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김주동,육정환,김용만,최원용,김용진,임정택,오성태,김병식,Kim Joo Dong,Yook Jeong Hwan,Kim Yong Man,Choi Won Yong,Kim Yong Jin,Lim Jung Taek,Oh Sung Tae,Kim Byung Sik 대한위암학회 2004 대한위암학회지 Vol.4 No.2
Purpose: A Krukenberg tumor is an ovarian tumor of a signet-ring cell type. This tumor arises more commonly in young women, and the prognosis is poor. The primary focus of this tumor is often found at gastrointestinal malignancy, especially gastric cancer. We tried to identify the clinical characteristics of this tumor, and in that regard, this report might be helpful. Materials and Methods: We reviewed the 61 patients with Krukenberg tumors, who had been diagnosed at our hospital from 1994 to 2002, and retrospectively analyzed the clinical features. Results: The age distribution ranged from 15 to 59 years, and the mean age was 41 years. The most common symptom was a lower abdominal mass ($46\%$). Fourty-two cases ($77\%$) showed bilateral ovarian involvement, and the size of this tumor was variable, but in 24 cases ($4\%$) the size was $5\∼10$ cm for the largest diameter. Among 54 cases, 40 cases had ascites, and the volume of ascites was variable. The median survival of the 61 patients was 10 months, and Krukenberg tumor developed 19.7 months after the primary operation. The median survival durations of recurrence patterns were 20 months for the Krukenberg tumor alone, and 7 months for the Krukenberg tumor with peritoneal seeding. Conclusion: In young women treated with a gastrectomy, especially one for an advanced tumor, closed observation with abdominal ultrasonography or computed tomography to detect a Krukenberg tumor is recommended. The patient with a Krukenberg tumor alone has a better prognosis than one with a Krukenberg tumor combined peritoneal seeding. We will have to consider more progressive treatment for the patient with a Krukenberg tumor alone.
복강경식 근치적 자궁경부절제술 이후 협부협착이 발생한 환자에서 협부확장술 시행 후 자궁강내 인공수정 시술을 통한 성공적인 임신 및 분만
임유진 ( You Jin Lim ),김정훈 ( Chung Hoon Kim ),김주연 ( Joo Yuen Kim ),권수경 ( Su Kyoung Kwon ),심재윤 ( Jae Yoon Shin ),김성훈 ( Sung Hun Kim ),채희동 ( Hee Dong Chae ),김용만 ( Yong Man Kim ),강병문 ( Byung Moon Kang ) 대한산부인과학회 2011 Obstetrics & Gynecology Science Vol.54 No.9
Uterine cervical cancer is one of the most common malignant disease in women, For young patients with early stage cervical cancer who want to preserve their fertility, radical trachelectomy is a promising fertility-sparing treatment in well-selected group of patients, However, isthmic stenosis is reported to occur in 15% of patients who received radical trachelectomy, Isthmic stenosis is one of causes of infertility following radical trachelectomy. In addition patients who underwent radical trachelectomy are at high risk of obstetric complications including preterm labor, premature rupture of membrane and preterm delivery. Herein we report a case of successful pregnancy and childbirth by intrauterine insemination following isthmic dilatation due to isthmic stenosis after laparoscopic trachelectomy with a brief review of the literature.
자궁 육종에서 p53, bcl-2 및 bax 단백의 발현에 관한 면역조직화학적 연구
남주현,김용만,임소덕,김종혁,추형식,목정은,나준희,고창원,허주령 대한부인종양 콜포스코피학회 1997 Journal of Gynecologic Oncology Vol.8 No.4
Uterine sarcomas are rare tumors with unpredictable prognosis, comprising about 3% of uterine cancers. Little is known of epidemiologic risk factors and similarly, little work has been performed assessing molecular alterations in sarcomas. Proteins encoded by p53, bcl-2 and bax genes are important regulators of programed cell death, hence apoptosis. Alterations in the expression of these apoptosis-related genes can contribute to the development of most of human cancers, as well as possibly influence the prognosis of the cancer patients. Using antibodies specific for the p53, bcl-2 and bax proteins in combination with immunohistochemical methods, we examined for the first time the expression of these genes in 19 cases of uterine sarcoma, managed at Asan Medical Center between June, 1989 and December, 1996, including 13 leiomyosarcomas, 4 endodermal stromal sarcomas and 2 malignant mixed mullerian tumors. Twelve patients had stage I disease and 7 stage Ⅲ, and 9 patients had tumors with mitoses less than 10 per10 HPF, and the others had those with mitoses equal to or more than 10 per 10 HPF. The results were evaluated by semiquantitative analysis as non-(0%), low(1 ∼25%), moderate(26 ∼75%) and high expressors(>76%), and the latter two were defined as tumors with overexpression. The immunoreactivity of bcl-2 and bax appeared in the cytoplasm, while that of p53 was localized solely in the nuclei. p53 immunostaining revealed 4 non-expressors, 7 low, 3 moderate and 5 high expressors, showing 42.1% rate of overexpression. Immunostaining of bcl-2 showed 13 non-expressors, 2 low, 1 moderate and 3 high expressors, resulting 21.1% rate of overexpression and that of bax showed 1 non-expressors, 4 low, 6 moderate and 8 high expressors, resulting 73.7% rate of overexpression. We could not find any significant correlation among the degrees of the expressions of these three proteins. The overexpression of these three proteins did not show any significant association with stage of disease or mitotic count of tumor. In conclusi although apoptosis-related factors such as p53, bcl-2 and bax are strongly suggested to play a certain role in tumorigenesis of uterine sarcoma, the correlation among them and prognostic implications need further investigation.