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산전 초음파로 조기진단된 Prune - belly syndrome 1 예
강용필(Yong Pil Kang),선진규(Jin Gyu Sun),기광수(Kwang Soo Kee),정금지(Kum Ji Jung),박애별(Ae Byul Park),최윤정(Yoon Jung Choi),천예영(Yea Young Chun) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.7
Prune-belly syndrome is a rare compound fetal anomaly, characterized by absence or hypoplasia of abdominal wall musculature associated with urinary tract abnormalities and cryptorchidism. The prenatal ultrasound diagnosis was based on the findings of a lower abdominal cystic echo caused by abnormal dilatation of the bladder, upward compression of small intestines and decreased amniotic fluid volume. We experienced a case of Prune-belly syndrome diagnosed by ultrasound in a 12 weeks fetus following to IVF-ET pregnancy. Termination was performed at 12 weeks and autopsy confirmed the distended bladder, absence of abdominal muscles and urethra. So, we reported this case with a brief review of literature.
배란유도 및 자궁강내 인공수정후 발생한 병합임신 1 예
김호룡 ( Ho Ryong Kim ),정석 ( Seok Jung ),선진규 ( Jin Gyu Sun ),기광수 ( Kwang Soo Kee ),정금지 ( Kum Ji Jung ),강용필 ( Yong Pil Kang ),최윤정 ( Youn Jung Choi ) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.7
Heterotopic pregnancy is defined as simultaneous intrauterine and extrauterine pregnancy. The incidence of heterotopic pregnancy was about 1 to 30,000 pregnancies, but it has been increased. This increased incidence is explained by the rise in PID, pelvic surgery, IUD and assisted reproductive technologies-in vitro fertilization/gamate intrafallopian insernination/intrauterine insemination. Thus careful pelvic examination combined with serial β-hCG determinations and transvaginal sonography to evaluate the adnexal regioa are necessary prerequisites for early diagnosis. We report a case of heterotopic pregnancy following in ovulation induction and intrauterine insemination with a brief review of literature.
김형호,김병선 ( Byoung Sun Kim ),배유영 ( Yu Yung Bae ),선진규 ( Jin Gyu Sun ),기광수 ( Kwang Soo Kee ),임헌정 ( Hun Jung Im ),이주엽 ( Ju Yub Lee ) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.7
Retroperitoneal Schwannama is relatively rare and benign tumor originating from Schwann cell. Schwannomas arising in the retroperitoneum are infrequently reported. The majority of Schwannoma is found incidentally and misdiagnosed for other benign conditions both clinically and radiologically. We report a case of a benign retroperitoneal pelvic Schwannoma which was preoperatively misdiagnosed as an ovarian tumor with brief review of literatures.
강기철(Gi Chul Kang),이장용(Jang Yong Lee),배유영(Yu Young Bae),김대화(Dae Hwa Kim),기광수(Kwang Soo Kee),임헌정(Hun Jung Im) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.9
Heterotopic pregnancy, simultaneous intrauterine and extrauterine pregnancy, is an extremely rare case. The incidence of heterotopic pregnancy was about 1 to 30,000 pregnancies, but it has increased after wider use of assisted reproductive technology. The rising incidence presents a serious problem as the diagnosis of this potentially fatal condition is often missed. Careful pelvic examination combined with serial β-hCG determinations, and transvaginal sonography to evaluate the adnexal region are necessary prerequisites for early diagnosis. We report a case of heterotopic pregnancy following in vitro fertilization and embryo transfer(IVF-ET) with a brief review of literature.
이장용(Jang Yong Lee),홍선웅(Sun Woong Hong),박애별(Ae Byul Park),강용필(Yong Pil Kang),기광수(Kwang Soo Kee),임헌정(Hun Jung Im),김경수(Kyung Soo Kim) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.8
Actinomycosis is a rare disease in human and has variable clinical features, which make the diagnosis difficult. Actinomycosis may be confused with malignancy and other inflammatory diseases because of its infiltrative nature and its tendency to invade normal anatomic barriers. We have experienced a case of abdominal actinomycosis combined with ovarian mucinous cystadenocarcinoma and report this case with brief review of literatures.
자궁절제경술을 이용한 자궁내유착증의 치료 예후에 대한 임상고찰
김병원(Byong Won Kim),신성희(Sung Hee Shin),정석(Suk Jung),홍선웅(Sun Woong Hong),김대화(Dae Hwa Kim),기광수(Kwang Soo Kee),임헌정(Hun Jung Im) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.10
목적: 본원 불임클리닉에 불임증을 주소로 내원한 환자중에, 자궁난관조영술상에서 비정상적인 자궁내막소견을 보인 자궁내유착증환자에게 자궁절제경술을 시행하여 이의 효과적인 치료결과와 자궁내유착증의 재발생 빈도 그리고 이의 예방법의 유용성에 대하여 고찰하였다. 연구방법: 45명의 자궁내유착증환자를 대상으로 했으며 이를 중앙부 유착, 변연부 유착, 그리고 다발성 유착으로 구분했으며, Storz사 제품의 26F Resectoscope를 사용하여 수술을 시행하였고 재유착을 예방하기 위해서 자궁내 피임장치을 삽입하거나, 소아용 폴리카테타를 삽입하였으며, 자궁내막 상피화를 증진시키기 위하여 Conjugated estrogen(Premarin) 5mg을 30-50일간 투여한후 medroxy progesterone acetate(Provera) 10mg을 10일간 투여하여 소퇴성출혈을 유발시킨후 자궁 난관촬영술을 시행하여 수술 전후의 자궁내 상태를 비교하였다. 결과: 계속적인 추적관찰이 이루어진 41명에서 자궁난관조영술상 수술전 병변이 소실된 경우가 21명, 개선된 경우가 12명, 큰 변화가 없거나 재발된 경우가 8명으로 81%의 높은 치료율을 보였다. 41명중에서 재유착의 예방을 위해서 소아용 폴리카테타를 삽입한 경우는 20명으로 이중 5명(25%) 에서 재발을 하였고, 자궁내 피임장치를 삽입한 경우는 21명으로 이중 3명(14%)에서 재발을 하였다. 추적관찰환자중 15명에서 임신이 되었고 이중 10명은 만삭분만을 하였고 3명이 초기 자연유산이 되었으며 1명은 자궁외임신으로 복강경하 난관절제술을 시행했으며 1명은 임신이 진행중이다. 결론: 이상의 결과를 볼때 자궁내유착증의 치료에 자궁절제경술이 유용한 방법으로 사료되며, 수술 후 자궁내 재유착의 예방을 위해서 자궁내 피임장치를 삽입한 경우가 소아용 폴리카테타를 삽입한 경우에 비하여 재유착의 발생율이 비교적 낮은 경향을 보임을 알 수 있었으나, 향후 더욱 많은 예에 대한 연구와 면밀한 추적관찰이 필요하리라 생각된다. Objectives: From February 1995 to April 1998, those patients who had visited for evaluation of infertility, shown abnormal endometrial pattern on hysterosalpingography underwent resectoscopic operation. We evaluated about its therapeutic effect, recurrence rate of uterine adhesion and effectiveness of its assisted method. Method: We have reviewed 45 cases of intrauterine adhesion, classified as a central type, marginal type and multiple type. We used 26F resectoscope made in Storz for operation and inserted Lippes loop or pediatric foley catheter for prevention of readhesion. For promoting reepithelialization, conjugated estrogens(premarin) 5mg daily for 30 - 50 days were given and then 10mg of medroxyprogesterone acetate(provera) were added daily for the last 10 days. We evaluated the uterine cavity condition preoperatively and postoperatively by using hysterosalpingography. Result: In 45 cases, 41 cases were followed up postoperatively. 21 cases were markedly improved, 12 cases were improved and 8 cases were not improved or recurred on hysterosalpingography. In 41 cases, for prevention of readhesion 20 cases were used pediatric foley catheter and 5 cases(25%) were recurred. 21 cases were used Lippes loop and 3 cases(14%) were recurred. Pregnancy outcome was as follows;15 cases were pregnant and 10 cases delivered a viable infant, 3 cases aborted spontaneously, 1 case was ectopic pregnancy and laparoscopic salpingectomy was done, 1 case was ongoing pregnancy. Conclusion: This report suggests that resectoscopic operation is very effective in the treatment of intrauterine adhesion(therapeutic rate of 81%) and that the use of Lippes loop seems like to have the less recurrence rate than the use of pediatric foley catheter in prevention of postoperative readhesion, but more experience and further follow-up are necessary to obtain more detailed conclusions.
천예영 ( Yea Young Chun ),구진영 ( Jin Young Ku ),송정화 ( Jung Wha Song ),김병선 ( Byoung Sun Kim ),배유영 ( You Young Bae ),선진규 ( Jin Gyu Sun ),기광수 ( Kwang Soo Kee ) 대한주산의학회 2005 Perinatology Vol.16 No.2
목적: 본원에서 시행한 최근 9년간의 임신중기 양수천자 739예를 통해 핵형을 분석하여 염색체 이상이 나타나는 빈도와 적응증의 변화 및 염색체 이상과의 상관 관계 등을 분석하고자 하였다. 방법: 1995년 1월부터 2004년 9월까지 광주기독병원 산부인과를 방문한 임산부 중 태아염색체 이상이 의심되어 산전유전상담을 받은 후 양수천자를 시행한 739예를 대상으로 산모의 연령, 임신주수, 양수천자의 적응증, 염색체 핵형 분석 결과와 염색체 이상이 발생하는 빈도의 상관관계를 분석하였다. 결과: 연구대상 산모의 연령은 20~45세 사이의 분포를 보였으며 그 중 35~39세 군이 가장 많았다. 임신중기 양수천자의 적응증으로는 산모 혈청 표지자검사 양성이 가장 많았으며(49.8%), 그 다음으로 고령산모(31.1%)의 순서였다. 핵형 분석 결과 염색체 이상이 나타나는 빈도는 4.6% (34/739)이었다. 염색체 이상이 나타나는 빈도는 적응증별로 분석하면 초음파상 염색체 이상이 의심되는 경우에서 의미있게 높았다. 결론: 산전 세포 유전학적 진단의 여러 적응증 가운데 비정상 초음파 소견과 비정상적 산모 혈청 선별검사가 가장 중요한 적응증이었다. 특히, 비정상 초음파 소견은 비정상적인 핵형을 예측하는데 가장 민감한 지표임을 보여주고 있다. Objective: To analyze the change of indications and chromosomal abnormalities according to patient`s age and indications in midtrimester genetic amniocentesis. Methods: This study was reviewed 739 genetic amniocentesis results which were performed at Kwangju Christian Hospital from 1995 to 2004, as prenatal genetic diagnosis for the possibility of chromosomal abnormality of fetus. Age distribution, gestational weeks, indications of amniocentesis and cytogenetic results were the key factors for the analysis. Results: Maternal ages were ranged from 25 to 45, mostly 25~39, Of indications of prenatal genetic amniocentesis, abnormal maternal serum marker was the most common (49.8%), and followed by advanced maternal age (31.1%). The frequency of abnormal karyotypes was 4.6% (34/739). The incidence of abnormal karyotype according to indication had statistical significance in abnormal ultrasonographic finding. Conclusion : Among the several indications for prenatal cytogenetic diagnosis, ultrasonographic abnormalities and abnormal maternal serum markers might be important indications. Especially, ultrasonographic abnormalities could be the predictive markers for abnormal fetal karyotypes.
임신 초기 자궁내 장치의 자궁경 수술적 제거 후 성공적 분만 1 예
배유영(You Young Bae),김호룡(Ho Ryong Kim),김형호(Hyoung Ho Kim),강용필(Yong Pil Kang),선진규(Jin Gyu Sun),기광수(Kwang Soo Kee) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.6
In the case of pregnancy complicated by intrauterine device, complications such as ectopic pregnancy, septic abortion, preterm delivery are increased significantly. Especially in relation to intrauterine pregnancy, IUD should be removed to prevent complication. But when the tail is missed, therapeutic abortion has been done as an alternative method conventionally. Recently we experienced a case of hysteroscopic removal of IUD complicated by intrauterine pregnancy of 9th week without any harm to the G -sac or embryo. And she delivered healthy girl weighing 2950 gm. So we report this case with the review of articles related.