• Radiation Oncology Journal
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• 제10권2호
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• pp.227-236
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• 1992

1979년 3월부터 1986년 12월까지 과거에 아무런 치료를 받지 않은 자궁경부암 IIB병기 환자 232명을 서울대학병원 치료방사선과에서 치료하였다. 대상 환자들은 FlGO 방식으로 병기가 결정되었으며, 대다수의 환자에게 골반 외부 방사선 조사 및 강내 조사가 병용되어 치료되었다. 이학적 검사소견, 혈액 검사소견, 내과적 질환의 과거력, 조직학적 소견 및 복부-골반 전산화단층촬영 소견등의 치료전 인자들이 분석되었으며 이들 인자들의 5년 국소 치료율, 5년 무병 생존율 및 5년 생존율 등에 대한 잠재적인 예후적 유의성을 밝히기 위해 단변수분석과 다변량분석을 시행하였다. 조직학적 소견, 자궁내진시 자궁방결합조직의 침윤, 전산화단층촬영상 대동맥 임파절의 전이등이 자궁경부암 IIB 병기에서 예후적 유의성을 갖는 것으로 판명되었다.

• 한국임상수의학회지
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• 제30권1호
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• pp.53-56
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• 2013

10세령 중성화된 페키니즈 견이 배뇨장애와 복부 팽대와 혈뇨 증상으로 내원하였다. 복부 방사선 촬영에서 상복부의 난원형 연조직 종괴가 발견되었으며 초음파 검사에서 액이 차 있고 종괴가 있는 낭으로 확인되었다. 탐색적 개복술을 통해 직경 4 cm 크기의 낭성 구조를 발견하였으며 적갈색의 액성 물질과 벽에 붙어 있는 직경 1.5 cm 크기의 원형 종괴를 확인하고 수술적으로 제거하였다. 절개한 종괴의 날인 도말 표본에 대한 세포학적 검사 결과 여러가지 악성 조건을 만족하는 선암종 세포가 다수 관찰되었으며, 조직병리 검사에서 확진되었다. 환자는 수술 회복되어 퇴원하였으며 재발증상의 징후 없이 지내다가 술 후1년 후 증상이 재발되어 내원하였고 종괴가 재발되었음을 확인하고 종괴 제거를 위한 2차 수술을 실시하였다. 환자는 퇴원 후 2개월째에 다시 내원하였으며 종괴가 재발되고 폐 전이가 발생한 것을 확인할 수 있었다. 환자는 이후 3개월을 더 생존하다가 폐사하였다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2815-2819
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• 2014

Background: The aim of this study was to evaluate the prognosis of patients with stage IA-IIB cervical carcinoma and to investigate a possible correlation of histology with prognosis. Materials and Methods: Two hundred fifty one patients with adenocarcinoma and squamous cell carcinoma (SCC) histology for FIGO (International Federation of Gynecology and Obstetrics) stage IA-IIB uterine cervical carcinomas at the Radiation Oncology Clinic of GH Okmeydan Training and Research Hospital between January 1996 and December 2006 were selected, analyzed retrospectively and evaluated in terms of general characteristics and survival. Disease-free survival (DFS) and overall survival (OS) was calculated using the Kaplan-Meier method and differences were compared with the log-rank test. Multivariate analysis using a Cox-proportional hazards model was used to adjust for prognostic factors and to estimate hazard ratio (HR) with 95% confidence interval (CI). Results: There was no differences between the two tumour types in age, stage, pelvic nodal metastasis, parametrial invasion, surgical margin status, DSI, LVSI, maximal tumor diameter, grade, and treatment modalities. 5-year OS and DFS were 73% and 77%, versus 64% and 69%, for SCC and adenocarcinoma, respectively (p> 0.05). Multivariate analysis revealed independent prognostic factors including pelvic nodal metastasis and resection margin status for OS (p=0.008, p=0.002, respectively). Conclusions: Prognosis of FIGO stage IA-IIB cervical cancer patients was found to be the same for those with adenocarcinoma and SCC.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.651-658
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• 2013

Uterine leiomyomas (UL) are extremely common neoplasms in women of reproductive age, and are associated with a variety of characteristic choromosomal aberrations (CAs). The p53 gene has been reported to play a crucial role in suppressing the growth of a variety of cancer cells. Therefore, the present study investigated the effects of CAs and the p53 gene on ULs. We performed cytogenetic analysis by G-banding in 10 cases undergoing myomectomy or hysterectomy. Fluorescence in situ hybridization (FISH) with a p53 gene probe was also used on interphase nuclei to screen for deletions. In patients, CAs were found in 23.4% of 500 cells analysed, significantly more frequent than in the control group (p<0.001). In the patients, 76% of the abnormalities were structural aberrations (deletions, translocations and breaks), and only 24% were numerical. Deletions were the most common structural aberration observed in CAs. Among these CAs, specific changes in five loci 1q11, 1q42, 2p23, 5q31 and Xp22 have been found in our patients and these changes were not reported previously in UL. The chromosome breaks were more frequent in cases, from high to low, 1, 2, 6, 9, 3, 5, 10 and 12. Chromosome 22, X, 3, 17 and 18 aneuploidy was observed to be the most frequent among all numerical aberrations. We observed a low frequency of p53 losses (2-11%) in our cases. The increased incidence of autosomal deletions, translocations, chromatid breaks and aneuploidy, could contribute to the progression of the disease along with other chromosomal alterations.

• Tuberculosis and Respiratory Diseases
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• 제60권1호
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• pp.92-96
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• 2006

자궁근종으로 자궁절제술을 시행받은 과거력이 있는 43세 여자가 객혈을 주소로 내원하였다. 컴퓨터단층촬영에서 다발성 폐결절이 발견되어 흉강경하에서 조직검사 시행 후 양성 전이성 폐평활근종을 진단받았다. 폐경 전 환자로 GnRH analogues 치료를 시도하였고 3개월 후 추적검사에서 폐결절의 크기는 이전과 변화가 없는 상태를 확인하였고 객혈도 없는 안정된 상태로 경과 관찰중이다.

• Clinical and Experimental Reproductive Medicine
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• 제32권3호
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• pp.223-230
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• 2005

Objective: This study was performed to evaluate the accuracy of hysterosalpingography (HSG) for evaluating female infertility patients by comparison with hysteroscopic and laparoscopic examination. Methods and Material: Total 219 infertile patients were retrospectively analyzed between January 1, 2002 and December 31, 2003. Ninety seven patients (44.3%) were primary infertility, 122 patients (55.7%) were secondary infertility. We performed hysteroscopic and laparoscopic examination on next cycle when HSG revealed any abnormal finding, and 3~6 cycles later if HSG was normal. Results: The accuracy of HSG was 65.2% compared with hysteroscopic examination (sensitivity 88.4%, specificity 46.4%, false positive rate 53.6%, false negative rate 11.6%). The most common abnormal finding of hysteroscopy was uterine synechia (67.4%) followed by endometrial polyp, uterine anomaly (e.g. uterine septum), endometrial hyperplasia. Compared with laparoscopic examination, the accuracy of HSG was 76.9% (sensitivity 98.9%, specificity 70.6%, +LR 3.36, -LR 0.02). The positive predictive value of normal patent tube was excellent (99.6%) but that of proximal tubal blockage was only 46.7%. The unilateral tubal obstruction of HSG was poor accuracy (+LR 3.85 -LR 0.68) and 70% of those was patent by laparoscopic examination. Laparoscopic examination also revealed that 53% of patients had peritubal adhesion and 37% of patients has additional pelvic findings, especially endometriosis. Among the patients had normal HSG, 53.5% patients with normal ultrasonography was diagnosed endometriosis (25.6% of them had endometriosis stage I-II). Conclusion: Normal HSG shows a high negative predictive value. Nevertheless, the incidence of associated pelvic disease in the normal HSG group is high enough to warrant diagnostic laparoscopy if nonsurgical treatment is unsuccessful. Because HSG has poor accuracy in predicting distal tubal blockage and peritubal adhesion, and poor positive predictive value of proximal tubal blockage, laparoscopic examination could be considered in abnormal HSG group.

• 대한영상의학회지
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• 제84권3호
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• pp.698-704
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• 2023

중신 유사 선종은 2020년 World Health Organization 분류체계에서 자궁내막암의 한 아형으로 새롭게 분류되었고, 드물기 때문에 잘 알려지지 않은 질환이다. 저자들이 아는 한, 영어 문헌에서 영상의학적 소견은 아직 보고된 바 없다. 자궁의 중신 유사 선종은 일반적인 자궁내막암에 비해 예후가 좋지 않고 더 공격적인 생물학적 양상을 보인다. 저자들은 65세 여성의 자궁 체부에 생긴 중신 유사 선종의 영상의학적 소견에 대하여 보고하고자 한다. 자궁내막 고형 종괴가 심부 자궁근 침범을 보였고, 조영 증강은 잘되지 않았고 중등도의 확산제한을 보였다.

• Radiation Oncology Journal
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• 제24권2호
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• pp.123-127
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• 2006

목적: 7예의 자궁경부의 유리세포암 초기 병기 환자들을 통하여 임상적 특징, 병리조직학적 소견, 치료방법 및 예후를 알아보고자 하였다. 대상 및 방법: 1993년 1월부터 2005년 12월까지 계명의대 동산의료원에서 병리조직학적으로 자궁경부암기 유리세포암으로 확인된 FIGO 병기 IB 6예와 IIA환자 1예, 모두 7예의 환자를 대상으로 하였으며 이들 중 1예의 IB 환자에서는 자궁 내 임신 22주 상태였다. 환자들의 의무기록을 통하여 임상적 특징, 병리조직학적 소견, 치료방법 및 예후를 분석하였다. 진단은 병리조직학적으로 유리세포암의 특징적 소견을 보이는 세포들로 50% 이상 구성되어있을 때 유리세포암으로 진단하였다. FIGO 임상병기 IB인 6명의 환자에서 근치적 자궁절제술 및 양측 골반 림프절 절제술을 시행하였으며 이들 중 2명은 수술 후 동시 항암화학방사선요법을 받았다. 1예의 IIA 환자는 동시 항암화학방사선요법으로 근치적 방사선치료를 시행하였다. 결과: 조직학적으로 자궁경부암으로 진단 받은 전체 환자 3,745명 중 유리세포암 환자는 7명이었다(0.2%). 7예의 자궁경부 유리세포암 환자의 평균 연령은 44세였으며, 연령 분포는 35세에서 53세까지였다. 가장 흔한 증상은 질 출혈로 7예 중 5예에서 나타났다(86%). 치료 전 시행한 펀치 생검 소견으로 전체 7예에서 2예에서만 유리세포암으로 진단 가능하였으며, 나머지 5예는 선편평상피세포암 1예, 미분화 선암 2예, 편평상피세포암 2예로 진단되었으나, 수술 후 병리조직학적 검사에서 유리세포암으로 확진되었다. 추적관찰기간은 13개월에서 150개월이며, 평균 추적기간은 73개월로 모두 무병상태로 생존하고 있다. 결론: 자궁경부의 유리세포암은 비록 공격적이고 악성도가 높은 종양이지만, 초기 암 환자는 정확한 병기평가와 근치적 수술 후 동시 항암화학방사선치료와 같은 적극적인 보조치료를 시행하면 보다 향상된 생존율을 얻을 수 있을 것으로 예상된다.

• 한국발생생물학회지:발생과생식
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• 제24권1호
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• pp.1-17
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• 2020

Phthalates and those metabolites have long history in industry and suspected to have deficient effects in development and reproduction. These are well-known anti-androgenic chemicals and many studies have examined the effects of these compounds on male reproduction as toxins and endocrine disruptors. Uterus is a key organ for proper embryo development, successful reproduction, and health of eutherian mammals including women. To understand the effects of the phthalate, the horizontal approach with a whole group of phthalate is best but the known phthalates are huge and all is not uncovered. Di-(2-ethylhexyl) phthalate (DEHP) is the most common product of plasticizers in polymer products and studied many groups. Although, there is limited studies on the effects of phthalates on the female, a few studies have proved the endocrine disrupting characters of DEHP or phthalate mixture in female. An acute and high dose of DEHP has adverse effects on uterine histological characters. Recently, it has been revealed that a chronical low-dose exposing of DEHP works as endocrine disrupting chemicals (EDC). DEHP can induce various cellular responses including the expression regulation of steroid hormone receptors, transcription factors, and paracrine factors. Interestingly, the response of uterus to DEHP is not monotonous and the exposed female has various phenotypes in fertility. These suggest that the exposing of DEHP may causes of histological modification in uterus and of disease in female such as endometriosis, hyperplasia, and myoma in addition to developmental and reproductive toxicity.

• Clinical and Experimental Reproductive Medicine
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• 제38권3호
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• pp.174-177
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• 2011

Benign metastasizing leiomyoma (BML) is a rare disease, which usually occurs in women with a history of a prior hysterectomy or myomectomy for benign uterine leiomyoma, and has the potential to metastasize to distant sites, such as the lung, lymph nodes, muscular tissue, heart, or retroperitoneum. These lesions are slow-growing, asymptomatic, and usually found incidentally. The prognosis of BML is also excellent. However, there has been debate on the origin and the correct classification of BML, and there are no guidelines for the treatment of BML. We report here on a rare case of BML in both the retroperitoneal cavity and lung in a 48-year-old woman with a history of hysterectomy due to histologically benign uterine leiomyoma. The patient underwent retroperitoneal mass excision and bilateral salpingo-oophorectomy, and then wedge biopsy of two pulmonary nodules was performed additionally 9 days later. Until now, there has been no sign of recurrence and the patient remains asymptomatic. To our knowledge, pulmonary BML is rare and the co-existence of the retroperitoneal metastases after previous hysterectomy is even rarer.