임신 중반기의 무통성 자궁경관 개대에 대한 응급 자궁경관 봉축술의 임상적 의의에 대한 연구

신진웅(Jin Woong Shin),이종승(Jong Seung Lee),문희봉(Hee Bong Moon),안상권(Sang Kwon Ahn),변태섭(Tae Sup Byeun),장병우(Byeung Woo Jang),노덕영(Duck Yeong Ro),김도강(Do Kang Kim),김수평(Soo Pyung Kim) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.11

N/A A retrospective study was conducted to evaluate the clinical outcomes of midtrimester emergency cervical cerclage in patients with painless cervical dilatation with/without prolapsed amniotic sac, including cases of no previous history of cervical incompetence. 10 patients including 1 twin pregnancy were teviewed for study, All had received emergency cervical cerclage with Macdonald operation or Shirodka operation at 18 to 31 weeksgestation. The procedures were carried out without serious complication except for one patient who had received re-operation 3 days after Macdonald operation because of re-protrusion of amniotic sae. The mean procedure to delivery internal was 8.9+5.3 (range 1 to 17) weeks. The mean gestational age at delivery was 32.4+5.6 (range 22 to 39+6) weeks for the entire group, 36.1+2.6 (range 32+4 to 39+6) weeks for the 6 who achived viability, and 27.6+5.0 (range 22 to 29+4) weeks for the 3 who died during the neonatal period. 1 died during gestation and was delivered at 33+6 weeksgestation. The mean birthweight was 2181.6+971.6 (range 498 to 3500)g for the entire group, and 2712.9+ 571.5 (range 1860 to 3500)g for the 7 infants who lived until after neonatal period. The total survival rate for 11 babies was 64%. This study demonstrates that midtrimester emergency cervical cerclage for the patients who have dilated cervix with/without prolapsed amniotic sac is valuable method to try in the cases predicted they would lost the baby with conservative treatment only.

평면 디스플레이 패널 외관 검사 영역 설정 알고리즘

신진웅 ( Jin-woong Shin ) 한국정보처리학회 2012 한국정보처리학회 학술대회논문집 Vol.19 No.2

본 논문은 평면 디스플레이 패널 외관 검사의 무인 자동화를 위한 전처리 단계의 알고리즘으로 패널 외관 검사 영역의 정합성 향상 및 자동 설정하는 알고리즘 기술에 관한 것이다. 평면디스플레이 패널의 제조 공정 중, 점등 검사 공정 단계에서는 Line 불량, Point 불량, 얼룩 불량, 외관 불량, Pol불량 등 다양한 불량들을 검출한다. 이중 외관 불량 검사를 자동화하기 위한 전처리 단계로써 획득한 영상 내에서의 검사 영역을 설정함에 있어서 영상에서의 패널 위치의 변화, 패널의 Rotation/tilt, 패널 에지에 불량이 결부될 경우에도 실제 절단면을 정확하게 추출하여 불량 측정 오차를 최소화하는 알고리즘을 제안한다.

초고층 건축에서의 콘크리트 시공기술

이태왕(Lee Tae-Wang),김영태(Kim Young-Tae),신진웅(Shin Jin-Woong),황원순(Hwang Won-Soon) 한국콘크리트학회 2014 콘크리트학회지 Vol.26 No.5

자궁경부 상피내 병변 및 자궁 경부암 186 예에서 자궁경부 세포진 검사의 위음성률에 괸한 연구

송민경(Min Kyung Song),권용일(Yong Il Kwon),박태철(Tae Chul Park),천민정(Min Jung Chon),신진웅(Jin Woong Shin),이진우(Jin Woo Lee),이준모(Jun Mo Lee),남궁성은(Sung Eun Namkoong) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.4

N/A Objective : To estimate false-negative rate of cervical smears in histologically confirmed squamous intraepithelial lesion and squamous cell carcinoma. Method : From 1993 to 1998, total 186 cases of cervical smear performed within 1 year before histological confirmation squamous intraepithelial lesion and squamous cell carcinoma, were reviewed and the false negative rate of the each group was analyzed. Results : 1. Histologic diagnosis of 186 cases includes 8 cases of low grade SIL, 87 cases of high grade SIL, 91 cases of squamous cell carcinoma. 2. Overall false negative rate was 18.8% (35/186). False negative rate of LSIL was higher (50%; 4/8) compared with the other two groups. (HSIL:23% ;20/87, SCC:12.1% ;11/91) 3. 18 of 35 false negative cases were reviewed. 8 cases(44.4%) were sampling error and 10 cases(55.6%) were interpretation error. 4. Estimated overall sampling error was 8-9% ; interpretation error 10-11%. Conclusion : Reducing the false negative rate of cervical smears, especially in cervical intraepithelial neoplasia lesion is important to save the patients from invasive cervical cancer. Further studies on the causes of false negatives and the efforts to eliminate these barriers are actually needed.

자궁경부 상피내종양과 침윤성암에서 세포진 검사의 검진 양상 고찰

이근호(Keun Ho Lee),권용일(Yong Il Kwon),이원철(Won Chul Lee),임현우(Hyun Woo Rhim),신진웅(Jin Woong Shin),박태철(Tae Chul Park),박종섭(Jong Sup Park),남궁성은(Sung Eun NamKoong) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.10

목적: 이상 자궁경부 조직을 보인 우리 나라 여성에서 자궁경부 세포진 검진 양상을 보고자 하였다. 연구 방법: 241명의 자궁경부 상피내종양과 침윤성 자궁암 환자의 세포진 검사의 민감도 및 특이도를 655명의 정상 자궁경부 조직을 가진 여성과 비교하였다. 이중 138명을 대상으로 3년 이내의 검사 양상을 후향적으로 관찰하였다. 통계분석에 t-test가 사용되었다. 결과: CIN군과 침윤성암 군에서의 세포진 민감도는 각각 89.2%, 92.7%이였고, 특이도는 96.9%이었다. 138명을 대상으로 한 두 군의 최근 3년간 평균 검사 횟수는 각각 2.42회와 2.17회로 통계학적 차이를 보이지 않았고, 시기분포의 차이를 보이지 않았다. 최종 진단으로부터 이전의 마지막 검사 시기차이는 두군에서 각각 12.1개월과 13.7개월로 역시 통계학적 차이를 보이지 않았다. 결론: 우리 나라에서는 자궁경부 세포진 검사 양상이 자궁경부 상피내종양 및 침윤성암에 영향을 미치지 않으므로 세포진 검사는 검진 형태로 지속적으로 매년 시행을 하여야 할 것이다. Objectives: To investigate whether the aspects of Pap smear affect cervical abnormality in our country. Methods: We compared the sensitivity of Pap smear of 241 cases of pathologic proven CIN & invasive cancer, compared to that of 655 cases with normal cervical biopsy, and reviewed the history of the test of 138 cases, retrospectively. Results: The sensitivity of the test was 89.6%, 92.7% in CIN & invasive cancer group, respectively, with 96.9% specificity. Among 241 cases, 138 cases were examined for the frequency of test during the 3 years with the result of 2.42, 2.17/3yr in CIN and invasive cancer. And distribution of the test was not different between the two groups. The mean intervals of last two Pap smear before diagnosing final pathology in CIN and cancer were 12.1, 13.7 months, respectively, with no statistical significance (p>0.05). Conclusion: We concluded that in our country the aspects of Pap smear such as frequency and interval do not influence the result of cervical abnormality, so recommend the annual Pap test as a screening.

자궁외 근종으로 오인된 회장의 기질 종양 1 예

이수선(Soo Sun Lee),강대호(Dae Ho Kang),최성권(Song Kwon Choi),최윤경(Yoon Kyung Choi),오준환(Joon Hwan Oh),신진웅(Jin Woong Shin),김도강(Do Gang Kim) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.1

Gastrointestinal stromal tumor (GIST) of ileum is a rare tumor of gastrointestial tract that arise from primitive mesenchymal cells. GIST occur predominantly in persons over 40 years of age with an equal sex incidence. GIST expresses a heterogenous clinical course and the most important prognostic factors are tumor size, site, degree of mitotic activity, tumor necrosis. We report a case of GIST of ileum, which was misdiagnosed as extrauterine leiomyoma preoperatively.

자연 유산의 영양배엽에서 LH / CG 수용체 , α 및 β - hCG 의 발현

강대호(Dae Ho Kang),변태섭(Tae Sup Byeun),이수선(Su Sun Lee),이방현(Bang Hyeon Lee),최성권(Song Kwon Choi),류기성(Gi Sung Ryu),오준환(Joon Hwan Oh),신진웅(Jin Woong Shin),김도강(Do Kang Kim) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.10

N/A Objective : To investigate the mechanisms involved in the mRNA expressions of hCG, LH/CG receptor and in hormone secretion in the trophoblast of normal and abnormal early pregnancy. Methods : hCG, free β-hCG, and progesterone concentrations were measured in serum and the mRNA expressions of α,β-hCG and LH/CG receptor were measured in the placental trophoblast of 22 spontaneous abortion patients (spontaneous abortion group), 20 normal pregnancy women (normal pregnancy group) and 6 hydatidiform mole patients (hydatidiform mole group). Results : 1. Mean values of serum hCG and free β-hCG concentrations were the lowest in spontaneous abortion group (46343.63±40404.18 mIU/ml, p<0.001; 31.34±61.57 mIU/ml, p<0.01 respectively) among the three groups. Mean progesterone concentration was the lowest in spontaneous abortion group (11.84±7.60 ng/ml, p<0.01), too. 2. The expression levels of α,β-hCG were the highest in spontaneous abortion group (4.64±5.47, p=0.015; 4.57±4.42 p=0.002 respectively). The expression levels of LH/CG receptor were not different statistically among the three groups and they were high at the 5th week of gestation, reaching nadir at the 10th week of gestation when the concentrations of serum hCG showed peak values in normal pregnancy group. 3. The correlations between serum hCG and progesterone concentrations were positive in both spontaneous abortion (r=0.827, p<0.001) and normal pregnancy (r=0.438, p=0.054) group. Though they were not significant statistically, the correlations between progesterone concentrations and the levels of α,β-hCG expressions were negative in both spontaneous abortion (r=-0.237, p=0.289; r=-0.211, p=0.347) and normal pregnancy (r=-0.270, p=0.250; r=-0.235, p=0.318) group. In hydatidiform mole group, the correlation between progesterone concentrations and the levels of β-hCG expression was positive (r=0.968, p=0.002). Conclusion : Our results suggest that the mechanisms involved in the secretion of hCG, progesterone and the expression of α,β-hCG, LH/CG receptor be normal in spontaneous abortion as in normal pregnancy and in the both groups, hCG stimulate the secretion of progesterone by autocrine function and control the secretion of itself, through the suppression of the expressions of α,β-hCG and LH/CG receptors. So the cause of spontaneous abortion in early pregnancy may be not placental dysfunction but the defect of embryo itself with poor placental growth.

자궁거상기를 이용한 복강경하 전자궁 적출술 (TLH : Total Laparoscopic Hysterectomy) 300례에 대한 임상적 고찰

박태철,이진우,유영옥,이준모,신진웅,이희중,남궁성은,권용일 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.1

목적 : 부인과 수술 중 많은 빈도로 시행되고 있는 전자궁 적출술은 최근 복강경 기기와 수술방법의 발달로 복강경을 이용한 수술 빈도가 급격히 증가되고 있는 실정이다. 본원에서는 1992년 처음으로 복강경을 이용한 전자궁 적출술을 시행한 이래로 최근까지 LAVH방법을 선호하여 왔으나, 1998년 RUMITM uterine manipulator with colpotomizer를 도입한 후 약 300례의 TLH를 시행하여 이에 대한 성적을 보고하고자 한다. 연구방법 : 1998년 8월 1일부터 2000년 2월 28일까지 가톨릭대학교 의과대학 부속 의정부 성모병원에 내원하여 TLH를 시행한 300명의 환자를 대상으로 입원기간, 출혈량, 수술시간, 합병증 등을 분석하였다. 결과 : 환자의 평균 연령은 44세였고, 평균출산력은 2.28회였다. 수술의 적응증은 자궁근종이 196례(65%)로 가장 많았고, 자궁선종이 62례(21%), 자궁내막증 14례(4.6%), 자궁경부 상피이형증 9례(3%)등이었다. 대부분의 환자에서 TLH만이 시행되었고 심한 골반내 유착이 있는 경우 유착박리술을, 난소에 병변이 동반된 경우 부속기 절제술을 같이 시행하였다. 자궁을 원활하게 움직이고 요관을 보호하기 위하여 특별히 제작된 자궁거상기(RUMITM uterine manipulator with colpotomizer and pneumooccluder balloon)를 고정하였으며, 심한 자궁내막증의 경우 먼저 요관을 박리한 후 병변부위의 소작 및 복막 제거술을 시행하였고 Interceed를 부착하였다. 평균 수술 소요시간은 90분이었고, 수술 후 측정한 자궁의 무게는 300gm이었다. 수술시간에 영향을 주는 주된 요인으로는 자궁크기, 보조수술자의 숙련도, 기왕 수술이나 자궁내막증등에 의한 유착 등이었다. 수술시 출혈량을 평가하기 위하여 수술 전과 수술 후 1일째의 혈색소량의 변화는 평균 1.2g/dl 였다. 평균 입원기간은 3일이었다. 수술 중 합병증은 bipolar coagulator에 의한 요관 협착이 2례에서 발견되어 개복 수술을 시행하였고, 소장 천공 1례, 방광천공이 3례에서 있었으나 수술당시 복강경하에서 봉합하였으며 별 문제없이 퇴원하였다. 결론 : 복강경을 이용한 전자궁 적출술은 수술후 통증이 적고 입원기간이 짧아 유용한 수술방법이라 여겨지며 특히 자궁거상기(RUMITM uterine manipulator with colpotomizer)의 이용시 요관을 안전하게 보호할 수 있고, 자궁조작 및 자궁경부와 질 부착부위의 박리를 보다 원활하게 할 수 있다. 21세기에는 모든 복식 자궁적출술을 대체할 수 있는 유용한 수술방법으로 여겨진다. Objective: We analyzed our experience with total laparoscopic hysterectomy to evaluate the clinical data such as operation time, blood loss, hospital stay, and complications. Methods: A retrospective study was carried out in 300 women who underwent total laparoscopic hysterectomy (TLH). Results: The most common indications for TLH were uterine myomas, chronic pelvic pain (severe endometriosis), cervical intraepithelial neoplasia. Mean operating time was 90 minutes (range 50-200 min) and hospital stay was 3 days (range 2 days - 7 days). The most important factors for the surgery time were uterine size, assistant's skill, presence of adhesions (obliteration of the cul-de-sac due to severe endometriosis). Several techniques were used, including bipolar coagulation of the uterine vessels, and suture of the stump. A special uterine manipulator (RUMITM uterine manipulator with colpotomizer and pneumooccluder balloon) used in all procedures aided in anatomic definition and performing the circumferential colpotomy. We had three bladder injuries during operation which was diagnosed and immediately repaired laparoscopically. We had two cases of ureterovaginal fistula and one case of postoperative ileus. But there were no cases of death, thrombophlebitis neither other pulmonary complications. Conculsions: Total laparoscopic hysterectomy can be performed safely and effectively when the surgical team is sufficiently trained. And we believe that total laparoscopic hysterectomy offers benefits to the patients in the form of less post-operative pain, shorter time in hospital.