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동일 난소에서 발생한 충돌종양인 거대 장액성낭선종과 성숙기형종의 복강경적 치료 1예
이나혜 ( Na Hye Lee ),홍정희 ( Jung Hui Hong ),김윤숙 ( Yun Sook Kim ),문성택 ( Seong Taek Mun ),전섭 ( Seob Jeon ),선우재근 ( Jae Gun Sunwoo ),배동한 ( Dong Han Bae ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.1
충돌 종양은 같은 조직에서 조직학적으로 완전히 다른 두 개의 종양이 동시에 존재하는 것으로 난소에서의 발생은 매우 드물다. 난소 종양 중 양성 낭성기형종은 발생빈도가 매우 흔하여, 난소에서 다른 종양과 동시 발생하는 경우가 많다. 따라서 난소에서 충돌종양의 가장 흔한 조직학적인 조합은 점액성 종양과 양성 낭성기형종이며, 장액성 낭선종과 동시에 발생한 보고는 매우 드물다. 저자 등은 최근 우측 난소에서 동시 발생한 드문 충돌종양인 약 30 cm 크기의 거대 장액성 낭선종과 양성 낭성기형종을 복강경적으로 치료한 예를 경험하여 간단한 문헌고찰과 함께 보고하는 바이다. Collision tumor means the coexistence of two adjacent, but histologically distinct tumors without histologic admixture in the same tissue and is rare incidence involving ovary. Because of their incidence of occurrence, benign cystic teratomas often occur coincidentally with other abnormalities of the ovary. Most common histologic combination of collision tumor in the ovary is coexistence of teratoma with mucinous tumors. But its association with serous tumor has been noted rare and incidence is unknown. We have experienced a case laparoscopic treatment of a huge serous cystadenoma combined with ovarian benign cystic teratoma in right ovary, and report it with a brief review of literature.
박보라 ( Bo Ra Park ),이나혜 ( Na Hye Lee ),안치옥 ( Chi Ok Ann ),심현진 ( Hyun Jin Shim ),조은규 ( Eun Kyu Jo ),김윤숙 ( Yun Sook Kim ),배동한 ( Dong Han Bae ) 대한산부인과학회 2011 Obstetrics & Gynecology Science Vol.54 No.4
Ectopic pregnancy accounts for approximately 2% of all pregnancies and is the most common cause of pregnancy-related mortality in the first trimester. Initial evaluation consists of β-hCG and pelvic ultrasonography. The fallopian tube is the most common location for an ectopic pregnancy. Other types of ectopic pregnancy include cornual, ovarian, cervical, scar, and abdominal pregnancy. In very rare cases, the abdominal pregnancy may be retroperitoneal. The diagnosis is seldom established before surgery and therapy is surgical resection of the ectopic mass. A 26-year-old woman visited our emergency department with sudden massive vaginal bleeding. She had undergone curettage 3 weeks before. But the transvaginal sonogram of the cul-de-sac revealed no fluid collection. She failed variable-dose methotrexate therapy. On laparoscopic operation, we found a cystic, conception-like structure in the retroperitoneum. Histology of resected structure showed chorionic villi. We describe this case with a brief review of the literature.
산과적 출혈의 처치에 있어서 동맥색전술의 적용실례, 효과 및 합병증
박보라 ( Bo Ra Park ),이나혜 ( Na Hye Lee ),김윤숙 ( Yun Sook Kim ),문성택 ( Seong Taek Mun ),선우재근 ( Jae Gun Sunwoo ),배동한 ( Dong Han Bae ),강채훈 ( Chae Hun Gang ) 대한주산의학회 2009 Perinatology Vol.20 No.1
목적: 보존적 방법으로 조절되지 않는 산과적 출혈의 처치에 있어 본원에서 2년간의 정맥 색전술의 적용실례, 효과 및 합병증에 대해 알아보기 위해 시행했다. 방법: 2006년 1월 1일부터 2008년 12월 31일까지 순천향대학교 천안병원 산부인과학교실에 내원하여 내과적인 방법과 보존적인 지혈방법으로 지혈이 이루어지지 않아 동맥색전술을 받은 25명의 환자를 대상으로 했다. 결과: 적응증으로는 자궁이완증 10예, 제왕절개 시 근종절제수술을 함께 받았던 경우가 6예, 비정상적인 태반 이상의 경우가 5예, 동-정맥 기형이 3예, 자궁경부 임신의 경우가 1예였다. 전체 성공률은 25명 중 22명으로 88%였다. 평균 수혈량은 환자 1인 당 7.2 unit이었고, 색전술에 소요된 시간은 평균 55분이며, 평균 재원일수는 5.5일이었다. 성공한 22명에서 모두 정상적으로 생리가 돌아왔다. 합병증은 시술 후 한 명에서 우측하지 감각이상을 호소했고, 다른 한 명에서 생리량 감소가 있었다. 결론: 본 연구에서 보존적 치료에 실패한 산과적 출혈 환자에 있어서 색전술은 대량실혈을 방지하면서 자궁을 보존할 수 있는 비교적 안전하면서도 효과가 뛰어난 이상적인 방법임을 보여주고 있다. Purpose: The objective of this study was to evaluate the indications, effectiveness and complications associated with uterine arterial embolization as an alternative treatment of obstetrical hemorrhage. Methods: From January 2006 to December 2008, 25 patients who underwent angiographic embolization for the obstetrical hemorrhage that was not responsive to conventional treatments, like obstetric maneuvers and uterotonic drugs, were included in our study. All medical records were reviewed and detailed clinical data such as clinical status, underlying conditions, amount of transfusion, embolized arteries, hospital stay, the success rate and the complications were collected. Results: We have experienced clinically successful embolization in 22 (88%) of 25 patients with obstetrical hemorrhage resulting from various causes. After embolization, the patients` vital signs were stabilized. The causes of hemorrhage were atony of uterus (n=10), myomectomy during cesarean section (n=6), abnormal placentation (n=5), arterio-venous malformation (n=3), and cervical pregnancy (n=1). The average amount of blood transfusion was 7.2 units (range; 0~39 units). The average length of the time for the procedure was 55 minutes (range: 25~96 minutes). The average duration of hospitalization was 5.5 days (range: 2~14 days). In 22 patients, menses resumed spontaneously after procedures. The main complications after embolization were numbness and pain on lower extremities (n=1), and hypomenorrhea (n=1). Conclusion: The atrerial embolization is one of the safe and effective procedures that offers patients an alternative to hysterectomy for the treatment of intractable postpartum hemorrhage.
거대낭종성 변성을 동반한 자궁근종의 자연파열에 의한 혈복강
김미영 ( Mi Yeong Kim ),박보라 ( Bo Ra Park ),이나혜 ( Na Hye Lee ),김윤숙 ( Yun Sook Kim ),최승도 ( Seung Do Choi ),선우재근 ( Jae Gun Sunwoo ),배동한 ( Dong Han Bae ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.5
Uterine leiomyoma is common benign tumor in reproductive age woman. And secondary degeneration of uterine leiomyoma can be occurred usually during midpregnancy and the puerperium. But, spontaneous perforation of uterine leiomyoma with cystic degeneration is very rare. We have experienced a case of spontaneous perforation of a huge cystic degenerative uterine leiomyoma associated with massive hemoperitoneum in a menopausal woman, and report it with a brief review of literature.