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조항주(Hang Joo Cho),안창혁(Chang Hyeok Ahn),김지일(Ji Il Kim),김기환(Kee Hwan Kim),배자성(Ja Seong Bae),박우찬(Woo Chan Park),송병주(Byung Ju Song),정상설(Sang Seol Jung),김정수(Jeong Soo Kim) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.72 No.6
Purpose: The methylation of tumor suppressor genes has been implicated in the development of breast cancer. However, the role of methylation in the progression of cancer is still unclear. In this study, the methylation stati of nine tumor suppressor genes (p14, p16, DAPK, E-cadherin, RASSF1α, TWIST, RARβ, HIN-1, cyclin D2) in normal, benign, DCIS and invasive cancer tissues were examined, and the methylation patterns in DCIS and hypermethylated genes investigated to see if a change in the methylation status would lead to the development of cancer and progression to an invasive tumor. Methods: A total of 96 patients, who underwent surgery between March 2003 and March 2005, were retrospectively studied. DNA was extracted from tumor tissues, and the samples examined for aberrant hypermethylation using methylation-specific PCR (MSP). Results: The total number of methylated genes in each tissue type (normal tissues; 2.97±1.74, benign tumors; 4.36 ±1.42, DCIS; 5.73±1.35, invasive cancers; 5.42±2.05) increased with tumor progression (P<0.001). In benign tumors, HIN-1 (83%) was the most frequently methylated gene, but in DCIS, p14 (100%), RASSF (100%) and TWIST (91%) were frequently methylated. In invasive cancer, RAR β (60%) and p16 (37%) were frequently methylated compared to the other tissue types. In a multivariate study, TWIST was commonly hypermethylated in DCIS and invasive cancer; whereas, RARβ and p14 were frequently independently hypermethylated in invasive cancers. Conclusion: Methylation induced gene silencing appears to affect multiple genes in breast tissues, which increases with cancer progression. TWIST was hypermethylated in both DCIS and invasive cancers; therefore, it was concluded that methylation of the TWIST promoter may be an early event in the development of breast cancer. The hypermethylations of RARβ and p16 are useful marker for the progression of a DCIS lesion to invasive cancer. The methylation patterns of tumor suppressor genes in DCIS were similar to those found in invasive cancer, but also showed intermediate levels of methylation between benign tumors and invasive cancers.
조항주 ( Hang Joo Cho ),경연영 ( Yeon Young Kyoung ),오주석 ( Ju Suk Oh ),오영민 ( Young Min Oh ),최세민 ( Se Min Choe ),최경호 ( Kyoung Ho Choi ) 대한외상학회 2010 大韓外傷學會誌 Vol.23 No.2
Splenic rupture is a frequent surgical emergency in blunt abdominal trauma patients. There are several treatment options, including conservative treatment, a partial splenectomy, splenorrhaphy, and a splenectomy for splenic injury. Although reports on the safety and the efficacy of an elective laparoscopic splenectomy are abundant in the literature, a laparoscopic splenectomy for a ruptured spleen has only been reported in a few cases. We report a case of a laparoscopic splenectomy in the patient with Grade III traumatic splenic injury. To our knowledge, this is the first report in which a laparoscopic splenectomy was performed in Korea for the treatment of a traumatic splenic injury. (J Korean Soc Traumatol 2010;23:192-195)
조항주(Hang Joo Cho),황인용(In Yong Whang),김지일(Ji Il Kim),안창혁(Chang Hyuck Ahn),김정수(Jeong Soo Kim),유승진(Seung Jin Yoo),임근우(Keun Woo Lim) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.75 No.2
Purpose: We wanted to evaluate the value of intravenous contrast enhanced abdomen-pelvis computed tomography (CT) for diagnosing acute appendicitis and we wanted to determine which patients groups will benefit from preoperative CT. Methods: Between January and June 2006, the medical records of 354 patients who had clinically suspected acute appendicitis were retrospectively reviewed. Appendectomy was performed in 260 patients and CT was conducted in 108 patients of the 260 patients. The 5㎜ slice CT scans were evaluated for the presence of appendicitis. The sensitivity, specificity and accuracy of CT were calculated. The negative appendectomy rate (NAR) was compared between the patients with CT scans and those without CT scans. Furthermore, the patients were classified into the children and adults groups and the male and female groups and the differences of the NARs were analyzed for each group. Results: The sensitivity, specificity and accuracy were 95%, 93% and 94%, respectively. The NAR was lower for the patients with a CT scan (12%) compared to 27% for those patients without CT scans (P=0.002). The difference of the NAR between the preoperative CT group and the without CT group was statistically significant for the female (P=0.004) and adult groups (P=0.012) (14% vs 36%, 11% vs 26%, respectively). Conclusion: Preoperative intravenous contrast enhanced abdomen-pelvis CT was effective in reducing the negative appendectomy rate in patients who were suspected of having acute appendicitis. Especially, the adults and women benefit more from CT scanning and they had a significantly lower negative appendectomy rate than the children and men, respectively.
RKO 대장암 세포주와 MCF-7 유방암 세포주에서 Sodium Butyrate와 5-aza-2’-deoxycytidine에 의한 종양세포 성장억제 상승작용
조항주(Hang Joo Cho),박순철(Sun Cheol Park),김기환(Kee Whan Kim),강원경(Won Kyung Kang),조현민(Hyun Min Cho),김정수(Jeong Soo Kim),김영애(Young Ae Kim),안창혁(Chang Hyeok An) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.76 No.5
Purpose: It is known that DNA methylation is associated with histone acetylation status in regulation of gene expression. In this study, we investigate the effect of demethylating agents and histone deacetylase (HDAC) inhibitor on the tumor suppression and the combined effect of two agents according to methylation status in human colon and breast cancer cell lines. Methods: In this study, the RKO colorectal cancer cell line, MCF-7 breast cancer cell lines were considered. For each cell line, we used HDAC inhibitor sodium butyrate (SB), demethylating agent 5-aza-2’-deoxycytidine (5-aza-DC) and a combination of both agents. We estimated the percentage of cell survival using the XTT method and experimented with the augmentative effects of both agents. Results: In RKO cell line in which most of the genes are methylated, 74% of cell survival was shown for 5-aza-DC treatment and 83% of cell survival for SB treatment. In MCF-7 cell line that approximately half of the genes are methylated, 82% cell survival was shown for 5-aza-DC treatment and 63% cell survival for SB treatment. We observed that the survival fraction is lower after the combined treatment of 5-aza-DC and SB than that of 5?aza?DC or SB alone in both RKO (53%) and MCF-7 (49%) cell lines (P<0.001). Conclusion: For highly methylated genes, 5-aza-DC is more effective on the tumor suppression than SB. On the other hand, if the methylation of the promoter region is at low density, SB is noted to be more effective than 5-aza-DC. Furthermore, the combined treatment of 5-aza-DC and SB is more effective than using each agent alone.
조진범(Jin Bum Cho),조항주(Hang Joo Cho),신옥란(Ok Ran Shin),김기환(Kee Hawn Kim),안창혁(Chang Hyeok Ahn),김정수(Jeong Soo Kim),유승진(Seung Jin Yoo),임근우(Keun Woo Lim),김지일(Ji Il Kim) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.74 No.6
Purpose: A mucocele of the appendix is an uncommon pathology, representing 0.2% to 0.3% of all appendix specimens. It is often diagnosed clinically as a result of its ability to cause signs and symptoms similar to those of acute appendicitis. If it is asymptomatic, it is often detected as an incidental finding during ultrasonography, computed tomography, radiographic examination of the gastrointestinal tract, or laparotomy. The purpose of this study was to identify the clinical features of mucocele of the appendix. Methods: We describe 35 cases of mucocele of the appendix diagnosed at Uijeongbu St. Mary’s hospital between January 1993 and December 2006. We analyzed demographic, clinical, and pathologic data of all the cases. Results: A total of 12 males and 13 females with mean age of 54.7±14.9 years are described. The peak incidence occurred in the seventh decade (34.3%). Sixteen patients presented with symptoms and signs similar to those found in acute appendicitis. Ten patients complained of a palpable mass, 2 patients complained of non-specific abdominal pain, and 7 patients were asymptomatic. Fourteen cases were diagnosed preoperatively, and 3 cases were discovered incidentally. Pathologic examination revealed mucosal hyperplasia in 20% of the cases, cystadenoma in 71%, and cystadenocarcinoma in 9%. The mean age of cystadenocarcinoma patients was older than the mean age of mucosal hyperplasia patients, and the diameter of the appendix was larger in cystadenoma patients than in mucosal hyperplasia patients. Conclusion: The preoperative diagnosis of appendiceal mucocele is very important to make in order to facilitate treatment planning and avoid inadvertent rupture of the mucocele during operation. We recommend more diagnostic studies in cases of suspected mucocele. Mucocele of the appendix must be included in the differential diagnosis of patients with pain in the right iliac fossa, patients older than 40 years of age, patients suffering from long-term symptoms, and patient with a palpable mass in the right iliac fossa.
강현종(Hyunjong Kang),조항주(Hang Joo Cho),김기환(Kee Whan Kim),김지일(Jiil Kim),김정수(Jeong Soo Kim),유승진(Seung Jin You),임근우(Keunwoo Lim),이은정(Eunjeong Lee),안창혁(Changhyeok An) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.75 No.2
The rare cause of lower gastrointestinal bleeding is angiodysplasia. Angiolysplasia is most common in the right colon, but it can be found throughout the whole gastrointestinal tract. The main lesion of angiodysplasia is located at the submucosal layer. So, it is sometimes very difficult to search for the focus of bleeding via laparotomy or colonoscopy. We recently experienced a case of rectal arteriovenous malformation that was misdiagnosed as intussusception. A 57-year-old man visited the emergency room because of abrupt anal bleeding and low abdominal pain, and this was the third episode he’d experienced during the past 20 years. Sigmoidoscopy and abdominal CT revealed that his rectum was obstructed with a dark black colotuberant mass, which was suggestive of ischemic intussusception. We performed emergency laparotomy and we found an extremely swollen rectum with surrounding hematoma instead of intussusception. We performed low anterior resection and colo-anal anastomosis with ileostomy. The final pathologic diagnosis showed that the protuberant mass was a hematoma in the submucosal layer, and this developed by bleeding from an arteriovenous malformation in the rectum.
십이지장 혈관종의 출혈로 생긴 벽내 혈종에 의한 십이지장 폐색
김지훈(Ji Hoon Kim),조항주(Hang Joo Cho),서인영(In Young Seo),김기환(Kee Hawn Kim),안창혁(Chang Hyeok Ahn),김정수(Jeong Soo Kim),장은덕(Eun Duk Chang),유승진(Seung Jin Yoo),임근우(Keun Woo Lim),김지일(Ji Il Kim) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.74 No.2
Small bowel hemangioma is a rare benign lesion, and it usually presents with bleeding or as a leading point of an intussusception. However, obstruction due to intramural hematoma by this lesion is unusual. Intramural hematoma of the duodenum is also an uncommon lesion, and it is usually a complication of blunt abdominal trauma in children and young adults. We present here a case of an intramural hematoma that was caused by spontaneous bleeding of a hemangioma, and this caused duodenal obstruction.
이정임(Jung Im Yi),조항주(Hang Joo Cho),신옥락(Ok Ran Shin),김기환(Kee Hawn Kim),안창혁(Chang Hycok Ahn),김정수(Jeong Soo Kim),유승진(Seung Jin Yoo),임근우(Keun Woo Lim),김지일(Ji Il Kim) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.75 No.5
Primary retroperitoneal mucinous cystadenomas are rare tumors that are almost always found in women. They are similar to ovarian originated mucinous cystadenoma, but there is no any other evidence of an ovarian origin for primary retroperitoneal mucinous cystadenomas. A 33-year-old woman with complaints of RLQ pain was found to have a cystic mass in the right retroperitoneal space on her abdominal CT scan. The histological diagnosis was confirmed as primary mucinous cystadenoma. We report here on a case of retroperitoneal mucinous cystadenoma, and we also talk about this tumor, including its histogenesis, through a review of the available literature.
갑상선암의 내시경 갑상선 절제술에서 근전절제술 및 전절제술의 임상적 비교
유한모,김태원,배자성<SUP>1<,SUP>,조항주,김기환,안창혁,박우찬<SUP>2<,SUP>,이동호<SUP>3<,SUP>,김정수,Han Mo Yoo,M,D,Tae Won Kim,M,D,Ja Sung Bae,M,D,<SUP>1<,SUP>,Hang Joo Cho,M,D,Kee Hwan Kim,M,D,Chang Hyuk An,M,D,Woo Chan Park,M 대한갑상선-내분비외과학회 2009 The Koreran journal of Endocrine Surgery Vol.9 No.4
Purpose: The aim of this study was to evaluate and compare the surgical outcomes of endoscopic total and near-total thyroidectomies in patients with thyroid cancer. Methods: Between February 2000 and January 2009, among 387 patients who underwent endoscopic thyroidectomy in our hospital, we evaluated 50 patients who underwent endoscopic total or near-total thyroidectomy. Thirty- five and 15 patients underwent endoscopic total thyroidectomy and near-total thyroidectomy, respectively. We analyzed the patients' clinicopathologic characteristics and post-operative complications between the two groups. Results: The mean size of tumors was 1.08 cm (range, 0.1∼3.5 cm) and the mean operative time was 192 minutes. Forty-nine tumors were papillary cancers and 1 tumor was a follicular cancer. Two patients in the endoscopic total thyroidectomy group underwent re-operation because of bleeding. In the near-total thyroidectomy group, one patient had transient hypocalcemia and one patient had temporary recurrent laryngeal nerve palsy. In the total thyroidectomy group, nine patients had transient hypocalcemia and one patient had temporary recurrent laryngeal nerve palsy. There was no statistical difference in the post-operative complicationrates between the two groups (P=0.254 for hypocalcemia and P=0.470 for injury to the recurrent laryngeal nerve). Conclusion: Based on our experience, endoscopic total thyroidectomy is a safe and feasible alternative to endoscopic near-total thyroidectomy. (Korean J Endocrine Surg 2009; 9:201-205)