질 입구에 발생한 평활근종 1 례

이형근(HG Lee),유병대(BD Yoo),신진웅(JW Shin),노덕영(DY Ro),김도강(DK Kim),김수평(SP Kim) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.6

Leiomyomas of the vagina are rare benign solid tumors. A leiomyoma arises from muscle in the round ligament and appears as a firm movable tumor deep in the substance of the labium majus, but minority of these tumors occur in vaginal wall. A case of a 39 year old woman with leiomyoma of the vaginal orifice was reported with a brief review of literature.

비디오 골반경을 이용한 난소임신 치험 2 예

이형근(HG Lee),박원곤(WG Park),박정근(JK Park) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.1

Ovarian pregnancy is a rare form of ectopic pregnancy which has Spiegelberg`s criteria for a primary ovarian pregnancy. Two cases of ovarian pregnancy which were diagnosed and operated by surgical pelviscopy are presented with a brief review of literatures.

혈-화농성 자궁강질환의 임상적 고찰

최영석(YS Choi),이형근(HG Lee),전준연(JY Jeon),김진범(JB Kim),안상복(SB Ahn),박동춘(DC Park),박종섭(JS Park),이준모(JM Lee) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.10

Background:Hematopyometra, an accumulation of bloody, purulent material in the ute-rine cavity, is a relatively uncommon event. The incidence is almost 0.01∼0.5% in gynec-ologic patients. The most common cause of this condition is interference with the normal drainage of the uterus;endocervical obstruction by malignant disease. Other obstructive causes are the benign tumors in uterus, senile endocervicitis, long-term use of intrauterine device, cervical occlusion after surgery or radiation, intrauterinel infection, and congenital cervical anomaly. Methods:This report was performed to evaluate the hematopyometra patients, who were diagnosed and treated at Catholic University Medical College Hospitals from 1991 to 1995. Forty cases of hematopyometra were retrospectively reviewed by charts, radiologic and pathologic findings concerning with the clinical features. Results:1) The most frequent age of hematopyometra patients was 50 to 59 years(45 %) and mean age was 63 years old. 2) Four patients(10 %) were at premenopausal period, and remaining 36 patients(90 %) were at the period of menopause(p<0.01). 3) The clinical manifestations of the patients were variable;profuse vaginal discharge(75 %), vaginal ble- eding or spotting(40 %), and lower abdominal pain(30 %). 4) The associating medical cond- itions or possible risk factors of hematopyometra are senile atrophic change(52.5 %), IUD inserted condition(25 %), genital malignant diseases(17.5 %), and uterine myoma(5 %). 5) The bacterial infection are frequently associated with hematopyometra and the causative ag ents are streptococci(50 %), E. coli(42 %), and mixed type(17 %). 6) Eight cases of them showed generalized peritonitis in the preoperative clinical course and three patients had been serious condition by septicemia. 7) The genital malignant diseases are associated with he- matopyomerta in 7 cases(17.5 %) of them(cervical cancer;4 cases, endometrial cancer;2 cases, and ovarian cancer;1 case). 8) All the cancer patients could be followed-up at le-ast for 2 years. Two patients, who were diagnosed for cervical cancer in the stage Ⅱb and Ⅲ, died of the persistent or recurrent disease in the period of following-up after the pri-mary treatment.

무월경 14 주에 동반된 속발성복강임신 1 예

김준영(JY Kim),박원곤(WG Park),이형근(HG Lee),장미경(MK Chang),박정근(JK Park) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.7

Abdominal pregnancy is very rare and potentially life-threatening variation of ectopic pregnancy. Early diagnosis is very difficult. In the last several decades prenatal care has improved and noninvasive procedures such as ultrasound scanning and fetal cardiotocography have led to us a better assessment of fetal and maternal disorders. In the last 30 years an increase of diagnosed ectopic pregnancies has been noted and attributed to the greater frequency of pelvic inflammatory disease. Although the incidence of ectopic pregnancy is rising, the incidence of abdominal pregnancy, which is primarily a sequel of a missed ruptured ectopic pregnancy, remains low. We presented a case of secondary abdominal pregnancy in 14 wks with its review of literature.

골반경수술 110 예에 대한 고찰

박원곤(WG Park),김준영(JY Kim),이형근(HG Lee),장진석(JS Jang),정종기(JG Jeong),나상(S Na),박정근(JK Park) 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.7

One hundred ten cases of pelviscopic operation were perfomed at Pusan Kwang-Hye General from September 1993 to March 1995. The common indication were ectopic pregnancy(39%) myoma uteri(24%) ovarian cyst(21%) and frequent types of surgery were salpingectomy(32%), CISH and LAVH operation (24%) , slapingoophorectomy(15%) oophorectomy(7%) and ovarian cystectomy(7%). The age of the patients ranged from 21 to 55 years and the mean age was 33.6 years and maen parity of the patients was 1.52 and mean duration of hospitalization was 3.57 days. the operation time was variable from 30 minutes to 7 hours because of operation method and difficulty, but was more shorter recently. In our conclusion, pelviscopic surgery makes minimal incision, minimal postoperative adhesion, and low morbidity rate, and early recovering brings short hospitalization, and reduction of medical cost. This pelviscopic surgery is simple and useful method of treatment in the community hospital.

유도분만 직전 절경부에서 검출된 fetal fibronectin의 임상적 의의

안상복(SB Ahn),공기환(KH Kong),이형근(HG Lee),김진범(JB Kim),최소영(SY Choi),최영석(YS Choi),이영(Y Lee),김창이(CY Kim),김수평(SP Kim) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.1

Objective: Our purpose was to determine whether the detection of fetal fibronectin in cervicovaginal secretions of woman before labor induction reflected readiness of the uterus and ultimately the ease of induction of labor. Methods: We studied 52 women undergoing induction of labor by means of prostaglandin E₂after 37 weeks` gestation. A Dacron polyester swab specimen was first taken from endocervix and posterior vaginal fornix for assessment of the presence of the fetal fibronectin. The cervix was then assessed by digital vaginal examination and scored with modified Bishop score. The cervicovaginal fetal fibronectin was measurde quantitatively by fetal fibronectin immunoassay (Adeza Biomedical, Sunnyvale, California, USA). The results were considered positive when specimens had a fetal fibronectin concentration above 50ng/ml. Induction of labor was considered to be successful if vaginal delivery occured within 24 hours after the application of the PGE₂ tablets. We compared positive result for fetal fibronectin wtth high Bishop score(≥5) as a predictor of successful labor. Results: 9 samples were excluded due to blood contamination. Total 43 samples were studied. 21 had positive results for fetal fibronectin and 22 had negatibve results. 25 were delivered within 24 hours of the application of PGE₂. Of the women inthis group, two were delivered by cesarean section. The results were as follows: 1. Women with fetal fibronectin-positive cervicovaginal secretions had a significantly shorter(10 hours 57 minutes vs 29 hours 01 minutes, P=0.0001) interval between prostaglandin application and delivery, and needed a significantly lower(1.1:2, P=0.007) numbers of PGE₂tablets than did fetal fibronectin-negative patients. 2. Bishop`s score was not different in interval between prostaglandin application and delivery(group with high score 20 hours 09 minutes vs group with low score 16 hours 13 minutes, p = 0.5850), and numbers of PGE₂tablets(1.5 vs 1.51, P=0.855). 3. Patients with fetal fibronectin-positive cervicovaginal secretions were more delivered within 24 hours than Patients with fibronectin - negative group(fetal fibronectin positive group: 19/21, 90.5% vs fetal fibronectin negative group: 6/22, 22.3%). 4. The rate of unsuccessful induction of labor and operative delivery was highest in women with fibronectin-negative cervicovaginal secretions and olw Bishop`s score(7/8,87.5%) 5. Multiple logistic regression shows that only the fetal fibronectin enzyme immunoassay provides an independent statistically significant predictor for purposes of predicting vaginal delivery within 24 hours(P=0.0025, adjusted odds ratio 25.33). 6. The positive value of cervicovaginal fetal fibronectin was more predictive of successful labor induction than Bishop score ≥ 5(sensitivity 82.6%: 17.4%, positive predictive value 95.0%: 57.1%). Conclusions: Positive cervicovaginal fetal fibronectin before labor induction may be a useful biochemical predictor for successful induction of labor.

자궁경부암 환자에서 광범위 자궁적출술 전후의 방광과 요도의 해부학적 형태에 대한 연구 - 금속성 염주상 연쇄 요도방광 조영술을 이용한 분석-

김진범(JB Kim),이귀세라(GSR Lee),김사진(SJ Kim),안상복(SB Ahn),이형근(HG Lee),공기환(KH Kong),허수영(SY Hur),박태철(TC Park),김은중(EJ Kim),송승규(SK Song),김수평(SP Kim) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.1

This present study was undertaken to evaluate the chacteristic anatomic configuration of bladder and urethra in parients with cervical cancer before and after radical hysterectomy. From July 1994 to December 1996, metallic beaded chain urethrocystography was conducted in 33 patients with cervical cancer before and after radical hysterectomy at Holy Family hospital. The results were as follows 1. After radical hysterectomy, posterior urethrovesical angles at rest and strain were significantly increased(P = 0.0004 at rest, P = 0.0016 at strain) and posterior urethrovesical junction at rest and strai were significantly descended(P = 0.004 at rest, P = 0.0024 at strain). 2. Postoperative urethral inclination angle at rest was greater than before radical hysterectomy(P = 0.002), but postoperative urethral inclination angle at strain was not increased statistically(P > 0.05). From these results, we concluded that stress urinary incontinence after radical hysterectomy is the results of anatomically defective supports of urethrovesical junction and urethra. We must consider a proper surgical method to prevent stress urinary incontinnce and anatomical defect of urethrovesical junction.

한국 여성의 자궁경부이형증 환자에 있어서 Retinoic Acid 투여 후의 HPV Titrationd의 변화

공기환(KH Kong),정선안(SA Jung),김진범(JB Kim),안상복(SB Ahn),이형근(HG Lee),안웅식(WS An),남궁성은(SE Namkoong),김승조(SJ Kim) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.1

Retinoids have been recognized as a family of molecules capable of profound impact on many biologic functons, also known to possess antiproliferative, differentiative, and immunomodulatory properties. However, only recently have laboratory and precoinical and clinical oncology reseatch made this knowledge immediately relevant to the problem of malignancy. Cervical cancer is thr second most common malignancy in women worldwide and remains a significant health problem in women. While the natural history is well known, little is known of the pathobiology of cervical carcinogenesis, prevention of cervical cancer and its precursors are impprtant objectives. To assess the effect of 13-cis-retinoic acid(13-CRA) in the rteatment of 13 chronic cervicitis and 52 cervical intraepithelial neoplasia, we examined lower and high risk Human Papilloma Virus(HPV) titration(using Hybrid Capture system) and colposcopic and cervicographic examination before and after rteatment with 13-CRA 1㎎/㎏ for 4 to 12 weeks. The following results were obtainted : 1. The age distributon of patients was between 23 years and 64 year, average 36.6 years old. 2. Histology revealed the chronic cervicitis 13 cases, mild dysplasia 18 cases, moderate dysplasia 18 cases and severe dysplasia 16 cases, total 65 cases. 3. Among these groups the expression rates of high risk Human Papilloma Virus(HPV 16, 18) were 9 of 13 cases(69%) in chronic cervictis, 7 of 18 cases(39%) in mild dysplasia, 9 of 18 cases(50%) in moderate dysplasia and 12 of 16 cases(75%) in severe dysplasia, overall expression rate was 37 of 65 cases(57%) 4. After treatment, decreasing changes of HPV titration(high risk)vy hybrid capture system were 6 of 9 cases(66%) of chronic cervictis, 3 of 7 cases(43%) of mild dysplasia, 7 or 9 cases(77%) of moderate dysplasia, 8 of 12 cases(75%) of severe dysplasia,overall decreasing rate was 25 of 41 cases(61%).

골반경수술 583 예에 대한 고찰

김준영(JY Kim),강승철(SC Kang),윤병목(BM Yoon),이형근(HG Lee),박원곤(WG Park),장미경(MK Chang),박정근(JK Park) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.10

Five hundred eighty three cases of pelviscopic operation were performed at Kwang-Hye General Hospital from September 1993 to December 1997. The common indications were ectopic pregnancy (33%), myoma uteri (32%), ovarian cyst (21%) and types of surgery were salpingectomy (28%), Classical Intrafascial S.E.M.M Hysterectomy (CISH) and Laparoscopic Assisted Vaginal Hysterectomy (LAVH) (27%), salpingo-oophorectomy (17%), oophorectomy (8%) and ovarian cystectomy (8%). The age of the patients ranged from 21 to 55 years and the mean age was 37.6 years and mean parity of the patients was 1.66 and mean duration of postoperative hospitalization was 3.77 days. The operation time was varied from 30 minutes to 7 hours, mean time of CISH 112.34 minutes, ectopic pregnancy 67.45 minutes, ovarian cyst 69.37 minutes, but recently it was shorter than previously. In our conclusion, pelviscopic surgery makes minimal incision, minimal postoperative adhesion, and low morbidity , and early recovery brings short hospitalization, and reduction of medical cost. Pelviscopic surgery is effective and useful method of treatment in the community hospital.

자궁경부로 단독 전이된 유방암 1 예

필신혜(SH Pil),김재훈(JH Kim),김기홍(KH Kim),박동춘(DC Park),이형근(HG Lee),정대영(DY Chung),장은덕(ED Jang),유영옥(YO Yoo),김대훈(DH Kim),남궁성은(SE Namkoong) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.7

The uterine cervix is an infrequent site of metastatic cancer whose origin is an extrapelvic lesion. Especially the metastasis of breast cancer to the uterine cervix is extremely rare. Owing to the high incidence of cervical cancer in Korea, metastatic cervical cancer can be easily mistaken for primary cervical cancer. We present a case with breast cancer metastatic solely to the uterine cervix.