Two Noble heparin lyases from Bacteroides stercoris HJ-15, a human Intestinal Bacterium

BT Kim,WS Kim,YS Kim,DH Kim 대한약학회 1999 大韓藥學會 總會 및 學術大會 Vol.48 No.-

자궁경부 상피내종양의 진단 및 치료에 Cold-Knife 원추생검과 Cold-Coagulation 병합술식의 효능

김병기,박상윤,김종훈,박기복,이경희,이의돈,이경화,김병택,전영숙 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.9

This study was performed to demonstrate the efficacy of combination of cold-knife conization and cold-coagulation for the treatment of cervical intraepithelial neoplasia(CIN). In addition, the accuracy of the colposcopic biopsy and Pap smear compare to conization was determined. Cold-coagulation was performed simultaneously in 151 patients after cold-knife conization for diagnosis and treatment of CIN from Jan. 1995 to Dec. 1996. Medical records and pathologic slides of those patients were reviewed. Histologic comparison between the Pap smear and conization specimens showed agreement with 70 % within one grade difference ; Histologic comparison between the colpodirected punch biopsy and conization specimens showed agreement with 80 %. The margin involvement of conization was seen in 35 patients(23 %). There was a tendency of increasing rate of positive cone margin with grade of the lesion : 14 %(1/7) in CIN 1, 20 %(2/10) in CIN 2, 35 %(31/88) in CIN 3, and 33 %(1/3) in microinvasive cervical cancer. Among these 35 patients, 11 patients underwent hysterectomy and showed residual disease in 4 patients(36 %). Recurrence of CIN was found in 4 patients(16 %) with positive cone margin and 1 patient(0.9 %) with negative cone margin. Bleeding was observed in 13 patients(9 %). Two patients underwent hysterectomy because of severe bleeding. These results suggest that cold-knife conization with cold-coagulation is an effective procedure to reduce recurrence rate of the patients with CIN regardless of status of cone margin and to reduce the severity of bleeding after conization.

재발성 자궁경부암 진단시 부대동맥 혹은 쇄골상부 림프절의 전이를 가진 환자들의 예후에 관한 연구

김병기,박상윤,김종훈,박기복,이경희,이의돈,이경화,김병택,최석철,전영숙,김병섭 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.11

This study was performed to evaluate the survival of the patients found to have metastasis only to the para-aortic or/and supraclavicular lymph nodes at the time of diagnosis of recurrence of the cervical cancer. In addition, the survival was compared between the patients metastasis limited to the para aortic or/and supraclavicular lymph nodes only and those having other concurrent metastatic sites. From Jan. 1991 to Dec. 1995, total 105 patients were identified to have metastasis of para-aortic or/and supraclavicular lymph nodes by computerized tomography(CT) scan or/and percutaneous needle aspiration cytology. Their medical records and cytologic slides were reviewed. The information about survival and disease status was obtained from the last follow-up date in medical records or from interview via telephone. Forty-one(39%) patie-nts showed para-aortic node metastasis;23 patients(22%), supraclavicular node metastasis; 41(39%) patients, para-aortic and supraclavicular lymph node metastasis. Thirty-one(76%) of 41 patients involving para-aortic lymph node metastasis showed recurrent disease limited to the lymph nodes only; Eight(35%) of 23 patients with supraclavicular lymph node metastasis and sixteen(39%) of 41 patients with both lymph nodes metastasis showed lymph node metast-asis only. Supraclavicular lymph node metastasis was found concurrently in 41(50%) of 82 pa-tients with para-aortic lymph node metastasis at the time of recurrence. Forty-two patients(40 %) had been found to have previous pelvic lymph node metastasis at the time of initial treatm ent of the cervical cancer. The 3-year survival was 13.9% in patients with para-aortic lymph node metastasis;0% with supraclavicular lymph node metastasis;20.3% in para-aortic and supraclavicular lymph node metastasis. In addition, 3-year survival rate was not significantly different among the groups with different lymph node metastasis. Furthermore, there was no difference in the 3-year survival rate between the patients with lymph node metastasis only and those with other concurrent metastatic sites. These results showed that survival of the patients with metastasis to para-aortic or/and supraclavicular lymph nodes only at the time of diagnosis of recurrent cervical cancer may be still poor and was not different compara to that of the patients with other concurrent sites of metastasis.

자궁경부암 환자에서 발생한 다발성 원발 악성종양의 임상적 고찰

김병기,박상윤,김종훈,박기복,이경희,이의돈,이경화,김병택,최석철,전영숙 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.9

1976년 1월부터 1995년 12월까지 원자력병원 산부인과에서 자궁경부암으로 진단 후 치료받았던 환자들 중 진단시 자궁경부암과 다른 원발성 악성종양을 가진 중복암과 진단 전후로 다른 원발성 악성종양이 발생된 이차암군인 20명의 환자를 대상으로 다음과 같은 결과를 얻었다. 1. 자궁경부암과 동반된 다발성 원발 악성종양은 전체 20예였고, 이들의 중앙연령은 51세였 으며 syn- chronous 유형의 경우는 이들 중 8예 이었고, 12예가 metachronous 유형이었다. 2. 다발성 원발 악성종양 환자에서 발생한 자궁경부암의 FIGO 임상병기는 1기가 6예, 2기가 9예, 3기가 5예 였으며 20예 모두에서 병리조직학 분류상 침윤성 편평세포암이었다. 3. 자궁경부암과 동반된 다발성 원발 악성종양의 호발 부위는 자궁으로 20예 중 8예에서 발 생하였는데 1예에서 자궁내막 기질육종이 발생하였고, 1예에서 자궁내막 선암이 발생하였다. 과거 방사선조사의 기왕력이 있었던 6예에서 악성 혼합성 중배엽종양이 발생하였는데 이는 악성 혼합성 중배엽종양이 방사선치료와 강력한 연관성이 있음을 시사한다. 4. Synchronous 유형의 경우는 모두 8예로 이들 중 4예에서 치료 전 검사기간 동안에 진단 되었고 수술 중 또는 수술 후 병리조직 검사상 진단된 것이 3예로 대부분 조기에 진단된 경우였다. 이들 중 7예의 환자는 현재 무병생존 중이며 환자의 외래 추적검사 기간은 24개 월에서 9년 4개월(중앙값, 27개월)이었다. 5. Metachronous 유형의 경우는 모두 외래 추적검사 기간 중 진단되었으며 자궁경부암 진 단 후 1년에서 18년(중앙값 ; 9년 4개월) 후에 이차암이 진단되었다. 이들 이차암은 synchronous 유형보다 다소 진행된 병기에서 진단되었으며 이들 12예 중 유방암의 경우만 무병상태로 생존해있으며 나머지 11예는 이차암으로 인해 사망하였고 생존기간은 3년 9개 월에 19년 3개월(중앙값 ; 9년 6개월) 이었다. 6. Metachronous 유형 중 방광암 1예, 직장암 1예가 이차암으로 발생하였는데 이는 이전 자 궁경부암의 방사선 조사부위 내에 발생한 경우로 방사선치료와의 관련성을 예시한다. 이상의 결과로 보아 자궁경부암 환자에서 다발성 원발 악성종양에 대한 정기적 검진이 꼭 필요하다고 생각되지는 않으나 방사선치료를 시행한 환자에서는 방사선조사 부위내의 이차 암 발생에 대한 가능성은 항상 고려하여야 할 것으로 사료된다. Background : Knowledge about the degree of risk and location of multiple primary cancers can facilitate the targeting of screening and surveillance practices on follow-up after treatment of cervical cancer. Purpose : The retrospective study was performed to evaluate the characteristics of multiple primary malignancies in patients treated for cervical carcinoma. Method : From data base file of gynecologic cancer patients between 1976 and 1995, total 20 patients were found to have cervical cancer and another primary malignancy. Their medical records and pathologic slides were reviewed. Follow-up information was obtained from medical records or by telephone. Result : There were 8 synchronous and 12 metachronous multiple primary cancers (MPC) among 20 patients. Their mean age was 51 years (range 23 ∼ 68 years). The distribution of FIGO stage of the patients with cervical cancer was classified into stage I, 6 patients; stage II, 9 ; and stage III, 5. All patients showed squamous cell type histology of cervical cancer. Eight(40 %) of 20 patients developed second cancer in uterus : 6 malignant mixed Mllerian tumors(MMMT), one endometrial stromal sarcoma, and one endometrial adenocarcinoma. Seven of 8 synchronous type MPC patients are alive (median follow-up, 27 months). In contrast, only one out of 12 metachronous type MPC patients is alive(median follow-up, 114 months). The occurrence of eight malignancies including 6 MMMT, one bladder cancer, and one rectal cancer might be related with previous radiation therapy for cervical cancer. Conclusion : These results suggest that routine screening and surveillance work-up might not be necessary in most of patients with cervical cancer. However, the patients with cervical cancer undergoing radiation treatment have to be followed carefully with the consideration of possibility for developing second cancer in the field of irradiation.

Oral Care Practices for the Mechanically Ventilated Patients in the Critical Care Units

Kim Lam Soh,Sazlina Bt Shariff Ghazali,Kim Geok Soh,Sharifah Shafinaz Bt Sharif Ab 한국간호과학회 2007 한국간호과학회 학술대회 Vol.2007 No.11

미성숙 기형종이 성숙 기형종으로 전환된 증례 1 례보고

김병기,박상윤,김종훈,박기복,이경희,이강현,이의돈,이승숙,황대용,김병택,최동욱 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.11

본원 산부인과에서는 미성숙 기형종이 VBP 치료후 성숙기형종으로 전환되면서 원발부위의 직장과 방광벽의 침윤이 있고 또한 간, 신장, 피질 및 횡경막 침윤이 있었던 경우를 경험 하였기에 문헌적 고찰과 함께 보고하는 바이다. A 24-year-old female was found to have a malignant immature teratoma of the ovray 4 years ago. Treatment involves surgical resection followed by chemotherapy , 4 years later, bulky low abdominal mass was detected and treated with multiple-agent chemotherapy resulting in transformation or evolutin into a mature teratoma form of disease. Usually retroconversion present during the first year of diagnosis. We report a case of retroconversion of immature teratoma into mature teratoma 4 years following chemotherapy for grade II immature ovarian teratoma. The benign tumor unusually invaded the abdominal wall, bladder muscle, rectal muscle, and diaphragmatic muscle. The CT scan, MRI appearance, incidence, and biological significance of this phenomena are discussed.

IEC 표준기반 지능형 전력시스템 시각동기 최적화 구현방안 및 정밀도 시험 연구

김석곤(SK Kim),김남대(ND Kim),김우중(WJ Kim),박유영(YY Park),이창섭(CS Lee),이남호(NH Lee),장병태(BT Jang) 대한전기학회 2023 대한전기학회 학술대회 논문집 Vol.2023 No.7

IEC 표준기반 지능형 전력시스템 시각동기 최적화 구현방안 및 정밀도 시험 연구

김석곤(SK Kim),김남대(ND Kim),김우중(WJ Kim),박유영(YY Park),이창섭(CS Lee),이남호(NH Lee),장병태(BT Jang) 대한전기학회 2023 대한전기학회 학술대회 논문집 Vol.2023 No.7

자궁의 동정맥기형에 의한 산후출혈 1 예

김승룡,이재억,조수현,홍은경,황정혜,박병태 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.7

자궁의 동정맥기형은 1926년 Dubreuil등이 처음 보고한 이래 지금까지 30예 밖에 보고되지 않은 매우 드문질활으로 국내에서는 아직 보고된 바 없다. 이 질환은 주로 비정상 자궁출혈을 초래하며 임심시에는 다량의 산후출혈을 유발할 수 있으며 이 경우 소파술은 출혈을 더욱 악화시킨다. 동맥조형술, 자궁경 또는 초음파검사로 진단이 되나 대부분이 자궁적출 후 조직병리검사로 확인된다. 저자들은 최근 제왕절게 분만한 2주일후부터 심한 자궁출혈이 있어 내원한 24세 초산부에서 전자궁 적출술을 시행하여 자궁혈관기형이 확인된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Arteriovenous malformation of the uterus is extremely rare and only 30 cases have been reported in literature. A patient presented with massive postpartum bleeding which was aggrevated after curettage and was treated with total abdominal hysterectomy.

자궁경부암 항암제치료 환자에서의 Bleomycin Induced Pulmonary Toxicity 4 례

김승조,남궁성은,김세일,문봉태,홍경선,정난주,신진웅,이경숙 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.2

Bleomycin 사용으로 인한 폐 섬유화로 인하여 사망한 4례를 관찰한 결과 폐독성은 투여량에 반드시 비례하지는 않았다. Bleomycin에 의한 폐독성의 증상이 나타났을시에는 전례에서 치료에 반응하지 않고 급속히 사망하였다. 저자들은 항암효과가 탁월하고 cost effective한 항암제인 bleomycin의 사용으로 인한 폐섬유화증에 의한 사망 4례를 보고하며, 이 약제의 계속적인 사용이 필요한지 또는 부작용을 줄이며 효과면에서는 대등하다고 하는 대체 약제를 선택하여야 할 지 등에 대한 문제를 제기하는 바이다. Bleomycin has been widely used as chemotherapeutic agent for the treatment of uterine cervical cancer, Hodgkin`s disease, Malignant lymphoma and squamous cell cancer of skin, esophagus and Lung. Although Bleomycin has side effects of headache, nausea, vomiting and high fever and toxicities of skin pigmentation, hyperkeratosis and skin ulceration but most of all, interstitial pulmonary fibrosis is the most serious complication. From October, 1984 to August, 1990 in the Department of Obstetrics and Gynecology, Catholic University Medical College, we experienced 4 cases of death from Bleomycin induced pulmonary fibrosis during the courses of combination chemotherapy of VBP in patients with cervical cancer. Mean age was 51.8 and clinical stages were Ⅱ1, Ib, Ⅱa and Ⅲ (as FIGO classification). In case 1 the patient received radiation therapy concurrently with chemotherapy. In case 2 the patient received chemotherapy before and after radical hysterectomy. In case 3 the patient received chemotherapy after modified radical hysterectomy and radiation therapy. In case 4 the patient received chemotherapy after radiation therapy. Mean amount of administered Blecomycin was 343.8mg and mean duration from initial use of Bleomycin to the symptom apperance of pulmonary fibrosis was 7 and half months. Mean durations from appearance of symptom of pulmonary fibrosis to death was 3 weeks.