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태아 복부 고형 종양 (solid tumor)의 영상 진단
김의혁 ( Kim Ui Hyeog ),안은희 ( An Eun Hui ),임종철 ( Im Jong Cheol ),노진래 ( No Jin Lae ),조재성 ( Jo Jae Seong ),박용원 ( Park Yong Won ),김명준 ( Kim Myeong Jun ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.5
Objective : Ultrasonography is screening modality of choice and plays an important role in prenatal diagnosis of various diseases and neoplasm of fetus. Recently, Magnetic Resonance Imaging was used as a diagnosis tool to fetal disease. We would like to evaluate efficacy of ultrasonography and magnetic resonance imaging for the diagnosis of fetal abdominal solid tumor. Methods : Among 2,055 cases of abnormal ultrasonography findings detected by prenatal ultrasonography from January 1996 and June 2002, a comparison between the diagnosis made by prenatal ultrasonography, fetal magnetic resonance imaging (MRI), postnatal radiological studies and histopathologic studies was made in four cases with fetal abdominal solid tumor. Results : The first case was diagnosed as adrenal tumor or hepatic tumor by US, hemangioedothelioma of liver by fetal MRI, and confirmed as hemangioedothelioma postnatally. The second case showed concordance with mesoblastic nephroma among the diagnosis made by US, fetal MRI, and postnatal histopathologic studies. The third case was diagnosed as extrathoracic pulmonary sequestration by US and MRI, and the same diagnosis was made by postnatal histopathologic studies. The fourth case was suspected as kidney tumor by US and was diagnosed as adrenal as adrenal neuroblastoma postoperatively. Conclusion : Fetal solid tumor is not a common disorder, but the location, size and orgin of tumor plays important role in the prognosis of neonatal period; additional workup by fetal MRI would improve the diagnosis of such tumors.
배상욱 ( Bae Sang Ug ),정병화 ( Jeong Byeong Hwa ),윤보성 ( Yun Bo Seong ),김의혁 ( Kim Ui Hyeog ),정봉철 ( Jeong Bong Cheol ),박주현 ( Park Ju Hyeon ),신종승 ( Sin Jong Seung ),김세광 ( Kim Se Gwang ),박기현 ( Park Gi Hyeon ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.5
Objective : To identify 1) whether the endogenous steroid hormone metabolism in patients with pelvic organ prolapse was different from that of normal women, 2) the relationship between endogenous steroid hormone metabolites and the stage of the pelvic organ prolapse. Methods : Twenty postmenopausal women who were clinically diagnosed as having pelvic organ prolapse and 20 volunteer postmenopausal women not having pelvic organ prolapse were included in the study. We compared the urinary profiles of endogenous steroids between the two groups and investigated the relationship between urinary profiles of the endogenous steroids and the degree of pelvic organ prolapse. Urinary profiles of the endogenous steroids were assayed by gas chromatography-mass spectrometry. Results : The ages of the patients and control group were 64.6±6.5 and 63.5±3.9 years, and the Body Mass Index (BMI) was 23.96±3.14 and 24.11± kg/m^2 in patients and in normal subjects, respectively. The number of patients in each stage were 4 in stage Ⅰ, 4 in stage Ⅱ, 6 in stage Ⅲ and 6 in stage Ⅳ. 5-androstene-3β, 16β, 17β-triol (5-AT), 11β-hydroxy androstenedione (An) and 17β-estradiol were significantly increased in patients with pelvic organ prolapse over that of the control group (0.76±0.67 vs 0.06±0.03 μmole/g creatinine; p=0.002, 1.16±0.83 vs 0.65±0.23 μmole/g creatinine; p=0.04, 15.08±9.81 vs 8.53±6.19 μmole/g creatinine; p=0.04). However, tetrahydrocortisone (THE) was significantly increased in the control group over that in patients having pelvic organ prolapse (9.80±6.21 vs 5.22±4.89 μmole/g creatinine; p=0.04). The androgen metabolites, 5-AT and THE significantly correlated with the POP-Q stage (R=0.418; p=0.027, R=0.46; p=0.016). Among the estrogen metabolites, 17β-estradiol was correlated to the POP-Q stage but not mathematically significantly (R=0.38; p=0.05) and the 17β-estradiol/extrone ratio weakly correlated to pelvic organ prolapse stage (R=0.14l p=0.49,), by showing a low correlation coefficiency. Conclusion : The urinary concentrations of 17β-estradiol, 5-AT and 11β-hydroxy an increased in patients with pelvic organ prolapse over that of the control group and 5-AT, THE and 17β-estradiol showed a relationship to the progression of pelvic organ prolapse in Korean women. The metabolites of endogenous steroid hormones could be contributing factors in the pathogenesis of pelvic organ prolapse.