rarely, a benign uterine leiomyoma an be found in sites of the body other than the uterus. It is called benign metastasizing leiomyoma (BML). BML is a slow growing etastatic tumor, usually associated with a current or prior hisory of a uterine leiomyoma. The lung is the most common site of ML, but extrauterine locations such as the pelvic cavity, retroperioneal space, and even the lymphatic and vascular channels have lso been reported. BML of the brain is extremely rare and very few ases have been reported [2]. It has similar radiologic features as meningioma, and consequentially has often been misdiagnosed. varian leiomyomas are rare as well, and constitute less than 1% f all benign ovarian tumors. The treatment of BML is surgical esection of the mass to exclude malignancy, and the outcome is enerally good. We present a case of BML of the brain and the ovary

The Unique Liquid-Based Cytologic Findings of Thyroid Signet-Ring Follicular Adenoma: A Report of Two Cases with Fine Needle Aspiration Cytology

Background: Signet-ring follicular adenoma is a rare variant of follicular neoplasm, which has only been described using the conventional smear cytologic preparation. Here we report the unique cytologic findings of two cases of signet-ring follicular adenoma using liquid-based samples and corresponding histologic features and results of ancillary tests. Cases: Case 1: A 65-year-old man presented with a solitary nodule in the right lobe of the thyroid. Ultrasound-guided fine needle aspiration (FNA) yielded several groups of microfollicles containing colloid or mucin-like globules. The tumor cells had eccentrically located nuclei compressed by distended luminal globules. Case 2: A 51-year-old woman presented with a nodule in the left lobe of the thyroid. On liquid-based cytology, cord-like arrangements of microfollicules were noted. The tumor cells had large, clear vacuoles, but the nuclei maintained their round shape and central location. Conclusion: The liquid-based cytologic characteristics are quite different from those encountered in the conventional smear of FNA; therefore, pathologists must also be familiar with the cytomorphologic characteristics of liquid-based preparations. In addition, given the distinctive cytological and histological appearance and the benign clinical course, signet-ring follicular adenoma should be distinguished from other metastatic neoplasms displaying signet-ring cell features.

In Memoriam – A Tribute to Raj Kumar Gupta

the Niagara Regional Hospitals and affiliate laboratories from 1967 to 1979 (Canada). From 1979 to 1981, he served as Professor of Pathology at the National University of Singapore Faculty of Medicine and its affiliate University Hospitals. Dr. Gupta moved to Wellington, New Zealand, in 1981. There he served as Senior Consultant Cytopathologist and Head of the Cytology Unit to the Wellington Regional Hospital and School of Medicine, where he was consulted on literally thousands of cases until his retirement in December 2003. He continued to serve as SeOn September 25, 2012, Dr. Raj Kumar Gupta died in Wellington, New Zealand. He served a distinguished career in the medical profession spanning over 50 years and was a recognized international authority in cytopathology, where he contributed towards the increased understanding of this complex medical area. He was a Fellow of the College of American Pathologists (1971), Fellow of the International Academy of Cytology (1977), Diplomate of the International Board of Cytopathology (1980), Fellow of the Royal College of Physicians and Surgeons (Canada 1979), and Affiliate of the Royal College of Pathologists of Australia. Born in India in 1932, he earned his MBBS at Agra University in 1957. He also completed his thesis for his MD at Vikram University, India, in 1960. Dr. Gupta served in the Medical College Hospital in Gwalior between 1957 and 1958 and then as Senior Lecturer in Pathology at MA Medical College, New Delhi, between 1960 and 1961. He emigrated to North America in 1962, where he trained in pathology at the Massachusetts General Hospital Harvard Medical School-affiliated training program at Worcestor Memorial Hospital and served as Senior Resident in Anatomic Pathology (1964). He completed his postgraduate study in cytopathology at the Postgraduate Institute of Cytology at Johns Hopkins University (1972). From 1965 to 1979, Dr. Gupta served as Associate Professor of Pathology at the State University of New York School of Medicine and its affiliate University Hospitals in Buffalo, New York, and as Consultant Pathologist to Published online: December 6, 2012