액와 림프선 종대로 진단된 난소암

이천준,전창완 대한부인종양학회 2006 Journal of Gynecologic Oncology Vol.16 No.3

Ovarian carcinoma is usually asymptomatic in early stage and over 70% of it initially diagnose advanced stage due to diffuse intraabdominal disease. Presenting symptoms and signs often relate to the degree of intraabdominal spread. The most common presenting symptoms and sign include abdominal pain, distension and palpable pelvic mass. The enlarged finding of isolated, distant lymph node without intraabdominal symptom and sign is vary rare. We experienced a patient who initially diagnosed enlarged axillary lymph node from ovarian carcinoma. We report this case with a brief review of literature. 난소암은 70%이상에서 3기 이상으로 첫 발견되며 대게 골반과 복강 내에 직접 전이되기 때문에 골반과 복강증상으로 진단된다. 그리하여 골반과 복강의 증상 외에 첫 진단되는 예는 아주 드물다. 액와 임파선종대로 난소암이 첫 진단되는 예는 세계적으로 희귀하며 유방전이 없는 액와 임파선종대는 Hockstein이 1997년에 1예를 보고한 후에 지금까지 없었다. 이에 저자들은 69세 여성에서 촉지되는 우측 액와 임파선 종대를 주소로 내원하여 원발병소를 찾던 중 발견된 난소암 1예를 경험하여 문헌고찰과 함께 보고하는 바이다.

난소와 충수돌기의 경계성 점액종양에서 동시에 생긴 복막 위점액종 1례

이천준,김원규,이창원 고신대학교 의학부 2004 高神大學校 醫學部 論文集 Vol.19 No.1

Pseudmyxoma peritonei results from diffuse peritoneal involvement with mucinous material by implantation of malignant tumors of irritation from ruptured benign cysts. Its origin is usually associated with mucinous cystadenoma or cystadenocarcinoma of the ovary and appendix. This disease is characterized by relatively long term survival and absence of extraperitoneal metastases. However, to predict the disease progression remains difficult because of the wide spectrum of underlying pathologic processes with varying malignant potential. Aggressive surgical approach with resection of the tumor bulk of disease offers the optimal palliation and prognosis. We have experienced one case of peudomyxoma peritonei originated from borderline mucinous tumors of the ovary and appendix, and report this case with the brief review of literature.

위암말기환자의 임신 1례

이천준,이충한 고신대학교(의대) 고신대학교 의과대학 학술지 2004 고신대학교 의과대학 학술지 Vol.19 No.1

The pregnancy associated with gastric cancer is extremely rare. The hormonal environment of pregnancy may enhance the development and growth of gastric cancer. The diagnosis is usually delayed because symptoms are confused to the effect of pregnancy and end-stage gastric cancer. The prognosis is generally grave. We experienced a patient who underwent a gastrectomy and chemotherapy due to gastric cancer and who subsequently had been found pregnant. We report this case with a brief review of literature.

항암치료 중인 부인암 환자에서 고용량 비타민 C 사용 시 항암제 보조치료효과와 부작용 감소에 대한 연구

이천준,정명수,정지영,박혜은,김원규 대한부인종양학회 2007 Journal of Gynecologic Oncology Vol.18 No.2

Objective: The high-dose vitamin C is useful in the cancer. Consequently its use should have become how many help even from gynecological cancer patient who is in chemotherapy. Methods: The study was performed prospective on 57 patients who is diagnosed initially the gynecological cancer during chemotherapy at Gospel hospital of Kosin university between January 2005 and October 2006. The study was divided to its use 29(cervix cancer: 17, ovarian cancer 12) and no high- dose vitamin C use 28(cervix cancer: 11, ovarian cancer 17). The cervix cancer was treated by FP chemotherapy for all stage and the ovarian cancer was treated by CC chemotherapy for stage 1, CT or PT chemotherapy for advanced stage for 6 times respectively regarding a treatment in tumor marker change aspect and the side effect researched GOG classifications. Results: It evaluated the nausea and vomiting significantly in ovarian cancer(p<0.05). It evaluated for liver enzyme, Hb, WBC, platelet serum creatinine, sensory, motor nervous system and tumor marker with the high-dose vitamin C group does not have the difference from the control group statistically. Conclusions: The high-dose vitamin C is a possibility of reducing nausea and vomiting in the ovarian cancer chemotherapy without other side effect. The regarding a tumor marker change it was not significantly but when it analyzed a recurrence a survival rate with more patient and follow up in long period, its use of should have become how many help in gynecological cancer treatment. 목적: 많은 연구에서 고용량의 비타민 C는 암 환자에 유용한 것으로 알려져 있어 화학요법 중인 부인암환자에서 도 고용량의 비타민 C 사용이 얼마나 도움이 되는지 알아보고자 본 연구를 하게 되었다. 연구방법: 고신의과대학 복음병원에서 2005년 1월부터 2006년 10월까지 처음 부인암으로 진단받고 화학요법으 로 치료중인 57예를 대상으로 전향적으로 연구하였다. 화학요법 전후에 혈관으로 20-30g의 고용량의 비타민 C를 투 여하였다. 비타민 C를 투여한 군은 29예이고 대조군은 28예이었고 비타민 C를 투여한 군 중 자궁경부암이 17예 이고 난소암은 12예이었고, 대조군은 자궁경부암이 11예이었고 난소암은 17예이었다. 자궁경부암은 5-FU, cisplatin(FP)항암화학요법을 , 난소암은 FIGO병기가 Ⅰ기초에서는 cyclophosphamide, cisplatin(CC)를 그 이상 의 병기에서는 carboplatin, paclitaxel(CT) 또는 cisplatin, paclitaxel(PT)화학요법을 각각 6회를 시행하고 치료에 대한 반응은 종양표지자의 변화양상으로 관찰하였고 부작용은 Gynecologic Oncology Group의 분류를 기 준으로 연구하였다. 결과: 소화기계 부작용으로 오심, 구토, 설사를 평가하였으며 난소암 환자에서 항암화학요법시 오심과 구토가 통계학적으로 유의하게 고용량 비타민 C 투여군에서 감소하는 결과가 나왔다(p<0.05). 혈색소, 백혈구, 혈소 판, 간효소(AST/ALP), 혈청 크레아티닌 수치, 감각신경계와 운동신경계 부작용은 통계학적으로 유의한 차이가 없었다. 종양표지자의 변화도 통계학적으로 유의한 차이가 없었다. 결론: 부인암 중 난소암으로 항암화학요법으로 치료하는 환자에서 고용량의 비타민 C 사용군은 오심 및 구토의 소화기계 부작용을 줄일 수가 있었고 다른 부작용에 대해서도 안전하게 사용할 수 있었다. 치료효과에 대한 반 응으로 단기간의 종양표지자의 변화는 통계학적 유의성은 없었으나 보다 많은 수의 환자에 대한 연구와 장기간 의 추적관찰로 재발 및 생존율을 분석하면 고용량의 비타민 C 사용이 부인암치료에 얼마나 도움이 되는지 알 수 있을 것으로 생각된다.

위암말기환자의 임신 1례

이천준,이충한 고신대학교 의학부 2004 高神大學校 醫學部 論文集 Vol.19 No.1

The pregnancy associated with gastric cancer is extremely rare. The hormonal environment of pregnancy may enhance the development and growth of gastric cancer. The diagnosis is usually delayed because symptoms are confused to the effect of pregnancy and end-stage gastric cancer. The prognosis is generally grave. We experienced a patient who underwent a gastrectomy and chemotherapy due to gastric cancer and who subsequently had been found pregnant. We report this case with a brief review of literature.

난소와 충수돌기의 경계성 점액종양에서 동시에 생긴 복막 위점액종 1례

이천준,김원규,이창원 고신대학교(의대) 고신대학교 의과대학 학술지 2004 고신대학교 의과대학 학술지 Vol.19 No.1

Pseudomyxoma peritonei results from diffuse peritoneal involvement with mucinous material by implantation of malignant tumors or irritation from ruptured benign cysts. Its origin is usually associated with mucinous cystadenoma or cystadenocarcinoma of the ovary and appendix. This disease is characterized by relatively long term survival and absence of extraperitoneal metastasis. However, to predict the disease progression remains difficult because of the wide spectrum of underlying pathologic processes with varying malignant potential. Aggressive surgical approach with resection of the tumor bulk of disease offers the optimal palliation and prognosis We have experienced one case of pseudomyxoma peritonei originated from borderline mucinous tumors of the ovary and appendix, and report this case with the brief review of literature.

난소의 원발성 악성 혼합성 뮬러리안 종양 1예

이천준,김성한 KOSIN UNIVERSITY COLLEGE OF MEDICINE 2006 高神大學校 醫學部 論文集 Vol.21 No.1

Malignant mixed Müllerian tumor (MMMT) is neoplasm consisting of both a sarcomatous and carcinomatous component. MMMT of the ovary is rare, constituting less than 1% of all primary ovarian tumors. Almost all it is found in postmenopausal women, often with low parity and usually in an advanced stage. It is a particularly aggressive and rapidly progressive tumor, especially in advanced stages. It is highly malignant and the prognosis is poor due to frequent metastasis and recurrence. The survival rate is very low in spite of surgery, chemotherapy and radiotherapy. There is no uniform opinion about optimal therapy. We have experienced one case of MMMT of the ovary and report this case with the brief review of literature.

난소의 원발성 악성 혼합성 뮬러리안 종양 1예

이천준,김성한 고신대학교(의대) 고신대학교 의과대학 학술지 2006 고신대학교 의과대학 학술지 Vol.21 No.1

Malignant mixed Miillerian tumor (MMMT) is neoplasm consisting of both a sarcomatous and carcinomatous component. MMMT of the ovary is rare,constituting less than 1% of all primary ovarian tumors. Almost all it is found in postmenopausal women,often with low parity and usually in an advanced stage. It is a particularly aggressive and rapidly progressive tumor, especially in advanced stages. It is highly malignant and the prognosis is poor due to frequent metastasis and recurrence. The survival rate is very low in spite of surgery, chemotherapy and radiotherapy. There is no uniform opinion about optimal therapy. We have experienced one case of MMMT of the ovary an公 report this case with the brief review of literature.

일반연제 발표 : 부인종양학 1 ; 자궁 경부암의 예후 인자로서의 P53과 Bcl-2의 발현에 관한 연구

이천준,김동휘,박은동 대한산부인과학회 1998 대한산부인과학회 학술대회 Vol.82 No.-

부인암 항암화학요법에서 항구토제 효과에 대한 비교 연구

이천준,김원규 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.4

Background: Chemotherapy-induced nausea and vomiting (CINV) are major adverse effects of cancer chemotherapy. The serotonin [5-hydroxytriptamine-3 (5-HT3)] receptor antagonists (RAs)(ondansetron) significantly advanced antiemetic therapy for cancer patients, but despite treatment with a 5-HT3 RA plus a corticosteroid according to published guidelines. The 5-HT3 RAs prevent vomiting in the first 24 hour after chemotherapy when coadministered with steroids but they appear to lack efficacy in the delayed phase. We compared the impact of acute (during the first 24 hours postchemotherapy) and delayed (days 2 through 5 postchemotherapy) CINV on patients of an aprepitant regimen with an ondansetron regimen, for antiemetic efficacy after highly emetogenic chemotherapy (HEC). Materials and Methods: The study was performed prospective on 61 patients who is diagnosed initially the gynecological cancer during chemotherapy at Gospel hospital of Kosin university between March 2007 and October 2007. The study was divided according to an aprepitant regimen use 30 patients and an ondansetron regimen 31 patients. The efficacy of controlling acute/delayed nausea, vomiting and adverse effects were compared. Statistical analysis was performed using the chi-square test. Results: The efficacy of controlling nausea with an aprepitant regimen and an ondansetron regimen was 86.7%, 83.9% in acute periods and 99%, 83.9% in delayed periods respectively. The efficacy of controlling vomiting with an aprepitant regimen and an ondansetron regimen was 93.3%, 90.3% in acute periods and 96.7%, 83.9% in delayed periods respectively. The efficacy of controlling delayed vomiting with an aprepitant regimen reported significantly(p value=0.034). The common adverse effects in both groups were not statistical significantly in incidence and severity. Conclusions: The regimen including aprepitant was superior in preventing CINV as compared with a regimen in which both ondansetron and dexamethasone were given delayed periods in patients receiving chemotherapy.