악성 난소 배세포종양의 임상적 고찰

이승호,이두진,이재열,이영기,이미나,이상원 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.12

영남대학교 의과대학 산부인과학교실에서는 1983년 5월부터 1992년 4월까지 만 9년동안 21예의 악성 배세포종양을 경험하여 다음과 같은 결과를 얻었다. 1. 악성 난소 배세포 종양의 빈도는 21예로 배세포 종양의 10.6%를 차지하였고, 악성 난소종양의 21.9%를 차지하였다. 2. 악성 난소 배세포 종양의 조직학적 분류에 따른 종양의 분포를 보면 내배엽동종양이 7예(33.3%)로 제일 많았으며, 미분화 배세포종과 미성숙 기형종이 각각 6예(28.6%)로 그 다음순이었고 그외 태생암과 양성 성숙기형종에서 유래한 선암이 각 1례(4.8%)씩 있었다. 3. 환자의 연령은 10세에서 73세까지 분포하였고 10대가 가장 많았으며 (57.1%) 평균 연령은 22.7세였다. 4. 임상적 병기의 분포는 I기가 13예(61.9%)로 대부분을 차지하였고 II 기가 1례(4.8%), III기가 5례 (23.8%), IV기가 2례(9.5%) 였다. 5. 발생부위는 좌측 및 우측이 각각 9례식으로 같았고 양측성이 3례 있었다. 6. 2년 생존률은 60%였으며 암기별로는 I기가 75%, II기 이상이 50%였고 조직학적 형태별로는 미분화 배세포종이 66.7%, 내배엽동종양이 33%, 태생암이 100%였다. 7. 난소의 악성 배세포 종양의 예후인자로는 조직학적 형태와 잔류종양의 크기 및 임상적 병기등이 있었다. 8. Disease-free interval 은 내배엽동 종양에서는 10개월에서 50개월이었고 미분화 배세포종에서는 37개월에서 87개월이었다. A clinical study was made on 21 cases of malignant germ cell tumors treated at the Department of Obsterics and Gyunecology in Yeungnam University Hospital between May 1983 and April 1992. The results obtained were as follows: 1. The frequency of malignant germ cell tumor among 96 cases of ovarian cancer in this period was 21.9%, By the histologic type, the endodermal sinus tumor was 7 cases (33.3%), dysgerminoma was 6 cases (28.6%), immature teratoma was 6 cases (28.6%), embryonal carcinoma was 1 case (4.8%) and adenocarcinoma arising in the benign cystic teratoma was 1 case(4.8%). 2. The mean age of the patients at presentation was 22.7 years (10-73 years). 3. The mean tumor diameter was 14.1cm (10-30cm). 4. No site predilection of development of malignant germ cell tumor was identified in this study : raght side in 9 cases (42.9%) left side in 9 cases(42.9%), and bilateral tumor in 3 cases (14.3%). 5. Main clinical symptoms were abdominal pain/discomfort(47.6%), abdominal mass (38.1%) and abdominal distention (14.3%) in order 6. Sixty-two percent (13/21) of malignant germ cell tumors was FIGO stage I at the time of initial diagnosis. 7. Eight of twenty-one patients were treated by surgery alone, 10 of 21 patients by surgery and multiple agent combination chemotherapy, 1 of 21 patients by surgery and radiotherapy and 1 of 21 patients by surgery, radiothery and chemotherapy 8. Two of twenty-one patients underwent second look operation after 9 courses of chemother : All patients had shown surgical complete remission and no patients recurred following negative second look operation. 9. Diseae-free interval was from 10 months to 50 months in EST and from 39 months to 87 months in dysgerminoma. And overall 2-year survival rate of malignant germ cell tumor was 60%. 10. Prognostic factors of malignant germ cell tumor in this study were the clinical stage, the histologic type and the size of residual tumor mass.

유두자극과 양막박리가 지연임신에 미치는영향

이승호,이태형,이영기,김종호,황보호준,이미나,이상원 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.7

지연임신으로 인한 태아와 산모의 위험을 감소시키기 위해 유두자국과 양막박리를 시행한 후 자연진통이 유발되어 지연임신의 율이 감소되는지를 알아보기 위해 1991년 10월부터 1992년 7월까지 영남대학교 의과대학부속병원 산부인과 외래에서 임신 만38주 이상된 산모중 대조군, 유두자극군 그리고 양막박리군을 각각 100명씩을 선정한 후 조사하여 다음과 같은 결과를 얻었다. 1. 지연임신의 빈도는 대조군에서 17%, 유두자극군에서 4% 그리고 양막박리군에서 8%로 유두자극 군과 양막박리군에서 유의하게 감소하였다(p$lt;0.05). 2. 분만시 평균 임신주수는 대조군에서 41.2+_0.9주, 유두자극군에서 40.2+_0.9 그리고 양막박리군에서 40.5+_0.9로 유두자극군과 양막발리군에서 약1주 정도 임신기간이 단축되었다. 3. 실험 시작일로부터 분만까지의 기간은 대조군에서 17.1+_6.1일, 유두자극군에서 10.8+_5.2일 그리고 양막박리군에서 12.2+_5.8이로써 유두자극군과 양막박리군에서 분만기간이 단축되었다. 4. 실험 시작일로부터 1주일이내 분만한 경우는 대조군에서 10%, 유두자극군에서 41% 그리고 양막 박리군에서 30%이었고, 1주이내 부만치 못한 경유 평균 Bishop score의 변화는 대조군에서 0.40+_0.59점, 유두자극군에서 1.35+_0.66점으로 유두자극군과 양막박리군에서 유의하게 높았다 (p$lt;0.05). 5.양수의 태변착색의 빈도는 만기임신의 경우 7.7%, 지연임신의 경우에서 62.1%로 지연임신에서 유의하게 높았다.(p$lt;0.05) 6. 흡인분만과 제왕절개술의 빈도는 지연임신에서 유의하게 높았다(p$lt;0.05) 7. 조기양막파수의 빈도는 만기임신과 지연임신간에는 차이가 없었고, 만기임신 및 지연임신 모두에서 대조군에 비해 유두자극군든 유의한 차이가 없었으나, 양막박리군과 비교했을 때는 유의한 차 이가 있었다(p$lt;0.05). 이상의 결과로 보아 유두자극과 양막박리를 임신만 38주이상된 산모에서 시행하였을 때 지연임신의 발생률을 유의하게 감소시킬 수 있음을 볼 수 있었다. A postterm pregnancy is one sthat persists for 42 weeks or more from the onset of a menstrual peripd. The risks of postterm pregnancy on mother and fetus are greater than those of similar gestations completed at or mear term. An investigation was undertaken to determine that nipple stimulation and membrane stripping could safely reduce the postterm pregnancy. Delivery outcomes of spontaneous labor induced by nippled stimulation and membrane stripping were compared with control group of pregnant women above completely 38 weeks gestational age. The frequency of postterm pregnancy was significantly decreased in the group of nipple stimulation (4%) and membrane strippimg (8%) with control (17%) (p$lt;0.05). The gestational age at delivery was significantly longer in the control group(41.2 weeks) with the nipple stimulation(40.2 weeks) and the membrane stripping(40.3 weeks). The meconium in the amniotic fluid was increased in the postterm pregnancy compared with term pregnancy from 7.7% to 62.1%. The ratio of the vacuum delivery and cesarean section was increased in the postterm pregnancy with term pregnancy(p$lt;0.05). The nipple stimulation and membrane stripping were found to be an inexpensive, simple,noninvasive and effective methods for induction of labor and ripening of cervix.

원발성 난관융모상피암의 1예

이성환(SW Lee),조영래(YL Cho),이규인(K.I Lee),안종호(JH Ahn),이태호(TH Lee) 대한산부인과학회 1982 Obstetrics & Gynecology Science Vol.25 No.2

Primary tubal choriocarcinoma is extremely rare occurance. We had experienced a care of primary tubal choriocarcinoma, 33 year old house wife was thought as ruptured ectopic pregnancy was disclosed primary tubal choriocarcinoma by biopsy following surgery. Brief case history was presented with pertinent literature.

성숙 난소기형종의 임상 고찰

이승호,이두진,박윤기,이영기,이상원 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.8

1983년 1월부터 1994년 1월까지 영남대학교 의과대학 산부인과학교실에서 성숙 난소기형종으로 진단되어 수술을 받은 291명 환자의 병력과 해부 병리학적 고찰을 통해 환자의 나이분포, 발생빈도, 증상, 진단 방법, 종양크기, 양측성 빈도, 종양 표지물과의 관계, 수술방법 등을 분석하여 다음과 같은 결론을 얻었다. 1. 291명의 성숙난소 기형종 환자에서 수술을 시행하였는데 평균 나이는 31.8+-10.6세 이었으며 매년 24.3+-12.2례의 발생빈도를 보였다. 2. 증상별로는 복통 (37.8%) 골반 압박감(33.4%), 무증상 (30.6%), 복부 종괴 촉진 (20.6%) 비정상 자궁출혈(8.9%) 요통(3.1%) 월경곤란증 (2.1%)의 순이었다. 3. 진단은 초음파(73.1%) 내진(21%) 컴퓨터 단층찰영(15%), 자기공명 영상술(1%)을 이용하였다. 4. 평균 종양크기는 8.4+-3.8cm좌측 종양크기는 8.7+-4.1cm 우측 종양의 크기는 7.8+-3.0cm로 위치별에 따른 종양의 크기에는 유의한 차이가 없었고 양측성의 빈도는 16.5%이었다. 5. 난소기형종의 합병증은 염전 7.0%, 파열 4.0%이었고 골반내 유착을 동반한 경우가 15.5% 이었으며 염전 및 파열과 종양의 크기에는 서로 유의성이 없었다. 6. 동반된 종양으로는 자궁근종(5.2%), 반대편 난소에 단순낭종(4.8%)이었다. 7. 종양크기가 클수록 낭종제거술보다 난소제거술을 더 많이 시행하였다. 8. 연령이 증가할수록 자궁절제술을 같이 시행했으며 30세미만의 연령층에서는 98.7%에서 보존적 수술을 시행하였고 ,1989년 이후로는 낭종제거술의 빈도가 증가하였다. 특히 35세이 하로서 종양의 크기가 4.0cm에서 8.0cm 사이인 경우 생식력을 고려하여 난소절제술보다 낭 종 절제술을 더 많이 시행하였다. In order to evaluate the clinical and pathologic presentation of mature cystic treatment and trens in management, 291 cases were analyzed with respect to patient age , annual incidence, symptoms, methods of diagnosis, tumor size, bilaterality and methods of management. The obtained results were as follows. 1. The mean age was found to be 31.86+-10.6year old there were an average of 24.3+12.2 cases per year. 2. The symptoms were abdominal pain pelvic haeviness, palpable abdominal mass, abnormal uterine bleeding backache, dysmenorrhea and the 89cases(30.6%) were asymptomatic. 3. Diagnosis was made by pelvic examination, ultrasonogram. CT and MRI. 4. The mean tumor size was 8.4+-3.8cm and bilaterality rate was 16.5%. The mean cyst diameter for patients undergoing cystectomy was 7.6+-2.8cm ; for oophorectomy, 8.4+-3.8cm ; and for hyserectomy, 8.9+-4.2cm 5. The most common complications of tumor were torsion(7.0%) and rupture(4.0%) and these complications were correlated with tumor size. 6. Mature cystic teratomas were found in association with uterine myoma (5.2%) and functional cyst(4.8%) on the contralateral ovary. 7. When compared to cystetomies ; oophorectomies were performed more frequency for tumors of large than 6cm in diameter(p=0.01). 8. The number of hysterctomies increased with an increasing age. The number of oophorectomies decreased markedly but the number of cystectomies increased since the year of 1989 in the group of mature cystic teratoma under 35 years of age, of which size is between 4.0cm and 8.0cm.

초음파검사에 의한 한국인 태아의 임신주수별 태아성장지표의 정상치에 관한 연구

이재훈,김승욱,이진용,신희철,윤보현,전종관,이성구 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.10

본 연구는 1993년 서울대학교 의과대학 교육연구재단 산부인과학교실 지정연구기금의 보조로 이루어진 것임. Fetal weight and other fetal growth parameter gestational age tables have been calculated for 442 singleton fetuses by ultrasonic measurement. Twin pregnancies, stillborn and malformed infants were excluded as were those born to mothers with diabetes mellitus, preeclampsia, eclampsia and any medical and surgical illness during pregnancy that have any possibilities of altering fetal growth. The 5th, 10th, 25th, 50th, 75th, 90th and 95th percentiles were determined for 25-42th nearest weeks of gestation and compared with preexisting reportes by postnatal study. The results were as follows. 1. Fetal weight calculated by ultrasonic measurement in our prenatal study showed significant difference compared with that in previous postnatal studies before 37th nearest week of gestational age. 2. There were no significant growth velocity deceleration after 40th nearest week of gestational age. It is concluded that any growth standards based on prenatal study by ultrasonic measurement of fetal grwth parameters can be used as our standard without significant problems.

동시에 발생한 자궁의 악성 혼합 뮬러씨 종양 및 자궁내막선암의 1 예

이승호,이두진,박윤기,이영기,김성웅,이용훈,최혜정,최준혁 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.10

본원에서 자궁에 악성 혼합 뮬러씨 종양과 자궁내막선암이 동시에 발생한 1 예를 경험하였기에 간단한 문헌 고찰과 함께 보고하는 바이다. Malignant mixed mullerian tumor (MMMT) of the uterus, which is classified as homologous or heterologous, is uncommon neoplasm composed of malignant epithelial and stromal elements. Adenocarcinoma of the endometrium is presently the most common gynecologic malignancy in the U.S.A. Recently, the incidence of endometrial carcinoma tends to increase gradually in Korea. Concurrence of uterine malignant mixed m llerian tumor and endometrial adenocarcinoma is very uncommon. The authors present a case of concurrent uterine malignant mixed mullerian tumor and endometrial adenocarcinoma with brief review of the literatures.

Urocystitis, pyelonephritis, renal papillary necrosis and chronic tubulointerstitial disease causing chronic renal insufficiency in a Siberian tiger (Panthera tigris altaica): a case report

Lee, SW,Elfadl, AK,Chung, MJ,Arif Ullah, HM,Yuh, DK,Lee, SH,Jeong, KS,Park, JK Czech Academy of Agricultural Sciences 2018 Veterinární medicína Vol.63 No.10

<P>The present case report describes a case of chronic renal failure characterised by renal medullary fibrosis and renal papillary necrosis in a male Siberian tiger (Panthera tigris altaica). A 12-year-old male Siberian tiger presented with depression, anorexia and weight loss. Blood urea nitrogen (&gt; 50.4 mmol/l) and ammonia (71.7 µmol/l) were increased, suggesting chronic renal failure and uraemia. The tiger died secondary to gastric haemorrhage. At necropsy, the kidneys had yellow lesions in the medulla and renal papillae and petechiae in the cortex. The stomach had multiple mucosal ulcers and haemorrhage. Microscopically, marked renal medullary fibrosis and renal papillary necrosis were observed with tubular atrophy, degeneration, coagulative necrosis, calcification and chronic inflammatory cell infiltration. The renal cortex showed moderate interstitial inflammation. The urinary bladder exhibited epithelial desquamation and submucosal fibrosis. The tiger was diagnosed with chronic renal failure secondary to renal papillary necrosis and medullary fibrosis.</P>

Structure-Activity Relationship of Phenylpropanoids on Anti-inflammatory and analgesic activities

SW Moon,HJ Kim,YH Lee,JH Lee,JM Chung,SS Sim,CJ Kim 대한약학회 1999 大韓藥學會 總會 및 學術大會 Vol.48 No.-

Sertoli-Leydig Cell tumor , Poorly Differentiated의 1 례

이근영,강성원,이의열,이예교 대한산부인과학회 1991 Obstetrics & Gynecology Science Vol.34 No.6

저자 등은 poorly differentiated cell type의 sertoli-leydig cell tumor를 가진 22세 미혼여성에서 남성화현상이 나타나지 않으면서, highly malignant clinical progression을 나타내는 1례를 경험하였기에 간단한 문헌과 함께 보고하는 바이다. The Sertoli-Leydig cell tumor is a gonadal tumor of sex-cord type, similar to that seen in the various phase of testicular development in the male. This tumor account for less than 0.4% of all ovarian tumor, exhibit a wider range of patterns and cell types than any other ovarian neoplasms, sometimes resulting in inappropriate therapy. This case has been presented of a 22 years old female who has a stage Ia Setoli-Leydig cell tumor with poorly differentiated. She died about two months after unilateral salpingo-oophorectomy, because of rapid malignant progression with multiple metastasis including retroperitoneal lymph nodes. We present this case with the brief review of literatures.

Preventive effects of Zoledronic acid (Bisphosphonate) on osteoporosis in the Ovariectomized Rat Mod

SW Cha,BJ Song,H Choi,DH Lee,WC Park,SJ Oh,JS Kim,JH Lee,SS Jung 대한외과학회 2004 대한외과학회 학술대회 초록집 Vol.2004 No.10