복강경 불임술의 임상적관찰 ( 제2보 )

류석권(SK Yoo),엄승호(SH Ohm),김태홍(TH Kim),윤석한(SH Yoon) 대한산부인과학회 1979 Obstetrics & Gynecology Science Vol.22 No.2

저자는 1974년 5월 1일부터 1978년 7월 31일까지 국립의료원 산부인과를 방문한 불임시술 희망자중 복강경불임술을 시행하였던 총 900례(전기 소작법 680례 Ring법 220례)에 대한 조사 분석한 결과는 다음과 같다. 1. 연령분포는 31∼35세군이 전체의 42.6%로 수위이었고 차위는 36∼40세군으로 32.7%이었으며 평균연령은 34.3세, 최소연령은 21세, 최고연령은 46세이었다. 2. 자녀수는 3명이 전체의 50.8%로 가장 많았고 2명이 26.6%로 차위이었으며 평균 자녀수는 3명이었다. 3. 인공유산을 경험한 부인은 전체의 89%이었으며 경험이 한번도 없었던 경우는 11.0%에 불과하였다. 4. 개복수술의 기왕력이 있었던 경우는 전체의 10.4%이었고 충수돌기 절제술이 10.0%로 가장 많았으며 자궁부속기 절제술이 0.3%, 제왕절개술이 0.1%의 순이었으나 시술에 특별한 지장은 없었다. 5. 시술전까지의 피임방법은 경구피임약이 35.7%로 가장 많았고 condom법이 21.2%, 자궁내 장치법이 13.6%의 순이었고 무피임의 경우가 26.8%이었다. 6. 최종임신은 86.6%에서 임신중절수술을 행하였고 가장 많은 빈도를 차지하였다. 7. 최종임신결과로부터 불임시술과의 기간은 1∼3년인 경우가 전체의 43.3%로 가장 많았다. 8. 마취방법은 전체의 97.8%가 국소마취이었고 전신마취는 불과 2.2%이었다. 9. 시술시 CO2 gas 소요량은 4∼5l의 경우가 대부분이었으며 전체의 74.7%를 차지하였다. 10. 시술소요시간은 30분이내가 소작법군에서 전체의 70.6%, Ring법군에서 85.6%로 대부분을 차지하였고 Ring법에서 소요시간이 약간 짧았음을 보여 주었다. 11. 시술후 재원시간은 대부분이 3시간 이내로 전체의 69.2%이었고 소작법군에서 66.3%, Ring법군에서 78.4%를 차지하였다. 12. 시술과 동시에 실시한 수술로 가장 많았던 수술은 임신중절수술로서 전체의 40.2%이었으며 단지 불임시술만 실시하였던 경우는 전체의 42.7%이었고 수술소요시간이나 합병증의 발생에 있어서 큰 차이는 없었다. 13. 시술중 가장 많았던 합병증은 경미한 자궁부속기 출혈로 소작법군에서 34례(5.0%), Ring법군에서 2례(0.9%)가 있었으며 소작법 시행중 장손상이 1례 있었고 자궁천공이 3례 있었다. 전체적으로 합병증은 소작법군에서 54례(7.6%), Ring법군에서 11례(5.0%)가 있었다. 14. 시술후 가장 많이 호소하였던 증상은 요통 및 복부불쾌감으로 소작법군에서 235례(34.5%), Ring법군에서 136례(62.0%)로 양군에서 큰 차이를 볼 Among 900 cases of laparoscopic tubal Sterilizations, 220 procedures of Yoon`s ring application and 680 procedures of coagulation were performed mostly under the local anesthesia for the recent 5 years from May 1974 to July 1978. Differences between Yoon`s ring and coagulation method were made in various aspects. The results obtained were as follows; 1) The mean age of the patients was 34.3 years. The youngest was 21 years and the oldest 46 years. Age group of 31 to 35 years was most common with the incidence of 42.6%. 2) The average number of living children was 3.0, which encountered in 50.8% of the total and that of two in 23.8%. 3) Induced abortion of 13 times was the largest frequency ever found. 99 cases(11.0%) did not have the history of induced abortion, whereas 8 cases(0.9%) had experienced it more than 7 times. 4) No considerable technical difficulty during the tubal sterilization was encountered with those 103 cases(10.4%) who had previous history of laparotomy such as appendectomy in 99 cases(10.0%) adnexectomy in 3 cases(0.3%) and cesarean section in one case(0.1%). 5) Contraceptive method with oral pill prior to laparoscopic tubal sterilization was 35.7% of total cases, with condom 21.2% and with I.U.D 13.6%, respectively. 214 cases(26.8%), however, had not practiced any contraceptive method. 6) The last pregnancy before this laparoscopic sterilization was terminated by induced abortion in 86.6%, whereas term pregnancy in 13.0%. 7) The interval between outcomes of the last pregnancy and sterilization was one to three years, which occupied 43.3% of total cases. 8) Laparoscopic tubal sterilization was performed under the local anesthesia in 97.8% and under the general Anesthesia in 2.2%. 9) Four to five liters of Co2 gas were consumed for pneumoperitoneum in 74.7% of all cases. 10) Hospitalization for less than 3 hours was required in 66.3% of the coagulation group and 78.4% of the rihg group. 12) The incidental induced abortion followed by sterilization was encountered in 40.2%, an

악성난소종양의 임상병리학적 고찰 ( 제2호 )

박인서(IS Park),조인제(IJ Cho),윤석한(SH Yoon),김현찬(HC Kim) 대한산부인과학회 1975 Obstetrics & Gynecology Science Vol.18 No.3

1) 악성난소종양의 발생빈도는 전난소종양의 11.4%이었다. 2) 환자의 년령분포는 35-39세에서 가장 빈도가 높았고 평균연령은 40세 이었다. 12) 수술을 시행한 46례의 생존률은 극히 낮었고 추적불능한 예가 많아 정확한 수치는 알수가 없었다. Clinico-pathological survery was made on a series of 46 malignant ovarian tumor operated on at the National Medical Center, Seoul, Korea The results were obtained as follows; 1. The incidence of malignant ovarian tumor among all ovarian tumor was 11.4% 2. Age distribution of malignant ovarian tumor showed the highest frequency between 30-39 years group 3. Twenty one cases (45.6%) of all malignant ovarian tumor had regular menstrual cycle, remaining (19.6%) of them had menstrual disorder to some extent and rest of all (34.8%) had physiological amenorrhea. 4. As to the subjective symptoms of all malignant tumors, palpable mass in the lower abdomen, regardless the presence of ascites was 97.8% lower abdominal pain in 37.1% and G-1 truoble in 30.4% 5. Palpable masses were observed in 89.1% ascites in 63.0% abdominal distension in 39.1% anemia in 15.0% pleural effusion in 13.0% and cachexia in 2.2% on objective findings. 6. Cytological examination with vaginal and cervical discharge, and ascites were positive in 7.1% and 63.6% respectively. the associated malignancy of endometrium was not found by the histopathology of preoperative diagnostic curettage and surgical specimen. 7. The macroscopic and microscopic bilaterality were noted in 34.8% and 45.7% respectively 8. According to the international classification of the clinical stage, stage I was seen in 58.8% stage II 43%, stage III in 13.0% and 23.9% in stage IV, respectively.

여성성기결핵의 임상적 관찰

박주배(JB Park),주창남(CN Joo),윤석한(SH Yoon),박인수(IS Park) 대한산부인과학회 1975 Obstetrics & Gynecology Science Vol.18 No.10

A study has been made for 64 cases of genital tuberculosis in women who have been treated during 11 years from January 1, 1963 to December 31, 1973 Among 64 cases 25 cases were histologically proved with biopsy and 39 cases were histologically proved with surgical specimens at laparotomy. Among 25 cases which were diagnosed with biopsy, 2 cases of tuberculosis of vagina and 6 cases of tuberculosis of cervix were included. Five hundred and eighty curettings were examined for the study of inferility and tuberculosis of endometrium was found in 3.4% genital tuberculosis occurred with greatest frequency between the ages of 21 and 30 years an incidence of 45.3%. The average age was 30 years at the first attendance the youngest patient being aged 16 years and the oldest 63. The most frequent site of tuberculous lesion in the surgical specimens was the fallopian tubes. Among the fallopian tubes of 27 patients, tuberculous involvement was noted in 23 among the ovaries of 25 patients the lesion was noted in 10 and among the uteri of 14 patients in 4. Three patients were unmarried among the remaining 61 cases 27, at least gave a history of previous pregnancy History of previous extragenital tuberculous were noted in 32 cases ; namely pulmonary tuberculous in 14, plurisy in 9, peritonitis in 8 and osseous tuberculous in 1.

10대 여성의 임신과 유산에 관한 의학적 고찰

이명근(MK Lee),장명익(MI Chang),김성자(SJ Kim),윤석한(SH Yoon),박인서(IS Park) 대한산부인과학회 1976 Obstetrics & Gynecology Science Vol.19 No.2

1. The majority of the gravidas belonged to the old teen-age group and no sighnificant correlation was found between the prevalence of teen-age pregnancy and the different year. 2. The highest incidence of age at menarche fell on 14 years old and average age at menarche was 14.4 years old. 3. Mean age at marriage showed a mild but regular rise to 1940 and then the sharper incline in the survey. From 1925 through 1968, the marriage age rose form 20.2 to 26.8 for men and from 16.7 to 23.0 for women, arise of about six and half years in each case 4. The majority of teen-age groups neither had abortion nor used contraception. 5. Abortion rate had risen considoderably at all ages since 1964 study but proportionately most at the youngest age. 6. According to the occupation of teen-age gravidas, legally approved housewife occupied 29.0%. 7. Forty five percent of all materials lived with thier parents and the rest of them lived in broken family or alone. 8. Illiterate group comprised 2.9% of all materials. No college girls were involved because they were usually beyond this teen-age group. 9. Out of 29 cases of interruption of pregnancy 10 cases were interrupted in the first trimester, 17 cases in the second trimester and 2 cases in the third trimester. respectively 10. Pregnancies were interrupted by means of dilatation and evacuation in 15 cases. pitocin incution with bougie in 9 cases and intraamniotic hypertonic saline instillation in 2 cases respectively.