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자궁경부 상피내종양 환자의 치료로써 원추형 절제술의 효용성
금승섭(Seung Seob Keum),이정필(Jung Pil Lee),유희석(Hee Sug Ryu),장기홍(Ki Hong Chang),박영한(Young Han Park),임재현(Jae Hyun Lim),오기석(Kie Suk Oh) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.6
Objective: The objective of this study is to evaluate the efficacy of conization of the cervix in patients with cervical intraepithelial neoplasia. Study design: Cold-Knife conization was performed in total 436 patients from June 1994 to May 2000. Indications and complications of conization were studied. And the results of cervical cytology, cervical histology, colposcopic findings and patbologic diagnosis of conization specimens were evaluated in comparison with the pathologic diagnosis of hysterectomy specimens and follow-up check of the patients. Results: Followings are results summarized. 1. Patients distribution according to cone biopsy results was 31.0% for CIS, 43.3% for CIN III, 14.7% for CIN II, 7.6% of CIN I, 3.4% for CNI, respectively. 2. The rate of agreement between colposcopy-directed biopsy and conization was 63.1%. 3. The positive rate of resection margin was 15.1%. 4. The recurrence rate in c]ear resection margin group was 7.0%. But there was no recurrence after hysterectomy in cases with positive resection margin of conization specimen, and the recurrence rate of positive resection margin without hysterectomy group was 10.5%. 5. The incidence of delayed hemorrhage (bleeding after 2 weeks) in hemostatic suture group and electric cauterization only group was 4.7% (l3/279) and 15.6% (23/157), respectively. Conclusion: We conclude that conization of the cervix as the surgical treatment was effective in CIN patients with careful patient selection.
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태아의 이형성 신질환을 동반한 임신의 임상 양상 및 주산기 예후
오기석(Kie Suk Oh),김행수(Haeng Soo Kim),양정인(Jeong In Yang),오준환(Joon Hwan Oh),금승섭(Seung Seop Keum) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.1
Objective: To obtain clinically useful data regarding prenatal diagnosis, proper antepartum counseling and obstetric management in pregnancies with fetal dysplastic kidney disease. Methods: We retrospectively reviewed 13 cases of MCDK(Multicystic dysplastic kidney) and PCDK(Polycystic dysplastic kidney), diagnosed by antenatal ultrasound and delivered from June 1994 through July 1999 at Ajou University School of Medicine, Department of Obstetrics and Gynecology, with regard to prenatal ultrasonographic findings, perinatal outcomes, maternal complications and associated fetal anomalies. Results: The incidence of MCDK and PCDK was one in 1,066 and one in 2,398 births, respectively. Of the 9 cases of MCDK, one case was terminated due to severely associated anomaly, and 6 cases were delivered by spontaneous labor or pitocin induction at term, of which 1 case was delivered by pitocin induction at 36 weeks gestation due to intrauterine fetal death. Two cases were delivered by cesarean section. There were no neonatal deaths in 7 cases of MCDK and they have been followed up to date, and alive. Of the 4 cases of PCDK, 3 cases were terminated by induced abortion or induced vaginal delivery, and 1 case was delivered by cesarean section, which was combined with hypertrophic cardiomyopathy, and the baby died within 24 hours after birth. Perinatal complications consisted of small for gestational age, urinary tract infection, hydronephrosis, acute respiratory failure, acute renal failure, periventricular hemorrhage and laryngomalacia in the neonatal period. Conclusion: It is suggested that antenatal ultrasonography and genetic analysis to evaluate accurate diagnosis and associated anomalies should be performed to manage and councel properly the pregnancies with fetal dysplastic kidney disease.
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임산부 자궁경부 조직에서 cyclooxygenase-1 , -2의 발현 양상
오준환(Joon Hwan Oh),김행수(Haeng Soo Kim),양정인(Jung In Yang),김명신(Myung Sin Kim),양성천(Sung Chun Yang),한기수(Gee Soo Han),금승섭(Seung Sub Keum),오기석(Gee Suk Oh) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.11
Objective : To determine whether cyclooxygenase (COX)-1 and COX-2 are expressed differentially during the whole gestational period in the pregnant human uterine cervix and if they are involved in the process of labor. Methods : Nine patients were matched for obstetrical history and maternal age were divided into an abortion group who aborted between 13 and 16 weeks(n=3), a preterm group who delivered between 20 and 37 weeks(n=3), and a term group who delivered between 37 and 42 weeks of gestation(n=3). Immediately after vaginal delivery cervical biopsy samples were obtained and immunohistochemically stained for COX-1 and COX-2 and the degree of staining was evaluated by H-scoring system. Results : Expression of COX-1 and COX-2 was found in epithelial and stromal cells of uterine cervical tissues of preterm and term group. The immunohistochemical expression of COX-1 and COX-2 was strongest in the term group compared to the preterm group in stromal cells(HSCORE : 2.0 vs. 4.0 ; 2.0 vs. 3.0), and in epithelial cells(HSCORE : 1.0 vs. 3.0 ; 1.0 vs. 3.0). Conclusion : Although small amount of the groups were investigated, in the pregnant human uterine cervix, COX-1 and COX-2 are found to be expressed, and both shows the strongest expression in term cervical tissue. It is suggested that the uterine cervix, under the control of prostaglandins, is actively involved in the process of labor, and it is thought that the role of COX-1 and COX-2 is more important in parturition process with advancing gestational age.
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