양성 난소기형종과 합병된 난소섬유종 1 예

김영태(YT Kim),김재욱(JU Kim),김동규(DK Kim),박찬규(CK Park),김경호(KH Kim) 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.1

Ovarian fibromas account for approximately 3% to 5% of all tumor of this origin. They are usually asymptomatic, incidental findings at laparotomy. They are usually seen in the premenopausal woman, the average age being 48 years, the range 16 to 80 years. A case of ovarian fibroma with teratoma of the ovary in 20 year old woman was presented and reviewed briefly.

자궁내막암조직에서 c-erbB-2 암유전자 단백산물과 예후인자와의 연관성

김영태(YT Kim),윤혜정(HJ Yoon),김동현(DH Kim),이학천(HC Lee),김세광(SK Kim),김재욱(JU Kim) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.4

The c-erbB-2 oncogene encodes a 185,00 dalton transmembrane glycoportein with tyrosine kinase activity, and the aberrant overexpression of which has been implicated in the indution of a malignat phenotype. Overexpression of the c-erbB-2 has been found in many human adenocarcinomas, especially mammarian and ovarian carcinomas, and that is associated with poor prognosis. We used an enzyme-linked immunosorbent assay(ELISA) to explore the relationship between c-erbB-2 oncoprotein and prognostic factors of endmetrial cancer and analyzed the tissued form the 24patients with endometiral cancer and 10 control cases. patinens with endometrial cancer were found to bave 20% of c-erbB-2 oncoprotein overexpression rate and signficiantly higher c-erbB-2 median oncoprotein expression than conterol C-erbB-2 oncoprotein overexpression showed no statistically significant association with known prognostic factors including stage, grade, histologic cell type, myometrial invasion and lymph node metastases, although the c-erbB-2 oncoprotein overexpression rate was increased by stage, and was higher in lymph node metastatic group than in confined to the uterus goup. High c-erbB-2 oncoprotein overexpression was correlated with absence of estrogen receptor (Rs=-0.46, p=0.047) and progestreone receptor (Rs=-0.57, p=0.045), further studies are needed to determine the significance of the c-erbB-2 everexpression in endometrial cancer.

멕켈 - 그루버 증후군 1 예

김영태(YT Kim),김한겸(HK Kim),김윤환(YH Kim) 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.3

The principle signs of Meckel-Gruber syndrome are encephalocele, polydactyly, and polycystic kidneys with normal karyotype. Due to rarity of the Meckel-Gruber syndrome, the cause is still unknown. At present, autosomal recessive is thought to be as one of the causes. A case of Meckel-Gruber syndrome is presented with a brief literature review.

자궁경부암에서의 cyclin D1 및 E의 발현

김영태(YT Kim),이지원(JW Lee),김재욱(JU Kim),조남훈(NH Cho) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.6

Multiple genetic changes occur during the evolution of normal cells into cancer cells. Recent work has identified another category of genes that, when mutated, increase genetic instability and accelerate cellular evolution. These genes encode components of cell cycle checkpoints, which are positions of control that ensure the order of events in the cell cycle. And several checkpoints are regulated by a family of protein kinases, the CDKs, and their obligate activating partners, the cyclins. One of the most important checkpoint is in late G1, at which the cell commit itself to another round of DNA replication and at which both positive and negative external signals are integrated into the cell cycle. Many checkpoints are deregulated in oncogenesis, and this is often due to changes in cyclin-CDK complexes. Consequently, cell growth and division to become insensitive to external cues. G1 cyclins, cyclin D1 and E, together with a cdk partner, are believed to regulate cell cycle progression from G1 into S phase by modulating the activity of their substrates. In these studies, we examined for HPV types 16 and 18 by polymerase chain reaction (PCR) and for the accumulation of cyclin D1 and E by immunohistochemistry in 94 cases of cervical tissues. Cyclin index (CI) was defined as the percentage of positively labeled nuclei per 1000 cells. We found cyclin D1 and E expression was significantly low in HPV-positive cases. Other clinicopathologic prognostic factors were not correlated with cyclin D1 and E expression. Further study based on larger numbers of cases with correlation of cyclin D1 and E status and survival data will be necessary to examine the potential use of cyclin expression as a prognostic marker.

한국의 임신성고혈압 환자에서 안지오텐시노겐의 분자생물학적 변이에 관한 연구

김영태(YT Kim),구병삼(BS Koo),이민수(MS Lee) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.1

Pregnancy-induced hypertension(PIH) is one of the major causes of maternal, fetal and neonatal morbidity and mortality. Although many causes are encountered, etiology of PIH is still unknown. A molecular variant of angiotensinogen, M235T, reported to be linked with essential hypertension and PIH. This study was to evaluate the molecular variation of angiotensinogen in Korean pregnancy-induced hypertension. Our results did not provide any definite relation with the molecular variant of angiotensinase, M235T, and Korean PIH.

자궁내막증식증의 임상병리학적 분석

김영태(YT Kim),김재욱(JU Kim),김동규(DK Kim),송찬호(CH Song) 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.6

Endometrial hyperplasia is an abnormal proliferation, predominantly of the glandular component of the endometrium, which may progress to well differentiated carcinoma in a small percentage of women. Appropriate management of patients with endometrial hyperplasia depends on a number of clinical and pathologic factors. Recently, the International society of Gynecologic Pathologists, under the auspices of WHO, has developed a novel pathologic classification according to whether cytologic atypia is present. However, there have been few clinopathological study of endometrial hyperplasia by this classification. We have exprienced 107 cases with endometrial hyperplasia from January 1988 to December 1993. the age of the study subjects ranged from 27 to 71 years with a mean of 48.7 years. There were 51 cases with simple endometrial hyperplasia, 47 cases with complex hyperplasia and 9 cases with atypical endometrial hyperplasia. pregnancy was never experienced in 9 cases (8.4%) and the mean parity was 2.7. The most frequent complaint was metrorrhagia which was shown in 45 cases (42.1%) whereas postmenopausal bleeding in 9 cases(8.4%) and abdominal pain in 4 cases(3.7%) were observed. Out of the 51 cases with simple endometrial hyperplasia, 41 cases were treated by hysterectomy and 2 cases received hormone therapy. From 47 cases with complex hyperplasia , 42 patients had hysterectomy and only 1 case received hormone therapy. From 9 patients with atypical endometrial hyperplasia , 8 cases underwent hysterectomy and 1 case received hormone therapy.

미세침윤 자궁경부암의 임상병리학적 분석

김영태(YT Kim),김재욱(JU Kim),김동규(DK Kim) 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.5

The diagnosis and management of microinvasive cervical cancer remains a controversial subject. Most authorities define microinvasion by depth of penetration by cancer cells of less than an arbitrarily and subjectively determined 1 or 3 or 5 or more millimeters beneath the basement membrance. Recently, the International Federation of Obstetrics and Gynecology(FIGO) has developed a new cervical cancer staging. We used the definition as stromal invasion of cancer cell with maximum depth of 3 mm and no wider than 7 mm from the base of the epithelium. We conducted this retrospective study in order to evaluate the results of therapeutic approaches in patients with microinvasive cervical cancer. We have experienced 55 cases with microinvasive cervical cancer from November 1987 to May 1995. The age of the study subjects ranged from 39 to 71 years with a median of 39 years. Pregnancy was never experienced in 2 cases(3.6%) and the mean parity was 2.7. The most frequent complaint was postcoital bleeding which was shown in 20 cases(32.1%), whereas most cases were revealed incidentally through the routine Pap smear. The corresponding rate of Pap smear to histologic diagnosis was approximately 36.4%. However, corresponding rate within on histologic grade was about 92.8%. As to the reports of colposcopically directed biopsy, 72.7% of cases showed microinvasion. Type I extended hysterectomy was performed in 26 cases and type II extended hysterectomy was done in 7 cases with less than 1mm invasion and 19 cases with greater than 1 mm and no greater than 3 mm stromal invasion. There was no surgery-related deaths in this series and 5 year survival was 100%. In conclusion, we suggest that less radical therapeutic approach for the patients with no greater 3 mm stromal invasion may be beneficial. But further prospective study based on larger numbers of cases with multi-institutional cooperation and designed protocol will be necessary.

13-cis-Retinoic Acid 가 자궁경부암의 항암화학요법에 미치는 영향

김영태(YT Kim),김재욱(JU Kim),김동규(DK Kim),이정필(JP Lee),송찬호(CH Song) 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.5

BACKGROUND : Retinoid are strong inhibitors of epithelial cancer promotion and progression in experimental carcinogenesis. Recently, therapeutic trial of retinoids have demonstrated activites in cervical cancer and precancerous lesion of cervix, Our purpose was to determine whether the administraion of 13-cis-Retinoic Acid is more effectual in the neoadjuvant chemotherapy of cervical carcinoma. METHODS : From January 1994 through January 1995, 40 patients with invasive cervical cancer were enrolled in this prospective study and divided by two groups. group 1 had neoadjuvant chemotherapy plus 13-cis-Retinoic Acid (RA) at a dosage of 1mg/kg/day for 1 month. Patients between group 1 and group 2 were similar with respect to age, parity, clinical stage, and histological subtype. Therapeutic responses were compared using Fisher`s exact test, Mann-Whitney test, and Wilcoxon signed rank test. RESULTS : RA increased the complete response rate of neoadjuvant chemotherapy from 0% in the group 1 to 5% in group 2. but difference of overall response rate between two group was not evident. The drug toxicities between group 1 and group 2 included anemia in 30.0% and 23.7%, leukopenia in 6.7% and 15.2% and hepatotoxicity in 6.7% and 6.8% respectively. More skin side effectes were seen in the patients of group 2, but these effects were mild and reversible. CONCLUSION : It would be suggested that RA plus chemotherapy may be superior chemotherapy alone in increasing the complete response rate of neoadjuvant chemotherapy forpatients with cervical cancer. The impact of such a treatment on survical needs to be futher explored.

침윤성 자궁경부암조직에서 c-erbB-2 암유전자 단백의 함량측정 및 예후인자와의 관련성

김영태(YT Kim),김재욱(JU Kim) 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.4

c-erbB-2 oncogene is a gene that encodes a growth factor receptor-like molecule with tyrosine kinase activity and has a structure similar to that of the epidermal growth factor receptor. The oncoprotein endoded by this gene is a 185-kilodalton transmembrane glycoprotein. Overexpression of the c-erbB-2 oncoprotein is detected in human adenocarcinoma of the breast, ovary, and salivary gland, in which association between overexpression of the c-erbB-2 and poor prognosis of the disease has been reported. The role of c-erbB-2 oncoprotein in the tumorigenesis of the uterine cervix has been poorly understood and controversial. In order to explore the relationship beteen c-erbB-2 oncoprotein status and cervical carcinoma, tissues were analyzed from 40 patients, each of whom had invasive cervical carcinoma prior to treatment, 10 patients with cervical intraepithelial neoplasia(CIN) and 10 control cases who underwent hysterectomy due to benign gynecological disease at Yonsei University College of Medicine. We measured c-erbB-2 oncopretein with an enzyme-linked immunosorbent assay(ELISA) which was a sandwich type. Patients with invasive cervical cancer were found to have significantly higher median c-erbB-2 oncoprotein expression than patients with either the patients with CIN(P=0.02) or the control(P=0.001), respectively. However, there was no significant difference in c-erbB-2 oncoprotein status between CIN and the control groups. Overexpression of c-erbB-2 oncoprotein was found in 12 of 40(30%) invasive cervical cancers and in 1 of 10(10%) CIN patients. In invasive cervical cancer, no significant difference in c-erbB-2 oncoprotein levels was noted when stratified according to age, menopausal status, histological cell type, lesion size or clinical stage. Our results were consistent with the concept that c-erbB-2 oncoprotein may play an important role in malignant transformation and tumorigenesis in cervical cancer. But, further study based on larger numbers of cases with correlation to c-erbB-2 oncoprotein status and complete follow-up survival data will help to define the prognostic significance of c-erbB-2 oncoprotein in patients with cervical carcinoma.

부인과 진료에서의 Buscopan Compositum사용의 임상적 관찰

김영태(YT Kim),이동구(DK Lee) 대한산부인과학회 1968 Obstetrics & Gynecology Science Vol.11 No.9

An 100 Patientinnen, die an sog, "akuten Abdomen" verschiedener Genese oder an sonstigen gynaekologischen Beschwerden litten, wurde die spasmolytische und analgetische Wirkung von Buscopan Compositum erprobt, wobei entweder I Ampulle I.V. oder 2 Tabletten per os verabreicht wurden. Ohne Verschleierung akuter Bauchsymptome konnten die Patientinnen von ihren teilweiseunertraeglichen Schmerzen befreit werden. Unerwuenschte Nebenwirkungen traten dabei nicht auf.