난소암 조직에서 Ureaplasma urealyticum의 분리 배양과 검출

여태홍(Tae Hong Yeo),석원일(Won Il Seok),김홍열(Heung Yeol Kim) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.5

Background & Objectives : According to recent studies, Mycoplasma DNA was positive in 20% of uterine cervical cancer tissue and 48% of gastric cancer tissue. It also showed the correlation with human cancers and infection of Mycoplasma. Ureaplasma urealyticum(U. urealyticum) is a bacteria of high infection rate in women's urogenital system, but it is difficult to find a report about the relations to cancer. So, the objectives of this studies are to investigate the infection rate of the U. urealyticum from Korean women's ovarian cancer, borderline ovarian cancer and benign ovarian tumor, and to discover the relationship between these ovarian tumors with U. urealyticum's infection. Methods : In obstetrics and gynecology department of Kosin medical college, the PCR procedure and cultivation was performed on extracted cancer tissues of 22 ovarian cancer patients and 5 borderline ovarian cancer patients who had operation, and it was also performed on 30 benign ovarian tumor patients as an control group. Results : The detection freguency of U. urealyticum in ovarian cancer tissue was 31.8% (7/22) which was higher than 13.3% (4/30) of benign ovarian tumor but had no statistical relation (p=0.318). In borderline ovarian cancer, the detection frequency was 0.0% (0/5). The infection frequency of U. urealyticum was 22.7% (5/22) in ovarian cancer tissue and 0.0% (0/5) in borderline ovarian tumor and 3.3% (1/30) in benign ovarian tumor, so the infection frequency was higher in ovarian cancer tissue than benign ovarian tumor which was showing statistical relation (p=0.024). The detection frequency of U. urealyticum from benign ovarian tumor tissue was 23.0% (3/13) in mature teratoma and 16.7% (1/6) in epithelial ovarian tumor, which was showing higher frequency in mature teratoma but had no statistical relation(p=0.589). The infection frequency was showed only in epithelial ovarian tumor as 16.7% (1/6) but also had no statistical relation(p=0.388). The detection frequency of U. urealyticum followed by the FIGO stage of malignant ovarian cancer was 33% in stage I and 30.8% (4/13) in stage III, which was higher in stage I but had no statistical relation(p=0.662). The infection frequency was 11.1% (1/9) in stage I and 30.8% (4/13) in stage III, which was higher in stage III but had no statistical relation(p=0.360). Conclusion : With the above results, there was no significant relation between U. urealyticum infection and ovarian cancer. There is, however, few study and case on ovarian cancer internally and externally. It is considered that more studies on the subject with much cases should be made.

자궁 육종 12례에 대한 임상적 고찰

김홍열,박은동 고신대학교 의학부 1992 高神大學校 醫學部 論文集 Vol.8 No.2

Sarcoma of the uterus is a malignant tumor arising from the muscle or connective tissue & very rare malignant tumor. There are only a few case reports in Korea. We have experienced twelve cases of the uterine sarcoma between 1986 and 1992 for 6 years. The results were obtained as follows : 1. The distribution of uterine sarcoma by histologic type was 4 cases (33.3%) for leiomyosarcoma, 3 cases(25.0%) for endomtrial strumal sarcoma, 3 cases(25.0%) for maligangt mixed mu¨llerian tumor, 2 cases(16.7%) for rhabdomyosarcoma. 2. The average age was 44.7 years. 3. The clinical symptoms were abdminal mass(66.7%), abnormal bleeding(33.3%), pelvic or abdominal pain(33.3%). 4. The mean survival time seemed to be decreased with increasing numbers of mitotic figure per 10 high power field.

여성의 갱년기 치료요법

김홍열 고신대학교 의학부 1993 高神大學校 醫學部 論文集 Vol.9 No.2

Menopause is an event common to all women. For some women, it is not difficult, but for many it arrives with complication, both physiological and psychological. Although there is perhaps no gynecologic disorder in which the indication for hormone therapy is more rational than in the treatment of typical climacteric symptoms, especially the vasomotor group, it must be remembered that many symptoms frequently observed in menopausal women are not directly due to the endocrine readjustments of this period but are more logically explained as due to environmental and psychogenic factors. Estrogen therapy is indicated for the control of acute symptoms of the hot flush and insomnia. If treated soon after onset with adequate dosage, the symptoms can usually be controlled rapidly. As the menopausal woman is not totally estrogen deficient, but only relatively deficient in respect to reproductive capacity. some women will not need constant low-dose estrogen replacement therapy as indicated in the premature menopausal patient. Prophylactic estrogen therapy for the prevention of arteriosclerotic cardiovascular disease may be needed. For the patient at risk for osteoporosis, low-dose prophylactic estrogen therapy may be needed. The action of estrogen on bone is to prevent calcium resorption, and there is little evidence that it will stimulate new bone formation. The two cardinal principles of hormon therapy are most important in such long-term treatment, as little "as necessary to control symptoms over as short as possible a duration" Consequently, today a healthy fifty-year-old women can resonably expect to live for another thirty to forty years.

자궁근종에 대한 GnRH agonist치료에 따른 효과 : 임상적 효용 및 전자현미경적 연구 A study on the clinical effect and ultrastructural changes

김홍열,박은동,장희경,허만하 고신대학교 의학부 1993 高神大學校 醫學部 論文集 Vol.9 No.1

Administration of gonadotropin hormone-releasing hormone(GnRH) agonist, through a process of pituitary desensitization and down-regulation of receptors, inhibits the secretion of gonadotropin and sex-steroids and induces a reversible suppression of gonadal activity. This approach can be used as an effective endocrine therapy for some hormone-dependent tumors. We have used GnRH agonist, for the treatment of four patients with uterine leiomyomas, thereafter myometomy was performed in all cases To assess the effect of treatment with GnRH agonist, ultrastructural changes of the tumor cells of leiomyoma are studied, along with measurement of changes in serum hormone levels (LH, FSH, and E2) and the sizes of the neoplasm . Electron microscopic findings of myoma cells after the use of GnRH agonist included the following : increased mitochondria, swelling of mitochondria with loss of cristae, clumping of nuclear chromatin, dilation of endoplasmic reticulum and perinuclear vacuolation, and loss myofilaments. The use of GnRH agonist may be effective in reducing the size of a myoma considerably by primarily inducing medical hypophysectomy and would allow easier surgical removal.

난소암으로 혼동된 골반방선균증 1예

오영림,김홍열 고신대학교의과대학 2006 고신대학교 의과대학 학술지 Vol.21 No.2

골반 방선균증은 여성 생식기의 감염에서 드물게 보는 질환의 하나로서 수술 전 진단이 어렵고 골반 또는 복부 악성종양으로 오인되어 수술하는 경우가 많다. 저자들은 자궁내 피임장치를 착용한 병력이 없으면서 하복부 동통을 호소하던 환자에 대하여 임상 소견상 난소암을 의심하고 개복수술을 시행한 결과 병리학적 소견상 양측성 난소난관 농양과 골반내 방선균증으로 판명된 1예를 경험하였기에 이를 문헌고찰과 함께 보고한다. Actinomycosis is a rare entity, especially in the female genital tract, which presents some difficulties in establishing a correct preoperative diagnosis. Pelvic actinomycosis can mimic pelvic or intraabdominal malignancy leading to multilating surgical exercise. We have experienced a case of abdominal actinomycosis and report this case with brief review of literatures.

비스포스포네이트 일차성 골다공증 치료에서 골에 미치는 효과

오영림,어완규,최영식,김홍열 고신대학교의과대학 2006 고신대학교 의과대학 학술지 Vol.21 No.2

Background Bisphosphonates are well-known agents for treatment of osteoporosis. Oral pamidronate treatment for osteoporosis were studied on Caucasian, but not in Korean. Effects of oral pamidronate was studied in Korean primary osteoporosis patients. Methods Twenty primary osteoporosis patients were treated with 100 mg of daily pamidronate (panorin, Hanlim Co, Korea) for mean duration of 14.5±1.9 months. Serum alkaline phosphatase, urine calcium/creatinine ratio, bone mineral densities of spine(L1-4) and femur (neck, trochanter, ward, and total) were followed up. Results Serum alkaline phosphatase decreased from 93.6±18.3 to 71.2±15.3 IU/L(P<0.0l). Urine calcium/creatinine ratio decreased from 0.121±0.054 to 0.072±0.031(P<0.05). Bone mineral density of spine increased form 0.691±0.123 to 0.752±0.125 g/cm2(p<0.01). Conclusion Bone mineral density of total proximal femur increased biochemical bone turnover rate.