대장암 유전 분석의 임상적, 병리학적 의의

김호근 ( Ho Guen Kim ) 대한소화기학회 2004 대한소화기학회지 Vol.43 No.5

The molecular genetics of colorectal carcinomas are among the best understood of common human cancers. Three inter-related molecular pathways are involved. The chromosomal instability pathway begins with inactivation of the APC/β-catenin genes followed by activation of oncogenes and inactivation of additional suppressor genes, commonly with high frequency of allelic losses, cytogenetic abnormalities. The microsatellite instability pathway begins with inactivating one of a group of genes responsible for DNA nucleotide mismatch repair leading to extensive mutations in both repetitive and non-repetitive DNA sequences with low frequencies of allelic losses and rare alteration of tumor DNA content. Finally, the CpG island methylation pathway involves inactivation of genes by methylation of cytosines in promoter regions to silence gene expression without DNA sequence alterations. Molecular genetics have the potential for clinical applications. Combination of genetic classification of high levels of microsatellite instability (MSI-H), gene expression analysis of mismatch repair genes and subsequent mutation analysis of inactivated genes can be used as an effective method for the identification of hereditary nonpolyposis colorectal carcinoma patients. Molecular genetic alterations have been proposed to be of prognostic value, including allelic deletion on chromosome 18q, and on chromosome 17p. MSI-H has been reported as a marker for better prognosis. Individualizing chemoradiation by use of predictive markers for response or resistance to therapy is important in patients with advanced disease or candidacy for adjuvant therapy. (Korean J Gastro-enterol 2004;43:275-282) gene expression analysis of mismatch repair genes and subsequent mutation analysis of inactivated genes can be used as an effective method for the identification of hereditary nonpolyposis colorectal carcinoma patients. Molecular genetic alterations have been proposed to be of prognostic value, including allelic deletion on chromosome 18q, and on chromosome 17p. MSI-H has been reported as a marker for better prognosis. Individualizing chemoradiation by use of predictive markers for response or resistance to therapy is important in patients with advanced disease or candidacy for adjuvant therapy. (Korean J Gastro-enterol 2004;43:275-282)

만성 B형 간염에서의 ALPHA-FETOPROTEIN 측정의 의의

김호근 ( Ho Guen Kim ),문대혁 ( Dae Hyuk Moon ),홍태의 ( Tae Ui Hong ) 국군의무사령부 1987 대한군진의학학술지 Vol.18 No.1

점액세포가 관찰되는 침샘 관암종 -세침흡인 세포검사에서 점액표피모양암종으로 오인했던 1예 보고-

김혜령,김현기,김호근,김진,홍순원,김세훈,Kim, Hae-Ryoung,Kim, Hyun-Ki,Kim, Ho-Guen,Kim, Jin,Hong, Soon-Won,Kim, Se-Hoon The Korean Society for Cytopathology 2006 대한세포병리학회지 Vol.17 No.1

Salivary duct carcinoma (SDC) is a rare primary salivary gland malignancy characterized by histological features similar to those of ductal carcinomas of the breast. It is regarded as a high-grade malignancy associated with frequent local recurrences and early distant metastases that require aggressive treatment. The typical fine needle aspiration cytology (FNAC) findings in SDC include cellular smears showing tumor cells with eccentric pleomorphic nuclei and a granular cytoplasm arranged in flat sheets or cribriform patterns against a necrotic background. However, the presence of mucin-containing cells in SDC has been rarely described. We report the FNAC findings in a patient with histologically confirmed SDC that demonstrated numerous mucin-containing cells and was subsequently misdiagnosed as a high-grade mucoepidermoid carcinoma. Here we discuss the problems involved in distinguishing SDC from high-grade mucoepidermoid carcinoma on the basis of cytologic findings alone.

전체 위장관을 침범한 베체트 장염 환자에서 연속 발생한 위, 결장 천공

신동엽 ( Dong Yeob Shin ),천재희 ( Jae Hee Cheon ),박재준 ( Jae Jun Park ),김호근 ( Ho Guen Kim ),김태일 ( Tae Il Kim ),이용찬 ( Yong Chan Lee ),김남규 ( Nam Kyu Kim ),김원호 ( Won Ho Kim ) 대한소화기학회 2009 대한소화기학회지 Vol.53 No.2

Behcet`s disease (BD) has been recognized as multi-systemic chronic vasculitic disorder of recurrent inflammation, characterized by the involvement of multiple organs and resulting in orogenital ulcers, uveitis, and skin lesions. Involvement of the central nervous system, vessels, and intestines in BD often leads to a poor prognosis. Digestive manifestations in BD have been reported in up to 1-60% of cases, although the rate varies in different countries. The most frequent extra-oral sites of gastrointestinal involvement are the ileocecal region and the colon. Gastric or esophageal involvement is reported to be very rare. Moreover, there have been no reports on the simultaneous involvement of the esophagus, stomach, ileum, and colon. Here, we present a 55-year-old Korean man with intestinal BD and multiple ileal and colonic ulcerations complicated by perforation, gastric ulcer with bleeding followed by perforation, and esophageal ulcers with bleeding. (Korean J Gastroenterol 2009;53:106-110)

수평·수직하중을 동시에 받는 더블앵글로 접합된 철골조의 절점 보강시스템

양재근,김호근,김기환,Yang, Jae Guen,Kim, Ho Keun,Kim, Ki Hwan 한국강구조학회 2004 韓國鋼構造學會 論文集 Vol.16 No.5

철골조는 작용하중을 지탱하기 위한 구조시스템 중의 하나로 널리 사용되고 있고, 보와 기둥의 강성, 보와 기둥의 강성, 지점조건, 보강의 유무, $P-{\Delta}$효과 등의 변화에 따른 영향들을 포함하는 최적의 설계를 필요로 한다. 본 연구는 볼트 수의 변화에 의한 더블앵글 접합부의 회전강성 변화가 철골조의 거동에 미치는 영향을 파악하기 위하여 진행되었다. 또한, 수평 수직하중을 동시에 받는 더블앵글로 접합된 골조의 처짐에 대한 제한 조건을 만족하도록 하는 최대 허용하중 산정에 관한 연구도 병행하였다. 더블앵글 접합부의 회전강성을 얻기 위하여 접합부 실험을 수행하였고, 골조의 처짐 및 최대 작용하중을 정확하게 파악하기 위한 단순해석 모델도 제안하였다. A steel frame is one of the most commonly used structural systems due to its resistance to various types of applied loads. Many studies have been conducted to investigate the effects of several parameters, such as connection flexibility, the boundary condition of each support, and beam-to-column stiffness ratio, on the characteristic behavior of a frame. Based on the results of these studies, several design methods have been proposed. This research focused on the number of bolts on the rotational stiffness of a double-angle connection, and its effect on the story drift of a frame. To achieve these purposes, a simplified analytical model was proposed. Several experimental tests were also conducted to obtain the rotational connection stiffness of each double-angle connection.

보와 기둥이 더블앵글로 접합된 골조의 거동

양재근(Yang Jae-Guen),이수권(Lee Soo-Kueon),김호근(Kim Ho-Keun) 대한건축학회 2003 大韓建築學會論文集 : 構造系 Vol.19 No.6

Frame is one of the most commonly used structural systems for the resistance of applied loads. Many researchers have recently conducted their studies to investigate the effect of several parameters such as the connection flexibility, boundary condition of each support, beam-to-column stiffness ratio. These parameters play important roles on the characteristic behavior of frames. A simplified spring model is proposed to obtain the story drifts of frames with various beam-to-column connection stiffnesses in this research. A point bracing system with adequate spring stiffness is also suggested to establish the relationship between the applied load and the resisting translational spring stiffness within the limit state of story drift.

Hyperimmunoglobulin E 증후군에서의 결장천공 - 증례보고 -

오정탁,김인규,한석주,김호근,황의호,Oh, Jung-Tak,Kim, In-Gyu,Han, Seok-Joo,Kim, Ho-Guen,Hwang, Eui-Ho 대한소아외과학회 1996 소아외과 Vol.2 No.2

Hyperimmunoglobulin E syndrome is a relatively rare primary immunodeficiency syndrome characterized by recurrent infection, abscess formation and marked elevation of serum IgE level. The common infectious organism is Staphylococcus aureus and recurrent infection indicates some defects in the immunologic system. Although the infection can affect various organs, gastrointestinal tract involvement is rare and only one case of colon perforation has been previously reproted. Herein we report another one case of colon perforation which ocurred in an 8-year-old girl with hyper immunoglobulin E syndrome. The patient was admitted to the hospital due to an abscess on right neck. The diagnosis of hyper immunoglobulin E syndrome was made because she had eczematoid dermatitis on the face, pneumatocele on left upper lung field and markedly elevated serum IgE level(>15,000 IU/ml) with a past histories of frequent scalp abscesses and otitis media. Abdominal pain developed on the 13th day of admission and abdominal plain X-ray revealed free air. An exploratory laparatomy was performed and two free perforations of the transverse colon were noted. Segmental resection and double barrel colostomy were performed. Colostomy closure was done 4 month later and she had no gastrointestinal problem during a follow up period of 15 months.

알코올성 간질환의 임상적 고찰

김남동(Nam Dong Kim),권상옥(Sang Ok Kwon),김현수(Hyun Soo Kim),이동기(Dong Ki Lee),배선우(Sun Woo Bae),장우익(Woo Ick Jang),김호근(Ho Guen Kim),박찬일(Chan Il Park) 대한내과학회 1992 대한내과학회지 Vol.43 No.2

N/A Background: Alcoholic liver disease (ALD) is caused by chronic drinking. The amount and duration of drinking which develop ALD have been reported variously for the different studies. Also the state of liver is various from normal liver to liver cirrhosis or hepatoma for chronic drinkers. Even though the interest on the ALD is growing recently due to the increase of the drinking population and the alcohol consumption in Korea, the clinical research is still insufficient. So this study was started to get the characteristics of the histologic pattern of ALD, required minimum amount of alcohol to develop ALD and clinical differences in various types in Korea. Methods: Authors analysed drinking history, clinical and laboratory findings of 126 patients who were con- firmed as ALD by liver biopsy. Results: 1) In histologic types, 13 fatty liver, 2 alcoholic hepatitis, 69 alcoholic hepatic fibrosis, 18 alcoholic chronic active hepatitis and 24 liver cirrhosis were found. 2) The subjects were 42. 7 years old in average with no difference in types, all male except 2 cases. 3) 106 patients whose drinking history was known drank 149.9 gm per day and 808.3 kg in total amout in average. Alcoholic chronic active hepatitis or liver cirrhosis patients drank more than fatty liver patients in daily amount (p < 0. 05), but the duration of drinking had no difference in types with 16.9 years in average. Also 98.1% of the subjects drank more than 45 gm of alcohol in daily average and 99.1% of the subjects had been drinking for more than 3 years. 4) Symptoms were various such as fatigue or general weakness, abdominal pain, nausea or vomiting, anorexia. Physical signs were also various such as hepatomegaly, jaundice and spider angioma. But any statistical meaning between types cannot be given due to the small number of subjects. 5) In hematologic and biochemical tests, the albumin level was lower in liver cirrhosis than fatty liver or alcoholic hepatic fibrosis (p<0.05), and the platelet count was lower in alcoholic chronic active hepatitis or liver cirrhosis than fatty liver or alcoholic hepatic fibrosis (p<0.05), but there was no laboratory finding to distinguish the types. Conclusions: Results of this study suggest that alcoholic hepatitis is rare and alcoholic hepatic fibrosis is the most frequent in histologic types of ALD. 98,1% of the subjects drank more than 45 gm of alcohol in daily average for more than 3 years. The types of ALD cannot be distinguished by the symptoms, physical signs, hematologic and biochemical tests.

현미부수체 변이표현형 자궁내막암의 표적 유전자 동정

유권태 ( Kwon Tae You ),김호근 ( Ho Guen Kim ),박찬규 ( Tchan Kyu Park ),손익숙 ( In Sook Sohn ),이지영 ( Ji Young Lee ),장동욱 ( Dong Wook Jang ),양원규 ( Won Gyu Yang ),김수녕 ( Soo Nyung Kim ) 대한산부인과학회 2005 Obstetrics & Gynecology Science Vol.48 No.5

다발성 글루카곤 생성 내분비세포종을 동반한 췌장 알파세포의 Nesidioblastosis 및 과다증식 1예

강화평 ( Hua Pyong Kang ),김세화 ( Se Wha Kim ),임태섭 ( Tae Seop Lim ),이혜원 ( Hye Won Lee ),최흔 ( Heun Choi ),강창무 ( Chang Moo Kang ),김호근 ( Ho Guen Kim ),방승민 ( Seung Min Bang ) 대한소화기학회 2014 대한소화기학회지 Vol.63 No.4

Nesidioblastosis is a term used to describe pathologic overgrowth of pancreatic islet cells. It also means maldistribution of islet cells within the ductules of exocrine pancreas. Generally, nesidioblastosis occurs in beta-cell and causes neonatal hyperinsulinemic hypoglycemia or adult noninsulinoma pancreatogenous hypoglycemia syndrome. Alpha-cell nesidioblastosis and hyperplasia is an extremely rare disorder. It often accompanies glucagon-producing marco- and mircoadenoma without typical glucagonoma syndrome. A 35-year-old female was referred to our hospital with recurrent acute pancreatitis. On radiologic studies, 1.5 cm sized mass was noted in pancreas tail. Cytological evaluation with EUS-fine-needle aspiration suggested serous cystadenoma. She received distal pancreatectomy. The histologic examination revealed a 1.7 cm sized neuroendocrine tumor positive for immunohistochemical staining with glucagon antibody. Multiple glucagon-producing micro endocrine cell tumors were scattered next to the main tumor. Additionally, diffuse hyperplasia of pancreatic islets and ectopic proliferation of islet cells in centroacinar area, findings compatible to nesidioblastosis, were seen. These hyperplasia and almost all nesidioblastic cells were positive for glucagon immunochemistry. Even though serum glucagon level still remained higher than the reference value, she has been followed-up without any evidence of recurrence or hormone related symptoms. Herein, we report a case of alpha-cell nesidioblastosis and hyperplasia combined with glucagon-producing neuroendocrine tumor with literature review.