안드로겐 과잉증 , 인슐린 저항성과 흑색극세포증 ( HAIR-AN ) 증후군 1 례

김기태(KT Kim),박주진(CJ Park),김유곤(YK Kim),장봉림(BR Jang),박양서(YS Park),김현규(HG Kim),김두만(DM Kim) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.11

The HAIR-AN syndrome affects between 2% and 5% of hirsute women and is charactedrized by elevated insulin levels due to insulin resistance, acanthosis nigricans, and hyperandrogenemia. The insulin resistance and compensatory hyperinsulinemia is typically due to a decreased number of insulin receptors, decreased functional activity of the receptor or circulating antiinsulin receptor antibodies. Multiple, independent lines of evidence support that chronic hyperinsulinemia causes ovarian hyperandrogenism. Acanthosis nigricans is considered a marker for insulin resistance in hirsute women. Although the association between hyperinsulinemia and hyperandrogenism remains to be fully explained at the molecular level, chronic hyperinsulinemia appears to be an important cause of hyperandrogenism.

양성 난소기형종에서 발생한 편평상피세포암 2 례

김기태(KT Kim),강정배(JB Kang),허진숙(JS Hur),김홍배(HB Kim),이근영(KY Lee),강성원(SW Kang),박양서(YS Park),심정원(JW Shim) 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.7

The dermoid cyst is one of the most common ovarian neoplasm. Due to the wide variety of tissues present derived from all three germ layers, many different types of cancer may be anticipated. Squamous cell carcinoma is by far the most common malignancy. Histogenetically, squamous cell carcinoma in mature cystic teratoma has been considered to arise either from the epidermis or from the respiratory epithelium in a teratoma, although the exact origin remains controversial. The prognosis is generally poor. We experienced two cases of squamous cell carcinoma arising in benign cystic teratoma of the ovary, and report these cases with a brief review of the concerned literatures.

경계성 난소상피종양에 대한 임상적 고찰

김현찬(HC Kim),김기태(KT Kim),김우경(WK Kim),오희연(HY Oh),최영태(YT Choi),한지원(JW Han) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.11

A clinical and pathological study was made on a series of 34 cases of borderline epithelial ovarian tumors, which were managed at Pusan Paik Hospital of InJe university, from January 1985 to December 1996. The results obtained as follows: 1. The incidence was 19.9%(34/171 cases) among all epithelial ovarian malignancies. 2. Age distribution was between 14 and 78 years old, mean age was 37 years old. 3. As for the parity, nulliparity was most common(38.2%). 4. Abdominal discomfort(58.8%), palpable mass(41.2%) and abdominal distension(41.2 %) were the main symptoms. 5. As for the FIGO stage, 29(85%) cases were at Ia, 2(5.9%) cases at Ic, 1(2.9%) case at IIc, at IIIb, at IIIc, respectively. 6. The most common histological type was mucinous, 28(82.4%) cases, the next was serous, 5(14.7%) cases. 7. Among the surgical staging procedures, the positive rate of peritoneal cytology was 29 %(5/22) and that of omentectomy was 12.5%(2/16). 8. Twenty one(61.8%) cases were managed by conservative operation and 13(38.2%) by extirpative operation, and postoperative chemotherapy was given in 2 cases. 9. Follow-up was possible in 27(79.4%) cases. The duration of follow-up ranged from 7 to 115 months. Mean duration was 32.9 months. The presumed 5 year survival rate was over 85%.

난소낭종흡인으로 치유한 중증 난소과배란증후군 8 예

김인수(IS Kim),김기태(KT Kim),박찬우(CW Park),김경택(KT Kim),김유곤(YK Kim),장봉림(BR Jang),이우영(WY Lee),박양서(YS Park) 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.11

The 8 cases of severe ovarian hyperstimulation syndrome among 78 cases of ovulation induction by gonadotropins at the Department of Obstetrics and Gynecology, Hallym university from January 1, 1993 to August 31, 1995 were treated by ovarian cyste aspiration and reviewed. The results were summarized as follows: 1. The origin of ovarian hyperstimulation syndrome is in the ovaries. 2. Aspiration of the ovarian cysts in the severe ovarian hyperstimulation syndrome was safe and not only relieved the symptoms but also shortened the disease process, and allowed outpatient treatment.

진행된 국소 자궁경부암에서 선행 항암요법의 효과

김용학(YH Kim),유병규(BK Yoo),김기태(KT Kim),김현찬(HC Kim) 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.9

To evaluate the therapeutic potential of cytotoxic therapy in patients with cervical cancer, 57 previously untreated patients with bulky mass (more than 3 cm) in stage Ib, IIa, and IIb locally advanced cervical cancer were treated with three courses of induction chemotherapy of Cisplatin and 5-FU combined regimen and placed on subsequent radical surgery or radiation therapy during Jan. 1, 1988 to April 31, 1990. The results were obtained as follows. 1. As to the response rates, complete response was seen in 22 cases (38.6%), and partial response in 30 cases (52.6%), so the total response rate was 91.8%. 2. The rewponse rates seemed to increase in the lower clinical stage than the higher and the smaller size of the lesion than the bigger. 3. Thirteen cases of the 48 surgical specimens (27.1%) were found to be histologically free of disease. 4. The overall incidence of surgically documented nodal metastasis was found to be 29.1% and higher incidence was found in advanced clinical stage and poor responders. 5. Patients achieving complete response (CR) to induction chemotherapy with subsequent radical surgery had much more improved mean 2 year disease free survival rate compared with those who had radiation therapy after CR. 6. Toxicities encountered during chemotherapy were nausea and vomiting, alopecia, bone marrow depression, hepatotoxicity, nephrotoxicity, etc. and well tolerated in most of cases except one case of death due to severe bone marrow depression and septicemia. Conclusively, this preliminary study suggests that Cisplstin and 5-FU combination, followed by radical surgery is one of the most effective and beneficial treatment methods in the management of some patients who are at high risk for failure with conventional treatment. It is still necessary to take well designed prospective long term study with longer follow-up to define which modality of treatment could positively influence prolonged disease free survival.

거대 난소낭종 1 예

최영태(YT Choi),안수현(SH Ahn),김영남(YN Kim),김우경(WK Kim),성문수(MS Sung),김기태(KT Kim),김현찬(HC Kim) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.10

A case of huge ovarian cyst in 30-year old woman is presented with a brief review of literature. This tumor was measured 60×60×30 cm in size, and weighed 75 kg. The pathologic diagnosis was mucinous cystadenoma, borderline malignancy, left ovary.

산후 난소정맥혈전성정맥염의 1 예

최원배(WB Choi),최훈(H Choi),김기태(KT Kim) 대한산부인과학회 1988 Obstetrics & Gynecology Science Vol.31 No.2

인제의과대학 부속 부산백병원 산부인과에서 쌍태임신의 제왕절개분만후 발생한 난소정맥혈 전성정맥염을 임상적 제반 소견과 heparin 및 항생제를 투여하여 진단 및 치료한 1례를 경 험하였기에 문헌적 고찰과 함께 보고하는 바이다 Puerperal ovarian vein thrombophlebitis (POVT) has been thought to be a rare postpartum complications and usually presents as a syndrome consisting of lower abdominal or flank pain fever, and a deep tender mass the thrombosed ovarian vein , The right ovarian vein is involved far more often than the left and uterine infection is present or suspected in a sizable number of cases before or at the onset of symptoms of POVT. Diagnosis is made by laparotomy (80%) or clinical ground(20%) . treatment requires administration of broad spectrum antibiotics, intravenous heparin, ovarian vein and vena cara ligation in selected cases. We present a case of POVT of which diagnosis is based on the compatible clinical finding and response to heparinization with a brief review of literatures

고위험군 융모성질환에서 EMA-CO요법의 치료 결과

최상림(SL Choi),김용학(YH Kim),김기태(KT Kim),김현찬(HC Kim) 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.1

Eighteen patients of high-risk(mean risk score of 10.6±2.5) gestational trophoblastic dsisease had been treated (Jan. 1986∼Dec. 1989) with EMA-CO regimen. The results could be summarized as follows : The sustained remission rate (mean duration of follow up, 20.0±10.4 months) was 88.9% with mean applied course of 6±2, and additional 1.9 courses of chemotherapy. The toxicity of EMA-CO regimen was relatively frequent, in order of frequency, alopecia and nausea(100%), bone marrow depression(94.4%), vomiting(77.8%), stomatitis(33.3%) etc. However it could be manageable and tolerable for scheduled course of chemotherapy. EMA-CO regimen was not satisfactory on one case of previous failed chemotherapy(risk scor of 13) and the other case of multiple metastasis of brain, kidney and lung(risk score of 15). BEP regimen was appleid on those cases but could not achieve remission. As a conclusion, we could believe that EMA-CO regimen was quite effective one with tolerable toxicity and we also could suggest combination chemotherapy, consisted of etoposide and cisplatin, from the outset on ultra high-risk group (risk score over 13 or/and multiple site of metastasis, brain etc.).

자궁경부 상피내종양(CIN III)의 진단과 치료에 관한 임상 및 병리학적 고찰

유병규(BK Yoo),이정형(JH Lee),이재영(CY Lee),이은관(EK Lee),김기태(KT Kim),김현찬(HC Kim) 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.3

To evaluate the outcome of diagnostic procedures and treatments, a clinical and pathological observation was made on the 162 cases of CIN III(from June 1, 1980 to December 31, 1990) which were confirmed by the pathological examination of surgical specimens. The results were as follows: The majority were belong to the age group of 30~49 (75%), married, multiparous and non user of contraception. The mean age was 41 and mean age of marriage was 22.4. About one-fifth were menopaused. The main presenting symptoms were leukorrehea (37%), lower abdominal discomfort (30.9%), vaginal spotting (22.2%) and post coital spotting (16.7%). About one-fifth were asymptomatic and detected by incidental routine check up. The most common gross finding was erosion (66.7%) and the others were chronic inflammation with hypertrophy (14.8%), acute inflammation (11.1%). Some cases (5%) disclosed grossly malignant looking, otherwise, the cervix were grossly innocent in 20%. The cytologic reports were exactly in accord with pathologic findings of surgical specimens in 63%. The corresponding within one histologic degree was about 87.1%. The colposcopy showed abnormal finding in 68.7% of the cases. The most common one was white epithelium (57.8%) and the others were punctation (32.8%), mosaicism (17.2%), atypical vessel (10.9%), leukoplakia (1.6%) in order. Those findings were present and mixed together in two third of the cases. Based upon Pap. Smear, colposcopy with aimed biopsy and conization of the selected cases, the corresponding rate between pre-treatment diagnosis and that of surgical specimen was 98.2%. The majority (79%) was treated by hysterectomy and the others by conization or local destructive measures. As to the post treatment complications, the most common one was vaginal vault granulation (28.1%) and the next was cystitis (14.1%). The others were less than 10%, respectively and not problematic. One case of recurrence was encountered during the mean follow up period of 37 months. Because of insufficient follow up, the status and rate of recurrence are remained to be evaluated by further follow up.

난소 낭성기형종에서 발생한 편평상피세포암 2 례와 선세포암 1 례

민유선(YS Min),이병준(BC Rhee),정인석(IS Jung),최정미(JM Choi),김기태(KT Kim),김현찬(HC Kim) 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.9

The mature cystic teratoma is the most common ovarian neoplasm arising in young women. The vast majority of them benign: however malignant transformation has been reported to occure in 1-2% of these lesion. The malignant neopalsms arising in mature cytic frequency . We experinced two cases of squamous cell carcinoma and one case of adenocarcinoma arising in mature cystic teratoma of the ovary and report these cases with a brief review of the literatures.