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김종호(Jong Ho Kim),최석철(Suck Chul Choi),양회생(Hoe Saeng Yang),심재철(Jae Chul Sim),배철성(Cheol Seong Bae),윤혜원(Hae Won Yoon),강민아(Min A Kang) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.3
N/A Objective: The objective of this study was to determine the relationship between the fetal doppler flow velocimetry and birth weight in low risk pregnancy population. Methods: From December 1995 to May 1996, We prospectively performed doppler study in 254 uncomplicated, term pregnant women, who visited Pohang Hospital, Dongguk University. Using pulsed color doppler, we measured umbilical artery RI, middle cerebral artery RI and middle cerebral-umbilical artery RI ratio within one week before delivery. Results: The result was that low birth weight group (below 2500gm) had very significant lationship with umbilical artery RI(P<0.01), middle cerebral artery RI(P<0.05) and middle cerebral-umbilical artery RI ratio(P<0.05), but there was no significant relationship in these blood flow indices between normal birth weight group (2501gm- 3999gm) and macrosomia group (above 4000gm). Conclusions: We concluded that application of doppler ultrasonopaphy in the assessment of fetal weight is somewhat helpful for identification of low birth weight, not for macrosomia.
완전 고환성 여성화증후군 환자에 생긴 Sertoli 세포선종 1 예
강민아(Min A Kang),김종호(Jong Ho Kim),최석철(Suck Chul Choi),양회생(Hoe Saeng Yang),심재철(Jae Chul Sim),김정란(Jung Ran Kim) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.1
Testicular feminization is an uncommon genetic disorder with considerably familial predisposition and results in total feminization due to end-organ unresponsiveness to androgens. It is characterized by the presence of testes in phenotypically female with adequate breast development, normal extemal genitalia, absence of mullerian structures, and meager or absence of body hair. These patients characteristically have male karyotype(XY) and negative sex chromatin and are at increased risk of undergoing malignant transformation of the undescended gonad. In recent times, the malignant potential of the dysgenetic gonads in the intersex patients with a Y chromosome has been stressed by many authors, but few reports of an association between testicular feminization syndrome and benign tumors such as Sertoli cell adenomas. In the present study, postoperative pathology revealed that the gonads were Sertoli cell adenomas. The main features of clinical presentation and histological studies are briefly discussed with a review of the literature.
송용중(Yong Jung Song),윤병선(Byoung Sun Yoon),김현희(Hyun Hee Kim),안준태(Joon Tae Ahn),최석철(Suck Chul Choi),유상영(Sang Young Ryu),김종훈(Jong Hoon Kim),김병기(Byoung Gie Kim),박상윤(Sang Yoon Park),이경희(Kyung Hee Lee) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.12
N/A Objectives : This study is to investigate clinicopathologic characteristics, survival and prognostic factors in patients with Krukenberg tumor of the ovary. Material & Methods : From Jan. 1991 to Dec. 2000, 42 patients with Krukenberg tumor of the ovary were investigated with clinical profiles, such as age, stage, primary sites, clinical symptoms, and survival, retrospectively. Results : A mean age of 42 patients was 44.8 years (range 27-77). Stomach was the most frequent primary site (30/42, 71.4%), followed by colon (7/42, 16.7%) and gallbladder (1/42, 2.4%). In 38 patients, primary sites diagnosed before or after 1 month of diagnosis of Krukenberg tumor of ovary (36/38 cases, 94.7%). The most common feature of patients with Krukenberg tumor of ovary was bilateral abdominal mass. 5-year survival rate of patients with Krukenberg tumor of ovary was 8.94% (95% CI=3.33-14.55) and median survival time was 11 months. Age, bilaterality of tumor, time of diagnosis, presence of ascites and the primary site did not affect the survival. The patients who received post-operative adjuvant chemotherapy had better 3-year survival than those who did not (17.28% vs 10% p=0.03). Conclusion : Krukenberg tumor of the ovary is an aggressive tumor with poor prognosis. Post-operative adjuvant chemotherapy may increase the survival of patients with Krukenberg tumor of the ovary. Further prospective studies for the role of surgery and chemotherapy are needed.
상피성 난소암에서 수술후 일차 항암화학요법으로 시행된 Paclitaxel - Cisplatin 의 효용성에 대한 연구
김상희(Sang Hee Kim),송용중(Yong Jung Song),이향(Hyang Lee),이삼미(Sam Mi Lee),최석철(Suck Chul Choi),유상영(Sang Young Ryu),김병기(Byoung Gie Kim),박상윤(Sang Yoon Park),이경희(Kyung Hee Lee) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.12
N/A Objective : The purpose of this retrospective study is to assess the efficacy and toxicity of paclitaxel/cisplatin as first-line chemotherapy after cytoreductive surgery in patients with epithelial ovarian cancer. Material & Methods : From November 1999 to April 2001, 31 patients with histologically-proven epithelial ovarian cancer not previously treated with chemotherapy entered the study. FIGO stage IA or IB and grade 1 or 2 tumors were excluded. A comprehensive staging was performed during initial laparotomy. Paclitaxel was administered at a dose of 135 mg/m2, intravenously with cisplatin (75 mg/m2) every 3 weeks for 6 planned cycles, with prophylactic oral dexamethasone regimen (20 mg b.I.d.). The response of patients was evaluated with tumor markers and CT before and after chemotherapy. Responses and toxicities were defined according to the Gynecologic Oncology Group (GOG) criteria. Results : The overall response rates were 73% (16/22) in patients with residual disease after cytoreductive surgery (complete response, 64%; partial response, 9%). The median survival was 18 months. Grade 3/4 neutropenia and neuropathy (grade 2) were observed in 16 (52%), 12 (39%) patients, respectively. Conclusion : The combination of paclitaxel and cisplatin is a well tolerated regimen with significant activity in the treatment of epithelial ovarian carcinoma after surgery.
김상희(Sang Hee Kim),김현희(Hyun Hee Kim),송용중(Yong Jung Song),윤병선(Byung Sun Yoon),최석철(Suck Chul Choi),유상영(Sang Young Ryu),이경희(Kyung Hee Lee) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.1
It is estimated that approximately 35% of patients with invasive cervical cancer will have recurrent or persistent disease following therapy. The common metastatic sites of recurrent cervical cancer included the lung, liver and vertebra, however, colon metastases from cervical cancer were extremely rare. Recently we experienced a case of colonic metastasis in a patient with cervical cancer who had been treated with radiation and chemotherapy. We present this case with a brief review of literature.
부대동맥 림프절 또는 쇄골상부 림프절에 국한된 전이가 있는 재발성 자궁경부암 환자들의 예후에 관한 연구
최석철,문형배 동국대학교 의학연구소 1998 東國醫學 Vol.5 No.-
자궁경부암에서 림프절 전이가 병소의 재발이나 환자의 예후에 악영향을 미친다는 것은 주지의 사실이다. 그러나 자궁경부암으로 일차치료 후에 재발한 자궁경부암 환자들 중에서 부대동맥 및/혹은 쇄골상부 림프절에 전이가 있는 환자들의 임상적 특징 및 예후에 대해서는 잘 알려져 있지 않다. 따라서 본 연구는 자궁경부암으로 근치적 전자궁적출술 및 골반림프절 절제술이나 방사선치료 후에 재발한 환자들 중 부대동맥 및/혹은 쇄골상부 림프절에 전이가 있는 환자들의 임상적 특징 및 예후에 대해 알아보고자 하였다. 1991년 1월부터 1995년 12월 까지, 원자력병원 산부인과에서 자궁경부암으로 일차치료 후 전산화 단층촬영 및 세침흡인 세포검사에서 부대동맥 및/혹은 쇄골상부 림프절전이가 증명된 재발성 자궁경부암 환자 55명을 대상으로 하였다. 1. 대상환자 55례 중 부대동맥 림프절에 국한된 전이가 있었던 경우는 31례(56.4%)였으며, 쇄골상부 림프절에 전이가 있었던 경우는 24례(43.6%)였다. 쇄골상부 림프절에 전이가 있었던 24례 중 8례는 쇄골상부 림프절에 국한된 전이가 증명된 경우(Supraclavicnlar lynph node : SCLN only군)였고, 나머지 16례는 부대동맥 림프절 및 쇄골상부 림프절에 전이가 동시에 있는 경우(both군)였다. 2. FIGO 임상병기별 분포는 Ⅰ기 9.1%, Ⅱ기 56.4%, Ⅲ기 32.7%, Ⅳ기 1.8%였다. 세포형태에 따른 림프절 전이율은 편평상피세포형이 96%(53/55)였다. 대상환자 55례 중 22례(40.0%)는 일차치료 당시 이미 골반림프절에 전이가 있었던 경우였다. 대상 환자들의 원발암 치료는 방사선 치료만을 시행 받은 경우가 60.0%(33/55), 방사선 치료와 항암화학요법을 시행 받은 경우가 18.2%(10/55), 수술 및 방사선 치료, 항암화학요법을 시행 받은 경우가 18.2%(10/55), 그리고 수술 및 방사선 치료를 시행 받은 경우가 3.6%(2/ss)였다. 3. 전체 연구대상 환자 55례의 3년 생존율은 14.4%이었으며, 부대동맥 림프절전이군과 쇄골상부 림프절전이군의 3년 생존율은 각각 15.4%, 10.7%이었고, SCLN only군 및 both군의 3년 생존율은 각각 0%, 19.7% 이었다. 결론적으로, 쇄골상부 림프절 전이가 있는 환자는 부대동맥 림프절에 국한된 전이가 있는 환자보다 3년 생존율이 낮음을 알 수 있었으며, 이에 따라 재발성 자궁경부암 환자에서는 쇄골상부 림프절의 전이 유무가 환자의 예후를 추정하는데 중요한 지표가 될 것으로 생각되었다. It is evident from previous reports that in patients with cervical cancer with metastases to lymph nodes have unfavorable outcome, there are, however, few reports have previously been made of the clinical characteristics and prognosis of patients with metastasis limited to para-aortic lymph nodes(PALN) only versus supraclavicular lymph nodes(SCLN) following primary treatment. This paper attempts to discuss the outcome of Patients with recurrent cervical cancer metastasis limited to these lymph nodes. This report is a retrospective analysis of 55 patients with recurrent cervical cancer metastasis limited to para-aortic or supraclavicular lymph nodes following radical hysterectomy or definitive radiation therapy treated at the Korea Cancer Center Hospital, from January 1991 through December 1995. The results were as follows. 1. Of the 55 patients entered, 31(56.4%) had positive nodes on para-aortic area only and 24(46.3%) had positive nodes on supraclavicular area. 8 of 24 patients had limited metastasis to SCLN only and 16 had metastatic nodes on both para-aortic and supraclavicular area. 2. The distribution of patients according to initial FIGO stage were 9.1% in stage Ⅰ, 56.4% in stage Ⅱ, 32.7% in stage Ⅲ, and 1.8% in stage Ⅳ. In 96.4%(53/55) of cases, the histologic type was a squamous cell carcinoma. 22(40.0%) of 55 patients had pelvic lymph node metastasis at the time of initial treatment. The distribution of patients by treatment modalities prior to recurrence was 60.0%(33/55) for patients treated with radiotherapy alone, 18.2%(10/55) for patients treated with combined chemotherapy and radiotherapy, and 18.2%(10/55) for patients treated with combined surgery, radiotherapy, and chemotherapy. 3. The overall 3-year survival rate for patients with positive nodes on para-aortic or supraclavicular area was 14.4%; those who had lymph nodes limited to para-aortic only achieved 15.4%; those who had lymph nodes limited to supraclavicular lymph node achieved 10.7%. Of these, those who had nodes on supraclavicular lymph node only or both supraclavicular and para-aortic lymph node achieved 0% and 19.7% 3-year survival rate, respectively. In conclusion, the outcome for patients with metastasis to supraclavicular lymph nodes was worse than for patients with metastasis to para-aortic lymph nodes only. This suggest that the presence of metastatic carcinoma on supraclavicular lymph node may be a reliable Predictor of probability of survival in such patients.
강민아,김도균,최석철,양회생,배철성,윤혜원,심재철,하달봉 동국대학교 경주대학 1997 東國論集 Vol.16 No.1
Prenatal ultarsound represents an accurate and reliable method for the detection of intrauterine anomalies, especially urinary tract anomalies. Hydronephrosis is the most common congenital condition detected by prenatal ultrasound. Prenatal ultrasonographic diagnosis allows a good condition and therapeutic assessment of the patients prior to serious impairment of renal function so that in most cases the urological surgeon can opt for a parenchymal conserving procedure. The authors have experienced a case of congenital ureteropelvic obstruction with hydronephrosis diagnosed at 32 weeks of pregnancy and report our experience with a brief review of literature.