대장암의 조기 발견 및 치료에 대한 전략 ; 최근에 한국인에서 대장암이 증가하는 이유는?

고성준 ( Seong Joon Koh ),김주성 ( Joo Sung Kim ) 대한내과학회 2010 대한내과학회지 Vol.79 No.2

The incidence of colorectal cancer in Korea has increased dramatically over the past few decades. According to the National Cancer Registry, the age-standardized incidence rates increased from 27.1 to 44.5 per 100,000 for men and from 17.2 to 24.3 per 100,000 for women between 1999 and 2007. The overall incidence of colorectal cancer increased by 7.0% annually in men and 5.3% in women from 1999 to 2007, while the incidence rates of the most common cancers, such as stomach and liver cancers, decreased during the same period. Epidemiologic studies have suggested that higher intakes of red and processed meat, a lack of physical activity, obesity, and alcohol drinking are risk factors for colorectal cancer. During the past few decades, significant socio-economic changes have taken place in Korea with respect to the economy, industrial structure, dietary habits, physical activity, and prevalence of obesity. Changes in dietary habits and lifestyle-related factors are believed to be the reasons for the increase in the incidence of colorectal cancer in Korea. (Korean J Med 79:97-103, 2010)

위장관 ; 배양검사로 확진된 지역사회 세균성 장염 환자에서 과민성 장증후군의 발생률과 위험요인

고성준 ( Seong Joon Koh ),이동호 ( Dong Ho Lee ),이상협 ( Sang Hyub Lee ),박영수 ( Young Soo Park ),황진혁 ( Jin Hyeok Hwang ),김진욱 ( Jin Wook Kim ),정숙향 ( Sook Hyang Jeong ),김나영 ( Na Young Kim ),임종필 ( Jong Pil Im ),김 대한소화기학회 2012 대한소화기학회지 Vol.60 No.1

Background/Aims: The aim of this study was to investigate the incidence and risk factors of irritable bowel syndrome (IBS) in community subjects with culture-proven bacterial gastroenteritis. Methods: This was a prospective, community-based, cohort study, which followed patients with a recent history of culture-proven bacterial gastroenteritis. IBS was diagnosed with the use of the Rome II criteria at 3 and 6 months after bacterial dysentery. Results: Sixty five cases were included and completed the 6 month follow-up. Thirty four cases (52.3%) were female. Salmonella was the pathogen most frequently identified and seen in 41 patients (63.1%). The cumulative incidence of IBS among patients with microbiologically proven bacterial gastroenteritis within a community was 9.2% and 12.3% at 3 and 6 months of follow-up, respectively. The duration of initial diarrhea (≥7 days) was associated with an increased risk for the development of IBS (aOR, 14.50 [95% CI, 1.38-152.72]; p=0.022). Conclusions: Our study suggests that the incidence of IBS among patients with culture-proven bacterial gastroenteritis within a community is similar to that reported among Western populations. A large, prospective study is encouraged to confirm our results and to evaluate the influence of the microbial species on the epidemiology of IBS in Asian populations. (Korean J Gastroenterol 2012;60:13-18)

증례 : Kimura 병 경과관찰 중 발생한 NK/T 세포 림프종 1예

양기영 ( Ki Young Yang ),고성준 ( Seong Joon Koh ),김철우 ( Chul Woo Kim ),김인호 ( In Ho Kim ),윤성수 ( Sung Soo Yoon ),박선양 ( Seon Yang Park ),김병국 ( Byoung Kook Kim ) 대한내과학회 2007 대한내과학회지 Vol.73 No.6

본 증례는 Kimura 병으로 진단받은 후 경과관찰 중폐에 악성 림프종이 발생하였으며, 두 질환의 조직 모두에서 Epstein-Barr virus가 발견되었던 예로 이를 통해 두 질환 사이의 발병 기전의 연관 가능성을 시사하는 증례로서 국내외에 유사보고가 없는 것으로 생각되어 보고하는 바이다. Kimura`s disease is a rare chronic inflammatory disease of the lymphoid organs and this presents as painless nodules in the head and neck area. It occurs endemically in the Far East Asia and sporadically in the West. Its exact etiology is unknown and it has no potential to transform into malignant disease. However, it is often confused with malignant disease such as malignant lymphoma. We report a case of NK/T cell lymphoma patient who had Kimura`s disease in the right thigh 3 years ago. She then suffered from sudden dyspnea. Radiological studies revealed multiple small nodules scattered in both lung fields. NK/T cell lymphoma was diagnosed by open lung biopsy. In addition, Epstein-Barr virus (EBV) was detected in the previous site of Kimura`s disease and lung nodule by molecular pathologic examination. To the best of our knowledge, this is the first case of NK/T cell lymphoma complicating Kimura`s disease with coexisting chronic EBV infection.(Korean J Med 73:656-660, 2007)

제주도의 국제화, 세계화에 대한 기초연구 : 일본 북해도 및 중국 해남도와의 비교분석

신행철(Haeng Chull Shin),고성준(Seong Joon Ko),김경태(Kyung Taeg Kim),김항원(Hang Won Kim),유철인(Chul In Yoo),장성수(Sung Soo Jang),장원석(Won Seok Jang),조성윤(Sung Youn Cho),고충석(Chung Suk Koh),김부찬(Boo Chan Kim) 제주학회 1995 濟州島硏究 Vol.12 No.-

헬리코박터 파일로리 제균 치료가 위암 관련 유전자의 CpG Island 과염기화에 미치는 영향

최정민 ( Jeongmin Choi ),김상균 ( Sang Gyun Kim ),김병관 ( Byeong Gwan Kim ),고성준 ( Seong-joon Koh ),김지원 ( Ji Won Kim ),이국래 ( Kook Lae Lee ) 대한소화기학회 2016 대한소화기학회지 Vol.68 No.5

Background/Aims: Helicobacter pylori infection induces aberrant DNA methylation in gastric mucosa. We evaluated the long-term effect of H. pylori eradication on promotor CpG island hypermethylation in gastric carcinogenesis. Methods: H. pylori-positive patients with gastric adenoma or early gastric cancer who underwent endoscopic resection were enrolled. According to H. pylori eradication after endoscopic resection, the participants were randomly assigned to H. pylori eradication or non-eradication group. H. pylori-negative gastric mucosa from normal participants provided the normal control. CpG island hypermethylation of tumor-related genes (p16, CDH1, and RUNX-3) was evaluated by quantitative MethyLight assay in non-tumorous gastric mucosa. The gene methylation rate and median values of hypermethylation were compared after one year by H. pylori status. Results: In H. pylori-positive patients, hypermethylation of p16 was found in 80.6%, of CDH1 in 80.6%, and of RUNX-3 in 48.4%. This is significantly higher than normal control (p16, 10%; CDH1, 44%; RUNX-3, 16%) (p<0.05). In the H. pylori eradication group, methylation rates of p16 and CDH1 decreased in 58.1% and 61.3% of the patients, and the median values of hypermethylation were significantly lower at one year compared with the non-eradication group. However, RUNX-3 hypermethylation did not differ significantly at one year after H. pylori eradication. The non-eradication group hypermethylation did not change after one year. Conclusions: H. pylori infection was associated with promotor hypermethylation of genes in gastric carcinogenesis, and H. pylori eradication might reverse p16 and CDH1 hypermethylation. (Korean J Gastroenterol 2016;68:253-259)

악성 대장 폐쇄 환자에서 자가팽창성 금속 스텐트의 임상적 효과: 내시경적 및 방사선적 삽입법 비교

김지원 ( Ji Won Kim ),정지봉 ( Ji Bong Jeong ),이국래 ( Kook Lae Lee ),김병관 ( Byeong Gwan Kim ),정용진 ( Yong Jin Jung ),김원 ( Won Kim ),김휘영 ( Hwi Young Kim ),안동원 ( Dong Won Ahn ),고성준 ( Seong Joon Koh ),이재경 ( Jae K 대한소화기학회 2013 대한소화기학회지 Vol.61 No.1

Background/Aims: This study compared the clinical outcomes between endoscopic and radiologic placement of self-expandable metal stent (SEMS) in patients with malignant colorectal obstruction. Methods: In total, 111 patients were retrospectively enrolled in this study between January 2003 and June 2011 at Seoul National University Boramae Hospital. Technical and clinical success rates, complication rates, and stent patency were compared between using an endoscopic (n=73) or radiologic (n=38) method during the SEMS placement procedure. Results: The technical success rate was higher in the endoscopic method than in the radiologic method (100% [73/73] vs. 92.1% [35/38], respectively; p=0.038). In addition, in 3 of the remaining 35 patients in the radiologic-method group, adjuvant endoscopic assistance was required. In the six patients (including the three aforementioned patients), the causes of technical failure were the inability to pass the guidewire into an obstructive lesion due to a tortuous, curved angulation of the sigmoid or descending colon (n=4), and a difficult approach to a lesion located at the descending or transverse colon (n=2). The clinical success rate, complication rate, and stent patency did not differ significantly between the two methods (p=0.424, 0.303, and 0.423, respectively). Conclusions: When the colorectal obstruction had a tortuous, curved angulation of the colon or was located at or proximal to the descending colon, the endoscopic method of SEMS placement appears to be more useful than the radiologic method. However, once SEMS placement was technically successful, the clinical success rate, complication rate, and stent patency did not differ with the method of insertion. (Korean J Gastroenterol 2013;61:22-29)

대장내시경에서 원위부 용종이 발견되었을 때 근위부 용종의 유병률과 임상적 특징

주세경 ( Sae Kyung Joo ),김지원 ( Ji Won Kim ),이국래 ( Kook Lae Lee ),김병관 ( Byeong Gwan Kim ),정지봉 ( Ji Bong Jeong ),이재경 ( Jae Kyung Lee ),고성준 ( Seong Joon Koh ),김영훈 ( Young Hoon Kim ) 대한소화기학회 2013 대한소화기학회지 Vol.62 No.1

목적: 대장암은 서구뿐 아니라 국내에서도 증가하고 있으며 이로 인한 사망률도 높아 조기에 발견을 하는 것이 중요하다. 대장암의 선별 검사로 분변 잠혈 반응 검사와 구불창자내시경이 가장 보편적으로 시행되고 있다. 그러나 분변 잠혈 반응 검사의 경우 민감도와 특이도가 낮다는 문제가 있으며 구불창자내시경의 경우 대장암의 전구 병변인 대장 용종의 진단이 위치에 따라 불가능하다는 문제가 있다. 이번 연구는 근위부 대장까지 검사가 가능한 대장내시경을 이용하여 위치에 따른 용종의 유병률과 임상적 특성을 알아보고자 하였다. 대상 및 방법: 2009년 1월 1일부터 2010년 12월 31일까지 보라매병원 소화기센터에 내원하여 대장내시경을 시행받은 6,417명의 환자를 대상으로 후향적 의무 기록을 분석하였다. 결과: 총 1,972명의 환자에서 1개 이상의 대장 용종이 발견되었다. 염증성 장질환이 있거나 대장암으로 치료받은 병력이 있는 경우, 가족성 선종 용종증을 갖고 있는 경우에는 제외하였다. 633명(32.1%)의 환자는 근위부에서만 용종이 발견되었다. 원위부와 근위부 모두에 용종이 있는 환자는 530명 (26.9%)이었으며 남자와 노인인 경우 통계적으로 유의하였다. 근위부에만 용종이 있는 경우 임상적 특징은 원위부에만 용종이 있는 경우와 비교하여 통계적 차이가 없었고 원위부용종의 크기나 숫자와도 관련이 없었다. 또한 진행성 선종의 경우 원위부에 용종이 없이 근위부에만 용종이 존재한 경우가 29.4%로 나타났고 원위부 용종의 크기가 증가할수록, 조직형이 진행할수록 근위부 진행성 선종의 유병률이 증가하였다. 결론: 용종의 크기와 숫자와 관계 없이 모든 환자에서, 특히 남자 노인인 경우에 전 대장내시경을 추천한다. Background/Aims: Colorectal cancer is the third most common type of cancer and second leading cause of cancer death overall. Recently, there has been an emphasis on primary screening for colorectal cancer with colonoscopy. In this study, we aimed to address clinical characteristics and incidence of colonic polyps according to location. Methods: From January 2009 to December 2010, 6,417 total colonoscopic examinations were performed at Boramae Hospital in Seoul, Korea. We reviewed these patients retrospectively. The distal colon was defined as the rectosigmoid junction. Results: Overall, 1,972 patients (31.3%) had one of more colorectal polyps. Total of 4,445 patients were excluded from this study because of combined advanced colorectal cancer, inflammatory bowel disease, or familial adenomatous polyposis. Patients who had only proximal polyps were 633 (32.1%), 530 patients (26.9%) had both proximal and distal polyps, and 809 patients (41.0%) had polyps only in the rectosigmoid region. The prevalence of the proximal polyps in patients with rectosigmoid polyps was found to be significantly related to the male gender and elderly patients. However, the prevalence of the proximal colonic polyps was not related to the size and number of rectosigmoid polyps. In 530 patients with both rectosigmoid and proximal colonic polyps, the characteristics of proximal colonic polyps as size and number were similar to those of rectosigmoid polyps. Advanced proximal adenomas without distal polyps were found in 25 (29.4%) patients whom were associated with size and pathology. Conclusions: We recommend total colonoscopic examination in all patients regardless of the size and number, especially in elderly males. (Korean J Gastroenterol 2013; 62:42-48)

現代의 革命的 마르크스主義 이데올로기에 對한 硏究

高忠錫,韓昌榮,高性俊 제주대학교 1983 논문집 Vol.15 No.2

When we approach national unification, we have to start discussing on the Communist Ideology of the North Korea. In a totalitarian society like north Korea, political ideology has become the backbone of the entire social system. It determines the direction of political development, the uniform rule that regulates the whole political activities, the pace setter that covers all aspects of social life of the entire people, and the solemn religion that provides with moral criteria of evaluating everyone's mental activities. Political ideology is a historical product. It reflects prevailing ideals of the people living in an era, If a group of people share common frustration in a particular social system, they begin to envisage a dream of an ideal society where such frustration is presumed not to exist. In such circumstances, when someone provides logical nexus linking the current unsatisfactory state and the desirable logical nexus linking the current unsatisfactory state and the desirable future utopia, and suggest also an action program for the social changes necessary to get to the ideal state, we call it a birth of an ideology, we can say then that a political ideology is the will of the people to resist against the contemporary political or social system. There fore it is inevitable that a political ideology directly reflects both the static and dynamic system-state of a society in a particular era. How we prescribe the characteristics of Modern Marxian Revolutionary Ideologies? They are transformed based on the traditional Marxism Leninism according to specific circumstances. For example, Euro-communism, the thought of Kim Il-song, Marxist dependence theory are what we call Modern Marxian Revolutionary Ideologies. Nowaday in Communist Societies, the dream of classless society is not pratical. Rather, as Milovan Djilas said, new class came in view. Poland in the past two year and a half has taught the world a lesson that is both stark and undeniable: as a means of organizing an economy and providing for the well-being of a citizenry, Comnlunism is a failure. These mean that Marx's theory, in soviet practice, is collapsed. Euro-communism is drifted about recently. Marxist dependence theory has lost support because of radical and unrealistic points. The Thought of Kim Il-Song is no other than a tool for indoctrination of the people to accept Kim's one-man dictatorship. What we learn above is that modern Marxian revolutionary ideologies are only false-consciousness.

중남미의 사회주의에 관한 연구

高性俊 건국대학교 1988 論文集 Vol.26 No.1

This paper briefly surveys the background and development of socialism in Latin America, and argues the future of socialism in Latin America. Eyen though most countries in Latin America were liberated from Spanish and Portuguese colonial government in the 1820's, the absolute culture and socio-economic institution of their colonial systems have been preserved. The characteristics of the socio-economic structure of Latin America formed liked this are hacienda, mono-culture economy, imbalance in income distribution, Catholic culture and bipolar social class, and all of them become the background of socialist movement which have been developed since the mid 19th century, with the problem of inequality doe to the processes of industrialization being posed. Socialist political movements emerged in Latin America in the mid-nineteenth century, primarily in southern South America where European immigration was high. These groups usually were composed of middle class intellectuals, had little success in winning the broad working class support and were divided into Marxist, anarchist, syndicalist and democratic approaches to socialism. In the 20th century, socialist parties were firmly established in some countries like Argentina and Chile, but in many instances they were firmly established in some countries like Argentina and Chile, but in many instances they were supressed by dictatorial governments. Democratic socialist parties lost support to other leftist reform that adopted in part the socialist program, including land reform, nationalization of foreign-owned enterprise and social welfarism. The establishments of Communist parties after World War I and radical "popular socialist" after World War II divided the socialist movement. A few communist parties of Latin America predated the Bolshevik Revolution of 1917 in Russia, but most of them were created in the 1920's. Orthodox Latin communist parties joined the Communist International and were much Influenced by the doctrines and policies laid down by the Soviet Union, but communists tried to command power within the system by anticommunist policies of powerful rightist military influence and U.S. A. It was in 1959 when socialist revolution was succeeded by Fidel Castro in Cuba. Cuban revolution became the model of communist revolution in this area and encouraged communist movements. But it also brought about the division of communist movement by adding Cuban-type to the orthodox communist movement. In the 1970's, a wave of neomilitarism in Latin America drove most of communist parties Into the underground and they had little popular support in other nations. Only the Sandinista Revolution succeeded through guerrilla war in Nicaragua in 1979. Will the socialist revolution like those of Cuba and Nicaragua spread in Latin America ? It is doubtful that such revolution will happen in other nations because of the military influence and U.S. A. The march of democratization in Latin America will dissolve political, economic and social causes to promote communist penetration too. But when democratization may not progress successfully, radical socialist movement will raise its head strongly again.

共産主義體制의 內在的 危機要因에 關한 硏究 : 蘇聯 및 東歐를 中心으로

高性俊,韓昌榮,金恒元 제주대학교 1983 논문집 Vol.16 No.2

This year is 100th since Marx died. There have been so many reports that the 100th anniversary of Marx's death was being marked in unforgettable ways. If Marx were to come back, what does he discover? Maybe he discovers that things aren't what he has expected. What is the significance of polish crisis in early 1980s? It has taught the world a lesson that is both stark and undeniable: as a means of organizing an economy and providing for the well-being of a citizenry, Communism is a failure. It is related to the dark future of communism. The causes of polish crisis are two: one is the fall of social status and the consciousness of frustration. The other is the continuous failure of Economic policy and the bankrupty of national Economic life. If we interpretate the two causes on the thread of connection in communist system, the former implies the "equality" idea of communism is falseconsciousness. The latter means the practical limit of communist economic system. Nowaday in Communist Societies, the dream of classless society is not practical. Rather as Millovan Djilas said, new class came in view. He sees the party as the incumbent institution of class rule: The new ownership is not the same as the political government, but is created and aided by that government. The use, enjoyment, and distribution of property is the privilege of the party and the party's top men. We call them Nomenklatura. The alienation of the worker from his work is at least as great today at the plants in communist countries as it was in the Manchester textile mills that Engels studied in the mid-l9th century. The command economy, too is slowing down if not breaking down. No communist country has met the proclaimed goals of its Five-Year plan: The desired results that the economies were organized to achieve have simply failed to materialize. And the projections for the next ten years are even gloomier. So U.S.S.R and Eastern Europe try to reform the economic policy, But those reforms challenge the very essence of the system, which is totalitarianism. It is the dilemma of the communist countries hold. What is the result of Soviet Communist System? The result is a tension and a paradox. On the one hand, inefficiency, stagnation and alienation are theinevitable accompaniments of the centralization, elitism and repression that are necessary to carry out the first order of businss: the preservation of power. On the other hand, the political system is well designed to be impervious to the consequences of the economic failure and social demoralization that are built into it.