선천성 자궁기형 여성의 산과적 문제점에 관한 연구

이해혁(Hae Hyeog Lee),이정재(Jeong Jae Lee),남계현(Kae Hyun Nam),이임순(Im Soon Lee),이권해(Kwon Hae Lee),이효환(Hyo Hwan Lee),이석민(Seok Min Lee),정갑인(Kab In Jung),정한우(Han Woo Jung),신정옥(Jeong Ok Shin),구도형(Do Hyoung Koo) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.2

N/A Objective: To evaluate the frequency and obstetric consequences of women with uterine anomalies and correlation between obstetric consequence and congenital uterine anomalies. Materials and Methods: A retrospective study was made on 65 patients with uterine anomalies in order to evaluate the obstetric consequence at department of obstetrics and gynecology, Soonchunhyang University Hospital from January 1994 to June 1997. The diagnosis of uterine anomalies was made with hysterosalpingogram or ultrasonogram, or at the time of cesarean section. The uterine anomalies were classified according to the classification of Buttram and Gibbons and compared the pregnancy outcome for each classification. The obstetric consequences were divided into preterm delivery, premature rupture of membranes, intrauterine growth restriction, and abnormal presentation of fetus. Statistical analysis was carried out using chi-square test, the significance was defined as P < 0.05. Results: 1. The incidence of uterine anomalies accounted for 1.04% (65/6,250 deliveries). 2. The most common uterine anomalies were class III (Uterine didelphys, 47.7%). 3. We noted preterm birth rate (16.9%), premature rupture of membranes rate (20%), intrauterine growth restriction rate (9.2%) in 65 patients. 4. The rate of breech presentation was 41.5% and the mean birth weight was 2,747 gram. 5. When uterine anormalies were present, the incidence of obstetric consequences was significantly increased. Conclusion: We concluded that congenital uterine anomalies were closely related to obstetric consequences, such as preterm, breech presentation, intrauterine growth retardation.

여성 생식기 염증에서 Chlamydia trachomatis , Mycoplasma hominis , Ureaplasma urealyticum 의 검출

이해혁(Hae Hyeog Lee),주갑순(Kap Soon Ju),이권해(Kwon Hae Lee),원남희(Nam Hee Won) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.3

N/A Objective: A polymerase chain reaction (PCR) was developed in the detection of Chlamydia(C) trachomatis, Mycoplasma(M) hominis and Ureaplasma(U) urealyticum, which have been common causes of sexual transmitted diseases in the female genital tracts and in neonatal infection. To investigate tbe frequency of these organisms in the female genital tract infection and to know any association of these infections with clinical manifestations, PCR was performed. Methods: PCR was performed in 300 cases of vaginal swabs and 154 paraffin embedded tissues including 50 cases of chronic endometritis, 50 cases of cleonic salpingitis, 50 cases of ectopic tubal pregnancy and 4 cases of normal endometrium. Results: Among 300 cases of vaginal swabs, C. trachomatis, M. hominis and U. urealyticum were detected in 1.3%, 4.0%, and 29.6%, respectively. Mixed infection was found in 12.0%. the overall positive rate was 47.0%. The cytologic features from C. trachomatis, M. hominis and U. urealyticum positive patients revealed no specific findings. The clinical manifestations between positive and negative cases for these organisms had no differences. In tissue samples, only C. trachomatis was detected 2% of chronic endometritis, 8% of chronic salpingitis and 4% of ectopic tubal pregnancy. Conclusion: With the above results, it suggests C. trachomatis can evoke an ascending chronic infection of the female genital tracts and ectopic tubal pegnancy,

폐경 여성에서 비타민 D의 역할

이해혁 ( Hae Hyeog Lee ) 대한폐경학회 2008 대한폐경학회지 Vol.14 No.2

Types of Vitamin D are alfacalcidol (1-hydroxycholecalciferol), calcitriol (1,25-dihydroxycholecalciferol), ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3). As adults age, the ability to make vitamin D through the skin decreases and people who are housebound and experience no sunlight exposure are unable to make vitamin D and get little weight bearing exercise. Vitamin D, the sunshine vitamin, is currently the subject of controversy. Its role in preventing vitamin D deficiency, rickets is undisputed but how much vitamin D is required for maintaining bone strength is unclear. And the efficacy of vitamin D supplementation for preventing hip and other fracture in healthy postmenopausal women remains equivocal. Recently, calcium and vitamin D supplementation was the treatment of choice for preventing fractures and fall in the elderly. Recent, recommended intake of vitamin D of National Osteoporosis Foundation (NOF) for more than 50 years old, vitamin D3 is 800∼1,000 IU/day and calcium is 1,200 mg/day.

호르몬 대치요법과 프로게스테론 제재에 의한 불편감

이해혁(Hae Hyeog Lee) 대한폐경학회 2000 대한폐경학회지 Vol.6 No.2

N/A N/A

초음파 유도하에 자궁내막 소파술로 치료된 자궁내막 골화생

이동운 ( Lee Dong Un ),이해혁 ( Lee Hae Hyeog ),구도형 ( Gu Do Hyeong ),김태희 ( Kim Tae Hui ),심일구 ( Sim Il Gu ),이권해 ( Lee Gwon Hae ),남계현 ( Nam Gye Hyeon ),이임순 ( Lee Im Sun ),권계원 ( Kwon Gye Won ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.12

The endometrial osseous metaplasia is one of a rare conditions which gynecologist experience clinically. Clinical presentation may include irregular menstration, abnormal uterine bleeding, discharge, dysmenorrhea, pelvic pain, and secondary infertility. H

임신중기 모체 혈청 알파 태아 단백 , free β - hCG 를 이용한 산전선별검사 위양성과 주산기 예후에 관한 연구

채명관(Myung Kean Chae),이해혁(Hae Hyeog Lee),최승도(Seung Do Choi),이항재(Hang Jae Lee),이정재(Jeong Jae Lee),남계현(Kae Hyun Nam),이임순(Im Soon Lee),이권해(Kwon Hae Lee) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.2

N/A Objective: To determne whether abnormal results of doble saeening tests for Down syndrome with MSAFP and free B-hCG are associated with adverse pregnancy outcome. Methods: Between October 1994 and September 1997, 205 among 1731 who were screened had increased risk for Down screening program of CIS biointernational, Fetuses with Chromosomal abnormality or congenital anomalies and less than 35 years of maternal age were excluded from this study. Down syndrome screening test was performed between 14-22 weeks of gestation. Results: Of 1731 women, 205 (13.4%) had increased Down syndrome risk. The pregnancy outcome of women with increased Down syndrome risk were compared with those of women without such risk There were no significant difference in the incidence of preterm labor (6[2.9%] vs 112[7.3%)), premature rupture of the membranes (2[0.9%] vs 56[3.6%]), pregnancy induced hypertension (2[0.9%] vs 36[2.3%]), abruptio placentae (0[0%] vs 2[0.1%]), low birth weight (2[0.9%] vs 21[1.3%]), oligohydramnios (4[1.9%] vs 10[0.6%]), intrauterine fetal death (0[0%] vs 2[0.1%]). Conclusion: False positive results of Down syndrome screening test in the 2nd trimester do not appear to be associated with adverse pregnancy outcome. But there are statistically significant increases of adverse pregnancy outcome in wemen with elevation of MSAFP or elevation of free B-hCG.

한국인 임신부에서 Factor V 유전자 돌연변이와 중증 전자간증의 관계

이주롱 ( Joo Long Lee ),이순곤 ( Soon Gone Lee ),이정재 ( Jeong Jae Lee ),이해혁 ( Hae Hyeog Lee ),정집광 ( Jib Kwang Chung ),최규연 ( Kyu Yeon Choi ),이임순 ( Im Soon Lee ),이권해 ( Kwon Hae Lee ) 대한주산의학회 2002 大韓周産醫學會雜誌 Vol.13 No.4

연구목적:단백 C는 활성화 단백 C(Activated protein C, APC)로 활성화되어 응고인자중 factor Va와 factor Ⅷa를 불활성화시키는 항응고 물질이다. 활성화 단백 C 내성이 유전성 혈전증의 중요한 원인이라는 사실이 밝혀졌으며, 이 대부분이 factor V 유전자의 돌연변이(factor V Leiden mutation)에 의한 것임이 알려졌다. 본 연구에서는 factor V 유전자 돌연변이로 야기되는 활성화 단백 C에 대한 내성이 중증 임신 전자간증의 임신부에서 관찰된 보고가 있고 병태 생리에 역할을 한다는 가설을 접하고 중증 전자간증 임신부에서의 factor V Leiden mutation의 빈도를 조사해 정상 임신부와 비교해 보고자 하였다. 방법:정상 혈압을 가진 403명의 임신부와 중증 전자간증으로 진단된 158명의 임신부의 혈청을 대상으로 factor V 유전자의 506번 아르기닌(arginin) 구간에 대한 중합 효소 연쇄 반응을 시행한 후 Mnl 1 제한 효소로 절단하여 절단 여부를 관찰하여 factor V Leiden mutation여부를 관찰하였다. 결과:정상 임신부 403명과 중증 전자간증 임신부 158명중 factor V Leiden mutation은 한 예에서도 관찰되지 않았다. 결론:본 연구결과 백인에서와는 달리 한국인에서는 활성화 단백 C 내성 및 factor V Leiden mutation이 발견되지 않았으며, 한국인에서의 중증 전자간증에 대한 위험요소중 유전자에 대한 다른 연구가 필요할 것으로 생각된다. Objective: A study showed that resistance to activated protein C may develope some cases of severe preeclampsia. A common missense mutation in the factor V gene, the Leiden mutation, is the most frequent genetic cause of resistance to activated protein C. Our objective was to determine whether this mutation is more prevalent in patients with severe preeclampsia than in normotensive controls. Method: Deoxyribonucleic acid was extracted from whole blood of 158 gravid women of severe preeclampsia and 403 normotensive gravid women. The polymerase chain reaction was used to amplify exon 10 of the factor V gene, followed by allele-specific restriction with Mnl 1 for mutation detection. Results: No patients were homozygous for the Leiden mutation. We could not find any positive case with FV: Q506 in the normal or patient group. Conclusion: We could not find that carriers of the factor V Leiden mutation are increased risk for severe preeclampsia. In contrast to the reports in Caucasian, the prevalence of APC resistance and FV: Q506 might be very low or absent in the Korean population. But, carriers of this common thrombophilic mutation may be identified so that other causes and risk factors for inherited thrombophilia should be investigated in the Korean population.

임신 이삼분기 이후 임신종결을 위한 미소프로스톨의 질내 삽입

이항재 ( Hang Jae Lee ),이해혁 ( Hae Hyeog Lee ),이석민 ( Seok Min Lee ),정성윤 ( Seong Yun Jeong ),이지연 ( Ji Yeon Lee ),윤석범 ( Seog Beom Yoon ),최규홍 ( Kyu Hong Choi ),이정재 ( Jeong Jae Lee ),이임순 ( Im Soon Lee ),이권해 ( 대한주산의학회 1999 大韓周産醫學會雜誌 Vol.10 No.4

무심 쌍태아 1례

정성윤 ( Seong Yun Jeong ),이해혁 ( Hae Hyeog Lee ),이석민 ( Seok Min Lee ),조환성 ( Hwan Sung Joe ),남계현 ( Kye Hyun Nam ),이임순 ( Im Soon Lee ),이권해 ( Kwon Hae Lee ),김동원 ( Dong Won Kim ) 대한주산의학회 2000 Perinatology Vol.11 No.2

한국 여성 1 , 131 명의 피임실천 및 실태에 대한 조사

이임순(Im Soon Lee),이윤희(Yun Hee Lee),정집광(Jib Kwang Chung),이석민(Seok Min Lee),이해혁(Hae Hyeog Lee),이정재(Jeong Jae Lee) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.6

목적 : 1,131명을 대상으로 한 설문지 조사로 한국여성의 피임에 대해서 조사하여 최근 가장 많이 사용하는 피임방법, 문제점과 만족도를 알아보고 앞으로의 방향을 제시하고자 하였다. 연구 대상 및 방법 : 2000년 1월부터 2001년 10월까지 순천향대학병원 산부인과를 방문한 성경험이 있는 가임기 여성 1,131명을 대상으로 설문지 조사를 실시하였다. 설문지 내용은 크게 대상자의 일반적 특성, 피임방법, 부작용, 만족도를 포함하여 조사하였다. 결과 : 조사 대상자 1,131명의 평균 연령은 35.1±5.9세였으며 직업은 주부 (68%)가 가장 많았고 교육정도는 고등학교졸업 (49.2%)이 가장 많았다. 대부분이 결혼한 여성 (92.6%)이었으며 평균자녀수는 1.7±1.1명이었고 평균 유산수는 0.8±1.5회였다. 피임에 대한 조사에서 평균 피임기간은 4.6±4.9년이였으며 가장 많이 사용하는 피임 방법은 콘돔 (29.0%), 자궁내장치 (21.1%), 난관수술 (13.5%), 경구피임약 (12.2%), 날짜피임법 (9.3%), 정관수술 (7.9%), 질외사정법 (6.4%), 기타 (1.2%) 순이였다. 41세 이상과 중학교 졸업 이하에서는 난관수술이 많았고 40세 이전에서는 콘돔과 경구 피임약을 많이 사용하였다. 자궁내장치가 부작용이 가장 많다고 하였으며 분비물 증가와 월경량 증가를 꼽았다. 만족도 조사에서는 대체적으로 피임에 만족하였으며 난관수술과 정관 수술의 만족도가 높았다. 결론 : 가장 많이 이용하는 피임방법은 콘돔이였고, 과거의 영구적 불임 방법에서 일시적인 피임 방법으로 변화하는 추세이었으며, 일시적 피임 방법은 부작용이나 피임실패율로 인하여 만족도가 떨어지는 있는 것으로 조사되어 콘돔, 자궁내 장치, 경구피임약 등의 사용방법에 대한 교육이 시급한 실정이다. Objective : We conducted a research into the current method of contraception used by Korean women (1,130 were surveyed) in order to understand about any problems they may be experiencing and their levels of satisfaction. Our objective is to be able to suggest appropriate methods of contraception which are desired by Korean women. Method : We gave questionnaire to reproductive age women who visited Soonchunhyang University Hospital in Seoul from January 2000 to October 2001. Items of the survey contained general characteristics such as, the method of contraception, side effect (if any), and level of satisfaction. Results : The mean age was 35.1±5.9 years and the most common occupation was that of housewife (68%), the mean parity was 1.7±1.1, and the mean abortion was 0.8±1.5. The mean contraception period was 4.6±4.9 years, of the methods used, condoms were the most common (29.0%), followed by intrauterine device (21.1%), tubal sterilization (13.5%), oral contraceptive (12.2%), periodic abstinence (9.3%), vasectomy (7.9%), coitus interruptus (6.4%) and others (12.4%). Among women above 41 years of age, sterilization was the most common method. Condom and oral contraceptives were the most common methods among women under the 40 years of age. The side effects, menorrhagia and leukorrhea were the most common among the women who had used the method of contraception with inrauterine divice. Tubal sterilization and vasectomy gave the most satisfaction. Conclusion : The most common used contraceptive method among Korean reproductive age women was the condom. We found that the form of contraception has been changing from permanent method to a temporary one. Therefore the education for women in the use of condom, oral contraceptives, and intrauterine device should be completed as soon as possible.