레이저 원추절제의 임상적 고찰 및 원추 생검경계부위의 침윤유무가 잔여병소 발현에 미치는 영향

진규섭,이선경,김승보,이재현 대한산부인과학회 1995 대한산부인과학회 학술대회 Vol.75 No.-

자궁방조직을 침범한 paragonimus Westermani 의 1 례

진규섭,오보훈,이주희,추민호 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.7

지금까지 여러 폐흡충증의 이소기생예의 문헌고찰에서 보면 비뇨생식기 및 난소 그외 여러 부위가 있었으나 본 예에서와 같이 자궁방 조직에 침입하여 종괴를 일으킨 경우는 없었기에 문헌고찰과 함께 보고하는 바이다. Paragonimiasis was first reported by Kervert in 1878, and named by Westermann. The chief habitat of the adult parasite is the lungs, however, other organs are invaded, such as liver, peritoneum, tests intestine, skin, muscle, and brain. We have observed a very rare case of paragonimiasis in the female genital organ involving the parametrium. The patient has complained low back pain for one year. This case was proved by the postoperative microscopic evidence with necrosis and multiple embeded eggs of P.W. We present a rare case of paragonimiasis with a brief review of the literatures.

포스타 : 부인 종양학 ; 조기 자궁경부암 환자의 근치적 자궁적출술후 재발양상에 대한 연구

윤현하,진규섭,이선경,김승보 대한산부인과학회 1997 대한산부인과학회 학술대회 Vol.80 No.-

임신중 자근근종의 임상적 의의

박원식,진규섭,신진옥,이선경 대한산부인과학회 1994 대한산부인과학회 학술대회 Vol.74 No.-

자궁경부에 발생한 Verrucous Carcinoma 1 례

이선경,진규섭,장미경,최영일 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.2

경희대학교 의과대학 산부인과학교실에서는 53세여자환자에서 자궁경부의 Verrucous Carcinoma로 판명되어 광범위 자궁적출술을 시행하였으며, 그후 좋은 예후를 밟고 있는 증 례를 경험하였기에 간단한 문헌 고찰과 함께 보고하는 바이다. A vareity of unusual squamous cell carcinoma was first identified as a distinct entity by Ackermann in 1948 in lesion of the oral cavity, by Kraus and Perez-Mesa in 1966 in vulva, and in 1972 by Jennings in uterine cervix. This carcinoma is a highly differentiated variant of epidermoid carcinoma with a polypoid pattern of growth, extremely well differented cystic appearance and capacity for local invasion, but not metastatic spread and long recurrence-free survival after simple hysterectomy. There were numerous reports in literature describing lesion of genital verrucous carcinomas, but rare in uterine cervix. Authors present a case belived to be a verrucous carcinoma of cervix and review literature about this case.

임신중 자궁근종의 임상적 의의

이선경,진규섭,신진옥,박원식 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.6

1983년 3월부터 1994년 2월까지 경희대학병원 산부인과에서 입원 치료받은 환자중 자궁근종 을 동반한 임산부 152예를 대상으로 하였으며, 같은 기간 동안에 본원에 내원하여 분만 및 유산된 임산부 18,146예를 대조군으로 두군 간의 임상적 특징을 비교분석하여 다음과 같은 결론을 얻었다. 1. 자궁근종을 동반한 임산부에서의 평균연령은 30.97세로 대조군의 27.36세에 비해 약 4세 가량 많았으며, 자궁근종 환자는 초산부(58.6%)가 다산부(41.4%)에 비해 많았다. 2. 대부분의 자궁근종(76.3%)은 임상적 진찰이나 초음파검사에 의하여 임신전 또는 산전에 진단되었으며, 산전에 발견되지 않은 환자들은 제왕절개 분만 중에 우연히 발견되었다. 3. 자궁근종은 장막하 근종이 가장 많았으며, 가장 많이 생긴곳은 자궁체부의 저부였으며, 장막하 근종중 육경을 가진 경우 발견 당시 난소종양으로 오인하는 경우 (3.3%)도 있었다. 4. 임상적 진찰이나 초음파 검사로 주로 직경 3cm이상의 자궁근종이 진단이 되었고, 직경 3cm미만의 작은 근종들은 그 대부분이 제왕절개분만시 우연히 발견되었다. 근종의 크기는 5-9.9cm 크기가 전체의 44.1%로 가장 많았고 2개 이하의 자궁근종들을 가진 경우 (85.5%)가 대부분이었다. 5. 임신의 결과로는 자궁근종을 동반한 임산부에서 대조군에 비해 제왕절개분만 (78.4%, 87/111)이 유의하게 증가하였으며, 그 적응증으로는 자궁근종(41.4%)가 가장 많았고, 그 다음으로 반복제왕절개술, 노령초산부, 골반협착 등의 순서였다. 또한 제왕절개 자궁적출술에서도 근종군에서 유의한 증가를 보였다. 6. 산과적 합병증으로는 근종을 동반한 군에서 절박유산과 자연유산이 유의한 증가를 보였으며 그외 태반 조기박리, 조기진통, 조기양막파수, 자궁내 태아 발육지연, 이상태위 등에서 유의성이 없었다. 절제된 자궁근종의 병리조직 검사의 이차적 변성은 41.3%에서 보였으며 제일 먼저 초자변 성, 적색변성, 기타 변성 및 낭성변화 그리고 석회화 등의 순서였다. In a retrospective review of 18,146 pregnancies(control group )from March 1983 to February 1994, at the Department of Obsterics and Gynecology, Kyunghee University Hospital and the uterine leiomyomas were documented by sonography and pelvic examination on the prior to pregnancy or during the antenatal care in 152(0.84%) myoma associated pregnancies at the same period. Clinical manifestation such as mode of diagnosis, size of myoma, outcome of pregnancy and complications were analysed between the myoma associated group and control group . The result were as follows; 1. Mean age of the patients in myoma associated group and control group were 30.97 and 27.36 years old respectively. And also myomas were more detected in primi(58.6%) than multi (41.4%). 2. Almost uterine myomas (76.3%) were detected by clinical examination and ultrasonogram prior to delivery, and the rest (23.7%) were detected incidentally during cesarean section. 3. The most common type of uterine myomas was subserosal and the most common location was uterine fundus. The some subserosal myomas with pedicle were mis-diagnosed as ovarian tumor in about 3.3% on first detetion. 4. In clinical examination and ultrasonogram, diameter 3 cm or more sized uterine myoma were detected , Small myomas less than 3cm in diameter were detected incidentally at cesarean delivery. The majority (44.1%) of myomas were 5-9.9cm sized , and the major number(85.8%) of myomas in one case is 2 or less. 5. In pregnancy outcomes, cesarean section was increased significantly in myoma group (78.4%, 87/111) than control . And the first indication of cesarean section in myoma group is uterine myoma(41.4%) then the other indications were repeat cesarean delivery. old primigravida, pelvic contracture, etc. orderly. Also cesarean hysterectomy rate was increased in myoma group . 6. In obsteric complications , threatened and spontaneous abortion were increased significantly in myoma group than control, but abruptio placentae, preterm labor ,IUGR, PROM, malpresentaion were not significant increased. Secondary pathologic changes in the myomectomy specimen were seen in 41.3% and the first was hyaline degeneraion and the next was red degeneraion.

무월경 32 주에 동반된 복강임신 1 예

김승보,진규섭,허주엽,홍진기,강인석 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.5

저자들은 임신 32주까지 지속된 복강임신에서 제왕절개술 후 생존한 1.9kg의 건강한 아이를 분만하였기에 이에 간단한 문헌 고찰과 함께 보고하는 바이다. A pregnancy in which the conceptus develops on the peritoneal surfaces of the abdomen is termed an abdominal pregnancy. Approximately 0.03% of all ectopic pregnancy are abdominal pregnancy. Early diagnosis is of the utmost importance in light of the maternal and perinatal mortaliy. We report a case of abdominal pregnancy with a review of literature.

산전 초음파로 진단된 태변성 복막염

이선경,진규섭,장미경,정재돈,신진옥,추민호 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.6

최근 본원 산부인과에서 산전 초음파검사 결과 태변성 위낭종과 석회화, 양수과다증 등의 소견이 있었던 태변성 복막염 환자를 제왕절개만출술로 분만후 신생아는 2차에 걸친 장문합 수술로 현재 특이 사항없이 성장하고 있는 태변 복막염 1례를 경험하였기에, 문헌고찰과 함 께 보고하는 바이다. Meconium peritonitis is a chemical or foreign body reaction of the peritoneum resulted from the prenatal small bowel perforation associated with or without obstructive lesions and malformation. Extravasation of sterile meconium into the peritoneal cavity causes an intense peritoneal reaction resulting in characteristic calcification and ascites which might be observed by the prenatal ultrasonographic examination. Prenatal ultrasonographic detection of the meconium preitonitis allows the preparation for the proper management which should reduce the mortality and morbidity of the neonates. Recently, a case of prenatal meconium peritionitis diagnosed by ultrasonography at 38 gestational age weeks was experienced at our department. We represent this case with a brief review of literatures concerned.

자궁경부암 환자의 근치적자궁적출술 후 재발 양상에 대한 연구

이선경,김승보,진규섭,윤현하 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.1

The incidence of recurrence in early stage cervical carcinoma is 10∼20%. Approximately 15% of patients who have recurrence will survive 2 years free of disease after additional therapy. Several prognostic factors associated with an increased risk of recurrence have been determined. Few reports have dealt with the clinical nature of recurrence following radical surgery. This paper review, in a retrospective manner, radical hysterectomy and pelvic lymphadenectomy for early stage cervical cancer. The women who recurred after radical hysterectomy and pelvic lymphadenectomy during the follow-up period were 25 cases(16.8%). Our results are as follows; Histopathologic distribution are as follows: squamous cell carcinoma 15.7%, adenocarcinoma 25.0%, adenosquamous cell carcinoma 33.0%. Anatomic site of recurrence are as follows ; central pelvic recurrence are 10 cases(40.0%), lateral pelvic recurrence are 5 cases(20.0%), distant recurrence are 10 cases(40.0%). Adjuvant radiation therapy after radical hysterectomy and pelvic lymphadenectomy significantly reduced the pelvic recurrence comparing to surgery alone(42.8% vs 81.8%)( p < 0.05 ). The incidence of recurrence are higher when in advanced stages, lymph node metastasis is seen(36.8% vs 10.0%), and the primary therapeutic modality is surgery plus adjuvant radiation therapy(26.9% vs 11.4%). Tumor size( > 4 cm) is significantly related with recurrence(8.0% vs 44.4%)(p < 0.05). Mean disease free interval according to primary therapeutic modality, recurrence site, nodal status, FIGO stage are as follows ; surgery alone compared to surgery plus radiation(22.2 months vs 12.7 months), pelvic recurrence compared to distant recurrence(20 months vs 13 months), lymph node negative compared to positive (22.4 months vs 12.6 months), FIGO stage Ib, IIa, IIb(20.3 months vs 14.2 months vs 11 months). Overall cumulative survival rate are as follows; within 6 month is 80%, within 1 year is 48%, within 2 year is 20%, and 5-year survival rate is 16%. The purpose was to evaluate which factors are related with the risk of recurrence and to analyze the outcome of recurrent patients. FurthermorE a try was made to find out how surveillance program most effective in detecting recurrence.

자궁경부암 근치수술후 발생한 합병증에 관한 임상적 고찰

추민호,정재돈,진규섭,이선경,김승보,이재현 대한산부인과학회 1995 대한산부인과학회 학술대회 Vol.75 No.-