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자궁내막암 수술시 임파절 전이의 예측인자로서 CA 125의 임상적 유용성
김진휘,이성종,임채춘,남궁성은 대한부인종양 콜포스코피학회 2002 Journal of Gynecologic Oncology Vol.13 No.4
목적 : 자궁내막암 환자에 있어서 골반 임파절 전이의 예측인자로 수술 전 CA 125 값의 유용성을 알아보고자 하였다. 연구 방법 : 1992년 10월부터 2002년 10월까지 가톨릭대학교 의과대학 강남성모병원에서 자궁내막암 진단하에 수술받은 환자 100명을 대상으로 의무기록을 토대로 수술전 CA 125와 임파절 전이유무의 관계를 살펴보았다. 통계적 방법으로는 만-휘트니 유 테스트와 카이 제곱 피셔 테스트를 사용하였다. 결과 : 수술 전 CA 125 값은 병기가 증가함에 따라, 자궁근층을 1/2 이상 침범한 경우, 자궁경부나 부속기를 침범한 경우, 골반 임파절 전이가 있는 경우 유의하게 높게 측정되었다(p<0.05). 결론 : 수술 전 CA 125의 증가는 자궁내막암의 골반 임파절 전이를 예측하는데 있어 유용하다고 할 수 있다. Objective : The aim of this study is to evaluate the clinical usefulness of preoperative CA 125 levels in determining the need for lymphadenectomy in patients with endometrial carcinoma. Methods : CA 125 levels were measured in 100 patients diagnosed with endometrial carcinoma who underwent surgery at Kangnam St. Mary's Hospital between October 1992 and October 2002. Statistical analysis was performed using the Mann-whitney U test and x-Fisher's exact test. Results : Univariate analyses showed that elevated CA 125 levels were significantly correlated with an advanced stage, increasing depth of myometrial invasion, cervical invasion, adnexal involvement, high grade hystology and lymph node metastases (p<0.05). Conclusion : Our data provide an evidence that the elevation of preoperative CA 125 levels can be considered as a predictor for full pelvic lymphadenectomy in the surgical staging of endometrial cancer.
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Clinical analysis of intra-operative frozen section proven borderline tumors of the ovary
김진휘,김태정,박용규,이성하,이정원,송민종,이근호,허수영,배석년,박종섭 대한부인종양학회 2009 Journal of Gynecologic Oncology Vol.20 No.3
Objective: We have assessed the accuracy of frozen section diagnosis and the outcomes of misdiagnosis in borderline tumors of the ovary (BTO) according to frozen section. Methods: All pathology reports with BTO in both frozen and permanent section analyses between 1994 and 2008 at Seoul St. Mary’s Hospital were reviewed. Frozen section diagnosis and permanent section histology reports were compared. Logistic regression models were conducted to evaluate the correlation of patient and tumor characteristics with diagnostic accuracy. The clinical outcomes of misdiagnosis were evaluated. Results: Agreement between frozen section diagnosis and permanent histology was observed in 63 of 101 patients (62.4%). Among the 76 patients with frozen section proven BTO, under-diagnosis and over-diagnosis occurred in 8 of 76 (10.5%) and 5 of 76 patients (6.6%), respectively. Mean diameter of under-diagnosed tumor was larger than matched BTO (21.0±11.4 vs. 13.7±7.1; p=0.021). Tumor size 20 cm was determined as the optimal cut-off for under-diagnosis (50% sensitivity, 87.3% specificity). Among 8 under-diagnosed patients, no patient relapsed. Among 5 over-diagnosed patients, 2 patients < 35 years of age had fertility-preserving surgery. Conclusion: Although frozen section diagnosis is an important and reliable tool in the clinical management of patients with ovarian tumors, over-diagnosis and under-diagnosis are relatively frequent in frozen proven BTO. Surgical decision-making for BTO based on frozen section diagnosis should be done carefully, especially in large tumors. Objective: We have assessed the accuracy of frozen section diagnosis and the outcomes of misdiagnosis in borderline tumors of the ovary (BTO) according to frozen section. Methods: All pathology reports with BTO in both frozen and permanent section analyses between 1994 and 2008 at Seoul St. Mary’s Hospital were reviewed. Frozen section diagnosis and permanent section histology reports were compared. Logistic regression models were conducted to evaluate the correlation of patient and tumor characteristics with diagnostic accuracy. The clinical outcomes of misdiagnosis were evaluated. Results: Agreement between frozen section diagnosis and permanent histology was observed in 63 of 101 patients (62.4%). Among the 76 patients with frozen section proven BTO, under-diagnosis and over-diagnosis occurred in 8 of 76 (10.5%) and 5 of 76 patients (6.6%), respectively. Mean diameter of under-diagnosed tumor was larger than matched BTO (21.0±11.4 vs. 13.7±7.1; p=0.021). Tumor size 20 cm was determined as the optimal cut-off for under-diagnosis (50% sensitivity, 87.3% specificity). Among 8 under-diagnosed patients, no patient relapsed. Among 5 over-diagnosed patients, 2 patients < 35 years of age had fertility-preserving surgery. Conclusion: Although frozen section diagnosis is an important and reliable tool in the clinical management of patients with ovarian tumors, over-diagnosis and under-diagnosis are relatively frequent in frozen proven BTO. Surgical decision-making for BTO based on frozen section diagnosis should be done carefully, especially in large tumors.
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김진휘,박금애,이근호,박태철 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-
The objective of the current study was to evaluate the efficacy and feasibility of fibrin sealant (Tisseel®) in loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia (CIN 2 or 3). We designed a single-blinded prospective randomized study in consecutive in 40 women undergoing LEEP for biopsy-confirmed CIN 2 or 3 at Uijeongbu St. Mary`s Hospital, Korea. Informed consent was obtained from all participants. 2ml of fibrin sealant (Tisseel®) was applied to the uterine cervix of 20 women right after LEEP surgery (treatment group). We evaluated abdominal pain, vaginal bleeding, vaginal discharge and impairment in daily living after 1weeks using visual analogue scale questionnaires, and compared the results with the result of 20 women who did not receive fibrin sealant (control group). Among the 40 women who returned for the 1-week follow up after LEEP, 25 women (62.5%) reported at least one moderate to severe postprocedural symptom, including abdominal pain, vaginal bleeding, vaginal discharge and impairment in daily living. The mean duration of moderate to severe vaginal bleeding and impairment in daily living during postoperative week 1 for the treatment group and the control group was 0.3±0.80 days vs 1.7±2.36 days (p=0.015) and 0.9±1.37 days vs 3.00±2.62 days (p=0.060) respectively. Our results showed for the first time that the intraoperative application of fibrin sealant (Tisseel®) in LEEP can decrease the postoperative vaginal bleeding and impairment in daily living. Further large-scaled studies are needed to confirm the effectiveness of fibrin sealant (Tisseel®) in LEEP.
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김진휘 세계기독교통일신령협회 2003 統一世界 Vol.- No.12
우리가 흔히 ‘씨’라고 하면 눈에 보이는 자연계의 씨만을 생각하기 쉬운데, 그것보다 더 중요한 씨가 있다. 그것은 눈에 보이지 않는 인간의 ‘마음씨’와 ‘말씨’이다. 이것은 사람만이 갖는 특별한 ‘씨’로서 마음의 씨가 ‘품은 씨’라면 말하는 것은 ‘심는 씨’라고 볼수 있다. 왜냐하면 누구나 하는 말들은 품고 있는 마음속에서 비롯되어 표현되는 것이므로 어떤 마음을 품고 사느냐 하는 것이 매우 중요하다.
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