수질아세포종 환자에서의 성공적 임신과 분만

곽세현 ( Se Hyoun Kwak ),박인양 ( In Yang Park ),위지선 ( Ji Sun We ),최미랑 ( Mi Rang Choi ),신종철 ( Jong Chul Shin ) 대한산부인과학회 2011 Obstetrics & Gynecology Science Vol.54 No.3

Medulloblastomas are rare neoplasms in adults. Medulloblastomas are treated by surgical removal of the tumor followed by radiotherapy. Because craniospinal irradiation can damage the hypothalamic-pituitary axis, uterus, and ovaries, and consequently result in infertility, the probability of pregnancy is quite low. We managed a patient who had undergone resection of a posterior fossa medulloblastoma and received craniospinal irradiation, who conceived spontaneously during follow-up. She was diagnosed with a recurrent medulloblastoma with metastasis to the spine accompanied by headaches and back pain at 26 weeks gestation. Conservative treatment measures were utilized in an effort to prolong the pregnancy. She was delivered by cesarean section due to recurrent seizure activity at 29 weeks plus 3 days gestation. The neonate made favorable progress and was discharged in good condition.

A comparison between prenatal ultrasound and fetal MR Imaging in Life-threatening diffuse neonatal hemangiomatosis (DHN) complicated with Kasabach-Merritt-syndrome

곽세현 ( Se Hyoun Kwak ),Se Kyung Choi,Jeong Su Choi,Yeun Hee Kim,Ki Chul Kil,Gui Se Ra Lee,Sa Jin Kim,Hyun Young Ahn,Jong Chul Shin 대한산부인과학회 2008 대한산부인과학회 학술대회 Vol.94 No.-

The comparison of β-hCG Levels according to treatment modalities in tubal pregnancy

위지선 ( Ji Sun We ),Se Hyoun Kwak,Youn Jee Chung,Sae Kyung Choi,Jeong Soo Choi,Hyun Young Ahn,In Yang Park,Jong Chul Shin 대한산부인과학회 2008 대한산부인과학회 학술대회 Vol.94 No.-

단일융모막쌍태임신에서 일측태아의 우측폐무발생증

최미랑 ( Mi Rang Choi ),곽세현 ( Se Hyoun Kwak ),천주영 ( Ju Young Cheun ),위지선 ( Ji Sun We ),이영 ( Yong Lee ),신종철 ( Jong Chul Shin ) 대한산부인과학회 2011 Obstetrics & Gynecology Science Vol.54 No.5

Unilateral pulmonary agenesis is uncommon congenital malformation which refers to total absence of pulmonary parenchyma and blood vessels as well as bronchia beyond the tracheal bifurcation. And, it is rarely to make prenatal diagnosis. Indirect prenatal sonographic findings in this malformation include mediastinal shift of the heart together with lack of evidence of diaphragmatic hernia. And more reliable diagnosis is obtained by Doppler sonographic finding with lack of branching of the pulmonary artery. Its prognosis depends largely on the presence of associated other congenital anomalies. But unilateral pulmonary agenesis does not result in the death of the infant and is compatible with long-term survival. So, selective termination is not recommended. In the case herein, right pulmonary agenesis of one fetus in a monochorionic twin pregnancy was diagnosed by prenatal sonography. We describe this case with a brief review of the literature.

STRUCTURAL EVOLUTION OF THE EASTERN SOUTH YELLOW SEA BASIN INTERPRETED FROM CROSS-SECTION RESTORATION

Gwang H. Lee,Booyong Kim,Gi-Hyoun Kim,Won-Jun Kwak,Se-Jin Park 대한지질학회 2000 대한지질학회 학술대회 Vol.2000 No.

Successful maternal Low dose digoxin therapy of fetal arrhythmia(초)

위지선 ( Ji Sun We ),( Ju Young Cheon ),( Se Hyoun Kwak ),( Jae En Shin ),( Sae Kyung Choi ),( In Yang Park ),( Jong Chul Shin ) 대한산부인과학회 2009 대한산부인과학회 학술대회 Vol.95 No.-

난관임신에서 치료방법에 따른 β-hCG의 수치변화의 비교

위지선 ( Ji Sun We ),곽세현 ( Se Hyoun Kwak ),정윤지 ( Youn Jee Chung ),최세경 ( Sae Kyung Choi ),최정수 ( Jeong Soo Choi ),안현영 ( Hyun Young Ahn ),박인양 ( In Yang Park ),신종철 ( Jong Chul Shin ) 대한주산의학회 2008 Perinatology Vol.19 No.2

목적: 난관임신의 치료에서 MTX 치료와 난관절제술에서의 혈청 β-hCG수치의 변화를 비교하여 MTX 치료의 효과를 확인하고, MTX 치료의 실패군과 성공군의 차이를 확인하여 MTX 치료의 선택기준의 결정에 도움이 되자 하였다. 방법: 2006년 1월부터 2007년 12월까지 난관임신으로 진단받은 후 강남성모병원 산부인과에 입원하여 치료를 받은 118명의 환자의 의무기록을 후향적으로 연구하였다. 결과: 총 118명의 환자 중 52명에서는 MTX요법을 시행하였고 66명은 나팔관절제술을 시행하였는데, MTX요법으로 치료를 받은 환자 중 33명은 MTX 요법만으로 치료가 종결 되었으나 19명은 수술적 처치가 필요하였다. MTX 요법의 성공군과 실패군에서 임신 일수는 차이가 없었으나, 초음파상 나팔관임신 부위의 혈종 크기와 혈복강의 양, 혈청 β-hCG 수치 등은 통계적으로 유의한 차이가 있었다(p<0.05). MTX 요법은 나팔관 절제술에 비해 치료 후 혈청 β-hCG의 감소의 비율이 적고 치료 초기에는 오히려 증가하는 양상을 보였으나 치료 후 7일 이후 급격히 감소하여 치료 후 28일에는 나팔관절제술과 같은 결과를 보였다. MTX 요법에서 치료 초기(~3일)의 혈청 β-hCG 변동 비율은 치료 실패 여부와 관련성이 유의하지 않았다. 결론: 나팔관임신 부위의 크기와 혈복강의 양 및 치료 전의(초기) 혈청 β-hCG수치는 MTX 치료의 성공 여부에 중요한 인자이다. 혈역학적으로 안정되어 있는 나팔관임신의 환자에서 특히 나팔관의 보존이 필요한 경우에 MTX 치료를 비교적 안전하고 효과적으로 사용해 볼 수 있겠다. Objective: The aims of this study were to evaluate the effect of the methotrexate (MTX) method by comparing the change of the serum β-hCG level between the MTX method and salpingectomy for treating tubal pregnancy, furthermore by analyzing differences between the MTX success group and the failure group, and to provide helps in establishing criteria for choosing the MTX method. Methods: Medical records of the 118 patients who were diagnosed with tubal pregnancy were reviewed retrospectively for the period of January 2006 to December 2007 at Kangnam St. Marys Hospital. Results: Between the MTX success group and the failure group, no difference was observed in pregnancy duration, but statistically significant differences were observed in the size of hematoma and the quantity of hemoperitoneum at the site of tubal pregnancy in ultrasonography and in the serum β-hCG level (p<0.05). Compared with salpingectomy, the MTX method showed the patterns of a low decrease rate of serum β-hCG level after treatment and even its increase during the early period of treatment, but the serum β-hCG level decreased rapidly from Day 7 after treatment and became equal to that of salpingectomy on Day 28 after treatment. Conclusion: The size of hematoma and the quantity of hemoperitoneum at the site of tubal pregnancy and the serum β-hCG level before treatment are important factors for success in the MTX method. The MTX method may be safe and effective relatively in hemodynamically stable tubal pregnancy patients, who need preserve the salpinx particularly.

황해 및 인접 지역 퇴적분지들의 구조적 진화에 따른 층서

유인창,김부용,곽원준,김기현,박세진,Ryo In Chang,Kim Boo Yang,Kwak won Jun,Kim Gi Hyoun,Park Se Jin 한국석유지질학회 2002 한국석유지질학회지 Vol.8 No.1

A comparison study for understanding a stratigraphic response to tectonic evolution of sedimentary basins in the Yellow Sea and adjacent areas was carried out by using an integrated stratigraphic technology. As an interim result, we propose a stratigraphic framework that allows temporal and spatial correlation of the sedimentary successions in the basins. This stratigraphic framework will use as a new stratigraphic paradigm for hydrocarbon exploration in the Yellow Sea and adjacent areas. Integrated stratigraphic analysis in conjunction with sequence-keyed biostratigraphy allows us to define nine stratigraphic units in the basins: Cambro-Ordovician, Carboniferous-Triassic, early to middle Jurassic, late Jurassic-early Cretaceous, late Cretaceous, Paleocene-Eocene, Oligocene, early Miocene, and middle Miocene-Pliocene. They are tectono-stratigraphic units that provide time-sliced information on basin-forming tectonics, sedimentation, and basin-modifying tectonics of sedimentary basins in the Yellow Sea and adjacent area. In the Paleozoic, the South Yellow Sea basin was initiated as a marginal sag basin in the northern margin of the South China Block. Siliciclastic and carbonate sediments were deposited in the basin, showing cyclic fashions due to relative sea-level fluctuations. During the Devonian, however, the basin was once uplifted and deformed due to the Caledonian Orogeny, which resulted in an unconformity between the Cambro-Ordovician and the Carboniferous-Triassic units. The second orogenic event, Indosinian Orogeny, occurred in the late Permian-late Triassic, when the North China block began to collide with the South China block. Collision of the North and South China blocks produced the Qinling-Dabie-Sulu-Imjin foldbelts and led to the uplift and deformation of the Paleozoic strata. Subsequent rapid subsidence of the foreland parallel to the foldbelts formed the Bohai and the West Korean Bay basins where infilled with the early to middle Jurassic molasse sediments. Also Piggyback basins locally developed along the thrust. The later intensive Yanshanian (first) Orogeny modified these foreland and Piggyback basins in the late Jurassic. The South Yellow Sea basin, however, was likely to be a continental interior sag basin during the early to middle Jurassic. The early to middle Jurassic unit in the South Yellow Sea basin is characterized by fluvial to lacustrine sandstone and shale with a thick basal quartz conglomerate that contains well-sorted and well-rounded gravels. Meanwhile, the Tan-Lu fault system underwent a sinistrai strike-slip wrench movement in the late Triassic and continued into the Jurassic and Cretaceous until the early Tertiary. In the late Jurassic, development of second- or third-order wrench faults along the Tan-Lu fault system probably initiated a series of small-scale strike-slip extensional basins. Continued sinistral movement of the Tan-Lu fault until the late Eocene caused a megashear in the South Yellow Sea basin, forming a large-scale pull-apart basin. However, the Bohai basin was uplifted and severely modified during this period. h pronounced Yanshanian Orogeny (second and third) was marked by the unconformity between the early Cretaceous and late Eocene in the Bohai basin. In the late Eocene, the Indian Plate began to collide with the Eurasian Plate, forming a megasuture zone. This orogenic event, namely the Himalayan Orogeny, was probably responsible for the change of motion of the Tan-Lu fault system from left-lateral to right-lateral. The right-lateral strike-slip movement of the Tan-Lu fault caused the tectonic inversion of the South Yellow Sea basin and the pull-apart opening of the Bohai basin. Thus, the Oligocene was the main period of sedimentation in the Bohai basin as well as severe tectonic modification of the South Yellow Sea basin. After the Oligocene, the Yellow Sea and Bohai basins have maintained thermal subsidence up to the present with short periods of marine transgressions 황해 및 인접 지역에 위치하는 퇴적 분지들의 구조적 진화에 따른 층서를 이해하기 위한 비교 연구가 통합층서기술을 이용하여 수행되었다. 본 연구의 잠정적 결과로 우리는 각 분지별 퇴적층들의 시$\cdot$공간상의 대비가 가능한 층서틀을 제안한다. 본 연구의 결과로 제안된 층서틀은 향후 황해 및 인접 지역의 석유자원 탐사를 위한 새로운 층서적 사고의 틀로 사용될 수 있을 것이다. 생층서 자료와 결합시켜 수행한 통합층서해석 결과, 캠브로-오오도비스기, 석탄기-트라이아스기, 쥬라기 초기-중기, 쥬라기 말기-백악기 초기, 백악기 후기, 팔레오세-에오세, 올리고세, 마이오세 초기, 마이오세 중기-플라이오세 퇴적층 등 9개의 단위층들이 인지된다. 본 연구를 통해 인지된 9개 단위층들은 구조층서단위로 황해 및 인접 지역 퇴적 분지들의 퇴적 작용 및 분지 형성과 변형에 관련된 구조운동 등에 관한 정보를 제공해 준다 남황해 분지는 고생대 동안 남중국 지괴의 북쪽 연변부에 발달하는 대륙 연변부 분지로 시작되었다 쇄설성 및 탄산염 퇴적물들이 상대적 해수면의 변동에 따라 윤회성을 보이면서 분지 내에 퇴적되었다. 그러나, 데본기 동안의 칼레도니안 조산운동에 의해 분지는 융기되어 침식을 받았으며, 결과로 캠브로-오오도비스기 단위층과 석탄기-트라이아스기 단위층 사이에 부정합이 형성되었다. 북중국 지괴와 남중국 지괴가 충돌될 때인 페름기 말기로부터 트라이아스기 말기 사이에 인도시니안 조산운동이 일어났다. 북중국 지괴와 남중국 지괴의 충돌에 따라 친링-다비-수루-임진강 습곡대가 형성되었으며, 고생대 퇴적층들은 융기된 후 변형을 받게 되었다. 이 후 습곡대에 평행한 대륙전사면이 빠르게 침강하면서 발해 분지 및 서한만 분지와 같은 대륙전사면 분지가 형성되어 쥬라기 초기-중기의 후조산성 퇴적물들이 분지를 충진시켰으며, 지역적으로 피기백 형태의 소규모 분지들이 저각의 역단층을 따라 발달하게 되었다. 이들 대륙전사면 분지나 피기백 형태의 분지들은 쥬라기 말기 동안에 일어나는 앤샤니안 조산운동 (일차)에 의해 변형된다. 그러나, 남황해 분지는 쥬라기 초기 및 중기 동안에 대륙내 침강 분지였던 것으로 보인다. 남황해 분지의 쥬라기 초기 및 중기 단위층은 분급도와 원마도가 양호한 규암역을 포함하는 두꺼운 기저 역암층과 함께 하성 및 호성 환경 하에서 퇴적된 사암 및 셰일들로 구성되어 있다. 한편, 탄루 단층대는 트라이아스기 말기로부터 좌수향의 운동을 시작하였으며, 쥬라기와 백악기를 거쳐 제삼기 초까지 계속되었다. 쥬라기 말기에 들어와 탄루 탄층대를 따라 이차 및 삼차 순위의 주향이동 단층들이 발달되면서 소규모 열개 분지들이 형성되기 시작하였다. 에오세말까지 지속된 탄루 단층의 이동에 의해 남황해 분지는 대규모의 횡압력을 받게되어 소규모 열개 분지들은 인리형 분지로 확장되었다. 그러나 쥬라기 말기와 에오세 말기까지 발해 분지는 융기되어 심한 변형을 받게되었다. 발해 분지의 백악기 초기 이후 에오세 말기까지의 부정합이 앤샤니안 조산운동 (이차 및 삼차)에 의해 형성된 것으로 해석된다. 한편 에오세 말에 이르러 인도판과 유라시아판의 충돌에 의한 히말라얀 조산운동의 영향으로 탄루 단층의 이동방향이 좌수향에서 우수향으로 변환되기 시작하면서 남황해 분지는 구조역전의 현상이 일어났으며, 동시

A new method and device of aligning patient setup lasers in radiation therapy

Hwang, Ui‐,Jung,Jo, Kwanghyun,Lim, Young Kyung,Kwak, Jung Won,Choi, Sang Hyoun,Jeong, Chiyoung,Kim, Mi Young,Jeong, Jong Hwi,Shin, Dongho,Lee, Se Byeong,Park, Jeong‐,Hoon,Park, Sung Yong,K unknown 2016 Journal of applied clinical medical physics Vol.17 No.1

<P>The aim of this study is to develop a new method to align the patient setup lasers in a radiation therapy treatment room and examine its validity and efficiency. The new laser alignment method is realized by a device composed of both a metallic base plate and a few acrylic transparent plates. Except one, every plate has either a crosshair line (CHL) or a single vertical line that is used for alignment. Two holders for radiochromic film insertion are prepared in the device to find a radiation isocenter. The right laser positions can be found optically by matching the shadows of all the CHLs in the gantry head and the device. The reproducibility, accuracy, and efficiency of laser alignment and the dependency on the position error of the light source were evaluated by comparing the means and the standard deviations of the measured laser positions. After the optical alignment of the lasers, the radiation isocenter was found by the gantry and collimator star shots, and then the lasers were translated parallel to the isocenter. In the laser position reproducibility test, the mean and standard deviation on the wall of treatment room were 32.3±0.93 mm for the new method whereas they were 33.4±1.49 mm for the conventional method. The mean alignment accuracy was 1.4 mm for the new method, and 2.1 mm for the conventional method on the walls. In the test of the dependency on the light source position error, the mean laser position was shifted just by a similar amount of the shift of the light source in the new method, but it was greatly magnified in the conventional method. In this study, a new laser alignment method was devised and evaluated successfully. The new method provided more accurate, more reproducible, and faster alignment of the lasers than the conventional method.</P><P>PACS numbers: 87.56.Fc, 87.53.Bn, 87.53.Kn, 87.53.Ly, 87.55.Gh</P>