Vslue of Squamous Cell Carcinoma Associated Antigen fTA-41 in Patients Iurith Invasive Carcinoma of the Uterine Cervix

조문준,김재성,박승호,남상륜,Cho Moon-June,Kim Jae-Sung,Park Seoung-Ho,Nam Sang-Lyun The Korean Society for Radiation Oncology 1993 Radiation Oncology Journal Vol.11 No.2

We investigated the usefulness of tumor-associated antigen (TA-4) by a radioimmunoasay method in estimating the extent of disease and tracking the clinical course of disease in 58 patients with cervical cancer. According to our results and those of other authors, the normal range of serum TA-4 was arbitrarily taken to be less than 2 ng/ml. The proportion of the pretreatment positive serum TA-4 level of 48 squamous cell carcinoma patients was $60\%.$ And $40\%$ in 5 adenocarcinoma patients. Advanced disease group showed higher incidence of positive serum TA-4 level; $40\%,\;72\%,\;63\%,\;and\;100\%$ in stage I to IV, respectively. And the absolute values of TA-4 were higher in advanced disease. In patients treated with radiation, elevated serum TA-4 level usually declined after 3000 cGy and further dropped to normal range in $44\%$ after 5000 cGy. The positive rate in primary cervical cancer was $59\%,$ (32/54) and $100\%$ (4/4) in recurrent conical cancer. And 15 patients with recurrent or persistent disease during follow-up revealed $80\%$ positive serum TA-4 level. In conclusion, it would be suggested that serial serum TA-4 measurements may be helpful in tracking the clinical course during and after treatment. 자궁경부암 환자의 병변의 범위 및 임상 경과를 추정하는데 TA-4의 유용성을 검토하고자 충남대학교병원에서 자궁경부암으로 진단 받은 58명의 환자를 대상으로 혈청 TA-4치를 RIA 방법으로 측정하여 $\le2\;ng/ml$을 정상 범위로 정하여 다음과 같은 결과를 얻었다. 1) 치료전 평평상피암 환자의 TA-4의 양성율은 $60\%,$ 선암은 $40\%$였다. 2) 병기가 진행될수록TA-4의 양성율및 평균치가 높아서, 양성율 병기 I는 $40\%,$ II는 $72\%,$ III는 $63\%,$ IV는 $100\%$였으며 평균치는 병기 I에서 3.1, II는 6.6, III는 8, IV는17.7 ng/ml였다. 3) 방사선 치료후 혈청내 TA-4치는 감소하여 5000 cGy 조사후 치료전 양성을 보였던 환자의 $44\%$에서 TA-4치 가 정상으로 돌아왔다. 4) 원발성 자궁경부암 환자의 양성율은 $59\%$였으나 지속성 또는 재발성등 치료에 실패한 15명 환자의 양성율은 $80\%$였다. 이상으로 연속적 혈청내 TA-4치의 측정은 자궁경부암 환자의 방사선치료에 따른 임상 경과를 관찰하는데 도움이 될 것으로 사료된다.

태반 및 태아막에 있어서 E-cadherin의 발현에 관한 연구

강길전 ( Kil Chun Kang ),남상륜 ( Sang Lyun Nam ),이기환 ( Ki Hwan Lee ) 대한주산의학회 2001 Perinatology Vol.12 No.2

변형된 배씨 자궁거상기를 이용한 복강경하 전자궁적출술

이기환(Ki Hwan Lee),남상륜(Sang Lyun Nam),서영석(Young Seok Seo),이석수(Seok Soo Lee),손성경(Sung Kyong Son),강길전(Kil Chun Kang),노흥태(Heung Tae Noh) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.1

N/A Objective : Hysterectomy is one of the most common gynecological operations. The objective of this study was to introduce a new uterine elevator for total laparoscopic hysterectomy. Methods : Bae's uterine elevator was modified for laparoscopic hysterectomy. Modified Bae's uterine elevator was 5 cm longer than original one and handle was modified to vertical position and stopper, silicon tube and silicon adapter for colpotomizer was installed on the shaft. Three hundred and fifty seven cases of total laparoscopic hysterectomies using modified Bae's uterine elevator were performed from Jan 1999 to Jun 2000. Results : Mean age of the patients was 41.8, operation time was 48.3 minutes and uterine weight was 245.5 gm. Leiomyoma was the most common cause of hysterectomies (70.9%), and followed by adenomyosis (16.2%), endometriosis (7.6%). There were no major operative complications such as vascular, bladder, ureter or intestinal injuries. Conclusions : Three hundred and fifty seven cases of total laparoscopic hysterectomies using modified Bae's uterine elevator were performed successfully without any major complications. Modified Bae's uterine elevator was very convenient for uterine manipulation during total laparoscopic hysterectomy.

소아 및 청년기 부인과 질환의 분포에 관한 연구

신연승(Yeon Seung Shin),강길전(Kil Chun Kang),남상륜(Sang Lyun Nam),이기환(Ki Hwan Lee) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.6

N/A Objective: The purpose of this investigation was to review the distribution and treatment of gynecologic disease in pediatric and adolescent patients. Methods: Two hundred forty-four pediatric and adolescent patients were evaluated clinically, who were admitted to Department of Obstetrics and Gynecology, Chungnam National University Hospital from Jan. 1989 to Sep. 1999. Results: The most common disorder was ovarian tumors(43.0%) including 78.1% of neoplastic diseases and 21.9% of nonneoplastic diseases, and followed by pregnancy-associated disorders(20.5%), infectious disorders(1 l.5%), congenital abnormalities(9.8%), traumas(7.4%) and miscellaneous(7.8%). Pregnancy associated disorders include abortion(42%), gestational trophoblastic disease(30.0%), and ectopic pregnancy(28%). Infectious disorders include acute pelvic inflammatory disease(53.6%), hydrosalpinx(2l.4%), condyloma accuminata(10.7%) and tuberculous salpingitis(3.5%). Congenita] abnormalities include congenital uterine anomalies(41.7%), imperforate hymen(20.8%), male hermaphroditism( l2.5%), female hermaphroditism(8.3%), pure gonadal dysgenesis(8.3%) and mixed gonadal dysgenesis(8.3%). Traumas inc]ude vulvar laceration (33.3%), vulvar hematoma(33.3%), and vaginal wall laceration(33.3%). Conclusion: We analyzed two hundred forty-four pediatric and adolescent patients who were admitted to Department of Obstetrics and Gynecology, Chungnam Natianal University Hospital from Jan. 1989 to Sep. 1999. The most common disorder was ovarian tumors(43.0%) and followed by pregnancy-associated disorders (20.5%), infectious disorders(l l.5%), congenital abnormalities(9.8%), traumas(7.4%) and miscellaneous(7.8%).

자궁경부 상피내 종양과 자궁경부암 환자에 있어 Telomerase 활성도 발현의 차이에 관한 연구

김진(Jin Kim),이종범(Jong Bum Lee),서영석(Young Suk Seo),남상륜(Sang Lyun Nam) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.10

N/A Objectives: Objective: Cellular immortality is believed to be a critical step in tumorigenesis. As an important component of the telomere maintenance mechanism, the activation of the enzyme telomerase is tightly associated with cellular immortality and cancer. However, little is known about the status of telomerase during human cervical cancer development. To assess the role of telomerase in the development of malignant transformation of the uterine cervix, this investigation was performed. Patients and Methods: Telomerase activity was measured by telomeric repeat amplification protocol(TRAP) assay in 8 cervical intraepithelial neoplasia(CIN) and 24 cervical cancers. The tissue adjacent to the lesions from the same patients was also examined for the presence of telomerase activity. Results: Thirty one of the 32(96.9%) lesions were positive for telomerase activity. In the CIN patients, four of the 8(50.0%) lesions showed moderately to strongly positive activities. In the cervical cancer Ia lesions, five of the 9(55.6%), and beyond the stage Ib lesions, fourteen of the 15(93.3%) showed moderately to strongly positive activities. There was a positive correlation between the grade of the lesion and the telomerase activity(P=0.023). Patient's gravida and telomerase activity also had a positive correlation(P=0.022). Conclusion: Relatively weak telomerase activity was detected in the low grade cervical lesion and strong activity was detected in the high grade lesion. There was a progressive increase of telomerase activity in association with an increased degree of cervical lesion. Patient's gravida also had an association with telomerase activity. These results suggest that the expression of telomerase activity may play a crucial role in cervical carcinogenesis.

난소 기형종에 대한 복강경 및 개복수술의 비교 연구

최지식(Ji Sik Choi),이기환(Ki Hwan Lee),홍달수(Dal Su Hong),민경수(Kyong Su Min),남상륜(Sang Lyun Nam),강길전(Kil Chun Kang) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.8

N/A Objective : The objective of this study was to compare laparoscopic surgery with laparotomy for surgical management of ovarian dermoid cysts. Methods : One hundred and fifteen patients were managed with laparoscopy and eighty two patients were managed with laparotomy. Two groups were compaired for age, marrital status, parity, tumor size, operation type, previous surgery, operating time, blood loss, pre-, and postoperative hemoglobin change, hospital stay, complications and recurrences. Results : Unilateral slapingo-oophorectomy was the most common type of operation in either group. Between twenty one and thirty was the most common age in either group and para 0 in laparoscopy and para 2 in laparotomy group was the most common. Unilateral ovarian cystectomy was significantly more common for para 0 in laparoscopy group (p=0.035). Number of singles were significantly higher in laparoscopy group (p=0.046). Tumor size was significantly larger in laparotomy group (6.1 vs 7.8 cm). Operating time was shorter for unilateral ovarian cystectomy in laparoscopy group. Blood loss, pre-, and postoperative hemoglobin change, hospital stay was significantly less in laparoscopy group. Febrile morbidity was higher in laparotomy group (p<0.001). However no major complications were noted in either group. Conclusion : We conclude that operative laparoscopy has many advantages in the management of ovarian dermoid cysts. However tumor size was a relative limitations for laparoscopy compaired with laparotomy.

한국인에서 자궁경관임신의 치료에 관한 연구

고지환(Jee Hwan Ko),이종범(Jong Bum Lee),오영균(Young Kun Oh),손성경(Song Kyong Son),서영석(Young Seok Seo),이기환(Ki Hwan Lee),남상륜(Sang Lyun Nam),노흥태(Heung Tae Noh),강길전(Kil Chun Kang) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.8

N/A Objective : The study was designed to find out current state of conservative treatment modalities for cervical pregnancies in korean. Method : 64 cases of cervical pregnancies reported by the joining of The Korean Society of Obstetrics & Gynecology from 1960 to 2000 and the 10 cases at Chungnam National University Hospital were analyzed retrospectively. Results : The average age of the 74 cases was 31.7±6.6 years, and the average gestational age at the time of diagnosis was 8.3±3.4 weeks. The average duration of hospitalization was 8.2±4.8 days. Most (67/74) of the patients had previously experienced delivery or abortion. Out of the 74 cases, 36 had total hysterectomy; 4 cases had curettage; 12 were used only methotrexate; 11 had combined curettage and methotrexate; 10 cases had Foley catheter ballooning after curettage. From the 1960's to the end of 1980's, 33 (84.6%) cases out of 39 were performed hysterectomy. Whereas mainly conservative methods, in particular methotrexate treatment, were performed in the 1990's. Among the conservative modalities, Foley catheter ballooning after curettage had the shortest length of hospitalization with 4.3 days. Conclusion : After comparing the conservative methods for treating cervical pregnancies, it was found that methotrexate treatment was performed the most; however, Foley catheter ballooning after curettage seems to be an excellent treatment option.

융모성 질환의 임상적 연구

남상륜,손영선,이영일,노흥태,강길전 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2

Seventy nine cases of trophoblastic disease were analyzed at the Department of Obstetrics and Gynecology, Chungnam National University from January, 1985 to October, 1989. The results are as follows: 1. Incidence of trophoblastic disease was one per 31.8 deliveries(3.15%), and it was pathologically consisted with partial mole(27.8%), complete mole(45.6%), invasive mole (17.7%), choriocarcinoma(8.9%). 2. Age group of 26 to 30 was found most frequent(40.5%) and primipara was the most frequent group(43.0%). There was no increase for the persistent disease according to age and para. 3. Clinical manifestations were vaginal bleeding(91.1%), the most common, nausea and vomiting(20.3%), abdominal pain(10.1%) and etc. 4. Molar pregnancies with excessive uterine enlargement were found in 35.6% and were at increased risk for the persistent disease. 5. Antecedant pregnancies prior to trophoblastic disease were abortion(43.0%), term pregnancy(16.5%) and molar pregnancy(16.5%). 6.β-hCG concentration before November, 1986 was significantly lower than after ten. And the first postevacuation β-hCG level was increased in cases of the persistent disease. 7. The treatment regimens in molar pregnancies were suction curettage with prophylactic Act-D(41.4%) and without Act-D(43.1%), hysterectomy with Act-D(13.8%), and hysterotomy(1.7%). There was no difference in complication persistent disease between with and without prophylactic chemotherapy. 8. Non-metastatic and metastatic low risk patients were treated with hysterectomy with or without MTX-CF(66.7%), curettage with MTX-CF, Act-D or MAC(33.3%) to attain remission without failure. All metastatic high risk patients were treated with hysterectomy with 1-6 courses of MAC triple chemotherapy except 1 case of death from respiratory failure and 1 lost case. 9. Side effects after chemotherapy include gastrointestinal symptoms(91.1%), fever(57.8%), leukopenia(49.0%), hepatotoxicity(46.9%), stomatitis(40%), alopecia(28.9%), thrombocytopenia(15.3%) and etc, in order of frequency.

조기 진통 산모의 혈청 Ferritin치

남상륜 충남대학교 의과대학 지역사회의학연구소 1986 충남의대잡지 Vol.13 No.2

In order to observe the possible correlation of serum ferritin with the premature labor, serum ferritin was assayed using RIA in 15 patients with the premature labor from January, 1986 to October, 1986. The results were as follows. 1. The serum levels of ferritin in patients with the premature labor were : under 28 weeks of pregnancy, 16-20 ng/ml in 3 cases and over 21 ng/ml in 1 case, in 29-32 weeks of pregnancy, 11-15 ng/ml in 1 case and 16-20 ng/ml in 2 case, and over 33 weeks of gestation, 11-15 ng/ml in cases. 2. the serum levels of ferritin in patients with the premature labor was 16.78±3.53 ng/ml and it was not significant comparing to the control group.

진행된 원발성 및 재발성 자궁경부암의 5-FU와 Cisplatinum 병합요법의 반응 및 독성에 관한 임상적 고찰

남상륜,손영선 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2

It has been suggested that synergism between 5-FU and cisplatin could make this combination a useful regiment in treating advanced squamous cell carcinoma of uterine cervix. Between July, 1988 and October, 1989, seventeen patients with advanced or recurrent squamous cell carcinoma of cervix were treated with a chemotherapy regimen consisting of cisplatin 60㎎/㎡ IV, day 1 and 5-FU 1gm/㎡/day as a 12-hour IV infusion, days 1-5 repeated at 3-week intervals. The results are as follows: 1. Of the seventeen patients, 12 were evaluable and 5 were inevaluable because of being lost. 2. Median age of the patients was 52 years(range 34-58). 3. Overall response rate was 83% (10/12), 4 CR’s (33%) and 6 PR’s (50%). And response rates of advanced and recurrent group were 91%(10/11) and 0%(0/1). 4. Analysis of the various prognostic factors revealed that none was significantly related to response. 5. Nausea and vomiting were the most commonly encountered toxic manifestations (100%), bet were easily controlled, and were followed in frequency by alopecia (92%), leukopenia (75%), anemia (42%), diarrhea (33%), stomatitis (25%), abdominal pain (25%) and hepatotoxicity (25%). There was no treatment-related death. In conclusion, combination chemotherapy with cisplatin and continuous infusion of 5-FU seems to be a highly active regimen in the treatment of advanced squamous cell carcinoma of the cervix and deserves to do further investigation of this regimen in treating this disease as a neoadjuvant chemotherapy before surgery of radiation therapy. But more cases need to be evaluated in patients with recurrent cervical cancer.