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- 저자 : 김형춘(Hyoung Choon Kim) (검색결과 4 건)
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근층내 자궁근종에 대한 복강경하 근종적출술의 안정성과 유용성에 관한 고찰
김형춘(Hyoung Choon Kim),오성택(Sung Tack Oh) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.4
Purpose: This study was undertaken to evaluate the safety and usefulness of laparoscopic myomectomy compare to abdominal myomectomy in pregnancy outcome through estimating the uterine wall thickness in second, third trimester pregnancy and delivery. Materials and Methods: Total number of patients underwent operations for intramural myomectomy in Department of Obstetrics and Gynecology in Chonnam University Hospital was 95. Patients underwent laparoscopic myomectomy(Group A) patients are 42 and abdominal myomectomy (Group B) are 53 patients. Age, parity, size of fibroid, number of fibroid, indications of myomectomy, pregnancy loss, delivery methods and complications during delivery were evaluated. Uterine wall thickness in second and third trimester pregnancy was measured by Aloka SSD-2000 sonography. Results: Mean age of patients was 32.84.6 years in Group A and 32.45.1 years in Group B. Operation time, admission period and postoperative complications were not sinificantly different but operative blood loss was significantly small amount in Group A(p=0.001). Pregnancy rates was 47.6%(20/42) in Group A and 49.1%(26/53) in Group B after surgery(p=0.182). Successful delivery was 80%(16/20) in Group A and 76.9%(20/26) in Group B(p=0.182). Early pregnancy loss was 20%(4/20) in Group A and 19.2%(5/26) in Group B. Therefore pregnancy rates and successful delivery was not significantly different in Group A and B. Complications of pregnancy were premature rupture of membrane, preterm labor, pregnancy induced hypertension. There were no difference between Group A and B. In delivery methods, elective cesarean section was done 15 in Group A and 16 in Group B. Vaginal delivery was done 1 in Group A and 4 in Group B. Early pregnancy loss was 4 in Group A and 6 in Group B. Mean gestational weeks was 38.02.2 in Group A and 38.21.9 in Group B. In operative findings, adhesion was 5 in Group A and 7 in Group B at previous myomectomy site. Only one case was uterine wall thinning in Group B but maternal and fetal conditions were good. Mean uterine wall thickness was 4.2 2.5mm in Group A and 4.0 2.8mm in Group B at 2nd trimester, 4.0 2.7mm in Group A and 3.8 2.5mm in Group B at 3rd trimester, 4.0 2.5mm in Group A and 3.9 2.7mm in Group B at delivery. Conclusion: We conclude that pregnancy after laparoscopic myomectomy is safe, useful method comparable to abdominal myomectomy without increased risk of pregnancy loss and complications.
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김윤하(Yoon Ha Kim),송태복(Tae Bok Song),김형춘(Hyoung Choon Kim),김기민(Ki Min Kim),이경철(Kung Chol Lee),김석모(Seok Mo Kim),변지수(Ji Soo Byun) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.2
Objective : To determine the efficacy and safety of labor induction in patients previously delivered by a low transverse cesarean section. Method : A retrospective review was done at Chonnam National University Hospital, Kwangju, Korea. All patients with a previous cesarean section who required labor induction from April, 1986 to June, 1999 were identified. Outcome of labor induction, including mode of delivery, maternal and perinatal morbidity, and birth trauma were evaluated. Results : Trial of labor was undertaken by 1256 women(55.8%) who had previously been delivered by a low transverse cesarean section. 973 patients(77.5%) with a previous cesarean birth had a spontaneous onset of labor. Labor was induced in 283 patients(22.5%) with a previous cesarean birth. Successful vaginal delivery rate were 82.9%(807/973) in spontaneous labor and 79.2%(224/283) in induced labor group (p= NS). There were no differences in uterine dehiscence and rupture rate, perinatal and maternal mortality rate, and the rate of infants with low 1 or 5-minute Apgar scores between patients attempting a trial of labor after cesarean, spontaneous and induced. Conclusion : we conclude that labor induction in patients with a previous low transverse cesarean section is a safe procedure requiring close peripartum maternal and fetal surveillance.
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Control Mechanisms of Ovulation by Pituitary Adenylate Cyclase-Activating Polypeptide
이여일,김형춘,김미영,전상영,Lee, Yu-Il,Kim, Hyoung-Choon,Kim, Mi-Young,Chun, Sang-Young The Korean Society for Reproductive Medicine 2005 Clinical and Experimental Reproductive Medicine Vol.32 No.2
배 경: Pituitary adenylate cyclase-activating polypeptide (PACAP)은 양의 시상하부에서 추출된 신경펩타이드 호르몬으로 난소에도 존재하여 배양된 과립막 세포에서 스테로이드합성과 cyclic AMP 형성을 촉진함이 보고되었다. 목 적: 흰쥐 난소를 실험 모델로 사용하여 배란시 황체화호르몬 (luteinizing hormone; LH)에 의해 유도된 PACAP과 PACAP 수용체의 유전자 발현양상과 신호 전달경로를 규명하고자 하였다. 재료 및 방법: 미성숙 흰쥐의 배란전 난포를 체외 배양하면서 LH로 처리하고 PACAP 및 PACAP수용체의 유전자 발현을 보기 위해서는 Northern blot 분석과 in situ hybridization (ISH)을, 그리고 단백질 수준의 PACAP 검색을 위해서는 enzyme linked immunosorbent assay (ELISA) 분석을 이용하였다. 결 과: LH 처리 후 Northern blot상의 PACAP 유전자 발현은 6~9시간에 일시적으로 최고치에 도달하였으며 ISH로 보아 과립막 세포에서 발현됨을 알 수 있었다. ELISA 분석 상 PACAP 단백질도 LH처리 후 6~12시간에 최고치를 나타내었으며, PACAP 수용체 mRNA 역시 3~9시간에 최고치로 과립막 세포에서 발현되었다. Adenylate cyclase (AC) 억제제인 MDL12330A 처리시 LH로 발현된 PACAP mRNA가 감소되며, AC의 활성제인 forskolin 처리에는 LH시와 유사한 PACAP mRNA의 발현양상을 나타내었다. 그러나 protein kinase C (PKC)의 억제제인 chelerythrine과 2-0-tetradecanolphorbol-13-acetate (TPA) 처리로는 PACAP 의 유전자 발현에 영향을 주지 못하였다. 5-lipoxygenase의 억제제인 MK886이나 nordihydroguaiaretic acid (NDGA)로 처리한 결과 LH로 유도된 PACAP 유전자의 발현이 감소되었으나, cyclooxygenase의 억제제인 indomethacin은 별로 영향을 주지 못하였다. MEK와 p38의 억제제인 PD98059와 SB203580도 LH로 촉진 된 PACAP의 유전자 발현을 농도 의존적으로 억제하였다. 결 론 : 배란전 난포에서 PACAP과 PACAP 수용체의 유전자 발현은 모두 LH의 폭발적 분비에 의해 유도되어 일시적으로 과립막 세포에서 나타나 배란을 위한 국소적인 조절 작용을 할 것으로 추정되며, LH로 촉진된 PACAP 유전자 발현을 위한 신호전달은 cAMP-PKA, lipoxygenase 및 MAP kinase 경로를 통하는 것으로 사료된다.
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FIGO 병기 Ib 기와 IIa 기 자궁경부암 환자에서 시행한 근치적 복식 경부절제술 ( Radical abdominal trachelectomy ) 2예의 예비적 보고
최호선(Ho Sun Choi),김석모(Seok Mo Kim),신광식(Kwang Sik Shin),김형춘(Hyoung Choon Kim),변지수(Ji Soo Byun),남종희(Jong Hee Nam) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.5
Traditionally, radical hysterectomy is the main surgical method for the treatment of early cervical carcinoma and always results in the loss of fertility. But, large numbers of young women are recently being diagnosed with cervical carcinoma and fertility preservation has become a concern. So, there has been a move towards more conservative approaches for the treatment of cervical carcinoma in recent years. Radical trachelectomy, which allows preservation of uterus but removes the cervix, parametrium and upper one third of the vagina, is a conservative but locally radical procedure. We performed radical abdominal trachelectomy with pelvic lymphadenectomy for two cases of invasive cervical carcinomas, which may be the first report in korea. One patient was 37 years old single women who had stage Ib cervical cancer and was disease free for 17 months after treatment. The other patient was 19 years old student who was also single and had stage IIa cervical cancer and was disease free for 14 months after treatment. We report the first two cases and review the literature on radical trachelectomy.
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