기저세포암에서 Syndecan-1과 Beta-catenin 발현에 관한 면역조직화학적 연구

김해련 ( Hae Ryun Kim ),김민성 ( Min Sung Kim ),나찬호 ( Chan Ho Na ),신봉석 ( Bong Seok Shin ) 대한피부과학회 2012 大韓皮膚科學會誌 Vol.50 No.8

Background: Syndecan-1 and B-catenin are cell adhesion molecules, which are expressed primarily on the surface of adult epithelial cells. The expressions of them have been appeared to be inversely correlated with tumor aggressiveness and invasiveness. Objective: The purpose of this study was to investigate the expression of syndecan-1 and B-catenin in tissue sections of the nodular and high-risk (micronodular and infiltrative type) basal cell carcinomas. Methods: Ten cases of nodular basal cell carcinoma and 10 cases of high-risk basal cell carcinoma (each 5 cases of micronodular and infiltrative type) were investigated. Specimens were assessed for syndecan-1 and B-catenin expression, using a semi-quantitative method in which the intensity of membranous staining was evaluated. Results: In a nodular basal cell carcinoma, syndecan-1 and B-catenin were expressed as similar intensity to normal epidermis. In high-risk basal cell carcinoma, syndecan-1 always showed decreased staining intensity relative to that showed in the normal skin. But, B-catenin showed similar to normal epidermis in the 5 cases, and decreased intensity relative to that of the normal epidermis in the rest. Conclusion: Our results suggest that the decreased expression of syndecan-1 and B-catenin in basal cell carcinoma is associated with the tumor aggressiveness. Especially, of the two adhesion molecules, syndecan-1 is more associated with the high-risk basal cell carcinoma.

난소암 환자에서 발생한 표피 낭종 형태의 피부 전이

김해련 ( Hae Ryun Kim ),나찬호 ( Chan Ho Na ),신봉석 ( Bong Seok Shin ),최규철 ( Kyu Chul Choi ),김민성 ( Min Sung Kim ) 대한피부과학회 2012 대한피부과학회지 Vol.50 No.6

Cutaneous metastasis from the ovarian cancer has been found to be exceedingly rare. We report a case of a metastatic ovarian mucinous cystadenocarcinoma, which clinically manifested as the epidermal cyst-like skin nodule on the right upper quadrant of abdomen.

히스테리구 환자에서의 식도 내압검사 소견

김해련(Hae Ryun Kim),김상윤(Sang Youn Kim),민영일(Young Il Min) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.4

N/A Lump sensation in throat is common symptom in middle aged woman and in that case, true dysphagia is usually absent. Globus hystericus is generally assumed to be of psychic origin but its pathophysiology is still remained unknown. We performed this study to evaluate esophageal functional abnormality in patients with globus hystericus by esophageal manometry. An or- ganic cause for their symptorns were ruled out by physical examination of laryngopharynx and esophagoscopy. Patients with posterior nasal drip were ex luded. Thirty six patients(mean age 45 years, 28 63) and control group of 23(mean age 49 years, 35 67) were examined with water perfused 6 lumen catheter and low compliance system. The data was analyzd with soft- ware of Synetic2'Low esophageal sphincter(LES) pressure of control group was 18.2k5.3mmHg (station pull through;SPT, mean+S.D.), 25.7+6.5mmHg(rapid pull throught, RPT) and % relaxation was 94.3+ 5.9%. Five(14% ) of patient group showed abnormally high or low LES pressure and the other 2 patients showed incomplete relaxation. Upper esophageal sphincter (UES) pressure of control group was 82.1k29.1mmHg(SPT, meankS.D.), 91.5+30.3rnmHg (RPT) and % relaxation was 88.8+5.5%. Three(8%) of patient group showed abnormally high UES pressure and the other 3 patients showed incomplete relaxation. Basal pressure of upper esophageal body(7.5mmHg) was significantly higher than that of control group (4.3mmHg, p<0.01, t t,est). In t,he body of esophagus, various kinds of abnormal finding with wet swallow were noted; nutcracker esophagus in 3 patients(8%), high amplitude of upper esophagus in 3 patients(8% ), and non-specific esophageal motility disorder in 7 patients. Twen- ty three out of 36 patients(64%) with globus hystericus showed at least one abnormal esopha geal motility findings. It could be concluded that dysmotility of esophageai body as well as UES may be pathophysiology of globus hystericus.(Korean J Gastroenterol 1994; 26: 625 630)

비심인성 흉통환자에서 흉통의 원인으로서의 식도질환

김해련(Hae Ryun Kim),이근찬(Gyn Chan Lee),양석균(Suk Kyun Yang),송재관(Jae Gwan Song),민영일(Young Il Min) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.1

N/A Noncardiac chest pain is a vexing diagnostic problem. Recently, awareness of the potential for the esophagus to cause chest pain is increasing, But a causal relationship between esopha- geal motility or reflux disease and chest pain may be difficult to prove. We perform this study to evaluate the importance of esophageal abnormalities as a potential cause of recurrent noncardiac chest pain. We underwent endoscopy, esophageal manometry with edrophonium provocation test and 24hour esophageal pH monitoring in 54 patients with normal coronary arteriogram and negative vascular spasm studv. Eighteen patients (33%) had abnormal esophgeal manometry test and in 15 patients, the chest pain could be provocated with edrophonium injection (80,u g/kg). But only 6 patients (II %) showed positive edrophonium provocation test and abnormal motilty test. These were 3 cases of diffuse esophgeal spasm, I case of nutcracker esophagus and 2 cases of hypertensive lower esophageal sphincter(LES). In twenty eight patients with 24hour pH monitoring, 9 pa- tients (32.1 %) had pathologic reflux and 1 9 patients experienced chest pain during test time. Ten patients out of 1 9 patients had positive symptom index (S.I,) and 6 patients (31.6%) had both pathologic reflux and pisitive S.I.. Mean S.I. Of these 6 patients was 65.5% (range 50- 1 00%). In conclusion, about 40% of patients with noncardiac chest pain had esophageal disease as probable cause of chest pain and gastroescphai,,cal, reflux disease as well as esophageal motili- ty disease was important cause of chest pain even if without evidence of reflux esophagitis. (Korean J Gastroenterol 1994; 26 : 1-8)

광주, 전남 지역의 피부 기저세포암과 편평세포암의 통계학적 고찰(2006~2010)

김해련 ( Hae Ryun Kim ),나찬호 ( Chan Ho Na ),신봉석 ( Bong Seok Shin ),최규철 ( Kyu Chul Choi ),김민성 ( Min Sung Kim ) 대한피부과학회 2011 대한피부과학회지 Vol.49 No.12

Background: The incidence of cutaneous malignant tumors has been continuously increasing worldwide. Objective: The purpose of this study was to analyze recent trends in the incidence of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in patients from Gwangju City and Chonnam Province. Methods: We reviewed clinical data and histopathological reports of 82 cases of BCC and 60 cases of SCC in outpatients who had visited the department of dermatology at Chosun University Hospital between 2006 and 2010. Results: The male-female ratio was 0.61:1 in patients with BCC and 0.87:1 in patients with SCC. The most frequent age group was the eighth decade (42% BCC and 67% SCC). Mean patient ages were 65.1 years and 67.8 years, respectively. The most common involved site was the face (90.2% BCC and 78.3% SCC), particularly the cheek. More skin cancers were found on the left than the right side of head and neck area in male automobile drivers only. The most frequent histological BCC subtype was the nodulocystic type (59.7%), followed by the pigmented (12.1%), and adenoid type (9.7%). The most frequent histological pattern of SCC was the well-differentiated type (66.6%). Development of BCC (61.3%) was more frequent than that of SCC in sun-exposed areas. Conclusion: Our data were similar to those previously reported. In our study, no difference in demographic variables such as age, gender or residence were found between patients with BCC and SCC. Additionally, no differences were observed in the incidence of BCC or SCC among the other variables. Further cohort studies that include cumulative lifetime sun exposure and a large sample size are needed. (Korean J Dermatol 2011;49(12):1073~ 1078)

직장암 환자의 수술전 병기 판단을 위한 내시경적 초음파 단층촬영술의 유용성 평가

김해련(Hae Ryun Kim),김진천(Jin Chun Kim),이문규(Mun Gyu Lee),민영일(Young Il Kim) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.3

N/A Endoscopic transrecta) ultrasonography (EUS) is used to stage rectal cancer by assessing depth of invasion through rectal wall layers and/or involvement of lymph nodes. Preoperative ElJS and pelvis CT findings were compared with post operative pathologic findings to evaluate the effectiveness of EUS in staging rectal cancer. We performed EUS in 38 patients (male 24, female 14, mean age 53 years) with rectal cancer diagnosed with colonoscopic biopsy. The Olympus GF-UM3 and EU-M3 endoscopic ultrasound and display system (7.5/12 MHz) was used. Examination was performed with saline enema and diazepam injection. Water filled ballon and free filling of rectum with deaerated water provide good image. Postoperative find- ing showed 1 case of mucosal cancer, 3 cases of submucosal involvement, 9 cases of proper muscle invasion and 25 cases of serosa and peri-rectal fat involvement. Overall accuracy of EUS in determination of depth of invasion was 84% (32/38). And in cases of relatively early stage of rectal cancer (mucosa and submucosa involvement), the accuracy was 75% (3/4). Moreover 1 case of prostate involvement could be correctly diagnosed with EUS. With preop- erative pevis CT, it was impossible to diffrentiate layers of rectal wall. The sensitivity of peri- rectal fat invasion was 33% (8/24) and the false positivity was 15% (2/13). In conclusion, EUS appears to be promissing method for depth of invasion in pre-operative staging of rectal concer whereas CT scan is useful method for detection of distant metastasis. (Korean J Gastroenterol 1994; 26: 491 497)

두피에 발생한 색소성 에크린 땀구멍종

김해련 ( Hae Ryun Kim ),나찬호 ( Chan Ho Na ),신봉석 ( Bong Seok Shin ),최규철 ( Kyu Chul Choi ),김민성 ( Min Sung Kim ) 대한피부과학회 2012 대한피부과학회지 Vol.50 No.1

Eccrine poroma is a benign tumor, which is thought to originate from the epidermal eccrine sweat duct unit. It occurs primarily on the hairless acral surface. However, there have been some cases occurring in atypical area like scalp and face. In general, eccrine poroma lacks melanin pigment clinically and melanocytes on microscopic examination. However, in either black or yellow skin, melanin granules and melanocytes can occasionally be found dispersed within the tumor. We report a case of pigmented eccrine poroma occurring on the scalp. The lesion was located on an unusual occurring site as well as contained melanocyte and melanin. (Korean J Dermatol 2012;50(1): 79∼81)

특집 : 패션 마케팅 현황과 전략 ; 패션 산업의 첨단 기술 융합 사례 및 발전 방향

김해련 ( Hae Ryun Kim ) 한국의류학회 2005 패션정보와 기술 Vol.2 No.-

B 형 만성간질환 환자에서 Hepatitis Be Antigen 양성여부와 PPD 반응과의 상호 관계

김해련(Hae Ryun Kim),이효석(Hyo Suk Lee),김정룡(Chung Yong Kim) 대한내과학회 1989 대한내과학회지 Vol.37 No.4

N/A The immunopathogenesis of chronic hepatitis type B still remains unknown. HBeAg positivity correlated more closely with the viral replication characterized by higher infectivity and a greater degree of liver damage than HBeAg negativity. Recently it has been suggested that BCG vaccination may be of therapeutic value in chronic hepatitis B infection, on the basis of an inverse association between HBeAg positivity and PPD reactivity. This study was designed to confirm the inverse association in Korea, where BCC vaccination is almost always given in infancy and where hepatitis B infection is prevalent. A total of 189 HBsAg positive patients with chronic liver diseases including 75 chronic active hepatitis and 114 liver cirrhosis, and 71 HBsAg-positive patients with primary liver cancer were tested for HBeAg, anti-HBe and PPD skin test. The results were summarized as follows: 1) There was no significant inverse association of PPD reactivity by HBeAg positivity or negativity (53. 6% vs 63.6%) in patients with chronic liver diseases or in patients with primary liver cancer (46.4% vs 58.1%). 2) An inverse association was not found in PPD negativity by anti-HBe positivity or negativity (60.6% vs 64.7%) either. 3) The age distribution of both HBeAg positivity and PPD reactivity showed a closely correlated declining tendency in positive reaction as age increased. These findings suggested that there was no significant inverse association between HBeAg positivity and PPD reactivity. We may conclude that BCG vaccination is of na value in converting HBeAg positivity to negativity.

식도암 환자에서 악성기관지 - 식도루

김성배(Sung Bae Kim),김상희(Sang Hee Kim),김상위(Sang We Kim),서철원(Cheol Won Suh),이규형(Kyoo Hyung Lee),이정신(Jung Shin Lee),김해련(Hae Ryun Kim),민영일(Young Il Min),송호영(Ho Young Song),최은경(Eun Kyung Choi),이재원(Jae Won Le 대한내과학회 1995 대한내과학회지 Vol.48 No.5

N/A Objectives: Patients with esophageal cancer and a malignant tracheoesophageal fistula(TEF)have an extremely poor prognosis, with or without treatment. However, the presence of a TEF has historically been considered a relative contraindication to radiation therapy. Methods: To determine the appropriate treatmement(use of radiation therapy)for patients with esophageal cancer and malignant TEF, a review was performed of all such cases, obeserved at Asan Medical Center between 1989 and 1993. Results: 1) Six patients with malignant TEF were seen in total 130 esophageal cancer patients, so the incidence was 4.6%. 2) All of the patients were male, had squamous cell histologies. 3) Dysphagia as initial presenting symptom was a chief complaint in all six patients. 4) The number of TEF formation was one in five of six patients, two in the rest. 5) Three TEFs were developed during radiotherapy, two of them stopped radiation therapy, and one patient continued to treat with hyperfractionated radiation and cured. 6) The median survival length was 33(3-60) weeks after initial tumor diagnosis and 16(2-39) weeks after the first TEF occurred. The duration between initial tumor diagnosis and TEF formation was 17.6(0.6-22) weeks. 7) As a pllliative aim, gastrostomy was done in two patients, jejunostomy in one patient, and stent insertion in the other two patients. Associated symptoms with TEF were markedly improved after stent insertion. 8) The cause of death was sepsis as a resulf of aspiration pnenumonia and lung abscess in five of six patients, and advanced esophageal cancer with lung metastasis in the rest. Conclusion: Early detection and proper management were essential in malignant TEF and esophageal cancer. Stent insertion was good palliation. Radiation therapy might be initiated or continued in the presence of a TEF, and eventual resolution of the fistula might occur. Prospective randomized trials are necessary to define the role of radiation treatment, and further attempts to improve the malignt TEF are required.