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문가을 ( Ga Ui Mun ),조은규 ( Eun Kyu Cho ),김윤숙 ( Yun Sook Kim ),남두현 ( Du Hyun Nam ),이현주 ( Hyun Ju Lee ) 대한산부인과학회 2012 Obstetrics & Gynecology Science Vol.55 No.9
괴사성 근막염은 드물지만 빠르게 진행하며 높은 치사율을 보이는 연부조직 감염으로 근막을 포함한 심부 연부조직을 침범한다. 위험인 자로는 당뇨, 비만, 악성 종양, 만성 간질환 등이 있다. 의심되면 적절한 항균제의 즉각적인 투여가 필요하며, 수술적 괴사조직 제거가 주요치료로 사망률을 의미 있게 감소시킨다. 저자들은 평소 건강하던 33세 여성에서 제왕절개수술 1일 후 갑자기 발생한 고열, 홍반, 부종, 상복부의 농포를 주소로 전원된 환자에서 괴사성 근막염이 의심되어 조기 복합항생제 투여와 수술적 괴사조직의 제거로 치료한 매우 드문예를 경험하여 문헌고찰과 함께 보고하는 바이다. Necrotizing fasciitis (NF) is a rare, rapidly progressive and potentially fatal soft-tissue infection characterized by widespread severe infection of the deep soft tissue, including fascia. Predisposing conditions for NF include diabetes, malignancy, obesity, and chronic liver disease. Patients with suspected NF should be empirically and immediately managed with broad-spectrum antibiotics covering the commonly suspected organisms. And surgical debridement is the mainstay of treatment of NF. We experienced a very rare case of NF with 33-year-old healthy woman who presented with high fever, erythema, edema, and pustule on upper abdomen one day after cesarean section. NF was strongly suspected and immediate surgical intervention and broad spectrum antibiotics were used. We report it with a brief review of literatures.
문가을 ( Ga Ui Mun ),전혜지 ( Hye Ji Jeon ),조은규 ( Eun Kyu Cho ),김윤숙 ( Yun Sook Kim ),배동한 ( Dong Han Bae ),이석열 ( Seok Yul Lee ),조현득 ( Hyun Deuk Cho ) 대한산부인과학회 2012 Obstetrics & Gynecology Science Vol.55 No.7
Endometriosis is a relatively common gynecologic disease. Thoracic endometriosis syndrome occupies half of various types of external endometriosis, however it is very rare condition, We experienced a case of 40-year-old woman who presented with recurrent episodes of spontaneous right-sided pneumothorax that occurred during her menstrual periods. After the localization of the disease site by means of chest radiography and high resolution computed tomography of the thorax, thoracoscopic assisted diaphragm endometriosis resection and suture were performed. After pathologic diagnosis, a hormonal treatment with gonadotropin-releasing hormone agonist was also conducted. We report this case with a brief review of the concerned literatures.
산전 초음파로 진단된 태반 기저층의 광범위 경색에 의한 태아사망
안치옥 ( Chi Ok Ahn ),김시선 ( Shi Sun Kim ),조은규 ( Eun Kyu Cho ),심현진 ( Hyun Jin Shim ),김윤숙 ( Yun Sook Kim ),배동한 ( Dong Han Bae ),양승하 ( Seoung Ha Yang ) 대한산부인과학회 2011 Obstetrics & Gynecology Science Vol.54 No.1
Placental infarction is a localized area of ischemic villous necrosis, resulting from interruption in maternal blood supply. These have been associated with postterm pregnancies, maternal hypertension, and anticardiolipin antibodies. Most are due to thrombotic occlusion of an uteroplacental artery. But, infarction in the basal layer of the placenta is very rare and characterized histologically by massive deposition of fibrin. The etiology remains uncertain. However, it has clearly associated with significant perinatal morbidity and mortality including stillbirth, preterm birth, and intrauterine growth restriction. This condition has been diagnosed by prenatal ultrasonography with hyperechoic areas along the maternal side, but extending through much of the placental tissue. Recently we have experienced a case of extensive infarction in the basal layer of the placenta diagnosed by prenatal ultrasonography at 17 weeks, resulted in stillbirth. We describe this case with a brief review of the literature.
임신에 의해 악화된 원발성 하지불안증후군(restless leg syndrome)의 치료
김시선 ( Shi Sun Kim ),안치옥 ( Chi Ok Ann ),조은규 ( Eun Kyu Cho ),심현진 ( Hyun Jin Shim ),김윤숙 ( Yun Sook Kim ),배동한 ( Dong Han Bae ),양광익 ( Kwang Ik Yang ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.10
Restless leg syndrome (RLS) is characterized by intense restlessness and unpleasant creeping sensations deep inside the lower legs, occurring during periods of rest, evening and night. These symptoms can be improved by movement. There are two different phenotypes of RLS. One early-onset form starts before 36 years old. It has mostly a familial history, severe symptoms, and highly genetically determined. And it is a highly dependent to iron level of the brain. The other delayed-onset form starts after 36 years old, mostly secondary, without familial history, with a rapid evolution in two or three years. And it is associated with frequent low ferritin level of serum. Pathophysiology of RLS remains incompletely understood. However, advanced studies suggest that RLS may be generated by dopamine dysfunction locally within the central nervous system. Dopaminergic agonists are the treatment of choice, if the symptoms are severe. And iron therapy improves RLS symptoms in iron deprived patients. Early detection during pregnancy is needed because RLS gives an important impact on sleep efficiency and quality of life. Recently we have experienced a case of primary RLS patient diagnosed at 24+3 weeks, treated by dopaminergic agonist ropinirole and iron. We describe this case with a brief review of the literature.
이미라 ( Mi Ra Lee ),김민정 ( Min Jeong Kim ),전혜지 ( Hye Ji Jeon ),최슬아 ( Sl A Choi ),조은규 ( Eun Kyu Cho ),김윤숙 ( Yun Sook Kim ),배동한 ( Dong Han Bae ) 대한산부인과학회 2012 Obstetrics & Gynecology Science Vol.55 No.5
Dilatation and curettage (D&C) is one of the most frequently performed procedures for first trimester surgical abortion, also nonobstetric D&C can be performed for both diagnostic and therapeutic indications. The mortality and morbidity of D&C are very low, and perforation of uterus is rare. But curettage of a large, soft postpartum uterus can be a formidable undertaking because the risk of perforation is high and the procedure commonly results in increased rather than decreased bleeding. Although many perforations are innocuous, others lead to infection, hemorrhage, and trauma to abdominal contents. Bowel perforation is an infrequent complication, it persists as an important cause of peritonitis and sepsis. The following cases describe two women, who suffered intestinal perforation after D&C at delayed postpartum period.
김민정 ( Min Jeong Kim ),이미라 ( Mi Ra Lee ),전혜지 ( Hye Ji Jeon ),최슬아 ( Sl A Choi ),조은규 ( Eun Kyu Cho ),김윤숙 ( Yun Sook Kim ),배동한 ( Dong Han Bae ) 대한산부인과학회 2012 Obstetrics & Gynecology Science Vol.55 No.3
Uterine rupture in pregnancy is a rare condition, but an obstetric emergency. It threatens the life of both the mother and the newborn. Hemorrhage from the wound surface is the principal complication. Therefore, mortality rates strongly depend on the time elapsed between onset and diagnosis of the uterine rupture, and on the possibility of immediate surgical intervention. Prompt diagnosis of the uterine rupture is of prime importance. The major risk factor for uterine rupture is previous cesarean delivery. Other risk factors identified as contributing to uterine rupture are malpresentations, second stage dystocia, labor induction, use of epidural for pain control, preterm delivery and delivery after the 42nd week of gestation. We experienced a woman with a history of corneal resection 1 year ago, who suffered uterine rupture at 35 weeks` gestation during preterm labor.