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강원지역에서의 질 Trichomonas Vaginalis 유병률
권장연,차동수,김명철,최교선,구재석,어영 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.7
Since Donne`s description of the Trichomonas vaginalis in 1836, the reports of numerous observers have emphasized its very frequent occurrence in women and its being a cause of purulent vaginal discharge of women with severe vaginitis. And it was well-known that trichomoniasis has been emerged as the most common sexually transmitted disease of parasitic origin. In the recent years, Trichomonas vaginalis has been implicated in the pathogenesis of preterm labor, premature rupture of the membranes, and upper reproductive tract postsurgical infections. So, to compare and evaluate distribution and prevalence of Trichomonas vaginalis in kangwon area, we analyzed the papancolaou smear and direct wet smear results during the years 1988 to 1993. The results were as follows. 1) The prevalence of Trichomonas vaginalis by papanicolaou smear and direct wet smear were 8.1% and 6.5%, respectively. 2) In geographic distribution of Trichomonas vaginalis in kangwon area by papanicolaou smear and direct wet smear, the prevalence of urban area were 14.3 and 24.1%, rural area were 6.2 and 4.0%, respectively. 3) The prevalence of Trichomonas vaginalis showed increasing trend as the gravida and parity were increasing. 4) No close relation were found between gynecological diseases or surgical past history and the prevalence of Trichomonas vaginalis. In Conclusion, we recommed that screening tests of T. vaginalis are performed to high risk women of trichomoniasis and think that studies on accurate and rapid diagnostic tests to find out women carrying Trichomonas vaginalis are required.
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한상원,차동수,조미연,구재석 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.6
저자들은 본원 산부인과에서 악성 홉합성 뮬러리안종양 2예를 경험하였고 그 중 1예가 방사선 조사의 기왕력이 있는 환자를 경험하였기에 문헌과 함께 보고하는 바이다. Malignant Mixed Mullerian tumor(MMMT) is an uncommon tumor containing epithelial and mesenchymal components. According to stromal element, it is divided to homologous type and heterologous type. MMMT is highly malignant and the prognosis is poor due to frequent metastasis and recurrence. The disease is usually advanced when diagnosed. We experienced two case of MMMT(a case received irradiation for the rectal cancer 7 years prior to the diagnosis of tumor). So we report above cases with brief review of literature.
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한상원,한혁동,차동수,이영진,김명철,박현희,구재석,송종민 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.11
Large proportion of ovarian tumor in pregnancy belongs to benign, and thus malignant ovarian carcinoma in pregnancy remains a rare event. Recently, incidence of primary ovarian tumor complicated in pregnancy shows an increasing tendency in various literatures. Management of ovarian tumor in pregnancy has a crucial importance. The treatment depends on the multiple factors such as symptoms, complications, gestational weeks, possibility of dystocia and presence of malignancy, etc. In this study, clinical and pathologic review of the ovarian tumor in pregnancy including one case report of ovarian malignancy was present. The records of 83 ovarian tumors complicated in pregnancy among 28,435 deliveries were reviewed at Department of Obstetrics and Gynecology, Yonsei University, Wonju College of Medicne from July, 1981, to July 1995. The results obtained were as follows; 1) The incidence of benign ovarian tumor in pregnancy was 1 in 343 deliveries. The incidence of malignant tumor and borderline malignancy was 2.4% and 4.8% of ovarian tumors complicated in pregnancy, respectively. 2) Mean age was 27.5 years, and the range was 19~39 years, 90.4% of this tumor was distributed among 21~34 years of age. 3) As to the initial chief complaints or the mode of presentation, low abdominal pain or discomfort were found in 33 cases(39.8%), no symptom including incidentally diagnosed -adenexal mass during the Cesarean section was 27 cases(32.5%); palpable mass in 9 cases(10.8%), known mass in 6 cases(7.3%), vaginal bleeding in 5 cases(6.0%), genitourinary discomfort in 1 case(1.2%), lumbargo in 1 case(1.2%), and fever in 1 case(1.2%). 4) 48 cases(57.9%) were diagnosed in the first trimester, 10 cases(12.0%) in 2nd trimester, 23 caes(27.7%) in third timester and during Cesarean section and 2 cases in puerperium. 5) According to mode of diagnosis, 31 cases(37.4%) were discovered during routine pelvic examination with abdominal or transvaginal ultrasonogram. Only ultrasonogram was applied in 27 cases(32.5%), when the tumors were not able to be diagnosed with physical examination due to small size or impalpable mass. 19 cases(22.8%) were diagnosed incidentally at the time of cesarean section. 6) According to location of tumor, unilateral tumor was 73 cases(88.0%), and there was no statistical difference between left and right site(p$gt;0.05). Bilaterality was shown in 10 cases(12.0%). In all cases of teratoma, bilaterality was 19.0%. In all cases of corpus luteal cyst, bilaterality was 26.3%. 7)Histopathologically, benign tumor was 78 cases(92.8%), borderine epithelial tumor was 4 cases(4.8%), and malignant ovarian neoplasm was 2 cases(2.4%). Most common tumor was benign teratoma(21 cases ;25.0%). Cortus luteal cyst was 19 cases(22.6%). Simple cyst was II cases(13.4%). Mucinous cystadenoma and serous cystadenoma were 8 cases(9.5%) and 8(8.3%) respectively. other benign ovarian tumors were one thecom a and one cystic adenofibroma. 8) According to size of tumor, group of tumors less than 5cm in mean diameter was 21 cases(25.0%), between 6-10cm being 39 cases(46.4%). between 11-20cm being 17 cases(20.1%), and more than 20cm being 6 cases(7.1%). 9) According to complication of tumor, torsion was 12 cases(14.5%), and rupture was 4 cases(4.8%). 10) Obstetrical complication rate after adnexal operation was 15.9%, which was composed of abortion(3 cases) and preterm labor(4 cases). 11) Mode of delivery was as follows : normal spontaneous vaginal delivery in 20 cases (45.5%), Cesarean section at term in 17 cases(38.0%), preterm delivery in 4 cases(9.1%), and spontaneous or missed abortion in 3 cases(6.8%).
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