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복강경하 일측 난관절제술 후 발생한 복강 내 착상 융모조직의 치료 예
문성택 ( Seong Taek Mun ),김윤숙 ( Yun Sook Kim ),전섭 ( Seob Jeon ),최승도 ( Seung Do Choi ),선우재근 ( Jae Gun Sunwoo ),배동한 ( Dong Han Bae ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.4
The incidence of ectopic pregnancy has increased considerably a decade. And treatment has changed from salpingectomy by laparotomy to conservative laparoscopic surgery or medical treatment. This procedure has many advantages, but there are also disadvantages with the conservative approach and several studies have reported a higher incidence of residual trophoblastic tissue remaining in the tube after treatment. Postoperative follow up of human chorionic gonadotropin (hCG) levels and ultrasonography are needed. This report describes a rare case of persistent trophoblastic implants to the ovary and peritoneum 40 days after laparoscopic salpingectomy. Treatment consisted of laparoscopic excision with biopsy forceps and bipolar, followed by medical treatments. So we report with a brief review of literatures.
문성택 ( Seong Taek Mun ),김윤숙 ( Yun Sook Kim ),전섭 ( Seob Jeon ),최승도 ( Seung Do Choi ),선우재근 ( Jae Gun Sunwoo ),배동한 ( Dong Han Bae ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.9
Uterine prolapse is extremely rare during pregnancy. However in some cases significant complications such as urinary tract infection, voiding difficulty, abortion, and preterm labor may develop. Conservative management consisted of bed rest and use of a pessary. An elective cesarean section near term is the safest mode of delivery in cases where the cervix is edematous and elongated. We present a case of a patient developing uterine prolapse at 12 weeks of gestation, treated with bed rest and use of a pessary. A repeat cesarean section was performed at 38 weeks of gestation and report with a brief review of literatures.
동일 난소에서 발생한 충돌종양인 거대 장액성낭선종과 성숙기형종의 복강경적 치료 1예
이나혜 ( Na Hye Lee ),홍정희 ( Jung Hui Hong ),김윤숙 ( Yun Sook Kim ),문성택 ( Seong Taek Mun ),전섭 ( Seob Jeon ),선우재근 ( Jae Gun Sunwoo ),배동한 ( Dong Han Bae ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.1
충돌 종양은 같은 조직에서 조직학적으로 완전히 다른 두 개의 종양이 동시에 존재하는 것으로 난소에서의 발생은 매우 드물다. 난소 종양 중 양성 낭성기형종은 발생빈도가 매우 흔하여, 난소에서 다른 종양과 동시 발생하는 경우가 많다. 따라서 난소에서 충돌종양의 가장 흔한 조직학적인 조합은 점액성 종양과 양성 낭성기형종이며, 장액성 낭선종과 동시에 발생한 보고는 매우 드물다. 저자 등은 최근 우측 난소에서 동시 발생한 드문 충돌종양인 약 30 cm 크기의 거대 장액성 낭선종과 양성 낭성기형종을 복강경적으로 치료한 예를 경험하여 간단한 문헌고찰과 함께 보고하는 바이다. Collision tumor means the coexistence of two adjacent, but histologically distinct tumors without histologic admixture in the same tissue and is rare incidence involving ovary. Because of their incidence of occurrence, benign cystic teratomas often occur coincidentally with other abnormalities of the ovary. Most common histologic combination of collision tumor in the ovary is coexistence of teratoma with mucinous tumors. But its association with serous tumor has been noted rare and incidence is unknown. We have experienced a case laparoscopic treatment of a huge serous cystadenoma combined with ovarian benign cystic teratoma in right ovary, and report it with a brief review of literature.
산과적 출혈의 처치에 있어서 동맥색전술의 적용실례, 효과 및 합병증
박보라 ( Bo Ra Park ),이나혜 ( Na Hye Lee ),김윤숙 ( Yun Sook Kim ),문성택 ( Seong Taek Mun ),선우재근 ( Jae Gun Sunwoo ),배동한 ( Dong Han Bae ),강채훈 ( Chae Hun Gang ) 대한주산의학회 2009 Perinatology Vol.20 No.1
목적: 보존적 방법으로 조절되지 않는 산과적 출혈의 처치에 있어 본원에서 2년간의 정맥 색전술의 적용실례, 효과 및 합병증에 대해 알아보기 위해 시행했다. 방법: 2006년 1월 1일부터 2008년 12월 31일까지 순천향대학교 천안병원 산부인과학교실에 내원하여 내과적인 방법과 보존적인 지혈방법으로 지혈이 이루어지지 않아 동맥색전술을 받은 25명의 환자를 대상으로 했다. 결과: 적응증으로는 자궁이완증 10예, 제왕절개 시 근종절제수술을 함께 받았던 경우가 6예, 비정상적인 태반 이상의 경우가 5예, 동-정맥 기형이 3예, 자궁경부 임신의 경우가 1예였다. 전체 성공률은 25명 중 22명으로 88%였다. 평균 수혈량은 환자 1인 당 7.2 unit이었고, 색전술에 소요된 시간은 평균 55분이며, 평균 재원일수는 5.5일이었다. 성공한 22명에서 모두 정상적으로 생리가 돌아왔다. 합병증은 시술 후 한 명에서 우측하지 감각이상을 호소했고, 다른 한 명에서 생리량 감소가 있었다. 결론: 본 연구에서 보존적 치료에 실패한 산과적 출혈 환자에 있어서 색전술은 대량실혈을 방지하면서 자궁을 보존할 수 있는 비교적 안전하면서도 효과가 뛰어난 이상적인 방법임을 보여주고 있다. Purpose: The objective of this study was to evaluate the indications, effectiveness and complications associated with uterine arterial embolization as an alternative treatment of obstetrical hemorrhage. Methods: From January 2006 to December 2008, 25 patients who underwent angiographic embolization for the obstetrical hemorrhage that was not responsive to conventional treatments, like obstetric maneuvers and uterotonic drugs, were included in our study. All medical records were reviewed and detailed clinical data such as clinical status, underlying conditions, amount of transfusion, embolized arteries, hospital stay, the success rate and the complications were collected. Results: We have experienced clinically successful embolization in 22 (88%) of 25 patients with obstetrical hemorrhage resulting from various causes. After embolization, the patients` vital signs were stabilized. The causes of hemorrhage were atony of uterus (n=10), myomectomy during cesarean section (n=6), abnormal placentation (n=5), arterio-venous malformation (n=3), and cervical pregnancy (n=1). The average amount of blood transfusion was 7.2 units (range; 0~39 units). The average length of the time for the procedure was 55 minutes (range: 25~96 minutes). The average duration of hospitalization was 5.5 days (range: 2~14 days). In 22 patients, menses resumed spontaneously after procedures. The main complications after embolization were numbness and pain on lower extremities (n=1), and hypomenorrhea (n=1). Conclusion: The atrerial embolization is one of the safe and effective procedures that offers patients an alternative to hysterectomy for the treatment of intractable postpartum hemorrhage.
비전형 초음파 소견을 보이는 임신 9주에 진단된 자궁각임신
유애리 ( Ae Li Ryu ),김윤숙 ( Yun Sook Kim ),문성택 ( Seong Taek Mun ),전섭 ( Seob Jeon ),최승도 ( Seung Do Choi ),선우재근 ( Jae Gun Sunwoo ),배동한 ( Dong Han Bae ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.4
자궁각임신은 난관의 간질부에 착상이 일어나는 자궁외임신의 한 종류이다. 자궁각임신은 자궁외임신의 드문 형태로 임상적 소견은 난관임신과 유사하여 조기 진단이 어려운 경우가 많다. 모든 난관임신의 2~4%의 빈도를 차지하는 드문 질환이지만, 간질부의 풍부한 혈관 분포로 인하여, 파열될 경우 대량 출혈의 위험으로 인하여 산모의 이환율 및 사망률이 높은 질환이다. 자궁각임신에 의한 자궁파열은 주로 임신 8주에서 16주 사이에 일어나는 것으로 알려져 있다. 저자들 A cornual pregnancy occurs when the conceptus implants at the cornus of the uterus which is the junction between the fallopian tube and uterine cavity. Cornual pregnancy is a rare form of ectopic pregnancy and its diagnosis is difficult. It accounts for 2
단일 신장의 요로결석에 의한 급성신부전증과 중복자궁에서의 자궁질유혈증
유애리 ( Ae Li Ryu ),김윤숙 ( Yun Sook Kim ),문성택 ( Seong Taek Mun ),전섭 ( Seob Jeon ),최승도 ( Seung Do Choi ),선우재근 ( Jae Gun Sunwoo ),배동한 ( Dong Han Bae ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.2
The unique clinical syndrome of the uterus didelphys, a unilateral partially or completely obstructed vagina, and ipsilateral renal agenesis is quite rare, and observed on the right side in greater frequency than on the left. The case of fifteen year old girl with uterus didelphys, unilateral partially obstructed vagina and acute renal failure associated with ureteral stone in unilateral kidney is described. Extracorporealshock wave lithotripsy (ESWL) and evacuation of the hematocolpos and excision of the vaginal septum were done. Aware of this relatively rare condition is mainstay of prompt diagnosis which will prevent permanent renal failure and unnecessary and destructive surgery.
계류유산 후 진단된 자연 병합임신과 급성충수돌기염의 복강경 치료
류은석 ( Eun Seok Ryu ),김윤숙 ( Yun Sook Kim ),문성택 ( Seong Taek Mun ),전섭 ( Seob Jeon ),최승도 ( Seung Do Choi ),선우재근 ( Jae Gun Sunwoo ),배동한 ( Dong Han Bae ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.12
Ectopic pregnancy and appendicitis in pregnancy are two most common causes of acute abdomen in young women and differenciation of these diseases is very difficult. Heterotopic pregnancy is a rare event, occuring less than 1:30,000 pregnancies in natural conception cycles. However, with assisted reproduction techniques, this incidence has increased. We experienced a case of spontaneous heterotopic pregnancy after missed abortion and acute appendicitis treated by laparoscopy. So we report this case with brief review of literature.
현혜선 ( Hye Sun Hyeon ),박보라 ( Bo Ra Park ),김윤숙 ( Yun Sook Kim ),문성택 ( Seong Taek Mun ),전섭 ( Seob Jeon ),선우재근 ( Jae Gun Sunwoo ),배동한 ( Dong Han Bae ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.8
Premature ovarian failure (POF) is defined as the complete cessation of menses less than 40 years of age. The criteria are more than four months of amenorrhea, with serum follicle stimulating hormone value of >40 mIU/mL and the frequency of POF is about 1% of all women. Although the etiologies of POF remain unknown, suggested factors are genetic, autoimmune, chemotherapy, radiotherapy and environmental toxins. The cytogenetic abnormalities predominantly concern the X chromosome, including Turner syndrome, Fragile X syndrome and deletion, translocation, or duplication of X chromosome. We report a very rare case of premature ovarian failure with the following karyotype: 46,X,dup(Xq), and report it with a brief review of literature.
Toremifene 사용과 관련된 자궁내막 폴립 1 예
정집광(Jib Kwang Chung),이석민(Seok Min Lee),박은희(Eun Hee Park),방성윤(Sung Yun Bahng),김태성(Tae Sung Kim),문성택(Seong Taek Mun),진소영(So Young Jin) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.7
Antiestrogens have been widely used in the treatment of breast cancer patients. Although tamoxifen is one of the most prevalent antiestrogens, some reported its hepatocarcinogenic effects and the long-term treatment may increase the risk of endometrial and gastrointestinal cancer. Toremifene is an interesting new antiestrogen and have a similar antitumor efficacy as tamoxifen, with less side-effect including less uterotrophic effect compared to tamoxifen, in mice. we report a case of endometrial polyp which were associated with toremifene use, in postmenopausal woman with breast cancer, with a brief review of literature.