폐경기 여성에서 호르몬 대치 요법시 병행 투여된 프로제스토젠 투여 방법에 따른 골대사의 생화학적 지표에 미치는 영향

이권해,강선영,임경빈,이해혁,구도형,이석민 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.1

Purpose : To evaluate the impact of added progestogen on biochemical markers of the bone turnover undergoing hormone replacement therapy in the postmenopausal women. Materials and Methods : There are 71 postmentopausal women who are divided into three groups (Group I, Group II, Group III). Group I(continuous combined)is given conjugated equine estrogen (CEE, 0.625mg, day 1-30) plus medroxyprogesterone acetate (MPA, 2.5mg, day 1-30), Group II(unopposed estrogen) is given conjugated equine estrogen (CEE, 0.625mg, day 1-30) plus medroxyprogesterone acetate (MPA, 5mg, day 1-12). And there were measured serum osteocalcin, serum total alkaline phosphatase and urinary deoxypyridinoline excretion before starting hormone replacement therapy and 12 months later. Results : The serum osteocalcin, serum total alkaline phosphatase and urinary deoxypyridinoline excretion significantly decreased after hormone replacement therapy (Group, I, II, III). And there was no significance in decreases in biochemical markers of the bone turnover among three groups. Conclusions : It was concluded that the impact of added progestogen on the biochemical markers of the bone turnover undergoing hormone replaced therapy in postmenopausal women was not significant than nothing added group. Thus we concluded that progestogen was not impact on decreasing on the biochemical markers of the bone turnover in postmenopausal women undergoing hormone replacement therapy.

폐경기 여성에서 1년간 호르몬 대치 요법이 혈청 지질에 미치는 영향

이해혁,남계현,김승형,이임순,이권해,최승도 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.2

Cardiovascular disease is one of the most common cause of death in postmenopausal women. After the onset of menopause, the risk of cardiovascular disease is increased. Several risk factors of cardiovascular disease are well known to us. Among the risk factors, the changes of lipid profiles are roles for cardiovascular disease. Estrogen appears to protect the development of cardiovascular disease, by several mechanism. Especially the protective effect is believed to be mediated by the changes of lipid profiles. Decreased high-density lipoprotein (HDL)-cholesterol and increased low density lipoprotein (LDL)-cholesterol are important factors for development of cardiovascular disease. The purpose of this study was to evaluate the effect of hormone replacement therapy on the lipid profiles to include total cholesterol (TC), high density lipoprotein(HDL)-cholesterol, low density lipoprotein(LDL)-cholesterol, and triglycerides. We measured lipid profiles in 31 postmenopausal women and gave each conjugated equine estrogen (CEE, 0.625mg, day 1-30) plus medroxyprogesterone acetate (MPA, 5mg, day 1-12) for 12months. The levels of serum TC, LDL-cholesterol, and triglycerides were decreased significantly (p<0.05) and HDL-cholesterol was increased significantly (p<0.05) after 12months of hormone replacement therapy. These data suggest that hormone replacement therapy appears to protect agianst the development of cardiovascular disease by the changes of lipid profiles.

자궁내 태아사망의 임상적 고찰

이권해,이정재,조현철,이석민,이임순,이해혁,김권대,이순곤,남계현 순천향의학연구소 1999 Journal of Soonchunhyang Medical Science Vol.5 No.2

Objective: This study was designed to evaluate diagnosis and complication, prognosis during clinical study of cases of intrauterine fetal death. Methods and materials: This is a clinical study of 56 cases of the intrauterine fetal death among 8064 deliveries at Seoul Sunchunhyang university hospital during 5 years from January, 1994 to December, 1998. Results: The incidence was 0.7%. The age distribution of mothers was 18 - 44 years and was highest in the 25 - 29 years range(46.4%). The parity was the most highest in the nulliparous group(51.8%). The most common gestational weeks was 20 - 28 weeks gestational period(46.4%), and most common presentation was cephalic(73.5%). The most common weights of the intrauterine fetal death was from 5,00gm to 1,000g(48.2%). The mode of the most common delivery was the induction of delivery(57.2%). The etiologic factors were: unknown(42.9%), preeclampsia(17.9%), chorioamnionitis(14.3%), congenital anomaly(12.5%), abruptio placenta(7.1%), cord complication(3.6%), placenta previa, death of one for twin. There were 2 cases of maternal complication(DIC, Uterine atony). Conclusion : Intrauterine fetal death should be diagnosised early and treated properly to reduce risk of the maternal complication.

자궁경부 임신

이해혁,이권해 한국의학사 2000 診斷과治療 Vol.20 No.2

거대 난소 종양의 염전 1예

김미영,이해혁,유애리,박정희,이임순,정수호,고은석,레앙소팥,배동한,김태희,이권해 순천향의학연구소 2008 Journal of Soonchunhyang Medical Science Vol.14 No.1

..

골반 초음파 감시 하에 16 Gauge Angioneedle™을 사용하여 치료적 더글라스와 천자를 시행하여 치유된 복강 내 출혈 1예

김미영,이해혁,유애리,박정희,이임순,정수호,레앙소팔,배동한,김태희,이권해 순천향의학연구소 2008 Journal of Soonchunhyang Medical Science Vol.14 No.1

Culdocentesis is a procedure that checks for abnormal Quid in the space just behind the vagina (cul-de-sac). First, a pelvic examination is done. Then, after exposing the postehor vaginal fonix with a bivalve vaginal speculum the posterior lip of the cervix is grasped with a tenaculum. The cul-de-sac is then entered through the postehor vaginal wall with an 18-20 gauge needle with a syringe inserted. As the cul-de-sac is entered, suction is applied, and the intraperitoneal contents are aspirated. In the recent past, culdocentesis was commonly used in the evaluation of a vahety of common intraperitoneal conditions, principally, the hemorrhage associated with ectopic gestations and ruptured ovarian cysts the presence and/or drainage of purulent associated with pelvic inGammatory disease, and as a screening procedure to facilitate early diagnosis of ovarian neoplasms. Usually 16-18 gauge needle with a syhnge attached was used for culdocentesis. But we have experienced a case of therapeutic culdocentesis with 16 gauge angioneedle in patient of hemoperitoneum. So, report it with a bhef review of literature.

2차원 및 3차원 초음파를 이용한 태아표면의 해부학적 선별 검사에 관한 연구

윤석범,이해혁,이정재,최경훈,이순곤,이임순,이권해 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.2

Objective : Our purpose of this study was to determine the clarity and consuming time of fetal surface screening in thirty-eight fetuses from 24 to 32 weeks of gestation by use of two and three-dimensional ultrasonography. Methods : From May 1998 to July 1998, we performed the fetal surface screening of the fetal face, extremities, and spine. Thirty-eight fetuses of 24-32 weeks of gestation (thirty-seven normal fetuses and one abnormal fetus) were studied by use two-dimensional (AI 5200S, 3.5-5.0MHz; Acoustic Imaging Technologic Cooperation, U.S.A.) and three-dimensional ultrasonography (Volusion 530D, 3.5-5.0 MHz ; Kretz-Medicine, Korea). On the fetal face, we evaluated both orbits, nose, lips and brow. Both hands and feet, five digits and toes should be seen in this study. We evaluated cervical spine and lumbosacral junction of the spine. Results : The maternal average age of 38 patients was 29.9 years and the average gestational age was 29.7 weeks. The results of fetal surface screening were as follows : face (both orbits 89.5%, lips 92.1%, nose 92.1%, and brow 89.5%), extremities (both hands 68.4% and feet 73.7%), and spine (cervical spine 94.7% and lumbosacral junction 97.4%) by use of two-dimensional ultrasonography. By use of three-dimensional ultrasonography, results were as follows : face (both orbits 76.3%, lips 81.6%, nose 81.6%, and brow 78.9%), extremities (both hands 76.3% and feet 78.9%), and spine (cervical spine 71.1% and lumbosacral junction 73.7%). Consuming time for two-dimensional ultrasonography were 4.7 minutes for face, 11.6 minutes for extremities, and 5.7 minutes for spine. Using three-dimensional ultrasonography results were 12.8 minutes for face, 17.9 minutes for extremities, and 11.7 minutes for spine. Average consuming time of all fetal anatomic screening was 22.0 and 42.4 minutes by use of two and three dimensional ultrasonography. In one abnormal fetus had cleft lip and polydactyly of right foot which were detected all by three-dimensional ultrasonography, but we couldn't detect the polydactyly by two-dimensional ultrasonography. Conclusion : Three-dimensional ultrasonography was more time-consuming method, but we suggested that three-dimensional ultrasonography was superior than two-dimensional ultrasonography in fetal surface screening.

조산의 예측 지표로서의 fetal fibronectin의 유용성

정집광,이해혁,이정재,이석민,이순곤,남계현,이임순,이권해 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Objective: The purpose of this study was to evaluate clinical efficacy of fetal fibronectin as a marker to predictor of preterm labor. Materials & Methods: The study group consisted of sixty-eight healthy pregnant women, at gestational age between 24 and 36 weeks, who visited our department with vaginal discharge from April, 1995 to December, 1997. For comparison, we divided all of the pregnant women into two groups by the result of ROM-Check^®, positive groups(N=21) and negative groups(N=47). When preterm labor appeared, 50mg of ritodrine hydrochloride(Yutopar^®) mixed I liter of 5% dextrose solution was administered slowly intravenously. Results: 1) The gestational age at delivery and the interval time from admission to delivery in the positive groups were significantly shorter than those of the negative groups(p<0.05). 2) The positive groups had significantly lower birth weight and Apgar scores than the negative groups(p<0.05). 3) Among the negative groups, in case of tocolytics administration, the interval time from admission to delivery significantly delayed more than that time in case of no tocolytics administration(p<0.05). Conclusions: The detection of the fetal fibronectin in vaginal discharge had a useful method as a predictor of preterm labor. Tocolytics was more effective in the negative groups than in the positive groups.

임신 종결 후 발생한 자궁 동정맥 누공에서 자궁동맥색전술로 치료한 1예

김종민,이해혁,김태희,남계현,심일구,이권해,김형문,이임순,장종호 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Arteriovenous fistula of uterus is rarely reported disease. This vascular malformation is very dangerous condition because Dilatation & curettage can cause massive uterine bleeding without accurate diagnosis. The diagnosis is made by angiography, gray scale ultrasonography, color and duplex doppler ultrasonography, computed tomography, and magnetic resonance imaging is helpful. Especially color and duplex doppler ultrasonography is allows convincing detection and diagnosis of arteriovenous fistula. Recently transcatheter uterine artery embolization is treatment of choice. We have experienced a case of arteriovenous fistula of uterus. Which is presented with a brief review of literature.

복식 전자궁적출술후 절단부에 발생한 난관탈출증 1예

송은석,이해혁,김태희,김정식,남계현,이권해,고은석 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Prolapse of the fallopian tube into the vaginal vault after hysterectomy is a rare complication. Since most of cases may resolve before detection or remain undiagnosed, the exact incidence is still unknown. Though most common sign of tubal prolapse is tender friable tissue in vaginal cuff, with the simptoms of lower abdominal pain, dysparenunia, vaginal discharge, or postcoital spotting. The definitive diagnosis should be confirmed histologically Recently, we experienced a case of fallopian tube prolapse after abdominal hysterectomy in a 41-year-old woman and report with a brief review of the literature.