원발성 난소 명세포암의 임상병리학적 연구

목정은(Jung Eun Mok),정지윤(Ji Yoon Jung),나준희(Jun Hee Na),김종혁(Jong Hyeok Kim),김봉희(Bong Hee Kim),허주령(Joor Rung Huh),김용만(Yong Man Kim),김영탁(Young Tak Kim),남주현(Joo Hyun Nam) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.12

N/A Clear cell carcinoma of the ovary is a clinicopathologic entity with distinct morphologic characteristics and known to be associated with poor prognosis irrespective of stage and prognostic benefits of chemotherapy have not been evidently demonstrated. This represents 2-3.6% of all ovarian malignancies. From October, 1991 to January, 1998, nine patients with primary clear cell carcinoma of the ovary treated in the deptartment of Gynecology and Obstetrics, University of Ulsan, Asan Medical Center were identified, and clinical and histologic review(including architectural pattern, mitotic activity, nuclear grading) was performed retrospectively. The age of the patients ranged from 30 to 67 year(mean+S.D.; 46.0+11.8) and the mean parity was 1.2 (+1.3). Five(55.6%) of nine patients had elevated level of CA 125. The size of the tumors varied from 3 cm to 20 cm with the mean maximal diameter of 12.1 (+6.3) cm. The FIGO stages of the patients were IC(6 cases, 66.7%), IIC (2 cases, 22.2%) and IV(1 case, 11.1%). All patients except one were treated by total abdominal hysterectomy and bilateral salpingoophorectomy with or without omentectomy and pelvic lymph node dissection. All except two were received postoperative chemotherapy with regimens such as CEC (cyclophosphamide + epirubicin + carboplatin), TC(taxol + carboplatin), CC(cyclophosphamide + carboplatin) or CAP (cyclophosphamide + adriamycin + cisplatin). The mean follow-up duration was 14.6 (+ 8.6) months and 8 patients were free of disease and one patient with stage IV disease died of disease during postoperative chemotherapy(4 months after surgery).

심포지움 : 난소암의 수술요법 ( Symposium : Surgical Treatment of Ovarian Cancer )

목정은(Jung Eun Mok) 경희대학교 경희의료원 1986 慶熙醫學 Vol.2 No.4

산전 초음파로 진단된 양측성 신결여 1 예

목정은(Jung Eun Mok),황보천(Chun Hwangbo),원혜성(Hye Sung Won),유혜경(Hye Kyung Yoo),이필량(Pyl Ryang Lee),이인식(In Sik Lee),김암(Ahm Kim) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.1

Fetal bilateral renal agenesis is a lethal congenital anomaly. An early and reliable prenatal diagnosis is extremely important as it may offer options for pregnancy termination as early as possible. The criteria for the ultrasonographic diagnosis of bilateral renal agenesis are severe oligohydramnios, nonvisualization of the bladder, and the empty renal fossae. However, severe oligohydramnios makes it difficult to diagnose the disease because of poor sonographic resolution. We present a case of fetal bilateral renal agenesis diagnosed by ultrasonography after amnioinfusion at 19 weeks gestation.

원발성 난관암의 임상병리학적 연구

목정은(Jung Eun Mok),조준식(Jun Sik Jo),나준희(Jun Hee Na),김종혁(Jong Hyeok Kim),김봉희(Bong Hee Kim),허주령(Joor Rung Huh),김용만(Yong Man Kim),김영탁(Young Tak Kim),남주현(Joo Hyun Nam) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.3

N/A Objective The aim of this study was to evaluate the clinicopathologic findings of eight patients with primary cancer of fallopian tube diagnosed and treated in the department of Obstetrics and Gynecology, University of Ulsan, Asan Medical Center for nine years. Methods Demographic characteristics, symptoms, signs, stage, tumor grade, mode of therapy and survival of patients were reviewed retrospectively. Results The patients with primary cancer of fallopian tube constituted 0.4% of all gynecologic malignancies encountered during this period. The age of patients ranged 42 to 70 years(mean+- S.D.; 53.9+-9.9) and half of patients were postmenopausal and two patients were nulliparous. Patients were treated by simple or radical hysterectomy and bilateral salpingoophorectomy with or without omentectomy and five patients received postoperative chemotherapy. The FIGO surgical stages of the patients were I(4 cases), II(2 cases), III(1 case) and IV(1 case). There were 3 cases of adenocarcinoma, 3 cases of malignant mixed Mullerian tumor, 1 case of undifferentiated carcinoma and 1 case of serous cystic tumor of low malignancy potential. Serum CA 125 values were followed during treatment and decreased during clinical remission and increased at the time of tumor progression. The mean follow-up duration was 24.3(+28.3) months and 7 patients were alive free of disease and one patients with stage Ic died of the disease. Conclusion Primary fallopian tube cancer is an extremely rare malignancy of the female genitalia and preoperative diagnosis of this disease is difficult. Cytoreductive surgery and postoperative combination chemotherapy seem to be effective treatment and CA 125 value could reflect the disease status during the treatment and follow-up of patients.

탈모 치료에 사용되는 레이저 출력에 관한 논문 연구

목정일,이지은,서형식,Mok, Jung-Il,Lee, Ji-Eun,Seo, Hyung-Sik 대한한방안이비인후피부과학회 2014 한방안이비인후피부과학회지 Vol.27 No.2

Objective : The purpose of this study is to analyze research trends on laser output used for treatment of hair loss. Methods : We searched papers using Pubmed, NDSL, KISS, and RISS. First search used the keyword "Laser, Alopecia" in Pubmed. Inclusion criteria were last 15 years, English, related to output. Finally we searched papers using the keyword "Laser and Alopecia" in NDSL, KISS, and RISS. Inclusion criteria were the same as first research except for English. Results : A total of 43 studies were found, 28 studies were excluded and 15 studies were selected and analyzed. And of the 15 studies, 7 studies were foreign papers and 8 studies were domestic papers on clinical application of laser status. Mainly Used type of laser was a diode laser. As a result, we found that treatment group had more improvement than control group. The range of the laser-output was 1mW-150W in Alopecia laser therapy. Conclusions : Low-level (LLLT) as well as High-level laser therapy (HLLT) can be effectively used as an alternative to the treatment of alopecia. Thus, further attention and studies are needed on this topic in order to reduce the side effects and demonstrate the effectiveness clearly.

국소적으로 진행된 자궁경부암의 방사선치료와 복합 항암화학요법의 동시치료 결과

강원철(One Chul Kang),최은경(Eun Kyung Choi),정원규(Weon Kuu Chung),김종훈(Jong Hoon Kim),장혜숙(Hyesook Chang),김용만(Yong Man Kim),김영탁(Young Tak Kim),남주현(Joo Hyun Nam),목정은(Jung-Eun Mok),이무송(Moo-Song Lee) 대한방사선종양학회 1998 Radiation Oncology Journal Vol.16 No.3

목 적 : 국소적으로 진행된 자궁경부암환자에서 방사선 치료와 5-FU, CDDP 복합항암요법의 동시 치료에 의한 종양관해율, 치료부작용, 예후인자, 실패양상과 생존율을 분석하기 위하여 전향적 제 2상연구를 시행하였다. 대상 및 방법 : 울산대학교 서울중앙병원 방사선종양학과와 산부인과에서 1992년 5월부터 1997년 1월까지 FIGO병기 IIB, III, IVA의 국소적으로 진행된 자궁경부암으로 진단받고 치료한 환자 73명중 방사선치료와 동시에 2회의 FP 항암요법을 시행한 68명을 대상으로 분석을 시행하였다. FIGO병기에 의한 분포는 IIB 46명, IIIA 2명, IIIB 15명, IVA 5명이었고, 이들의 연령분포는 31세에서 77세까지로 중앙값 58세이었다. 방사선치료시 외부조사는 전골반부에 4,140-5,040 cGy를 시행후 192Ir 고선량 근접치료기로 주 3회씩 6-7회의 강내조사를 시행하며 동시에 B점추가조사를 시행하여 A점에 7,500-8,000 cGy, B점에 6,000-6,500 cGy가 되도록 조사하였다. FP (5-FU;1,000mg/m2/24 hours, 4 days+CDDP; 20mg/m2/3 hours, 3 days) 항암화학요법은 방사선치료 시작 제 1일과 제 29일에 각각 4일간 투여하도록 하였다. 치료효과는 치료종료시점과 치료후 1개월, 3개월에 시행한 부인과 검사와 MRI로 판정하였다. 결 과 : 전체 환자의 추적기간은 4개월에서 68개월 (중앙값 24개월)이었다. 생존율을 분석한 환자 64명의 5년생존율 및 무병생존율은 각각 52%와 64%였으며, FIGO병기 IIB인 환자의 5년생존율과 무병생존율은 각각 58%, 71%이었고, FIGO병기 III와 IVA인 환자는 각각 36%, 46%이었다. 재발양상은 전체 재발율이 27.9% (19/68)로, 국소재발이 5.9% (4/68), 원격전이가 10.3%(7/68), 국소재발과 원격전이가 같이 있는 경우가 11.8% (8/68)로 나타났다. 치료종료 한달 후 치료 효과를 판정할 수 있었던 64명중 78% (50/64)가 완전관해를 보였다. 예후인자는 단변량분석시 5년생존율에 FIGO병기, 치료반응율, 골반내와 대동맥주위 림프절 전이유무가 통계적으로 의미 있었고, 다변량분석시 치료반응율과 치료중 혈색소 농도가 통계적으로 의의있게 나타났다. 치료에 따른 독성은 10%내외로 치료후 대부분 자연 회복되었으나, 2차 항암약물투여중 폐부종이 발생한 1명과 치료종료후 8개월에 만성합병증인 장천공이 발생한 1명은 치료에 따른 부작용으로 사망하였다. 결 론 : 국소적으로 진행된 자궁경부암에 대한 방사선치료와 복합항암요법의 동시치료는 수용 가능한 독성을 보였고, 진행된 경우 생존율의 향상을 관찰할 수 있었다. 좀 더 장기적인 추적관찰 후 여러 예후인자들을 고려하여 초기 치료반응율을 높이는 치료방법의 선택이 필요하리라 생각되며, 동시 방사선-항암화학요법의 종양관해율과 생존율의 차이를 알아보기 위한 제 3상 무작위 연구가 필요한 것으로 생각된다. Purpose : Prospective, single arm, Phase I/II clinical trial was performed to assess the efficacy and toxicity of the concurrent chemotherapy and definitive radiotherapy (RT) in patients with previously untreated locally advanced carcinoma of the uterine cervix. Methods and Materials : From May 1992 to January 1997, a total of 73 patients with advanced cervical carcinoma were entered on the protocol but 5 patients were excluded in analysis because of patients' refusal of treatment. Their ages ranged from 31 to 77 years, median 58 years. The International Federation of Gynecology and Obstetrics (FIGO) stage distribution was as follows: IIB 46, IIIA 2, IIIB 15 and IVA 5. RT consisted of external beam irradiation to 4,140-5,040 cGy/23-28 fractions plus high dose rate intracavitary treatments to deliver a dose of 30-35 Gy to point A in 6-7 fractions. During the intracavitary treatments parametrial boost was delivered for point B dose of 60 Gy in stage IIB and 65 Gy in stage IIIB. Two cycles of concurrent 5-fluorouracil and cisplatin (FP) chemotherapy (5-fluorouracil 1,000 mg/m2/day continuous infusion for 4 days, day 1-4, 29-32 and cisplatin 20 mg/m2/day intravenous bolus for 3 days, day 1-3, 29-31) administered starting on day 1 of RT. Results : The median follow -up was 24 months (range 4-68+). Sixty-four patients were evaluable for survival rate in this protocol; The 5-year actuarial and disease-free survival rate were 52% and 64%, respectively. The 5-year actuarial survival for stage IIB and III+IVA patients were 58% and 36%, respectively. The 5-year disease-free survival rate for stage IIB and III+IVA patients were 71% and 46%, respectively. Of the 68 patients evaluated for patterns of failure, overall recurrence rate was 27.9% (19/68): local failure in 5.9% (4/68), distant metastasis in 10.3% (7/68) and both in 11.8% (8/68). Of the 64 patients evaluated for response at one month after the completion of treatment, the complete response rate was 78% (50/64). Concurrent chemoradiation appear to be a well-tolerated regimen but there were two treatment-related deaths. Conclusion : Concurrent chemotherapy of FP with high-dose definitive RT in locally advanced carcinoma of the uterine cervix is feasible and effective with acceptable toxicities. This chemoradiation regimen may offer a modest survival benefit for advanced stage. Further follow -up of these patients will evaluate the impact of this regimen on the long-term local control and their survival.

Large-Scale Analysis of Anther-Specific and -Preferentially Expressed Genes in Lily by cDNA Sequencing

Eun-Jung Suh(서은정),Hee-Ju Yu(유희주),Bong Hee Han(한봉희),Yong Pyo Lim(임용표),Il-Gin Mok(목일진) 한국원예학회 2002 한국원예학회 학술발표요지 Vol.2002 No.3

Isolation and Characterization of tissue-specific Promoter in Acapulco Lily (Lilium hybrid cv. Acapulco)

Eun-Jung Suh(서은정),Hee-Ju Yu(유희주),Bong Hee Han(한봉희),Byeong Woo Yae(예병우),Il-Gin Mok(목일진) 한국원예학회 2003 한국원예학회 학술발표요지 Vol.2003 No.10

자궁내막암의 수술 후 보조적 방사선치료

신경환(Kyung Hwan Shin),최은경(Eun Kyung Choi),안승도(Seung Do Ahn),장혜숙(Hyesook Chang),목정은(Jung-Eun Mok),남주현(Joo Hyun Nam),김영탁(Young Tak Kim),김용만(Yong Man Kim),김종혁(Jong Hyeok Kim) 대한방사선종양학회 2000 Radiation Oncology Journal Vol.18 No.1

목 적 : 수술 및 수술 후 보조적 방사선치료를 시행한 자궁내막암 환자의 예후인자, 재발 장소 및 생존율 등을 분석해 보고자 하였다. 대상 및 방법 : 1991년 9월부터 1997년 12월까지 서울중앙병원에서 수술 및 방사선치료를 받은 27예의 자궁내막암 환자 를 대상으로 하였다. 수술은 단순자궁적출술이 6예, 단순자궁적출술 및 림프절 절제술이 8예, 근치적 자궁적출술이 13예 에서 시행되었다. 모든 환자에서 외부 방사선치료가 시행되었으며 이 중 16예에서 ovoid를 이용한 질내조사가 추가되었 다. 조사선량은 외부 방사선치료는 총 50.4 Gy 를 조사하는 것을 원칙으로 하였고, 질내조사는 1회 분할선량 4∼5 Gy씩 4내지 5회 시행하였다. 추적기간은 6개월에서 95개월로서 중앙추적기간은 30개월이었다. 결 과 : FIGO 병기는 I-18예(67%), II-1예(4%), III-8예(29%)이었고, 조직분화도는 1∼14예(52%), 2∼6예(22%), 3∼7예(26%)이었다. 수술 후 조직 소견상 조직분화도가 나쁠수록, 자궁근층의 침범 정도가 심할수록, 자궁부속기의 침범이 있는 경우, 림프-혈관 침범이 있는 경우 골반내 림프절이 양성을 보이는 경우가 많았으나 통계적인 의미는 없었다. 추적이 종료된 시점에서 사망한 환자가 한 예도 없어 전체 생존율은 100%이었으나 3예에서 병이 재발되어 3년 및 5년 무병생존율이 각각 89.6%, 76.8%이었다. 재발 장소는 골반내, 대동맥방림프절, 폐를 포함한 다발성 등이 각각 1예 이었고 질 재발은 관찰되지 않았다. FIGO 병기( p=0.01), 림프-혈관 침범( p=0.03), 골반내 림프절 침범( p=0.0001) 등이 무병생존율에 영향을 미치는 것으로 나타났고 조직분화도가 나쁠수록 무병생존율이 저조한 경향을 보였다( p= 0.1). 치료부작용으로는 1예에서만 Grade I의 직장출혈이 나타났으나 중등도 이상의 합병증을 보인 경우는 없었다. 결 론 : 수술후 조직학적 소견에 따른 외부방사선치료 및 추가 질내조사는 국소재발을 억제하는데 효과적인 것으로 판단되며 결과적으로 생존율을 향상시키는데 기여하는 것으로 생각된다. 다만, 병기 및 조직분화도에 따라 질내조사를 추가하지 않는 경우 질 재발이 호발하는 환자군에 대한 연구가 더 진행되어야 할 것으로 판단된다. Purpose : To evaluate the histopathological prognostic factors, rela pse pattern and survival in patients with endometrial carcinoma who were treated with surgery and postoperative adjuvant radiotherapy (RT). Methods and Materials : From September 1991 to December 1997, 27 patients with endometrial carcinoma treated with surgery and postoperative adjuvant RT at Asan Medical Center were entered in this study. Surgery was performed with total abdominal hysterectomy in six, total abdominal hysterectomy with pelvic lymph node dissection in eight and radical hysterectomy in 13 pa tients. External RT of 50.4 Gy was done to all patients and among these, additional high dose rate vaginal vault irradiation of 20 ∼25 Gy with fractional dose of 4∼5 Gy was boosted in 16 patients. The patients were followed for 6∼95 months (median 30). Results : The number of patients according to FIGO stage were I 18 (67%), II 1 (4%) and III 7 (26%). Patients with poor histologic grade, deep myometrial invasion, adnexal involvement, lymphovascular invasion showed more pelvic lymph node involvement, but no statistical significance was indicated. The 5 year overall and disease free survival were 100% and 76.8%, respectively. Relapse sit es were pelvic, para-aortic lymph node, and multiple metastases including lung, and no vaginal relapse was developed. Factors that were associated with disease free survival were FIGO stage ( p=0.01), lymphovascular invasion ( p=0.03), pelvic lymph node involvement ( p=0.0001). There was only one Grade 1 rectal bleeding without moderate to severe complications. Conclusion : Postoperative adjuvant RT is considered to reduce the loco-regional failure, resulting the improvement of survival. The group of patien ts with the risk of vaginal failure without vaginal vault irradiation should be investigated according to stage and grade.

자궁 내막암의 수술 후 방사선치료 결과

노오규(O Kyu Noh),신성수(Seong Soo Shin),이상욱(Sang-Wook Lee),안승도(Seung Do Ahn),최은경(Eun Kyung Choi),김종혁(Jong-Hyeok Kim),김용만(Yong-Man Kim),남주현(Joo-Hyun Nam),목정은(Jung-Eun Mok),김종훈(Jong Hoon Kim) 대한방사선종양학회 2007 Radiation Oncology Journal Vol.25 No.2

목 적: 근치적 자궁절제술 후 보조적 방사선 치료를 시행 받은 자궁내막암 환자의 치료 성적 및 예후 인자를 알아 보고자 하였다. 대상 및 방법: 1991년 9월부터 2003년 8월까지 서울아산병원에서 자궁내막암으로 자궁 절제술을 시행한 후 보조적 방사선치료를 받은 76명을 대상으로 하였다. FIGO 병기는 I, II, III기가 각각 41명(53.9%), 12명(15.8%), 23명(30.3%)이었다. 조직분화도는 1이 29명(38.2%), 2가 20명(26.3%), 3이 27명(35.5%)이었다. 방사선치료는 외부방 사선 조사와 강내 조사를 함께 시행한 환자가 42명, 외부 방사선 조사만 시행한 환자가 33명, 강내 조사만 시행한 환자는 1명이었다. 외부 방사선 치료의 조사 선량은 50.4 Gy였으며, 강내 조사는 1회 분할 선량을 4~5 Gy씩 4~6 회 실시하였다. 생존환자의 추적기간은 5개월에서 121개월로서 중앙값은 51개월이었다.결 과: 5년 전체 생존율은 89.6%이었으며, FIGO I기는 96.8%, II기는 91.7%, III기는 75.7%였다. 5년 무병 생존율은 83.7%이었고, FIGO 병기에 따라 I기는 94.8%, II기는 91.6%, III기는 59.8%이었다. 단변량 분석에서 전체 생존율에 유의한 영향을 미치는 인자에는 FIGO 병기, 림프절 양성 유무, 조직분화도였고, 무병 생존율에서는 관계되는인자는 FIGO 병기, 림프절 양성 유무, 림프혈관침범 유무였다. 총 11명에서 재발하였고, 국소재발 1명, 원격전이가 10명이었다. 방사선 치료 후에 중등도 이상의 합병증을 보이는 경우는 없었다. 결 론: 자궁내막암의 수술 후 방사선 치료의 성적은 좋은 결과를 보였다. 그러나 주로 원격전이로 재발하는 양상으로 보이므로 항암치료가 도움이 되리라 생각된다. 따라서 FIGO 병기가 높거나, 림프절 양성이거나, 림프혈관침범이 있거나, 조직 분화도가 높은 고위험 군에서 항암제를 포함한 방사선치료 방법에 대한 연구가 필요할 것으로 판단된다. Purpose: To evaluate the outcome and prognostic factors of postoperative radiotherapy in endometrial carcinoma. Materials and Methods: From September 1991 to August 2003, 76 patients with endometrial carcinoma received postoperative adjuvant radiotherapy after hysterectomy at Asan Medical Center. Stage was classified as FIGO I in 41 (53.9%), II in 12 (53.9%), and III in 23 (30.3%). Histologic grade 1, 2 and 3 were in 29 (38.2%), 20 (26.3%), and 27 (35.5%) respectively. Forty two patients received both external beam radiation therapy (EBRT) and intracavitary radiation (ICR), 34 patients were treated with EBRT or ICR alone. EBRT dose was 50.4 Gy, ICR was performed in 4∼6 fractions with 4∼5 Gy per fraction. Median follow‐up period was 51 (range 5∼ 121) months. Results: Five‐year overall survival was 89.6%. In univariate analysis, statistically significant factors to overall survival were FIGO stage, lymph node metastasis and histologic grade. In disease free survival, FIGO stage, lymph node metastasis and lymphovascular invasion were significant prognostic factors. Recurrence was seen in 11 patients. Of these, systemic failure was in 10 patients. There were no moderate to severe complications after radiation therapy. Conclusion: The outcome of postoperative adjuvant radiotherapy in endometrial carcinoma was good. Main pattern of failure after postoperative radiotherapy was distant metastasis. So, adjuvant chemotherapy may help in improving outcome. Further study on chemotherapy in combined with postoperative radiotherapy will be needed, especially for patients with high risk factors such as high FIGO stage, lymphovascular invasion, and high histologic grade.