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자궁내막 Interleukin-1 receptor type 1의 조절
김승보,이보연,윤현하 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.2
The Interleukin-1 system has been suggested as an important modulator for implanta-tion process, although its clear mechanism of action has not been elucidated. In this study we investigate the response of interleukin-1 receptor type1 in cultured endometrial cells by various embryonic products known to be involved in successful pregnancy outcome, includ-ing IL-1β, platelet activating factor(PAF) and human chorionic gonadotropin(hCG). Human endometrial tissue was separated to glandular epitherial cells and stromal cells. After 6 days culture of confluent monolayer in the serum containg media with progesterone, endometrial cell layers were further cultured with 6ml media each containing IL-1β(10 IU/ml), PAF(200 nM) or hCG(10 IU/ml). After 24 to 48 hr of culture endometrial cell layers were scraped and IL-1RtI expression was determined by Northern blot analysis. Endometrial expression of IL-1RtI messenger ribonucleic acid(mRNA) was increased until 24 hours and did not ch-anged until 48 hours. IL-1RtI mRNA expression of endometrial stromal cells cultured with IL-1β and PAF were higher than that of control(P>0.05). HCG did not affect the endome-trial stromal IL-1RtI mRNA expression. These results suggest that IL-1 system plays a role in embryo- endometrial communication.
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자궁경부암 환자의 근치적자궁적출술 후 재발 양상에 대한 연구
이선경,김승보,진규섭,윤현하 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.1
The incidence of recurrence in early stage cervical carcinoma is 10∼20%. Approximately 15% of patients who have recurrence will survive 2 years free of disease after additional therapy. Several prognostic factors associated with an increased risk of recurrence have been determined. Few reports have dealt with the clinical nature of recurrence following radical surgery. This paper review, in a retrospective manner, radical hysterectomy and pelvic lymphadenectomy for early stage cervical cancer. The women who recurred after radical hysterectomy and pelvic lymphadenectomy during the follow-up period were 25 cases(16.8%). Our results are as follows; Histopathologic distribution are as follows: squamous cell carcinoma 15.7%, adenocarcinoma 25.0%, adenosquamous cell carcinoma 33.0%. Anatomic site of recurrence are as follows ; central pelvic recurrence are 10 cases(40.0%), lateral pelvic recurrence are 5 cases(20.0%), distant recurrence are 10 cases(40.0%). Adjuvant radiation therapy after radical hysterectomy and pelvic lymphadenectomy significantly reduced the pelvic recurrence comparing to surgery alone(42.8% vs 81.8%)( p < 0.05 ). The incidence of recurrence are higher when in advanced stages, lymph node metastasis is seen(36.8% vs 10.0%), and the primary therapeutic modality is surgery plus adjuvant radiation therapy(26.9% vs 11.4%). Tumor size( > 4 cm) is significantly related with recurrence(8.0% vs 44.4%)(p < 0.05). Mean disease free interval according to primary therapeutic modality, recurrence site, nodal status, FIGO stage are as follows ; surgery alone compared to surgery plus radiation(22.2 months vs 12.7 months), pelvic recurrence compared to distant recurrence(20 months vs 13 months), lymph node negative compared to positive (22.4 months vs 12.6 months), FIGO stage Ib, IIa, IIb(20.3 months vs 14.2 months vs 11 months). Overall cumulative survival rate are as follows; within 6 month is 80%, within 1 year is 48%, within 2 year is 20%, and 5-year survival rate is 16%. The purpose was to evaluate which factors are related with the risk of recurrence and to analyze the outcome of recurrent patients. FurthermorE a try was made to find out how surveillance program most effective in detecting recurrence.
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이선경,김승보,이상욱,최현우,김범수,윤현하,조윤제 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.7
경희대학교 의과대학 산부인과학교실에서는 1979년 1월부터 1996년 12월까지 만 17년간 악성 배세포종양으로 진단받고 치료했던 20명의 환자를 대상으로 연구한 결과 다음과 같은 결과를 얻었다. 1. 악성 배세포종양은 20예로서 배세포종양 중 3 %, 전체 난소종양 중 1.52%를 차지했다. 2. 환자의 연령 분포는 20대가 45%로 가장 많았고 다음 으로는 10대로 25%를 차지하였고 평균 연령은 24세였다. 3. 출산력에 있어 미산군의 환자는 15명(75%)였고 한 번의 출산력의 환자는 1명(5%), 두 명 이상의 출산력을 가진 환자는 4명(20%)이었다. 4. 환자의 증상으로는 복부 종괴 촉지가 11명으로 가 장 많았고 복부 통증 혹은 불편감이 4명이었다. 5. 악성 배세포종양의 조직학적 분류에 따른 분포는 미성숙 기형종이 38.08%, 미분화 배세포종양이 33.32%, 내배엽동 종양이 14.28%, 태생암, 기형종에서 유래된 상피암, 혼합배세포종 등이 각각 4.76%를 보였다. 6. 임상적 병기는 Ⅰ기가 12명(60%), Ⅱ기가 0명(0 %), Ⅲ기가 7명(35%), Ⅳ기가 1명(5%)였다. 7. 발생 부위는 좌측이 8명(40%), 우측이 8명(40 %), 양측성의 환자는 4명(20%)이었다. 8. 종양의 크기에 있어 15 cm 이상인 경우가 9명(45 %), 15 cm 미만인 경우가 11명(55%)였다. 9. 종양표지물질은 CEA가 10명 중 5명이, αFP이 12 명 중 7명이, βhCG는 10명 중 3명이, LDH는 8명 중 4명 이, CA 125는 7명 중 6명이, CA19-9는 7명 중 5명이 의미 있게 증가된 소견을 보였다. 10. 5년 생존율은 81.82%였고 통계학적 유의성을 갖 는 예후인자로는 환자의 병기, 종양의 편측성, 잔류종양, 병리조직학적 형태 등이다. A clinical study was made on 20 cases of malignant germ cell tumors that were treated at the Department of Obstetrics and Gynecology in Kyunghee University Hospital between January 1979 and December 1996. The cases of malignant germ cell tumor were 20 cases and the frequency of malignant germ cell tumor was 1.52% among ovarian tumors in this period. The mean age was 24 years. Malignant germ cell tumors classified by histologic type were 8 cases with immature teratoma, 7 cases with dysgerminoma, 3 cases with endodermal sinus tumor, 1 case with embryonal carcinoma, 1 case with teratoma with malignant change, and 1 case with mixed germ cell tumor. Sixty percent of the patients were FIGO stage I at the time of initial diagnosis. All patients were underwent operation and 13 patients were treated with adjuvant combination chemotherapy (BEP, VBP, VAC). The actuarial 5-year survival rate was 81.82% and significantly prognostic factors were stage, laterality, residual mass and pathologic diagnosis.
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