류원두개 1례

기광수(KS Kee),위개룡(GR Wee),하명희(MH Ha),정우길(WG Jeong),임현정(HJ Im) 대한산부인과학회 1984 Obstetrics & Gynecology Science Vol.27 No.6

Cebocephalus is a very rare congenital malformation which is closely related to the cyclopia deformity. The orbits were small and shallow but not fused. The nose had a single opening. Recently we experienced a case of cebocephalus associated with hydramnios, hydrocephalus and normal karyotype. We report this case with a brief review of its liteature available.

골형성부전증아 1 예

위계량(GR Wee),정성수(SS Chung),진일섭(IS Chin),기광수(KS Kee) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.12

골형성부전증아 1 예 Osteogenesis imperfecta, also called osteopsathyrosis, fragilitas ossium and brittle bones, is an inherited defect of the mesoderm characterized by fragile bones, blue sclera and osteosclerosis. This disease appears in two main forms: Osteogenesis imperfecta congenita in which the fetus is severly affected and is born dead or survives only a few days, and osteogenesis imperfecta tarda, in which fractures are common in infancy (Osteogenesis imperfecta tarda gravis) or in later lift(Osteogenesis tarda levis). We present a case of osteogenesis imperfecta with a brief review of the literature.

발육지연 태아의 주산기예후에 대한 태아 생물리학적 계수검사와 제대동맥 혈류속도파형 분석의 유용성에 대한 고찰

임헌정,기광수,김대화,선진규,김재익,양정형 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.12

In a prospective study of 89 women who delivered Small-for-Gestational-Age fetuses with singleton pregnancies after 30 weeks` gestation, fetal biophysical assessment and umbilical artery resistance index wer performed within 72 hours before delivery. Patients with abnormal fetal biophysical profile and umbilical artery RI had a significantly higher rate of preterm delivery , cesarean section for fetal distress , low Apgar score , significant neonatal norbidity , perinatal death , and admission to Neonatal-Intensive-Care-Unit than patients with normal tests. It was 87.6% vs. 84.3% that over all efficiency of tests to predict adverse perinatal outcome. Multiple logistic regression analysis indicated that abnormal umbilical artery RI and fetal biophysical profile were significant independant predictors for the development of adverse perinatal outcome beyond the risk of preterm baby(odds ratio=119 , p=0.0000; odds ratio=34 , p=0.0001). In this study , we can suggest that umbilical artery RI & fetal biophysical profile are useful independant predictors of adverse perinatal outcome with similar efficacy in Small-for-Gestational -Age fetuses.

자궁내막 요인성 불임환자에서 자궁절제경술의 유용성

임헌정,기광수,박병삼,이상녕,강창구 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.11

From May 1995 to February 1997, 46 patients underwent resectoscopic surgery for infertility. Of 46 patients, 32 patients had uterine synechiae, 5 patients had polyps, 3 patients had septums, 3 patients had bony foreign bodies, 2 patients had submucosal myomas, 1 patient had tuberculous endometritis. The resectoscopic procedure proved of special value for resection of intrauterine adhesion, submucosal myoma, septum and polyp. Except 5 patients, intrauterine conditions were improved and 10 patients were conceived. So it goes without saying that resectoscopic surgery is a effective and acceptable procedure for the management of infertility of endometrial factors. However, with the finding of slightly less satisfactory results with time and number, further follow-up is still needed to establish the usefulness of the procedure.

임신 중기 양수천자시 발견된 갈색 변색 및 캔디다 감염 2 예

임헌정,기광수,신성희,김대화,양정형,김병원,정석 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.10

양수의 갈색 변색과 동반된 캔디다 감염은 흔치 않은 것으로 알려져 있으나, 저자들은 일상적인 임신 중기 양수천자에서 얻은 양수의 갈색 변색과 더불어 양수의 배양 균주에서 캔디다 진균을 발견하여 항생제 치료 후에 이차 채취된 양수에서는 호전된 투명한 양수 소견을 보이고, 양수 균 배양검사에서는 캔디다 또는 다른 어떤 균주도 발견되지 않는 상태를 보였던 2예의 임상 경험을 하였고, 2예 모두에서 각각 35주, 32주의 조산 분만으로 임신을 종결하게 됨에 따라 무증상성 캔디다 양수 감염의 치료와 조기 진통 및 신생아 사망률에 연관된 연구가 부족하여 앞으로도 이와 관련된 전향적인 연구가 필요 할 것으로 사료되어 문헌 고찰과 함께 보고 하는 바다. Brown discoloration of the amniotic fluid, reported to occur in 1.3 to 1.9% of specimens obtained at second trimester amniocentesis, has been attributed to intraamniotic hemorrhage remote from the amniocentesis. As reported earlier, a preexisting infection may have caused the intraamniotic hemorrhage. Chorioamniotic infection caused by a variety of microorganisms has emerged as a possible explanation for unexplained cases of ruptured membrane or preterm labor. Although female reproductive tract infection was associated with preterm delivery, there was also reported about subclinical amniotic fluid infection as a cause of preterm labor. We have experienced two cases of brown discoloration and candidial infection in amniotic fluid at the time of second trimester amniocentesis, and report these cases with a brief review of the concerned literature.

불임환자에서 진단적 복강경술의 유용성에 대한 고찰

임헌정,기광수,신성희,김대화,김재익,양정형,김병원 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.10

One hundred and forty-nine infertile women underwent hysterosalpingography and di-agnostic laparoscopy as a part of their infertility work up at the Kwangju Christian Hospital. The diagnostic value of hysterosalpingography was compared with diagnostic laparoscopy. It was found that hysterosalpingography is a sensitive means to determine tubal patency. However, diagnostic laparoscopy revealed peritubal adhesion in 25.5% of patients, whereas hysterosalpingography made an accurate diagnosis in only 10.5%. And in 61.7% of the cases, there was complete agreement between hysterosalpingography and diagnostic laparoscopy. It is concluded that hysterosalpingography is a simple and non-invasive and useful method of assessing the tubal patency, and should remain an integral part of female infertility investigation. Diagnostic laparoscopy is a more useful method to evaluate pelvic pathology than hysterosalpingography, and thus should always be performed whenever a peritoneal factor is suspected in female infertility.

45,tX,dic(X;X)(q28;q26),der(13;14)(q10;q10)/44,X,der(13;14)(q10;q10) 핵형을 보이는 터너 증후군 1 예

임헌정,기광수,양승옥,박중기,강기철,이장용 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.7

저자들은 사춘기 지연 및 원발성 무월경을 주소로 본원 산부인과에 내원한 16세 여아에서 X 염색체 모자이시즘과 상염색체의 로�맒�전좌를 동반한 45,tX,dic(X; X)(q28;q26),der(13;14)(q10;10)/44,X,der(13;14)(q10;q10) 핵형을 보이는 터너 증후군 1예를 경험하였기에 간단한 문헌 고찰과 함께 보고하는 바이다. Turner syndrome, the most common female gonadal dysgenesis, is characterized by short stature, sexual infantilism, neck webbing, cubitus valgus and low posterior hairline, which is often associated with many variant mosaicisms and aberrations of X chromosome. We experienced a case of 16-year-old phenotypic female examined because of delayed puberty and primary amenorrhea, and showing 45,tX,dic(X;X)(q28;q26),der(13;14)(q10;q10)/44,X,der(13;14)(q10;q10) karyotype. To our knowledge, this karyotype may be a very rare variant of Turner syndrome, and we report this case with brief review of related literatures.

저등급 자궁내막 간질성육종 1 례

임헌정,김동진,기광수,김경수,양승옥,박중기,강기철 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.8

A low grade endometrial stromal sarcoma is a rare malignant tumor in woman. We experienced this infrequent malignant tumor in a 36 years old woman showing metas- tasis to both ovaries, omentum, rectum and mesenteric lymph nodes, and she was treated by total abdominal hysterectomy with bilateral salpingo-oophorectomy followed by VAC(vincristi n, actinomycin, cyclophoshamide) chemotherapy. The authors report this case with the clinicopathologic findings and brief review of literature.

복강경하 질식 자궁적출술의 임상체험 43 예

임헌정,김동진,기광수,강용필,이상녕,강창구,이주엽 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.10

1997년 5월부터 1998년 2월까지 자궁적출술을 요하는 43명의 환자에서 복강경하 질식 자궁적출술을 시행하여 다음과 같은 결과를 얻었다. 1. 환자의 평균 연령은 44.67±6.56였다. 2. 수술의 적응증은 자궁근종이 22예(51.2%)로 가장 많았고, 생리통 및 골반통 9예(20.9%), 부정자궁출혈 8예 (18.6%), CIN Ⅱ, Ⅲ 3예(7.0%), 그 외 1예(2.3%)였다. 3. 평균 수술 시간은 123.14±37.99분이었고, 평균 출 혈량은 304.07±212.41 ml였고, 평균 자궁 무게는 276.40 ±119.83 gm이었다. 4. 동시에 시행한 수술로는 일측 난소난관 적출술 (11.6%), 후질벽성형술(9.3%), 유착박리술(7.0%), 양측 난 소난관 적출술(2.3%), 난관절제술(2.3%) 등이었다. 5. 수술중, 수술 후 합병증으로는 수혈(7.0%), 수술 후 고열(2.3%), 방광천공(2.3%)이었다. 이상의 결과로 볼 때, 복강경하 질식 자궁적출술은 복식 자궁적출술의 대체 수술로써, 수술 후 통증 감소와 입 원 기간의 단축, 미용상의 효과, 수술 후 합병증의 감소, 수술 후 빠른 회복 등의 장점으로, 적절한 술기와 단순 복강경 기구만으로도, 개복수술을 요하는 환자에게 시술 하여, 환자의 정신적, 육체적 고통을 경감시키고, 합병증 을 줄일 수 있었다. 그러나, 복식 자궁적출술에 비해 수술 시간이 다소 길고,출혈량이 많았지만, 이 문제는 보다 많은 수술 경험과 함께 숙련된 수술 술기로써 극복할 수 있으며, 그럼으로써 복강경하 질식 자궁적출술의 보편화 에 적극적으로 일조할 수 있을것으로 사료된다. Hysterectomy is the most common gynecologic operation. Traditionally, hysterectomy was performed either through an abdominal approach or through a vaginal approach. The merits, indications, and contraindications for each approach have been debate for many years. Complication rate of vaginal hysterectomy is lower than abdomnal hysterectomy but, only 30% of hysterectomy was performed through a vaginal approach. With the addition of laparoscope in hysterectomy, it offers a technique to convert some abdominal hysterectomies into vaginal hysterectomies. This clinical study is a retrospective review of 43 cases of laparoscopically assisted vaginal hysterectomy (LAVH) between May 1997 and Feb 1998. We used simple electrosurgical technique and avoid the use of disposable staples and other instruments. The surgical indications of hysterectomy were myoma uteri (51.2%), dysmenorrhea and pelvic pain (20.9%), dysfunctional uterine bleeding (18.6%), cervical intraepithelial neoplasia (7.0%), and others (2.3%). Average operative time was 123.14±37.99 minutes. The mean uterine weight was 276.40±119.83 gram. The mean blood loss was 304.07±212.41 ml. The most common associated procedure with LAVH was unilateral salpingoophorectomy, which comprise 11.6%, posterior colporrhaphy (9.3%), adhesiolysis (7.0%), bilateral salpingoophorectomy (2.3%), salpingectomy (2.3%) were also carried out concomitantly. The comlication rate was 11.6% and the most common one is blood transfusion (6.9%). But, compared with other route of hysterectomy, overall complication rate was markedly decreased. This report suggest that LAVH can decrease the number of patients requiring a laparotomy for hysterectomy. It appears useful when adnexal indication for surgery or adhesion is exists. And it provides a shorter hospital stay, quicker recovery, fewer complications than those undergoing the same procedeure abdominally. But, operative time and blood loss were increased than abdominal hysterectomy.

자궁내막유착증의 자궁내시경치료 후에 발생한 화농성척추염 (Pyogenic Spondylitis) 1 례

임헌정,김동진,기광수,유범준,양승옥,박중기 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.11

Hysteroscopy is an endoscopic procedure generally free of complication. The potential risks of hysteroscopy include uterine perforation, bleeding, infection, thermal trauma, complications related to anesthesia, and complications related to the distending media. The pulmonary edema and water intoxication by intravasation of distending medium is a serious complication. Postoperative infection after operative hysteroscopy is rare and may arise as endometritis, pyometra, parametritis or pelvic infection. However, it has not been reported for pyogenic spondylitis. The authors have experienced a case of pyogenic spondylitis after hysteroscopic treatment of uterine synechiae and report our experience with a brief review of the literature.