인공유산후 중증 장해를 제외하고 야기하는 후유증에 대하여

김인선(HS Kim) 대한산부인과학회 1960 Obstetrics & Gynecology Science Vol.3 No.1

근래 증가하는 인공중절후에는 일시적이나마 상당한 빈도로 월경이상 자율신경계실조 등이 발생하며 인공중절술을 반복할수록 이러한 증상을 야기함이 많다. 또한 중요한 과제로서는 술후 차회 유조산 자궁외임신을 야기하기 쉽다는 것이다. 따라서 술자는 술시에 부손상에만 주의할 뿐 아니라 술후 발생하는 각종자각증상과 원격후유증을 염두에 두며 가급적 반복시행을 피함이 가하다고 생각한다. As the number of artificial abortion increases recently, there becomes great number of patients with various complaints, despite of perfect technique during procedure. The author studied about post operative sequelae on 928 clinic patients (excluding severe disturbances, such as perforation of the uterus, massive bleeding, retained secondines, serious infection), who received artificial abortion in the other hospital and visited author during the past 2 years (January 1958-November 1959). They are divided into two groups, subjective symptom and remote sequelae groups. A. Subjective symptom group: Incidence: 280 cases out of 928 total patients, 40.95%. Of 380 cases; 1. Abnormality of menstruation, 42.1% 2. Pain etc. 36.6%. Approximately 1/2 patients complained of lower abdominal pain, next common was lumbago. 3. Disturbance of alimentary system, 21.1%. B. Remote sequelae: 1. Miscarriage of pregnancy following operation. Spontaneous miscarriage after operation was 214 cases out of 928 total cases, 23.06%. 2. Ectopic pregnancy following operation. Of total ectopic pregnancy of 130 cases, 44 cases, were after artificial abortion. The incidence to total 928 cases of artificial abortion is 4.74±0.698%. There is significant difference to compare with 0.96±0.103%. in ectopic pregnancy without preceeding artificial abortion. Though abnormality of menstuation, disturbances of autonomic nerve system etc. Were yielded temporarily, they occured in considerable number after artificial abortion, and the more artificial abortion repeated, the more it resulted in those symptomes. The most important problem is the frequent occurence of miscarriage of pregnancy and ectopic pregnancy etc. following the operation. The author believe that the operator should not only be careful about organ damage during the procedure, but also avoid repeated operation as much as possible, considering above various subjective complaints and remote sequelae

자궁경부와 자궁내막에 발생된 다발성 원발 악성종양 1 예

김창곤(CG Kim),오동규(DK Oh),이규완(KW Lee),박용균(YK Park),홍성봉(SB Hong),김인선(HS Kim) 대한산부인과학회 1987 Obstetrics & Gynecology Science Vol.30 No.3

c저자들은 자궁경부와 자궁내막에 발생된 매우 희귀한 다발성 원발 악성종양 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다 Since Bilorth described the first case in 1889, multiple primary malignant neoplasms seem to be increasing in frequency This may have come about with improved clinical awareness, increased life expectancy, increased use of chemotherapeutic agents, and degree of existing malignancy When discussing multiple primary cancer, it is clinically important to ascertain whether the patient with an initial cancer has an increased, decrease, or unchanged risk of developing a second cancer Recently we experienced a very rare case of multiple primary carcinoma involving the uterine cervix and the uterine endometrium Accordingly we present this rare case with a brief review of the literatures

자궁재임신에 관한 임상통계학적 고찰

김근(K Kim),이순호(SH Lee),오창학(CH Oh),정원화(WH Chung),이관복(KB Lee),박영하(YH Park),김인선(HS Kim) 대한산부인과학회 1984 Obstetrics & Gynecology Science Vol.27 No.1

Thanatophoric dwarfism is the term applied to a distintive, lethal form of bone dysplasia described by Maroteaux, Lamy and Robert in 1967. Aspecific chondrodystrophy which they named thanatophoric (death producing) dwarfism, since it result in death shortly after birth. This report presents the clinical, rakiographic, and autopy findings of a case of thanatophoric dwarfism detected postnatally by radiologic examination and discusses the diffeenciation of this disorder from other forms of congenital short limbed dwarfism.

자궁경부암종 및 상피내종양에서 저위험 및 고위험 인유두종 바이러스 감염에 관한 연구 : 경부도말의 Hybrid Capture 에 의한 연구

강재성,김인선,홍성미 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.4

The assocication between human papillomavirus infection (HPV) and cervical lesionhas been well established. for detection and typi8ng human papilloma virus deoxyribonucleic acid in cervical tissues, Southern blot hybridzation and polymerase chain reaction are commonly regarded as reference standard methods. However it has the limitation includeing technical difficulty, safety, subjectivey in result interpretation. Recently the chemilnuminescent molecular hybridization assay method has been windely used and it has been known that it can detect less hybridization assay method has been windely used and it has been known that it can detect less then 1 pg of DNA in a 100micro l aliquot of a crude specimen. This study was perfomed to determine the usefulness of hybrid capture HPV DNA assay for detecting low-risk and high-risk human papillomaviruses in histologically confirmed normal, cervical intraepithelial lesion(CIN) and invasive squamous cell carcinoma of the cervix, and to compare the correlation among cervical cytology, hiopsy finding and HPVs infelction ,and to detirmine whether the additon of the hybrid capture test to cytologic studies would improve the ability to identify signifcant lesions. Cervical cytologic smears, hybrid capture HPVs DNA assay, and pucnh bhiopsies were performed on 78 women who have normal cervix(28cases),cervical intraepithelila lesion (24cases), and invasive squamous cell carcinoma(26cases). At first the probes for low-risk HPV(6,11,42,43,44) and the proves for high-risk HPV(16,18,31,33,35,45,51,52,56)were used and secondly retyping was done for HPV 16 abd 18 in high-risk HPV positive cases. The results obtained were as follows; 1. Low-risk HPVs infections were 14.3% and 8.3% in normal cervix and cervical intraepithelial lesion respectively. High-risk HPVs infection were 7.1%, 70.8% and 73.1% in normal cervix, cervical intraeithelial lesion and squamous cell carcinoma respecitively. These was highly significant corelation between positive high-risk HPVs test, cervical intraepithelial lesion and squamous cell carcinoma. 2. Positivities of low and high-risk human papillomaviruses in patients with negative cytologic result were 9.1% and 15.1% respectinvely. 3. In patients with high-risk human papillomaviruses infection, human papilloma viurs 16 and 18 types were detected in 47.4% and 13.2%, respectinvely, and both HPV 16 and 18 positive and negative detention were 15.7% 23.7% respectinvely. Among 12patinent of cervical intraepithelial neoplasia with high risk HPVs infection, HPV 16 was detected in 66.6% and HPV 18 in 16.7% Among 24 squamous cell carcinomas with high risk HPVs infection, HPV 16was detected in 41.7% and HPV 16 in 12.5% and both HPV and 18 in 25%. 4. In patients without koilocytosis by cervical tytology, low and high-risk human papillomaviruses or both were positive in 30.7%. 5. In patients with positive high-risk HPVs, sensitivitives of koilocytosis were 64% and 69 % in histologic and cytologc diagnosis, and specificities and specifictites were58.5% and 62% respectively. Above result suggest that detection for high-risk human papilloma viruses type by hybrid capture assay improves the management of cervical intraepithelial neoplasia and is more useful method over cervical cytology only.

상피성 난소암에 있어서 DNA Flow Cytometry의 임상적 의의

이규완,김인선,구병삼,김해중,문준,이상희 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.6

저자들은 1992년 4월부터 1994년 3월까지 복부종괴를 주소로 본원 산부인과를 내원하여 시 험개복술을 시행한 환자중 병리조직검사에서 상피성 난소암을 진단된 27예를 대상으로 flow cytometry로 DNA를 분석하여 임상적 양상과 비교하여 다음과 같은 결과를 얻었다. 1. 상피성 악성종양에서 aneuploidy 발현율은 45.0%, SFP 비율은 11.9+-5.7% 로 경계성 난 소종양의 14.3%, 6.6+-6.0%보다 높았으나, SFP비율에서만 통계적인 유의성이 있었다(p$lt;0.05). 2. 병기 3, 4기의 난소 진행암에서의 aneuploidy 발현율운 44.4%로 1, 2기의 22.2%보다 높았으나 통계적인 유의성은 없었고 SPF 비율은 진행암의 경우에서 12.2+-5.1%로 1, 2기의 6.6+-3.1%보다 유의한 차이가 있었다(p$lt;0.05). 3. 난소암의 분화도가 grade III 인 미분화암에서 aneuploidy 발현율이 61.5%, SPF 비율이 14.5+-6.3%로 경계성 난소암의 12.5%나 5.6+-4.0%보다 유의하게 높아 통계적인 유의성이 있었다(p$lt;0.05). 4. 난소의 악성종양에서 조직학적 분류에 따른 DNA flow cytometry 양상은 서로 통계학적 유의성은 없었다(p$gt;0.05). 5. 상피성 난소암의 flow cytometry 분석에서 aneuploidy 양상과 18% 이상의 높은 SPF 비율을 보인 전예에서 진행된 암의 소견과 grade III 의 미분화 양상을 보여 임상적 예후가 불량한 예들이었다. 이상과 같은 결과로 미루어 상피성 난소암에서 DNA flow cytometry 측정은 그 임상적 양상이나 예후를 판정하는 주요 진단수단으로 의의가 있을 것으로 사료되나 앞으로 더욱 많은 예들의 분석과 이들에서의 5년생존율에 대한 연구를 병행하여야 되리라고 본다. We investigated the clinical significance of DNA content and proliferative activity or tumor cell populations as flow cytometry analysis from twenty epithelial malignant turmor of the ovary and seven boderline malignant tumors of the ovary. The DNA aneuploidy was found in nine cases of twenty malignant epithelial tumors(45.0%) of the ovary and one case of seven boderline tumors of the ovary(14.3%). The S-phase fraction(SPF) of malignant ovarian tumor(11.9+-5.7%) was significantly higher than that of boderline ovarian tumor (6.5+-6.0%). The DNA aneuploidy and S-phase fraction were significantly correlated with FIGO stge and tumor grade. The DNA aneuploidy rate and S-phase fraction were higher in the advanced and poorly differentiated epithelial malignant ovarian tumors. Analyzing the result of flow cytometry, the malignant epithelial ovarain tumors were separated into the three groups, aneuploidy group with a SPF greater than 18% aneuploidy group with a SPF less than 18% and diploidy group. All cases of the aneuploidy group with a SPF greater than 18% showed advanced stage(stage III-IV) and poorly differentiated grade(grade III). From our results we suggested that the flow cytometric DNA pattern correlate with the aggresive potential of a malignant epithelial ovarian tumor and provide additional information about tumor prognosis.

장액성 표면유두상암 1 례

이규완,김인선,김영태,황인구,서학범 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.4

저자들은 1990년 1월 고려대학교부속 안산병원에서 난소암 중에서도 매우 드문 장액성 표면유두상암 1례를 경험하였기에 간단한 문헌고찰과 함께 보고하는 바이다. Serous surface papillary carcinoma is classified as a special of serous carcinoma by WHO. But in contrast to the common epithelial serous cancers, it is a large exophytic mass that originates in the ovarian surface and spreads rapidly throughout the peritoneum. We experienced a case of serous surface papillary carcinoma in 34 year old nulliparous woman, and this case was presented with a brief review of the literatures.

자궁 경부에서 발생한 Transitional cell carcinoma 1 예

이미정,오화은,나정아,김인호,여민구,김순규,김인선,서호석 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.6

저자들은 3차례 선행화학요법 후 근치적 광범위 자궁적출술을 시행한 후 TCC로 진단된 환자 1예를 경험하였기에 문헌적 고찰과 함께 보고하는 바이다. Transitional cell carcinoma is an uncommon, aggressive group of cervical tumors which is considered to have a similarity to papillary transitional cell carcinoma of the urinary tract. The histologic appearance is characterized by cells that are mostly oval to elongated in shape with their long axes oriented perpendicular to the surface and flattening of only the most superficial layers. We present a case of transitional cell carcinoma of uterine cervix with a brief review of the literature.