선천성 처녀막 폐경증에 의한 질 및 자궁 유혈종의 1례

곽정상(JS Kwak),장선구(SG Chang),강은정(EJ Kang),제구화(KW Je) 대한산부인과학회 1982 Obstetrics & Gynecology Science Vol.25 No.1

The imperforated hymen is a rare congenital malformation. In most instances, definite finding is noticed after menarche as retention signs of menstrual flow. We are presented a case of hematocolpora, hematometra and urinary bladder distension associated with imperforated hymen at the age of 19. The cure was followed by the crucial incision on imperforated hymen and about 340 cc of tarry blood evacuated. we present this case with reviewing the litratures concerning imperforated hymen.

자궁외임신의 임상적 고찰

곽태로,곽정상,정승기,윤병철,박웅석,이기석 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.12

1. 분만건수에 대한 자궁외임신의 빈도는 1:30이었다. 2. 호발연령은 31∼35세가 33.9%로 가장 많았고, 26∼35세까지가 64%나 되었다. 3. 임신횟수는 3회가 20.4%, 분만횟수의 경우 미산부가 22.5%이었으며 한번이상 인공유산을 경험한 예가 75.1%이었다. 4. 기왕력은 복강경 난관불임술 19.0%, 자궁외임신 9.3%, 과거 개복술을 경험하였던 경우가 17%이었다. 5. 증상발현시기는 임신 6∼8주엣 35.6%로 가장 많은 빈도를 보였고, 주요 증상으로는 하복부 동통 92.7%, 성기출혈 81.3%, 무월경 75.4%, 복강내 종괴촉진 29.1%이었다. 6. 진단으로 소변 임신반응검사 양성율이 73.7%이었고, 다를라스와천자는 89.2%가 양성이었다. 7. 착상부위로는 96.2%에서 난관이었는데 그중 팽대부에 73%로 가장 빈발하였고, 협부, 체부의 순이었다. 8. 중절양식으로는 난관파열이 54.9%, 난관유산이 43.1%이었다. 9. 복강내 출혈량은 500cc이학 33.9%로 가장 많았고, 혈색소치는 10mg%이하가 21.8%, 수혈이 필요없었던 경우는 40.8%이었다. 10. 수술방법은 환측 난관절제술이 51.2%, 환측 부속기 제거가 34.9%이었다. 11. 전 례에서 완치 퇴원하였다. This study was undertaken for the clinical evaluation and statistical analysis on the 289 cases of ectopic pregnancy who were admitted and treated from Jan. 1, 1985 to Dec. 31, 1988. The results were as follows; 1. The incidence of ectopic pregnancy was 1:30.8 deliveries(289/8501). 2. The most common age group was 26∼35 years of age, comprising of 64.0%. 3. Primigravida was 5.2%, nullipara 22.5%, and the cases who have experienced artificial abortion were 75.1%. 4. In past history, 19.0% of the patients had previous laparoscopic tubal sterillization and 17.0% experienced previous abdominal surgery. Among them, repeat ectopic pregnancy was 9.3%. 5. General symptom as presented by the patients included the classical triad of pain(92.7%), vaginal spotting or bleeding(81.3%), and amenorrhea(75.4%). 6. The most frequent interval between LMP and the onset of symtom was 6∼8 weeks in 35.6%. 7. Culdocentesis was positive in 89.2% and pregnancy test was positive in 73.7%. 8. Implantation site of ectopic pregnancy was on tube in 96.2%(interstial 43.1%, isthmic 11.7%, ampullar 73.0%, fimbrial 8.0%). 9. Tubal pregnancy was terminated by rupture in 54.7%, by abortion in 43.1%, and intact type was 2.2%. 10. Intra-abdominal hemorrhage was under 500ml in 33.9% and 16.6% of total cases were trasfused 3 pints. 11. 51.2% of total cases were treated by salpingectomy alone, and 34.9% by salpingoophorectomy. 12. Of 289 total cases, no death occurred.

보존적 요법으로 치유된 자궁경관임신 2 예

곽태로,곽정상,김태균,하병욱,김흥로,김평국 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.8

Implantation of a blastocyst within the endocervical canal is termed a“cervical pregn-ancy”, which is one of the most dangerous forms of ectopic pregnancy. It is even less common, but the incidence appear to be increasing, in part due to newer forms of assisted reproduction. Proper management is indicated as soon as the diagnosis is suspected. Hemorrhage may be massive and sometimes fatal. In the past, hysterectomy was often the only choice available because of profuse hemorrhage that accompanied attempts at removal of the cerv- ical pregnancy. We report two cases of cervical pregnancy treated conservatively without hysterect- omy. Hemorrhage from the implantation site was controlled by intracervical placement of a Foley catheter balloon without hemostatic cervical sutures at 3 and 9 o clock. Immediate insertion of a Foley catheter into the cervical canal and inflation of the catheter bulb after endocervical suction curettage appears to be a simple and effective technique of managing cervical pregnancy in a patient who wishes to maintain childbearing capacity.

조기파막의 임상적 고찰

이대,한광수,곽정상,곽태노 대한산부인과학회 1980 Obstetrics & Gynecology Science Vol.23 No.5

난소와 대망막을 침범한 Paragonimus Westermani의 1예

정윤상,문두만,윤병철,곽정상,곽태로,이하종,송수복 대한산부인과학회 1988 Obstetrics & Gynecology Science Vol.31 No.7

보존적 요법으로 치유된 자궁경관 임신 2예

김흥로,김평국,하병욱,김태균,곽정상,곽태로 침례병원 1998 浸禮病院學術誌 Vol.14 No.-

일측 폐쇄성 질 및 동측 신장불형성을 동반한 중복자궁 1례

김태균,박정용,권욱현,곽정상,곽태로 침례병원 1994 浸禮病院學術誌 Vol.11 No.

Meigs 증후군 1예

장성규(SK Chang),곽정상(JS Kwak),강은종(EJ Kang),곽태로(TR Gwag) 대한산부인과학회 1982 Obstetrics & Gynecology Science Vol.25 No.2

당 병원 산부인과에사 복수와 흉수를 동반한 난소섬유종 1례를 경헙하였기에 이를 보고사는 바이다. Meigs syndrome is a relatively uncommon and the unusual condition of ascites and fluid in the chest associated with benign and solid tumors of the ovary with the gross appearance of a fibroma. This case is a 35 years old multipara with fibroma of the right ovary. The laparotomy revealed 17.0x12.0x7.0cm in sized firm tumor. After removal of the tumor, ascites and hydrothorax, had been completely subsided within 1 days. This case is reported with brief review of literature.

난소와 대망막을 침범한 Paragonimus Westermani의 1예

이하종,송수복,정윤상,문두만,윤병철,곽정상,곽태로 釜山醫師會 1989 釜山醫師會誌 Vol.25 No.5

소파술 및 자궁내시경을 위한 자궁경관 확대에 있어서 경구 미소프로스톨의 유용성

강영호,김태균,김정욱,조기식,김평국,홍성일,곽정상,곽태로 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.6

목적: 최근 프로스타글란딘은 임신여성에서 자궁경관의 숙화 및 개대에 사용되어져 왔다. 그러나 비임신 여성에서의 사용은 아직 잘 확립되어 있지 못하다. 우리는 경구 미소프로스톨의 자궁경관 숙화 효과를 임신 및 비임신 여성에서 비교하였다. 자궁내막 소파와 자궁내시경 검사는 산부인과 영역에서 폭넓게 시행되고 있다. 자궁내경[internal os]의 통과 장애가 특히 미경산부경우 경험하게 된다. 자궁경관 숙화약물의 사용은 자궁경관 확장동안에 생길 수 있는 합병증을 줄이는데 효과적이다. 우리는 통상적으로 자궁내막 소파와 자궁내시경 검사전 자궁경관 개대 목적으로 삼투성 개대제인 라미나리아[laminaria]를 사용해 왔다. 그러나 라미나리아는 때때로 환자에게 위험하고 불편감을 준다. 우리는 이 연구를 통하여 임신 및 비임신 여성 모두에게 자궁경관 개대를 하는데 있어서 안전하고, 경제적이며, 불편감이 없는 새로운 자궁경부 숙화제인 경구용 미소프로스톨의 사용을 제안한다. 연구방법 : 자궁경관 확대 및 소파술, 자궁내시경 검사를 필요로하는 100명의 환자를 대상으로 하였다. 환자들은 시술 12시간 전에 미소프로스톨 200 마이크로 그램을 투여 받았다. 경구 미소프로스톨의 효과는 수술실에서 Hegar dilator number에 의해 평가되었다. 결과: 평균 Hegar dilator number는 저항을 주어 최대까지 개대가 가능했던 경우의 수치[H]가 9.69, 저항없이 들어간 경우의 수치[M]가 7.9 였다. 임신 여성에서 H는 10.2, M은 8.3이었으며, 비임신 여성에서는 H가 9.18, M이 7.5였다. 미경산부에서 H는 9.76, M은 7.88, 초산부에서 H는 10.1, M은 7.88, 다경산부에서 H는 9.52, M은 7.98이었다. 총 100례 중, 4례에서 H가 8미만으로 소파술 및 자궁내시경 검사가 어려웠다. 효과적으로 시술이 가능했던 경우는 96% 였다. 결론: 이 연구는 경구용 미소프로스톨이 임신 및 비임신 여성 모두에서 소파술전 자궁경관 개대에 효과적임을 보여주었다. Objective: Recently, prostaglandins were used for cervical ripening and dilatation in pregnant women. However, its use in non-pregnant women is not well established. We compared pregnant versus non-pregnant woman for cervical ripening effect of oral misoprostol. Endometrial curettage and hysteroscopy are widely performed procedure in obstetrics and gynecology department. Difficulty in entering the internal os may be encountered, especially in nulliparous woman. The use of cervical priming agent is effective in reducing complications during cervical dilatation. We have used osmotic dilator[laminaria] for cervical dilatation prior to endometrial curettage and hysteroscopy. But laminaria is occasionally dangerous and uncomfortable to patient. We propose a new cervical priming agent[oral misoprostol] which is safe, cheap, comfortable and effective for cervical dilatation in both pregnant and non-pregnant woman. Methods: One hundred of patient requiring D&C and hysteroscopy were recruited for this study. The patients were received misoprostol 200μg orally 12 hours before D&C and hysteroscopy. The effect of oral misoprostol was evaluated by number of Hegar dilator at operation room. Results: The mean Hegar dilator number with resistance[H] was 9.69, without resistance[M] was 7.9. In pregnant women, H = 10.2, M = 8.3. In nonpregnant women, H = 9.18, M = 7.5. In nullipara, H = 9.76, M = 7.88. In primipara, H = 10.1, M = 7.88. In multipara, H = 9.52, M = 7.98. Of total 100 cases, four cases were difficult to perform D&C and hysteroscopy because Hegar dilator number with resistance[H] was below 8. Overall success rate was 96%. Conclusion: This study suggests that oral misoprostol is effective for cervical dilatation before curettage in both pregnant and non-pregnant women.