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문제원 ( Jei Won Moon ),김지영 ( Ji Young Kim ),신유정 ( You Jung Shin ),이미영 ( Mi Young Lee ),최혁재 ( Hyuck Jae Choi ),박정열 ( Jeong Yeol Park ),남주현 ( Joo Hyun Nam ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.9
Primary malignant melanoma arising from the ovarian mature cystic teratoma is extremely rare, with only 31 cases have been described in the literature. It is one of the rarest forms of malignant transformation of ovarian mature cystic teratoma and usually develops unilaterally after menopause. Recently, we experienced a case of primary malignant melanoma arising from ovarian mature cystic teratoma in 71-year-old woman. The diagnosis was confirmed by positive immunohistochemical results of S-100 protein and HMB 45. Here we report the rare case with review of literature.
태아 선천성 갑상샘기능저하증에서 자궁 내로 티록신(thyroxine) 주입한
이미영 ( Mi Young Lee ),원혜성 ( Hye Sung Won ),김유진 ( Eu Gene Kim ),엄정민 ( Jeong Min Eom ),문제원 ( Jei Won Moon ),유래미 ( Ree Mi You ),이필량 ( Pil Ryang Lee ),김암 ( Ahm Kim ) 대한주산의학회 2009 Perinatology Vol.20 No.2
A 28-year-old primi gravida visited our department at 20 weeks gestation. The ultrasound screening revealed twin gestation, and follow up screening revealed a bilobed large fetal neck mass in the 1st twin. We measured thyroid volume with ultrasound which was 5.072 cm3. Other fetal organs appeared normal. Cordocentesis was performed for fetal thyroid function and congenital hypothyroidism was confirmed. In addition, maternal thyroid hormones were checked. The other fetus was normal. Thyroid stimulating hormone (TSH) in the maternal serum was increased, but thyroxine (T3) was (within normal range). Two weeks later, we checked TSH and free T4 in amniotic fluid and administered intra-amniotic thyroxine (200 μg). We repeated the procedures 2 more times in two consecutive weeks. After 3 intra-amniotic thyroxine injection, follow-up cordocentesis revealed euthyroid status of the fetus. Although the thyroid gland had decreased in size and volume, it was still goitrous. At 36 weeks of gestation, the patient was admitted for preterm premature rupture of the membranes and the twin was delivered vaginally. The 1st twin was proved as an euthyroid status and antithyroid antibody was not detected. During the 3 years follow up, the baby had no considerable developmental problem. The intrauterine recognition and treatment of congenital goitrous hypothyroidism may not only reduce the obstetric complications associated with large goiters, but possibly improve the prognosis for normal growth and mental development of affected fetuses.
난소의 난황낭종양을 가진 환자에서 bleomycin, etoposide 및 cisplatin의 병합 항암화학요법 후 결과 분석
김지영 ( Ji Young Kim ),신유정 ( Yu Jung Shin ),문제원 ( Jei Won Moon ),박정열 ( Jeong Yeol Park ),김대연 ( Dae Yeon Kim ),이주학 ( Joo Hak Lee ),김종혁 ( Jong Hyeok Kim ),김용만 ( Yong Man Kim ),김영탁 ( Young Tak Kim ),남주현 ( 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.11
목적: 난소의 난황낭종양에서 시행하는 bleomycin, etopside, cisplatin (BEP)의 항암화학요법 후의 치료 결과 및 부작용에 대해 연구하고자 한다. 연구 방법: 1994년 10월부터 2008년 12월까지 서울아산병원에 내원하여 난소의 난황낭종양으로 진단받고 BEP 병합화학요법을 시행한 43명의 환자를 대상으로 의무기록을 후향적으로 분석하였다. 결과: 전체 43명 중 39명(90.7%)이 완전관해를 보였다. 1명(2.3%)이 부분관해를 보였고 3명이 암의 진행을 보였다. 43명의 환자들이 총 179 주기의 BEP 병합 항암화학 요법을 받았다. 혈액학적 독성 중 호중구 감소증은 21명의 환자에서 총 46주기에서 나타났으며, 빈혈은 40명의 환자에서 총 138주기에서 나타났다. 혈소판 감소증은 6명의 환자에서 총 8주기에서 나타났다. 간독성은 16명의 환자에서 총 27주기, 호흡기 독성은 1주기, 신독성은 보이지 않았다. 근치적 수술을 받은 환자 8명과 사망환자 4명을 제외한 31명의 환자 중에서 규칙적 생리를 보이는 환자는 29명(93.5%)이고, 불규칙 생리를 보이는 환자는 1명(3.2%)이었다. 치료 후 임신을 시도한 경우는 5명이며 임신을 한 경우는 3명이고, 이 중 2명은 정상만삭 질식분만, 1명은 현재 임신 중이다. 결론: BEP 항암화학요법은 난소의 난황낭종양을 가진 환자들에서 매우 효과적이며 안전한 치료이고, 치료 후 월경 및 생식기능은 대부분의 환자에서 보존되었고, 임신결과 또한 좋은 것으로 생각된다. Objective: The aim of this study was to evaluate the oncologic and reproductive outcomes of patients with ovarian yolk sac tumor after bleomycin, etoposide, cisplatin (BEP) chemotherapy following surgery. Methods: Of 145 patients with histologically confirmed malignant ovarian germ cell tumor, 43 had yolk sac tumor and received BEP chemotherapy after surgery. A retrospective analysis of these patients was performed. Results: The mean age of 43 patients was 24.8 years (range, 7 to 59 years). Thirty eight patients were nulliparous. Of 179 BEP chemotherapy cycles, grade 1~2 hematologic and non-hematologic adverse events occurred in 46 cycles in 21 patients. Thirty nine patients showed complete remission, 1 patient showed partial remission, and 3 patient had progressive disease during BEP chemotherapy. After median follow-up time of 57 months (range, 3 to 153 months), 5 patients had recurrent disease and three of them died of disease. The 5-year recurrence free survival rate and overall survival rate were 86% and 94%, respectively. After chemotherapy, all but one premenarchal patients had normal menstruation. Of them 5 patients tried to conceive and 3 of them succeeded in pregnancy. Conclusion: BEP chemotherapy was very safe and effective in patients with ovarian yolk sac tumor. Survival outcomes are excellent and reproductive outcomes are promising after BEP chemotherapy.