• Clinical and Experimental Reproductive Medicine
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• 제34권3호
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• pp.167-172
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• 2007

목 적: 본 연구는 청소년기와 성인 미혼 여성에서의 자궁내막증의 특징을 비교해 보고 청소년기에 조기 발견 및 치료의 중요성에 대해 알아보고자 한다. 연구방법: 000년 1월부터 2007년 9월까지 대구 소재 두 대학병원을 방문하여 수술을 시행한 환자를 대상으로 청소년 (14$\sim$21세, 23예)과 성인 미혼 여성 (22$\sim$26, 107예)의 자궁내막증의 임상양상, 진단과정, 수술소견, 혈액검사소견(CA-125) 등을 의무 기록 분석을 통한 후향적인 방법으로 비교하였다. 결 과: 대구 지역 청소년은 cyclic pain을 주증상으로 흔히 호소하였다. 청소년은 52.2%가 stage I, II였으며, stage III는 47.8%, stage 4는 없었다. 반면에 성인에서는 stage I이 1.86%에 불과하였으며, stage II 및 stage III가 82.2%로 대다수를 차지하였으며 stage IV도 15.8%차지하였다. 청소년에서도 CA-125가 상승되어 있는 경우가 많았고 이를 병의 경과 관찰에 이용할 수 있을 것이다. 청소년에서 순수 자궁내막증을 의심하여 수술한 경우는 전체 23예 중에 10예에 불과하였으며 이외 13예는 다른 진단으로 시행한 수술에서 우연히 발견되었다. 이는 전체 56.5%로 많은 비중을 차지하며, 성인 여성에서 27.5%에 불과한 것과는 대조적이다. 결 론: 대구 지역 청소년들을 대상으로 시행한 이번 연구에서는 청소년기에서 주기성 통증이 우세하였으며 이는 임상증상 만으로도 조기 발견에 도움이 될 수 있을 것이다. 자궁내막증은 진행하는 병임은 틀림없으므로 만성 골반통이 있는 청소년을 대상으로 적절한 산부인과적 검사를 통한 조기 진단 및 치료가 중요할 것으로 사료된다.

• Radiation Oncology Journal
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• 제10권1호
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• pp.43-48
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• 1992

1989년부터 1989년까지 인제대학교 의과대학 서울백병원에서 25명의 환자가 수술 및 술후 방사선치료를 받았다. 25명의 환자가 고찰이 가능하였고, 이중 II병기에 7명, III병기에 14명, 그리고 IV병기에 2명이 속해있었다. 21명의 환자가 변성근치유방절제술을, 2명의 환자가 단순유방절세술을 실시하였다. 추적관찰기간은 2년에선 8년이었다. 전체군에서의 국소치유율은 $83\%$이었다. 전이된 액와임파절의 수가 국소치유에 영향을 미치고 있었다. 전이된 임파절이 없거나 3개 이하의 임파절을 갖고 있는 환자의 국소치유율은 $100\%$,이고, 4개 이상을 갖고 있는 환자에서는 $72\%$이었다. 전체환자군의 5년 생존율은 $59\%$이고 5년 무병생존율은 $32\%$이었다. 각 병기에 따른 5년 생존율은 II병기에서 $83\%$, III병기에서 $59\%$, IV병기에서 $50\%$이었다. 원격전이는 23명중 10명에서 발생하였고 가장 빈발부위는 골부위였다. 결론적으로 술후방사선치료가 실패율이 높은 유방종양환자의 치료에서 중요한 역할을 하고 있었다.

• Clinical and Experimental Reproductive Medicine
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• 제33권4호
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• pp.219-227
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• 2006

목 적: 자궁내막증이 체외 수정에 미치는 영향에 대하여 알아보고, 자궁내막증의 체외 수정 결과의 차이에 대해 살펴보고자 하였다. 연구방법: 1994년부터 2004년까지 제일병원 아이소망센타에서 자궁내막증으로 체외 수정을 시술 받은 697명의 환자 (총 1,199주기)를 후향적으로 연구하였다. 경증의 자궁내막증은 638주기, 중증의 자궁내막증은 561주기였으며, 난관 요인을 가진 325명 (459주기)를 대조군으로 하였다. 제외 기준으로는 여성의 나이가 35세 이상, basal FSH level이 20 mIU/ml 이상인 경우, 심각한 남성 요인의 경우를 제외하였다. 결 과: 중증의 자궁내막증은 난관 요인 보다 획득된 난자의 수 ($9.97{\pm}7.2$ vs. $13.4{\pm}7.9$ (p<0.0001)), 총 배아 수 ($6.5{\pm}4.8$ vs. $9.1{\pm}5.6$ (p<0.0001)), 양질의 배아 수 ($2.43{\pm}1.6$ vs. $2.74{\pm}1.7$ (p=0.013))가 통계적으로 유의하게 낮았다. 하지만, 중증의 자궁내막증의 임신율은 난관 요인과 유사하였다 (35.7 vs. 36.8 (%)). 경증의 자궁내막증은 중증의 자궁내막증과 난관 요인보다 불임 기간이 길었으며 ($55.4{\pm}25.7$ vs. $47.6{\pm}25.6$ vs. $44.4{\pm}30.9$ (개월) p<0.0001)), 수정률이 의미 있게 낮았으나 ($64.8{\pm}22.9$ vs. $69.9{\pm}22.5$ vs.$70.8{\pm}20.8$ (%) (p<0.0001)), 임신율에 유의한 차이는 없었다 (31.1 vs. 35.7 vs. 36.8 (%)). 또한, 체외 수성 이전에 치료 받은 병력이 있던 경증과 중증의 자궁내막증 (363주기 vs. 470주기)은 경증의 자궁내막증에서 중증의 자궁내막증보다 불임 기간이 길고 ($56.5{\pm}26.3$ vs. $46.9{\pm}25.8$ (개월), p<0.0001), 수정률이 낮았으며 ($64.7{\pm}23.3$ vs. $70.5{\pm}22.7$ (%), p=0.001), 임신율과 태아 생존율이 통계적으로 유의하게 낮았다 (29.2 vs. 36.2 (%), p=0.045, 23.9 vs. 31.5 (%), p=0.043). 결 론: 체외 수정 시 이전에 치료를 받았던 경증의 자궁내막증은 중증의 자궁내막증보다 임신율과 태아 생존율이 낮았고, 이는 현저한 수정률 감소와 긴 불임 기간이 관련이 있다고 생각된다. 따라서, 장기간의 불임 기간을 가진 경증의 자궁내막증을 가진 불임 여성은 체외 수정을 좀 더 일찍 고려해 볼 수 있겠다.

• Radiation Oncology Journal
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• 제13권3호
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• pp.259-266
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• 1995

Purpose : The aim of this study is to analyze the survival rate, treatment failure and complication of radiation therapy alone in stage III uterine cervical cancer. Materials and Methods : From January 1980 through December 1985, 227 patients with stage III uterine cervical cancer treated with radiation therapy at Kosin Medical Center were retrospectively studied. Among 227 patients, 72 patients($317{\%}$) were stage IIIa, and 155 patients($68.3{\%}$) were stage IIIb according to FIGO classification. Age distribution was 32-71 years (median: 62 years). Sixty nine patients($95.8{\%}$) in stage IIIa and 150 patient ($96.8{\%}$) in stage IIIb were squamous cell carcinoma. pelvic lymph node metastasis at initial diagnosis was 8 patients($11.1{\%}$) in stage IIIa and 29 patients($18.7{\%}$) in stage IIIb, Among 72 patients with stage IIIa, 36 patients ($50{\%}$) were treated with external radiation therapy alone by conventional technique (180-200 cGy/fr.) and 36 patients($50{\%}$) were treated with external radiation therapy with intracavitary radiotherapy(ICR) with $Cs^{137}$ sources, and among 155 patients with stage IIIb, 80 patients ($51.6{\%}$) were treated with external radiation therapy alone and 75 patients ($48.4{\%}$) were treated with external radiation therapy with ICR. Total radiation doses of stage IIIa and IIIb were 65-105 Gy(median: 78.5 Gy) and 65-125.5 Gy (median 83.5 Gy). Survival rate was calculated by life-table method. Results : Complete response rates were $58.3{\%}$(42 patients) in stage IIIa and $56.1{\%}$(87 patients) in stage IIIb. Overall 5 year survival rates were $57{\%}$ in stage IIIa and $40{\%}$ in stage IIIb. Five year survival rates by radiation technique in stage IIIa and IIIb were $64{\%},\;40{\%}$ in the group treated in combination of external radiation and ICR, and $50\%,\;40\%$ in the group of external radiation therapy alone(P=NS). Five year survival rates by response of radiation therapy in stage IIIa and IIIb were $90\%,\;66\%$ in responder group and $10\%,\;7\%$ in non-responder group (P<0.001) There were statistically no significant differences of 5 year survival rate by total radiation doses and external radiation doses(40 Gy vs 50 Gy) of whole or true pelvis in stage IIIa and IIIb(P=NS). Treatment failures rates were $40.3\%$(29 patients) in stage IIla and $57.4\%$(89 patients) in stage IIIb. 17 patients ($23.6\%$) in stage IIIa and 46 patients ($29.7\%$) in stage IIIb experienced complications. Total radiation doses more than 85 Gy produced serious complication in both stage IIIa($50\%$) and IIIb($50\%$). Serious complication rates were higher in group received external radiation doses of 50 Gy than 40 Gy to whole or true pelvis in stage IIIa and IIIb. Serious rectal complication developed in rectal doses more than 65 Gy, and serious bladder complication developed in bladder doses more than 75 Gy. Major cause of death was cachexia due to locoregional failure in both stage IIIa($34.7\%$) and IIIb($43.9\%$). Conclusion : From this study, we found that external radiation therapy with ICR was found to have a tendency to be superior to external radiation therapy alone in survival rate, local control rate and complication rate but not different in statistics, and external radiation doses of 50 Gy than 40 Gy to whole or true pelvis produced serious rectal and bladder complications in stage III uterine cervical cancer.

• 자원환경지질
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• 제39권1호
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• pp.53-61
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• 2006

Geochemical and sedimentological analyses of sediment piston core were used to trace paleoceanographic environmental changes in the East China Sea. The analytical results revealed three lithostratigraphic units (I, II, and III) corresponding to a highstand stage, a transgressive stage, and a lowstand stage, respectively. Accelerator mass spectrometry (AMS) $^{14}C$ dated the boundaries between the units as 7 ka and II ka. That is, Unit I extended from the present to 7 ka, Unit II occupied a transitional episode from 7 to 11 ka, and Unit III was older than 11 ka. The transitional episode was characterized by sudden fluctuations in various geochemical proxies. Most strikingly, there was a gradual upward increase in both carbonate and total organic carbon (TOe) contents post-7 ka, during which time the ${\delta}^{l3}C$ values of organic material increased to a constant value. The gradual upward increase in the TOC and $CaCO_3$ contents in Unit I were accompanied by slight variations in grain size that probably reflect a stable modern oceanographic environment. Within Unit II (7 to 11 ka), the geochemical signals were characterized by abrupt and steep fluctuations, typical of a transgressive stage. Vertical mixing may have provoked an increase in productivity during this interval, with large amounts of terrigenous organic matter and/or freshwater being supplied by neighboring rivers. The geochemical signals remained stable throughout Unit III but exhibited different patterns than signals in Unit I. The high terrigenous organic matter content of Unit III suggests correspondence to a lowstand stage.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제12권3호
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• pp.23-33
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• 1990

A clinical study of selected patients with intraoral squamous cell carcinoma which were managed in the Department of Oral Oncology of Korea Cancer Center Hospital from January 1982 to August 1989 was done. And following results were obtained. 1. Males were involved more than females by intraoral squamous cell carcinoma in a ratio of 4:1. and most of the cases occurred in the 7th and 6th decades (69%). 79% of total patients and 92.5% of males were. 2. The mean duration of symptomatic period was 5.9 months. 3. The common symptoms were swelling (63%), pain (40%), ulceration (33%), and trismus (23%) 4. In the histologic findings, well differentiation comprised 58.0%. 5. The primary sites were the upper alveolar mucosa (32%), the floor of the mouth (21%), the lower alveolar mucosa (19%), tongue (14%), retromolar trigone (8%), palate (7%) and buccal mucosa (3%). 6. According to TNM system, Stage I, Stage II, Stage III, and Stage IV comprised 4%, 15%, 32%, and 49% respectively. 7. In the management of intraoral squamous cell carcinoma, surgeries were done in the 32 cases, 23 cases of which were managed by radiation therapy or chemotherapy concurrently. And radiation therapy alone was received in 35 cases. 8. Overall 3 and 5-year survival rates without regarding to stage were 27.6% and 21.4%. 9. 3-year survival rate of female patients was 47.2% and that of male patients was 22.6%. 10. 5-year survival rate was 53.9% for "early" cancer (stage I and II) and 15.6% for "advanced"cancer (stage III and IV). Survival rate of patients in the early stages of cancer appeared to be higher than that of patients with stage III and IV(p<0.05).

• Journal of Chest Surgery
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• 제18권3호
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• pp.506-512
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• 1985

We have experienced 120 non-small cell primary carcinomas of the lung between June, 1974 and December, 1984, at Seoul National University Hospital. They were 107 males and 13 females. 95% of all were ranged from 40 years to 69 years of age with 56 years of mean age. They were composed of 70 [66.7%] squamous cell ca., 20 [19%] adenoca., 6 [5.7%] undifferentiated large cell ca., 4 [3.8%] undifferentiated small cell ca., and 5 [4.8%] mixed adenosquamous cell ca. 41 [36%] and 35 [30.7%] patients have received pneumonectomies and lobectomies with a 66.7% resectability rate. Of the 36 stage I and 21 stage II patients, 56 were resectable but only 20 [31.7%] of the 63 stage III patients were resectable. This informed us the significance of the stage of the disease at the time of operation. The actuarial survival rate in 70 patients was as follow: 1, 3, 5 year survival rate of the patients in stage I were 80%, 80%, and 60% respectively. Both 1, 3 year survival rate of patients in stage II were 84%. But 1, 2, 3 year survival rate of patients in stage III were 40%, 11%, and 5% respectively. By dividing the patients in stage III into resectable group and nonresectable one, both 1, 2 year survival rate of the former were 37% and those of the latter were 42% and 7%. According to the cell type of the cancer, 1, 3, 5 year survival rate of the squamous cell ca. were 63%, 40%, and 26% respectively. 1, 3 year survival rate of the adenoca. were 43% and 34%. Hospital death were only 2 cases with a 1.7% operative mortality rate. We had acceptable long-term survival rate and have convinced the necessity and hope of the early detection and resection of the lung carcinoma.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제38권3호
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• pp.145-151
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• 2012

Objectives: Angiogenesis and lymphangiogenesis are correlated with tumor growth and lymph node metastasis in cases of oral squamous cell carcinoma (OSCC). Endoglin is one of the representative vascular endothelial cell markers. Podoplanin is also a representative marker used in order to detect lymphatic endothelial cells. The aim of this study was to determine the correlation between the expression of endoglin/podoplanin and clinical variables associated with OSCC progression. Materials and Methods: Paraffin embedded tissue specimens from 21 patients diagnosed with OSCC were used in this study. Ten patients were diagnosed with early clinical stage (I or II) and 11 patients with advanced clinical stage (III or IV) OSCC. Five patients had positive lymph node involvement. Primary antibodies for endoglin and podoplanin were used to perform the immunohistochemical detection of the vascular and lymphatic endothelial cells. The expression of endoglin and podoplanin was examined by an image analysis program in the three most highly expressed regions of each specimen. Results: The average endoglin expression was observed to be $1.691{\pm}0.920$ in the advanced stage (III, IV) specimens and $0.797{\pm}0.583$ in the early stage (I, II) specimens (P=0.020). The average expression of podoplanin was $0.286{\pm}0.228$ in the advance stage (III, IV) specimens and $0.374{\pm}0.157$ in the early stage (I, II) specimens (P>0.05). There was no statistically significant difference in the expression of endoglin and podoplanin, regardless of whether or not the lymph node was positive. Conclusion: The expression of endoglin was significantly higher in the advanced stage specimens than that in the early stage specimens. Therefore, we concluded that endoglin is a useful molecular marker for use in the evaluation of the progression of OSCC.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.5957-5961
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• 2015

Background: We designed this randomized controlled trial (RCT) to assess whether lobaplatin-based concurrent chemotherapy might be superior to cisplatin-based concurrent chemotherapy for FIGO stage II and III cervical cancer in terms of efficacy and safety. Materials and Methods: This prospective, open-label RCT aims to enroll 180 patients with FIGO stage II and III cervical cancer, randomly allocated to one of the three treatment groups (cisplatin $15mg/m^2$, cisplatin $20mg/m^2$ and lobaplatin $35mg/m^2$), with 60 patients in each group. All patients will receive external beam irradiation (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT). Patients in cisplatin $15mg/m^2$ and $20mg/m^2$ groups will be administered four cycles of $15mg/m^2$ or $20mg/m^2$ cisplatin intravenously once weekly from the second week to the fifth week during EBRT, while patients inthe lobaplatin $35mg/m^2$ group will be administered two cycles of $35mg/m^2$ lobaplatin intravenously in the second and fifth week respectively during pelvic EBRT. All participants will be followed up for at least 12 months. Complete remission rate and progression-free survival (PFS) will be the primary endpoints. Overall survival (OS), incidence of adverse events (AEs), and quality of life will be the secondary endpoints. Results: Between March 2013 and March 2014, a total of 61 patients with FIGO stage II and III cervical cancer were randomly assigned to cisplatin $15mg/m^2$ group (n=21), cisplatin $20mg/m^2$ group (n=21) and lobaplatin $35mg/m^2$ group (n=19). We conducted a preliminary analysis of the results. Similar rates of complete remission and grades 3-4 gastrointestinal reactions were observed for the three treatment groups (P=0.801 and 0.793, respectively). Grade 3-4 hematologic toxicity was more frequent in the lobaplatin group than the cisplatin group. Conclusions: This proposed study will be the first RCT to evaluate whether lobaplatin-based chemoraiotherapy will have beneficial effects, compared with cisplatin-based chemoradiotherapy, on complete remission rate, PFS, OS, AEs and quality of life for FIGO stage II and III cervical cancer.

• Radiation Oncology Journal
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• 제12권3호
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• pp.323-329
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• 1994

Purpose: In supraglottic cancer, radiation therapy is used to preserve the laryngeal function but combined surgery and radiation therapy is required in advanced stage. The authors Present the results of radiation therapy alone and combined surgery Plus Postoperative radiation therapy for supraglottic cancer. Methods and Materials: A retrospective analysis was done for 43 patients with squamous cell carcinoma of the supraglottic larynx who were treated from Feburary 1982 to December 1991, in the Department of Radiation Oncology, Korea University Hospital. Patient distribution according to the AJCC staging system was as follows: I, 3($7.0\%$); II, 7($16.3\%$); III, 17($39.5\%$); IV, 16($37.2\%$). Patients' age ranged from 30 to 72 years(median 62). Follow up durations were from 21 to 137 months(median 27). Seventeen patients($39.5\%$) were treated by radiation therapy alone with radiation doses of 6840-7380 cGy and 26 patients($60.5\%$) were treated with surgery plus postoperative irradiation with doses of 5820-6660 cGy. Results: Overall five-year survival rate for all stage was $51.8\%$, with $100\%$ for Stage I and II, $47.3\%$ for Stage III, and $29.2\%$ for Stage III. The difference of the survival rate by stage was statistically significant(p=0.0152). Five-year survival rates were $100\%$ for locally confined tumor in the supraglottic larynx, $37.5\%$ for transglottic extension, $26.7\%$ for hypopharynx extension, and only two of 5 patients with both transglottic and hypopharynx extension were alive(p=0.0033). Five-year survival rates by neck node status were as follows: $55.0\%$ for NO, $64.3\%$ for N1, $50.0\%$ for N2, and all 2 of N3 were died of disease. Overall survival rate for radiation therapy alone group was $42.8\%$, and it was $56.7\%$ for surgery plus postoperative radiation therapy group with no statistically significant difference(p=0.5215). In Stage I and II, all Patients survived. In Stage III and IV, 5-year survival rate for radiation therapy alone group was $28.5\%$ and $43.4\%$ for surgery plus postoperative irradiation group(p=0.5103). Local control rate was $58.8\%$(10/17) for radiation therapy alone group and $73.1\%$ (19/26) for surgery plus postoperative irradiation group. Three patients from surgery plus postoperative radiation therapy group developed distant metastasis in lungs. Conclusion: Treatment results of radiation therapy alone was excellent in early stage supraglottic cancer. In advanced stage, even the difference was statistically not significant, the result of postoperative radiation therapy group was superior compared with radiation therapy alone group. Since 1992, concomitant chemoradiotherapy with hyperfractionated radiotherapy is being used to improve the result of the treatment and preserve the laryngeal function in advanced stage supraglottic cancer.