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태아 심초음파 검사로 진단 된 뒤 출생 후 Propafenone으로 치유된 신생아 심방조동 1례
이경화,하창우,김철호,송민섭,성문수,Lee, Kyung Hwa,Ha, Chang Woo,Kim, Chul Ho,Song, Min Seob,Sung, Moon Su 대한소아청소년과학회 2002 Clinical and Experimental Pediatrics (CEP) Vol.45 No.7
저자들은 재태 연령 $38^{+6}$주에 태아 심초음파 검사에 의해 태아 심방 조동이 발견되어 산모에게 digoxin을 투여하였으나 효과가 없어 제왕 절개술을 통해 분만한 후, digoxin, 전기적 심율동 전환에 의해서도 치료되지 않아 propafenone을 복용하여 정상 동율동으로 회복된 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Perinatal atrial flutter is a potentially lethal arrhythmia. Management of this disorder is difficult and controversial. Fetal atrial flutter is a serious and life threatening rhythm disorder particulary when it causes hydrops; it may be associated with fetal death or neurological damage. Although the initial episode of flutter may be difficult to control, recurrence of atrial flutter after successful resolution of the arrhythmia seems highly unlikely and long-term prognosis is excellent. We experienced a case of a atrial flutter diagnosed in utero at $38^{+6}$ weeks' gestation by fetal cardiac echocardiography. He was treated with maternal digoxin, but he continued to have atrial flutter until delivery. Restoration of sinus rhythm occured with propafenone therapy in this patient after failure of initial digoxin therapy and direct current cardioversion.
조유경 ( Yu Kyung Cho ),김미성 ( Mi Sung Kim ),조인호 ( In Ho Jo ),정은정 ( Eun Jeong Jeong ),변정미 ( Jung Mi Byun ),김영남 ( Young Nam Kim ),정대훈 ( Dae Hoon Jeong ),성문수 ( Moon Su Sung ),김기태 ( Ki Tae Kim ),이경복 ( Kyeong 대한주산의학회 2010 Perinatology Vol.21 No.4
The conventional treatment of cervical incompetence is cerclage operation. In most cases, the classical surgical cerclage methods described by McDonald and Shirodkar are performed. The cervicoisthmic cerclage is beneficial for the treatment of patients who have short cervix due to conization, cervisectomy or congenital anatomical deformity of uterus. This procedure is different from the classical McDonald and Shirodkar cerclages in that the suture site is placed at the junction of the cervix and the isthmus of uterine body. There are two approaches in cervicoisthmic cerclages, transabdominal and transvaginal ones. The transvaginal cervicoisthmic cerclage is easier to perform and less dependent on uterine size compared with the transabdominal cerclage. In addition there is less chance of direct uterine handling associated with bladder laceraton or fetal loss in transvaginal cervicoisthmic cerclage. We report two cases of transvaginal cervicoisthmic cerclage for the first time in Korea, in which patients have delivered at full term by cesarean section.
제왕절개 반흔 부위에서 발생한 자궁근층내 임신의 보존적 치료
길민경 ( Min Kyung Gil ),강영미 ( Young Mi Kang ),김성용 ( Sung Yong Kim ),정수전 ( Su Jeon Jeong ),김영남 ( Young Nam Kim ),정대훈 ( Dae Hoon Jeong ),이경복 ( Kyung Bok Lee ),성문수 ( Moon Su Sung ),김기태 ( Ki Tae Kim ) 대한주산의학회 2005 Perinatology Vol.16 No.4
Intramural pregnancy, implanted in the previous cesarean section scar, is one of the rare and dangerous forms of ectopic pregnancies, because a delay in either diagnosis or treatment can lead to uterine rupture, hysterectomy, or significant maternal morbidity, due to severe hemorrhaging. With the development of transvaginal ultrasound and MRI, early diagnosis and conservative treatment of intramural pregnancy is possible. For young patients who wish to maintain their fertility, an earlier diagnosis and more conservative treatment are desirable. We experienced a case of intramural pregnancy, developed in the previous cesarean section scar and successfully treated it with conservative management. So we report this case with a brief review of literature.
자궁경부암 병기 IIB 환자에서 치료법에 따른 예후 비교: 근치자궁절제술, 신보강화학요법 후 근치자궁절제술 및 동시화학방사선요법의 예후를 비교한 후향적 연구
김기태 ( Ki Tae Kim ),김영남 ( Young Nam Kim ),서영진 ( Young Jin Seo ),성문수 ( Moon Su Sung ),이경복 ( Kyoung Bok Lee ),우영주 ( Young Ju Woo ),정대훈 ( Dae Hoon Jeong ),변정미 ( Jung Mi Byun ),김수선 ( Su Seon Kim ) 대한산부인과학회 2012 Obstetrics & Gynecology Science Vol.55 No.12
목적 자궁경부암 병기 IIB인 환자들에서 근치자궁절제술, 신보강화학요법 후 근치자궁절제술 및 동시화학 방사선요법을 시행받은 군 간의 예후를 비교하였다. 연구방법 2000년 1월부터 2006년 12월까지 인제대학교 부산백병원 산부인과에서 자궁경부암 IIB로 진단된 104명의 환자에서 근치자궁절제술, 신 보강화학요법 후 근치자궁절제술 및 동시항암화학 방사선요법을 시행받은 군 간의 5년 무병생존율 및 전체생존율과 재발률을 비교하여 각각 치료에 대한 예후를 분석하였다. 결과 근치자궁절제술을 시행받은 20명, 신보강화학요법을 시행한 후 근치자궁절제술을 시행받은 43명, 동시항암화학 방사선요법을 시행받은 23명을 포함하여 총 86명을 대상으로 분석하였다. 연령이 낮을수록(P<0.001) 신보강화학요법이 시행되었고, 종양크기가 클수록 신보강화학요법이나 동시화학방사선 요법보다는 근치자궁절제술이 시행되었다(P<0.001). 세 군 중 신보강화학요법을 받은 군에서 원격재발이 의미 있게 낮았다(P = 0.014). 근치자궁절제술만 시행한 군과 신보강화학요법 후 근치자궁절제술을 한군을 비교하였을 때, 근치자궁절제술을 한군의 조직학적 소견에서 중등도 위험인자인 4 cm 이상인 종양크기와 림프혈관강 침윤이 통계적으로 의미 있게 증가하였다 (P = 0.0459, 0.0158). 결론 세군 간 5년 무병생존율 및 전체생존율에 차이는 없었으나 신보강화학요법은 원격전이를 낮추고, 종양의 크기와 림프혈관강 침윤을 감소시켜 불필요한 추가치료를 피할 수 있도록 하였다. Objective We aimed to compare the prognosis of patients with stage IIB cervical cancer treated with radical hysterectomy alone, with neoadjuvant chemotherapy followed by radical hysterectomy, and with concurrent chemoradiation therapy (CCRT). Methods From January 2000 to December 2006, 104 patients with cervical cancer IIB were diagnosed and managed with radical hysterectomy alone, neoadjuvant chemotherapy followed by radical hysterectomy, and CCRT. The outcomes of patients in terms of the 5-year disease-free survival, overall survival, and recurrence rates were compared. Results Of 86 eligible patients, 20 were treated with radical hysterectomy alone, 43 with neoadjuvant chemotherapy, and 23 with CCRT. Neoadjuvant chemotherapy with radical hysterectomy was performed in young (P<0.001) and radical hysterectomy alone was performed in the patients with a large tumor size ( P<0.001). Among the 3 groups, distant metastasis was the lowest in the neoadjuvant chemotherapy group ( P=0.014). Between the neoadjuvant chemotherapy group and radical hysterectomy alone group, radical hysterectomy alone group showed a larger tumor size (>4 cm) ( P=0.0459) and more extensive lympho-vascular involvement ( P=0.0158) in pathologic finding. Conclusion No significant differences in the 5-year disease-free and overall survival rates were observed among the 3 groups. However, the neoadjuvant chemotherapy group showed lower distant metastasis, smaller tumor size, and less extensive lympho-vascular involvement than the other 2 groups. Accordingly, unnecessary adjuvant therapy could be avoided. These results imply that neoadjuvant chemotherapy could improve the prognosis of patients with cervical cancer IIB.
Klippel-Trenaunay-Weber 증후군의 산전 초음파 진단 2예
박영미 ( Young Mi Park ),김영남 ( Young Nam Kim ),조인호 ( In Ho Jo ),정수전 ( Su Jeon Jeong ),정대훈 ( Dae Hoon Jeong ),성문수 ( Moon Su Sung ),윤혜경 ( Hye Kyoung Yoon ),김기태 ( Ki Tae Kim ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.6
Klippel-Trenaunay-Weber syndrome is a rare congenital disorders which is characterized by the presence of multiple hemangiomata, arteriovenous fistulas and unilateral Limb hypertrophy. There has been some reports that Klippel-Trenaunay-Weber syndrome was diagnosed at birth or infant, but the prenatal diagnosis was very difficult in pregnant women who have not family history. Recently, the prenatal diagnosis of Klippel-Trenaunay-Weber syndrome has been occasionally reported according to improvement of prenatal ultrasound. We recently experienced two cases of Klippel-Trenaunay-Weber syndrome. So we report our cases with brief review of Literature.
변정미 ( Jung Mi Byun ),김영남 ( Young Nam Kim ),정대훈 ( Dae Hoon Jeong ),이경복 ( Kyung Bok Lee ),성문수 ( Moon Su Sung ),김기태 ( Ki Tae Kim ),전가원 ( Ga Won Jeon ),신종범 ( Jong Beom Sin ) 대한주산의학회 2009 Perinatology Vol.20 No.3
Congenital diaphragmatic eventration is defined as an abnormal elevation of the diaphragm resulting from developmental abnormality of muscle fibers during gestation. Differentiation between congenital diaphragmatic hernia (CDH) and eventration is very difficult but important for perinatal management and prognosis, because CDH is associated with higher perinatal and neonatal mortality. We describe a case that was initially diagnosed by prenatal sonography as a right CDH and later confirmed as a congenital diaphragmatic eventration after the delivery with a brief review of the literatures.