장막하 낭포성 자궁근종의 1 례

김종화(JH Kim),장상호(SH Chang),진건(K Jin),장윤석(YS Chang) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.2

Cystic degeneration is a rather common secondary change of myoma. In extreme cases, all of the original tumor is involved, being converted into a large cystic cavity, simulating ovarian cysts. We presented the case with a brief review of the literature.

금강초롱꽃의 자생지 식생 및 생육조사

임학태(Lim HT),김종화(Kim JH),김정기(Kim JK),이우철(Lee WT),유기억(Yoo KO),김원배(Kim WB),김병현(Kim BH),김정간(Kim JK) 한국원예학회 1993 한국원예학회 학술발표요지 Vol.11 No.2

자궁선근증에 대한 임상 몇 병리학적 고찰

김학순(HS Kim),김종화(JH Kim),강순범(SB Kang) 대한산부인과학회 1986 Obstetrics & Gynecology Science Vol.29 No.1

자궁선근증 , 임상 몇 병리학적 고찰 The clinical study was performed to 311 patients with adenomyosis among 1324 patients who were undertaken total hysterectomy in the department of Gynecology, Seoul National University Hospital, during July 1983 and February 1985. For comparison 1013 patients without adenomyosis were selected for control group among the same 1324 patients. The results were summarized as follows: 1. The incidence of adenomyosis was 23.5%(311/1324). 2. The patients with adenomyosis in the fifties were 179(57.6%), peak in incidence and statistically significant compared to control group (P*<0.01). 3. Parity was 3.05 in average and 295 patients(94.9%) were parous(p*>0.10). 4. Frequency of artificial abortion was 3.32 in average ande 267 patients(85.9%) experienced more than one (p*<0.01). 5. Frequency of spontaneous abortion was 0.43 in average and 92 patients(26.4%) experienced more than one (p*=0.03). 6. There was no significant relationship between the incidence of adenomyosis and previous laparotomy including cesarean section. 7. Menstrual disturbances were present in 243 patients(78.8%) and the duration of symptoms was below 6 months in about half. 8. Preoperatively adenomyosis was suspected in 25 patients(8.0%), especially up to 15.0% in uncomplicated adenomyosis. 9. The associated pathology was leiomyoma(34.1%), pelvic endometriosis(6.8%, p*<0.01) and endometrial adenocarcinoma(1.0%, p*>0.10). etc. 10. Uterus was enlarged significantly in patients with "adenomyosis without myomas" and mean uterine weight is 159gm (p*<0.01). 11. Endometrial findings were proliferative phase 41.1%, secretory phase 32.5%, and hyperplasia 3.2%, etc. 12. There was no statiscally significant difference between uncomplicated and complicated adenomyosis.

심장판막이식과 수술후의 임신에 관한 임상적 고찰

이재관(JK Lee),김종화(JH Kim),강순범(SB Kang),김종환(JW Kim),서경필(KP Suh) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.8

Patients who have had cardiac valve replacement are being seen increasingly often as candidates for antenatal care. The outcome of 23 pregnancies in 14 patients with bioprosthetic cardiac valves is analyzed and reported here. The results were summarized as follows: 1. Twenty three pregnancies in 14 patients with bioprosthetic cardiac valves resulted in 11 healthy, 2 low birth weight infants, 2 spontaneous abortions, 7 elective terminations of pregnancy, and one tubal pregnancy. 2. Pregnancy and labor seemed to have been tolerated relatively well in these patients. 3. There were 3 males and 10 females among the 13 infants born. 4. Birth weights ranged from 2,140 to 3,670g(mean 3,030). 5. Apgar scores at five minutes ranged from 4 to 10 (mean 9.1). 6. There were no instances of congenital malformations, maternal or fetal hemorrhagic complications. 7. There were 4 spontaneous vaginal deliveries, 7 elective vacuum extraction deliveries, 1 elective forcep delivery, and 1 cesarean section. 8. All patients received prophyllactic broad-spectrum antibiotics for infective endocarditis, and no nistances of endocarditis developed. 9. There were no stillbirth, no neonatal deaths, and no maternal deaths. 10. There were 2 instances of thromboembolism; one in the immediate postoperative period, and the other 5 years after valve replacement. All seemed to be unrelated to pregnancy. 11. Anticoagulants were not used in pregnancies which went to term except one patient, in whom coumarin was administered until 6th week of gestation. 12. One pregnancy was complicated with premature labor, one with gestational edema, one with preexisting chronic active hepatitis, five with worsening of cardiac status (one of the five, with newly developed atrial fibrillation). 13. 34.8% of all pregnancies after cardiac valve replacement were unwanted ones, and at the same time preventable `risk factors`.

Real-time초음파와 혈청hCG검사를 이용한 자궁외임신의 진단

최원도(WD Choi),김종화(JH Kim),신희철(HC Shin) 대한산부인과학회 1986 Obstetrics & Gynecology Science Vol.29 No.1

Real-time초음파 혈청hCG검사 자궁외임신의 진단 Twenty three patients were evaluated with suspicious of an ectopic pregnancy by ultrasonography in the Department of Obstetrics and Gynecology, Seoul National University Hospital. Among them 15 patient were proven to have ectopic gestation. This study was based on 15 patients with ectopic pregnancy who had both a sonographic examination of the pelvis and determination of serum beta human chorionic gonadotropin(s-hCG). Emphasis was focused on the spectrum of sonographic appearance that may occur in ectopic gestation. The results were as follows: 1. Among 23 patients who were suspicious of ectopic pregnancy by ultrasonography, 15 patients(65%) were proven to have ectopic gestation. 2. The physical examination of ectopic pregnancy did not significantly contribute to the diagnosis of ectopic pregnancy, but culdocentesis significantly did. 3. The positive rate of u-hCG was 80% and that of s-hCG was 100%. The range of s-hCG by radioimmunoassay was between 150mlU/ml and 48,000mlU/ml. 4. There were 5 patients who had embryo in pathologic report. Among them there were 2 patients(40%) whose fetal pole had been detected in ectopic pregnancy by ultrasonography. The values of s-hCG in patients whose fetal pole had been detected in ectopic pregnancy by ultrasonography were above the level of discriminatory hCG zone by Kadar. 5. The positive ultrasonographic findings of ectopic pregnancy were as follows: uterine enlargement had been observed in 47%, intrauterine gestational sac in 0%, increase of endometrial echo in 40%, cystic or ring-like adnexal mass in 80%, gestational sac in adnexa in 20%, fetal pole in adnexa in 13%, cystic or irregular outlined cul-de-sac mass in 20%, bulging of cul-de-sac in 67% and ascites-like bowel echo pattern of abdomen in 53% of cases studied. 6. Culdocentesis was more accurate diagnostic method than the ultrasonographic changes in cul-de-sac, but one of three negative culdocentesis showed positive ultrasonographic finding. So more accurate diagnosis of ectopic pregnancy could be made by combine

생쥐 하수체 성선자극호르몬 분비세포의 개체발생 및 임신기간에 따른 변화에 관한 연구

김종화,이진용 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.10

생쥐 태자의 하수체에서 FSH분비세포 및 LH분비세포의 위치를 확인하고 개체발생을 규명하며, 어미생쥐에서의 임신기간에 따른 이들 분비세포들의 형태학적 변화를 연구하기 위하여 , 성숙한 BALB/c게 암생쥐의 임신군 및 태자들의 하수체를 대상으로 FSH분비세포 및 LH분비세포에 대한 광학현미경적 면역조직화학염색과 전자현미경적 면역세포화학염색을 시행한 결과 다음과 같은 결론을 얻었다. 1. 임신 생쥐의 어미 및 태자들의 하수체내 parsdistalis의 일부 세포들에서 anti-FSH 및 anti-LH 에 양성반응을 보인 세포들을 관찰할 수 있었다. 2. FSH분비세포 및 LH분비세포의 개체발생 시기는 광학현미경 하에서나 전자현미경하에서 모두 태령 제 17일이었다. 3. 태자 생쥐에서 FSH분비세포 및 LH분비세포의 개체발생 시기이후 태령이 증가할수록 이들의 수는 유의하게 증가하였다. 4. 어미 생쥐에서 FSH분비세포 및 LH분비세포의 면역양성부위는 세포내 분비과립이었다. 5. 어미 생쥐에서 임신기간에 따라 FSH분비세포는 type I세포가 임신중기와 임신말기에 증가되었고 type III세포가 임신 15일과 17일에 증가되었으며 LH분비세포는 type I세포가 임신중기에 type III세포가 임신말기에 증가되었다. FSH분비세포 및 LH분비세포에서 type II세포는 임신기간에 따라 큰 변화가 없었다. 이상의 소견으로 볼때 본 연구는 생식에 중요한 호르몬인 FSH 및 LH의 생성 및 분비과정을 규명하는데 기초적인 자료로 이용될 수 있으리라 사료된다. This study was carried out to localize the FSH cells and LH cells in mice pituitaries , to investigate the ontogenesis of these cells , to classify the FSH cells and LH cells , to detect the immunoreactive sites in these cells , and to see the morphological cnanges of these cells in the pituitaries of the female mice at electron microscopic levels. Fifteen BALB/c female mice and 50 BALB/c fetal mice were used in this study. The avidin-biotin peroxidase complex ( ABC ) method was used for the immunohistochemical study of fetal mice pituitaries and the immunogold method was used for the immunocytochemical study of fetal and adult mice pituitaries. FSH cells and LH cells were localized in the pars distalis of pituitaries of all mothers and some fetuses. FSH cells and LH cells were first detected on the 17th day of gestation at the light and electron microscopic levels. FSH cells and LH cells showed significant increase in number during the late developmental period by immunohistochemistry. Immunoracctive stainings were detected only in the secretory granules in FSH cells and LH cells at the electron microscopic level. FSH cells and LH cells could be classified into Type I cells ( which were round and contained evenly distributed large secretory granules ). Type II cells ( which were angular and contained loosely distributed , small and medium-sized granules ) and Type III cells ( which were angular and contained peripherally distributed small secretory granules ) by their morphology. Type I FSH cells were abundant in midpregnanyc and term , and Type III FSH cells increased in percentage on the 15th and 17th day of gestation. Type I LH cells Type II FSH cells and Type II LH cells showed no significant changes in percentage during pregnancy.

난소종양 및 골반내 농양 환자에서 혈중 CA-125 항원의 수술전 평가

김종춘,박재기,황미정,정창근,김완영,이종학,김종화,백원영 대한부인종양 콜포스코피학회 1993 Journal of Gynecologic Oncology Vol.4 No.2

We evaluated serurn CA-125 levels in 122 patients with adnexal masses prospectively. The serum CA-125 levels were measured by immunoradiometric assay before laparotomy in 92 cases of benign ovarian tumor, 20 cases of malignant ovarian tumor, and 10 cases of pelvic abscess. In normal control sixty-six apparently healthy women, the mean concentration of serum CA-125 level was 19. 2U/ml and false positive rate at cut-off limits 35U/ml and 65U/ml were l0.6% and 0%. The mean concentrations of preoperative surum CA-125 antigen in benign, malignant ovarian tumor and pelvic abscess were 32.8U/ml, 267. 1U/rnl, and 218. 5U/ml respectively. Among 92 patients with benign ovarian tumor, CA-125 levels above 35, and 65U/ml were detected in 23(25%), and 9(10,9%) cases of the patients respectively. Fifteen(75%) of 20 malignant ovarian tumors were associated with CA-125 levels above 35U/ml and 11 of 20 cases(55%) had levels that exceeded 65U/ml. Among 10 patients with pelvic abscess, CA-125 levels greater than 35U/ml or 65U/ml were detected in 10 (100%) and nine (90%) patients. In 112 patients with benign and malignant ovarian tumors, the positive rates of preoperative serum CA-126 levels were 75% sensitivity, 75% Specificity, 39.6% positive predictive value, 93,2% negative predictive value, and 75% diagnostic efficiency for a 35U/rnl cut-off and 55~%, 89.1% 52.4%, 90.1%, and 83.0% respectively for a 65U/ml cut-off. These findings suggest that elevated serum CA-125 levels help differential diagnosis of ovarian rnalignancy from benign ovarian tumor preoperatively. The serum CA-125 levels serum to provide less information for early diagnosis of malignant ovarian tumors due to false negativity of early stage in ovarian malignaney but preoperative CA-125 levels have good correlation with clinical stage of ovarian mahgnancy. Accurate diagnosis of the malignant ovarian tumors may be difficult because pelvic abscess showed especially high concentrations and false positive rate of preoperative serum CA-125, Therefore further evaluations of CA-125 levels in pelvic abscess is needed.

심장기형과 폐기형을 동반한 Meckel-Gruber Syndrome 1 례

이종학,김종화,백원영,김규현,신반철,한성천,최원준,김진성 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.9

저자들은 임신 36주의 임산부를 산전초음파로 태아기형을 진단하고 임신 종결후 신생하 부 검을 시행한 결과 비교적 빈도가 낮은 발병률을 보이는 심장기형 및 폐기형을 동반한 Meckel-Gruber Syndrome 1례를 경험하였기에 간단한 문헌고찰과 함께 보고하는 바이다. The major features of Meckel-Gruber Syndrome are occipital encephalocele, postaxial polytactyly, and polycystic kidneys. This syndrome is lethal and its cause is still unknown due to rarity. At present, autosomal recessive is thoughth to be as one of the causes. The importance of recognizing this sysdrome is the high risk of recurrence (one in four)in future pregnancies. A case of Meckel-Gruber Syndrome combined cardiac anomaly and pulmonary anomaly of very lower incidence is presented with a brief literature review and autopsy.

난소갑상선종의 1 례

이종학,김종화,백원영,이순애,한성천,강태길,권성택 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.7

Struma ovarii, an ovarian teratoma of which all or a large part is composed of thyroid tissue, is an uncommon tumor accounting for 2.7% of all ovarian teratomas. We reported a case of struma ovarii and review the literature concerning this tumor briefly.

흰쥐 뇌의 Brain Natriuretic Peptide 함유신경세포의 분포에 관한 연구

이종학,김종화,백원영,이순애 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.12

Brain natriuretic peptide(BNP) is a recently discovered neuropeptide from porcine brain and is highly homologous to atrial natriuretic peptide. This study was carried out to localize the BNP containing neurons morphologically and investigate the distribution in rat brain. Colchicine injections were made into the lateral ventricle of brain, and rats were perfused with 4% paraformaldehyde-lysine periodate and brains were resected after 48 hours. By Immunohistochemical staining with Avidine-Biotin-Complex method, BNP containing neuronal cells showed strong immunoreactivity in situ. Mostly, BNP containing neurons were multipolar in shape and were localized at the areas of paraventricular nucleus, parabrachial nucleus, locus ceruleus, substantia nigra, nucleus of facial nerve, dorsal vagal nucleus, hypoglossal nucleus, raphe nucleus and nucleus ambiguus.