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      • KCI등재

        구순열이 동반되지 않은 구개열의 산전 초음파진단 1 예

        남계현,이권해,조태호,윤길중,최용귀,김창해,김수선 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.7

        필자 등은 1990년 1월 20일 본원 산부인과에서 산전 초음파검사로 구개열 1예를 진단하여 분만 종결후 확인하였기에 간단한 문헌적 고찰과 함께 보고하는 바이다. Recently, antenatal detection of subtle fetal anomalies by high resolution real time ultrasound equipments was facilitated, due to improving the technique and the evolution meticulous examination of the fetal maxillary region in several anatomical planes. We have performed the antenatal careful evaluation of the fetal face in the angled coronal views % more angled coronal views of lower fetal racial parts by high resolution real time ultrasonographic equipment on the case associated with the suspicious fetal anomalies(hydramnios etc.). Thus, we antenatally detected a case of cleft palate without cleft lip by high resolution real time ultrasonographic examination (ALOKA. ECHO SSD-650, 3.5 MHz) & present this case with the brief reviews of concerned literatures.

      • KCI등재

        자궁부속기 염전의 임상병리학적 고찰

        남계현,이권해,조태호 대한산부인과학회 1991 Obstetrics & Gynecology Science Vol.34 No.4

        1974년 7월 6일부터 1988년 12월 31일까지 만 14년간 순천향대학교 의과대학 산부인과학교실에서 자궁 부속기종양으로 수술한 819예중 자궁부속기 염전으로 진단된 50예를 대상으로 후향적조사를 다음과 같은 결론을 얻었다. 1.자궁부속기 종양으로 수술한 819예중 자궁부속기 염전의 합병증은 50예로 6.1%를 차지했으며, 임신중 염전은 18.6%로 비임신시의 5.1%에 비해 의의있게 임신중에 자궁부속기 염전이 많았다. 2. 연령 및 분만빈도를 보면, 20세에서 29세사이가 40%로 가장 많았으며, 분만횟수는 미산부가 39.5%로 가장 많았다. 3. 임상증상은 하복부동통이 90%로 가장 많았으며, 다음 증상은 오심, 구토, 복부촉지물 순이었다. 4. 난소종양의 직경은 10~14 cm사이가 40%로 가장 많았으며, 종양의 크기와 염전횟수의 상관관계를 조사시 통계적으로 의의가 없었다. 5. 염전의 위치는 우측이 26예, 좌측이 24예로 좌우에 차이가 없었으며, 좌우측에 따른 회전방향도 통계적으로 차이가 없었다. 6. 염전횟수와 수술전 체온을 비교시 염전횟수가 증가시 체온이 높았으며, 염전횟수외 백혈구증가와는 의의가 없었다. 7. 수술전 자궁부속기 염전의 진단율은 78%였으며, 기타의 진단은 골반내종양, 수술적 관찰 및 신우신염 등이었다. 8. 임신중에 일어난 난소염전은 총 11예중 6예가 12주전에서 일어났으며, 이중 2예가 유산이 일어났으며, 2예가 만삭 자연분만을 하였다. 9. 자궁부속기 염전의 수술은 염전측의 자궁부속기 절제술이 86%로 가장 많았으며, 염전된 종양의 병리소견을 보면 임신시가 비임신시 모두 낭종성기형종이 가장 많아 26%를 차지했으며, 다음은 부난소종양 및 점액성난소낭종의 순이었다. Acute pelvic pain is a symptom encountered by the gynecologist. Torsion of the uterine adnexa should always be considered in the differential diagnosis since such torsion can result in serious complication, including necrosis of the ovary and tube, peritonitis, shock and rarely death. This study was undertaken for clinicopathological review and statistical analysis on the 50 cases of torsion of the uterine adnexa who were operated at dept. of obstetrics & gynecology Soonchunhyang university from July. 6, 1974 to Dec. 31, 1988. The obtained results were as follows; 1. The overall incidence of torsion was 6.1% of all ovarian tumors. The incidence of torsion in pregnancy was 18.6% which is significantly higher when compared with incidence of 5.1% in nonpregnant state. 2. Almost the patient(90%) presented with lower abdominal pain and had other symptoms and signs, such as abdominal mass, nausea and vomiting and so on. 3. The most prevalent size was 10~14 cm(40%) and next was 5~9 cm(36%). 4. The correlation between turns of torsion and tumor size was not significant statistically. 5. The percent of the right site torsion(52%) was not different from left site(48%) and the direction of the torsion was not different statistically, irrespective of site. 6. The body temperature was high as number of the torsion increased but leucocytosis was not different compared to number of the torsion. 7. The preoperative diagnosability was 78% and other diagnosis were pelvic mass, surgical observation and so on. 8. The 5 cases among 11 cases in pregnancy were occured before gestational age of 12 weeks and 3 full deliveries were procedured. 9. The most common operation of the torsion was ipsilateral salpingoophorectomy and most common histologic diagnoses were cystic teratoma, irrespective of pregnancy.

      • KCI등재

        자궁경부암 선별검진시 질세포진 (Pap smear) 검사와 자궁경부확대촬영 (Cervicography) 검사의 효과

        남계현,이권해,이해혁,이슬기,김상엽,정한우 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.2

        Cervicography is a rapid, technically simple screening test which involves obtaining and evaluating a photographic image of the cervix for cervical abnormalities and can be used in conjunction with Papanicolaou smear. The purpose of this study was to evaluate the screening use of cervicography as an adjunct method and compare its efficacy with that of Papanicolaou smear to identify premalignant and malignant lesion of cervix. A total of 524 subjects were screened by Pap smear, followed by cervicography who were seen in the department of Obstetrics and Gynecology, college of medicine, Soonchunhyang university from March. 7, 1996 to August. 30, 1996. Those subjects in whom abnormalities were detected by either test went through histologic examination with specimens obtained. The histologic specimens comfirmed evidence of cervical abnormality for 64 women. The results were as follows : 1. Among 64 cases, positive pathologic finding (above CINI) was in 44 cases. 2. The result of Pap smear was normal in 27 cases (42.2%) and abnormal in 37 cases (57.8%) among 64 cases. False negative rate was 27.3%(12 cases among 44 cases with positive histologic findings). False positive rate was 25%(5 cases among 20 cases with negative histologic findings). 3. Cervicographic findings were negative in 5 cases (7.8%) and positive in 57 cases (92.2%) among 64 cases. False negative rate was 2.5% (1 case among 44 cases with positive histologic findings). False positive rate was 80% (16 cases among 20 cases with negative histologic findings). 4. Sensitivity and specificity of Pap smear was 72.2%, 75% respectively. 5. Sensitivity and specificity of cervicography is 97.7%, 20% respectively. 6. Sensitivity of cervicography is significantly higher than that of Pap smear. (Sensitivity, Cervicography: 97.7%, Pap smear: 72.7%) 7. Specificity of cervicography is significantly lower than that of Pap smear (Specificity, cervicography: 20%, Pap smear: 75%) 8. Combination of both screening tests increased the sensitivity of the screening(100%). 9. Cervicography correctly detected all 22 cases of invasive cervical cancer, but Pap smear did not detect 6 cases among 22 cases. Cervicography provides excellent sensitivity and will improve the detection of cervical disease when used in conjunction with Pap smear.

      • KCI등재

        복식 자궁적출술후 발생한 심한 질외번증 환자에서 미야 �을 이용한 천골가시인대 고정술 2 예

        남계현,이권해,이해혁,이정재,최경준 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.11

        Massive eversion of the vagina is one of the most disturbing disorders confronting a woman. It is a complex disorder that always surgical, and all defects. The managements is always surgical, and all defects must be repaired concomitantly. Current surgical practice relies primarily on the strength of the endopelvic fascia and certain ligaments. Massive eversion of the vagina can be treated by a variety of transvaginal and transamdominal surgical technique. In most instances a transvaginal approach is useful. If strong cadinal and uteroscral support in not available fiocation of the vginal vault to the sacrospinous ligment is useful. In 1987, Miyazaki introduced his Miya Hook ligature carrier. With this instrument, introduction of the needle became safer and easier than with the Deschamp aneurysm needle. We had experienced two cases of massive eversion of vagina after the total abdominl hysterectomy who were treated succesfully with sacrospinous ligement fixation by using Miya Hook. We report above two cases and review briefly.

      • KCI등재

        자궁경부상피의 암화 과정에 있어서 Integrin β4의 발현에 관한 연구

        남계현,조태호,이철호 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.2

        Integrin β4 is expressed in normal squamous epithelium and in squamous cell carcin-omas. We evaluated by immunohisto- chemistry the topography of the β4 subunit in 40 biopsy samples representative of the sequence from normal exocervical epithelium to invas-ive squamous cell carcinoma. In normal and metaplastic squamous cervical epithelium, and in condylomas, β4 was detected in basal and parabasal cells. In moderate and severe dys-plasia there were enhanced β4 expression and upward shift of β4 topography to the whole epithelial thickness. The β4 chain was diffusely expressed in most invasive squamous cell carcinomas. These observations suggest that profound alterations in the expression of the α6β4 adhesion glycoprotein occur in the intraepithelial phase of cervical carcinogenesis.

      • KCI등재

        초기 임신에서 혈청 Progesterone 측정의 의의

        남계현,이권해,이해혁,이정재,이석민,이명환,강준모 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.7

        임신 4∼5주 사이의 초기 임신시 정상 임신군과 비정상 임신군의 혈청 progesterone치는 통계학적 유의한 차이를 보였다(p<0.05). 반면에 임신 6∼7주 사이의 임신시 비정상 임신군에서는 정상 임신군에 비해 혈청 progesterone치가 감소되어 있었지만, 통계학적으로 유의성은 없었다. 초기 임신에서 비정상 임신을 감별하고 예후를 결정하는 데 있어서 혈청 progesterone의 일 회 측정이 도움을 주며 비정상 임신을 예측하기 위한 혈청 progesterone 농도의 가장 적절한 임계 농도치는 14 ng/mL이었다. Objectives: To assess the prognostic value of a single maternal serum progesterone measurement in the immediate diagnosis of early pregnancy and in the long term prognosis of pregnancy outcome. Methods: Women with early pregnancies of 4∼7 weeks who visit to the hospital for a pregnancy test were included to this study. Measurement of serum progesterone was peformed prospectively. The comparative study groups were divided into two groups according to their final diagnosis retrospectively at each gestational age. Seventy patients were evaluated in this study. Normal intrauterine pregnancy group consisted of 34 patients with continuing pregnant with fetal heart activity by ultrasonography, abnormal intrauterine pregnancy group consisted of 36 patients with missed abortion, incomplete abortion and anembryonic pregnancy. Results: Progesterone levels were significantly lower in the abnormal intrauterine pregnancy (5.6±3.8 ng/mL, 11.5±5.8 ng/mL) than in the normal intrauterine pregnancy group (21.0±6.5 ng/mL, 20.3±6.6 ng/mL) at 4∼5 weeks of gestation (p<0.001, p<0.05), but were not significantly differentiated between two groups at 6∼7 weeks of gestation. The level of progesterone below 15 ng/mL conceived by receiver-operator characteristic curve was found to be detecting a abnormal pregnancy from comparative groups at 4∼5 weeks (specificity 88.9%, 77.0%, sensitivity 100%, 88.9%). Conclusions: A single serum progesterone measurement taken in 4∼5 weeks of gestation is valuable in the immediate diagnosis of early pregnancy and in the long term prognosis of pregnancy outcome. The best progesterone cut off point that predicts abnormal early pregnancy is 14 ng/mL.

      • SCIESCOPUSKCI등재

        Reid의 질확대경 점수제와 질확대경하 조준생검 결과와의 상관관계

        남계현,이권해,천일미 대한부인종양 콜포스코피학회 1995 Journal of Gynecologic Oncology Vol.6 No.4

        Colposcopy was employed to evaluate over 48 patients with abnormal Papanicolaou tests suggestive of subclinical human papillomaviral infection or worse. In order to evaluate the severity of the lesion, Reid's colposcopic index(RCI) which 4as four colposcopic signs was used. Four colposcopic signs, margin, color, vessels, and iodine response, are graded into three objective categories. The colposcopy-guided biopsy result, and colposcopic score were compared to evaluate the diagnostic accuracy of colposcopic index. The overall accurate rate was 79.8%(38/48), the overestimate of diagnosis 6.5%(3/48) and the underestimate of diagnosis 14.6(7/48). Because formulation of Reid's colposcogic index(RCI) is based on objective analysis rather than pattern recall, this method is simple, reproducible and accurate and will be useful to learn the colposcopic skill.

      • SCIESCOPUSKCI등재

        부인과 종양 동결절편 진단의 정확성에 대한 연구

        남계현,김민섭,김동원 대한부인종양 콜포스코피학회 1996 Journal of Gynecologic Oncology Vol.7 No.1

        In a retrospective study to determine the accuracy of frozen section diagnosis in gynecologic tumors, the results of consecutive frozen section diagnosis of 73 gynecologic tumors from May 1993 through Dec. 1995 were compared with the final diagnosis. The accuracy of frozen section diagnosis of gynecologic tumor were 94.5% and inaccuracy were 5.5%. Inaccuracy(5.5%) were due to limited sampling for frozen section. We therefore suggest that careful examination with sampling of any suspicious lesions be carried out at the time of surgery for patients with benign frozen section diagnosis, since this may avoid a second staging laparotomy, if the final diagnosis is malignant.

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