악성혼합성 배세포종 1 례

임헌정,박성윤,이근형,배근영,정해석 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.9

저자들은 18세된 소녀에서 발생된 혼합생식세포종양 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Germ cell tumors are neoplasms that develop from primodial germ cells. They account for about 3% of malignant disease in children and adolescents. Ovarian germ cell malignancies carry a very poor prognosis. The prognosis for mixed germ cell neoplasia may depend on both the quantity and nature of the malignant element. We experianced a case of mixed germ cell tumor in 18 years old unmarried woman. Accordingly we present this case with a brief review of this literature.

녹색관광(Green tourism)의 중요성에 관하여

임헌정 충남대학교 농과대학 2007 논문집 Vol.- No.13

저등급 자궁내막 간질성육종 1 례

임헌정,김동진,기광수,김경수,양승옥,박중기,강기철 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.8

A low grade endometrial stromal sarcoma is a rare malignant tumor in woman. We experienced this infrequent malignant tumor in a 36 years old woman showing metas- tasis to both ovaries, omentum, rectum and mesenteric lymph nodes, and she was treated by total abdominal hysterectomy with bilateral salpingo-oophorectomy followed by VAC(vincristi n, actinomycin, cyclophoshamide) chemotherapy. The authors report this case with the clinicopathologic findings and brief review of literature.

불임환자에서 진단적 복강경술의 유용성에 대한 고찰

임헌정,기광수,신성희,김대화,김재익,양정형,김병원 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.10

One hundred and forty-nine infertile women underwent hysterosalpingography and di-agnostic laparoscopy as a part of their infertility work up at the Kwangju Christian Hospital. The diagnostic value of hysterosalpingography was compared with diagnostic laparoscopy. It was found that hysterosalpingography is a sensitive means to determine tubal patency. However, diagnostic laparoscopy revealed peritubal adhesion in 25.5% of patients, whereas hysterosalpingography made an accurate diagnosis in only 10.5%. And in 61.7% of the cases, there was complete agreement between hysterosalpingography and diagnostic laparoscopy. It is concluded that hysterosalpingography is a simple and non-invasive and useful method of assessing the tubal patency, and should remain an integral part of female infertility investigation. Diagnostic laparoscopy is a more useful method to evaluate pelvic pathology than hysterosalpingography, and thus should always be performed whenever a peritoneal factor is suspected in female infertility.

발육지연 태아의 주산기예후에 대한 태아 생물리학적 계수검사와 제대동맥 혈류속도파형 분석의 유용성에 대한 고찰

임헌정,기광수,김대화,선진규,김재익,양정형 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.12

In a prospective study of 89 women who delivered Small-for-Gestational-Age fetuses with singleton pregnancies after 30 weeks` gestation, fetal biophysical assessment and umbilical artery resistance index wer performed within 72 hours before delivery. Patients with abnormal fetal biophysical profile and umbilical artery RI had a significantly higher rate of preterm delivery , cesarean section for fetal distress , low Apgar score , significant neonatal norbidity , perinatal death , and admission to Neonatal-Intensive-Care-Unit than patients with normal tests. It was 87.6% vs. 84.3% that over all efficiency of tests to predict adverse perinatal outcome. Multiple logistic regression analysis indicated that abnormal umbilical artery RI and fetal biophysical profile were significant independant predictors for the development of adverse perinatal outcome beyond the risk of preterm baby(odds ratio=119 , p=0.0000; odds ratio=34 , p=0.0001). In this study , we can suggest that umbilical artery RI & fetal biophysical profile are useful independant predictors of adverse perinatal outcome with similar efficacy in Small-for-Gestational -Age fetuses.

45,tX,dic(X;X)(q28;q26),der(13;14)(q10;q10)/44,X,der(13;14)(q10;q10) 핵형을 보이는 터너 증후군 1 예

임헌정,기광수,양승옥,박중기,강기철,이장용 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.7

저자들은 사춘기 지연 및 원발성 무월경을 주소로 본원 산부인과에 내원한 16세 여아에서 X 염색체 모자이시즘과 상염색체의 로�맒�전좌를 동반한 45,tX,dic(X; X)(q28;q26),der(13;14)(q10;10)/44,X,der(13;14)(q10;q10) 핵형을 보이는 터너 증후군 1예를 경험하였기에 간단한 문헌 고찰과 함께 보고하는 바이다. Turner syndrome, the most common female gonadal dysgenesis, is characterized by short stature, sexual infantilism, neck webbing, cubitus valgus and low posterior hairline, which is often associated with many variant mosaicisms and aberrations of X chromosome. We experienced a case of 16-year-old phenotypic female examined because of delayed puberty and primary amenorrhea, and showing 45,tX,dic(X;X)(q28;q26),der(13;14)(q10;q10)/44,X,der(13;14)(q10;q10) karyotype. To our knowledge, this karyotype may be a very rare variant of Turner syndrome, and we report this case with brief review of related literatures.

임신 중기 양수천자시 발견된 갈색 변색 및 캔디다 감염 2 예

임헌정,기광수,신성희,김대화,양정형,김병원,정석 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.10

양수의 갈색 변색과 동반된 캔디다 감염은 흔치 않은 것으로 알려져 있으나, 저자들은 일상적인 임신 중기 양수천자에서 얻은 양수의 갈색 변색과 더불어 양수의 배양 균주에서 캔디다 진균을 발견하여 항생제 치료 후에 이차 채취된 양수에서는 호전된 투명한 양수 소견을 보이고, 양수 균 배양검사에서는 캔디다 또는 다른 어떤 균주도 발견되지 않는 상태를 보였던 2예의 임상 경험을 하였고, 2예 모두에서 각각 35주, 32주의 조산 분만으로 임신을 종결하게 됨에 따라 무증상성 캔디다 양수 감염의 치료와 조기 진통 및 신생아 사망률에 연관된 연구가 부족하여 앞으로도 이와 관련된 전향적인 연구가 필요 할 것으로 사료되어 문헌 고찰과 함께 보고 하는 바다. Brown discoloration of the amniotic fluid, reported to occur in 1.3 to 1.9% of specimens obtained at second trimester amniocentesis, has been attributed to intraamniotic hemorrhage remote from the amniocentesis. As reported earlier, a preexisting infection may have caused the intraamniotic hemorrhage. Chorioamniotic infection caused by a variety of microorganisms has emerged as a possible explanation for unexplained cases of ruptured membrane or preterm labor. Although female reproductive tract infection was associated with preterm delivery, there was also reported about subclinical amniotic fluid infection as a cause of preterm labor. We have experienced two cases of brown discoloration and candidial infection in amniotic fluid at the time of second trimester amniocentesis, and report these cases with a brief review of the concerned literature.

자궁근종에 대한 임상 및 병리학적 연구

임헌정,김동호,김홍관,선진규,박병삼 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.6

1990년 1월 1일부터 1993년 12월 31일까지 4년간 광주기독병원 산부인과에 입원하여 수술을 받고 자궁근종으로 확진된 544례를 대상으로 임상 및 병리학적 연구로 다음과 같은 결과를 얻었다. 1. 자궁근종의 발생빈도는 18.3%이었다. 2. 연령분포는 40-49세가 57.7%로 가장 많았고, 평균연령은 43.4세이었다. 3. 주소가 동통인 경우가 73.3%, 이상자궁출혈의 경우가 66.5^, 종류감이 23.9%의 순이었다. 4. 평균 혈색소치는 11.3%이었으며, 혈색소치가 10 g%미만인 경우가 10%이었다. 이중 수혈을 받은 경우는 7.7%이었다. 5. 발생부위는 체부가 96.1%, 경부가 1.8%, 광인대내가 1.7%, 체경부가 0.4%의 순이었다. 조직학적으로는 근내형이 67.8%, 혼재형이 16.2%, 장막하형 8.1%, 점막하형 7.9%의 순이었다. 6. 임신경험이 한 번도 없었던 경우가 3.5%였으며, 평균 임신횟수는 5.6회, 평균 분마뇟수는 3.1회이었다. 불임인 경우는 6.6%에서 보였으며, 이중 원발성은 3.5%, 속발성은 3.1%이었다. 7. 절제된 자궁 또는 자궁근종의 무게는 200-299 g인 경우가 26.3%로 가장 많았고, 평균무게는 197.8g이었다. 8. 자궁근종의 이차변성은 5.3%에서 보였으며, 초자양 변성이 3.9%로 가장 많았다. 9. 자궁근종과 합병된 병변은 86.6%이었고, 이중만성 자궁경부염이 49.8%로 가장 많았다. 10. 월경과다증은 56.6%에서 나타났으며, 월경과 다중과 자궁근종의 조직학적 발생부위(p$lt;0.005), 자궁선근증(p$lt;0.005) 사이에는 유의한 상관관계가 있었다. 그러나 자궁무게와 월경과다증 사이에는 유의한 상관관계가 없었다(p$gt;0.5). 11. 월경곤란증은 46.1%에서 나타났으며, 월경곤란증과 자궁근종의 조직학적 발생부위(p$lt;0.005), 자궁무게(p$lt;0.005), 자궁선근증(p$lt;0.005) 사이에는 유의한 상관관계가 있었다. 12. 수술방법은 57.7%가 복식전자궁절제술만, 42.1%에서 복식전자궁절제술 및 자궁부속기절제술을 시행하였으며, 질식자궁적출술과 자궁근핵적출술이 각각 1례씩 있었다. 13. 수술후 합병증은 31.1%에서 나타났으며, 상기도 감염이 18.4%로 가장 많았다. 수술에 따른 심각한 합병증이나 사망한 경우는 1례도 없었다. 14. 평균 입원기간은 9일이며, 10일이내의 경우가 86.4%로 대부분을 차지하였다. There were 2,975 cases of major gynecologic at Department of Obstetrics and Gynecology, Kwangju Christian Hospital from January 1990 to December 1993. Among these, 544 cases were uterine myoma, all of which were confirmed histopathologically. A clinicopathologic study on these 544 cases was carried out to understand the clinical characteristics of uterine myoma. The follwing results have been obtained. 1. The incidence of myoma among 2,975 cases of major gynecologic surgery during this period was 18.3%. 2. Myoma was observed most frequently in the age group 40 to 49 years, and the mean age was 43.4 years. 3. The most frequent chief complaint was pain which was observed in 426 cases (73.3%), the next abnormal bleeding in 362 cases (66.5%), palpable mass in 130 cases (23.9%) respectively. 4. The mean value of hemoglobin was 11.3% and the anemia (Hb$lt;10.5g%) was observed in 109 cases (20.0%). Transfusion was taken in 42 cases (7.7%). 5. The corporeal myoma was observed in 523 cases (96.1%), cervical in 10 cases (1.8%), combined in 2 cases (0.4%), and intraligamentary in 9 cases (1.7%) respectively. The intramural type was observed in 369 cases (67.8%), subserous in 44 cases (8.1%), submucous in 43 cases (7.9%), and mixed type in 88 cases (16.2%) respectively. 6. The parity was 3.1 in average. The infertility was observed in 36 cases (6.6%), in which the primary infertility was 3.5% and wecondary 3.1% respectively. 7. The mean weight of the resected uterine myoma was 197.8% g. In 51 cases (9.4%), the weight was below 100 g. 8. The secondary change in myoma was found in 29 cases (5.5%) and the most common change was hyaline degeneration (3.9%). 9. The most common associated condition was chronic cervictis seen in 271 cases (49.8%). 10. Hypermenorrhea was observed in 308 cases (56.6%) and there was significant correlation between the presence of hypermenorrhea and the type of myoma (p$lt;0.005), adenomyosis (p$lt;0.005) but no correlatio with the weight of myoma(p$gt;0.5). 11. Dysmenorrhea was observed in 251 cases (46.1%) and there was significant correlation between the presence of dysmenorrhea and the type of myoma (p$lt;0.005), the weight (p$lt;0.005), and adenomyosis(p$lt;0.005). 12. Total abdominal hysterectomy was performed in 313 cases (57.5%), total abdominal hysterectomy with unilateral adnexectomy in 189 cases (34.7%), total abdominal hysterectomy with both adnexectomy in 40 cases (7.4%), vaginal hysterectomy in 1 case(0.2%), and myomectomy in 1 case (0.2%) respectively. 13. The postoperative complications were found in 248 cases (45.6%) and the most common complication of these was the respiratory infection seen in 100 cases (18.4%). 14. The mean period of hospitalization was 9 days. It was below 10 in 470 cases (86.4%).

복강경하 질식 자궁적출술의 임상체험 43 예

임헌정,김동진,기광수,강용필,이상녕,강창구,이주엽 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.10

1997년 5월부터 1998년 2월까지 자궁적출술을 요하는 43명의 환자에서 복강경하 질식 자궁적출술을 시행하여 다음과 같은 결과를 얻었다. 1. 환자의 평균 연령은 44.67±6.56였다. 2. 수술의 적응증은 자궁근종이 22예(51.2%)로 가장 많았고, 생리통 및 골반통 9예(20.9%), 부정자궁출혈 8예 (18.6%), CIN Ⅱ, Ⅲ 3예(7.0%), 그 외 1예(2.3%)였다. 3. 평균 수술 시간은 123.14±37.99분이었고, 평균 출 혈량은 304.07±212.41 ml였고, 평균 자궁 무게는 276.40 ±119.83 gm이었다. 4. 동시에 시행한 수술로는 일측 난소난관 적출술 (11.6%), 후질벽성형술(9.3%), 유착박리술(7.0%), 양측 난 소난관 적출술(2.3%), 난관절제술(2.3%) 등이었다. 5. 수술중, 수술 후 합병증으로는 수혈(7.0%), 수술 후 고열(2.3%), 방광천공(2.3%)이었다. 이상의 결과로 볼 때, 복강경하 질식 자궁적출술은 복식 자궁적출술의 대체 수술로써, 수술 후 통증 감소와 입 원 기간의 단축, 미용상의 효과, 수술 후 합병증의 감소, 수술 후 빠른 회복 등의 장점으로, 적절한 술기와 단순 복강경 기구만으로도, 개복수술을 요하는 환자에게 시술 하여, 환자의 정신적, 육체적 고통을 경감시키고, 합병증 을 줄일 수 있었다. 그러나, 복식 자궁적출술에 비해 수술 시간이 다소 길고,출혈량이 많았지만, 이 문제는 보다 많은 수술 경험과 함께 숙련된 수술 술기로써 극복할 수 있으며, 그럼으로써 복강경하 질식 자궁적출술의 보편화 에 적극적으로 일조할 수 있을것으로 사료된다. Hysterectomy is the most common gynecologic operation. Traditionally, hysterectomy was performed either through an abdominal approach or through a vaginal approach. The merits, indications, and contraindications for each approach have been debate for many years. Complication rate of vaginal hysterectomy is lower than abdomnal hysterectomy but, only 30% of hysterectomy was performed through a vaginal approach. With the addition of laparoscope in hysterectomy, it offers a technique to convert some abdominal hysterectomies into vaginal hysterectomies. This clinical study is a retrospective review of 43 cases of laparoscopically assisted vaginal hysterectomy (LAVH) between May 1997 and Feb 1998. We used simple electrosurgical technique and avoid the use of disposable staples and other instruments. The surgical indications of hysterectomy were myoma uteri (51.2%), dysmenorrhea and pelvic pain (20.9%), dysfunctional uterine bleeding (18.6%), cervical intraepithelial neoplasia (7.0%), and others (2.3%). Average operative time was 123.14±37.99 minutes. The mean uterine weight was 276.40±119.83 gram. The mean blood loss was 304.07±212.41 ml. The most common associated procedure with LAVH was unilateral salpingoophorectomy, which comprise 11.6%, posterior colporrhaphy (9.3%), adhesiolysis (7.0%), bilateral salpingoophorectomy (2.3%), salpingectomy (2.3%) were also carried out concomitantly. The comlication rate was 11.6% and the most common one is blood transfusion (6.9%). But, compared with other route of hysterectomy, overall complication rate was markedly decreased. This report suggest that LAVH can decrease the number of patients requiring a laparotomy for hysterectomy. It appears useful when adnexal indication for surgery or adhesion is exists. And it provides a shorter hospital stay, quicker recovery, fewer complications than those undergoing the same procedeure abdominally. But, operative time and blood loss were increased than abdominal hysterectomy.

시분할 다층블럭부호화된 변조방식을 이용한 비균등 에러방지 ( Unequal Error Protection Using Time Division Multiplexed Multilevel Block Coded Modulation )

임헌정,양운근 대한전자공학회 1994 대한전자공학회 학술대회 Vol.1994 No.7