자궁평활근 섬유육종의 1례

이광택(KT Rhee),이희정(HJ Lee),정신호(SH Chung),이규택(KT Lee),채민석(MS Chai),이현식(HS Lee) 대한산부인과학회 1972 Obstetrics & Gynecology Science Vol.15 No.7

저자는 최근 본병원 산부인과에서 희유한 자궁 평골근 면유육종의 1예를 경험하였기에 이에 대한 간단한 문헌적 고찰을 검토하여 보고하는 바이다. Leiomyosarcoma of the uterus is far less common, high malignant tumor of the mesoder- mal origin. The diagnosis of this tumor is very difficult pre-operatively because the symp- toms and physical findings are attibuted to the myomata. A case of leiomyosarcoma found post-operatively is presented with a brief review of litera- ture available.

한국 여성 방광질요루 35예의 임상적 고찰

이광택(KT Rhee),이희정(HJ Lee),정신호(SH Chung),이규택(KT Lee),이현식(HS Lee) 대한산부인과학회 1973 Obstetrics & Gynecology Science Vol.16 No.8

주산기사망에 관한 연구를 통하여 산전관리의 경험이 있는 예는 29.1%에 불과하였다. We report our experience showing as the following about 35 cases of Begico-baginal fistula treated surgically from 1965 to 1972 at Presbyterian medical Center. 1. The most common group appears as 15 cases (42.8%) occurring from the birth trauma among the 35 cases. 2. 11 cases occurred from AgNO3 solution infiltration in order to correct the uterine prolaps took a proportion of 31.4%. 3. The age incidence of patient visited at P.M.C. were 40`s, 30`s and 50`s in order. 4. Successful surgical repair was done in 28 cases and failed in 7 cases which proportion is similar to other`s reports. 5. Because 3 cases among the failed 7 cases were contributed to the obstruction of urinary catheter, we think it is important factor in leading to successful operation to keep good urinary drainage after surgical repair. 6. The period of 3 cases among the all surgical repaired cases from the onset of the fistula to the day taking an operation was less that 3 months and surgical operation of those all cases were failed. 7. The worst prognosis was the case originated AgNO3 solution infiltration.

렙토스피라 백신 면역군의 혈청학적인 평가

김주성,이명숙,김동술,이혜경,정경태,이길웅,이상묵,박강수,이인택 국립보건연구원 1989 국립보건원보 Vol.26 No.

이분지 병변에서 스텐트 시술중 발생한 유도 철선 Fracture 1예

이항진,손민수,주기탁,송광식,이호명,이정선,신익균 대한순환기학회 2001 Korean Circulation Journal Vol.31 No.11

과립막세포종의 1례

이규택(KT Lee),최영중(YJ Choi),최영균(YK Choi),정신호(SH Chung),부영철(YC Boo) 대한산부인과학회 1977 Obstetrics & Gynecology Science Vol.20 No.7

저자들은 60세의 폐경기경산부에 발생한 과립막세포종 1예를 경험하였기에 문헌과 함께 보고하는 바이다. Granulosa cell tumor is one of rare feminizing tumor of ovary. A case of granulosa cell tumor in 60 year old woman was reported and a brief review of literature on granulosa cell tumor was made.

연속형 측추력기의 공력 간섭력 유동해석 및 풍동시험 결과와의 비교

강경태(KT. Kang),이은석(E.S. Lee),이영빈(Y.B. Lee) 한국전산유체공학회 2015 한국전산유체공학회 학술대회논문집 Vol.2015 No.10

Prostaglandin E1 투여에 의한 유도분만에 있어서의 혈중 스테로이드 및 단백질호르몬의 변화

김경태(KT Kim),이우영(WY Lee),정민섭(MS Chung),허필형(PH Hur),이진우(JW Lee) 대한산부인과학회 1980 Obstetrics & Gynecology Science Vol.23 No.2

결론 임신 말기의 산모에게 PGE2를 매시간 1정씩 6회 경구 투여하여 산모 형중의 스테로이드 및 단백 호르몬에 미치는 영향을 관찰하 기 위하여 자연분만 산모 40예와 PGE2 유도분만 성공산모 52예 및 PGE2 유도분만 실패산모 20예에서 분만 경과의 시간에 따른 혈중 progesterone, estradiol, cortisol, hCG b-Subunit 및 hPRL의 변동을 측정 관찰하여 다음과 같은 결과를 얻었다. 1. 자연분만 산모에서 혈중 progesterone은 진통 시작후 3시간 까지 증가한 후 분만시 까지 감소하였고, 혈중 cortisol은 진통 이 경과함에 따라 점점 증가하였으며 estradiol, hCG b-subunit 및 hPRL은 변동이 없었다. 2. PGE2 유도분만 성공삼모에서는 자연분만 산모와 비슷한 호르몬의 변동을 보였다. 3. PGE2 유도분만 실패 산모에서는 유의한 호르몬의 변동은 없었다. 4. PGE2 투여후의 혈중 estradiol값은 PGE2유도분만 성공 산모에서 실패 산모보다 유의하게 높았다. 5. 이상의 관찰로 미루어 PGE2경구 투여로 유도분만이 성공된 산모에서는 자연분만과 비슷한 혈중 호르몬 변동을 보여주었고 진 통 유발시의 혈중 호르몬 변화와 기전도 유사한 것으로 사려된다. In order to measure the effect of oral prostagkandin E2(PGE2) on the serem level if steroid peotein hormones during labor of term pregnant woman PGE2 tablets (0.5mg) were administered orally six times with hourly interval to women in their full term period of pregnancy for induction of labor, and observations were made on the changes of serum level of progesterone, estradiol, cortisol, hCG b-xubunit and hPRL in 52successful cases, 20 unsuxxessful cases of PGE2-induction and 40 cases of spontaneous labor for comparison. 1. Serum progesterone of the women of spontaneous labor increased initially for 3 hours from the onset of labor and then decreased until the time of delivery, while the serum cortisol showed continued increase with the lapse of time. There was no significant change in serum estradiol, hCG b-subunit and hPRL. 2. In the successful cases of PGE2-induction, pattern of hormonal changes were quite similar te those of the women of spontaneous labor. 3. No significant hormonal change was observed in the group of unsuccessful cases of PGE2-induction. 4. The values of serum estradiol were significantly higher in those of successful PGE2-induction than in those of unsuccessful one. 5. From the above findings, it can be concluded that the successful cases of PGE2-induction show aimialr hormonal changes to those of spontaneous labor, and the change as well as mechanism of the hormones during are also similar.

자궁경부 상피내종양(CIN III)의 진단과 치료에 관한 임상 및 병리학적 고찰

김현찬,이재영,김기태,이정형,유병규,이은관 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.3

1980년 6월부터 1990년 12월까지 약 10년간 인제대학교부속 부산백병원 산부인과에서 중증 이형상피증과 자궁경부 0기암(CIN III)으로 수술표본에서 확진된 162명을 대상으로 진단 및 치료의 결과를 평가하기 위하여 임상 및 병리학적 관점에서 소급적 관찰을 하여 다음과 같이 결과를 요약할 수 있었다. 1. 조사대상의 약 3/4은 30~49세이었고, 평균연령은 41세이었다. 부인과 수술환자에 대한 빈도는 약 3.6%이었다. 평균 결혼연령은 22.4세였으며, 평균 결혼생활 기간은 18.6년이었다. 전체의 18%가 폐경된 상태로 그 평균연령은 48.4세이었다. 평균 임신회수는 5.8회, 평균 분 만회수는 3.1회이었다. 전체의 33.8%가 피임을 했으며, 그 방법은 난관결찰술(26.6%), 경구피 임제(3.6%), 자궁내피임장치(3.6%)이었다. 2. 임상증상이 없이 정기검진으로 내원한 경우가 30례(18.5%)이었으며, 비특이적 임상증상으 로는 대하가 60례(37.0%), 하복부 불쾌감이 50례(30.9%), 점상출혈 36례(22.2%), 성교후 출혈 27례(16.7%)등의 순이었다. 3. 자궁경부의 육안소견은 33례(20.4%)에서는 전혀 이상소견을 발견하지 못한 정상소견이었 으며, 관찰된 소견을 개별적으로 열거하면, 약 2/3정도인 108례(66.7%)에서 미란을 보였으며, 만성자궁경관염을 동반한 자궁경부비대가 24례(14.8%), 급성염증소견이 15례(11.0%), 위축소 견이 11례(6.8%)이었다. 4. 세포진검사소견과 치료전 자궁경부 조직검사 소견이 정확히 일치한 경우가 약 63%였으며 세포진검사가 조직검사 소견보다 진행된 병변의 경우로 판정된 경우가 약 14.2%, 조직소견보 다 경도의 병변으로 판정된 경우가 약 22.8%이었다. One histologic degree이내의 일치율은 약 87.1%이었다. 5. 162례 중 128례에서 세포진검사 결과후 질확대경검사를 시행한 바 88례(68.7%)에서 한가 지 혹은 두가지 이상의 복합적인 이상소견을 보였다. 백색상피가 74례(57.8%)로 가장 많았 으며, 적점반 42례(32.8%), 모자이크상이 22례(17.2%), 이형혈관이 14례(10.9%), 백반 2례 (1.6%)의 순이었다. 두가지 이상의 이상소견을 보인 경우는 67%이었다. 6. 세포진검사 후 질확대경 하에서 시행한 자궁경부 생검결과와 수술표본의 일치율은 145례 로 약 89.6%이었으며, 원추절제술을 한 경우를 포함시키면 98.2%의 일치율을 보였다. 7. 치료로 대부분 복식전자궁적출술을 새행하였고, 14례(8.6%)는 치료적 원추절제술을 시행하 였으며, 나머지 20례(12.4%)에 대해서는 국소적 처치를 하였다. 전자궁적출술(128례) 및 원 추절제술(14례)을 시행한 142례의 환자에서 한가지이상의 합병증이 발생된 경우는 56례 (39.4%)로 그 중 질구개육아종 31례(21.8%), 방광염이 20례(14.1%), 창상감염이 11례(8.6%), 질구개감염이 10례(7.7%), 일시적 방광기능장애가 9례(6.3%), 그외 출혈 및 열성이환이 각각 5례(3.5%), 호흡기계 감염이 3례(2.1%)등의 합병증이 있었고, 두가지 이상의 합병증이 동반된 경우는 21례(14.8%)이었다. 8. 치료를 받은 162례 중 68례(42%)가 1년이상의 추적관찰이 가능하였고, 평균 추적기간은 37개월이었다. 한 예에서 재발을 경험하였으나 추적이 불충분하여 재발에 관한 정확한 빈도 및 여부에 대한 결과를 얻지 못하였다. To evaluate the outcome of diagnostic procedures and treatments, a clinical and pathological observation was made on the 162 cases of CIN III(from June 1, 1980 to December 31, 1990) which were confirmed by the pathological examination of surgical specimens. The results were as follows: The majority were belong to the age group of 30~49 (75%), married, multiparous and non user of contraception. The mean age was 41 and mean age of marriage was 22.4. About one-fifth were menopaused. The main presenting symptoms were leukorrehea (37%), lower abdominal discomfort (30.9%), vaginal spotting (22.2%) and post coital spotting (16.7%). About one-fifth were asymptomatic and detected by incidental routine check up. The most common gross finding was erosion (66.7%) and the others were chronic inflammation with hypertrophy (14.8%), acute inflammation (11.1%). Some cases (5%) disclosed grossly malignant looking, otherwise, the cervix were grossly innocent in 20%. The cytologic reports were exactly in accord with pathologic findings of surgical specimens in 63%. The corresponding within one histologic degree was about 87.1%. The colposcopy showed abnormal finding in 68.7% of the cases. The most common one was white epithelium (57.8%) and the others were punctation (32.8%), mosaicism (17.2%), atypical vessel (10.9%), leukoplakia (1.6%) in order. Those findings were present and mixed together in two third of the cases. Based upon Pap. Smear, colposcopy with aimed biopsy and conization of the selected cases, the corresponding rate between pre-treatment diagnosis and that of surgical specimen was 98.2%. The majority (79%) was treated by hysterectomy and the others by conization or local destructive measures. As to the post treatment complications, the most common one was vaginal vault granulation (28.1%) and the next was cystitis (14.1%). The others were less than 10%, respectively and not problematic. One case of recurrence was encountered during the mean follow up period of 37 months. Because of insufficient follow up, the status and rate of recurrence are remained to be evaluated by further follow up.

Unresectable AFP Producing AGC was treated by Neoadj CTx followed by surgery and adj CTx

( Sb Bae ),( Sc Lee ),( Kt Lee ),( Hj Kim ),( Cy Choi ),( Ja Hwang ),( Jh Lee ),( Ms Lee ),( Mw Son ) 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1

Serum AFP is normally produced in some fetal organs, hepatocytes and HCC. However, AFP levels sometimes are elevated in patients with primary gastric ca. Gastric ca with a high level of AFP is termed AFP producing gastric ca. Prevalence of AFP-producing gastric ca is reported to be 6.2-6.3% in Korea and 15% in the US. Most of cases were a high rate of metastasis to the liver and LNs. We reported a rare case that unresectable AFP producing AGC was treated by neoadj CTx followed by surgery and adj CTx. A 60-years-old man had no history of medication or familiy history. He had nausea, epigastric pain and Physical examination did not show hepatosplenomegaly and epigastric tenderness. GFS revealed BorrmannIII tumor on antral lesser curvature. APCT showed irregular enhancing wall thickening in stomach antrum, lesser curvature, and metastatic LNs around aorta, portal vein, portal, IVC and perigastric area, tumor thrombus in proximal SMV and main portal vein. PET CT showed multiple FDG uptake in perigastric LNs, lt gastric, common hepatic artery and portocaval area. Clinical TNM staging classification according to AJCC was cT4N2/N3M1. GFS bx was adenocaricnoma PD. AFP was elevated at 41,513 ng/mL but, CEA,CA19-9 were normal range. He was performed neoadj CTx by 3cycle DCF [docetaxel 75 mg/m2 D1, cisplatin 75 mg/m2 D1, 5-FU 750 mg/m2 D1-D5] regimen. PET CT was not only markedly decreased wall thickening and FDG uptake but also decreased size and FDG uptake of metastatic perigastric LNs, lt gastric and common hepatic artery area. Patient underwent subtotal gastrectomy with D2 dissection. The resected stomach contained a 3.6 × 2.0 cm BorrmannIII ca. Primary tumor cell invaded subserosa and had a adenocarcinoma MD. Dissected 27 regional LNs were no metastasis. Postop stage was IIA (T3N0M0). Preop AFP was 485 and postop AFP on day 12 and day 24 were 16.88 and 5.41 ng/mL, serial f/u AFP levels were normal until recently. Adj CTx (DCF) was administered on postop day 24, and adverse events of grade 3 of acute kidney injury, febrile neutropenia, nausea and grade 2 of mucositis, vomiting, general weakness had arisen. Patient was treated with 30% dosage reduction and completed with 4 cycle of adj CTx. He had no progression up to now.

질에 발생한 원발성 평활근육종 1 례

김현찬,김기태,이경복,윤혜경,이수,이재준,오희연 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.8

The primary malignant neoplasm of the vagina is rare and represents about 1% of all hynecologic malignancies. The majority are carcinomas. Primary sarcomas of vagina constitute only 2% of all malignant neoplasms of vagina. But sarcomas are the most common malignant mesenchymal tumor in the vagina. Among sarcomas, sarcoma botryoides predominates in childhood, whereas leiomyosarcoma is the most common neoplasm in adults. Because of the rareness of the leiomyosarcomas, the standard criteria of diagnosis and histopathologic classification have not been established, therefore the recommendation of the treatment modality also has not been established. We have recently experienced a case of primary leiomyosarcoma arising from vagina in 45 years-old woman and report our case with a brief review of the literature.