악성난소종양의 임상병리학적 고찰

김창학(CH Kim),박주은(JU Park),김재욱(JU Kim) 대한산부인과학회 1979 Obstetrics & Gynecology Science Vol.22 No.6

A Clinico-pathological study was made on a series of 59 malignant ovarian tumors operated at the Presbyterian Hospital, Jeon Ju, Korea, during the period of eleven years from 1965 to 1975. The results were as follows; 1. The incidence of malignant ovarian tumors of all ovarian tumors was 16.6%. 2. Age distribution of malignant ovarian tumors showed the highest frequency between 40-49 years group(average 40 years). 3. As to subjective symptoms of all malignant tumors, palpable mass in the lower abdomen was 94.9%, lower abdominal pain in 61.0% and gastro-intestinal trouble in 47.5%. 4. Palpable adnexal or abdominal mass were observed in 84.7%, abdominal distention in 57.6%, ascites in 40.7% and anemia in 23.7%. 5. According to the international classification of the clinical stage, stage Ⅰ was seen in 25.4%, stage Ⅱ in 18.6%, stage Ⅲ in 15.3% and 40.7% in stage Ⅳ. And it`s bilaterallity was 47.4%. 6. According to the Novak`s histhopathological classification, serous cystadenocarcinoma was found in 28.8%, solid carcinoma in 20.3%, mucinous adenocarcinoma in 16.9% and Krukenberg tumor in 13.6% etc. 7. Treatment was surgical with total abdominal hysterectomy with bilateral salpingo-oophorectomy with or without omentectomy. Adjuvant treatments, Chrolambucil or Cytoxan and Co60 external irradiation were used in 18 cases. 8. It was hard to get 5 year survival rate because of insufficient follow up study.

자궁외 임신의 임상 통계학적 고찰

박주은(JU Park),김창학(CH Kim),홍성구(SK Hong),최영중(YJ Choi) 대한산부인과학회 1979 Obstetrics & Gynecology Science Vol.22 No.5

1. 자궁외임신의 분만수에 대한 빈도는 1:21였으며 연도별 발생빈도의 현저한 증감의 추세는 없었다. 2. 빈발연령은 25∼39세로서 74.0%가 이 연령층에 속하였다. 3. 불임자는 5.3%, 미산부는 22.4%이며 한번 이상의 인공유산을 경험한 경우가 45.3%이었다. 4. 불임기간은 3년 8개월이었고, 9년 이상이 11.2%였다. 5. 기왕력은 인공유산이 45.3%, 개복수술이 16.5%, 이중 반복자궁외임신이 8.5%였으며, 골반내염증은 2.7%, 자궁내 삽입장치는 2.2%이었다. 6. 증상은 하복부동통이 89.6%, 성기출혈 67.2%, 오심구토 22.4%, 현기증 26.8%, 골반부위 중압감 8.1%, 급뇨와 빈뇨 2.7%, 견통이 2.2%였고, 내진시 복부압통 78.5%, 종류 촉지 36.3%, 자궁경부 동통 55.6%, 복부팽만 28.2%, 자궁증대 15.6%, 쇼크가 21.5%에서 나타났다. 7. 더글라스와 천자는 95.4%의 적중율을 보였고 임신반응검사는 45.1%에서 양성이었다. 8. 착상부위는 난관이 92.0%, 난소 1.3%, 잔류자궁각 4.9%, 자궁경부 1.3%, 복막이 0.5%이었으며, 난관임신에서는 난관채가 11.7%, 팽대부 66.8%, 협부 18.6%, 간질부 2.9%였다. 9. 혈색소치가 10mg% 이하의 빈혈을 보인 예가 69.1%이고, 1,000cc 이상의 복강내 출혈량을 보인 경우가 72.2%이었다. 10. 중절양식은 파열이 67.3%, 유산이 31.4%, 무상이 1.3%였다. 11. 수술 방법은 환측 난관 제거가 90.5%, 환측 부속기 제거가 35.8%이었으며 동시에 병행한 수술은 대촉난관결찰 15.6%, 충수절제술 14.8%, 자궁전적출술 45.7%, 난관성형술은 0.9%였다. 12. 자궁외임신에 동반된 타질환은 난관수종 3.6%, 골반내염증 13.0%, 난소낭종 7.6%, 골반결핵 0.5%, 자궁경부암 0.5%였다. 13. 수술 후 합병증으로서 요로감염 4.0%, 폐렴 0.5%, 무기폐 0.5%, 급성신부전 0.5%, 상처감염 0.9%였다. 14. 전 자궁외임신 환자중 사망자는 한명도 없었다. The study is a clinico-statistical analysis of 223 cases who were admitted and treated at Presbyterian Medical Center from Jan. 1, 1973 to Dec. 31, 1977. The results were as follows; 1) The incidence of ectopic pregnancy was 1 in 21 deliveries. There has been no significant increase or decrease in the incidence of ectopic pregnancy. 2) The most frequent age group was in 25-39 years of age, comprising of 64.1%. 3) Nulligravida was 5.3%, nullipara 22.4% and the cases who have experienced artificial abortion over one time was 45.3%. 4) The mean duration of sterility was 3 years 8 months and 11.2% was 9 years or more of sterility. 5) A history of previous curettage was 45.3% and previous laparotomy 16.5%. Of previous laparotomy, repeat ectopic pregnancy was found in 8.5%. 2.7% was pelvic inflammatory disease and IUD in 2.2%. 6) Symtoms were lower abdominal pain in 89.6%, vaginal spotting in 67.2%, nausea and vomiting in 22.4%, dizziness in 26.8%, bearing down sensation in 8.1%, urgency and frequency in 2.7% and shoulder pain in 2.1%. On pelvic examination, abdominal tenderness was noted in 78.5%, adnexal mass in 36.3%, pain on the motion of cervix in 55.6%, abdominal distention in 28.2%, enlarged uterus in 15.6% and shock in 21.5%. 7) Culdocentesis was positive in 95.4% and Gravindex test was positive in 45.1%. 8) On implantation site, tubal pregnancy was detected in 92.0%, ovary in 1.3%, cornus in 4.9%, cervix in 1.3% and peritoneum in 0.5%. Of tubal pregnancies, fimbrial extremity was noted in 11.7%, ampullar portion in 66.8% isthmic portion in 18.6% and interstitial portion in 2.9% respectively. 9) Hemoglobin level less than 10mg% was found in 69.1% and the amount of free peritoneal blood over 1000cc in 72.2%. 10) Tubal pregnancy were terminated by rupture in 67.3%, by abortion in 31.4% and unruptured in 1.3%. 11) 90.5% of total cases was treated by salpingectomy and 35.8%, by salpingoophorectomy. The incidental procedures were tubal ligation in 15.6%, appendectomy in 14.8%, total abdominal hyste

자궁외임신의 중요한 원인의 하나로서의 난관불임술

라영호(YH Rha),변용진(YJ Byen),신영우(YW Shin),김창학(CH Kim),이응수(ES Lee) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.3

Although it was an observation during a short period of time, among 27 women who received surgery under the impression of ectopic pregnancy and confirmed pathologically as tubal pregnancy in our hospital in 1982, 9 women, that is 33.3%, were turned out to have received tubal sterilization before. The methods had been largely LTS. And with the positive history of previous sterilization, many of them were in some troubles in both being sent to a gynecologist and being diagnosed as ectopic pregnancy. Through this study, we insist that if a woman of her reproductive age presents herself in front of a physician with amenorrhea, lower abdominal pain and/or vaginal spotting, the possibility of tubal pregnancy would be much higher if she has a positive history of tubal sterilization.

비파열 흔적자궁각임신 1 례

이지성(JS Lee),오운영(EY Oh),김윤형(YH Kim),김상호(SH Kim),김창학(CH Kim),박영하(YH Park) 대한산부인과학회 1986 Obstetrics & Gynecology Science Vol.29 No.6

비파열 흔적자궁각임신 A case of unruptured rudimentary uterine horn with 3 month gestation is presented with a brief review of literatures concerning uterine anmalies.

자궁내구기능불전증에 대한 임상적 고찰

박형철(HC Park),허혁(H Huh),임성렬(SY Lim),김창학(CH Kim) 대한산부인과학회 1983 Obstetrics & Gynecology Science Vol.26 No.12

We Studied 56 cases with incompetent internal os of the cervix, 35 patients of them were underwent cervical cerclage at lnje Medical College during the period from Jan. 1. 1977 to Dec. 31. 198l. The obtained result was as follows; l) The rate of encounted IIOC was approximately once in every 130 deliveries. 2) The most frequent age incidence was from 26 to 29 age group, and its most frequent, contributing factor was induced abortion and the next was cervical 1aceration. 3) The operation was performed in 35 patients of 56 cases. Operation was carried out by McDonald technique. 4) After operation. all patients were admitted to the hospital for about 6 days and placed in the position with foot side of the bed elevated. They were all medicated with valium, gestanon, proluton depot, or prophylactic antibiotics under close obser vation of vaginal bleeding and lower abdominal pain. 5) 35 patients undertaken surgery had been followed up to deliveries with 31 successful pregnancies, and a over-all fetal salvage rate after operation was 88.6%. 6} The delivery methods after operation were via vaginal route in 28 cases (73. 12%) and abdominal route in 7 cases (20%) 7) The most common causes of abdominal delivery were due to cephalopeIvic dis proportion (4 cases) and one cesarean section was carried out due to partial placenta1 previa 8) The most common causes of failed operation (10 cases) were premature 1abor (5 cases) and vaginal bleeding (3 cases) 9) The optimal time for operation was between the 17 th and 20th week of gestation and the success rate of the surgery was 92.3%. 10) The success rate of surgery was inversely proportional to the degree of the dilatation or effacement of the cervix. It was highest in the group of one cm or less in diameter of cervical dilatation.