미니랩 난관불임술 2,256례에 대한 임상적 고찰

이승재(SJ Lee),백원영(WY Paik),박재일(JI Park),김승욱(SW Kim) 대한산부인과학회 1984 Obstetrics & Gynecology Science Vol.27 No.10

Tubal sterilization is rapidly becoming one of the most important methods of family planning. Minilaparotomy is surgical entry into the lower abdominal cavity through a small transverse suprapubic incision for the purpose of tubal ligation. A clinical analysis has been made on 2,256 cases of minilaparotomy tubal sterilization which had been performed at the Dept. of Obstet. & Gynecol., Seoul National University Hospital from May 1976 to November 1982. The results were as follows: 1. The most common age group was 30 to 34 years of age and the mean age was 33.7. 2. Most of client had 2 or more living children and the mean parity was 2.7. 3. About two-thirds of the clients experienced 2 or more artificial abortions and the mean number of artificial abortion was 2.8. 4. The histories of previous laparatomy were in 1.2% but did not disturb the operative procedure. 5. Minilapatotomy tubal sterilizations were performed 4 years after delivery in about half of the clients. 6. Sterilization was performed at the time of abortion in about two thirds of the clients. 7. Most of procedures were successfully completed under the local anesthesia. 8. Most of procedures could be finished within 30 minutes and the mean operation time was 24.3 minutes. 9. Most of clients returned less than 6 hours after operation. 10. The operative complications were encountered i 1.7% but no intensive medical care were required for these complications. 11. The operative technical failure rate was 0.8% and the operative method failure rate was 0.04%. 12. Sterilization procedures were coincidentally performed with the salpingectomies(8 cases), ovarian cystectomies(7 cases), Adnexectomies(4 cases), parovarian cystectomies(4 cases), and biopsies(2 cases) through minilaparotomies. It is concluded that minilaparotomy tubal sterilization is simple, safe, acceptable, inexpensive, and widely applicable procedure for female sterilization.

Gamete Intrafallopian Transfer ( GIFT ) 시행직전 배란된 불임여성에서 Intratubal Insemination에 의한 임신 1 예

이상복(SB Lee),박정순(JS Park),이재승(JS Lee),이승재(SJ Lee),박종민(JM Park) 대한산부인과학회 1991 Obstetrics & Gynecology Science Vol.34 No.5

The present report describes the case of a woman scheduled to undergo gamete intra-fallopian transfer(GIFT), but who was found to have ovulated at the time of laparoscopy. She became pregnant following intra-tubal insemination and the value and limitations of such a procedure are discribed.

경질초음파를 이용한 다태임신의 선택적 유산

민응기(EG Min),이승재(SJ Lee),노성일(SI Rho),박종민(JM Park),전종영(JY Jun) 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.3

The induction of grand multiple gestation is a known complication of infertility treatment. Various studies show that the incidence of multiple gestation as a complication of induced ovulation therapy in infertile patients ranges from 16% to 39%. Although there is a good deal of information about the gestation of twins, there is very little on triplets, and virtually nothing but case reports have been published on pregnancies involving four or more fetuses. There are so many complications as high fetal and neonatal mortality rate(31% in triplets, 43% in quadruplets and 91% in sextuplets), abortion, preterm labor, pregnancy-induced hypertension, premature rupture of membrane, post-partum hemorrhage, anemia and so on. Without any intervention, an extremely poor prognosis could be expected for viable pregnancies in the multiple gestation. Thus, we believed that an attempt to reduce the number of fetuses to a manageable number was the best possibility for a successful pregnancy outcome. We performed the selective termination (selective reduction) at first trimester (6 to 13 weeks of gestation) for 10 patients, 9 treated with human menopausal gonadotropin and 1 occurred naturally. Using the transvaginal sonoraphy, we carried out cardiac puncture in all cases, and after then, we injected the air into the fetal heart in five cases, injected the KCI solution in three cases and exanguinated the intracardiac blood in two cases. In 5 of the 10 cases, the pregnancies continued to near term without problems and resulted in the delivery of healthy babies. In 3 of the 10 cases, the pregnancy continued without problems for more than 20 weeks of gestation. Septic abortion was occurred just after procedure in 1 case and spontaneous incomplete abortion was developed 4 weeks after procedure in another 1case.

765㎸ 송전계통 보호계전기의 오차분석을 통한 정정지침에 관한 연구

崔勉松(MS Choi),李承宰(SJ Lee),姜相熙(SH Kang),趙誠振(SJ Cho),裵玲浚(YJ Bae),趙範燮(BS Cho),柳永植(YS Yoo) 대한전기학회 2003 전기학회논문지A Vol.52 No.1

체외수정 및 배아이식에 있어서 Color Doppler Ultrasonography의 임상적 연구

차영범(YB Cha),김홍기(HK Kim),이승재(SJ Lee),박종민(JM Park),이영호(HY Lee) 대한산부인과학회 1991 Obstetrics & Gynecology Science Vol.34 No.5

The condition of the endometrium is a crucial factor for successful implantation, but published research into the reasons for failure of implantation of embryos has been confined to histochemical and histological studies of the endometrium. This paper presents the functional aspects of the endometrium and ovaries in view of the blood flow patterns with the use of the color Doppler ultrasonography. In 43 women from an in vitro fertilization(IVF) program, the uterine and ovarian blood flows were investigated by color Doppler ultrasonography. The Resistance Index(RI) was used to evaluate the blood flow pattern. Blood flows to the uterus and ovaries were increased during the stimulated cycles and were well correlated with the serum estradiol level. When comparing the patients who became pregnant after embryo transfer(n=7) with those who did not conceive(n=36), the RI of pregnant group was lower than non-pregnant group on the day of embryo transfer, but it is not significant. In conclusion, the color Doppler ultrasonography of the uterine and ovarian arteries was useful in the hemodynamic evaluation of the uterus and ovaries and the data available so far suggest that hemodynamic parameters detected by color Doppler ultrasonography may provide additional aid to decision making with regard to IVF-ET.

자궁경관을 통한 배우자 난관내이식과 수정란 난관내이식

차영범(YB Cha),박종민(JM Park),이승재(SJ Lee),최규완(KW Choi),양현원(HW Yang),강희규(HK Kang) 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.5

Since the first report on transcervical tubal catheterization by Jansen et al., transcervical catheterization of the fallopian tube for the purpose of transferring zygotes and gametes has been gaining popularity in the treatment of infertile couples when the female partner has at least one patent fallopian tube. Several techniques has been developed for guiding the catheters into the fallopian tube. These include the use of the hysterocscope, ultrasound guidance, and tactile sensation. This study was designed to evaluate transcervical GIFT (Gamete intrafallopian transfer) and ZIFT (Zygote intrafallopian transfer) by tactile sensation. Transcervical GIFT and ZIFT was tried in 14 patients and the catheterization was succeeded in 11 patients. In succeeded cases, one patients delivered full term baby and the other case is on-going pregnancy. Comparing with other procedures, this technique is simple, non-invasive and not painful. Also more physiologic condition can be made. We performed all the procedure in ambullatory base.

임신과 동반된 선천성 항트로빈 - Ⅲ결핍증의 1 예

손영수(YS Son),박광태(KT Park),조현섭(HS Cho),이승재(SJ Lee),문신용(SY Moon) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.10

Congenital antithrombin Ⅲ deficiency is a familial disease which is caracterized by coincidence between congenital antithrombin Ⅲ deficiency adn incerased frequency of thromboembolism The prevalence of antithrombin Ⅲ deficiency in Norwegian popualtion has been estimated 1 per 2,000 population The risk of thromboembolism in women with congenital antithrombin Ⅲ deficiency is further incerased during pregnancy Some form of prophylaxis against thromboembolism therefore seems indicated in pregnant women with congenital antirthrombin Ⅲ deficiency We experienced a case of congenital antithrombin Ⅲ deficiendy in pregnancy in 27-year old woman We present this case with a brief review of the literatures.

난관근위부폐쇄의 비개복적치료에 있어서 자궁경관을 경유한 난관의 카테터삽입술의 의의

노성일(SI Rho),강서옥(SO Kang),권혁찬(HC Kwon),조정현(JH Cho),박종민(JM Park),이승재(SJ Lee),이도연(DY Lee),조병제(BJ Cho) 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.7

The obstruction of the proximal fallopian tube occurs in 15% of hysterosalpingograms(HSG) performed for infertility. Conventional HSG or laparoscopy may not differentiate the cornual spasm or other temporary causes from true occlusion. We used the transcervical cannulation of the proximal fallopian tubes with a 3-F teflon catheter and a flexible guidewire, 0.015 inch(0.038 cm) in diameter muder the hysteroscopic or fluoroscopic guidance to evaluate and treat the patients with proximal fallopian tube obstruction. Fifty eight patietns with obstructions of the proximal portion of one or two fallopian tubes based on a hysterosalpingogram or a laparoscopic examination were selected for the procedure. Twelve patietns found to have patent oviducts by the selective salpingogram & the selective chromopertubation were therefore excluded from this study. Tubal patency of at least one fallopian tube was achieved in 27 patients(51 tubes), as demonstrated by hysterosalpingogram immediately after the transcervical cathterization procedure. The success rate of recanalization was 62.5%(35/56 tubes) under fluoroscopy and 66.7% (16/24 tubes) under hysteroscopy. In a mean follow-up of twelve months (range: from 8 months to 17 months), eight women with patient tubes after the procedure became pregnant. We conclude that transcervical catheterization appears to represent a useful, less invasive and safe technique to achieve patency in selected cases of proximal tubal obstruction.

운동성정자 분리를 위한 Swim-up방법과 Percoll Gradient방법의 비교연구

이승재,이재승,박정순,이상복,최규완,홍재엽 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.5

Procedures to separate motile spermatozoa with high rates of recovery may have clinical application in in vitro fertilization and intrauterine insemination in increasing the probability of fertilization and subsequent pregnancy rate. Semen ejaculates from tweitn-three men, whose semen analysis findings were normal in 17 and abnormal in 6, were prepared by using the swim-up method and a discontinuous Percoll gradient method. The separated sperms were assessed for % motility and recovery rate. The % motility was increased compared with the original samples after separation by two methods, but there was no difference between two methods in normal group. In abnormal group, the % motility and the recovery rate by Percoll gradient method were more significantly increased than by the swim-up method. The results suggest that the Percoll gradient separation method fro sperm, particulary in oligo-astheno-teratozoospermia, may be more effective in the preparation of sperm for IVF or IUI.

체외수정 및 배아이식후 발생된 이소성임신 1 예

박종민,이승재,민응기,강서옥,차영범,송주철 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.12

이소성임신은 최근 과배란유도에 따른 시험관아기시술 등 적극적인 불임치료 과정에서 종종 볼 수 있는 임신의 합병증으로, 세심한 관찰로 조기진단이 가능하며 적기에 자궁외임신의 치료를 하면 자궁내임신을 정상적으로 지속시킬 수 있는 바, 자궁외임신이 파열 전에 진단함이 매우 중요하며, 이러한 비정상임신의 발생 가능성이 높다고 판단되는 고위험군 환자에 있어서는 초음파 추적검사시 다발성 황체 등에 가려져 정확히 식별되지 못하는 자궁외임신의 존재 가능성을 항상 생각하므로써 진단 및 치료의 적정시기를 놓치지 않을 수 있을 것이라 생각되어 문헌의 고찰과 함게 저자들의 경험을 보고하는 바이다. The heterotopic pregnancy, a kind of abnormal pregnancy, is believed to result from the implantation of dzygotic embryos at widely separated sites and assisted reproductive technology would seems to enahnce the spontaneous occurrence of this event. Several studies reported an incidence of 1 in 30,000 spontaneous pregnancies, but recently assisted reproductive technology such as in vitro fertilization(IVF) or gamete intrafallopian transfer(GIFT) increase the incidence of this type of pregnancy up to 1%. We experienced a case of heterotopic pregnancy, combined intrauterine and left tubal pregnancy occured after in vitro fertilization and embryo transfer. Therefore, we presented this case with a brief review of the literatures.