WHO 분류에 따른 골수섬유화를 동반한 급성범골수증식증 1례

강소영,박찬정,서을주,이규형,지현숙 大韓血液學會 2003 大韓血液學會誌 Vol.38 No.3

부인과 질환의 진단시 진단적 복강경술의 임상적 효용성에 관한 연구 1987 년-1994 년 6665 예의 분석과 이전 5000 예와의 비교

최영민,강순범,이효표,이유미,이진용,장윤석,문신용,김정구,신창재,김석현,서창석,기숙현,심종옥 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.9

1974년 6월부터 1987년 5월까지 서울대학교병원 산부인과에서 시행된 5000예의 진단적 복강 경술과 1987년 6월부터 1994년 3월까지 시행된 6665예를 대상으로 통계학적 분석을 시행하 며 다음과 같은 결론을 얻었다. 1. 적응증은 원발성 및 속발성 불임증 환자가 각각 3391(67.9%)와 3500예(52.5%)로 가장 많 았고 난관복원술 전에 시행했던 경우가 509예(10.2%)와 1233(16.8%) 자궁외임신이 의심되는 환자가 각각 369예(7.4%)와 249예(3.4%) 불확실한 종괴가 238예(4.8%)와 859예(11.7%) 원발성 무월경이 151예(3.0%)와 30예(4.1%) 등의 순으로 과거에 비해 자궁외임신은 감소하였고 불확 신한 종괴가 증가하여 적응증의 순이 바꾸었다. 2. 불임증 환자의 경우 각가 84.5%와 85.5%에서 골반내 이상소견이 보였는데 양측 난관 폐 색이 34.4%와 25.1% 편측 난관폐색이 18.6%와 11.3% 골반내 유차이 13.8%와 16.1%, 자궁내 막증이 3.3%와 17.9%, 다낭성 난소가 3.0%와 0.47%로 난관폐색은 전체적으로 감소하였으며 자궁내막증과 골반내 유착이 과거에 비해 현저히 증가하여 불임증환자의 상당부분을 차지하 게 되었고 다낭성 난소의 경우는 감소된 추세로 나타났다. 3. 자궁난관조영술과 진단적 복강경술의 일치율은 각각 77.0%와 75.5%이었다. 4. 자궁외임신이 의심되었던 360예와 249예에서 복강경술을 시행한 결과 각가 206예(55.8%) 와 216예(86.7%)에서 자궁외임심으로 확진되었으며 이중 165예(44.7%)와 169예(67.9%)는 비파열성 자궁외임신으로 복강경술에 의하여 조기에 진단할 수있었다. 5. 골반내 종양이 의심되었던 238예와 859예에 있어서 임상적 진단의 오류는 각각 24.9%와 6.64%로 상당히 감소하였으며 17.1%와 7.33%에서 불필요한 개복수술을 피할 수 있었다. A Clinical analysis of the recent 6665 cases of diagnostic laparoscopy from the June, 1987 to March, 1994 was preformed and we compared with the previous 5000 cases from June 1974 to May 1987. Infertility was the most common indication (67.9%, 52.5%) pelvic abnoramlities were found in 84.5% of 3391 infertile patients and 85.5% of 3500 infertile patients respectively, and tubal occlusion and pelvic adhesions were the most common abnoramlities. With regard to the tubal patency, there was a discrepancy rate between laparoscopic and hysterosalpingographic finding in 23.0% of 1976 inferitle patients and 24.5% of 2600 infertile patients, respectively. In 55.8% of 369 patients and 86.7% of 249 patients with the suspected ectopic pregnancy, the diagnosis was confirmed by laparoscopic examination. And laparoscopic evaluation could circumvent the unnecessary laparotomy in 33.1% and 34.8% of patients respectively. The error in prelaparoscopic diagnosis of the obscure pelvic mass was 29.4% and 6.64%, respectively, and laparotmy could be avoided in 17.1% and 7.33% following laparoscopic examination.

임신자궁파열 14례

배정민(JM Pae),강민자(MJ Kang),조정신(JS Cho),김춘지(CJ Kim),강신명(SM Kang) 대한산부인과학회 1972 Obstetrics & Gynecology Science Vol.15 No.7

임신자궁파열 14례에 관한 보고를 하는 바이다. The clinical data presented were based on 14 cases of the ruptured gravid uterus among the 9429 cases of total deliveries seen in Ewha Woman`s University Hospital, Seoul, during 6 years period from Jan. 1962 to March 1968. The summary analysed were as follows. 1. The incidence of uterine rupture was 0.15% or 674:1 among total cases of deliveries and it seemed to be remaining steady in it`s tendency for the past 6 year`s period. 2. The leading cause of uterine rupture was abuse of the oxytocin accounting for 36% of the cases and it resulted in mostly by non-obstetrical man or midwives. 3. The occurence of rupture of previous uterine scar were obviously more often (3 out of 4) in the classical scars rather than in the low cervical scars. 4. Fetal mortality were considered high as 50% of the cases. However, no maternal death encountered. 5. All of the uterine rupture were invariably happened in the multiparous gravida. Particularly in the cases with para 1 there showed rather high incidence of uterine ruptures (37.5%) in which means that even one who had a previous vaginal delivery does not necessary guarantee it free of the accident or danger of abusing oxytocin. 6. The common type of uterine rupture was the complete rupture of the uterus (64%) which is a serous one, and it had been found mostly in the area of the low segment. 7. We have treated with immediate total hysterectomy in 5 cases, subtotal gysterectomy in 4 cases and simple repair in 5 cases depend on the reptured site, extension and the patient status. We would like to empasize that the proximal end of the uterine artery concealing in the clots must be identified and ligated for prevention of the possible late bleeding after the clot resolution takes place. 8. It was our hope that the accident of uterine rupture could be greatly reduced to 29% of the total cases by the adequate correction of the medical man`s mismanagement such as oxytocin abuse, prolonged labor and technique of Cesarean sections, furthermore, the remaining risk can be prevented to zero by the correction of the patient`s delayed admissions.

냉동 보존된 정자를 이용한 난자의 체외수정에 관한 연구

장윤석,문신용,신창재,김석현,강석진,방명걸 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.1

저자들은 정상 생식능력이 입증된 남성 10명의 정액을 대상으로 신선정자 및 dry-ice pellet 방법을 이용한 냉동 보존 및 융해 후 정자로 SPA를 시행하여 다음과 같은 결과를 얻었다. 1. 냉동정액의 정자 운동성은 41.0 ± 13.7 %로서 신선정액의 71.5 ± 13.4 %에 비하여 유의하게 감소되었으며, 냉동 보존 및 융해 후 정자 운동성의 회복율은 60.3 ± 23.1 %이었다. 2. 냉동정액의 햄스터 난자 침투율은 70.0 ± 11.8 %로서 신성정액의 78.8 ± 12.6 %에 비하여 유의하게 감소되었으며, 난자 침투율의 회복율은 89.1 ± 7.6 %이었다. 3. 냉동정액의 난자 침투율과 신선정액의 난자 침투율 사이에 유의한 상관관계가 있었다. 4. 냉동정액의 햄스터 난자 침투지표는 2.3 ± 1.1로서 신성정액의 4.0 ± 1.5에 비하여 유의하게 감소되었으며, 난자 침투지표의 회복율은 59.1 ± 24.2 % 이었다. 이상의 결과로서 dry-ice pellet method를 이용하여 냉동 보존된 정자는 SPA 시행시 대조 정자 및 검체 정자로서 사용이 가능하며, 신선정자를 사용할 때의 제반 문제점을 줄일 수 있어 불임 질환의 진단에 있어서 매우 유용할 것으로 사료된다. To elucidate the amount of change in the results of the sperm penetration assay(SPA) following freezing and to assess the clinical usefulness of cryopreserved semen in the SPA, semen samples from 10 fertile donors were each divided into 2 equal volumes in which one was frozen and thawed using dry-ice pellet method while the other half remained untreated, and evaluations for sperm motility and SPA were made on both fresh and frozen spermatozoa. The sperm motility was significantly decreased in frozen sperm (41.0%) when compared with fresh sperm (71.5%) with the recovery rate of 60.3%. Both the hamster ovum penetration rate and the penetration index (mean penetrations per ovum) were significantly reduced in frozen sperm (70.0%, 2.3) when compared with fresh sperm (78.8%, 4.0) with the recovery rates of 89.1% and 59.1%, respectively. There was a significant correlation in the penetration rate between frozen and fresh sperms. Cryopreserved sperm from normal fertile donors yielded the same fertility classification as fresh sperm in 100% of the cases with the SPA. These data suggest that cryopreserved semen from normal fertile donors can be used as the source of an effective internal control sperm and that the SPA using frozen-thawed sperm can serve as an alternative to the conventional SPA using fresh, untreated sperm to assess male fertility in vitro.

Direct Activation Of Capsaicin Receptors By Products Of Lipoxygenases : Endogenous Capsaicin-Like Substances

SW Hwang,H Cho,JS Shin,SH Cho,SY Lee,CJ Kang,JY Kwak,MH Wang,Y-G Suh,U Oh 대한약학회 1999 大韓藥學會 總會 및 學術大會 Vol.48 No.-

혈관내 초음파를 이용한 국소형과 미만형 관동맥 경련부위의 형태학적 차이

임상현,승기배,장기육,김범준,정해억,강동헌,정욱성,김종진,박인수,김재형,홍순조,최규보 대한순환기학회 2001 Korean Circulation Journal Vol.31 No.8

한국형 자궁경부 촬영진 ( New Cervicography ) , 세포검사 그리고 HPV-DNA 검사를 이용한 새로운 자궁경부암 검진 모델 ( Model ) 개발

김승조(SJ Kim),박찬규(CK Park),이효표(HP Lee),남궁성은(SE Namkoong),강순범(SB Kang),서호석(HS Saw),이재관(JK Lee),김수녕(SN Kim),김재원(JW Kim),배석년(SN Bae),김찬주(CJ Kim),이근호(KH Lee),이선영(SY Lee),김인호(IH Kim),이찬(C Lee),이정노(JN Lee) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.5

N/A Objective : The false negative rate of conventional cytology is reported to range from 18 to 45%. It is necessary to develop more effective screening strategies that would ideally be more accurate than conventional cytology. This study is designed to investigate the potential of conventional cytology, cervicography, HPV-DNA testing and their combinations as primary screening techniques for cervical neoplasia. The purpose of this project is to develop the models and guidelines for screening tools of cervical cancer of the uterus by evaluating sensitivity, specificity and cost-effectiveness of all the screening methods. Study design : We conducted a screening of random sample of women who visited the department of OB-Gyn. of five different major university hospitals such as Catholic University Hospital, Korea University Hospital, Seoul National University Hospital, Yeonsei University Hospital and Pochon CHA University Bundang CHA Hospital, from May 1, 1996 to April 30, 1999. In a cohort women with an age range of 20 to 70 who underwent routine cytologic screening at Catholic University, Hospital Bundang CHA General Hospital and local clinics from April 1, 1996 to Decomber 31, 2000. cervicography (n=417,125) and testing for HPV-DNA (n=1,347) by the hybrid capture assay were studied for the ability of the cervical cancer screeuing. A new cervicography system with Kim's classification which was developed by Prof. Kim Seung Jo as an adjunctive method for the cervical cancer screening was applied in this cohort study. And then, accuracy, effectivencess, cost-effectiveness of the single or combined screening method were analysed. Result : Sensitivity and specificity of Pap smear were ranged from 55.6% to 83.1% and 72.8% to 88.3% respectively. The combination of Pap smear and cervicography had sensitivity from 89.7% to 98.6%, specificity from 68.2% to 93.2%. With combination of Pap smear, HPV DNA test and cervicography, sensitivity became also highest accuracy among all screening methods from 92.8% to 98.8%. Considering medical charges for diagnosis and social cost occurred by false positive and false negative results, the most cost-effective diagnostic modality was thought to be the combination of Pap smear and cervicography(91,433 won). In patients who were diagnosed as LSIL, colposcopic examination confirmed progression to high grade intraepithelial lesion(HSIL) in 10.7% patients, persistence of LSIL in 55% patients during the 3 year follow-up period. Accuracy of the screening for cervical cancer and CIN can significantly be improved by cytology with new cervicography rather than cytology alone. We concluded that cervicography can be important adjunctive tests for cervical cytology, improving the effectiveness of cervical screening by allowing a more sensitive detection of cervical neoplasia.