심폐소생술 교육의 대국민 인식에 따른 개선 홍보 방안 연구

기은영 사단법인 한국응급구조학회 2006 한국응급구조학회지 Vol.10 No.3

Primary ovarian malignant mixed mesodermal tumor - case report

기은영,최윤진,변승원,이근호,박종섭,배석년,허수영 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.98 No.-

Malignant mixed mesodermal tumor (MMMT)s are highly aggressive tumors, usually diagnosed in advanced stage. Cases of MMMT derived from either ovary and uterus. The ovarian MMMT is consisting only 1% of all ovarian tumors. Because of the rarity of this disease, optimal treatment modality is not established. The range of operation, the effect of the radiation therapy, and proper chemotherapeutic regimen are still controversial. But for advanced stage ovarian MMMTs, optimal cytoreduction and adjuvant chemotherapy including platinum as part of the regimen are important. We report 4 cases of ovarian MMMTs (1: heterologous, 3: homologous) period 1990-2011. The patients were underwent operation immediately, after histopathologically confirmation, patients were treated with platinum based combination chemotherapy.

GO-3 : A clinicopathological review of pulmonary metastasis from uterine cervical cancer

기은영,이근호,배석년,박종섭,허수영 대한산부인과학회 2014 대한산부인과학회 학술대회 Vol.100 No.-

목적: To investigate the clinicopathological features of pulmonary metastasis from uterine cervical cancer. 방법: We reviewed the medical records of 56 patients with cervical cancer who were treated with radical hysterectomy and concurrent chemoradiation or systemic chemotherapy and showed pulmonary metastasis between January 1990 and March 2014. 결과: A total of 56 patients were diagnosed with pulmonary metastasis from cervical cancer. The incidence of pulmonary metastasis was 3.6%. The mean event-free duration was 12 months. Twelve patients underwent surgical removal of metastatic lesions. The overall survival (OS) of patients with ≤3 metastatic lung lesions was 40.7 months, which it was longer than that with >4 lesions (p=0.034 ). The OS of patients who underwent surgical resection was 53.8 months, which was longer than that of those who did not (p=0.006). In addition, the OS of patients with adjuvant platinum-based chemotherapy was 32.6 months (p=0.02). 결론: Most pulmonary metastases from cervical cancer are detected incidentally. Although many factors are associated with the prognosis of pulmonary metastasis from cervical cancer, there is still controversy regarding definitive prognostic factors for pulmonary metastasis. Further studies on prognostic factors and successful treatment modalities are warranted.

Methylation of liquid based cervical cytology infected with human papillomavirus type 16 DNA according to the degree of cervical pathology

기은영,최윤진,변승원,이근호,허수영,배석년,박종섭 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.98 No.-

The clinical relevance of human papillomavirus type 16 (HPV16) DNA methylation has not been well documented, although its role in modulation of viral transcription is recognized. Detection of hypermethylated genes in cervical scrapings has been suggested as a promising tool for identification of cervical intraepithelial neoplasia and cancer. The aim of this study was to evaluate the presence of hypermethylated genes according to the degree of cervical disease. Study subjects with HPV 16 DNA positive were 122 women attending Seoul St. Mary`s Hospital from January 2009 to July 2011. Cervical cytology positive for HPV 16 were normal, CIN1, CIN2, CIN3, and cancer. Using quantitative bisulfite-pyrosequencing, we measured the methlyation of PAX1, CADM1, ADCYAP1 and MAL genes of cervical scrapings. Cervical scrapings were used for detection of the methylation in normal (n=29), CIN 1 (n=29), CIN2 (n=4), CIN3 (n=42), and cervical cancer (n=18). We observed that 4 genes (PAX1, CADM1, ADCYAP1, MAL) were more frequently methylated in cervical cancer (83.3, 77.8, 88.9 and 72.2 %) than in normal cytology (0, 3.4, 3.4 and 6.9%). ROC curve demonstrated that methylation of the 4 genes discriminated between high grade cervical lesions (≥CIN 3) and low grade cervical lesions (< CIN3). The estimated specificities of these 4 genes for detecting high grade lesion were 100, 96.6, 96.6 and 93.1% (p=0.0001). And the estimated sensitivities of that were 83.3, 77.8, 88.9 and 93.1%(p=0.0001). Additional ADCYAP1/PAX1 methylation analysis on the HPV16-positive women increased the sensitivity to 88% with a specificity to 96.7%(p<0.001). Methylation of the PAX1, CADM1, ADCYAP1 and MAL is significantly associated with the development of ≥ CIN3. Hence, testing for methylation may provide a diagnostic marker for the triage of high risk HPV-positive women at risk of ≥ CIN3.

Laparoendoscopic Single Site Surgery for the Treatment of Huge Ovarian Cysts Using an Angiocatheter Needle

기은영,박은경,정인철,박성은,황혜성,정유현,송민종 연세대학교의과대학 2019 Yonsei medical journal Vol.60 No.9

Purpose: The aim of this study was to evaluate the feasibility and safety of laparoendoscopic single site (LESS) surgery using anangiocatheter needle in patients with huge ovarian cysts (diameter ≥15 cm). Materials and Methods: Thirty-one patients with huge ovarian cysts underwent LESS surgery using an angiocatheter needle betweenMarch 2011 and August 2016. An intra-umbilical vertical incision (1.5–2.0 cm) was made in the midline. After the cyst wallwas punctured using an angiocatheter needle, the fluid contents were aspirated with a connected vacuum aspirator. After placinga Glove port in the umbilical incision, LESS surgery was performed using a rigid 0-degree, 5-mm laparoscope and conventional, rigid,straight laparoscopic instruments. Knife-in-bag morcellation was instituted for specimen collection. Results: The median maximal diameter of ovarian cysts was 18 cm (range, 15–30 cm), the median operation time was 150 minutes(range, 80–520 minutes), and the median volume of blood loss was 100 mL (range, 20–800 mL). Three patients (9.7%) werediagnosed with malignant ovarian cancer using intraoperative frozen examination, and 1 patient was converted to laparotomy dueto advanced disease. Thirty patients underwent LESS, and there was no need for an additional laparoscopic port. Conclusion: LESS surgery using an angiocatheter needle, with leaving only a small postoperative scar, was deemed feasible forthe management of huge ovarian cysts.

Comparison of the PANArray HPV Genotyping Chip Test with the Cobas 4800 HPV and Hybrid Capture 2 Tests for Detection of HPV in ASCUS Women

기은영,이윤경,이아원,박종섭 연세대학교의과대학 2018 Yonsei medical journal Vol.59 No.5

Purpose: This study aimed to evaluate the performance of the PANArray human papilloma virus (HPV) test, a PCR-based DNAmicroarray assay, in detecting HPV from patient samples and its concordance with the cobas 4800 HPV and Hybrid Capture 2(HC2) tests. Materials and Methods: The PANArray HPV, cobas 4800 HPV, and HC2 tests were performed on 504 cervical swab samples frompatients with atypical cells of undetermined significance at five hospitals. The samples that were interpreted as ‘HPV-other’ typepositive in the PANArray HPV test were confirmed by direct sequencing. Results: The concordance rates were 80.8% between the cobas 4800 HPV and PANArray HPV tests [κ=0.59, 95% confidence interval(CI) 0.52−0.66] and 80.2% (κ=0.6, 95% CI 0.55−0.68) between the HC2 and PANArray HPV tests. Among the 62 patients negativeon PANArray HPV (defined as the absence of high risk HPV), but positive on both cobas 4800 HPV and HC2 tests, 42 (67.7%) testedpositive for ‘HPV-other’ types on the PANArray HPV test, and 31 (50.0%) had gray zone results [relative light unit/control (RLU/CO), 1.4−9.25] in the HC2 test. Of the patients deemed positive by the PANArray HPV test, 43 tested positive for high-risk (HR)HPV in cobas 4800 HPV and HC 2 tests. Among them, 58.2% showed HR HPV, including HPV 16, by direct sequencing, of which25% had gray results. Conclusion: Results classified as ‘HPV-other’ type by the PANArray HPV test, or gray zone results by HC2 (RLU/CO ratio level1−10) should be carefully interpreted using comprehensive clinical information.

A Clinicopathological Review of Pulmonary Metastasis from Uterine Cervical Cancer

기은영,이근호,박종섭,허수영 대한암학회 2016 Cancer Research and Treatment Vol.48 No.1

Purpose The purpose of this study was to investigate the clinicopathological features of pulmonary metastasis from cervical cancer. Materials and Methods We reviewed the medical records of 56 patients with cervical cancer who developed pulmonary metastasis after radical hysterectomy, postoperative concurrent chemoradiation or systemic chemotherapy between January 1990 and March 2014. Results Fifty-six patients were diagnosed with pulmonary metastasis from cervical cancer. The preva- lence of pulmonary metastasis was 3.6%. The mean event-free duration was 12 months. Twelve patients underwent surgical removal of metastatic lesions. The overall survival (OS) of patients with ! 3 metastatic lung lesions was 40.7 months, longer than those with > 4 lesions (25 months, p=0.034). The OS of patients who underwent surgical resection was 53.8 months, longer than that of those who did not (p=0.006). In addition, the OS of patients with adjuvant platinum-based chemotherapy was 32.6 months (p=0.027). Conclusion In this study, we found that the number of metastatic nodules, surgical resection, and post- operative platinum-based chemotherapy can influence clinical outcome. Further studies on prognostic factors and successful treatment modalities are warranted.

Retroperitoneal Liposarcoma -A Case report

기은영,박성택,변승원,배석년,윤주희,박종섭,허수영 대한산부인과학회 2011 대한산부인과학회 학술대회 Vol.97 No.-

Immunocytochemistry negativity for human papillomavirus L1 capsid protein as a biomarker in atypical squamous cell of undetermined significance or low grade squamous intraepthelial lesion

기은영,송민종,김진휘,이근호,윤주희,박동춘,허수영,박종섭,이성종 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-

목적: The aim of this study was to evaluate the immunocytochemical expression of human papillomavirus (HPV) L1 capsid protein in patients with atypical squamous cells of unknown significance (ASCUS), or low grade squamous intraepithelial lesions (LSIL) at high risk of HPV infection, and to analyze its association with pathologic diagnosis. 방법: Between January 2013 and December 2015, we performed immunocytochemistry of HPV L1 protein in cervical cytology samples (49 normal cytology , 70 ASCUS, and 215 LSIL) obtained from 334 patients using the Cytoactiv® HPV L1 screening set. The expression of HPV L1 capsid protein was assessed by using cytology and was compared with the results of histopathological examination of surgical samples 결과: Patients with ASCUS (n=70) or LSIL (n=215) in cervical cytology more frequently showed negativity for L1 capsid protein when they were diagnosed as ≥ cervical intraepithelial neoplasia(CIN) 2 (ASCUS group : 82.6%, p=00046; LSIL group : 72.2%, p=0.02). The negativity for L1 capsid protein was significantly higher in patients with HPV 16 or 18 infection when they were diagnosed as ≥CIN 2 (p=0.03). Model comparison analysis revealed that cytology plus HPV capsid protein immunocytochemistry or cytology plus HPV test improved the diagnosis rate compared with cytology alone (AIC: 229.9 vs 236.0 vs 241.0; SC: 245.2 vs 251.3 vs 252.4). 결론: Immunocytochemistry negativity for HPV L1 capsid protein can be used as a biomarker of poor prognosis in patients with ASCUS or LSIL.

자궁경부의 림프상피양 암종

기은영 ( Eun Young Ki ),노덕영 ( Duck Yeong Ro ),김효진 ( Hyo Jin Kim ),박병준 ( Byung Joon Park ),김용욱 ( Yong Wook Kim ),김태응 ( Tae Eung Kim ),정재근 ( Jae Keun Jung ),이안희 ( An Hi Lee ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.1

Lymphoepithelioma-like carcinoma (LELC) of the uterine cervix, also called lymphoepithelioma or medullary carcinoma, is a very rare variant of squamous cell carcinoma. Histologically, the tumor is characterized by groups and nests of poorly differentiated tumor cells with abundant cytoplasm and ill-defined cell borders, surrounded by an intense chronic inflammatory infiltrate. Epstein-Barr virus (EBV) may be involved in the development of LELC but the exact role remains unclear. The relationship between human papillomavirus (HPV) and LELC of the uterine cervix has also not been reported. The prognosis of LELC of the uterine cervix seems to be better than that of cervical squamous cell carcinoma. We report a case of LELC of the uterine cervix with a brief review.