A Case of Adenoid Basal Carcinoma of the Uterine Cervix

김휘곤,송용중,나용진,최욱환 대한폐경학회 2013 대한폐경학회지 Vol.19 No.3

Adenoid basal carcinoma of the uterine cervix is uncommon neoplasia mostly occurring in postmenopausal women. It has excellent prognosis and a favorable clinical course. In addition, adenoid basal carcinoma is differentiated from adenoid cystic carcinoma by histologic and cellular morphologies, and immunohistochemistry. In this paper, we present the case of a 22 year old Korean female. She initially had a high-grade squamous intraepithelial lesion (HSIL) on Pap smear and a subsequent cervical loop electrosurgical excision procedure (LEEP) specimen revealing adenoid basal carcinoma. The lesion showed the histologic characteristics of adenoid basal carcinoma. Because of the lesion’s low potential for recurrence and metastasis, the young primipara had a conization procedure performed and has been under close observation.

범불안장애 환자와 일반인의 걱정 내용 및 심각도의 비교

김휘곤,김대호,오대영,서호준,허휴정,채정호,Kim, Hwigon,Kim, Daeho,Oh, Daeyoung,Seo, Ho Jun,Huh, Hyu Jung,Chae, Jeong Ho 대한불안의학회 2015 대한불안의학회지 Vol.11 No.1

Objective : Generalized anxiety disorder (GAD) is a common anxiety disorder characterized by excessive worries and anxiety symptoms. To distinguish between pathological and normal worries, this study compared the contents and severity of worries among patients with GAD with those of matched non-psychiatric control Methods : Thirty outpatients with GAD receiving treatment at the psychiatric department of Hanyang University Guri Hospital were recruited. As a matched control group, we selected 30 adults without psychiatric history who participated in the Anxiety Disorder Survey, during the Mental Health Exposition held in Seoul in April, 2014. Matched demographic data were age, sex, education, and household income. Self-questionnaires included demographic data, contents of worry (10 categories of worries and each severity), and the Pennsylvania State Worry Questionnaire (PSWQ). Results : There was no statistical difference in the contents of worry between patient and control groups. However, the total PSWQ scores significantly higher in the GAD group. Conclusion : Our findings suggest that patients and non-patients worry about the similar contents and worries in GAD cannot be differentiated by what people worry about. Only the severity of worry was a distinguishable feature. Our finding supported inclusion of the diagnostic criterion of "excesslve wornes" in GAD.

편집자에게/독자에게

김휘곤,김영옥,이지섭,김윤미,한재원,조연혜 샘터사 2017 월간 샘터 Vol.566 No.-

A Case of Vaginal Cancer with Uterine Prolapse

김휘곤,송용중,나용진,최욱환 대한폐경학회 2013 대한폐경학회지 Vol.19 No.3

Primary vaginal cancer combined with uterine prolapse is very rare. We present a case of 80-year-old postmenopausal women complaints of something coming out per vagina for the past 20 years, along with blood stained discharge, foul odor leukorrhea, and severe pelvic pain for the last 3 months. A 4 × 5 cm ulcer was present on middle third of vaginal wall with marked edema and ulceration of surrounding tissue. The prolapse was reduced under intravenous sedation in operating room. On gynecologic examination, uterus was normal in size, no adnexal mass was examined, and both parametrium were thickened. Papanicolaou smear was normal. Biopsy of the ulcer at vaginal wall revealed invasive squamous cell carcinoma of vagina. Magnetic Resonance Imaging of abdomen and pelvis showed left hydronephrosis and liver metastasis. Positron emission tomography (PET)/computed tomography (CT) revealed metastasis to lung, liver and iliac bone. She died from progression of disease one month after diagnosis.

A Case of Torsion of a Subserosal Leiomyoma

김휘곤,송용중,나용진,최욱환 대한폐경학회 2013 대한폐경학회지 Vol.19 No.3

Uterine leiomyoma is one of the most common gynecological tumor, whereas acute torsion of the uterine leiomyoma is very rare. We report a case of subserosal leiomyoma that was first detected by ultrasonography, and further confirmed as torsion of subserosal leiomyoma by laparoscopic surgery.

국소 전이된 자궁경부암에서 Cisplatin과 5-Fluorouracil을 이용한 동시 항암화학방사선요법

김휘곤,이광현,김지현,이형식,차문석,김현호 대한부인종양 콜포스코피학회 2003 Journal of Gynecologic Oncology Vol.14 No.1

목적 : 국소 전이되거나 거대 종괴를 가진 자궁경부암에서 Cisplatin (CDDP)와 5-Fluorouracil (5-FU) 항암 치료와 방사선 치료를 동시에 시행하는 동시 항암화학방사선치료(Concurrent chemoradiotherpy)의 효용성과 부작용에 관해 알아보고자 하였다. 연구 방법 1997년 1월부터 2000년 12월까지 동아대학병원을 방문한 국소전이 되거나 거대종괴를 가진 자궁경부암환자 24명을 대상으로 하였다. 치료는 CDDP, 5-FU, 골반방사선으로 구성되며, 외부골반조사이후에 강내조사를 시행했다. 항암화학치료는 3주 간격으로 3회를 기준으로 투여했으며, 부분관해 혹은 무반응 환자에서는 추가로 항암화학치료를 시행했다. 결과 : 본 연구의 치료 결과 전체 반응률은 83.3%(완전관해 79.2%, 부분관해 4.1%)였고, 전체생존률과 무병생존률은 각각74.4%와 81.9% 였다. 추적 관찰 기간은 평균 36개월이었다 치료 기간중 발생한 급성 독성으로 오심과 구토증상은 대부분 경미했지만, 4명의 환자에서는 중등도의 구토증상이 있었고, 6명의 환자에서 혈액학적 독성이 나타났고, CDDP와 관련된 신독성이 1명 있었다. 만성 독성으로는 방광염과 직장염이 있었고, 2명의 환자는 질직장루가 발생하여 수술로 교정하였다. 결론 : 본 연구 결과 CDDP와 5-FU를 이용한 동시 항암화학방사선치료는 다른 치료방법에 비해 치료 효과는 높으나 급성 혹은 만성 독성이 증가하는 단점도 있었다. 그러나 본 연구의 대상 환자수가 적고, 추적관찰 기간이짝아 향후 보다 많은 환자를 대상으로 장기간의 추적 관찰이 필요할 것으로 생각된다. Objective : The aim of this study was to determine the feasibility and toxicity of concurrent 5-fluorouracil (5-FU), cisplatin (CDDP) and pelvic radiation therapy (RT) in patients with advanced cervical cancer. Methods : We reviewed the charts of 25 patients who underwent concurrent chemoradiotherapy at Dong-A University Hospital from January, 1997 to December 2001 for advanced cervical cancer. Treatment consisted of CDDP, 5-FU and pelvic radiotherapy. CDDP was administered at a dose of 75 mg/m2 before radiotherapy initiation and 5-FU at a dose of 1000 mg/m2 from day two to day five of each course. Radiation was administered to the pelvis in five-day courses at a dose of 1.8 Gy daily every 40 days until a medium dose of 50.4 Gy was reached. The irradiated zone was extended to include paraaortic lymph nodes if necessary. The same schedule was repeated after three weeks. The median number of combined treatment courses per patient was six. Results : Twenty-five patients were enrolled with a median a follow-up of 32 months. CDDP and 5-FU chemotherapy well tolerated. Acute toxicity consisted of grade II to III hematologic toxicity in eleveen patients (44%) and nausea and vomiting is mild, but grade III in only four patients. Late toxicity consisted of grade II cystitis in two patients (8%), grade II proctitis in three patients (12%) and grade IV rectovaginal fistula in two patients (8%). RT was delayed in only 1 patient due to grade III enteritis. The overall response rate was 80% (76% complete, 4% partial). Disease free survival rate and overall survival rate is 68% and 74%. Conclusion : This study shows that Concurrent chemoradiotherapy improves overall survival rates and disease-free survival rates but some increase in acute toxicity. Due to small size sample and short duration of follow up, further study of a large group of patients and the long term survival rate are necessary.

Postnatal neovascularization in a mouse model via stem cells derived from human fetal amniotic membranes

김휘곤 ( Hwi Gon Kim ),Jin Sup Jung,Ook Hwan Choi 대한산부인과학회 2008 대한산부인과학회 학술대회 Vol.94 No.-

수술적 폐경 여성에서 에스트로겐 대체요법이 혈중 지질 농도에 미치는 영향

김휘곤 ( Hwi Gon Kim ),김승철 ( Seung Chul Kim ),이규섭 ( Kyu Sup Lee ) 대한폐경학회 2007 대한폐경학회지 Vol.13 No.3

연구목적: 수술적 폐경 여성에서 에스트로겐 대체요법의 치료 시기에 따른 지질 농도의 변화를 알아보고자 하였다. 연구재료 및 방법: 총 227명을 폐경 여성을 대상으로 전 자궁 적출술과 양측 부속기 절제술을 시행한 수술적 폐경 여성군 120명은 0.625 mg conjugated equine estrogen (CEE)를 투여하였고 자연 폐경 여성 107명은 0.625 mg conjugated equine estrogen (CEE)과 5 mg medroxyprogesterone acetate (MPA)을 투여하였다. 3개월간 호르몬 치료를 받은 군을 단기간 치료군으로, 1년간 호르몬 치료를 받은 군을 장기간 치료군으로 정하여 총 콜레스테롤, 중성 지방, LDL 콜레스테롤 및 HDL 콜레스테롤을 측정하여 호르몬 치료가 심혈관계 질환의 위험에 미치는 영향을 평가하였다. 결과: 수술적 폐경 후 3개월 경과군과 1년 경과군 모두에서 호르몬 치료를 시행한 경우에 총 콜레스테롤과 LDL 콜레스테롤이 유의하게 낮았으며, HDL 콜레스테롤은 폐경 후 3개월 경과시 호르몬 치료를 시행한 군에서 더 높은 경향을 보였으나 통계학적 유의성은 없었다. 중성 지방은 호르몬 치료를 시행하지 않은 군에서 더 낮은 경향을 보였으나 통계학적 유의성은 없었다. 결론: 수술적 폐경 여성에서 호르몬 치료는 혈중 지질 농도에 유익한 영향을 주는 것이 본 연구에서 확인되었다. Objectives: To evaluate short-term and long-term effects of estrogen replacement therapy (ERT) on lipid profile in surgically menopaused women. Methods: In this cross-sectional study, 120 surgically menopaused women after total hysterectomy and bilateral oophorectomy and 107 natural postmenopausal women were enrolled. After surgical menopause, 28 women received 0.625 mg conjugated equine estrogen (CEE) and 32 women did not for 3 months, 28 women received and 32 women were did not for 1 year. Natural postmenopausal women received 0.625 mg conjugated equine estrogen (CEE) and 5 mg medroxyprogesterone acetate (MPA). The effects of hormone therapy on plasma levels of lipids were investigated. Results: During hormone therapy, total cholesterol and LDL cholesterol level decreased significantly for 3 months and 1 year in surgically menopaused women (P<0.05). HDL cholesterol level raised at 3 months but there was not significant statistical difference (P>0.05). Triglyceride level decreased in surgically menopaused women had not received ERT but there was no significant statistical difference (P>0.05). Conclusion: The results of our study results suggest that ERT had more beneficial effects on lipid profile in surgically menopaused women.

매실(Prunus mume) 메탄올 분획물의 처리에 따른 인체 전립선암세포 LNCaP의 apoptosis 유도 효과

김휘곤(Hwi-gon Kim),김정호(Jeong-Ho Kim),허지안(Ji-An Heo),원영선(Yeong-Seon Won),서권일(Kwon-Il Seo) 한국생명과학회 2021 생명과학회지 Vol.31 No.3

본 연구에서는 매실 메탄올 추출물(maesil methanol fraction, MMF)을 제조하여 인체 전립선암세포 LNCaP, RC-58T 및 PC-3에 대한 증식억제 효과를 확인하였다. 인체 전립선암세포인 PC-3 및 RC-58T와 비교해보았을 때, LNCaP은 MMF의 처리에 따른 증식억제 효과에 가장 민감했다. LNCaP의 형태학적 관찰과 apoptotic body 형성을 관찰해보았으며, MMF의 처리로 인한 형태의 변화, 핵 손상 및 응축을 확인했다. MMF의 처리로 인한 인체 전립선암세포 LNCaP에서 성장억제 효과가 내인성 apoptosis 경로와 관련 있는지 확인한 결과, pro-apoptotic 단백질인 Bax, caspase-3, caspase-9, PARP의 발현이 증가하였고, anti-apoptotic 단백질인 Bcl-2의 발현이 감소하는 것을 확인했다. MMF와 AIF inhibitor인 N-phenylmalemide (N-PM)의 병용처리군에 비해 MMF 단독처리군의 증식억제 효과가 유의적으로 나타났으며 AIF 및 Endo G의 발현 증가를 통해 외인성 apoptosis 경로에 영향을 미치는 것을 확인했다. 또한 PI3K inhibitor인 LY294002와 MMF의 병용처리군에 비해 MMF 단독처리군의 증식억제 효과가 유의적으로 나타났으며 PI3K, p-Akt, p-mTOR의 발현 감소를 통해 PI3K/Akt/mTOR 신호경로에 영향을 미치는 것을 확인했다. 결론적으로 인체 전립선암세포 LNCaP에서 MMF의 증식억제 효과는 천연물 유래 기능성 식품의 소재로써의 가능성을 보여준다. This study examined the growth inhibitory effect of the methanol fraction of maesil (Prunus mume) extract (MMF) on LNCaP, PC-3, and RC-58T human prostate cancer cell lines. Among these cell lines, LNCaP was the most sensitive to the inhibitory effects of MMF. Observation of the morphology and apoptotic body formation in the LNCaP cells revealed morphological changes, nuclear damage, and condensation in response to MMF treatment. The suppressive effect of MMF was related to the intrinsic apoptosis pathway, as indicated by increased expression of the pro-apoptotic proteins Bax, capase-3, capase-9, and PARP and decreased expression of the anti-apoptotic protein Bcl-2. Combined treatment with MMF and the AIF inhibitor N-phenylmalemide (N-PM) indicated that MMF treatment alone had a significant growth suppression effect. The involvement of the extrinsic apoptosis pathway was also confirmed by increased expression of AIF and Endo G. The growth suppression effect of MMF was also significant when compared to the effects of a combination of the PI3K inhibitor LY294002 and MMF. The reduced expression of PI3K, p-Akt, and p-mTOR confirmed the involvement of the PI3K/Akt/ mTOR signaling pathway in regulating the anti-proliferative properties of MMF. In conclusion, the growth suppression effect of MMF in the LNCaP human prostate cancer cell line shows the possibility of using this natural product in functional foods.

Serous cystadenofibroma of the mesosalpinx: A case report (초)

김휘곤 ( Hwi Gon Kim ),( Yeom Jung In ),( Dong Hyung Lee ),( Ook Hwan Choi ) 대한산부인과학회 2010 대한산부인과학회 학술대회 Vol.96 No.-