선행항암화학요법으로 치료된 자궁경부의 악성림프종 1례

손성경,황순호,김보연,박진희,이경은,이기환,노흥태 대한부인종양학회 2007 Journal of Gynecologic Oncology Vol.18 No.2

Non-Hodgkin’s lymphoma presented as a malignancy of the uterine cervix is exceedingly rare disease and accounts for approximately only 0.12-0.6% of extranodal lymphomas. There is no consensus on the management and prognosis of the disease because of its extreme rarity. Previously, treatment of this disease has been radiation therapy, surgery or chemotherapy either alone or in combination. We present the case of a 45-year-old woman diagnosed with diffuse, large B-cell non-Hodgkin’s lymphoma of the uterine cervix. We administered neoadjuvant chemotherapy according to CHOP protocol (cyclophosphamide, adriamycin, vincristine, and prednisone) followed by hysterectomy, bilateral salpingo-oophorectomy. The patient is alive 20months after the initial diagnosis. We report the case with a brief review of literature. 자궁경부에 발생하는 악성 종양중 비 호지킨 림프종은 매우 드문 질환으로 비 림프절 림프종의 약 0.12-0.6% 정 도만이 발생한다. 증례들이 희귀하여 아직까지 치료방법과 예후에 관해서는 확립된 가설이 없다. 이전의 치료방 법들은 방사선 치료, 수술 또는 항암화학요법, 이들의 병합요법등이 있었다. 이 증례는 자궁경부의 미만성, 대 형 B세포 비 호지킨 림프종 환자로 항암화학요법으로 CHOP를 시행한 후 자궁적출술, 양측 난소난관절제술을 시 행하였고 치료 시작 후 20개월이 경과한 후에도 재발이 없었던 경우였다. 저자들은 비정상 자궁경부 세포 검 사를 통해 내원하여 선행항암화학요법과 수술적 치료를 시행한 자궁경부의 악성 림프종 환자 1례를 경험하였 기에 간략한 문헌 고찰과 함께 보고하는 바이다.

흰쥐난소에서 황체 발달시기에 따른 대식세포의 변화: 면역조직화학적 및 투과전자현미경적 연구

손성경 ( Sung Kyong Son ),노흥태 ( Heung Tae Noh ),이윤이 ( Yune Yee Lee ),김수일 ( Soo Il Kim ),김원식 ( Won Sik Kim ),양윤석 ( Yun Seok Yang ) 대한산부인과학회 2005 Obstetrics & Gynecology Science Vol.48 No.10

이하선에 발생한 혼합 종양 1례

손성경,강성호,홍석찬 건국대학교 의과학연구소 1995 건국의과학학술지 Vol.5 No.-

This tumor usually present in the fourth or fifth decades. It was painless, slow growing, and usually found as an incidental mass in the cheek or near the angle of the mandibule. About 90% of this tumors arise superficially to the plane of the facial nerve. On gross pathologic examination, this tumor is a solitary, firm, round tumor with a thin delicate incomplete capsule. The treatment choice is excision of the tumor with a surrounding cuff of normal tissue with facial nerve preservation.

흰쥐 난포에서 저선량 방사선조사로 유도된 hormesis효과

이원정,손성경,이민아,양윤석,김원식 대한체질인류학회 2007 해부·생물인류학 (Anat Biol Anthropol) Vol.20 No.3

Hormesis효과는 생물체가 자연속에 존재하는 정도의 저선량 방사선 또는 독성물질 등에 노출된 후 단기 간 내에 나타나는 이로운 영향을 말한다. 저자들은 흰쥐 난포에서 저선량의 방사선을 조사한 후 고선량을 조사하 여 hormesis효과를 알아보고자 하였다. 본 실험에서는 4주령의 암컷 흰쥐(Sprague-Dawley계통)를 대조군, 2 cGy조사군, 2 cGy 조사후 2Gy조사군 및 2 Gy조사군으로 나누고, 각 군별로 단회 방사선 조사후 24시간에 희생시켜 난소를 적출하고 통상적인 방법으로 처 리한 후 H & E 염색과 TUNEL 면역염색을 실시하였다. 광학현미경으로 각 군 사이에 폐쇄난포의 비율과 난포의 발육단계별 정상난포의 비율을 비교하였다. 그 결과 난소내 전체 난포에서 차지하는 폐쇄난포의 비율은 2 Gy조사군(55.35 %)에서 2 cGy+2 Gy조사군 (39.27 %)에 비하여 현저히 증가하였으며, 난포의 발육단계에 따른 정상난포의 비율은 2 Gy조사군(일차난포, 82.15 %; 난포동형성전난포, 63.48 %; 난포동 난포, 21.58 %) 보다 2 cGy+2Gy조사군(일차난포, 94.37 %; 난포동형 성전난포, 78.81 %; 난포동 난포, 33.09 %)에서 모든 발육단계에서 유의하게 증가 하였다. 이같은 결과는 저선량의 방사선에 의해 난포발육단계에 hormesis효과가 나타났음을 의미하는 것으로 앞으로 방사선 hormesis연구에 있어 한 모델로 사용할 수 있을 것으로 사료된다. Hormesis is the generally-favorable biological responses to low exposures to toxins and other stressors. Radiation hormesis is the theory that ionizing radiation is benign at low levels of exposure, and that doses at the level of natural background radiation can be beneficial. The purpose of this study is to reveal the hormetic effect of low-dose radiation of ionizing radiation on the ovarian follicles of 4-week old female mice. Mice were grouped into control group, 2 cGy irradiated group, 2 cGy and 2 Gy irradiated group (2 cGY pre-exposure group), and 2 Gy irradited group. Mice were sacrificed by cervical dislocation 24 hours after irradiation, removed ovaries, fixed in neutral formaldehyde solution for 24 hours, embedded with paraffin, stained with hematoxylin and eosin and TUNEL immunohistochemically, and observed light microscopically the atretic follicles and normal follicles in various follicular developmental stages. In this experiment, the ratrio of atretic follicles to entire follicles in an ovary increased significantly in 2 Gyirradiated group compared with 2 cGY pre-exposure group, and the ratio of normal follicles to the entire follicles in an ovary in all the developmental stages were increased significantly in the 2 cGY pre-exposure group compared with 2 Gy-irradiated group. These results mean that low-dose radiation pre-exposure can induce the hormetic effect in the developing ovarian follicle.

HELLP증후군의 임상양상과 예후에 관한 연구

이창환,손성경,이석수,이윤이 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.2

The syndrome of hemolysis, elevated liver enzymes and low platelet count during pregnancy (HELLP syndrome) is recognized as a serous, multisystemic disease and associated with poor maternal and perinatal outcome. The purpose of this study is to elevate the clinical appearance and the maternal and perinatal outcome with HELLP syndrome. It was a retrospective study that maternal outcome and perinatal variables and the clinical course of eight cases HELLP syndrome in 234 cases with pregnancy induced hypertension who visited the Department of Obstetrics and Gynecology, Chungnam National University Hospital from January 1995 to December 1998. The results were as follows; 1. The incidence of the HELLP syndrome among patient with pregnancy induced hypertension was 3.4%(8/234) and mean age, mean gestational age was each 29.7 year-old, 36.7 weeks and there was 3 primigravidas and 5 multipara(38% vs 62%). 2. In the abnormal elevated laboratory finding on admission, mean platelet count, sGOT, sGPT, total bilirubin, LDH, BUN, and creatinine was each as 74,000/㎣, 2231U/ℓ, 1941U/ℓ, 1.7mg/㎗, 10951U/ℓ, 22.3mg/㎗ and 2.0mg/㎗. 3. About the coagulation system, PT and aPTT were all within the normal limit but in 38% of patient with HELLP syndrome fibrinogen was decreased, in 50% FDP was increased and in 25% patient was made diagnosis of DIC. 4. The 6 cases were perceived as immediate delivery, one case was vaginal delivery only and others cesarean section and maternal complication was placenta abruption, severe pulmonary edema, acute renal insufficiency, acute toxic hepatitis and cardiomyopathy but there was no maternal mortality in all cases. 5. The mean birth weight 2,374g, 50% of fetus were delivered before 38 weeks, the IUGR was found in 25% and the perinatal mortality rate was 25%. 6. Neonatal complication was neonatal asphyxia, RDS(> 2 grade), sepsis, hyperbilirubinemia, hypermagnesemia, TTN and major handicaps of PVL. These findings suggest that infants born to HELLP syndrome mother have an increased need for resuscitation at delivery and aggressive management for mothers. Thus obstetricians should be identified promptly and need for appropriate management of nowborn infant and mothers with HELLP syndrome.

난소암에서 Apoptotic Index와 임상병리적 인자 및 예후와의 상관관계에 대한 연구

노흥태,손성경 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.4

난소암에서 apoptotic index와 임상병리적 인자와 예후와의 상관관계를 알아보기 위해서 이 연구를 시작하였다. 아포토시스를 위해 연구에 이용된 난소의 악성종양은 34예이고, 양성기형종은 10예, 정상 난소조직은 10예였다. 아포토시스 세포는 terminal deoxynucleotidyl transferase mediated fragmentation end labelling method [TUNEL] 방법에 의해 관찰하였다. 400배 한시야[면적;0.24mm2]에서 관찰되는 전체 세포수를 total cell count로 하였고 apoptotic index[A.I]는 1000개의 전체세포에서 관찰 될수 있는 apoptotic cell의 숫자로 나타내었다. 악성종양 전체에서 나이가 증가함에 따라 apoptotic index도 증가하였으며 유의한 상관관계를 가졌다.[P=0.014] 악성종양 각각의 종류에 따른 apoptotic index와의 상관관계에서는 장액성 종양에서 병기와 조직학적 분화도가 높을수록 apoptotic index도 높게 나타나 유의한 상관관계를 가졌다.[P=0.038, P=0.032] 하지만 다른 종류의 난소종양에서는 병기와 조직학적 분화도와 apoptotic index와의 상관관계는 없었다. 또한 혈청 CA 125 수치와 전체 종양 세포수[total cell count], 그리고 예후도 apoptotic index와 상관관계는 없었다. 난소의 악성종양과 양성기형종, 정상조직 간의 apoptotic index 비교에서 유의한 상관관계는 없었으며[P=0.745] 악성종양 각각의 종류간의 apoptotic index 비교에서도 유의한 상관관계는 없었다. [P=0.810] 난소의 악성 종양 전체에서는 apoptotic index와 임상 병리적 예후인자와 상관관계를 보이지는 않았으나, 장액성 종양에서는 병기와 조직학적 분화도가 높을수록 apoptotic index도 높게 나와 연관성을 보여주었다. 난소암 환자에서 아포토시스는 독립적인 예후 인자는 되지 못하며 앞으로 이에대한 연구가 더 진행되야 할것으로 사료된다. Objective: To establish if any association exists between the apoptotic index and clinicopathologic factors and prognosis in ovarian carcinoma. Method: Archival samples from ovarian carcinomas [n=34], benign ovarian tumors [n=10], and normal ovarian tissue [n=10] were evaluated for apoptosis. Apoptotic cells were identified by the terminal deoxynucleotidyl transferase mediated fragmentation end labelling method in histologic sections. The apoptotic index [AI= sum of apoptotic bodies/ 1000 tumor cells] and total cell count [X 400 magnification] were then calculated. Result: A high apoptotic index[AI] [≥16.6] significantly correlated with age of all ovarian carcinoma. [P=0.014] A high apoptotic index[AI] [≥14.8] significantly correlated with high clinical stage [P=0.038], and high histologic grade [P=0.032] of serous ovarian carcinoma. No significant correlation was found between apoptotic index[AI] and clinical stage, histologic grade of other type ovarian carcinoma. Also no significant correlation was found between apoptotic index[AI] and other clinicopathological factors, such as serum CA 125 level, total cell count, and prognosis. Conclusion: Our results indicate that counting apoptosis cannot be useful for predicting patient survival in ovarian carcinoma, and that AI is not an independent prognostic factor.

수술흔적에 발생한 자궁내막증에 대한 임상적 연구

이기환,손성경,이민아,이진구,양정보,강길전 대한산부인과학회 2006 대한산부인과학회 학술대회 Vol.92 No.-

골반 종괴 환자에서 혈소판 증가증의 임상적 의의

노흥태,손성경 대한부인종양 콜포스코피학회 1998 Journal of Gynecologic Oncology Vol.9 No.4

The clinical usefulness of the preoperative platelet count and serum CA 125 level for predicting malignancy in patients presenting with a pelvic mass was investigated. A retrospective review of medical charts of 300 patients presenting with a pelvic mass between January 1995 and December 1997 was performed. Patients were divided into groups by pathologic diagnosis including ovarian cancer (n=20), benign ovarian tumor (n=60), endometrioma (n=20), uterine myoma (n=150), and adenomyosis (n=50). Thrombocytosis and elevated values of serum CA 125 level were defined as platelet count $gt; 400,000/ul and 35U/ml, retrospectively. The x2 test was used to analyze the data. The total number of case of ovarian carcinoma, benign ovarian tumor, and endometrioma were significantly correlated with thrombocytosis(P=0.001). The tumor type and the serum CA 125 level of benign ovarian tumors were also significantly correlated with thrombocytosis(P=0.032, P=0.009). Thrombocytosis was found in 25% of serous cystadenoma cases and in 30% of dermoid cyst cases but was not present in any case of mucinous cystadenoma. There was no significant correlation between thrombocytosis and clinicopathological factors, such as type, stage, and serum CA 125 level of ovarian carcinoma(P$gt;0.05). Also, myoma, adenomyosis and endometrioma were not significantly correlated with thrombocytosis. However, in 19.8% of intramural myoma cases, 46.1% of submucosal myoma cases, and 36.3% of subserosal myoma cases, thrombocytosis was present(P$gt;0.05). The platelet count is a test that is rapidly available and easily obtained. Thrombocytosis is apparantly a marker of tumor burden, but is a little value in planning the original management of women presenting with a pelvic mass.

복강경하 전자궁적출술

이기환,손성경,고길환,양정보,김도영,강길전 대한산부인과학회 2005 대한산부인과학회 학술대회 Vol.91 No.-

갑상선 결절에 관한 임상적 고찰

강성호,손성경,김진국,진정언,홍석찬,이태의 대한이비인후과학회 1997 대한이비인후과학회지 두경부외과학 Vol.40 No.3