항암제투여로 인한 말초백혈구 염색체변이에 관한 연구

이의돈(ED Rhee) 대한산부인과학회 1977 Obstetrics & Gynecology Science Vol.20 No.11

저자는 항암제투여가 이체백혈구염색체에 미치는 영향에 관하여 연구하였다. In vivo의 실험에서는 15예의 암환자를 5­FU 단독투여군과 5­FU의 투여와 Co조사를 병용한 군 및 5­FU를 비롯한 기타 항암제를 투여한 군으로 구분하여 치료전, 후의 말초백혈구염색체변이에 대한 소견을 비교 관찰하였다. 또한 im vitro의 실험에서는 5­FU(0.1㎍ ∼100㎍/㎖)를 배양중인 백혈구에 첨가하여 24시간 및 6시간 작용시킴으로써 유발된 염색체소견과 미리 5­FU로 작용시킨 배양액 에 thymidine(0.5㎎/㎖)을 첨가하여 6시간 작용시킴으로써 유발된 변화를 관찰, 검토하 여 다음과 같은 결과를 얻을 수 있었다. 1) 5­FU단독투여군에서 치료전 , 후의 염색체변이세포의 출현율은 가각 3.8%와 6.8% 이었고 이수성세포의 출현율은 각각8.3%와 10.9%이었고 배수체의 출현율은 각각 0%와 0.6%이었다. 또한 치료군에서의 염색체변이는 주로 열극과 절단이었다. 2) 5­FU의 투여와 Co조사를 병용한 군에서 치료전, 후의 염색체변이세포의 출현율은 가각 4.0%와 13.3%이었고 이수성세포의 출현율은 가각 8.7% 와 18.1%이었고 배수체의 출현율은 가각 0%와 2.0%이었다. 염색체변이로는 열극, 절단 ,단편, 이중착사점염색체, interchange 및 환상염색체가 관찰되었다. 3) 5­FU를 비롯한 기타 항암제 투여군에서 치료전, 후의 이수성세포의 출현율은 각각 0%와 1.2%이었다. 4) In vitro의 실험에서 5­FU(0.1㎍∼100㎍/㎖)을 24시간 작용시킨 경우 염색체변이세 포의 출현율은 농도에 따라 증가하였으나 5­FU(10㎍∼50㎍/㎖)를 6시간 작용시킨 경 우는 그 출현율이 약 20%(17.0-23.3%)이었고 thymidine(0.5㎎/㎖)을 첨가함으로써 각 각 12.0%와 15.0%로 감소하였다. 5) In vitro의 실험에서 유발된 염색분체와 염색체의 절단은 A군,C군 및 B군 염색체와 말단체절에서 가장 많이 출현하였다. The author aimed to investigate the influence of anticancer chemotherapeutic agents upon chromosome of human peripheral blood leukocytes was carried out on 15 cancer patients in an effort to compare the effcets of the respective agents in chromosome, dividing the patients into three groups, namely, the first group treated with 5-FU alone, the second group receiving 5-FU and 60Co irradiation, and the third group receiving 5-FU and other chemotherapeutic agents. In an in vitro study, 5-FU was added 24 hours and 6 hours prior to fixation with different doses (0.1㎍- 100㎍/ml) and consequent chromosomal aberrations were compared with the effects of thymidine (0.5mg/ml) that was added 6 hours prior to fixation to the cultures pretreated with 5-FU. 1) In the group treated with 5-FU alone, the frequency of metaphases with chromosomal aberration before and after the administration of the drug were 3.8% and 6.8% respectively. those of aneuploid cells were 8.3% and 1.9%, and those of polyploid cells were 0% and 0.6%. The chomosomal aberrations observed in post-treatment were mainly chomatid and isochromatid gaps and breaks. 2) In the group treated with 5-FU in conjunction with 60Co irradiation, the frequency of metaphases with chromosomal aberration before and after the administration of this agents were 4.0% and 13.3 respectively. Those of aneuploid cells were 8.3% and 18.1%, and those of polylpoid cells were 0% and 2.0%. In posttreatment, gaps, fragments, dicentric chromosomes, interchanges, and ring chromosomes were detected. 3) In the group treated with chemotherapeutic agents including or excluding 5-FU, the frequency of aneuploid cells before and after the administration of the drugs were 8.8% and 13.1%, and those of polyploid cells were 0% and 1.2%. 4) In and in vitro study, in which 5-FU (0.1㎍- 100㎍/ml) was added to cultures 24 hours prior to fixation, the mean percentage of metaphases with chromosomal aberration increased exponentially with the applied doses. When 5-FU (10㎍- 50 ㎍/ml) was added 6 hours prior to fixation, the mean percentage of metaphases with chromosomal lesion reached a level of about 20% ( 17.0% - 23.3%) and the cytogenetic action of 5-FU was slightly reversed when thymidine was added simultaneously. The main chromosomal aberration in an in vitro study were gaps and breaks. 5) The majority of breakages of chromosome were found among A.C, and B group chromosomes and located in distal segment of arm in an in vitro study.

악성 질 흑색종의 1예

이의돈(ED Rhee),이경희(KH Lee),신순철(SC Shin),이진용(JY Lee) 대한산부인과학회 1974 Obstetrics & Gynecology Science Vol.17 No.1

질에서 발생하는 원발성흑색종은 대단히 희유한 종역이며 여러 가지 치료방법에도 불구하고 예후가 나쁜 것으로 되어 있으나 가능하면 초기에 국소임파절을 포함하여 광범위한 전질부 및 근치자궁수술을 시향하면 비교적 좋은 결과를 얻기도 한다. Primary malignant melanoma of the vagina is estremely rare disease and the prognosis for melanoma of vagina remains poor in spite of several types of treatment. A report of our case and a review of the literature are here with presented.

융모성 종양에 대한 임상통계학적 관찰

이의돈(ED Rhee) 대한산부인과학회 1973 Obstetrics & Gynecology Science Vol.16 No.8

The present work deals with trophoblastic disease patients admitted at Seoul National University Hospital, Dept. of Obstetrics & Gynecology, from Jan. 1962 to Dec. 1971. The disease wise distribution of patients, 167 in total, is hydatidiform mole 87, destructive mole 18, and choriocarcinoma 58. When compared with the terminated pregnancies (normal deliveries, ectopic pregnancies, abortion, and trophoblastic disease) in the same period, the incidence of hydatidiform mole occupies a ratio of 0.73% (1:137.9), that of destructive mole 0.15%(1:667.5), and that of choriocarcinoma 0.48%(1:206.3). The peak incidence of hydatidiform mole is in the twenies(60.9%), that of destrucitve mole in the forties (44.4%), and that of choriocarcinoma in the thirties (43.1%). Among 131 patients of trophoblastic tumors with sufficient records, 73 persons(55.7%) belong to the lower class in socioeconomic sense. Though trophoblastic disese is more frequent for multiparas than primiparas, 17 case have been observed for the latters: hydatidifrom mole: 14cases(16.1%), destructive mole: 1 case(5.6%), choriocarcinoma: 2 cases (3.4%). 31% of choriocarcinoma patients as their previous pregnancy is hydaitidiform mole, 37.9% for hydatidiform mole, 38.9% for destructive mole, and 050.1% for choriocarcinoma as their pervious pregnancy is abortion. Main symptoms of each disease may be summed up in the following was: Hydatidiform mole: amenorrhea 100%, vaginal bleeding 87.4%, emetic symptoms 78.2%, anemia 76.8%, unexpected enlargement of uterine size 63.3%, fever and chill 49.3%, toxemic symptoms 27.6%. Destructive mole: vaginal bleeding 83.3%, anemia 76.5%, unwanted smaller uterine size 38.4%. Choriocarcinoma: anemia 80.8%, vaginal bleeding 77.6%, fever and chill 42.1%, bloody sputum and cough 45.6%, hemoptysis and hemiplegia 12.3%. Out of 36 patients managed only by mean of vaginal expulsion (I.V.P. induced or D & C), 11.1% showed malignant changed, while no malignant changes were found in the patients teated with hysterectomy and/or chemotheraphy. In the destructive mole patients, 3 cases of metastasis(16.7%) were observe. The treatment of destructive solely with hysterectomy showed 40% of complete remission wheras hysterectomy and chemotheraphy combined results is an 100% complete remission. In 45 cases (77.6%) of choriocarcinoma, metastasis was confirmed at the time of admission, site metatstasis being lung 87.2%, vagina 28.9%, brain 11.1%, ovary 8.9% and bladder 6.7%. When treated with chemotheraphy 20.8% of patients reached to complete remission. However, chemotheraphy separately performed attained nosingle case of complete remission. In cases metatstasis was not confirmed, the ratio of complete remission invariable, that is 50%, regardless whether hysterectomy is separately managed or combined with chemotheraphy. When hysterectomy performed, theca lutein cyst was found, 38.2% for destructive mole, and 50% for choriocarcinoma. The most frequent symptoms after freated with M.T.X. are or following: Stomatitis(19.1%), Nausea & Anorexia(17.6%), chill & fevb(7.4%), pharyngitis(7.4), vesicle(5.9%), gingivitis(5.9), Dysphagia(4.4) & skin truption (2.9%). W.B.C. count in blood: below 3,000(11.8%) & platelet count: below 100,000 (704%).

질에 발생한 투명세포선암 ( Clear Cell Adenocarcinoma ) 의 1 례

이의돈(ED Rhee),이제호(JH Lee),이경희(KH Lee),박기복(KB Park),장자준(JJ Jang),배광범(KB Bai) 대한산부인과학회 1986 Obstetrics & Gynecology Science Vol.29 No.2

질에 발생한 투명세포선암 Clear cell adenocarcinoma of the vagina is one of the rarest of the malignant process in the human body. We have experienced a case of clear cell adenocarcinoma of the vagina, and report with literatures.

자궁경암의 자궁강내 Radium 및 Co60에 의한 치료성적 - 1963년부터 1979년까지의 임상적 분석 -

이의돈(ED Rhee),이제호(JH Lee),이경희(KH Lee),박기복(KB Park),고경환(KH Koh),서성희(SH Seo),유성열(SY Yoo),김진용(CY Kim) 대한산부인과학회 1986 Obstetrics & Gynecology Science Vol.29 No.6

자궁경암의 자궁강내 Radium 및 Co60에 의한 치료성적 - 1963년부터 1979년까지의 임상적 분석 - From 1963 through 1979, 368 patients with carcinoma of the uterine cervix were treated with Intracavitary Radium and Co60 at Cancer Research Hospital, Seoul, Korea. The purpose of this report was to analyze the clinical data and survival rate of these patients. The results were as follows: 1. The clinical stage of 368 patients treated with ICR and Co60 were as follows; Stage IB, 32 cases(8.7%), IIA, 135 cases(36.7%), IIB 169 cases(45.9%), Ⅲ, 25 cases(6.8%), Ⅳ, 3 cases(0.8%), and Postoperation recurrent, 4 cases(1.1%). 2. The most frequent distribution of age was 41~50. 3. The results of histopathologic subtype were distributed as follows: Squamous cell carcinoma was 96.7%, Adenocarcinoma was 2.7% and Adenosquamous carcinoma was 0.5%. 4. The 5-year survival rates by stage in confirmed patients by follow up were Stage IB, 88.0%, IIA, 75.2%, IIB, 69.3%, Ⅲ, 55.0%, Ⅳ, 0%, and Postoperation recurrent, 50.0%. 5. The 10-year survival rates by stage in confirmed patients by follow up were Stage IB, 75.0%, IIA, 69.0%, IIB, 50.0%, Ⅲ, 30.0%, and Ⅳ, 0%.

자궁경암 15,092예 및 수술 561예에 대한 임상적 고찰 - 1963년부터 1983년까지의 임상적 분석 -

이의돈(ED Rhee),이제호(JH Lee),이경희(KH Lee),박기복(KB Park) 대한산부인과학회 1984 Obstetrics & Gynecology Science Vol.27 No.9

원자력병원이 개원한 1963년 11월부터 1983년 12월 31일까지 20년간 산부인과에 등록된 부인암중 자궁경암의 년도별 임상기 분포율의 변화와 1965년 1월 1일부터 1978년 12월 31일까지 14년간 수술한 자궁경암 561례의 치료성적을 조사하여 다음의 결과를 얻었다. 1. 1963년 11월부터 1983년 12월 31일까지 산부인과를 방문한 신 환자 140,906례중 부인암환자는 15,805례(11.2%)이었다. 2. 15,805례의 부임암중 자궁경암은 15,092례(95.5%)이었다. 자궁경암중에서는 제 0기부터 제 IV기까지가 11,952례(79%)이었고 타병원에서 수술이나 방사선치료를 받고 내원한 환자는 3,140례(20.8%)이었다. 3. 제 0기, I기 및 II기의 년도별 분포율의 변화는 1963-68년에 각각 0.1%, 8.0% 및 28.8%에서 1979-83년에는 각각 5.4%, 14.6% 및 48.1%로 증가하였고 제 III기와 IV기는 각각 57.4%와 5.6%에서 각각 3.02%와 1.7%로 감소하였다. 4. 수술환자 561례의 기별 분포는 제 0기가 54례(9.6%), IA 99례(17.7%), IB 314례(56.0%), IIA 73례(13.0%), 그리고 IIB 21례(3.7%)이었다. 5. 수술환자의 연령분포는 제 0기, I기 및 II기 모두 41-45세군(28.7%)이 가장 많았다. 6. 수술환자의 분만회수는 제 0기, I기 및 II기 모두 3-4회군(43.6%)이 가장 많았으며 임신동반율은 3.0%이었다. 7. 수술환자의 병리조직학적소견은 편평상피암이 95.8%, 선암은 4.0%, 그리고 선편평상피암세포암은 0.2%이었다. 8. 임파선전이율은 IA가 0%, IB 10.5%, IIA 13.9%, 그리고 IIB는 21.1%이었다. 9. 수술후 추적확인된 환자의 5년생존율은 제 0기와 IA는 100.0%, IB 91.3%, IIA 80.7%, 그리고 IIB는 75.0%이었다. 10. 수술후 추적확인된 환자의 10년생존율은 IB가 69.4%, IIA 61.5%, 그리고 IIB는 58.3%이었다. 11. 수술후 5년추적율은 제 0기가 70.4%, IA 80.4%, IB 71.8%, IIA는 70.4%, 그리고 IIB는 71.4%이었으며 전체의 73.6%가 추적되었다. 12. 수술후 10년추적율은 IB가 32.6%, IIA는 58.3%, 그리고 IIB는 57.9%이었다. 13. 수술후 재발 확인된 시기는 1년이내가 41.9%로 가장 많았고 다음은 1-2년(23.3%)이었다. From 1965 through 1978, 561 patients with carcinoma of the uterine cervix were treated primarily with surgery at Cancer Research Hospital, Seoul, Korea. The purpose of this report was to analyze the clinical data and survival rate of these patients. Also we compared the changing trends for the 15,092 cases of carcinoma of the uterine cervix registered simultaneously, according to clinical stage during the 20-year period from Nov.1963, the opening day of our hospital to 1983. The results were as follows: 1. The number of gynecologic malignancies registered from Nov.1963 to 1983 was 15,805 cases and the proportion of gynecologic malignancies to the new patients, 140,906 cases, was 11.2%. 2. The proportion of carcinoma of the uterine cervix to the gynecologic malignancies was 95.5%(15,092 cases). 3. The proportion of stage 1, I, & II increased from 0.1%, 8.0% & 28.8% in 1963-1968 to 5.4%, 14.6% and 48.1% in 1979-1983 respectively. But stage III & IV decreased from 57.4% and 5.6% to 30.2% and 1.7% in the same period respectively. 4. The clinical stage of 561 patients who had operation were as follows: Stage 0, 54 cases(9.6%); Stage IA, 99 cases(17.7%); Stage IB, 314 cases(56.0%); Stage IIA, 73 cases(13.0%; and Stage IIB, 21 cases (3.7%). 5. The results of histopathologic subtype were distributed as follows; Squamous cell carcinoma was 95.8%, adenocarcinoma was 4.0% and adenosquamous cell carcinoma was 0.2%. 6. The frequency of lymph node metastasis was 0% in Stage IA, 10.5% in Stage IB, 13.9% in Stage IIA, and 21.1% in Stage IIB. 7. The 5-year survival results by stages in confirmed patients by follow up were Stage 0, 100.0%; Stage IA, 100.0%; Stage IB, 91.3% Stage IIA, 80.7%; and Stage IIB, 75.0%. 8. The 10-year survival results in confirmed patients by follow up were Stage IB, 69.4%; Stage IIA, 61.5%; and Stage IIB, 58.3%.

원발성난관암 1예 보고

박기복(KB Park),이제호(JH Lee),이의돈(ED Rhee),이경희(KH Lee),임흥배(HB Im),송계용(KY Song) 대한산부인과학회 1983 Obstetrics & Gynecology Science Vol.26 No.2

결론 43세된 여자에서 발생된 원발성난관암 1예를 체험하였기에 간단한 문헌고찰과 보고하는 바이다. Primary carcinoma of the follopian tube is one of the least common gynecologic malignancies. This paper reports our experience with a case of primary fallopian tube carcinoma incidentally encountered.

Congenital Adrenal Hyperplasia 에 관한 여성 반음양의 1 예

강길전(KC kang),임희재(HJ Lim),오규철(KC Oh),이의돈(ED Rhee),장윤석(YS Chang) 대한산부인과학회 1977 Obstetrics & Gynecology Science Vol.20 No.5

저자는 1975년 12월에 congenital adrenal hyperplasia로 인한 female hermaphroditism을 1예 경험하였기에 증예보고와 함께 간단히 문헌적고찰을 하였다. A case of female hermaphroditism due to congenital adrenal hyperplasia in 24 years old woman was presented and the literature was reviewed briefly.

원발성 유두장액성 복막염 2 예

박기복,이경희,이의돈,이은희,이승숙,김병택,전영숙 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.11

The well-documented but rare primary papillary serous peritoneal tumors are difficult problems for the pathologist and the clinician. The peritoneal serous papillary tumors were morphologically identical to serous ovarian tumor of equivalent grade. Because of their unusual location, these tumor are often classified as mesothelioma or advanced epithelial ovarian carcinoma. We experienced two cases of primary papillary serous peritoneal carcinoma and report with brief review of literature.

OC 125 단세포군항체를 이용한 난소암의 면역신티그라피

박상윤,이제호,박기복,이경희,이의돈,임상무,홍성운 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.8

상피성난소암 환자 6명과 전이성난소암 환자 1명에서 8례의 131I OC 125 F(ab`)2면역신티그라피(ISG)를 시행하여 다음과 같은 결과를 얻었다. 1. 수술 및 경피적 조직천자생검으로 확인된 병소부위에 대한 ,ISG와 CT의 민감도는 각각 100%(14/14), 57.1%(8/14)이었으며, 특히 난소암에서 중요한 장간막 전이에 대한 민감도는 각각 100%(5/5), 20%(1/5)로 ISG가 우수하였다. 2. 혈청 CA 125 농도와 131I OC 125항체흡착의 종양 대 주변 방사능비는 상관관계가 없었다. 3. 131I OC 125 항체를 정맥주사한 후 3일, 5일, 7일째에 측정한 종양 대 주변 방사능비는 시간이 경과함에 따라 증가하는 경향이 있었다. 따라서 치료 전 혈청 CA 125농도가 높았던 난소암 환자에서 일차적인 진단시 보다는 난소암 치료 후 추적검사 중 다른 검사에 이상이 없는데도 불구하고 혈청 CA 125농도가 증가할 때, CT 등의 검사로 재발이 의심되면서 보조검사가 필요할 때, 혈청 CA 125농도에 관계없이 복부통증 등이 있어 재발이 의심될 때, 기왕에 사용되던 컴퓨터 단층촬영, 초음파검사, 진단적 복강경 등에 보완적으로 이용하거나, 또는 이상의 검사에서 찾아내지 못하는 작은 암종괴를 찾아내어 수술 및 약물치료에 활용할 수 있을 것으로 사료된다. Seven patients, suspected of having primary or recurrent ovarian carcinoma, were investigated by the method of immunoscintigraphy to diagnose primary and/or metastatic tumor sites. 131I labeled monoclonal antibody, OC 125 F(ab`)2 fragments (IMACIS-II , International CIS, Yvelines Cedex, France) were administered to all patients. Total body planar photoscans were recorded with a scintillation camera three to seven days after injection of radioantibody. The results were compared with operation and/or computed tomography(CT) findings. The tumor to background ratios were caculated in vivo. 1. The sensitivities of ISG and CT were 100% and 57.1% respectively in 14 hitopatologically proven tumor sites. 2. There were no correlations between the serum CA 125 levels and tumor to background antibody uptake ratios. 3. Tumor to background antibody uptake ratios were progressively increased from day 3 to day 7.