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자궁경부암종에서 방사선치료의 반응성과 p53 , bcl - 2 및 bax 단백질 발현
이의돈(Eui Don Lee),이광범(Kwang Beom Lee),석원익(Won Ik Suk),최준렬(Jun Ryeoul Choi),이종민(Jong Min Lee),이지성,박찬용(Chan Yong Park),하승연(Seung Yeon Ha),이규찬(Kyu Chan Lee) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.10
목적 : 자궁경부암종에서 방사선 치료의 예후 판정에 apoptosis 관련인자인 p53, bcl-2 및 bax 등이 유용한지를 알아보기 위해 본 연구를 시행함. 연구 방법 : 1998년 1월부터 2000년 5월까지 가천의대 길병원에 내원한 국소적으로 진행된 자궁경부암 (stage Ⅱb와 Ⅲ) 환자 30명을 대상으로 방사선치료를 받기 전에 자궁경부 조직 생검을 실시하여 Bcl-2, p53 및 bax에 대한 면역조직화학적 염색을 시행하였다. 결과 : 1. P53의 발현은 방사선 치료의 비관해군에서 관해군에 비하여 많이 관찰되었으나 통계적으로 유의한 차이는 없었다 (p=0.43). 2. Bcl-2의 발현은 방사선 치료의 비관해군에서 관해군에 비하여 유의하게 많이 관찰되었다 (p=0.001). 3. Bax의 발현은 방사선 치료의 관해군에서 비관해군에 비하여 유의하게 많이 관찰되었다 (p=0.04). 결론 : Bcl-2와 bax의 발현은 방사선치료의 반응성과 관련이 있으며 자궁경부암종에서 예후인자로서 사용될 수 있을 것으로 사료되며 p53은 보다 많은 연구가 필요하리라 생각된다. Objective : To evaluate the relationship between p53, bcl-2 and bax protein expressions and clinical response to radiation therapy in patients with cervical squamous cell carcinoma and possibility of using them as an useful marker for sensitivity of radiation therapy. Methods : This study included 30 patients with locally advanced cervical squamous cell carcinoma (stage Ⅱb and Ⅲ). The specimens were obtained from cervical squamous cell carcinoma before radiation therapy by colposcopic directed biopsy and processed for immunohistochemical staining against p53, bcl-2 and bax. Results : 1. P53 was more expressed in nonresponders than responders to radiation therapy, but it was not statistically significantly different (p=0.43). 2. Bcl-2 was significantly more expressed in nonresponders than responders to radiation therapy (p=0.001). 3. Bax was significantly more expressed in responders than nonresponders to radiation therapy (p=0.04). Conclusion : Expression of bcl-2 and bax are correlated with the clinical response to radiation therapy and would be considered as an useful marker for sensitivity of radiation therapy. However, it is necessary to further evaluate p53.
정상 단태아 임신과 동반된 Hyperreactio luteinalis 1 예
김광준(Gwang Jun Kim),이광범(Kwang Beom Lee),황병철(Byung Cheul Hwang),조현이(Hyun Yee Cho) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.6
Hyperreactio luteinalis is a rare disease characterized by marked cystic enlargement of the ovary due to multiple benign theca lutein cyst. The cause of this disease is not well known but is believed to be induced by high serum levels of human chorionic gonadotropins (hCG). It occurs usually in gestational trophoblastic disease, multiple pregnancies, and rarely in normal pregnancy. In nature, hyperreactio luteinalis is a benign condition. Therefore, the appropriate management is conservative, but surgical intervention is definitely indicated to remove infarcted tissue, control hemorrhage, or decrease androgen production in virilized patients. Here we report a case of hyperreactio luteinalis which was diagnosed at 11 weeks gestation. Lower abdominal pain was developed and progressed. Emergent right wedge oophorectomy and left salpingoophorectomy was performed due to probable torsion of left ovarian cyst and the pregnancy maintained. Theca lutein cysts were confirmed on pathologic examination.
자궁에 국한된 자궁내막암에서 림프혈관 침윤의 예후인자로서의 중요성
임소이 ( So Yi Lim ),이광범 ( Kwang Beom Lee ),박찬용 ( Chan Yong Park ) 대한산부인과학회 2012 Obstetrics & Gynecology Science Vol.55 No.2
목적: 자궁에 국한된 자궁내막모양형의 자궁내막암 환자에서 림프혈관 침윤이 재발의 위험인자인지를 조사하였다. 연구방법: 1998년부터 2010년까지 전자궁절제술, 양측 난소난관절제술, 복강세척 세포검사 및 림프절절제술 또는 자궁절제술, 양측 난소난관절제술, 복강세척 세포검사를 시행받은 자궁에 국한된 자궁내막모양형의 자궁내막암 환자 165명의 의무기록을 후향적으로 조사하였다. 복강 세척 세포검사가 양성으로 나온 환자를 제외하지는 않았다. 결과: 나이의 중간값은 52세였다(범위, 26-81세). 평균 추적기간은 46개월이었다(범위, 1-144개월). 124명(75.2%)은 보조적 치료를 받지 않았고, 41명(24.8%)은 항암화학요법, 방사선 치료, 동시 항암방사선요법의 치료를 받았다. 림프혈관 침윤은 29명(17.6%)의 환자에서 있었다. 8명(4.8%)에서 재발이 발생하였다. 단인자 분석상 50세 이상의 연령, 종양의 분화도, 림프혈관 침윤이 재발없는 생존과 연관이 있었다(P<0.05). 림프혈관 침윤은 종양의 분화도, 고령, 자궁근층 침윤과 같은 다른 예후 인자들과도 상호연관이 있었다. 그러나 다인자 분석에서는 통계적 의의를 보이지 않았다. 림프혈관 침윤은 재발을 예측하는 독립적 인자가 아니었다(P=0.093). 결론: 림프혈관 침윤은 자궁에 국한된 자궁내막모양형의 자궁내막암 환자에서 단인자 분석상 재발과 연관이 있는것으로 나타났으나 다인자 분석에서는 통계적 의미가 없었다. 림프혈관 침윤 그 자체로는 예후에 영향이 없는 것으로 보이며, 단독으로 치료계획을 정하거나 예후를 예측하지는 못할 것으로 생각된다. Objective: We evaluated whether or not lymphovascular space involvement (LVSI) is a risk factor for the relapse of disease in patients with uterine-confined endometrioid endometrial cancer. Methods: A retrospective chart review was carried out of 165 patients with uterine confined endoemtrioid-type endometrial cancer after initial treatments including total abdominal or laparoscopic hysterectomy, and bilateral salpingo-oophorectomy, with or without lymphadenectomy, peritoneal washing between 1998 and 2010. The patients with positive peritoneal cytology were not excluded. Results: The median age was 52 years (range, 26 to 81 years) with a median follow-up of 46 months (range, 1 to 144 months). One hundred twenty-four patients (75.2%) received no adjuvant treatment, 41 patients (24.8%) received adjuvant treatment including platinum-based chemotherapy, radiation therapy, and chemoradiation. LVSI was present in 29 patients (17.6%). Eight patients (4.8%) developed recurrences. Using univariate analysis, age>50 years, the tumor grade, and LVSI were found to relate to recurrence-free survival (P<0.05). LVSI was associated with other prognostic factors such as old age, a higher tumor grade, and deeper myometrial invasion. But multivariate analysis showed no significance. LVSI was not an independent factor to predict recurrence (P=0.093). Conclusion: LVSI was associated with an increased likelihood of recurrence via univariate analysis in patients with uterine-confined endometrioid endometrial cancer. Multivariate analysis showed no statistical significance. The presence of LVSI seems to have no effect, in and of itself, to alter the treatment plan or to predict the prognosis.
최유덕(Yu Duk Choi),이경훈(Gyoung Hoon Lee),김용욱(Yong Wook Kim),이광범(Kwang Beom Lee),서은정(Eun Jung Seo),손문성(Moon Sung Son),안현경(Hyun Gyoung Ahn),석원익(Won Eik Seok),최영진(Young Jin Choi),김광준(Gwang Jun Kim),김석영(Suk 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.10
N/A Objective : The birth weight distributions are obtained to be classified according to the duration of pregnancy, and then compared with other results already published in literature to verify the difference. Methods : A total of 17,291 deliveries in Gachon medical center hospital from January 1996 to December 1999 is retrospectively reviewed. The data of 28∼42th week of gestation are analysed, and the 10th, 25th, 50th, 75th and 90th percentiles of birth weight are determined for each week and also according to sex and parity. Furthermore the 10th, 50th, 90th percentiles are compared with those from other reports. Results : 1. The 10th, 50th, 90th percentiles of birth weight classifed according to gestational age are as follow : in 28th week of pregnancy, 1,068, 1,240 and 1,812 g; in 32th week, 1,470, 1,890 and 2,266 g; in 36th week, 2,170, 2,720 and 3,240 g; in 40th week, 2,910, 3,370 and 3,870 g; in 42th week, 2,977, 3,475 and 4,023 g. 2. The mean birth weight of the male neonates is greater than that of the female ones from 37th week to 41th week (p<0.01). 3. Comparisons of 10th, 50th, 90th percentiles of birth weight with Park groups show that there is an increase of birth weight by 100∼144 g. Conclusion : Comparison of the birth weight-gestational age table with ones published by other groups shows that infants tend to be heavier.