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Cold Knife 원추 절제와 저온 응고요법의 병합 술식에 의한 고등급 자궁 경부 상피내 병변(HSIL)의 처치
승희진,김현찬 인제대학교 백병원 2001 仁濟醫學 Vol.22 No.2
Objectives: To evaluate the efficacy of combination of cold knife conization(CKC) and cold coagulation(CC) for the management of high grade cervical intraepithelial lesions(HSIL) and to compare the diagnostic accuracy of Pap. smear and colposcopy directed biopsy to that of conization. Methods and Materials: Combination of CKC and CC was carried out on the 50 cases of HSIL which were diagnosed by colposcopy directed biopsy during the period from Jan. 1993 to May 1998. Clinical records and pathological reports were reviewed for data analysis. Mean duration of follow up was 26 months. Results: Of the 50 cases, 8 cases(16%) showed margin involvement. Among the 8 cases, 4 cases were undergone immediate hysterectomy and showed residual lesion in 1 case(25%). Recurrence of lesion was found in 1 case with negative cone margin(2.4%) and 1 case of positive cone margin(12.5%) during the follow up. One case of post-operative bleeding, infection and cervical stenosis were found respectively. Diagnostic agreement between Pap. smear and conization was 60.4%. Agreement between colposcopy directed biopsy and conization was 81.1%. Conclusions: These results suggested that CKC with cold CC could be effective management procedure for HSIL to minimize post-cone complications and recurrence rate. Long term follow-up with large material is needed to confirm the above suggestion.
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승희진(HJ Seung),김우경(WK Kim),이병익(BI Lee),김현찬(HC Kim) 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.4
저자들은 국내외 보고된 예가 드문 임신과 동반되어 파열된 자궁내막종 2례를 경험하였기에 문헌고찰과 함께 보고하는 바이며, 임신중 급성복증의 감별진단에 이를 염두에 두어야 할 것으로 사료된다. Pregnancy complicated by ovarian endometrioma is rare. Although infertility and endometriosis are closely related, endometriosis may be found with pregnancy. It has been written that endometriosis will regress with pregnancy, but occasionally complications may occur. This report illustrates such a complication with ruptured endometrioma. We present these 2 cases with a brief review of literatures.
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김현찬,이병익,이경복,김신욱,승희진,허윤근 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.10
저자들은 본원 산부인과에서 임신 제 39주에 초음파검사로써 태아 복부내 낭종으로 진단되고 정상질식분만후 소아외과에서 낭종제거술후 조직검사로써 확인된 태아 난소낭종 1예를 경험하였기에 관련 문헌 고찰과 함께 증레를 보고하는 바이다. Small ovarian cysts in the newborn are not uncommon. Fetal ovarian cysts, previously rarely reported, are being diagnosed with increasing frequency with wider utilization of obstetrical sonography. Most of these small cysts involute within the first few months of life and have no clinical significance. Occassionally, however, a large ovarian cyst is seen antenatally with sonography and presents as an abdominal mass. A large ovarian cyst can cause life-threatening complications during parturition and in the neonatal period. We have recently experienced a case of fetal ovarian cyst in a 28-year-old multiparous woman and report our experience with a brief review of related literatures.
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김현찬 ( Hyun Chan Kim ),승희진 ( Hee Jin Seung ),이병재 ( Byoung Jai Lee ),김우경 ( Woo Gyeong Kim ) 대한폐경학회 2009 대한폐경학회지 Vol.15 No.3
Facing to the recent aging society, Geriatric Gynecology is on the developing phase. The clinical features and co-morbidity of the aged woman are somewhat different from those of the younger. The Gynecologist as a primary physician and also a specialist has to cope with the demanding care of the aged, Therefore a guide, based on working knowledge, would be helpful for the better care of them. In this review, Items among the leading causes of morbidity/mortality and common complaints are selected and described briefly. (J Korean Soc Menopause 2009;15:145-163)
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초기정상 및 비정상 임신에 있어서 혈청내 b-hCG , Estradiol 및 Progesterone치
김현찬,이병익,김신욱,승희진,허윤근 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.10
저자들의 연구 결과 정상 자궁내 임신군에 비해 비정상 자궁내 임신군 및 자궁외 임신군에서 혈청내 b-hCG, estradiol, progesterone치가 유의하게 낮았으며, 비정상 자궁내 임신군과 자궁외임신군에서는 유의한 차를 발견할 수 없었다. 또한 정상 임신군과 비정상 임신군(비정상 자궁내 임신 및 자궁외 임신) 사이에 있어서 상기 세 호르몬의 cut-off level의 설정은 정하기 어려웠다. 결국 아직까지는 세호르몬의 측정이 정상임신과 비정상임신을 감별하는데에는 도움이 되지만, 비정상 자궁내 임신과 자궁외임신을 감별하는데에는 커다란 도움이 되지 않으므로 이를 알기 위해서는 질식초음파, 자궁내막검사 및 진단복강경검사가 요구된다. In a prospective study women in the first trimester, we evaluated the usefulness of serum b-hCG, estradiol(E2) and progesterone(P4) determinations in differentiating between normal intrauterine pregnancy (nl-IUP), abnormal intrauterine pregnancy (including missed abortion and incomplete abortion: abn-IUP), and ectopic pregnancy(EP). Values were obtained from 42 patients with nl-IUP, 30 patients with abn-IUP, and 60 patients with EP. The results were as follows; 1. The mean age and mean gestational period were 27.2 years and 7.1 weeks in nl-IUP, 31.4 years and 8.1 weeks in abn-IUP, and 30.5 years and 7.5 weeks in EP respectively. 2. The mean values (+-SD) of b-hCg were 53791.9+-14859.5 mIU/ml in nl-IUP, 16963.4+-6621.6 mIU/ml in abn-IUP, and 7745.2+-6628.5mIU/ml in EP respectively. 3. The mean values (+-SD) of E2 were 787.9+-262.6pg/ml in nl-IUP, 255.5+-218.3 pg/ml in abn-IUP, and 196.3+-88.7 pg/ml in EP respectively. 4. The mean values (+-SD) of P4 were 28.3+-6.0 ng/ml in nl-IUP, 4.4+-2.3 ng/ml in abn-IUP, and 6.8+-3.2 pg/ml in EP respectively. Although mean values of serum b-hCG, E2, and P4 were significantly lower in abn-IUP and EP than those in nl-IUP, those were not significantly idrfferent between abn-IUP and EP. Hormone assay, particularly serum b-hCG, E2 and P4 were useful in assessing normal pregnancy and abnormal pregnancy, But in order to differentiate abn-IUP with EP, additional diagnostic aids such as sonogram, diagnostic D & C and/or laparoscopy should be supplemented.
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