임신성 융모성 질환과 정상 태반 조직에서의 p53 단백의 과발현

남주현,김용만,김종혁,목정은,허주령,황성욱 대한부인종양 콜포스코피학회 1997 Journal of Gynecologic Oncology Vol.8 No.3

Mutations in the tumor suppressor p53 gene are the most frequently observed genetic lesions in human cancers. It seems that wild type p53 does significant role on growth and differentiation of normal cells. Mutations and allelic loss of the p53 gene are thought to be a cause of tumor development and to be correlated with the prognostic factors in various human cancers such as breast, ovary and lung cancer. Mutant p53 proteins have a prolonged half-life and can be detected by immunohistochemistry. In case of GTD(gestational trophoblastic disease), although the mutation of p53 gene mutation was revealed to be very rare, the overexpression of p53 in immunohistochemical staining has been reported in wide range of discrepancy and its role or prognostic significance in GTD is uncertain. This study is performed to define the status of p53 overexpression in GTD and to evaluate the correlations between p53 overexpression and prognostic factors of GTD. The results are as follows 1. p53 overexpression was detected in none of normal placental tissue, in 58.3%(14/24) of hydatidiform mole, in 75%(6/8) of invasive mole, in 75%(3/4) of choriocarcinoma, and in 100%(1/1) of placental site trophoblastic tumor, and showed significant difference of the p53 overexpression between normal placenta and GTD. We could not find any difference of the p53 overexpression between benign group(H-mole) of GTD and malignant one(invasive mole, choriocarcinoma, and placental site trophoblastic tumor) 2. In H-mole, low-risk group showed significantly higher prevalence of p53 overexpression than high-risk group did. In malignant group, there is no difference in the prevalence of p53 overexpression between early(FIGO stage I) and late(II-IV) stage-diseases, but the prevalence of p53 overexpression of low-risk group is slightly higher than that of high-risk group although we failed to find statistical significance. In conclusion, the high prevalence of p53 overexpression in GTD suggests that p53 may have a certain role in the pathogenesis of GTD or at least represent generalized DNA demage or genotic instability of GTD. And the hither prevalence of p53 overexpression in low-risk group suggests that accumulation of wild-type p53 may be related with favorable prognosis in GTD.

난소의 악성 혼합성 뮬러리안 종양 2예

남주현,목정은,김용만,김영탁,고준성,김경진,허주령,이인철 대한부인종양 콜포스코피학회 1995 Journal of Gynecologic Oncology Vol.6 No.2

Malignant mixed Mullerian tumor of is a rare tumor containing epithelial and mesenchymal components. Almost all mixed Mullerian tumors are found in postmenopausal women, often with low parity and usually in an advanced stage, Malignant mixed Mullerian tumor is highly malignant and the prognosis is poor due to frequent metastasis and recurrence. We experienced two cases of malignant mixed Mullerian tumor of ovary and report with a brief review of the literature.

난소암의 조기 진단

남주현 대한부인종양 콜포스코피학회 1994 Journal of Gynecologic Oncology Vol.5 No.4

뇌졸중 환자의 체간안정화 훈련이 자세조절과 일상생활동작에 미치는 영향 : 단일사례연구

남주현,심경보,곽성원 대한지역사회작업치료학회 2014 대한지역사회작업치료학회지 Vol.4 No.1

목적 : 이 연구에서는 단일 뇌졸중환자를 대상으로 체간안정화 훈련 프로그램 적용하여 자세조절과 일상생활 동작에 미치는 영향을 알아보고 분석함으로써 뇌졸중환자의 효과적인 임상적 중재 방안을 제시하고자 한다. 연구방법 : 경북 경주시에 소재한 C병원에 입원중인 75세 여성 뇌졸중 환자 1명을 대상으로 하였다. 연구 설계는 단일사례연구(single subject design)로써 ABA반전설계를 사용하였고, 연구기간은 2014년 4월 21 일부터 5월 23일까지 총 5주 동안 진행되었다. 실험 과정은 기초선(A) 3회, 중재 기간(B) 9회 유지(A’) 3 회로 총 15회 진행하였고 중재기간 동안 체간안정화 프로그램을 적용하였다. 연구 참여자의 자세조절과 일상생활동작의 평가를 위해 Postural Assessment Scale for Stroke(PASS)와 Modified Barthel Index(MBI) 를 사용하였다. 수집된 자료는 마이크로 소프트 오피스 Excel 2013 을 사용하여 그래프로 나타내는 시각 적 분석(visual analysis)을 사용하였다. 결과 : 자세조절 검사에서 평균 점수는 기초선 구간 11.7점, 중재 구간 14.8점, 유지 구간 15.3점으로 향상 되었고, 일상생활동작 평가에서 기초선 기간 66점으로 보통의 의존을 보였지만 중재 후와 유지 구간에서 는 80점으로 향상되어 가벼운 의존을 나타냈다 결론 : 체간안정화 훈련 프로그램이 뇌졸중 환자의 신체의 자세조절이나 정렬에 효과를 나타내고 나아가 일 상생활활동의 수행에도 유익한 향상을 보이는 것으로 확인되었다. Objective : This study intends to suggest an effective clinical intervention method for stroke patients by applying a trunk stabilization training program to a single stroke patient and investigating and analyzing the effects of the program on postural control and activities of daily living. Methods : The subject of this study was a 75 year-old female stroke patient hospitalized in C Hospital located in Gyeongju, Gyeongsangbuk-do. As for the research design, A-B-A reversal design was used with a single subject design; and the research period was a total of five weeks from April 21, 2014 to May 23, 2014. As for the research process, a total of 15 sessions were carried out including three sessions of baseline(A), nine sessions of an intervention period(B), and three sessions of maintenance(A'); and the trunk stabilization program was applied during the intervention period. To evaluate the participant’s postural control and activities of living life, the Postural Assessment Scale for Stroke(PASS) and the modified Barthel Index(MBI) were used. Visual analysis was used in which collected data were plotted on a graph, using Microsoft Office Excel 2013. Results : In the postural control test, the mean scores improved from 11.7 in the baseline phase to 14.8 in the intervention phase and 15.3 in the maintenance phase. In the evaluation of activities of daily living, the score improved from 66(medium dependence) during the baseline period to 80(low dependence) after intervention and at the maintenance phase. Conclusion : It was found that the trunk stabilization training program showed effects on the stroke patient’s postural control or alignment, and furthermore a beneficial improvement in the patient’s performing the activities of daily living, as well.

지역사회 성인에서의 수면시간, 좌식시간, 운동과 사회·심리적 스트레스지수(PWI-SF)와의 연관성

남주현,최현경,김재엽,이종구,강희태,오성수,고상백,장세진 대한직업환경의학회 2016 대한직업환경의학회 학술대회 논문집 Vol.2016 No.11

난소암 조기진단을 위한 정상여성에서의 혈중 CA 125와 CA 15-3의 유용성

남주현,목정은,한지수,김용만,김영탁 대한부인종양 콜포스코피학회 1994 Journal of Gynecologic Oncology Vol.5 No.2

Objective : The objective was to determine the efficacy of CA 15 3 as a complimentary marker to CA 125 for ovarian cancer screening. Study design : Serum CA 125 and CA 15-3 levels were measured by immunoradiometric assay in 550 apparently healthy women and 46 ovarian cancer. Results : The cut-off level of serum CA 125 in the apparently healthy women were 65.0 U/ml in the under 50 age group and 34.8 U/ml in the over 50 age group, And the cut-off level of serum CA 15---3 were 37.0 U/ml and 34.7 U/ml, respectively. The sensitivity of serum CA 125 were 95.7% at the cut-off level of 35 U/mi and 93.5% at the cut-off level of 65 U /ml. And that of serum CA15-3 were 52.2% at the cut off level of 30 U/ml and 45.7% at the cut, off level of 40 U/ml. The specificity of serum CA 125 were 95.6%(35 U/ml) and 99.3 %(65 U/ml). And that of serum CA 15 3 were 98.3(30 U/ml) and 99.6%(40 U/rnl). Conclusion : The serum CA 15-3 w~my combination with CA 125 would not contribute to increase the efficacy of screening strategy for ovarian cancer. The serum CA 125 is very use-full tumor marker in ovrian cancer screening ,especially m the over 50 age group and at 35 U/ml cut-off level.

Brenner 종양 3예

남주현,목정은,장현정,김용만,김영탁,이인철,황성욱,허주령 대한부인종양 콜포스코피학회 1995 Journal of Gynecologic Oncology Vol.6 No.2

Brenner tumor is an uncommon type of ovarian neoplasm which is typically small, solid and well circumscribed. It is composed of hyperlastic fibromatous matrix interspersed with nest of epithelioid cell which show characteristic coffee bean appearance. We experienced three cases of Brenner tumor, two benign and one malignant. One case of benign and malignant case were, associated with mucinous tumor. So we report these cases with a brief review of literature.

골반내 종괴의 악성 감별 진단에 있어서 종양표지물질 CA 125, CA 15-3 및 UGF의 유용성

남주현,목정은,김용만 대한부인종양 콜포스코피학회 1994 Journal of Gynecologic Oncology Vol.5 No.2

Objective : The purpose of our study was to evaluate wheather the combined use of various tumor markers, CA 125, CA 15-3 and UGF(urinary gonadotropin fragment) could improve the efficacy for differentiating malignant from benign pelvic tumors. Study design : Preoperative samples were collected from 109 patients with pelvic masses. Using immunoradiometric assays, CA 125, CA 15-3 and using enzyme immunoassay UGF were measured. Results : Serum CA l25 level, were elevated above 35 U/m1 in 78.l% and above 65 U/ml in 62.5% of 32 patients with malignant pelvic masses, and in 20.3%, and 8.7% of 69 patients with benign pelvic masses, respectively. Sensitivity of CA 15 3($gt;30 U/ml) and UGF($gt;3 fmol/mgCr) levels occured in 29% and 50% of patients with malignancies, and in l.7%, and 6.6% of patients with benign masses, respectively. Sensitivity of CA 125 were higher than those of CA l5-3 and UGF. However specificity of CA 125 was lower than those of other two markers. Sensitivity and Specificity of UGF were located between those of CA 125 and CA 15-3. For differentiating malignant from benign, among patients below 50 years of age, coordinate elevation of CA 125($gt;35 U/ml) and, CA 15-3($gt;30 U/ml) ar UGF($gt;3 fmol/mgCr) reveal with a sensitivity of 550% and a specificity of 100% in malignant pelvic masses, and with 57% of sensitivity and 100% of specificity in malignant epithelial ovarian cancer, respectively. Conclusion'.Combined use of CA 125 of CA l5-3 and UGF could obtain an acceptable sensi-tivity and an excellent specificity in differentiating malignant from benign pelvic masses, especially among patients below 50 years of age.

경계성 난소종양

남주현,목정은 대한부인종양 콜포스코피학회 1993 Journal of Gynecologic Oncology Vol.4 No.4

Ouarian tumors of low malignant potential(OTLMP) or borderline tumors account for approximately 10% of all ovarian neaplasms. Borderline tumors have some but not all of the histologic characteristics af ma lignancy : stratification of epitheliial cells, with some degree of nuclear atypia a,nd inereased mitotic actitity but. without stromal invasion. We reviwed 20 published Rnglish written articlea from 1978 to 1992 and Korean gynecologic cancer regestry of 1990. In this review, we tried to concentrate on several debating is sues in OTLMP: 1) What kind of surgery is needed for each stages?, 2) Is postoperative adjuvant t.herapy needed?, 3) Jf needed, which type? Following result were obtained from the basis of 1516 patients with OTLMP. Patients withh OTLMIP are younger than those with invasive ovarian cancers', mean age was in their forties. The majority of patients(74.5%) had stage I disease, and the incidence dropped ahruptly to 9.4% for stage ll, 15.7% for stage III and 0.4% for stage IV. The most cammon histologic subtype was serous(56.7% ), followed by muci noua(38.1%), However, interestingly in Korea and Japan, the mucinous type was the muust common one. The primary treatment for OTLMP was surgery, and the conservative surgery to preserve fertility in young women was sufficient for stage I disease with careful follow-up. The majority of patinets(79.1%) with stage I disease were treated by surgery alone. Adjuvant therapy such as chemotherapy(CT) and/or ratiotherapy(RT) could prolong the recurrence of disease a little later, but failed to increase disease-free survival significantly in stage I disease, In stage II disease, the surgery should be a total abdominal hysterectomy and bilateral salpingo-oophorectomy with multiple sampling of the peritoneal cavity. About a third of patiemts with stage II disease received no adjunva� therapy and the others received CT and/or RT, however, there was no difference on outcome of recurrence and survival. In advanced stage, 15% of patients received no adjuvant therapy after initial deulking surgery, and the rest of patients received no adjuvant therapy after initial dubulking surgery, and the rest of patients received CT and/or RT. No differences in recurrence and survival between each gruops were noticed, too. The status of second-look laparotomy(SLL) did not depend on the stage of the disease. Positive rate of SLL for stage I diaease was not statistically different from that for the combined stages II-IV. Survival for stage I at 5 years was reported to range from 80 to 100%, and even stage III had survival ranging from 64 to 96%, Long-term survival at 15~20 years was also good Although it si quite difficult to make conclusions because of the lack of prospective randomized studies from this review, it appears clear that surgical removed of the tumor and careful follow-up of patients are that are necessary in stage I disease and further multi-center prospective study for the effect of adjuvant therapy in advanced disease is difinitely needed.

양성 및 악성 충수돌기 점액류종 각 1예

남주현,목정은,한지수,이주학,전대준 대한부인종양 콜포스코피학회 1993 Journal of Gynecologic Oncology Vol.4 No.3

Mucocele of the appendix is uncommon and rarely diagnosed preoperatively. The malignant countpart-i. e. mucinous cystadenocarcinoma--has the same gross appearance and many micro scopic features in common with the benign form. It may be associated with ovarian mucinous cystadenoma of strikingly similar microscopic appearance. A serious complication is a rupture of the mucocele resulting in pseudomyxoma peritonei. Each case of benign and malignant mucocele of the appendix falsely diagnosed as an ovarian tumor before laparotomy are presented with a brief review of the literatures.