전자궁적출술이 보존된 난소의 기능에 미치는 영향

안은희(Eun Hee Ahn),송찬호(Chan Ho Song),김정연(Jung Youn Kim),박기현(Ki Hyun Park),배상욱(Sang Wook Bai),이재성(Jai Sung Lee),권자영(ja Yung Kwon) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.9

Objective : To assess the impact of premenopausal total abdominal hysterectomy (TAH) on the function of remaining ovaries by reviewing the menopausal age in patients treated with total abdominal hysterectomy. Methods : We retrospectively reviewed medical records of 510 women previously treated with TAH or TAH with unilateral salpingo-oophorectomy (USO) due to benign disease at the department of Obstetric and Gynecology, Yonsei University College of Medicine, between Jan, 1989 and Dec, 1992. Out of 510 women, 94 women who were thoroughly follwed up were included in the study, and their meopausal age based on patients symptoms were compared to those of the control group. Result : Mean menopausal age in patients treated with TAH was 46.3±3.0 years and in the normal control group was 49.1±3.2 years. The mean age of menopause was significantly lowered in patients treated with TAH/TAH with USO (P<0.001). There was positive correlation between age at operation and menopausal age. Conclusion : According to this study, TAH accelerated ovarian dysfunction, and younger the patient is at the time of operation, earlier the menopause. Therefore, woman treated with TAH is at risk of early menopause and should receive adequate hormone replacement therapy.

복강경하 자궁각절제술과 자궁경부이형성증 병력있는 환자에서 임신 제3분기에 일어난 연속적인 자궁파열사례

김영란 ( Young Ran Kim ),문명진 ( Myung Jin Moon ),장성운 ( Sung Woon Chang ),안은희 ( Eun Hee Ahn ),장항용 ( Hang Yong Jang ),이경미 ( Gyong Mi Lee ),정상희 ( Sang Hee Jong ) 대한산부인과학회 2012 Obstetrics & Gynecology Science Vol.55 No.12

Uterine rupture during the course of pregnancy is an uncommon obstetric event. Rupture of an unscarred uterus is rare, whereas rupture of a scarred uterus is more common and is usually the result of a Cesarean section. Uterine rupture during pregnancy usually occurs in patient with a scarred uterus, and recurrent uterine rupture usually occurs at a prior ruptured site. However, recurrent uterine rupture that occurs at a different site, regardless of prior rupture site, has yet to be reported. The patient described in this case report had cervical dysplasia with positive for human papilloma virus (HPV) type 16. As the presence of a precancerous lesion in the cervix is reported to increase the risk of preterm birth and spontaneous uterine rupture, a possible correlation between recurrent uterine rupture and cervical dysplasia was considered for this patient.

무심장 쌍둥이 임신에서 고주파 융해술 후 정상 태아 생존 출생한

장지현 ( Ji Hyon Jang ),문명진 ( Myoung Jin Moon ),박혜리 ( Hea Ree Park ),안은희 ( Eun Hee Ahn ),정상희 ( Sang Hee Jung ),이유미 ( Yu Mi Lee ),김은아 ( Eun A Kim ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.5

Acardiac twin is a rare anomaly that occurs 1% in monochorionic twins and 1 in 35,000 pregnancies overall. Acardiac twin, also known as twin-reversed arterial perfusion (TRAP) sequence, involves a “pump” or donor twin perfusing a recipient or “acardiac” twin through vascular (usually arterial-arterial and venous-venous) anastomoses. Perinatal mortality rate for the pump twin has been reported to be 50~75%, mainly as a result of polyhydramnios, preterm labor, and congestive heart failure. Therefore, occlusion of the circulation to the acardiac twin has been recommended to improve perinatal outcome of the pump twin. Radiofrequency ablation of the acardiac twin effectively protects the pump twin from high-output cardiac failure and death. We report our experience in the treatment of patients with TRAP sequence using radio frequency ablation to stop perfusion to the acardiac twin.

임신 중기 원인불명 인간 융모성 성선자극호르몬치 상승 임신부의 임신 결과

이윤정(Yun Jung Lee),김세광(Se Kwang Kim),안은희(Eun Hee Ahn),이진우(Jin Woo Lee),권혜경(Hye Kyung Kwon),이창희(Chang Hee Lee),김영한(Young Han Kim),배상욱(Sang Wook Bai),박기현(Ki Hyun Park),양영호(Young Ho Yang),송찬호(Chan Ho Song 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.4

Objective : Our purpose was to determine the association between unexplained elevation of maternal serum human chorionic gonadotropin (hCG) in the second trimester and adverse pregnancy outcomes. Material and methods : Between February 1995 and July 1999, we evaluated 1566 pregnant women who have underwent second trimester triple marker screening tests (alpha-fetoprotein, unconjugated estriol, human chorionic gonadotropin) and delivered at Severance Hospital, Yonsei Medical Center. Multiple pregnancies, abnormal fetal karyotypes, fetal anomalies, and abortions were excluded from the study. One hundred twenty-one women with hCG levels greater than 2.0 multiples of the median (MoM) were included in the study group while 1389 women with hCG levels less than 2.0 MoM served as the control group. Pregnancy outcomes were obtained from the delivery and neonatal records in our institution. Adverse pregnancy outcomes between the two groups were compared using chi-square test and Fisher's exact test. Results : Women with unexplained elevation of human chorionic gonadotropin levels were associated with statistically significant increased risks for preeclampsia, preterm delivery, and low birth weight (p<0.05). However, there were no significant differences between the study and control groups with respect to preterm premature rupture of membranes, abnormal fetal heart rate tracing, abruptio placentae, intrauterine fetal death, and neonatal death. Conclusion : An unexplained elevation in human chorionic gonadotropin level in the second trimester may increase the risk for preeclampsia, preterm delivery, and low birth weight but not for other adverse pregnancy outcomes such as preterm premature rupture of membranes, abnormal fetal heart rate tracing, intrauterine fetal death, or neonatal death.

자궁각임신에서 질식초음파 유도하에 KCl과 MTX의 국소투여법을 통한 치료방법

박혜리 ( Hea Ree Park ),문명진 ( Myoung Jin Moon ),신승주 ( Seung Joo Shin ),장성운 ( Sung Woon Jang ),안은희 ( Eun Hee Ahn ),정상희 ( Sang Hee Jung ),심성신 ( Sung Shin Shim ),강석호 ( Suk Ho Kang ),김현철 ( Hyun Chul Kim ),황윤 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.1

Objective: To evaluate efficacy and safety of local injection of potassium chloride (KCl) and methotrexate (MTX) in the treatment of cornual pregnancy. Methods: We retrospectively reviewed all cases of cornual pregnancy treated conservatively from 2005 through August 2007. Eight cases were identified and two cases were heterotopic interstitial pregnancy. All cases were managed with local injection of KCl or methotrexate under ultrasound guidance and 2 cases were treated with intra-muscular injection of MTX in combination. After the procedure all cases with cardiac activity was confirmed to be aborted by ultrasound. Also serial follow-up sonographic examination and serum β-hCG measurement were performed. Results: The mean initial β-hCG level was 53,331.6 mIU/mL and ranged from 14,332 mIU/mL to 125,721 mIU/mL. Mean gestational age was 48.3 days from 40 to 65 days. All cases were aborted successfully and follow up β-hCG were declined abruptly. Two cases of hetero-topic pregnancy resulted in successful deliveries at full term. Conclusion: Cornual resection or hysterectomy should no longer be the first line of treatment for hemodynamically stable patients with cornual pregnancy. They can be successfully treated through local injection of MTX or KCl by ultrasound guidance.

삼음교 지압이 분만통증 및 자궁수축양상에 미치는 영향

권자영 ( Ja Young Kwon ),박용원 ( Yong Won Park ),김유리 ( Yu Ri Kim ),김덕원 ( Deok Won Kim ),안은희 ( Eun Hee Ahn ) 대한산부인과학회 2005 Obstetrics & Gynecology Science Vol.48 No.8

질식 초음파로 진단된 태아 양측성 신장 무발생

임경란 ( Kyoung Ran Yim ),김현철 ( Hyeon Chul Kim ),문명진 ( Myoung Jin Moon ),강석호 ( Suk Ho Kang ),안은희 ( Eun Hee Ahn ),장성운 ( Sung Woon Jang ),신승주 ( Seung Joo Shin ),김광일 ( Kwang Il Kim ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.11

Fetal bilateral renal agenesis is a lethal congenital anomaly characterized by bilateral pulmonary hypoplasia, deformities and death due to severe oligohydramnios. This syndrome is associated with malformations of genitourinary tract, cardiovascular system, vertebral bodies or imperforated anus in more than half of the affected individuals. An early and reliable prenatal diagnosis is extremely important because it may offer options for pregnancy termination as early as possible. The criteria for the ultrasonographic diagnosis of bilateral renal agenesis are severe oligohydramnios, nonvisualization of the bladder, empty renal fossae. But poor sonographic resolution of severe oligohydramnios makes it difficult to diagnose the disease. We present a case of bilateral renal agenesis diagnosed at the 18th weeks gestation by using Transvaginal Ultrasonography and Color Doppler.

제대 염전을 동반한 단일 양막성 쌍태임신에서 sulindac 사용을 통한 양수감량과 초음파를 이용한 집중적 태아감시 후 양측 태아 모두 생존 출생한 1예

박혜리 ( Hea Ree Park ),김현철 ( Hyun Chul Kim ),문명진 ( Myoung Jin Moon ),장성운 ( Sung Woon Jang ),강석호 ( Suk Ho Kang ),안은희 ( Eun Hee Ahn ),백민정 ( Min Jung Baek ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.10

Monoamniotic twin pregnancies are relatively rare, but perinatal mortality is high about 30-70%. The major cause of fetal death is cord accident, congenital anomalies, twin-twin transfusion syndrome, and intrauterine growth restriction. Especially cord entanglement occurs; perinatal mortality is about 50%. So the active management of monoamniotic twins to reduce the complication of cord entanglement is important. This is a case of monoamniotic twin pregnancy with cord entanglement and both fetuses survival by elective cesarean section at 32+4 weeks after medical amnioreduction and intensive fetal surveillance.

클로스트리디움 보툴리눔 독소 A형은 미페프리스톤으로 유발된 조기진통 쥐 모델에서 자궁수축을 현저하게 감소시킨다

장항용 ( Hang Yong Jang ),이경미 ( Kyung Mi Lee ),박영신 ( Young Sin Park ),문명진 ( Myung Jin Moon ),한원보 ( Won Bo Hahn ),안은희 ( Eun Hee Ahn ) 대한산부인과학회 2012 Obstetrics & Gynecology Science Vol.55 No.9

Objective: We investigated the in vivo tocolytic effect of Clostridium botulinum toxin A (BoNT/A) on mifepristone-induced preterm labor in rats. Methods: On day 17 of gestation, an incision was made to expose the uterus, and BoNT/A (normal saline or 20 units) was injected into the uterine horns, On day 18, mifepristone was used to induce uterine contractions, Electrical activity of uterine contractions was measured via electromyography on day 19, Results: In rats treated with 20 units of BoNT/A, the amplitude of uterine contractions was significantly decreased by 45.2 ± 18.4 (P<0.05) from baseline, respectively. The total duration of uterine contractions was significantly decreased by 51.7 ± 7.9 (P<0.01), respectively. The frequency of contraction bursts after treatment with 20 units of BoNT/A was decreased by 5.6 ± 16.3 from the baseline (P=0.4). Conclusion: In rats undergoing mifepristone-induced preterm labor, BoNT/A significantly inhibited uterine contractility. The decrease in uterine activity was mainly caused by a decline in the duration and intensity rather than frequency of uterine contractions.

폐경 후 호르몬 보충요법중인 여성에게 병합 투여된 Alendronate의 효과

안은희,정경아,김정연,배상욱,이병석,박기현 대한폐경학회 2001 대한폐경학회지 Vol.7 No.2