• 한국임상수의학회지
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• 제32권6호
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• pp.514-518
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• 2015

1년령의 중성화 암컷, 2.35 kg의 아메리칸 숏헤어 고양이가 난소 자궁 절제술을 실시한 후 3개월 시점으로부터 2개월간 지속된 발정 증상을 주증으로 내원하였다. 방사선 및 초음파 검사상, 양쪽 신장 후방에 위치한 낭성 구조물을 확인하였고, 이는 혈액검사상 나타난 고에스트로겐혈증을 고려하여 난소 조직으로 의심되었다. 복강경을 이용한 복강 탐색을 실시하였고, 양측 신장 후방의 낭성 병변을 초음파 수술도를 이용하여 절제하였다. 환자는 특이사항 없이 회복하여 술 후 2년간 증상의 재발 없이 지내고 있다. 증례를 통하여, 선택적 난소 절제술뿐만 아니라 잔존 난소의 경우에도 복강경을 유용하게 적용할 수 있음을 확인하였다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권18호
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• pp.7793-7797
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• 2014

Objective: The aim of this study was to evaluate predictive role of risk of malignancy index in discriminating between benign and malignant adnexal masses preoperatively. Methods: This retrospective study was conducted with a total of 569 patients with adnexal masses/ovarian cysts managed surgically at our clinic between January 2006 and January 2012. Obtained data from patient files were age, gravidity, parity, menopause status, ultrasound findings and CA125 levels. For all patients ultrasound scans were performed. For the assessment of risk of malignancy index (RMI) Jacobs' model was used. Histopathologic results of all patients were recorded postoperatively. Malignancy status of the surgically removed adnexal mass was the gold standard. Results: Of the total masses, 245 (43.1%) were malignant, 316 (55.5%) were benign and 8 (1.4%) were borderline. The mean age of benign cases was lower than malign cases ($35.2{\pm}10.9$ versus $50.8{\pm}13.4$, p<0.001). Four hundred and five of them (71.2%) were in premenopausal period. Malignant tumors were more frequent in postmenopausal women (81% versus 29%, p<0.001). All ultrasound parameters of RMI were statistically significantly favorable for malignant masses. In our study ROC curve analysis for RMI provided maximum Youden index at level of 163.85. When we based on cutoff level for RMI as 163.85 sensitivity, specificity, PPV, NPV was calculated 74.7%, 96.2%, 94% and 82.6%, respectively. Conclusions: RMI was found to be a significant marker in preoperative evaluation and management of patients with an adnexal mass, and was useful for referring patients to tertiary care centers. Although utilization of RMI provides increased diagnostic accuracy in preoperative evaluation of patient with an adnexal mass, new diagnostic tools with higher sensitivity and specificity are needed to discriminate ovarian cancer from benign masses.

• Tuberculosis and Respiratory Diseases
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• 제77권6호
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• pp.258-261
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• 2014

Anaplastic lymphoma kinase (ALK) rearrangement, is a kind of driver mutation, accounts for 3%-5% of non-small cell lung cancer (NSCLC). NSCLC patients harboring ALK fusion genes have distinct clinical features and good response to ALK inhibitors. Metastasis from lung cancer to the ovary has rarely been known. We report a case of a 54-year-old woman with bilateral ovarian metastases from ALK rearranged NSCLC. She underwent bilateral salpingo-oophorectomy for ovary masses, which were progressed after cytotoxic chemotherapy although primary lung mass was decreased. Histopathological examination of the ovary tumor showed characteristic adenocarcinoma patterns of the lung and ALK rearrangement.

• Clinical and Experimental Reproductive Medicine
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• 제42권2호
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• pp.67-71
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• 2015

Objective: Elevated serum progesterone (P) levels on triggering day have been known to affect the pregnancy rate of in vitro fertilization (IVF). This study aimed to identify the possible factors influencing serum P levels on triggering day in stimulated IVF cycles. Methods: Three hundred and thirty consecutive fresh IVF cycles were included in the study. All cycles were first attempts and were performed in a single infertility center. The indications for IVF were male factor infertility (n=114), ovulatory infertility (n=84), endometriosis (n=61), tubal infertility (n=59), unexplained infertility (n=41), and uterine factor infertility (n=39). A luteal long protocol of a gonadotropin-releasing hormone (GnRH) agonist (n=184) or a GnRH antagonist protocol (n=146) was used for pituitary suppression. Ovarian sensitivity was defined as the serum estradiol level on triggering day per 500 IU of administered gonadotropins (OS[a]) or the retrieved oocyte number per 500 IU of administered gonadotropins (OS[b]). Results: Univariate analysis revealed that the serum P level on triggering day was associated with the serum estradiol level on triggering day (r=0.379, p<0.001), the number of follicles ${\geq}14mm$ (r=0.247, p<0.001), the number of retrieved oocytes (r=0.384, p<0.001), and ovarian sensitivity (OS[a]: r=0.245, p<0.001; OS[b]: r=0.170, p=0.002). The woman's age, body mass index, antral follicle count, and basal serum follicle stimulating hormone and estradiol levels were not associated with serum P level on triggering day. The serum P level on triggering day did not show significant variation depending on the type or cause of infertility, pituitary suppression protocol, or the type of gonadotropins used. Conclusion: The serum P level on triggering day was closely related to the response to ovarian stimulation.

• Asian Pacific Journal of Cancer Prevention
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• 제13권12호
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• pp.6435-6439
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• 2012

Chemoresistance to cancer therapy is a major obstacle to the effective treatment of human cancers with cisplatin (DDP), but the mechanisms of cisplatin-resistance are not clear. In this study, we established a cisplatin-resistant human ovarian cancer cell line (COC1/DDP) and identified differentially expressed proteins related to cisplatin resistance. The proteomic expression profiles in COC1 before and after DDP treatment were examined using 2-dimensional electrophoresis technology. Differentially expressed proteins were identified using matrix-assisted laser desorption/ ionization time-of-flight mass spectrometry (MALDI-TOF-MS) and high performance liquid chromatography-electrospray tandem MS (NanoUPLC-ESI-MS/MS). 5 protein spots, for cytokeratin 9, keratin 1, deoxyuridine triphosphatase (dUTPase), aarF domain containing kinase 4 (ADCK 4) and cofilin1, were identified to be significantly changed in COC1/DDP compared with its parental cells. The expression of these five proteins was further validated by quantitative PCR and Western blotting, confirming the results of proteomic analysis. Further research on these proteins may help to identify novel resistant biomarkers or reveal the mechanism of cisplatin-resistance in human ovarian cancers.

• Clinical and Experimental Pediatrics
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• 제53권4호
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• pp.603-606
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• 2010

부신생물 변연계뇌염(paraneoplastic limbic encephalitis)은 신경계의 전이가 없이 종양의 원격 작용에 의해 발생하는 질환으로 소아에서는 드물게 보고되고 있다. 저자들은 사춘기 여아에서 발생한 성숙 난소기형종에 동반된 부신생물 변연뇌염을 경험하고 보고하고자 한다. 15세 여자 환자가 신경정신증상, 기억력 저하, 경련, 의식 저하를 주소로 내원하였다. 뇌척수액 검사, 뇌 MRI는 정상이었으나, 뇌 SPECT 검사에서 양측 측두엽의 저관류가 관찰되었다. 복부 초음파와 MRI에서 좌측 난소의 낭성 종양이 발견되었다. 종양의 수술적 제거 후 성숙 난소기형종으로 확인되었으며, 종양 제거 및 면역글로불린 정맥 투여로 완전한 인지 기능의 회복을 보였다.

• Clinical and Experimental Reproductive Medicine
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• 제49권3호
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• pp.210-214
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• 2022

Objective: Platelet-rich plasma (PRP) therapy has received a considerable attention as an adjunct to fertility treatments, especially in women with very low ovarian reserve and premature ovarian insufficiency. Although recent studies have demonstrated that PRP led to improvements in folliculogenesis and biomarkers of ovarian reserve, the effect of intraovarian PRP administration on embryo genetics has not been studied. Methods: We report a pilot study of patients who had preimplantation genetic testing for aneuploidy (PGT-A) before and then within 3 months following PRP administration. Twelve infertile women with at least one prior failed in vitro fertilization (IVF) cycle underwent ovarian stimulation (cycle 1) with a gentle stimulation protocol and PGT-A performed at the blastocyst stage. Following cycle 1, autologous intraovarian PRP administration was performed. Within 3 months following PRP administration, the patients underwent cycle 2 and produced blastocysts for PGT-A. The percentage of euploid embryos between both cycles was compared. Results: The mean age of all participants was 40.08±1.46 years, and their mean body mass index was 26.18±1.18 kg/m². The number of good-quality embryos formed at the blastocyst stage was similar between cycle 1 and cycle 2 (3.08±0.88 vs. 2.17±0.49, respectively; p=0.11). Among all patients in cycle 1, 3 of 37 embryos were euploid (8.11%) while in cycle 2, 11 out of 28 embryos were euploid (39.28%, p=0.002). Three clinical pregnancies were noted among this patient group. Conclusion: This novel study is the first to present an improvement in the embryo euploidy rate following intraovarian PRP application in infertile women with prior failed IVF cycles. The growth factors present in PRP may exhibit a local paracrine effect that could improve meiotic aberrations in human oocytes and thus improve euploidy rates. Whether PRP improves live birth rates and lowers miscarriage rates remains to be determined in large trials.

• 대한방사선기술학회지:방사선기술과학
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• 제30권3호
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• pp.219-225
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• 2007

본 연구는 초음파검사를 이용하여 여성 골반내 질환의 발생빈도를 조사하였으며, 기초자료를 제공하기 위한 목적으로 수행되었다. S시에 있는 산부인과 병원에서 1년간에 골반강 초음파검사를 받은 25세 이상 69세 미만의 전체 여성 수검자 604명을 대상으로 하였다. 여성 골반내 질환은 자궁의 혹, 자궁내막 질환, 난소의 혹 및 경부낭종 등 4개 군으로 구분 조사하였고, 연구한 결과는 다음과 같이 나타났다. 위험요인으로 연령, 체중, 임신 횟수의 세 가지를 설정하였다. 분석 및 결론은 다음과 같다. 1) 연령별 발생빈도는 출산 연령층($25{\sim}35$세)에서 10.8%, 출산이 끝난 후 연령층부터 폐경 전 연령층($35{\sim}54$세)까지에서 38.9%, 폐경 후 연령층($55{\sim}69$세)에서 35.8%로, 출산이 끝난 후 연령층에서 폐경 전 연령층과 폐경 후 연령층에서 출산 연령층보다 발생빈도가 높게 나타났다. 2) 여성 골반내 질환의 발생빈도는 체중과 임신 횟수가 증가함에 따라서 증가하였다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권16호
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• pp.6881-6885
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• 2014

Background: The present study aimed to investigate the utility and importance of the various parameters of complete blood count panel for benign-malignant differentiation of adnexal masses. Materials and Methods: This retrospective study involved 316 patients with documented benign and 253 patients with malignant adnexal masses who underwent primary surgical treatment at a tertiary referral center. Prior to the study, all benign and malignant cases were compared within their own groups and then the benign and malignant cases were compared to each other. For all cases, cut-off, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for the neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), neutrophil, lymphocyte, platelet and CA-125 parameters, and the results were compared in regards to the groups. Results: NLR, PLR, neutrophil, CA-125, and platelet values were higher in the malignant compared to the benign cases (p<0.01). The lymphocyte value was lower in the malignant cases (p<0.01). No significant differences were found for basophils and eosinophils (p > 0.05). For CA-125, the sensitivity, specificity, PPV and NPV for all cases were 78%, 62%, 62% and 78%, respectively. For NLR, they were 65.6%, 72.1%, 65.3%, and 72.3%, and for PLR, 48%, 81%, 67%, and 66%. Additionally, the sensitivity and specificity were 55% and 77% for CA-125, 66% and 58% for NLR, and 61% and 58% for PLR in early malignant cases. Conclusions: NLR and PLR appear to be useful methods that can be applied together with CA-125 due to the relatively high sensitivity values for the malign-benign differentiation of ovarian masses. Although the specificity of these parameters is lower than CA-125, especially in cases with early malignant ovarian pathology, their sensitivity being higher is promising for the early diagnosis of ovarian cancer. It can be used to detect ovarian malignancies in the early stages, and it will increase the treatment options and improve survival rates.

• Neonatal Medicine
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• 제15권1호
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• pp.80-83
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• 2008

목 적 : 서혜부 탈장은 소아에서 비교적 흔하지만, 여아 탈장의 15-31%를 차지하는 난소 탈장은 아직까지 정립된 치료 원칙이 없고 국내에서는 질병의 경과에 대한 보고가 없다. 이에 연구자들은 난소 탈장 환아들의 특성과 임상 경과에 대하여 알아보고자 하였다. 방 법 : 2001년 3월부터 2007년 2월까지 관동대학교의과대학 제일병원에서 난소 탈장으로 진단받은 1세미만 여아 8명을 대상으로 환아들의 재태 연령, 출생체중, 난소 탈장 발견시기와 주 호소, 수술 시기 및 수술법, 수술 후 합병증 여부, 현재의 상태, 서혜부 초음파결과를 의무기록지와 전화 통화를 통해 후향적으로 조사하였다. 난소 탈장은 서혜부 종괴 여부와 초음파 검사 결과 난소가 서혜부에 위치하는 경우에 진단하였다. 결 과 : 환아들의 재태 연령은 $32^{+5}-40^{+1}$주 범위였으며, 이 중 37주 미만 미숙아는 4명(50%)이고, 출생체중은 1,600-3,505 g 범위였다. 대상 환아 중 7명(87.5%)은 좌측 난소 탈장이 있었으며, 1명(12.5%)은 우측에 난소 탈장이 있었다. 종괴를 발견한 시기는 생후 13-144일 사이로 다양하였으며, 수술 받은 환아들의 수술시기는 생후 50${\pm}$15일(35-65일)이었다. 현재까지 8명중 5명이 탈장 봉합술을 시행 받았으며, 합병증은 없었다. 수술을 시행하지 않은 3명은 경과 관찰 중에 수술없이 저절로 정복되었으며, 종괴가 사라진 나이는 생후121${\pm}$46일(70-161일)이었고, 관찰 기간 중(69-1,925일)감돈이나 재발은 없었다. 결 론 : 미숙아 여아인 경우 탈장의 빈도가 만삭아에 비해 높으므로 신체 검진을 통한 대음순 종괴의 발견이 중요하며, 초음파 검사를 통하여 확진한다. 소아의 난소 탈장은 아직까지 일관된 치료 방침이 없고, 외과의 의견을 따라 가능한 한 빠른 시일 내에 수술을 시행하였었기에 경과를 제대로 알 수 없었으나, 저자들이 경과 관찰을 하던 3명의 여아에서 생후 6개월 이내에 난소탈장이 저절로 정복되는 예를 경험하였고, 관찰 기간동안 재발은 없었다. 난소 탈장의 환자를 대상으로 추적관찰을 하여 적절한 치료 방침을 마련하여야 하겠다.