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신면우,김승철,송현진,성영미,김광준,송명화 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.11
저자들은 본 병원에서 난소 미성숙기형종 1례를 경험하고 수술후 PVB regimen에 따른 항암화학요법을 시행하여 호전중인 환자를 문헌고찰과 함께 보고하는 바이다. Immature teratoma of the ovary is a highly lethal, rare germ cell origin tumor. This tumor represents only 1% of all ovarian teratomas and occurs most commonly in children and young adults. The immature teratoma is composed of various quantities of immature tissue differentiating toward any or all three germ layers. Symptoms are abdominal pain, tenderness and palpable mass on abdomen or pelvis.
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체외수정 배양액에 대한 제대혈청 및 단백질 첨가의 난자성숙 및 난구 세포 분산에 미치는 영향
신현우,이여일,박현정 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.7
본병원 체외수정 시술후 임신된 배양액군과 임신에 실패한 배양액군에서 각각 Ham`s F-10 기본 배양액 및 소혈청단백 또는 태아제대혈청 첨가 배양액하에서 생쥐의 난자-난구 복합체 를 22시간 동안 배양하고 난자의 성숙도와 난구세포 분산정도를 비교분석한 결과 다음과 같은 성적을 얻었다. 1. 난자성숙의 진행정도는 Ham`s F-10 기본배양액과 소혈청단백 및 태아제대혈청첨가 배양 액 사이에 유의한 차이가 없어 두가지 첨가물 모두 난자 성숙에는 별로 영향을 주지않는 것으로 보인다. 2. 난구세포 분산에 있어서는 태아제대혈청 첨가배양액 만이 저명한 발현을 보여 이 혈청내 난구세포 분산 자극물질의 존재를 시사하였다. 3. 난자성숙과 난구세포 분산 공히 기본 배양액과 첨가 배양액에서 임신군과 비임신군 간에 유의한 차이가 없어 체외수정 성공여부와는 무관한 결과를 나타냈었으나, 생쥐 난자-난구 복합체 배양은 종전의 배아 배양 정도관리시 파악할 수 없었던 수정전 및 수정시기의 배양 조건의 질적평가에 새로운 시야를 제공하였다. OBJECTIVE : To investigate of effect of human cord serum(HCS) and bovine serum albumin(BSA) supplementation on oocyte maturation and cumulus cell expansion in vitro culture media. DESIGN : Random sampling of 6 conceptional media from 7 patients and 8 nonconceptional media from 14 patients resulted from our in vitro fertilization and embryo transfer(IVF-ET) program. Each medium was divided to three groups : Ham`s F-10(unsupplemented), Ham`s F-10 supplemented with 0.4% BSA and Ham`s F-10 supplemented with 10% HCS. Setting, Patients : In vitro fertilization (IVF) program and patients at the IVF clinic of Chonman University Hospital Kwangju. Korea. Interventions : oocyte cumulus cell(OCC) complexes were collected from removed ovaries of pregnant mare serum gonadotropin(PMSG) primed mice, and cultured in three different media. Main outcome Measures : The oocyte maturities were measured by the presence of germinal vesicle breakdown and polar body, and the cumulus cell expansions were analyzed by the degree of cellular dispersion. Results : Oocyte maturity was not significantly different among the three types of media. cumulus cell expansion was significantly increased only by HCS-supplemented media. Comparison of oocyte maturity and cumulus cell expansion among groups showed no significant differences between conceptional and nonconceptional media. Conclusions : The supplementions with HCS or BSA are not able to augment mouse oocyte maturation. The great cumulus expansion in HCS supplemented media suggest the presence of stimulatory in OCC complex. The OCC complex culture provides new insight into qualitative information on prefertilization and perifertilization events.
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신승권,최호준,윤길팔,양영균,양우열,고만석 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.4
The study was undertaken for the clinical evaluation and statistical analysis on the 222 patients with ectopic pregnancy who had been adbitted and treated at the Mokpo St. Columban`s Hospital from Jan. 1, 1993 to Dec. 31, 1995. The results were obtained as follows. 1. Hospital incidence of ectopic pregnancy wasd 1 in 45 deliveries(222/10,078). 2. Ectopic pregnancy was found to occur most frequently in the age group, ranging from 31 to 35 years(36.9%). 3. Nullipara was 26.5% and woman who had experienced artificial abortion was 69.8%. 4. Hemoglobin value over 10.0 gm/dL was in 78.8% and below 8.9 gm/dL in 4.1%. 5. Initial systolic blood pressure rise above 100 mmHg was in 75.0%, the mean value was 104.5mmHg. 6. The clinical manifestations were appeared in 64.4% from the last menstrual peroid to the next 5~8 weeks. 7. Total amount of intraperitoneal hemorrhage between 100~1,000 ml was in 62.1%, above the 1,000 ml was in 29.3% and less than 100 ml was in 8.6%. 8. Ectopic pregnancy was implanted follopain tuve in 95.0% ovary in 4.5% and cervix in 0.5%. Among tubal pregnancies, ampulla portion was involved in 76.6%, interstitial portion in 3.1%, isthmic portion in 12.2% and fimbrial portion in 3.1%. 9. In the past history, the laparoscopic tubal ligation was in 18%, peritonitis was in 1.8%, appendectomy was in 7.2% and cesarean section was in 8.6%. 10. Culdocentesis was positive in 70.0% and urinary HCG test was positive in 90%. 11. 77.8% of total cases was treated by salpingectomy, 14.9% by salpingoophorectomy and 1.4% by hysterectomy. 12. Of 222 total cases, no death occurred.
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신승권,한세준,최대용,최호준,김하봉,고종석 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.11
1981년 1월 1일부터 1987년 12월 31일까지 목포성골롬반병원 산부인과에서 자궁외임신 진단하에 입원 수술 후 병리학적 검사로 확인되었던 250예에 대하여 임상적 고찰을 하여 다음과 같은 결과를 얻었다. 1. 자궁외임신의 분만수에 대한 발생빈도는 1:77이었다(250예/19.222분만). 2. 호발연령군은 30∼34세로서 29.6%를 점유하였다. 3. 미산부가 24.4%였으며 인공유산의 경험이 있었던 경우가 66%였다. 4. 평균 Hb치는 9.9이었다. 5. 초기 수축기 혈압이 100이상인 경우가 80.4%였고 평균치는 109.7이였다. 6. 임상증상은 64.8%가 최종 월경일로부터 5∼8주에 나타났다. 7. 복강내 출혈량은 500∼1000ml가 22.4%, 1000ml이상은 66.4%, 500ml이하인 경우가 11.2%였다. 8. 착상부위는 난관이 97.8%, 난소 2.4%, abdomen이 0.4%였고, 난관중 팽대부가 79.2%, 간질부 4%, 협부 10.8% 난관채 3.8%였다. 9. 수술시 소견으로 골반염증 24.5%, 난소낭종 11.6%, 자궁근종이 0.4%였고, IUD를 장치한 경우도 5.2%였다. 10. 기왕력중 복강경 난관결찰술 15%, 반복 자궁외임신이 7.6%, 충수돌기 절제술 5.2%, 제왕절개술이 1.2%였다. 11. Douglas와 천자는 87.1%에서 적중율을 보였고, 12.9%에서는 음성을 보였고, 임신 반응검사는 65%에서 양성으로 나타났다. 12. 수술방법은 환측 난관절제술이 82%, 환측 부속기 제거가 13.6%, 자궁전적출이 2.8%이였다. 13. 사망률은 1예도 없었다. This study was undertaken for the clinical evaluation and statistical analysis on the 250 patients with ectopic pregnancy who had been admitted and treated at the Mokpo St. columban Hospital from Jan. 1, 1981 to Dec. 31, 1987. The results were obtained as follows. 1. Hospital incidence of ectopic pregnancy was 1 in 77 deliveries(250/19222). 2. Ectopic pregnancy was found to occur most frequently in the age group, ranging from 30 to 34 years(29.6%). 3. Nullipara was 24.4% and woman who had experienced artificial abortion was 66%. 4. Mean hemoglobin level 9.9mg/이. 5. Initial systolic blood pressure rise above 100 mmHg was in 80.4%. The mean value was 109.7 mmHg. 6. The clinical manifestation were appeared in 64.8% from the last menstrual peiod to the next 5∼8 weeks. 7. Total amount of intraperitoneal hemorrhage was between 50∼ 1000ml was in 22.4%, above the 1,000ml was 66.4% and less the 500ml was 11.2%. 8. Ectopic pregnancy was implanted in fallopian tube 97.8%, ovary in 2.4% and abdomen in 0.4%. Among tubal pregnancies, ampullar portion was involved in 79.2% interstitial portion in 4%, isthmic portion in 10.8% and fimbrial portion in 3.8%. 9. The combined pelvic disorders found during poeration were pelvic inflammatory disease in 24.5%, ovarian cyst in 11.6%, uterine myoma in 0.4% and the case applicated with IUD in 5.2%. 10. In past history, the laparascopic tubal ligation was in 15%, repeated ectopia was in 7.6%, appendectomy was in 1.5% and cesarean section was in 1.5%. 11. Culdocentesis was positive in 87.1%, negative in 12.9%, and Gravindex test was positive in 65%. 12. 82% of total cases was treated by salpingectomy, 13.6% by salpingoophorectomy and 1.6% by hysterectomy. 13. Of 250 total cases, no death occured.
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신승권,최호준,고만석,정병욱,정진국,이호형 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.1
From January 1992 to December 1996, 1371 cases of major gynecologic surgery were performed at Mokpo St. Columban`s Hospital. Among these, 282 cases were uterine myoma confirmed histopathologically. A clinicopathologic study on these 282 cases were carried out to understand the clinical characteristics of uterine myoma. The results were as follows. 1. Myoma was observed most frequently in the age group of 40 to 49 years, and the mean age was 43.7 years. 2. The parity was 3.6 in average. The infertility was observed in 17 cases(6.0%), in which the primary infertility was 3.2% and secondary 3.1% respectively. 3. The most frequent chief complaint was pain which was observed in 231 case(81.3%), abnormal bleeding in 207 cases(30.9%). Transfusion was taken in 42 cases(14.9%). 4. The mean value of preoperative hemoglobin was 11.2g% and the anemia (Hb < 10.0g%) was observed in 87 cases(30.9%). Transfusion was taken in 42 cases(14.9%). 5. The corporeal myoma was wbserved in 266 cases(94.3%), cervical area in 7 cases(2.5%), intraligamentary in 5 cases(1.8%), combined in 4 cases(1.4%) respectively. The intramural type was observed in 157 cases(55.7%), subserous in 46 cases(16.3%), mixed type in 44 cases(15.6%), submucous in 35 cases(12.4%) respectively. 6. The mean weight of the uterine myoma after myomectomy and uterus after hysterectomy was 347.3g. In 11 cases(3.9%), the weight was below 100g. 7. The secondary change in myoma was found in 26 cases(9.2%) and the most common change was hyaline degeneration(5.7%). 8. The most common associated condition was chronic cervicitis, which was observed in 141 cases(50.0%). 9. Hypermenorrhea was observed in 165 cases(58.6%) and there was a significant correlation between the presence of hypermenorrhea and the type of myoma, but no correlation with the weight of myoma. 10. Dysmenorrhea was observed in 108 cases(38.3%) and there was no sighificant correlations between the dysmenorrhea and the weight of myoma, and type of myoma. But, there was significant correlations between the dysmenorrhea and adenomyosis. 11. Total abdominal hysterectomy was performed in 184 cases(65.2%), total abdominal hysterectomy with unilateral adnexectomy in 45 cases(16.0%), total abdominal hysterectomy with both adnexectomy in 23 cases(2.8%), subtotal hysterectomy in 5 cases(1.8%) respectively. 12. The postoperative complications were found in 50 cases(17.7%) and the most common complication of these was infection of wound seen in 36 cases(12.8%). 13. The mean period of hospitalization was 8 days, and the period less than 10days was observed in 249 cases(88.3%).
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