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- 저자 : 이준환(JH Lee) (검색결과 3 건)
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이준환(JH Lee),박도순(DS Park),황동훈(DH Hwang),조태호(TH Cho) 대한산부인과학회 1967 Obstetrics & Gynecology Science Vol.10 No.10
The terms "Carcinoma in situ", "intraepithelial carcinoma", "non-in-vasive carcinoma", and "stage O cancer" have been used to denote the same pathological process in the epithelium of the cervix uteri. Since 1910 when Rubin described his first two cases of"incipient carcinoma", this condition has been accepted by increasing numbers of cliicians and pathologist as the morphological sequence of events through which the squamous epithelium of the cervix progress before it becomes of the cervix, the methods used for early detection, diagnosis, treatment, and follow-up of care- inoma in situ have heen studied by many authors. There are many reports and clinical reviews on carcinoma in situ of the cervix in other coun- tries but none yet in Korea in spite of great interest in the subject. It is the purpose of this paper to study clinical pictures and pathological findings and compare them with those of other athors. The author selected a total of 67cases of carcinoma in situ of the cervix which were admitted to the Medical Center of Yonsei University over the last five and a half years, from Jan. 1, 1961 to June 30, 196. The results were obtained as follows; 1.Most of cases were detected by Pap. smear or punch biopsy at the first visit. 2.87.2% of 47 cases showed suspicious and positive Pap. Smear and the false negative diag- nosis was 12.8%. 3. The average age incidence was 45 years and was 3 years less than that of invasive cancer. 4. There was minimal to moderate erosion of the cervix in about 50% of cases and 11.9% were normal in gross appearance. 5. 38.8% of all cases had no specific gynecological complaints and in about 70% the chief symptom was abnormal vaginal bleeding. 6. The pathological findings of post-cone bysterectomy specimens showed no residual cancer in 61.8%, residual cancer in 32.7%, atypical hyperplasia in 3.6%, and microscopic invasion in 1.9% respectively. 7. The post-operative morbidity revealed no relationship with the time interval between conization and hysterectomy. there was no significant difference in morbidity compared with the control group. Also although no effect on morbidity was achieved from prophylactic antib- iotics, it has been suggested that further study by made with more cases. 8. 36 patietns among 60 cases which received adequate treatment were followed for 1.7 years on the average, and have lived without recurrence to the present, but further close observation will be needed.
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곽현모(HM Kwak),이준환(JH Lee),이재억(JA Lee),송찬호(CH Song),김형식(HS Kim) 대한산부인과학회 1967 Obstetrics & Gynecology Science Vol.10 No.7
1. 빈도: 임신수 및 분만수에 대한 빈도는 포상기태가 1:113, 1:100, 침윤성기태가 1:1244, 1:1099, 그리고 융모암이 1:124, 1:110이었다. 2.호발연령 및 평균연령은 포상기태에서는 20-29세가 56.6%, 29세이고 침윤성기태는 포상기태와 비슷하였으나 융모암은 30-39세가 40%에, 36세이었다. 3. 중류 및 하류의 경제상황하의 부인층에서 빈도가 단연 높았다. 4. 주요증상; 가장 주요한 증상은 출혈로서 성기이상출혈이 포상기태에서는 96%, 침윤성기태에서는 전예 그리고 융모암에서는 80%였다. 5. 융모암의 최종선행임신은 정상분만이 37.5%, 유산이 20%, 포상기태가 40%, 자궁외임신이 2.5%였다. 6. 전이; 포상기태에선 1예에서 폐전이의 의심이 있었고 침윤성기태에선 2예(50%)에서 폐전이를 발견하였다. 융모암의 경우 87.5%에서 전이를 발견했으며 장기별 전이순은 폐, 질, 골반내장기, 뇌 및 피부 등의 순위 이였다. 7. 치료 : 포상기태; 대부분이 소파술 이었으며 자궁적출술이 11.3%, hysterotomy가 4.5%, 그리고 Methotrexate 사용이 4.5% 였다. 침윤성기태; 3례에서 자궁적출술을 1례에서 Methotrexate를 사용하였다. 융모암; 7.5%에서 자궁적출술, 2.5% 례에서 X-선요법, 25%에서 Methotrexate 요법 그리고 47.5%에서 수술 및 Methotrexate 병합요법을 시행하였으며, 치료를 받지 못한 예가 17.5% 였다. 8. 예후 : 포상기태; 근원당시 사망한 1예(2.3%)를 제외하고는 모두 양호하였으나, Follow up 이 환자들의 불협조로 불량하다. 악성률은 4.5% 였다. 침윤성기태; 근원시 모두 양호하엿으나, 그 중 1례가 재발하여 지입원치료하여 완치되었다. 융모암; 6개월-4년간의 생존률이 30%, 상망률이 45%, 재발률이 15% 였다. This article is the report by the Yonsei University College of Medicine, from June 1,1959 to October 31, 1966. A total of 88 cases were seen with the following distribution: Hydatidiform mole 44, Cho- rioadenoma destruens 4 and Choriocarcina 40. The following features were noted among the patients with hydatidiform mole. Hydatidiform mole occured once in about 113 precancies and 100 diliversies. Patients ranged in age from 22 to 49 of which majority were between 20-29. The average duration of pregnancies was 3 months. The shortest was 28 days from LMP and longest was 7 months. Toxemia was seen in 36% of patients, of which one case died of eclampsia. All cases of toxemia were occured in those moles in which uterus was elarged above the umbilicus. Half of the patients when first seen had uterine enlargement greater than expected by dates while 20% were consistent with their dates and the rest were smaller than their dates. 28% of the patients developed theca lutein cysts. The vast majority of patients were ma- naged by D & E, while hysterectomies were done in 11.3% and methotrexate therapies in 4.5%. 4.5% of patients developed true malignancies. Choriocarcinoma occured once in about 124 pregnancies and 110 deliveries. Patients with choriocarcin- oma ranged in age from 23 to 62. The average age was 36.40% of patients developed after hydatidiform moles, 37.5% after normal spontaneous vaginal delivery, 20% after abortions, and 2.5% after ectopec pregnancr. 22.5% of patients developed theca lutein cysts. 87.5% of cases showed metastatic lesions those were found in the lung in 70%, vagina in 25%, pelvic and adnexa in 10%, and brain in 7.5% Patients were managed by combined therapies as surgery and chemotherapy with methotrexates in 47.5%, chemotherapies with methotrexates alone in 25%. 17.5% of patients could receive no specific therapy for choriocarcinoma. At present 6 months to 4 years survival rate was 30%, mortality rate was 45% and recurrent rate was 15%.
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문영기(YK Moon),오성규(SK Oh),이준환(JH Lee),홍성선(SS Hong) 대한산부인과학회 1965 Obstetrics & Gynecology Science Vol.8 No.9
The Shirodkar operation were performed on 19 cases with incompetent internal os of the cervix in pregnancy. These cases were seen at Yonsei University Hospital between February, 1959 and August, 1964. However the following 2 cases showed abnormal tissue reactions around the cervix which disturbed the normal courses of labor. Vaginal deliveries following Shirodkar operation were 80% successful. Corrected data showed 93.3% Shirodkar operation and trachelorrhaphy are needed in cases of incompetent internal os with deep cervical laceration.
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