항생제 ( Ampicillin ) 가 수유부의 혈중 Prolactin치와 유즙분비에 미치는 영향에 관한 연구

송찬호(CH Song),박금자(KZ Park),김재욱(JU Kim),곽현모(HM Kwak) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.2

The most of the puerpara who had antibiotics during the early post-partum period complaine of the insufficient secretion of breast milk. This study aims to evaluate the effect of antibiotic(ampicillin) on the serum prolactin levels and postpartum lactation. 30 healthy puerperal women were selected among the patient who delivered at term at the Department of Obstetrics and Gynecology Yonsei University Medical Center from March 1983 to February 1984. To compare the serum prolactin levels and volumes of breast secretion, patients were divided into three groups: normal control group, bromocriptine group(bromocriptine 5mg daily for 14 days) and antibiotic group(ampicillin 2.0gm daily for 7 days). Each group consisted of 10 patients. The blood samples were taken at the time of delivery, 2nd, 3rth, 5th and 15th postpartum day. Prolactin was determined by radioimmunoassay(Abbott-Laboratory, USA). The volume of milk secreton was measured and degree of breast engorement and pain were clinically assessed. The results were as follow: 1. Mean serum prolactin levels at the time of delivery, 2nd, 3rd, 5th and 15th postpartum day of normal control group were 438±80.1ng/ml, 299.2±45.4ng/ml, 332.3±54.9ng/ml, 230±85.1ng/ml and 140.5±35.2ng/ml. The volume of milk secretion was about 300ml on the 3rd postpartum day and 400ml on the 5th day in the normal control group. 2. Mean serum prolactin levels of bromocriptine group were 286.4±116.3ng/ml, 2033±93.6ng/ml, 49.9±30.1ng/ml, 45.3±33.3 ng/ml and 19.5±10.1ng/ml respectively. Breast engorgement and pain were significantly suppressed. 3. Mean serum prolactin levels of antibiotic group were 458.3±103.0ng/ml, 397.3 ±55.4ng/ml, 371.7±82.0ng/ml, 261.9±56.6ng/ml and 116.8±40.9ng/ml respectively. The amount of milk secretion, engorgement and pain of breast were suppressed.

임산부 말초혈액에서 중합효소연쇄반은 ( PCR ) 을 이용한 태아의 성염색체 분석과 이의 산전유전 진단응용

송찬호(CH Song),양영호(YH Yang),김인규(IK Kim),김동욱(DW Kim),김미순(MS Kim),유향숙(HS Yoo),이미화(MH Lee) 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.3

산전유전검사를 받을 임산부 22예를 대상으로 이들의 말초혈액을 채취하여 Y chromosome-specific ZFY gene DNA sequence와 Y chromosome 단완의 DYS 14 locus에 위치한 Y-specific sequence를 nested polymerase chain reaction assay법으로 증폭하여 산전 태아 성(fetal sex)판정을 시도하여 다음과 같은 결과를 얻었다. 1. ZFY 유전자의 primer인 Z1, Z2 및 Z3, Z4를 이용한 중합효소연쇄반응 결과, 여아 및 남아를 임신한 전예에서 양성띠가 나타나 비특이성을 보였다. 2. Y-chromosome DYS 14 locus의 sequence primer인 Y1.5, Y1.6 및 Y1.7, Y1.8 primer를 이용한 중합효소연쇄반응 결과, sensitivity는 76.9%, specificity는 55.5%였으며, positive 및 negative predictive value는 각각 71.4%와 62.5%였다. 이를 임신주수별로 분석하여 보면 임신 초기, 중기 및 말기의 positive predictive value는 각각 66.6%, 66.6%와 80%로, negative predictive value는 각각 50%, 50% 및 100%로 나타났으며, 임신 9-16주에는 여아를 임신한 임산부 중 남성 특이의 band가 나타나는 경우가 6예중 3예, 남아를 임신한 임산부 중 남성특이의 band가 나타나지 않는 경우가 7예중 3예로 낮은 신회도를 보였으나 임신 18-40주에는 남아인 경우 1예를 제외하고는 남성 특이 band가 나타났으며, 여아인 경우는 모든 예에서 198 base pair의 남성 특이 band가 나타나지 않았다. 저자들은 본 연구에서 모체 말초혈액에서 중합효소연쇄반응(PCR)을 이용한 태아의 성판정은 임신후기에는 가능하나 임신초기에 있어서는 그 신뢰도가 낮은 것으로 생각 된다. 따라서, 임신 초기 모체혈액내에 있는 태아세포만을 선별적으로 구별할 수 있는 방법을 이용하여 Y1.5, Y1.6 및 Y1.7, Y1.8 primer를 이용 PCR을 하면 정확한 태아의 성판정이 가능할 것으로 사료된다. 본 연구는 연세대학교 의과대학 교수연구비에 의해서 이루어짐 (1994년도). Objectives : Detection of Y-chromosome specific gene in the maternal circulation has clinical importance because of its potential usefulness in determining fetal sex in mothers with severe X-linked disorders such as classic hemophilia A and Duchenne`s muscular dystrophy. Numerous attempts have been made to identify Y specific gene in bloods of mothers bearing male fetuses, however, the results have been controversial. Therefore, we have investigated the use of a nested polymerase chain reaction assay for the detection of a fetal specific Y-chromosome sequence. Methods : Y chromosome specific ZFY gene DNA sequence(using Z1, Z2 and Z3, Z4 primers) and Y chromosome sequence in DYS 14 locus (using Y1.5, Y1.6 and Y1.7, Y1.8 primers) have been identified by an in vitro enzymatic deoxyribonucleic acid amplification method in peripheral blood specimens of 22 pregnant women with gestational ages of 9 to 40 weeks. Results : All women bearing male or female baby were positive for the ZFY gene. Thirteen fetuses were confirmed as males by amniocentesis or chorionic villi sampling, and 10 of these were positive for the Y chromosome specific sequence in DYS 14 locus using Y1.5, Y1.6 and Y1.7, Y1.8 primers(sensitivity 76.9%), however, 4 of the 9 cases diagnosed as females were also positive(specificity 55.5%). Positive and negative predictive values were 71.4% and 62.5%. In terms of the gestational age, positive predictive values of 66.6%, 66.6% and 80% were obtained for the first, second and third trimesters, respectively. The corresponding negative predictive values are 50%, 50%, and 100%, respectively. Conclusion : Fetal sex determination by PCR employing maternal peripheral blood is usually possible in late pregnancy. It is less reliable in early pregnancy. It appears that using a method separating fetal cells from maternal blood and then by running PCR on these cells with Y1.5, Y1.6 and Y1.7, Y1.8 primers could make a fairly accurate fetal sex determination.

형광현미경에 의한 자궁암 세포 검사

안재영(JY Ahn),송찬호(CH Song) 대한산부인과학회 1970 Obstetrics & Gynecology Science Vol.13 No.6

The authors have compared the relative accuracy of cervicovaginal screening for malignant cells using a fluorescent method and the traditional Papanicolaou method. Duplicate smears were takenfrom 3,181 random patients in the clinics of the Department of Obstetrics and gynecology, stained by the traditional Papanicolaou method and Acridine orange method popularized by Riva and Tutner. Different members of the Department of Pathology read the regular smears while the fluorescent method was used by the authors. The patients with abnormal smear(ClassⅢ, Ⅳ, andⅤ) were subfected to tissue diandiangosis by either multiole biopsy or cold knife conization. 1. Among the 3,181 patients, an abnormal smear was found in 76 patients(2.39%)by the flourescent method and 89 patients(2,79%) by the Papanicolaou method. 2. Tissue diagnosis was obstained in 36 patients out of 76 abnormal smears found by the fluorescent method and 41 patients out of 89 abnormal snears found by the Papanicolaou method. Analysis revelaled that the ratio of being to maligant was 12:24 by the fluorescent method and 20:21 by the Papanicolaou method. 3. The study shows that in our hands the false positive and false negative rate was slightly lower in the fluorescent method than in the Papanicolaou method. 4. Uther evidence is presented to show that the fluorescent method is quicker and easier as a screening method and has a real place in the screening for cervical cancer. 5. In addition to its cancer detection, it is also useful in diagnosing cause of vaginal dischange such as trichomonas and monilia.

월경조절법에 관한 연구

곽현모(HM Kwak),송찬호(CH Song),오기석(KS Oh),황민철(MC Whang) 대한산부인과학회 1975 Obstetrics & Gynecology Science Vol.18 No.8

1. 월경조절법을 시술받은 부인의 중앙연령은 32세였고, 중앙분만회수는 2.6회였으며 교육수 준은 높았다. 2. 피임동태를 보면 월경조절법시술전에 비하여 시술후에는 좀더 효과적인 피임법을 원하거 나 불임수술을 원하는 경향이 현저하였다. 3. 무월경 기간에 따른 임신율을 보면 무월경 40-42일에 68%, 43-45일에 83.7%, 46-50일에 90.0%였다. 4. 진통진정제투여로 시술이 가능하였고 수술에 소요되는 평균시간은 6.1분이었다. 5. 총 합병증의 빈도는 4.3%였다. 그중 시술초기합병증은 1.5% 후기합병증은 2.8%였다. 6. 실패율은 0.5%였다. 이상으로 보아 월경조절법은 안전하고 효과적일 뿐만 아니라 간단하고 경제적인 방법이라고 사료된다. The present study is undertaken to analyse the sociodemographic characteristics and fertility profile of the menstrual regulation acceptors to evaluate the safety and effectiveness of menstrual regulation. A total of 695 cases were menstrually regulated at the Yonsei medical center fertility control room from February, 1974 to may 1975. Menstrual regulartion (M.R) refers to treatment of missed menstrual period before confirming evidence of pregnancy is available. The procedure consist of a simple aspiration of the endometrium with or without product of conception according to the underlying cause. For this a 4-8 mm plastic cannula is introduced without dilatation of the cervix and vacuum provided by evacuating air from a 50cc syringe or electric pump. The result of this study shows menstrual regulation acceptor were selected group of the population in Seoul. the median age was 32 years old and median parity was 2.6. Their education level was much higher than the general population in Seoul. There was no major complication. Failure rate of menstrual regulation was 0.5%. So menstrual regulation is a safe, effective, simple and acceptable low-cost procedure for preventing unwanted pregnancy.

난소종양의 임상적 및 생리학적 고찰

곽현모(HM Kwak),송찬호(CH Song),김용훈(Yh Kim),조동재(DJ Cho) 대한산부인과학회 1977 Obstetrics & Gynecology Science Vol.20 No.9

1966년 8월부터 12월까지 만 9년 5개월간 연세대학교 의과대학 부속 세브란스 병원에서 입원가료를 받은 환자중 수술에의해 제거된 조직표본의 조직검사상 난소종양으로 확진된 807예를 대상으로 하여 임상 및 병리학적 고찰을 실시, 다음과 같은 결론을 얻었다. 1. 총 807예중 비종양성 난소낭이 413예(51.2%), 양성종양이 335예(41.5%), 악성종양이 59 예(7.3%)였다. 2. 비종양성 난소낭을 제외한 전 난소종양중 양성 낭성기형종이 149예(37.8%)로 가장 많 았고, 장액성 낭선종이 70예(17.7%), 점액성 낭선종이 68예(17.2%)순이였다. 3. 비종양성 난소낭의 평균연령은 39.1세였고, 비종양성 난소낭을 제외한 양성종양은 36.0 세, 악성종양은 41.4세 였다. 4. 비종양성 난소낭을 제외한 난소종양의 주요 임상주소는 복부불편감 및 동통이 38.1%, 복부 종괴촉지가 33.8%, 성기출혈 및 불규칙한 월경주기가 15.7%, 복부 팽만감이 6.3% 순이었다. 5. 복수의 빈도는 비종양성 난소낭을 제외한 양성종양의 2.4%, 악성종양의 45.8%였다. 6. 종양의 평균 크기는 비종양성 난소낭을 제외한 양성종양의 경우 10.1㎝, 악성종양의 경우 11.5㎝이었다. 7. 양측성 난소종양의 빈도는 비종양성 난소낭을 제외한 양성종양이 13.2%, 악성종양이 28.8%였다. 8. 점액성 유형보다 장액성 유형이 유취장 증식이 많았다. 9. 비종양성 난소낭에서는 자궁외임신이 21.3%, 정상임신이 4.6%에서 동반되었고, 비종양 성 난소낭을 제외한 전 난소종양에서 임신과 동반된 예는 11.4%였는데 그중 정상임신이 7.9%, 자궁외임신이 3.3%, 포상기태가 0.3%였다. 10. 비종양성 난소낭을 동반한 부인과적 수술적응증으로는 자궁외 임신이 21.8%, 자궁조 종이 21.3%, 난소종양이 20.6%, 자궁경부암이 10.7% 등이었다. Ovarian tumors are the most common type of lesion encountered in the ovary, and they are a common form of noplasia in women, therefore ovarian tumors is important in women but the origin of ovarian tumor in often poorly understood because of complexity of ovarian structure. ovarian cancer accounts for about one-fifth of malignant tumors that occur in this reproductibe tract system. Recently, the method of early diagnosis and treatment of other malignant tumors such as carcinoma of the cervix, endometrial carcinoma and choriocarcinoma etc. was significantly improved, but those of ovarian caroinoma was not. This study was undertaken to investigate clinico-pathologic studies of the ovarian tumors among Korean women, Clinico-pathologic studies were on 807 cases of non-neoplastic and neoplastic ovarin tumors, that were admitted to the department of obstetric and gynecology, Yonsei university, College of Medicine, during the period of abort 10 years from 1966 to 1975. the ovarian tumors were classified by the Novak`s classification. the results were followings; 1) among 807 cases, 413 cases (51.2%) were non-neoplastic and 394 cases(48.8%) were neoplastic ovarian tumors among the all neoplastid ovarian tumors, Metastatic tumors among malignant tumors were 5 cases.(1.3%). 2) Among neoplastic ovarian tumors, cystic teratomas (149 cases, 37.8%) ranked first followed by serous cystadenoma (70 cases, 17.7 %) and mucinous cystadenoma (68 cases, 17.2%) in order of frequency. 3) Mean age of non-neoplastic ovarian cyst was 39.1 years and neoplastic ovarian tumors was 36.8 years, mean age of benign ovarian tumors was 36.0 years and malignant one was 41.4 years. 4) In the ovarian tumors, abdominal discomfort, and abdominal Pain (38.1%) ranked first followed by abdominal palpable mass (33.8%) and vaginal bleeding and irregular menstruation (15.7%). 5) Ascites was 2.4% in benign ovarian tumors and 45.8% in malignant ovarian tumors. 6) Mean diameter was 10.1cm in benign ovarian tumors and 28.8% in malignant one. 8) papillary projection of serous tumors was relatively more than one of mucinous tumors. 9) Ovarian tumors assiciated with pregnancy was 21.3% in non-neoplastic ovarian tumors and 11.4% in all ovarian tumors. 10) Main operative indication in non-neoplastic ovarian cysts were ectopic pregnancy (21.8%), myoma of the uterus (21.3%)and ovarian tumors (20.6%)

경구 피임제 Neovlar ( Neogynon ) 에 대한 임상적 연구

곽현모(HM Kwak),송찬호(CH Song) 대한산부인과학회 1973 Obstetrics & Gynecology Science Vol.16 No.7

이상의 결과를 종합하여보면 경구 피임제 Neovlar(Neogynon)에 대한 임상적 연구를 통해 그효용이 안전하며 부작용도 경미하여 자연소실됨을 확인할 수있다. The Neovlar is one of the new oral contraceptives characterized by extremly low doses of estrogenic and progestational constituents -0.25mg. d-norgestrel and 0.05mg. ethinyl estradiol per tablet. This study covers general patterns of acceptance of Neovlar with 382 acceptors observed during a total of 1584 cycles from April, 1972 to April, 1973. All cases were selected from among the women registered at the seven institutions in Korea. The average age of acceptors was 32.1 year old and majority were of 30-39. The average gravidity was 4.6. The number of living children ranged 0 to 7 and average was 2.9. The continuation rate was 80.4 percent by the end of second cycle, 70.2 percent by the end of third cycle, and 28.0 percent by the end of sixth cycle. Complaints were uncommon and no serious consequences were observed. The side effects or complaints were most notable during the first two cycles, diminishing spontaneously thereafter. The common side effects were increased leukorrhea, nausea, chloasma, and complaints related to menstrual function. No unplanned pregnancy was reported.

A Comparison of Laparoscopic Tubal Occlusion by Falope Ring and Electro-Cautery

곽현모(HM Kwak),송찬호(CH Song),김재욱(JU Kim) 대한산부인과학회 1976 Obstetrics & Gynecology Science Vol.19 No.1

In recent days, birth control is not only a problem limited to one specific country but an improtant problem for the whole world to solve. Up the present various methods of contraception and sterilization have been developed for population control. Laparoscopic sterilization is one of the recently developed methods of tubal sterilization and has been considered an important part of family planning programs. In laparoscopic sterilization the electro-cautery technique is the most preferred method, however there is the danger of serious burns during the procedure, which is an obstacle to its use. To avoid such a heat injury through the procedure of electro-cautery cold methods such as the clip application technique by Evans and Hulka and the silastic band application technique by yoon were developed and they have been in being studied. From April 1973 to August 1975, 3044 cases of laparoscopic sterilization, 1690 procedures of falope ring application and 1354 procedures of electro-cautery were performed at the Yonsei University College of Medicine Seoul, Korea.

Silastic Band결찰에 의한 가토난관의 병리조직학적 연구

이국(K Lee),송찬호(CH Song),곽현모(HM Kwak) 대한산부인과학회 1976 Obstetrics & Gynecology Science Vol.19 No.11

silastic band 및 장사로 가토난관결찰후 난관조영술을 실시하고 병리조직학적 변화를 비교관 찰하여 다음과 같은 결론을 얻었다. 1. 난관조영술결과 silastic band 결찰군 및 장사결찰군에서 결찰직후부터 난관이 폐쇄되었음 을 확인할 수 있었다. 2. 육안소견상 silastic band 는 결찰부위에 그대로 남아 잇었으나 장사는 결찰 12주후 흡수 되었다. 양군 대부분 결찰된 직후의 루프형을 이루고 초기에는 충혈 및 출혈소견을 보이나 곧 소실되고 섬유화성폐쇄현상 및 다소의 유착소견ㅇ르 보였다. 3. 병리조직학적 소견은 양군 모두 1주내에는 난관점막상피의 탈락, 울혈 및 부종, 염증반응, 점막괴사가 일어나나 흡수 소실되고 2주부터는 난관강이 섬유화 조직으로 폐쇄되었다 모세 혈관은 결찰후 24-72시간부터 4주까지 증식되었고 교원섬유의 증식은 결찰 1주부터 계속 관 찰되었다. 난관 점막상피세포의 재생은 관찰되지 않았다. 4. 난관조영술, 육안 및 병리조직학적 변화등을 종합하면 silastic band 결찰군과 장사결찰군 간에는 대체적으로 대동소이하나 이물반응에 있어서는 장사결찰 12주에서는 이물반응이 있 었으나 silastic band 결찰 12주에서는 이물반응을 관찰할 수 없었다. 이상의 실험성적으로 보아 silastic band 난관결찰법은 정확하며 이물반응 및 기타부작용이 적어 수태조절에 있어 크게 기여할 수 있는 안전하고 효과적인 방법이라고 사료된다. Morphological findings of the rabbit fallopian tubes occluded by silastic band and by chromic catgut were studied. Salpingograms were done to confirm that the tubes were satisfactory occluded. The results of this study are summarized as follows; 1. Salpingograms in both groups revealed obsteruction fo the fallopian tubes after 12 hours of tubal ligation. 2. All silastic bands remained in situ, but all chromic catgut was absorbed in 12 weeks following tubal ligation. Tubal status in the above mentioned group was similar in appearance to the fallopian tubes following the madlener procedure. Early gross findings consisted of congestion and hemorrhage in the loop of the tube but was gone 1 week later. One week following tubal ligation, the silastic band was partially or completely hidden in the adhesive tubal stuctures and contained fibrosed segments of tube 3. histopathologic changes in the mucosa of the fallopian tube were remarkable and consisted characteristically of exfoliated tubal mucosal epithelium, congestion nad edema of the lamina propria, mild infiltration of acute inflammatory cells and mucosal necrosis, which continued up to 1 week following tubal ligation the lumen was completely occluded with fibrous tissue paralleiling the marked proliferation of collagenfibers. The regeneration of the tubal mucosal epithelium was not observed. 4. There was no difference between the above 2 groups concerning the pathologic process in the salpingogram, gross and microscopic examination. A foreign body reaction was not observed 12 weeks after the silastic band ligation but int ws observed with chromic catgut ligation. In summary tubal occlusion by the silastic band was effective mechanically from the beginning and microscopically afterwards. The silastic band caused little harm and its technique was safe and effective as a routine ligation method. Therefore it is believed that the new silastic band ligation procedure contributes more and more to female tubal sterilzation and thus helps to meet the increasing demand for family planning and fertility control.

A Clinical Study on Intrauterine Contraceptive Device in Yonsei University Family Planning Clinic

곽현모(HM Kwak),송찬호(CH Song) 대한산부인과학회 1972 Obstetrics & Gynecology Science Vol.15 No.11

I. Introduction The national family planning programme was inagurated in the early 1960`s as part of the government policy to contribute to economic development by curbing the rapid rate of population growth. The Family Planning Clinic was founded at the Yonsei University Hospotal in 1962. The I.U.D. insertions have been performed in this clinic since early 1963. One year later the national family planning programme place primary emphasis on the I.U.D. The main activity of this clinic is the promotion of the family planning through the provisionf of modern and traditional methods of contraception, the most popular of which has been the I.U.D. In addition, the clinic provides many other services, such as assistance with home deliveries, health care for pregnant mothers and children early detection of cervical cancer, sterility clinic, and premarital guidance. Over 10,000 women have registered for contraception over past 10 years. Many clinical and experimental studies have been conducted by the clinic on the basis of this data. This paper covers general patterns of I.U.D. acceptance in this clinic from 1963 to 1971. II. Material and Method All cases were selected from among the clients registered in the Family Planning Clinic of Yonsei University Hospital. A total of 7,011 clients using I.U.D.`s were lelected for careful clinical appraisals from January, 1963, to December, 1971. Each individual was interviewed to determine her subjective and objective symptoms before and ofter the insertion of the I.U.D. Tthe recommented timing for insertion was soon after the onset of a menstrual period, at least six weeks after a delivery, or soon after cessation of the first menstrual period following abortion. All clients using I.U.D. were required to return to the clinic for follow-up observation, monthly for the first three months, then quarterly for three visits and semiannually thereafter. They were also requested to return promptly should any problem arise. The devices used in this study were the Lippes loop, Margulies coil, Organon loop, and Copper-T.

진단목적을 위한 복강경술에 관한 임상적 연구

김재욱(JU Kim),송찬호(CH Song),곽현모(HM Kwak) 대한산부인과학회 1976 Obstetrics & Gynecology Science Vol.19 No.7

연세대학교 의과대학 산부인과학교실에서 1974년 11월26일부터 1976년 2월말까지 진단목적 을 위하여 복강경술을 시행했던 62명을 대상으로 하여 연구 관찰한 결과 다음과 같은 결론 을 얻었다. 1. 연령별 분포는 25세에서 34세가 62예중 39예(62.7%)로 과반수 이상을 차지하였다. 2. 적응증은 자궁외임신을 의심했던 경우가 62예중 24예(38.8%)로 수위를 차지하였다. 3. 자궁외임신을 의심했던 24예중 11예에서 자궁외 임신을 조기에 확진함으로서 파열되지 않은 상태에서 수술을 할 수 잇었다. 4. 골반동통과 골반내 종물을 의심하는 환자에서 복강경을 통해 그 원인을 규명할 수 있었 으며 내진산으로는 진찰이 곤란한 endometriosis도 발견할 수 잇었고 골반종물을 의심한 7예 중 3예에서는 불필요한 개복술을 피할 수있었다. 5. 불임증 환자에서 복강경술을 통해 난관의 폐쇄여부에서 확인함은 물론 난관의 유착여부 및 그정도를 관찰함으로서 난관성형술의 가능성 여부도 판단할 수 잇었다. 6. 무월경 환자에 있어서 골반내 장기, 즉 자궁, 난관 및 난소를 정확하게 관찰함으로서 진 단을 하는데 크게 도움이 되었다. 복강경술에 관한 외국문헌 고찰과 본 연구를 통하여 부인과적 질환을 진단하는데 복강경을 이용함으로써 좀더 정확하고 안전하게 진단할 수 있었음을 알 수 있었다. Laparoscopy has been shown to be a precise and acceptable diagnosic tool for the gynecologist. IN a series of 62 cases performed at the Department of Obsterics and Gyunecology, Yonsei University Medical Center from November 23, 1973 to January 31. 1976, the procedures have been shown to be safe and relialbe. The historical background, technique and results are reviewed. the value of the procedure in the diagnosis and the treatment of infertility in the evaluation of acute and chronic pelvic pain and in the definition of obscure pelvic mass is discussed the laparoscopy may frequency obviate exploratory laparotomy and it can also help to avoid serious or even disastrous delays in surgery.