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자궁 천공이 동반된 만삭임신 후 전이성 융모상피암 1례
전선희,양훈진,김희옥,한지은 대한부인종양 콜포스코피학회 2000 Journal of Gynecologic Oncology Vol.11 No.3
Gestational trophoblastic tumor is one of the curable disease, but metastatic trophoblastic tumor still shows high mortality rate because of resistance to the chemotherapy. Choriocarcinoma may occur after an any type of human pregnancy. The incidence of choriocarcinoma following term pregnancy is very uncommon, and such tumor appears to follow a more aggressive course with more extensive metastatic spread and is less responsive to chemotherapy resulting in a poorer prognosis. Choriocarcinoma presenting as postpartum hemorrhage, and spontaneous tumor perforation with intra-abdominal hemorrhage is even rarer, requiring emergency laparotomy. We had experienced one case of metastatic choriocarcinoma following term pregnancy that required emergency total abdominal hysterectomy due to uterine perforation and hemorrhage. So, we report this case with brief review of literatures.
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산전 유전질환진단에 있어서 세포유전학적인 핵형 분석 , FISH 및 PRINS 의 임상적인 이용에 관한 연구
김영주(Young Ju Kim),우복희(Bock Hi Woo),양훈진(Hun Jin Yang),박미영(Mi Young Park),이영희(Young Hi Lee),안정자(Jung Ja Ahn) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.1
N/A Objective: Increasingly it is being recognized that genetic factors play a significant role in causing malformation. There are many available prenatal diagnostic methods including cytogenetic karyotyping using amniocentesis and cordocentesis, fluorescence in situ hybridization(FISH), and primed in situ labelling(PRINS). Our purpose was to attempt to discuss the clinical use of cytogenetic karyotyping, FISH, and PRINS. Methods: We conducted 222 cases of cytogenetic karyotyping using amniocentesis and cordocentesis, l0 cases of FISH, and 10 cases of PRINS from January 1996 to July 1998 at Ewha Womans University Mokdong Hospital. Age distribution, chromosomal abnormalities by age group, indication, karyotype, and baby outcomes were performed. Results: Overall incidence of chromosomal abnormalities was 7.7%(17cases) and chromosomal abnormalities were most frequently noted in 30-34 year old women and 35-39 year old women(2.3%, respectively). Among 222 cases, 25-29 year old women were highest(30.2%). Chromosomal abnormalities among cytogenetic karyotyping cases were Down syndrome, Edward syndrome, Patau syndrome, Deletion(8), Inversion(9), etc. The 5 cases of healthy baby among chromosomal abnormalities were delevered. Among 213 cases of karyotyping using amniocentesis, abnormal karyotyping cases were 15 cases. Among 15 cases, 8 cases were terminated and 5 cases of healthy baby were delivered. Among 9 cases of karyotyping using cordocentesis, 2 cases of chromosomal abnormalities(Edward, Down syndrome) were found and 3 cases healthy baby were delivered. Among 10 cases of FISH results, 6 case of FISH results were the same with G-banding and were different from G-banding. Among 10 cases of PRINS results, we got the PRINS results from 7 cases. Conclusion: It is concluded that cytogenetic karyotyping, FISH, and PRINS are very useful to detect chromosomal abnormalities.
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폐경전 자궁적출술을 시행받은 여성과 자연폐경 여성에서 에스트로겐 단독투여와에스트로겐+프로게스틴의 지속적 병합투여시 지질 및 고밀도의 변화에 대한 연구
김희옥(Hee Ok Kim),유민영(Min Young Yoo),김연정(Youn Jung Kim),박지은(Ji Eun Park),양훈진(Hoon Jin Yang),유은희(Eun Hee Yoo),전선희(Sun Hee Chun),김종일(Chong Il Kim),유한기(Han Ki Yu) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.10
목적 : 폐경전 자궁적출술을 시행받은 여성과 자연폐경 여성에서 에스트로겐 단독투여시와 에스트로겐과 프로게스테론의 지속적 병합투여시 지질 및 골밀도의 변화에 대한 차이를 비교하기 위한 연구이다. 연구방법 : 총 80명의 환자중 치료 1군(50명)은 폐경전 자궁적출술을 시행받은 환자로 접합 에스트로겐 0.625mg을 48개월간 지속적으로 투여받았고, 치료 2군(30명)은 접합 에스트로겐 0.625mg과 MPA 2.5mg을 지속적으로 병합 투여 받았다. 투여전과 투여후 6개월, 12개월, 24개월, 36개월, 48개월 후에 혈청 지질 및 지단백과 골밀도의 변화를 측정하였다.결과 : 총콜레스테롤치는 두 군에서 각각 치료 48개월후 9.9%, 10.8% 감소하였고, LDL-콜레스테롤치는 20.1%, 16.3% 감소하였다. HDL-콜레스테롤치는 각각 21%, 31.9% 증가하였다. 척추골 골밀도는 두 군에서 각각 치료 48개월후 11.6%, 14.9% 증가하였고, 대퇴골 골밀도는 12.9%, 14.9% 증가하였다.두 군 사이의 통계적 유의한 차이는 없었다.결론 : 에스트로겐 단독 투여와 에스트로겐과 프로게스테론의 지속적 병합 투여는 모두 심혈관질환과 골다공증에 유익한 효과가 있다. 자연 폐경 여성에서는 에스트로겐 단독 투여보다 에스트로겐과 프로게스테론의 지속적 병합 요법이 더 바람직하다고 할 수 있다. Objective : Our purpose was to investigate the effect of single estrogen and continuous combined estrogen + progestin on lipid profile and bone mineral density.Method : We have treated two groups of menopausal women for 4 years, ; Group 1(hysterectomised women) received conjugated equine estrogen(CEE) 0.625mg per day for 30 days ; Group 2(natural menopausal women) received continuous combined therapy(CEE 0.625mg and MPA 2.5mg per day) for 30 days.We compared pre-and poststudy serum lipid profile and bone mineral density in two groups.Result : The data demonstrated a beneficial effect in lipoprotein profile that total cholestrol decreased in two groups by 9.9% and 10.8% from the baseline values. Low density lipoproten(LDL)-cholesterol decreased in two groups by 20.1% and 16.3% in post HRT 48 months, high density lipoproten(HDL)-cholesterol increased in two groups by 21% and 31.9%. And HRT shows the beneficial effect in bone mineral densities. Lumbar BMD increased in two groups by 11.6% and 14.9% and femur BMD increased in two groups by 12.9% and 14.9% from the baseline value.Conclusion : Our result suggest that single estrogen therapy and continuous combined estrogen-progestin therapy has beneficial effect on cardiovascular disease and osteoporosis. Their effects were not significantly different among two groups. So we suggest that continuous combined estrogen-progestin therapy is preferable to single estrogen therapy.
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