한국 여름철 집중호우의 종관 및 역학적 특징

학위논문(박사) -- 서울대학교대학원 : 자연과학대학 지구환경과학부, 2023. 2. 손석우.Heavy rainfall events (HREs) are the most frequent natural disaster from which people in South Korea recurrently suffer every summer. However, our understanding of their mechanisms has been still limited because many previous studies were confined to case studies or qualitative analyses. In this dissertation, the synoptic–dynamic characteristics of HREs in the summer monsoon period in South Korea are elaborated both quantitatively and qualitatively based on all historical events that occurred in the recent four decades. First, by separately considering the HREs resulting from tropical cyclones (TCs; 18.9%) and those not directly related to TCs (81.1%), their climatological features are drawn through composite and statistical analyses. This result is then extended to their further synoptic–dynamic details as below. By numerically solving the quasigeostrophic omega equation, it is found that the vertical motion of non-TC-induced HREs (hereafter, simply HREs) is initially driven dynamically, but diabatic uplift becomes dominant in the mature stage of HREs. This implies the importance of dynamic processes in triggering HREs and nonlinear dynamic–diabatic feedback in the subsequent growth of HREs. By decomposing Q vectors into shearwise and transverse components to delineate the dynamical processes, it is further revealed that the dynamic omega is closely associated with a baroclinically-deepening trough in the upper troposphere. The role of thermally-direct secondary circulation on the entrance region of the upper-level jet, which has been emphasized in the literature as a key driver of HREs, turns out to be relatively minor. The quasigeostrophic diagnosis of vertical motion of HREs can be robustly applied to most summertime HREs, but the clustering analysis shows that HREs could occur under various surface weather patterns depending on the strengths and/or locations of surface synoptic-scale cyclones and the North Pacific high. Each cluster exhibits a distinct temporal evolution of surface weather patterns with different favorable seasons and regions. This result provides important forecasting factors to be differently considered depending on the synoptic categorization of HREs. While most previous studies on TC rainfall in South Korea have focused on the characteristics of TC itself and local factors (e.g., topography), it is found that TC-induced HREs (hereafter, TC-HREs) are also largely sensitive to midlatitude condition. The TC-HREs under strongly baroclinic condition are characterized by amplifying tropopause circulation (by negative potential vorticity advection by TC-induced divergent outflow) and structural changes of TC (reminiscent of extratropical transition). The synergistic TC–midlatitude flow interaction allows for widely enhanced quasigeostrophic forcing for ascent, causing heavy rainfall even before TC gets close to South Korea. The TC-HREs under weakly baroclinic condition, in contrast, do not accompany the meandering tropopause flow. In the absence of strong interaction with midlatitude flow, TC rapidly dissipates after entering midlatitude, and the upward motion is confined to the inherent diabatic TC convection. As a result, heavy rainfall occurs only when TC locates in the right vicinity of the country. Lastly, the record-breaking monsoon rainfall in the summer of 2020 is investigated. The abrupt change of HRE nature in late July is particularly of interest. While the HREs from 29 June to 27 July (P1) were determined by the passage of extratropical cyclones, those from 28 July to 15 August (P2) mainly occurred by the quasi-stationary monsoon rainband and mesoscale instability thereon. This sudden synoptic transition is explained by atmospheric teleconnections. During P1, the subtropical high anomalously extended westward but its northward expansion was hindered by the suppressed convection over the South China Sea. In contrast, the enhanced South China Sea convection in P2 prompted an abrupt northward jump of the subtropical high. The resulting monsoon circulations established favorable environments for extratropical cyclones and monsoon rainband, respectively, in the two subperiods. The atmosphere–ocean coupled mode over the Indo-western Pacific was particularly related to the suppressed convection over the South China Sea in P1. The summer North Atlantic oscillation also secondarily contributed to the anomalous monsoon flows in P1 and P2 with opposite phases, although the reasons for its synchronized phase transition with the South China Sea convection is still unclear. The summer of 2020 implies that multiscale analyses would be beneficial in future work for a better understanding of HREs.여름철 집중호우는 해마다 발생하는 가장 빈번한 자연재해이나 그간의 국내 연구들은 주로 사례 연구나 정성정 분석에 집중되어 있어 관련 메커니즘에 대한 완전한 이해는 담보되지 않은 상태이다. 본 논문에서는 최근 40년 동안 발생한 모든 여름철 집중호우 사례들을 활용하여 집중호우의 종관기상학적 특성을 정성적, 정량적으로 상세분석하였다. 기상청 호우주의보 기준인 12시간 누적강수량 110 mm로 정의된 집중호우 사례들을 태풍에 의해 발생한 사례(TC-HREs; 전체의 약 18.9%)와 태풍과 직접적으로 연관되지 않은 사례(HREs; 전체이 약 81.1%)로 구분하고, 합성장 및 통계적 분석을 통해 각각의 기후학적 특성을 먼저 도출하였다. 이를 기반으로 HREs와 TC-HREs의 종관 및 역학적 특징을 아래와 같이 더욱 상세화하였다. HREs의 경우, 집중호우 발생 전부터 상층 요란이 유의미하게 풍상측에 나타났으며 이는 시간에 따라 조직화된 상층골로 발달하는 것으로 확인되었다. 준지균 오메가 방정식의 수치적 해를 통해 집중호우의 발달기에는 역학적 강제력과 비단열적 강제력이 상승운동에 비슷한 정도의 역할을 하지만 집중호우 최성기가 되면 연직운동은 비단열 강제력에 지배되는 것으로 나타났다. 이는 집중호우가 역학적 강제력에 의해 촉발되고 이어 역학적-비단열적 되먹임 통해 빠르게 발달함을 암시한다. Q 벡터의 자연좌표계에서의 물리적 분해를 통해 역학적 강제력은 특히 하층 저기압과 경압불안정을 통해 발달하는 상층 골에 의해 지배되는 것으로 확인되었는데, 이는 선행연구에서 강조되어온 상층제트 입구에서 발생하는 이차순환의 역할이 다소 과장되었음을 의미한다. 집중호우 연직운동의 준지균적 진단은 대부분의 사례에 적용될 수 있으나, 집중호우는 조직화된 저기압의 위치/유무, 북태평양 고기압의 위치/강도 등의 차이 등에 따라 다양한 지상 일기 패턴하에서 발생할 수 있다. 이러한 집중호우의 다양성은 인공신경망 알고리즘을 이용한 군집분석을 통해 발견되었는데, 각 군집들은 저마다 다른 일기 패턴의 발달양상을 보여주며 주요 발생시기 및 발생지역 또한 뚜렷한 차이를 보이는 것으로 나타났다. 따라서 지상 일기 패턴 기반 집중호우 유형 분류는 여름철 집중호우의 종합적인 이해 뿐만 아니라 예보에 있서도 도움이 될 것으로 기대된다. TC-HREs에 관한 기존의 연구들은 주로 태풍 자체의 특성이나 지형 등과 같은 국지적인 요소들에 집중해왔으나, 태풍에 의한 집중호우는 중위도 조건에 의해서도 매우 민감하게 반응하는 것으로 확인되었다. 중위도 순환이 경압적으로 불안정한 조건에 놓여있는 경우, 태풍이 유도한 상층 발산류가 음의 잠재와도 이류를 일으켜 중위도 대류권계면의 파동활동이 두드러지고(예: 상층 기압골의 정체 및 상층 기압능, 제트의 강화), 북상하는 태풍의 온대저기압화 또한 빠르게 이루어진다. 이는 태풍과 중위도 순환 사이에 강한 상호작용이 이루어지기 때문인데, 이는 태풍 전면의 넓은 지역에 강한 준지균 상승운동을 유발하고 그 결과 태풍이 한반도에 미처 상륙하기 전부터 집중호우가 발생할 위험을 초래한다. 반면, 중위도 경압 조건이 약한 경우 이러한 태풍-중위도 순환 상호작용이 거의 나타나지 않으며 태풍 또한 중위도로 진입 후 빠르게 약화되는 특성을 보인다. 집중호우와 연관된 연직운동은 주로 태풍의 잔여 비단열적 대류에 지배되는 양상을 보이며 그 결과 태풍이 한반도에 상륙하거나 가까이 접근했을 때 비로소 집중호우가 발생한다. 마지막으로, 이례적으로 많은 호우 피해가 발생한 2020년 여름에 대한 사례분석을 수행하였다. 특히, 집중호우의 양상이 7월 말 갑자기 바뀐 것에 주목하였는데, 6월 29일부터 7월 27일까지의 기간(P1) 동안 집중호우는 온대저기압의 통과에 의해 발생한 반면, 7월 28일부터 8월 15일까지의 기간(P2) 동안 집중호우는 정체한 몬순강우대 상의 중규모 불안정에 의해 발생하였다. 이러한 종관적 특성의 급변을 이해하기 위해 대규모 순환을 분석한 결과, P1에는 북태평양 고기압이 서쪽으로 강하게 확장했으나 남중국해 대류 약화에 따른 파동 반응에 의해 북상하지 못한 채 남쪽에 머물렀고 그 결과 한반도로 온대저기압이 통과하기 좋은 조건이 만들어진 것으로 나타났다. 반면, P2에는 다시 대류가 강화되어 북태평양 고기압의 가장자리의 강한 기압경도가 한반도 위에 놓이게 되어 몬순 정체전선이 발달하기 좋은 환경이 형성된 것으로 확인되었다. 특히 P1 시기의 남중국해 대류활동은 인도-북태평양에서 이루어진 대규모 대기-해양 상호작용과 연관되어 있었으며, 북대서양 여름 진동 또한 7월 말 갑작스런 위상 변화를 통해 P1과 P2의 동아시아 몬순 순환에 서로 다른 영향을 준 것으로 판단된다. 2020년 사례는 향후 집중호우 연구에서 중규모-종관규모-대규모 순환을 아우르는 다중규모 분석이 필요함을 시사한다.Chapter 1. Introduction 5 1.1. Background 5 1.1.1. Precipitation climatology in South Korea 5 1.1.2. East Asian summer monsoon (EASM) 6 1.1.3. Large-scale modulation of EASM 7 1.1.4. Changma 8 1.1.5. Synoptic features of HREs 9 1.1.6. Mesoscale features of HREs 10 1.1.7. Thermodynamic characteristics of HREs 11 1.1.8. Tropical cyclones (TCs) 11 1.2. Aims of dissertation 13 Chapter 2. Climatological features of HREs and TC-HREs 14 2.1. Motivation 14 2.2. Data and methods 15 2.2.1. Data 15 2.2.2. Definition of HRE and TC-HRE 15 2.3. Composited synoptic conditions 18 2.3.1. HREs 18 2.3.2. TC-HREs 22 2.4. Spatiotemporal occurrence distributions 26 Chapter 3. Quasi-geostrophic diagnosis of HREs 28 3.1. Motivation 28 3.2. Data and methods 31 3.2.1. Dataset 31 3.2.2. QG diagnosis of vertical motion 31 3.2.3. Transverse and shearwise components of Q vector 32 3.3. QG forcing: Dynamic versus diabatic forcings 33 3.4. QG dynamic forcing: Transverse versus shearwise Q-vector forcings 39 3.5. Discussion 47 Chapter 4. Diverse synoptic weather patterns of HREs 49 4.1. Motivation 49 4.2. Data and methods 50 4.2.1. Dataset 50 4.2.2. Classification of HREs 50 4.3. Overview of the SOM clustering results 51 4.4. Synoptic patterns of the six HRE clusters 55 4.4.1. Quasi-stationary frontal boundary between low and high (C1 and C3) 55 4.4.2. ETC from eastern China (C2 and C5) 58 4.4.3. Local disturbance at the edge of the NPH (C4) 61 4.4.4. Moisture pathway between continental and oceanic highs (C6) 63 4.5. Discussion 68 Chapter 5. Role of midlatitude condition in TC-HREs 69 5.1. Motivation 69 5.2. Literature review of ET 70 5.2.1. Structure changes of TC 70 5.2.2. Impacts on midlatitude flow 71 5.3. Data and methods 73 5.3.1. Data 73 5.3.2. Definition of TC-HREs 74 5.3.3. Classification of TC-HREs 75 5.3.4. PV tendency equation 78 5.3.5. QG omega equation 78 5.4. Overview of the SOM clustering results 79 5.5. Synoptic evolutions under different tropopause patterns 83 5.5.1. Upper- and low-level evolutions 83 5.5.2. Vertical cross sections 90 5.6. Quantitative assessments 94 5.6.1. TC influence on the tropopause circulation 94 5.6.2. QG diagnosis of vertical motion 99 5.7. Discussion 106 Chapter 6. Record-breaking rainfall in the summer of 2020 108 6.1. Motivation 108 6.2. Data and methods 109 6.3. Overview of the 2020 summer rainfall 111 6.3.1. Record-breaking rainfall amount 111 6.3.2. Weather patterns of the HREs 113 6.4. Subseasonal variation of HREs and background flow 117 6.4.1. Synoptic characteristics of HREs in P1 and P2 117 6.4.2. Background monsoon flows in P1 and P2 121 6.5. Possible mechanisms of the monsoon circulation change 126 6.5.1. Meridional wave train by the SCS convection 126 6.5.2. Zonal wave train by the SNAO 129 6.5.3. Combined effect of the SCS convection and SNAO 130 6.6. Discussion 134 6.6.1. IPOC effect 134 6.6.2. BSISO 137 6.6.3. Other possible factors 138 Chapter 7. Conclusions and final remarks 139 7.1. Overall 139 7.2. Summary of dissertation 141 7.2.1. Chapter 2 Climatological features of HREs and TC-HREs 141 7.2.2. Chapter 3 Quasi-geostrophic diagnosis of HREs 142 7.2.3. Chapter 4 Diverse synoptic weather patterns of HREs 142 7.2.4. Chapter 5 Role of midlatitude condition in TC-HREs 144 7.2.5. Chapter 6 Record-breaking rainfall in the summer of 2020 145 7.3. Future directions 147 Appendix A 148 A1. Integrated water vapor transport 148 A2. 2D frontogenesis 148 A3. Curvature and shear components of geostrophic relative vorticity 148 A4. Wave activity flux by stationary Rossby wave 149 Appendix B 151 B1. Q-vector-form QG omega equation 151 B2. Numerical details of the QG omega equation inversion 154 B3. Transverse and shearwise Q vectors 156 B3.1. Mathematical expression and key physical meanings 156 B3.2. Further physical meanings 157 B3.3. Cartesian expression 159 Appendix C 160 C1. SOM algorithm 160 C1.1. Overview 160 C1.2. Topology and arrangement of nodes 160 C1.3. Iterative training procedure 162 Appendix D 164 D1. PV tendency equation 164 REFERENCES 165 국문초록 181박

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Carcinoid tumor of the middle ear cavity is a rare neoplasm of low malignant potential. It grows slowly and rarely metastasizes. We recently experienced a case of carcinoid tumor of the middle ear cavity occurring in a 51-year-old female who was presented with hearing loss and tinnitus of the right ear. A 1 cm sized pinkish soft mass was noted in the promontory of the middle ear. Histologically, the mass was composed of nests and cords of tumor cells with slightly pleomorphic nuclei and eosinophilic cytoplasm. The extracellular matrix was glassy pink, homogeneous and exhibited apple green birefringence under a polarized light microscope after Congo red staining. The tumor cells showed immunoreactivity for cytokeratin, chromogranin A, synaptophysin, neuron-specific enolase and calcitonin. Electron microscopic examination confirmed the presence of neurosecretory granules. The production of calcitonin and amyloid by the tumor cells suggests the possible relationship of this tumor to the thyroid C cells.ope

An empirical analysis of computerized substitution rate by matching Air-Force Wing position with job

학위논문 (석사) -- 서울대학교 대학원 : 공과대학 협동과정 기술경영·경제·정책전공, 2021. 2. 이정동.With the innovative development of technologies such as the Fourth Industrial Revolution, artificial intelligence and digital transformation, there is a great deal of concern that human labor will be replaced by computers, including machines. Various studies have been conducted to predict employment substitution for workers engaged non-routine jobs. The study underlying this study is by Frey & Osborne (2017). The study quantitatively analyzed the U.S. labor market by estimating the computerized replacement rate of American jobs. To predict changes in human labor replacement, domestic researchers also conducted a study using the results and methodology of the study by Frey & Osborne (2017) to predict the domestic labor market. In particular, research was conducted on the replacement rate of jobs in public institutions that provided public services. This study sought to estimate the replacement rate of jobs in the Air Force's wing, which is at the forefront of national security, among public institutions. Since the Air Force is organized and operated based on the wing, a single wing organization can be viewed as a society with a diverse set of occupations. Thus, matching the position within the wing with a civilian occupation can estimate the computerized replacement rate for the detailed occupation within the air force wing. This study demonstrated that the computerization replacement rate of public service jobs differs from that of private jobs through the matching of air force wing's each position with civilian jobs. The study method applied the methodology used in the study of Frey & Osborne (2017). The positions in the Air Force's wing were matched with jobs in the private sector, and the Air Force's wing was surveyed to estimate the replacement rate for computerization of those jobs. The results of the study showed that the replacement rate of the Air Force's wing occupation was low compared to the replacement rate of the occupation by occupation in the domestic private society, and that the jobs of the high-risk group were similar to those of the private sector, but the jobs of the low-risk group were different. Through this study, it was confirmed that the computerization replacement rate of the Air Force's wing job, a public institution, was lower than that of the private sector, as a result of the demonstration of the fact that the public institution analyzed that the computerization replacement rate was lower than that of the private sector in the preceding study. In addition, the relationship with the Air Force vocational education (period, course operation, and subjects) provided policy implications for improving and supplementing the Air Force vocational education.4차 산업혁명, 인공지능, 디지털 트렌스포메이션 등 기술의 혁신적인 발달로 인해 인간의 노동력이 기계를 포함한 컴퓨터로 대체될 것에 대한 걱정이 크게 증가하고 있다. 비정형적 직무에 종사하는 노동력의 고용대체 예측을 위해 다양한 연구가 진행되어 왔고, 이러한 연구의 기반이 되는 연구는 미국 직업들의 컴퓨터화 대체율을 추정하여 미국 노동시장을 정량적으로 분석한 Frey & Osborne(2017)이라고 할 수 있다. 인간의 노동력 대체의 변화를 예측하기 위해 국내의 연구자들 역시 Frey & Osborne(2017)의 연구 결과와 방법론을 활용하여 국내 노동시장을 예측하는 연구를 수행하였고, 특히, 공공서비스를 제공하는 공공기관에서도 직업의 컴퓨터화 대체율에 대한 연구가 진행되었다. 이에 더 나아가서 본 연구에서는 공공기관 중에서도 국가안보의 최전선에 있는 공군 비행단 내 직업의 컴퓨터화 대체율을 추정하고자 하였다. 공군은 비행단을 기준으로 편제가 구성되어 운영되기 때문에 1개의 비행단 조직은 다양한 직업의 집합으로 하나의 사회로 볼 수 있으며, 이 비행단 내 조직원의 직책을 민간 직업으로 매칭하면, 공군 비행단 내 세부 직업의 컴퓨터화 대체율을 추정할 수 있기 때문에 선행연구 결과를 실증 분석하는 연구를 진행하였다. 본 연구는 공군 비행단 직책과 민간 직업의 매칭을 통해 공공기관 직업의 컴퓨터화 대체율이 민간 직업과 차이가 발생하는 것을 실증하고, 공군 직업의 컴퓨터화 대체율 추정을 통해 공군 비행단 인력 구조 재배치 및 직업별 교육과정의 개선 사항에 대하여 제언한다. 연구 방법은 Frey & Osborne(2017)의 연구에 사용된 방법론을 적용하였다. 먼저, 공군 비행단 내 직책을 민간 사회의 직업과 매칭하여, 공군 비행단 내 직업의 개수를 산출하였다. 이후 공군 비행단 내 직업의 컴퓨터화 대체율 추정을 위하여 선행 연구에서 활용한 문항을 일부 수정하여 공군 비행단 자체 온라인으로 설문조사를 시행하였다. 연구 결과 대체로 국내 민간 사회의 직업별 컴퓨터화 대체율과 비교해서 공군 비행단 직업의 컴퓨터화 대체율은 낮은 것으로 분석되었고, 고위험군의 직업은 민간 직업과 유사하나, 저위험군의 직업은 다소 차이가 있는 것으로 분석되었다. 본 연구를 통해서, 공공기관인 공군 비행단 직업의 컴퓨터화 대체율은 민간 직업 대비 낮은 것에 대한 확인할 수 있었으며, 이는 선행 연구에서 공공기관이 민간 사회 대비 컴퓨터화 대체율이 낮다고 분석한 사실에 대한 실증한 결과이다. 또한, 공군 직업교육(교육기간, 과정 운영 및 과목)과의 관계를 통해서 공군 직업교육의 개선 및 보완에 대하여 정책적 함의를 얻을 수 있었다.1. 서 론 1 1.1 연구 배경 및 목적 1 1.2 연구 구성 4 2. 문헌 연구 5 2.1 정형적 직무 대체 5 2.2 비정형적 직무 대체 6 2.2.1 미국 등 세계 연구 6 2.2.2 국내 연구 10 3. 데이터 및 연구 방법 17 3.1 변수 17 3.2 데이터 20 3.3 설문조사 23 3.4 연구방법 27 4. 연구 결과 32 4.1 선행연구 데이터 분석 32 4.2 공군 비행단 직업 대체율 분석 결과 33 4.3 선행 연구 결과와 비교 36 4.4 공군 비행단 병력 구성 비율 38 4.4.1 직업별 병력 구성 비율 38 4.4.2 신분별 병력 구성 비율 40 4.5 공군 비행단 직업 대체율과 직업교육 42 4.5.1 공군 직업교육 42 4.5.2 공군 직업별 컴퓨터화 대체율과 직업교육기간 관계 45 4.5.3 공군 교육과정 과목 및 교관 운영 47 5. 결 론 50 5.1 요약 및 시사점 50 5.2 한계점 및 향후 연구방향 53 참 고 문 헌 55 부록 A(선행연구 표지 직업) 60 부록 B(공군 비행단 대상 설문지 예시) 62 부록 C(공군 비행단 직업의 컴퓨터화 대체율) 63 부록 D(공군 직업별 직업교육기간) 64 Abstract 65Maste

Expression of Matrix Metalloproteinase (MMP)-2, MMP-9, Tissue Inhibitor of Metalloproteinase (TIMP)-1 and TIMP-2 in Adenocarcinomas of The Gallbladder

Background: Matrix metalloproteinase (MMP)-2 and MMP-9 degrade type IV collagen and are antagonized by the tissue inhibitors of metalloproteinase (TIMP)-2 and TIMP-1, respectively. Methods: We studied by immunohistochemistry the expressions of MMP-2, MMP-9, TIMP-1 and TIMP-2 in 72 cases of adenocarcinoma of the gallbladder. Results: The MMP-2, MMP-9 and TIMP-1 expressions were significantly higher in well/moderately differentiated adenocarcinomas than in poorly differentiated adenocarcinomas, in adenocarcinomas that had invaded the lamina propria/proper muscle than in those that had invaded the perimuscular connective tissue or beyond the serosa, and in adenocarcinomas with fungating growth than in those with infiltrative growth. The TIMP-2 expression showed a similar pattern without statistical significance. Regarding the status of lymph node metastasis, the MMP-2 expression was significantly higher in cases without lymph node metastasis. The MMP-2 and MMP-9 expressions were significantly related to those of TIMP-2 and TIMP-1, respectively, with regard to depth of invasion, differentiation, and growth patterns of the adenocarcinomas. Conclusion: MMP-2, MMP-9, TIMP-1 and TIMP-2 are suggested to play important roles in the progression to early invasion of adenocarcinomas, in which the function of MMP-2 is inhibited by TIMP-2.ope

Porposal for Creating a Guideline for Cancer Registration of the Gastrointestinal Tumors (I).

BACKGROUND: Cancer registries are fundamental for cancer control and multicenter collaborative research. However, there have been discrepancies among pathologists in classifying cancer and assigning the codes according to the International Classification of Disease Oncology 3 (ICD-O3). To improve the quality of cancer registries as well as to prevent the conflict with medical insurance compensation, a guideline for the coding of cancer is mandatory. METHODS and RESULTS: Funded by the Management Center for Health Promotion, 40 members of the Gastrointestinal Pathology Study Group and the Cancer Registration Committee of the Korean Society of Pathologists participated in the 1st workshop for gastrointestinal tumor registration. The subjects of gastric epithelial tumor, intramucosal carcinoma of the colon, carcinoid tumor, gastrointestinal stromal tumor and appendiceal mucinous tumor were discussed to create a guideline. A survey to obtain consensus for the guideline proposed by the workshop was carried out by the members of the Korean Society of Pathologists and 240 members completed the questionnaire. CONCLUSION: Although there are some issues to be discussed further, such as coding of high grade dysplasia/adenoma and intramucosal carcinoma of stomach and colon, the members agreed upon most parts of the proposed guideline. Therefore, we suggest using the ICD-O3 coding guideline for gastrointestinal tumor.ope

Multicentric occurrences of hepatocellular carcinoma

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Sarcomatoid hepatocellular carcinoma

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Sclerosing Hepatic Carcinoma

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Up-Regulation of Telomere-Binding Proteins, TRF1, TRF2, and TIN2 Is Related to Telomere Shortening during Human Multistep Hepatocarcinogenesis

The telomeric repeat-binding factor 1 (TRF1), TRF2, and the TRF1-interacting nuclear protein 2 (TIN2) are involved in telomere maintenance. We describe the regulation of expression of these genes along with their relationship to telomere length in hepatocarcinogenesis. The transcriptional expression of these genes, TRF1 protein, and telomere length was examined in 9 normal livers, 14 chronic hepatitis, 24 liver cirrhosis, 5 large regenerative nodules, 14 low-grade dysplastic nodules (DNs), 7 high-grade DNs, 10 DNs with hepatocellular carcinoma (HCC) foci, and 31 HCCs. The expression of TRF1, TRF2, TIN2 mRNA, and TRF1 protein was gradually increased according to the progression of hepatocarcinogenesis with a marked increase in high-grade DNs and DNs with HCC foci and a further increase in HCCs. There was a gradual shortening of telomere during hepatocarcinogenesis with a significant reduction in length in DNs. Most nodular lesions (52 of 67) had shorter telomeres than their adjacent chronic hepatitis or liver cirrhosis, and the telomere lengths were inversely correlated with the mRNA level of these genes (P </= 0.001). This was more evident in DNs and DNs with HCC foci. In conclusion, TRF1, TRF2, and TIN2 might be involved in multistep hepatocarcinogenesis by playing crucial roles in telomere shortening.ope