미혼모의 출산과 사회복지 실태에 관한 고찰

주성홍 ( Sung Hong Joo ),장동욱 ( Dong Wook Jang ),백지영 ( Ji Young Beak ),이지영 ( Ji Young Lee ),손인숙 ( In Sook Sohn ),김수녕 ( Soo Nyung Kim ),조성진 ( Sung Jin Cho ) 대한산부인과학회 2005 Obstetrics & Gynecology Science Vol.48 No.7

선택적인 유산술후 진단된 병합임신 1 예

주성홍(Sung Hong Joo),변상국(Sang Kug Byun),최화영(Hwa Young Choe),조용호(Yong Ho Jo),정의식(Eui Sik Jung),조성진(Sung Jin Cho) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.7

Heterotopic pregnancy, simultaneous intrauterine and extrauterine pregnancy, is an extremely rare case. The incidence of heterotopic pregnancy was about 1 to 30,000 pregnancy, but it has been increased. Ectopic pregnancy is associated with significant mortality if not promptly diagnosed. Careful pelvic examination combined serial β-hCG determinations and transvaginal sonography to evaluation the adnexal region are necessary prerequisites for early diagnosis. We report a case of discovery of heterotopic pregnancy after elective abortion with brief review of literature.

10대 중반 산모의 임신과 출산에 관한 임상통계학적 고찰

이상현 ( Sang Hyun Lee ),김일동 ( Il Dong Kim ),백지영 ( Ji Young Baek ),김예진 ( Ye Jin Kim ),주성홍 ( Sung Hong Joo ),조성진 ( Sung Jin Cho ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.12

목적: 우리나라 여성의 임신가능 최저 연령대인 13-16세의 10대 중반 산모들의 임신과 출산에 관한 임상 양상들을 파악하여, 향후 10대 중반 산모들의 임신과 출산에 도움을 주고자 한다. 연구 방법: 1998년 1월부터 2005년 12월까지 본 원 산부인과에서 분만한 3,863명의 산모 중 16세 이하 산모 77명을 연구군으로 하고, 같은 기간 동안 무작위로 추출한 10대 후반 산모 100명과 20대 산모 100명을 각각 대조군으로 하여 통계적으로 비교분석하였다. 결과: 본 연구에서 10대 중반 산모는 전체 산모의 1.99%로 산전 진찰과 유산 경험 횟수, 초경 연령 등은 대조군들보다 통계적으로 유의하게 낮았으며, 특히 20대 산모보다 빈혈과 태변 착색 등은 통계적으로 유의하게 높았고, 제왕절개술의 비율은 통계적으로 유의하게 낮았다. 조산, 저 체중아, 조기진통, 산도열상 등의 비율이 대조군들보다 높았으나, 통계적 유의성은 없었다. 결론: 10대 중반의 산모는 신체적으로 미숙하고 열악한 사회경제적 여건 등으로 고위험 산모로 알려져 있으나 의학적, 사회경제학적 지지를 바탕으로 한 적절한 산전 관리, 충분한 영양 공급, 올바른 생활 습관 등을 통하여 그 위험성을 감소시킬 수 있다. Objective: This study is designed to help pregnancy and delivery of mid-teenager mothers by analyzing the clinical features of pregnancy and delivery of mid-teenager mothers ranging from 13 to 16 years old. Methods: This study includes 77 mothers aged 16 years and younger among the 3,863 mothers who delivered in our hospital from January 1998 to December 2005. We selected 100 mothers who aged between 17 and 19 years, 100 mothers who aged between 20 and 29 years as control groups respectively during the same period and statistical analysis is applied to compare the results. Results: In this study, mid-teenagers constitutes 1.99% of all pregnant women. The number of antenatal care, the number of women experienced abortion, and age of menarche were significantly low in the mid-teenager mothers. Especially, the risks of anemia and meconium staining were significantly higher and the rate of cesarean section was significantly lower than those of the mothers in twenties. The risks of prematurity, low birth weight infant, preterm labor, and birth canal injury were higher than those of control groups, but there were no significant differences in three groups. Conclusion: Mid-teenager mothers were known to be high risk mothers in obstetrics due to immaturity in physics and low socioeconomic status. However, the risks can be decreased by adequate prenatal care, sufficient nourishment and maintenance of good habits based on medical and socioeconomic supports.

서혜부 탈장을 동반한 완전 고환성 여성화 증후군

최화영 ( Hwa Young Choe ),주성홍 ( Sung Hong Joo ),김예진 ( Ye Jin Kim ),조성진 ( Sung Jin Cho ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.1

Complete testicular feminization syndrome (androgen insensitivity syndrome) is the most common form of male pseudohermaphroditism, transmitted by means of maternal X-linked recessive gene. This syndrome is marked by unique combination; Normal female pheno

여성 회음부에 생긴 지방육종 1예

백지영 ( Ji Young Baek ),박창서 ( Chang Seo Park ),주성홍 ( Sung Hong Joo ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.6

지방육종은 전체 암의 1% 정도를 차지할 정도로 성인에 발생하는 연조직육종 중 가장 흔하지만 회음부에서 발생하는 지방육종은 드문 질환으로 술 전 진단이 용이하지 않아서 대부분 수술 후 병리조직학적 검사로 확진된다. 저자는 약 4달전부터 서서히 커지기 시작한 양측 회음부의 무통성 종물을 주소로 내원한 33세 여자의 회음부 지방육종에 대해 완전한 수술적 절제 후 보조 방사선 치료 하지 않고 수술로 완전 절제가 이루어져 국소재발 없이 치료에 성공한 사례를 보고하는 바이다. Liposarcoma is one of the most common soft tissue sarcoma of adults and accounts for 1% in all malignant neoplasm. A liposarcoma of perineal origin is excessively rare, and preoperative diagnosis is difficult. Perineal liposarcoma was diagnosed in a 38-year-old woman. She presented with a large soft lump in the both perineal region of 4 months duration. We report a case of a liposarcoma on perineum which was treated with complete surgical resection without adjuvant radiation therapy. The patient has survived 2 years with no evidence of a recurrence.

후복막강에 단독으로 재발한 과립막세포종

김예진 ( Ye Jin Kim ),신재원 ( Jae Won Sin ),이상현 ( Sang Hyun Lee ),김일동 ( Il Dong Kim ),백지영 ( Ji Young Baek ),주성홍 ( Sung Hong Joo ),박창서 ( Chang Seo Park ) 대한산부인과학회 2005 Obstetrics & Gynecology Science Vol.48 No.1

골수이형성 증후군과 합병된 임신에서 자궁파열 1 예

임병도(Byeong Do Lim),이혁우(Hyuk Woo Lee),주성홍(Sung Hong Joo),정의식(Eui Sik Jung),박창서(Chang Seo Park),조성진(Sung Jin Cho) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.2

Myelodysplastic syndrome (MDS) is a relatively uncommon hematological disorder, charactedzed by cytopenia in the peripheral blood and normo-or hypercellularity in the bone marrow with morphological dysplastic change. Ineffective hematopoiesis leads to hematological failures in this syndrome. MDS is largeIy affected in older individuaIs with a median age of 60-75. It's association with pregnancy is even rarer. Although the exact incidence of MDS in pregancy is unknown, it is likely to be less than 1 per 100,000 pregnancies annually. Recently, we experienced a case of MDS presented initially during pregnancy in a 34-year-old primipara and managed with intensive hematologic support. Uerine rupture occurred in pregnancy complicated with MDS at 34 gestation weeks and a healthy infant was successfully delivered by Cesarean section. We report this case with a brief review of the literature.

고위험군 인유두종바이러스 검출에 있어 AMPLICOR HPV Test와 Hybrid Capture 2 Assay의 비교

윤여민 ( Yeo Min Yun ),김수녕 ( Soo Nyung Kim ),차윤정 ( Yun Jeong Cha ),박수경 ( Soo Kyung Park ),이선주 ( Sun Joo Lee ),주성홍 ( Sung Hong Joo ),손인숙 ( In Sook Sohn ),이지영 ( Ji Young Lee ),권한성 ( Han Sung Kwon ),송은영 ( E 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.6

목적: 본 연구에서는 최근에 소개된 중합효소연쇄반응(polymerase chain reaction, PCR)법으로 target DNA를 증폭하여 고위험군 HPV를 검출하는 AMPLICOR HPV test와 기존에 시행되어 왔던 Hybrid Capture 2 (이하 HC2으로 기술함) assay를 비교하여 임상적 유용성을 평가하고자 하였다. 방법: 질확대경 클리닉에서 자궁경부암 검사를 시행하였던 153명의 환자를 대상으로 하였다. 결과: 고위험군 HPV 검사에서 AMPLICOR HPV test에서 양성이었던 경우는 53/153 (34.6%)이었으며 HC2 assay에서 양성이었던 경우는 52/153 (34.0%)이었다. 두 검사 간에 결과가 일치했던 경우는 128예 (83.7%)로 통계학적으로 의미있는 일치도를 보였다(Cohen`s kappa=0.63, p<0.001). 두 검사 간에 결과가 다른 경우 HPV genotyping을 확인한 결과 AMPLICOR HPV test에서 음성, HC2 assay에서 양성인 군에서 고위험군 HPV는 검출되지 않았으며 AMPLICOR HPV test에서 양성, HC2 assay에서 음성인 13예 중 3예 (23.1%)에서 고위험군 HPV가 발견되었다. 자궁경부질세포진 검사에 따른 HPV 양성률은 고등급병변으로 진행됨에 따라 두 가지 검사 모두에서 고위험군 HPV 양성 비율이 증가되는 경향을 보였다 (p<0.001). 조직학적으로 진단된 110예에서 고위험군 HPV 양성 비율은 CIN 1에서 AMPLICOR HPV test 결과 38.7%, HC2 assay 결과 48.4%에서 양성으로 나타났으며 CIN3/cancer에서는 AMPLICOR HPV test에서 95.0%, HC2 assay에서 100%의 양성률을 보여 고등급병변으로 진행됨에 따라 두 가지 검사 모두에서 고위험군 HPV 양성 비율이 증가되는 경향을 보였다 (p<0.001). 조직학적 검사로 진단된 CIN 2 이상의 고등급병변을 기준으로 민감도와 특이도를 구한 결과 AMPLICOR HPV test에서 민감도는 90.9% (신뢰구간 75.9~97.0%), 특이도는 72.7% (신뢰구간 64.3~79.8%)였고 HC2 assay에서 민감도는 95.5% (신뢰구간 81.9~99.0%), 특이도는 69.3% (신뢰구간 60.7~76.7%)였다. AMPLICOR HPV test와 HC2 assay간에 민감도와 특이도는 의의있는 차이는 없었다. 결론: 고위험군 HPV를 진단하는 데는 AMPLICOR HPV test와 HC2 assay는 의미있게 일치하였으며 고등급병변을 진단하는데 있어서 민감도와 특이도는 두 가지 검사간에 차이가 없었다. AMPLICOR HPV test는 고위험군 HPV 검출에 유용한 검사법으로 사료된다. AMPLICOR HPV test가 선별검사로서의 유용성을 판단하기 위해서는 더 많은 자료에 대한 연구가 필요하리라 사료된다. Objective: The purpose of this study was to determine the efficacy of the AMPLICOR HPV test in comparison with the Hybrid Capture 2 (HC2) test in detecting HR HPV. Methods: One hundred and fifty-three consecutive women attending the Colposcopy Clinic were included and cervical scrape specimens were tested for the presence of 13 HR HPV genotypes by both AMPLICOR HPV test and HC2 assay. Results: The prevalence of HR HPV was 53/153 (34.6%) and 52/153 (34.0%) by AMPLICOR HPV test and HC2 assay, respectively. When discordant results were observed between AMPLICOR HPV test and HC2 assay, we used the HPV genotyping DNA chip and DNA sequence analysis, as reference standards. Concordant results were obtained for 128 (83.7%) of the 153 samples (Cohen`s kappa=0.63, p<0.001). The genotyping showed that no HR HPV was detected in the 10 AMPLICOR negative HC2 positive samples, while HR HPV genotype was found in 3/13 (23.1%) AMPLICOR positive HC2 negative samples. The detection rates of HR HPV with AMPLICOR HPV test and HC2 assay were 38.7% and 48.4%, respectively, in CIN1; 95.0% and 100%, respectively, in CIN3/cancer. HPV positivity of AMPLICOR HPV test and HC2 assay increased linearly with the increasing grade of cytology or histology (p<0.001). In detecting high grade (CIN2+) lesions, sensitivities were 90.9% (CI, 75.9~97.0%), 95.5% (CI, 81.9~99.0%), respectively, for AMPLICOR HPV test and HC2 assay (p=1.00). The specificities of AMPLICOR HPV test and HC2 assay were 72.7% (CI, 64.3~79.8%) and 69.3% (CI, 60.7~76.7%), respectively (p=0.75). Conclusions: AMPLICOR HPV test is comparable to HC2 assay for detection of HR HPV, with similar sensitivity and specificity in detecting CIN2+ lesions. AMPLICOR HPV test can be considered clinically useful for detection of HR HPV. However, more data are clearly needed on the performance of AMPLICOR HPV test as a screening tool.

북한 이탈 주민에서 발생한 암의 임상병리적 특징

박재민(Jae Min Park),김은영(Eunyoung Kim),정일용(Il Yong Chung),박세혁(Sei-Hyeog Park),박종민(Jong-Min Park),윤여규(Yeo-Kyu Youn),오흥권(Heung-Kwon Oh),김중석(Joong-Suck Kim),주성홍(Sung-Hong Joo) 대한종양외과학회 2014 Korean Journal of Clinical Oncology Vol.10 No.2

Purpose: In this study, we compared characteristics of cancer of North Korean defectors to South Korean. In order to clarify the clinicopathologic characteristics of cancer in North Korean defectors. Methods: This study is a retrospective study through chart review of patients diagnosed as cancer at National Medical Center from 2008 to 2013. Control group included South Korean cancer patients who were diagnosed as cervical cancer, thyroid cancer, liver cancer, stomach cancer at same hospital during same period. Two groups were analyzed and compared by sex, age, past medical history, cancer origin, cancer stage, and treatment. Results: Among 1,760 North Korean defector patient registered in National Medical Center, 61 patients were diagnosed as cancer, which was 3.5%. Cervical cancer (19.7%), thyroid cancer (19.7%), liver cancer (14.1%) and stomach cancer (10.3%) were 4 most frequent cancer. In South Korean cancer patient, percentage was as follows: thyroid cancer (33.7%), stomach cancer (7.8%), liver cancer (7.3%), cervical cancer (3.7%). Conclusion: Cancers closely related to socio-economic status, such as cervical cancer and hepatitis-B related liver cancer, were relatively more frequent in North Korean defectors than South Koreans. As for cancers in which early diagnosis is important such as thyroid cancer and stomach cancer, there were no significant differences in age-prevalence, disease course and treatment.