Osteogenic Sarcoma의 소견을 보이는 난소의 원발성 Malignant Mixed Mesodermal Tumor

허만하(MH Huh),박두철(DC Park),하근수(KS Ha),배국환(KH Bae),강대경(DK Kang),정재훈(JH Chung) 대한산부인과학회 1971 Obstetrics & Gynecology Science Vol.14 No.4

난관에 발생한 malignant giant cell tumor와 구별이 불가능한 병변을 특징으로 하는 mixed mesodermal tumor 1예를 보고한다. A case of malignant ovarian mixed mesodermal tumor in a 42 years old Korean female (in a artificial menopause) is presented. The histology of the tumor is unique in that it reveals mesenchymal components histologically indistinguishable from primary osteogenic sarcoma of bone. Discussion and literature review are made in relation to the histogenesis and histopathological features of malignant Mullerian mesodermal tumor or ovary. This reprents the first reported case of malignant mixed mesodermal tumor or ovary in Korean literature.

Lipiodol 조영술에 의한 난관이물육아종의 1예

송기명(KM Song),이희동(IS Lee),오세량(SR Oh),허만하(MH Huh) 대한산부인과학회 1973 Obstetrics & Gynecology Science Vol.16 No.4

This is the first case, reported in Korea, of foreign-body granulomatous lesions confirmed clinically and pathologically, following the use of Lipiodol for the (hysterosalpingography), Literature review realted to foreign-body granulomas of the fallopian tubes, following the use of Lipiodol, are carried out.

악성 자궁 흑색종

김용대(YD Kim),공기주(KJ Kong),강소삼(SS Kang),허만하(MH Huh) 대한산부인과학회 1978 Obstetrics & Gynecology Science Vol.21 No.7

자궁경부에서 발생했거나 주위 질 천정에서 발생했거나 간에 흑색소 암을 갖는 환자는 13년간의 수술후 생존기간을 가지며, 다발성 국소재발을 가지며 결국은 전신적인 전이로 사망한다. The malignant melanoma of the vulva and vagina was rarely reported but malignant melanoma of the uterine cervix and body was very rarely occurred. We present a case of malignant melanoma of the uterine cervix and body which we experienced, with a brief review of the concerned literature.

후복막에 생긴 임파성낭종 1 예

박은동,허만하,양승학,정숙금 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.6

저자들은 난소종양과 감별하기 어려웠던 후복막기원의 임파성종양 1예를 경험하였기에 간단 한 문헌고찰과 함께 보고하는 바이다. Retroperitoneal cysts are rare intra-abdominal tumors. They can appear as chronic abdominal pain, a painless abdominal mass, or acute abdomen. It is difficult to differentiate from ovarian tumor by pelvic examination. Diagnostic aids include pelvic computed tomography and ultrasound. We present a case of retroperitoneal lymphatic cyst required differential diagnosis.

인유두종 바이러스 16/18형 감염이 있는 자궁경부암에서 c-erb B2와 p53 단백의 과발현에 관한 연구 : 자궁경부암의 원인 및 임상병리학적 연구 Genesis and Clinicopathologic Analysis

박은동,허만하,김원규,이상민,이천준,허방,조무연,정인철 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.11

The 43 cases of the primary uterine cervical carcinoma were analyzed for HPV type 16/18 infection and also analyzed for overexpression of p53 and c-erb B2 oncoprotein to evaluate theirs oncogenic and clinicopathologic relationships. HPV type 16/18 infection was examined by polymerase chain reaction(PCR) and the overexpression of p53 and c-erb B2 protein by usi-ng immunohistochemical method. The results were as follow: 1. The HPV infection rate in primary uterine cervical carcinomas was 83.7% respectively.The standard clinicopathologic characteristics(age, histologic type, koilocytosis, mitosis, clinical stage, tumor size, cervical invasion depth, lymph node metastasis, parametrial invasion) were nat significantly correlated with HPV type 16/18 infectivity. 2. The overexpression rate of p53 protein was 72.1% and there was no Significant correlation between expression of p53 protein and the Clinicopathologic characteristics. 3. The overexpression of c-erb B2 oncoprotein was 44.2% and there was no significant correlation between the overexpression of c-erb B2 oncoprotein and the clinicopathologic char-acteristics. 4. There was no significant correlation between HPV type 16/18 infection and overexpression of p53 and c-erb B2 oncoprotein.

유년형 난소과립막세포종의 1예

김흥열,장희경,허만하,박은동 대한부인종양 콜포스코피학회 1993 Journal of Gynecologic Oncology Vol.4 No.4

Over 80% of the granulosa cell tumors are encountered in women over 40 years of age, and on;y about 5% before the age of normal puberty. Approximately 90% of the prepuhertal tumors & many of those found in women under the 30 years of age have clistrictive histologic features that differ from those of the typical granulosa cell tumors encountered in older women. A case of 13 years old nulliparous women who has a juvenile granulosa cell tumor of ovary is presented with brief review of literatures.

자궁경부암 제 1 기말 , 2 기초에서 DNA배수체와 국소적 T 세포침윤의 임상조직학적 예후인자들과의 상관관계에 관한 연구

박은동,김흥열,장희경,허만하,이영미,변용준 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.1

본 연구는 자궁경부암에서 DNP ploidy 양상과 암주변부 임파구 침윤도가 이미 알려진 여러가지 임상조직학적 예후인자들과 어떠한 연관성을 갖고 있으며 새로운 예후인자로서의 유용성 여부를 알아보고자 실시하였다. 1992년 11월 1일부터 1993년 5월 30일가지 본원에 내원하여 자궁경부암 제 1기말과 2기초로 진단받고 광범위 자궁절제술 및 임파절 제거술을 받은 환자를 대상으로 하였으며 수술시 적출된 신선조직으로 DNA flowcytometry를 실시하여 DNA 양상을 분석하였고 일반 조직학적 검경 및 면역조직화학적 염색을 실시하여 임파절 전이여부를 비롯한 조직학적 소견 및 면역세포의 국소적 상대분포도를 구하여 환자의 임상소견들과 비교 검토한 결과는 다음과 같았다. 1. DNA flowcytometry를 실시한 33예중 diploid군은 19예, aneuploid군은 14에로 나타나 aneuploidy의 발생빈도는 42.4%였으며 HPP는 79%로 나타났다. 2. 자궁경부암의 임상병기 Ib에서 IIa보다 유의하게 aneuploidy의 발생빈도가 높았다(p=0.049). 3. 연령이 증가할수록 aneuploidy의 발생빈도가 어느 정도 유의하게 높은 경향을 보였다(p=0.086). 4. 임파절전이가 있는 군에서 aneuploid의 발생빈도가 매우 유의하게 높았다(p=0.02). 5. 병변의 크기, 침윤정도 및 임파혈관게 침범유무는 각각 DNA ploid양상과 유의한 연관성이 없는 것으로 나타났다. 6. 세포의 형태, 분화도, mitotic activity 및 국소적 임파구 침윤정도를 각각 DNA ploidy양상과 비교하였을때 어느 것도 유의한 연관성을 보여주지 못했다. 7. 조직학적 악성도를 세포의 형태, 분화도, mitotic activity, 국소적 임파구 침윤정도 및 임파혈관계 침범유무의 다섯가지 항목으로 점수로 나타내었을때 조직학적 악성도가 증가할수록 어느정도 유의하게 aneuploidy의 발생빈도가 높아진ㄴ 경향을 볼 수 있었다(p=0.57). 8. 암주변부 T-cell의 상대적 분포도에 따른 임과혈관계 침범유무 및 임파절 전이여부에서는 T-cell의 침윤이 상대적으로 적을수록 임파혈관계 침범은 유의하게 많았으나(p=0.007) 임파절 전이와의 유의한 연관성은 나타나지 않았다. 이상의 결과로 미루어 볼 때 자궁경부암의 예후인자로 임상적 소견과 조직학적 소견과 더불어 DNA flowcytometry에 의한 DNA양상 및 immunohistochemical stain을 통한 국소적 임파구, 특히 T-cell의 침윤정도가 자궁경부암의 악성도와 치료방침의 결정 및 예후를 판정하는데 도움이 될 것으로 사료되는 바이다. 그러나 본 연구는 전향적 조사로서 계속해서 많은 예를 모으고 충분한 시간이 경과된다면 생존율의 비교를 통해 보다 확실한 결론을 얻을 수 있으리라 기대되며 자궁경부암의 에후판정에 보다 빠르고 쉬우며 정확하고 객관적이 지표를 제시할 수 있을것으로 사료된다. In a prospective study of 33 patients with the uterine cervical cancer stage Ib, IIa, the prognostic value of DNA ploidy was evaluated in relation to the clinicopathologic variables. And we studied degree of stromal T-cell infiltration in the periphery of tumor lesion in 43 patients via immunohistochemical stain. Then, its prognostic impact was evaluated in relation to lymph node metastasis and lymphovascular invasion. The subjects were patients who admitted to Kosin medical college under the diagnosis of cervical cancer and undertaken radical hysterectomy and pelvic node dissection from Nov., 1992 to May, 1993. The samples for DNA flowcytometry were obtained from the fresh surgical specimen and sent for laboratory. Via H-E stain and immunohistochemical stain, one pathologist inspected general histologic findings and degree of T-cell, B-cell stromal infiltration. Clinicopathologic variables included age, stage, lymph node metastasis, tumor size, invasion depth, cell type, degree of differentiation, mitosis, lymphovascular invasion, degree of lymphocyte infiltration. The results were as follows: 1. The incidence of aneuploidy was 42.4% and the incidence of high proliferative phase (HPP) was 79%. 2. The incidence of aneuploidy was significantly increased in stage Ib than stage IIa (P=0.049). 3. Increasing age the incidence of aneuploidy was increased (P=0.086). 4. In the group of lymph node metastasis, incidence of aneuploidy was significantly increased(P=0.02). 5. There were no significant relationships between DNA ploidy and tumor size, invasion depth, lymphovascular invision. 6. There were no significant relationships between DNA ploidy and the cell type, degree of differentiation, mitotic activity, degree of lymphocyte infiltration. 7. According to MSG including cell type, mitotic activity, degree of stromal lymphocyte infiltration and lymphovascular invasion, the higher MSG, the higher incidence of aneuploidy (P=0.057). 8. In the study of stromal T-cell infiltration, the lower infiltration of T-cell in the periphery of the tumor, the higher incidence of lymphovascular invasion(P=0.007). And there was no significant relationship between T-cell infiltration and lymph node metastasis. From the above results it is considered that DNA ploidy and stromal T-cell infiltration are heplful additative prognostic factors with clinicipathologic characters in the cervical carcinoma.

초기 자궁경부암에서 DNA 배수성 분석이 예후에 미치는 영향

박은동,김홍열,장희경,허만하,김인선,김원규,이영미 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.4

1. 38명의 자궁경부암 환자에서 이배수성암이 20예(57예), 비배수성암이 18예(43%)이였다. 2. 38예의 환자에서 광범위 자궁적출 및 양측 임파선 적출시 임파선 전이가 된 것이 8예(21%)이었고 그중 이배수성암이 5예(28%), 배수성암이 3예(15%)이었다. 3. 5년재발율에서는 이배수성암이 3예(15%), 비배수성암이 5예(28%)이었다. 4. 5년 무병생존율이 이배수성암에서는 79.72%, 배배수성암에서는 67.57%이었다. Prognostic value of flow cytometric DNA analysis was assessed for early cervical cancer patients (FIGO stage I & IIa) treated with radical abdominal hysterectomy and lymph node dissection. Flow cytometry was performed on archival paraffin-embedded tumor tissues of 38 subjects. 8 patients recieved radiotherapy post-operatively because ofthe presence of lymphnode metastasis at the time of initial surgery. 38 subjects were analized: 18 patients(47%) were categorized as DNA-aneuploidy and 20 (53%) patients were categorized as DNA. diploidy. 26 (68%) patients were in FIGO stage IB, 12(32%) in IIA. 8(21%) patients were found to have lymphnode metastasis at the time of initial surgery. 8(21%) patients recurred. There is no significant correlation between DNA-ploidy patterns and stage, differentiation, cell type or mitosis. Although the results are not significant statistically, aneuploidy tended to be more frequently observed in association with lymph node metastasis and recurrence. Overall 5 year disease-free survival for diloid and aneuploid were 79.72% and 67.57%, respectively.