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자궁경부암 환자에서 sentinel lymph node 탐색을 위해 isosulfan blue dye 사용시 발생한 급성 과민반응
임채춘 ( Chae Chun Rhim ),남궁성은 ( Sung Eun Namkoong ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.2
The sentinel lymph node is defined as the first node of a regional lymphatic basin that receives the lymphatic drainage from a tumor, thus representing an elective site of lymph node metastasis. According to the sentinel lymph node hypothesis, histologica
암 수술시 Sentinel Lymph Node 의 임상적 유용성
임채춘(Chae Chun Rhim),황성진(Seong Jin Hwang),박종섭(Jong Sup Park),남궁성은(Sung Eun Namkoong) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.6
목적 : 이 연구의 목적은 외음부 암 환자의 수술시 sentinel lymph node를 탐색하고 동결절편의 조직병리학적 결과를 통해 수술을 최소화 할 수 있는지에 대한 임상적 적용가능성을 평가하는 데 있다. 연구 대상 및 방법 : 2001년 3월부터 2002년 1월까지 가톨릭대학교 강남성모병원에서 외음부 암 확진 후 근치적 외음부 절제술 및 일측 또는 양측 서혜 대퇴부 임파절 절제술을 시행한 4명의 환자를 대상으로 하였으며, 수술전 technetium-99 m colloid albumin의 주입과 수술중 isosulfan blue dye를 주사한 후 sentinel lymph node를 찾아낸 뒤 이를 임상병리과에 보내고 그 동결생검 결과를 얻는다. 결과 : 4명의 환자에서 총 10개의 sentinel lymph node와 110개의 non-sentinel lymph node를 얻었다. 동결생검 결과 10개의 sentinel lymph node는 모두 음성 (benign)이었고 sentinel lymph node가 음성일 때 영구 조직검사 결과가 양성 (malignant)으로 나온 경우는 없었다. 결론 : 외음부 암 환자에서 sentinel lymph node를 찾아 이를 제거한 후, 동결절편의 조직병리학적 결과가 음성 (benign)일 경우에는 더 이상의 광범위한 서혜 대퇴부 임파 절제술을 피함으로써, 수술 후 합병증을 최소화하고 삶의 질을 향상시키는 데 임상적 유용성이 있을 것으로 생각된다. Objective : The purpose of this study is to evaluate the validity of sentinel lymph node detection and the possibility of clinical application in treatment of vulvar cancer patients. Patients and Methods : From March 2001 to January 2002, four patients with vulvar cancer were eligible for this study. All the patients were preoperative technetium-99 m colloid albumin and intraoperative isosulfan blue dye injection intradermally at the junction of tumor mass and normal skin. Superficial lymphatic channels and groin lymph node dissections were made to detect sentinel lymph node and then complete inguinofemoral lymph nodes dissection was performed. All the sentinel lymph nodes were sent to pathologic department for frozen biopsy. Results : Ten sentinel lymph nodes were identified in one-hundred and ten groin lymph nodes. All the ten sentinel lymph nodes showed benign. There was no case that non-sentinel lymph nodes were positive in the presence of negative sentinel lymph nodes by frozen biopsy (negative predictive value was 100%). Conclusion : Sentinel lymph nodes detection by combination use of technetium-99 m colloid albumin and isosulfan blue dye injection was simple and accurate in our preliminary study. To reduce postoperative morbidity, lymphedema and to minimize extensive inguinofemoral lymph nodes dissection, sentinel lymph node frozen biopsy may be a reasonable alternatives and a suitable method for limited control of vulvar cancer. This preliminary study showed the possibility of clinical application of sentinel lymph node detection in vulvar cancer surgery.
임채춘(Chae Chun Rhim),노성래(Sung Rae Roh),김동주(Dong Joo Kim),송민경(Min Kyung Song),이재성(Jae Sung Lee),주하경(Ha Kyong Joo),박윤희(Youn Hee Park),유기성(Ki Sung Ryu),한구택(Gu Taek Han),이종건(Jong Kun Lee),이준모(Joon Mo Lee) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.8
The malignant lymphomas are neoplastic transformation of cells that reside predominantly in lymphoid tissues. The two major variants of malignant lymphoma are non-Hodgkin's lymphoma and Hodgkin's disease. Although both of these tumors infiltrate reticuloendothelial organs, their biologic and clinical behaviors suggest that they are probably not related. More than 90% of all cases of non-Hodgkin's lymphomas are of B-cell derivation. This observation is based upon the expression of B-lineage-restricted antigens as well as clonal rearrangements of immunoglobulin heavy and light chain genes. The malignant lymphoma localized in uterine cervix is rare and characteristically symptom-free expressed. We experienced a case of malignant lymphoma originated from uterine cervix, so we report with a brief of literature.
임채춘(Chae Chun Rhim),김용옥(Yong Ok Kim),박기영(Ki Young PARK),상미란(Mi Tan Sang),유순원(Soon Won Ryu),김진홍(Jin Hong Kim) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.9
목적 : 본 연구는 반복제왕절개술시 복부 반월형 횡절개후 새로운 술기인 근막상 종절개술(Vertical incision on fascia) 을 비교하여 수술부위의 동통강도와 감각회복기간 및 재원기간에 미치는 영향을 알아보고자 하였다. 연구방법 : 1997년 1월 1일부터 동년 8월 31일 까지 가톨릭대학교 의과대학부속 성모병원에서 반복제왕절개술을 받은 산모들중 최초의 수술반흔이 복부 반월형 횡절개술(Pfannenstiel skin incision)로 시행받은 200명을 대상으로, 근막상 종절개술과 근막상 횡절개술로 수술한 산모를 각각 100명씩 선정한 후 이를 비교군과 대조군으로 나눈 뒤 설문조사를 시행하였다. 설문은 전화문의 및 입원기록을 병행하였다. 결과 : 수술 후 1병일 동통의 강도는 근막상 종절개술이 근막하 횡절개술보다 낮게 나타났다. (p<0.032) 제왕절개술후 수술부위 감각의 회복기간은 1개월이내 및 3개월이내에서 근막상 종절개술이 근막상 횡절개술보다 더 빨리 회복되는 것으로 나타났으며(p<0.0001), 수술후 평균 재원일수는 근막상 종절개술의 경우가 근막상 횡절개술보다 짧은 것으로 나타났다. (p<0.05) 결론 : 반복 제왕절개수술시 제12번 흉곽신경의 외측 피부가지신경, 음부대퇴신경 및 장골서혜신 경의 손상을 최소화함으로써, 수술후 동통의 감소 ,수술부위 감각회복기간의 단축 및 평균 재원기간의 단축에 근막상 종절개술(Vertical incision on fascia)이 근막상 횡절개술(Transverse incision on fascia) 보다 유의하게 우수한 것으로 나타난 바, 미용적효과와 수술후 산모의 만족도를 증진시킬 수 있는 근막상 종절개술기의 도입을 고려해볼 필요가 있다고 생각된다. Objective : Our purpose was to minimize the nerve and muscle injury during operation and to compare the strength of pain and sensory recovery intervals between vertical and transverse incision on fascia after Pfannenstiel skin incision in repeated cesarean section. Method : Two hundred women delivered by cesarean section from January 1st,1997. to August 31st, 1997. at St. Mary's Hospital were selected. They were divided into two groups. Each group was composed of one hundred women, respectively. One was vertical incision on fascia and the other was transverse incision on fascia. All of their initial skin scars were caused by Pfannenstiel approach and the cases of infraumbilical midline skin incision were excluded.Results : The strength of pain at postoperative first day (POD#1) was significantly diminished in vertical incision on fascia than in transverse incision on fascia(p<0.032). The sensory recovery intervals and mean hospitalization periods were significantly shortened in vertical incision than transverse incision on fascia(p<0.001 and p<0.05 respectively). Conclusion : The vertical incision on fascia after Pfannenstiel skin incision was significantly beneficial to repeated cesarean section delivery by diminishing the strength of pain, minimizing abdominal muscle injury, shortening the sensory recovery intervals and mean hospitalization periods. So it is the time that the introduction of new method-vertical incision on fascia after Pfannenstiel skin incision - that not only provides cosmetic effects but also improves the satisfaction of patients after operation will be taken into consideration.
최원석(Won Suk Choi),임채춘(Chae Chun Rhim),이성종(Sung Jong Lee),진기홍(Ki Hong Jin),홍승표(Seung Pyo Hong),김동주(Dong Joo Kim),이연수(Youn Soo Lee),남궁성은(Sung Eun Namkoong) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.2
Minimal deviation adenocarcinoma (adenoma malignum) is a variant of adenocarcinoma and is expressed from uterine endocervix. As a result of ever reported cases in the world, it is rare enough to occur in 1 to 2% of invasive cervical adenocarcinoma. Minimal deviation adenocarcinoma is well-differentiated form of adenocarcinoma in which the cytoplasmic mucin is rich and the glandular pattern simulates that of normal endocervical glands. Because of this, the tumor may not be recognized as malignant in small specimens, thereby causing delay in diagnosis. But recent studies have found a favorable prognosis if the disease is detected early. We experienced a case of minimal deviation adenocarcinoma, rare disease in the world, so we report with a brief review of literature.
김지훈 ( Ji Hoon Kim ),임채춘 ( Chae Chun Rhim ),남궁성은 ( Sung Eun Namkoong ) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.12
목적 : 이 연구의 목적은 저등급 자궁내막 간질성육종에 대한 치료와 예후를 평가하는데 있다. 연구 대상 및 방법 : 1993년부터 2002년까지 강남성모병원에서 치료받고 있는 세 환자를 대상으로 하여 저등급 자궁내막 간질성육종의 임상 병기, 치료 방법과 치료 결과를 분석하였다. 결과 : 세 명의 저등급 자궁내막 간질성육종 환자들은 초기 수술 후 호르몬 치료를 받으며 긴 생존률을 기록하고 있다. 두 명은 재발이 없는 상태로 생존해 있으며, 한 명은 호르몬 Objective : The aim of this study was to obtain information on the prognosis and treatment of the low grade endometrial stromal sarcoma. Patients and Methods : Three patients with low grade endometrial stromal sarcoma treated in kangnam St. Mary`s hospita
한정미 ( Jung Mi Han ),최정운 ( Jung Un Choi ),정윤아 ( Yoon A Jung ),임채춘 ( Chae Chun Rhim ),김성주 ( Sung Joo Kim ),박영한 ( Young Han Park ),강정배 ( Jung Bae Kang ),장봉림 ( Pong Rheem Jang ),전선영 ( Sun Young Jun ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.12
The synchronous existence of endometrial cancer and cervical cancer is very rare. The reported frequency of concurrent gynecologic neoplasms has ranged from 0.7% to 4.3%, synchronous primary tumors of the female genital tract are relatively rare, comprising only 0.49% to 1.7% of all genital neoplasms. The majority of synchronous multiple primary neoplasm of female reproductive tract are of endometrial and ovarian origin. Multiple primary neoplams involving uterine cervix and endometrium were regarded as rare entity. We experienced a rare case of multiple primary neoplasm involving uterine cervix and endometrium and report with brief review of literatures.
박은경 ( Eun Kyung Park ),서미영 ( Mi Young Seo ),팽기영 ( Ki Young Paeng ),임채춘 ( Chae Chun Rhim ),김도강 ( Do Kang Kim ),남궁성은 ( Sung Eun Namkoong ) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.9
Mucocele arised at the vermiform appendix is uncommon, either benign or malignancy and their clinical presentation is not specific. The preoperative diagnosis is rare,^1 their diagnosis is an incidental event. Mucocele seems to be developed due to chronic obstruction of the lumen of the appendix. Higa and Cowerkers^2 classified 73 cases of mucocele into three clinicopathologic entities; focal or diffuse mucosal hyperplasia, mucinous cystadenoma, mucinous cystadenocarcinoma. Appendiceal mucoceles are rare lesions of the appendix, characterized by a gross enlargement of the appendix from accumulation of mucoid substance within the lumen. It is encountered in only 01-04% of all appendectomies with a female predominance and an average age at the time of diagnosis over 50 years. A case of appendiceal mucocle found during total hysterectomy is presented with a brief review of the leteratures.
외음부 암 수술시 V-Y advancement 피판의 효과
정인철 ( In Cheul Jeung ),송민경 ( Min Kyung Song ),임채춘 ( Chae Chun Rhim ),남궁성은 ( Sung Eun Namkoong ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.3
목적 : 이 연구의 목적은 외음부 암 환자의 수술시 V-Y advancement 피판의 사용이 수술 후 일어날 수 있는 합병증을 최소화하고 조기에 일상생활로 복귀하는데 효과가 있는지를 알아보는데 있다. 연구 대상 및 방법 : 2001년 3월부터 2002년 9월까지 가톨릭대학교 강남성모병원 산부인과에서 외음부 암 확진 후 근치적 외음부 절제술 및 일측 또는 양측 서혜 대퇴부 임파절 절제술을 시행한 5명의 환자를 대상으로 모든 환자들에게 성형외과와 협진하여 Objective : The purpose of this study is to evaluate the clinical effect of V-Y advancement flap after vulvectomy in patients with vulvar cancer. Local and systemic morbidity, the degree of satisfaction after operation, length of hospital stay were evalua