진행된 쌍태아 임신과 동반한 포상기태 1 예

안영준,신향미,전권희,문인근,서홍식,송호영,안혜선 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.1

본 저자들은 31세 임산부에서 진행된 부분포상기태가 있으면서 쌍태아 임신을 경험하였기에 간단한 문헌고찰과 함께 보고하는 바이다. Ultrasonography has become the preferred noninvasive diagnostic imaging modality that enables early confirmation of gestational trophoblastic disease. Twin pregnancy with partial hydatidiform mole and coexisting fetuses was lived at a later gestational age, and had higher preevacuation beta-hCG levels. When disease is not metastatic, chemotherapy is started for a rising or persistantly elevated beta-hCG level. Teh common complications of hydatidiform mole, hemorrhage and infection, decreased in incidence recently due to early diagnosis and evacuation of hydatidiform molar tissue. We recently experienced one case of advanced twin pregnancy with partial hydatidiform mole and coexisting fetuses.

산부인과 영역에서 마이코프라스마 호미니스 감염에 관한 연구

안희성(HS Ahn),주갑순(KS Ju),이금자(KJ Lee),김상재(SJ Kim) 대한산부인과학회 1989 Obstetrics & Gynecology Science Vol.32 No.11

1987년 6월부터 9월까지 3개월간에 걸쳐서 고려대학교 구로병원 외래에 내원한 환자중 187명을 대상으로 M. hominis 배양 및 발육저지검사를 시행하여 다음과 같은 결론은 얻었다. 1. 대조군은 63예중 9예에서 M. hominis 양성을 보여 14.3%(9/63)의 감염율을 보였고, 불임군 골반염군 및 자궁경부염군에서 각각 22.7%(15/66), 21.4%(3/14) 및 17.9%(7/39)의 M.hominis 감염을 보였다. 2. 불임군 66예중 정상불임군, 배란이상군, 난관패색군, 자궁내막유착군, 골반염군 및 자궁경부염군으로 분류관찰한 바 각각 16.7%(3/18), 15.0%(3/20), 18.8%(3/16), 22.2%(2/9) 20.0%(1/5) and 40.0%(4/10)에서 M. hominis 의 감염을 보였나 대조군과 비교시 자궁경부염군에서만 유 의한 차이를 보였다. 3. 연령별 대조군에서는 연령이 증가됨에 따라 감염율이 증가되는 반면, 골반염군 및 자궁경관염군에서는 연령이 증가됨에 따라 감소되는 추세를 보였다. 4. 자연유산의 병력이 있는 예에서는 대조군보다 유의하게 M. hominis 의 감염율이 높았다. 5. 여성불임환자와 Artificial insemination of husband and in vitro fertilization을 시행함에 있어 반드시 M. hominis 검사를 시행하여야 한다고 사료된다. 1. Among 63 case of the control group , 9 cases were positive for M. hominis showing a 14.3%( 9/63) of the case. The positive rates for M. hominis in the infetility , PID and cervicities group were 22.7% (15/66), 21.49%(3/14) and 17.9%(7/39) respectively. 2. It was showing that the higher age, the higher infectivity in the control group except the cervicitis group which showed in the opposite way. 3. The 66 cases of infertiity group was subdivided into normal infertile couple, ovulatory failure tubal obstruction uterine synechia PID and cervicitis group and the positive rate for each group was consequently 16.7%(3/18), 15.0%(3/20), 18.8%(3/16), 22.2%(2/9) 20.0%(1/5) and 40.0%(4/10). The cervicitis group showed the highest infection of the M. hominis 4. The spontaneous abortion group showed a significantly higher infectivity rate for M. hominis 5. It is considered that tests for M. hominis were essential in infertility patients and case for artificial insemination of donor, Artificial insemination of husband and in vitro fertilization

초음파를 이용한 요도폐색을 동반한 낭포성 신장이형성의 산전진단 1 례

안희성(HS Ahn),김창곤(CG Kim),최남수(NS Choi),주갑순(KS Ju) 대한산부인과학회 1987 Obstetrics & Gynecology Science Vol.30 No.11

선천성 태아기형을 진단하는데는 여러 방법이 있지만 산모와 태아에 위험이 없고, 경제적인 초음파를 이용한 집단검진을 통해 태아 비뇨기계의 선천성기형을 조기에 발견하여 복구될 수 없는 비뇨기계 손상의 경우에는 부모에게 선택적 유산의 기회를 부여하고 폐색성 요로기형의 경우에는 외과적 시도를 통해 조기에 교정시켜 주는 것이 바람직하다. During the recent past ten years, or so, there has been much application in the use of ultrasonography as a diagnostic method in the field of Obstetrics and Gynecology. Ultrasonography has been used especially for detection of fetal abnormalities during the prenatal period. In Obstetrics, before the use of ultrasonography, the diagnosis or treatment for fetal urinary system developmental abnormalities was possible ustally only after delivery. In some instances, however, where there was a family history for urogenital system abnormalities followed with secondary symptoms, for example; fetal death, hyeramnios, cephalopelvic disproportion at delivery, etc., could there be any suspicion prenatally, for any abnormalities. However, with the development of ultrasonography, it is possible to observe the fetal urinary system with any possible developmental abnormality, 15 weeks after the last menstrual period. The authors of this case report found a 33 week old pregnant pregnant patient suspected of having an abnormal fetal position to have a fetal urinary tract abnormality, shown on a prenatal screening test with ultrasonography. This is a simple documentation to report a case of antenatal diagnosis of urinary tract abnormality-renal cystic hyperplasia accompanied with urethral obstruction.

난소종양 환자의 수술전 혈중 CA-125치의 분석평가

안재영,김성도,한종설,송혜섭,박정원,왕성리 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.7

1990년 1월부터 1994년 12월까지 서울 고려병원 산부인과에서 난소종양으로 개복수술을 시 행하고 수술전 혈청 CA-125치를 측정한 251예의 CA-125치의 분석결과는 다음과 같다. 1. 수술전 평균 혈청 CA-125치는 양성 난소종양, 경계성 난소종양 및 악성 난소종양에서 각각 36.6+-43.5(Mean+-SD) U/ml, 77.1+-41.2(Mean+-SD)u/ml and 567.7+-700.4(Mean+-SD)U/ml 로 나왔다. 2. 수술전 혈청 CA-125치는 양성 난소종양(36.6+-43.5(Mean+-SD) U/ml)에서보다 악성난소종 양 (567.7+-700.4(Mean+-SD)에서 경계성 난소종양 (77.1+-41.2(Mean+-SD)u/ml )에서 보다 악 성 난소종양에서 유의하게 높게 나타났다. 양성 난소종양과 경계성 난소암과의 비교에서는 유의한 차가 없었다(p$lt;0.05, mean+-SD). 3. 양성 난소종양에서 폐경전 연령군의 평균 CA-125치는 36.6U/ml이고 폐경후 연령군은 34.3U/ml로 두 연령군 사이의 CA-125치는 유의한 차이가 없었다(p$lt;0.05). 4. 양성 난소 종양군의 위양성율의 비교에서 기준치를 35U/ml와 65U/ml로 했을 경우 위양성율은 각각 31.2%와 10.5%로 기준치를 65U/ml로 한 경우가 35U/ml보다 위양성율이 유의하게 낮았다(p$lt;0.001). 5. 악성 난소종양의 임상기에 따른 CA-125 항원의 평균 농도는 1기 42.2+-23.9U/ml, 2기 67.3+-36.5U/ml, 3기 345.0+-231.5U/ml, 4기 21365.4+-1255.3U/ml로 병기가 증가할수록 CA-125 항원치는 유의하게 높게 나타났다(p$lt;0.05, mean+-SD). 6. 251예의 난소종양 환자의 평균 CA-125치는 기준치를 35U/ml로 했을때 만감도 75.8% 특이도 68.8%, 양성 예측치 35.5%, 음성 에측지 94.9%, 그리고 진단적 유효도는 69.7%이었고, 기준치 65U/ml로 했을 경우는 각각 57.6%, 89.5%, 78.6%, 93.3% 그리고 85.3%였다. 7. 양성 난소종양 중 자궁내막증에서 평균 CA-125치는 58.9+-33.5(mean+-SD)U/ml이고 하한치를 35U/ml와 65U/ml로 했을 경우 각각 55.5%, 23.2%로 가장 높은 위양성율을 나타내었다. 8. 임상병기에 따른 CA-125치의 양성율은 기준치를 35U/ml와 65U/ml로 했을 때 경계성 난소암의 경우 1기 57.1%. 42.8%, 2기 100%, 0%, 3기 100%, 100%, 4기 100%, 1000%이고 악성 난소종양에서 1기 50%, 25%, 2기 80%, 40%, 3기 100%, 100%, 4기는 100%, 100%이었다. 1기의 경우, 경계성 난소암의 경우 57.1%, 42.8%의 양성율과 악성난소종양의 경우 50%, 25%의 양성율을 보이므로 혈청 CA-125 단독 검사만으로 난소암의 조기진단은 어려울 것으로 사료된다. We evaluated serum CA-125 levels with 251 patients in ovarian tumor. The serum CA-125 levels were measured by immunoradiometric assay before lapartotomy in 218(86.8%) cases of benign ovarian tumor, 10 (4.0%) cases of low malignant ovarian tumor and 23(9.2%) cases of malignant ovarian tumor. The mean concentration of preoperative serum CA-125 antigen in benign, boderline and malignant ovarian tumor were 36.6+-43.5(Mean+-SD) U/ml, 77.1+-41.2(Mean+-SD)u/ml and 567.7+-700.4(Mean+-SD)U/ml, respectively. These findings suggest that elavated serum CA-125 levels help differential diagnosis of ovarian malignancy from benign and borderline ovarian tumor, but less relateive differential diagnosis of boderline malignant tumor from benign ovarian tumor(p$lt;0.05). Among 218 patients with benign ovarian tumor, CA-125 levels above 35U.ml, and 65U/ml were detected in 68(31.2%) and 23(10.5%) cases of the patients respectively. Seven of 10(70%) cases of boderline ovarian tumor were associated with CA-125 levels above 35 U/ml and 5 of 10(50%) cases had levels that exceeded 65U/ml. Eighteen of 23(78.3%) cases of malignant ovarian tumors were associated with CA-125 levels above 35U/ml and 14 of 23(60.9%) cases had levels that exceeded 65U/ml. In 251 patients with benign, boderline and malignant ovarian tumors, the positive rates of preperative serum CA-125 levels were 75.8% sensitively, 68.8% specificity, 35.5% positive predictive values, 94.4% negative predictive value, and 69.7% diagnostic efficiency for a 35Uml cut-off and 57.6%, 89.5%, 78.6%, 93.3% and 85.3% resectively for a 65U/ml cut-off. This serum CA-125 levels seem to provide less information for early diagnosis of both boderline malignant and malignant ovarian tumors due to highly false negativity of early stage in boderline malignant and malignant ovarian tumor. The mean concentration of preoperative serum CA-125 antigen of stage I, II, III, IV in malignant ovarian tumor were 42.2+-23.9(Mean +-SD)U/ml, 67.3+-36.5(Mean+-SD)U/ML, 345.0+-231.5(Mean+-SD)U/ml and 2136.4+-1255.3(mean+-SD), respectively. Preoperative CA-125 level have good correlation with clinical stage of ovarian maligancy. Accurate diagnosis of the malignant ovarian tumors may be difficult becase endometriosis(58.9+-33.5U/ml) and other benign ovarina tumors showed high concentration and false positive rate.

Antiangiogenic and antitumor effect of fumagillol derivatives

HS Lee,HJ Park,JH Lee,JM Lee,JS Shin,JK Kim,JG Kim,SK Ahn,HJ Shin,CI Hong 대한약학회 1999 大韓藥學會 總會 및 學術大會 Vol.48 No.-

임산부에서 페동맥색전증에 대한 임상고찰

안현숙,서성숙,황혜란,박영춘,이유희 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.8

Pulmonary embolism is a life threatening disease that needs early and accurate diagnosis. Clinical characteristics were analyzed from the chart record of the patients with pulmonary embolism from January, 1990 to July, 1995. The result are as follow; 1) Incidence of pulmonary embolism was 1 in 3715 deliveries(0.03%). 2) Pulmonary embolism was seen most frequently among the age group of less than 30 years of age. Mean age was 26.4 years. 3) The risk were postpartum(100%), operation(93.3%), anemia(46.7%), obesity(40.0%), hypertension(33.3%). 4) The common symptoms were chest pain(80.0%), dyspnea(66.7%), and sweating(26.7%). The common physical findings were tachycardia over 100/min(73.3%), tachypnea over 20/min(60.0%), decreasing breathing sound on auscultation(40.0%). 5) Laboratory findings were elevated LDH, leukocytosis, hypoalbuminemia under 3.0 mg/dl. 6) The most common EKG findings were sinus tachycardia(66.7%). 7) The chest X-ray showed normal in 53.3% and pleural effusion in 13.3%. 8) The lung perfusion scan showed multiple segmental defects in 46.6%. 9) All cases were treated by heparin and there was no maternal death.

중증 임신성구토와 동반된 Wernicke-Korsakoff증후군 1 례

안치석,노재숙,김학순,정은환,이종철 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.2

Thiamine deficiency is known to lead to certain neurological sequelae including Wernicke-Korsakoff syndrome. Signs attributable to this condition include ataxia, ophthalmoplegia, nystagmus, and mental confusion. The prompt use of thiamine prevents progression of the disease and reverses those lesions that have not yet progressed to the point of fixed structual change. We have experienced a case of Wernicke-Korsakoff syndrome associated with hyperemesis gravidarum, which seemed to be developed by prolonged thiamine-free dextrose therapy, we emphasise the need for thiamine supplementation in hyperemesis gravidarum patient.

Sertoli-Leydig Cell Tumor의 1 례

안정자,정희수,이미자,박경숙,김향미,유은희 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.4

저자 등은 23세의 미혼 여성에서 발생한 Sertoli-Leydig cell tumor의 1례를 경험하였으며, 수술후 현재 경과를 관찰중인 바 간단한 문헌고찰과 함께 보고하는 바이다. Sertoli-Leydig cell tumors of the ovary are sex cord stromal tumors, similar to that seen in the various phase of testicular development in the male. It is the most common type of all virilizing ovarian tumors. This case is presented with a brief review of the literature.

퇴행성 경추질환에서 자기공명영상과 컴퓨터 단층촬영간의 진단적 일치

안태준,현동근,박현선,김은영,박종운,하영수,박형천 대한신경외과학회 2002 Journal of Korean neurosurgical society Vol.32 No.1

양막대로 인한 무뇌증과 후경부 피부결손

안치석,노재숙,김학순,정은환 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.8

The association of major fetal malformations with amniotic bands has been known for many years. However, we are apt to ignore the possibility of amniotic band syndrome. In this case, fetal anencephaly was diagnosed at 17 weeks, menstrual age on the basis of sonographic findings. Following pregnancy termination, examination of the abortus rev- ealed the cerebral remnant which is similar to that found in dysraphic anencephaly, but collateral evidence of amniotic band was found. Therefore, when confronted with severe cranial or cerebral malformation amniotic band syndrome should be in the differential dia- gnosis.