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윤용복(Yong Bok Yoon),박상욱(Sang Wook Park),유윤환(Youn Hwan You),김남수(Nam Soo Kim),황익하(Ik Ha Hwang),김두표(Doo Pyo Kim) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.8
목적: 자궁선근증의 빈도와 위험인자를 평가하여 자궁선근증의 수술전 진단 정확도를 높히기 위해. 연구방법: 1991년 1월 1일 부터 1997년 12월 31일 까지 만 7년 간 인천기독병원 산부인과에서 시행한 자궁적출술 1127례 중 병리조직 검사로 확인되고 기록이 확실한 자궁선근증 206례를 후향적으로 평가. 결과: 다음과 같은 결과을 얻었다. 1. 자궁선근증의 빈도는 18.3%였다. 2. 호발연령은 41세에서 50세 사이의 연령군 이었으며, 평균연령은 46.9세였다. 3. 자궁선근증은 미산부와 경산부에서 각각 8.3% 와 91.7%로 경산부에서 월등히 높았다. 4. 육안적으로 임신 10주이상 자궁크기를 보이는 자궁선근증의 발생율은 62.4%였다. 5. 골반통(26.7%), 월경통(25.2%) 및 월경과다(19.4%)가 자궁선근증의 주요증상으로 나타났다. 6. 자궁선근증과 가장 많이 합병된 골반질환은 자궁근종으로, 53.4%의 발생율을 보였다. 7. 동반된 골반 자궁내막증은 이 연구에서는 발견되지 않았다. 8. 자궁선근증을 나타내는 절제된 자궁들의 자궁내막 소견은 정상 자궁내막의 증식기가 72.3%로 가장 많았고, 분비기 내막이 25.7%를 나타냈다. 9.자궁선근증의 수술전 진단 정확도는 8.2%였다.결론: 이상의 연구결과로 미루어 볼 때 자궁선근증에 대한 수술전 진단은 비교적 어려우나 자궁선근증의 주요 임상증상과 역학 및 질병에 대한 깊은 이해는 자궁선근증의 수술전 진단의 정확도를 높일 수 있으리라고 생각된다. Object: In order to estimate the frequency and risk factors for adenomyosis. Method: The clinical records of 1127 women undergoing hysterectomy were retrieved in the Department of Obstetrics and Gynecology, Incheon Christian Hospital, during 7 years, from Jan. 1st 1991 to Dec. 31st 1997. Result: The following results were obtained. 1. Adenomyosis was found in 206 of 1127 patients(18.3%) . 2. The highest incidence was 41-50 years of age group, an incidence of 55% and mean age group was 46.9 years. 3. Adenomyosis was more frequently observed in parous woman than non-parous woman, such as 8.3% and 91.7%, respectively. 4. Grossly, the size of uterus was enlarged more than 10 weeks gestational size in adenomyosis, an incidence of 62.4%. 5. Pelvic pain, dysmenorrhea and metrorrhagia were common symptom of adenomyosis, an incidence of 26.7%, 25.2% and 19.4%, respectively. 6. Myoma was the most combined disease in adenomyosis, showing the incidence of 53.4%. 7. Combined pelvic endometriosis was not observed in this study. 8. Endometrial findings of adenomyosis showed proliferative phase of normal endometrial cycle in the highest incidence, giving 72.3% of all cases. 9. Preoperative diagnostic accurracy of adenomyosis was 8.2%. Conclusion: This results show that deeply understanding of the common symptom and epidemiology of adenomyosis improve the preoperative diagnostic accuracy.
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난소암환자의 혈청내 변형 Ribonucleoside에 관한 연구
황익하,김용석,한중수,고재경 한양대학교 의과대학 1990 한양의대 학술지 Vol.10 No.1
In order to investigate whether the modified ribonucleosides in serum could be used as specific tumor markers for serous cystadeno-carcinoma(SCACa) and mucinous cystadenocarcinoma(MCACa) of ovary, analysis of serum samples from normal female controls and patients with these ovarian carcinoma was performed using reversed phase HPLC. For this study, a rapid and precise chromatographic method for the determination of very small amounts of modified nucleosides in serum by HPLC has been developed. The ribonucleosides were prefractionated with boronate affinity gel column. 1. The concentration of total modified nucleosides in serum of patients with SCACa was increased by 28% as compared to normal control level. Patients with SCACa had significantly higher concentrations of pseudouridine (Ψ), 5-methylcytidine(m??C), 4-thiouridine(s??U), 1-methylguanosine(m¹G), 4-acetylcytidine(ac⁴C), N², N²-dimethylguanosine(m²₂G) and N??-methyladenosine(N??A) than normals. Among these elevated nucleosides, positive rates ofΨ, m??C, s⁴U and ac⁴C as markers for this cancer were observed to be 55%, 91%, 100% and 55%, respectively. 2. When compared to normal control value, total modified nucleoside content in serum of patients with MCACa was increased to as high as 18%. Contents of Ψ, m??C, 7-methylguanosine (m??G), s⁴U, ac⁴C, 2-methylguanosine(m²C), m²₂G and N??A were significantly increased in serum of patients with MCACa. And positive rates of m??C, s⁴U and N??A were observed to be 76%, 100% and 65%, respectively, as markers for MCACa. 3. The concentrations of adenosine and cytidine in serum were significantly decreased but those of uridine and inosine in serum were increased significantly in both patients with SCACa and MCACa of ovary. The results suggested that serum levels of Ψ, m??C, s⁴U, and ac⁴C for the ovarian SCACa and those of m??C, s⁴U and N??A for the ovarian MCACa could be used as diagnostic or biochemical markers.
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