Pathological Analysis of Dysplastic and Malignant Nodules in 21 Explant Livers

Jung,ES,An,BM,Park,DH,Kim,BS,Choi,JY,Lee,CD,Park,YM,Han,NI,Byun,BH,Kim,BK,Bae,SH,Yoon,SK,Baek,JH,Byun,JY,Kim,DG,Kim,IC,Cha,SB 가톨릭중앙의료원 가톨릭암센터 1998 암심포지움 Vol.- No.2

동족 간이식이 보편화됨에 따라서 전체간을 분석할 수 있게 됨으로서 간암 및 전암병변에 대한 방사선학적, 병리학적 연구가 활발하게 진행되고 있다. 간경변증은 간암의 가장 중요한 선행질환으로서 이에 대한 병리조직학적 연구는 간암발생의 단계적 발전과정과 관련된 기전을 밝히는데 중요한 단서를 제공할 것으로 시사된다.

복강내 출혈을 동반한 광인대임신 1 례

정은숙(ES Jung),황인수(IS Hwang),김도강(DK Kim) 대한산부인과학회 1987 Obstetrics & Gynecology Science Vol.30 No.3

저자들은 매우 희귀한 광인대 임신의 복강내 출현 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다 A case of intraperitoneal hemorrhage of intraligamentary pregnancy is one of the most unusual tragic accidents in obstetrics The diagnosis of intraligamentary pregnancy is handly ever made prior to laparotomy or postmortem visualization of pelvic organ Authors presented a case of it with brief review of literature available

철분공급이 임신부와 태아의 혈청 Ferritin헤모글로빈 , 혈청철 및 철결합능에 미치는 영향

정은숙(ES Jung),송기창(KC Song),정운남(WN Jung),나덕진(DJ Rah),김대훈(DH Kim),나종구(JG Na) 대한산부인과학회 1989 Obstetrics & Gynecology Science Vol.32 No.7

1987년 10월부터 1988년 2월까지 5개월간 가톨릭의과대학 부속병원에서 정상분만한 임신부 54명과 그에게서 출생한 정상신생아 54명에서 혈청 ferritin, 혈색소, 혈청 철, 총 철결합능을 측정하여 다음과 같은 결론은 얻었다. 1. 임신부의 혈청 ferritin치는 평균 23.7+-21.7 ug/l, 혈색소치는 평균 11.4+-1.8g/dl, 혈청 철은 평균 121.0+-80.0ug/dl이고 총 철결합능은 평균 446.9+-133.9ug/dl이엇다. 이들에서 출생한 태 아의 제대혈의 혈청 ferritin치는 평균 118.0+-62.1ug/dl이고, 총 철결합능은 평균 289.9+-86.3ug/dl이었다. 임신부와 제대혈의 검사치를 비교하면 혈청 ferritin, 혈색소, 혈청철은 모두 제대혈에서 5배, 1.3배, 1.6배로 높았다. 2. 임신부의 ferritin치에 따라 구분해보면, ferritin치가 12ug/l이상인 군은 31명(58%)이고 그미 만인 군은 23명(42%)으로 임신부의 혈청 ferritin치와 제대혈청 ferritin치사이에는 유의한 상관 관계가 있었다. 그러나 임신부의 혈청 ferritin치와 제대혈의 혈색소치, 혈청 철사이에는 상관 관계가 없었다. 3. 임신부의 혈색소치를 기준으로 혈색소치가 11g/dl이상인 군과 그 미만인군으로 나누어 비 교해 보면 임신부의 혈색소치와 제대혈의 혈색소치, 혈청과 혈청 ferritin사이에 유의한 상관 관계가 없었다. 4. 철분공급에 따른 차이를 보면 철분공급을 받은 경우에 임신부와 제대혈에서 모두 혈청 ferritin의 상승을 보였으나 제대혈의 혈색소치와 혈청철에는 유의한 차이가 없었다. 5. 임신부의 연령, 임신회수, 임신주수와 태아체중에 따른 철분대사 기준의 변화는 없었다. Measurements of serum ferritin and other hematologic laboratory indices about iron metabolic state were done in 54 paired maternal and cord blood, and 17 of these 54 women had taken iron supplement during pregnancy. These values were analyzed by parameter of maternal serum ferritin hemoglobin, iron supplement, and following results were obtaiend. 1. Average value of maternal serum ferritin was 23.7+-21.6 ug/l and that of hemoglobin was 11.4+-1.8 g/dl and those for serum iron and TIBC were 121.0+-80.0 ug/dl and 446.9+-133.9 ug/dl respectively 2. Values of cord serum ferritin hemoglobin serum iron were higher than maternal values especially cord serum ferritin was about 5 times higher than maternal serum ferritin 3. There was linear correlation between maternal serum ferritin and cord ferritin . But there was no correlation between maternal serum ferritin and cord ferritin hemoglobin serum iron and TIBC. 4. There was no correlation between maternal hemoglobin and cord hemoglobin serum iron and serum ferritin. 5. By iron supllement, the average values of maternal hemoglobin , maternal ferritin and cord serum ferritin were increased. 6. Iron hematologic indices were not changeable by maternal age, parity gestational week and fetal weight.

음경에 발생한 선편평세포암

정일형,김기욱,이원기,이수성,양대열,김성용,김하영,남은숙 大韓泌尿器科學會 2003 Korean Journal of Urology Vol.44 No.1

임산부에서의 인유두종 바이러스 16 번과 18 번의 빈도에 관한 연구

송은섭,정재근,이병익,임문환,임영구,황성욱,방금화,박성휘,황태숙 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.3

저자들은 1996년 9월부터 1997년 8월까지 인하대병원 산부인과를 방문하여 산전진찰을 시행 받은 3314명의 산모 중 본 연구에 동의한 86명을 대상으로 자궁경부의 세포를 채취하여 인유두종 바이러스 16형과 18형을 중합효소반응을 통하여 감염 여부를 조사한 결과 다음과 같은 결론을 얻었다. 1. 본 연구에서의 산모에서의 인유두종 바이러스 16형의 빈도는 4.7%였다. 2. 본 연구에서의 산모에서의 인유두종 바이러스 18형의 빈도는 1.2%였다. 3. 정확한 빈도를 구하기 위해서는 지속적인 추가 연구가 필요하리라 사료된다. Objective: Because of incomplete data in the current literature, we would like to know the frequency of cervical human papillomavirus[HPV] type 16 and 18 infection in Korean pregnant women. Study Design: Pregnant patients who were seen for routine care at our clinic were recruited. Cervical cells were collected by special brushes and deoxyribonucleic acid[DNA] was extracted and tested to identify the presence of HPV DNA by polymerase chain reaction. Results: Results from 86 pregnant women were analyzed. The frequecncy of HPV DNA type 16 was 4.7% of the pregnant women in these samples and the frequency of type 18 was 1.2%. Conclusion: The frequence of HPV infection of the cervix in pregnant women was 4.7% in type 16 and 1.2% in type 18 in this study.

임산부에서 양수천자법에 대한 조사

송은섭,정재근,고승권,이병익,임문환,임영구,박지현 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.3

Amniocentesis was first performed for genetic studies in the 1950s. Serr and colleagues, and Fuchs and Riis were the first to report the use of amniocentesis for antenatal sex determination. From the 1970s, genetic amniocentesis became one of the most useful techniques of the prenatal detection of genetic disorders. Because the application of population-based maternal serum screening to prenatal diagnosis is now widespread, we can estimate the trend change of amniocentesis indications. So this study was carried out from May 1996 to April 1997 on 74 pregnant women who underwent amniocentesis in an university hospital in order to analyse the indications, age distribution, gestational age at the time of amniocentesis, frequency of needle insertions, color of amniotic fluid, outcome of pregnancy, and result of chromosome analysis. The results obtained are summarized as followings. 1. The most common indication for amniocentesis was abnormal maternal serum marker. 2. Two earl amniocenteses were performed. 3. 55 cases were single needle insertion and 6 cases were 3 or more needle insertions. 4. 11 discolored fluids[9 bloody, 2 brownish] were obtained during genetic amniocentesis of 74 patients. 5. Chromosomal abnormality was detected in one case of the 74 total cases.

체외수정 시술시 성공적인 과배란유도의 지표로서 clomiphene citrate challenge test 의 효용 성에 관한 연구

이은숙,배도환,이상훈,정병준 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.8

중앙대학교 의과대학 산부인과학교실에서는 1993년 1월부터 1994년 4월까지 불임을 주소로 내원한 환자중 자궁내막증, 고령에 의한 불임, 복강내 인자로 인한 불임환자, 과거 난소절제 술을 시행했던 환자, 원인불명의 환자 115명을 대상으로 기초불임 검사의 일환으로 CC challege test를 실시한 후 과배란유도 및 체외수정을 실시하였는데, CC 투여후 혈중 FSH 상승을 보인 비정상군에서는 그후에 시행된 과배란 유도와 체외수정시술에서 높은 시술 취 소율, 낮은 난자 채취율, 이식된 배아의 감소, 질이 낮은 난포 및 낮은 임신율을 볼 수 있었 으며 또한 비정상군 일수록 나이가 증가하는 경향을 보여, 난소의 과배란유도 및 체외수정 시술 전에 실시한 CC challenge test는 난소기능을 예견할수 있는 좋은 지표가 되며 CC challenge test에 비정상적인 반응을 보인 부적절한 환자군에서는 결과가 좋지 않음을 예측 할 수 있는 지표라고 사료된다. Despite a well conducted controlled ovarian hyperstimulation(COH) some patients will produce a very small number of follicles. This makes it neccessary either to cancel the COH or, if follicle is present, to attempt an IVF procedure, which has a very limited chance of success. The detection of these patients before starting an expensive, time-consuming and rather stressful procedure like IVF is certainly of great interest. A poor response of COH cannot be anticipated on the basis of clinical parameters such as the patients age or the characteristics of their spontaneous menstrual cycles. Because ovarian age does not always correspond to chronological age and many of them have a normal ovulatory cycle. By contrast the endocrine evaluation of these `poor responders` has revealed that at least some of them present an abnormally elevatd basal serum follicle stimulating hormone(FSH), which suggests that they suffer from incipient ovarian failure. But variations in FSH from cycle to cycle discourage clinicians from prognosticating stimulation outcome based on one FSH value alone. We studied to assess ovarian reserve in poor responders by means of serum FSH levels after Clomiphene citrate(CC) administration before COH for IVF from Jan, 1993 to April 1994. The group studied comprised 94 patients 115 cycles for IVF and who applied to patients 35 years or older, patients with extensive pelvic adhesion, ovarian endometriosis, or patients with only ovary patients elevated basal FSH level. The abnormal CC challenge test resulted in 28.6%, 28.6% and 42.9% of the patients in the age groups younger than 30,31-34,35 and older, respectively(p$lt;0.01). In the abnormal response group, the FSH levesl were significantly higher before CC administration compared with normal response group(p$lt;0.001). The E2 level was no difference before CC in the two groups, the E2 level after CC was significantly higner with a normal response group(p$lt;0.001). The cancellation rate per cycle were 15.4% in abnormal response group, 3.2% in normal response group, the cancellation rate was higher in the abnormal response group(p$lt;0.05). The number of oocyte retricved and embryos obtained in the normal response group were significantly higher than abnormal response group(p$lt;0.05). Eignteen clinical pregnancies were obtained in the normal response group, however, no pregnancies in the abnormal reponse group. The percentage of oocytes of high quality(Grade I, II) was 73.7% in normal response group, 18.5% in abnormal response group. The oocytes quality in the normal response group was better than in the abnormal response group. We concluded that the FSH response to CC administratin combined with basal level of FSH was good prognostic value of subsequent COH for IVF. We may suggest that CC challenge test in used to evaluate ovarian reserve before IVF esppecially in patients of 35 years or more and in all patients who have ovarian surgery or have ovarian endometriosis.

자궁내 태아사망의 임상적 고찰

이영혜,이형열,정두수,서승식,최주원,정은신 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.5

1986년 1월 1일부터 1990년 6월 31일까지의 만 5년 6개월동안 전주예수병원 산부인과에서 입원 분만한 15,838예중 자궁내 태아사망 231예를 임상적으로 연구하여 다음과 같은 결론을 얻었다. 1. 자궁내 태아사망의 발생빈도는 1.46%이었다. 2. 연령분포는 18세에서 42세까지의 분포를 보였으며, 25∼29세군이 52.6%로 가장 많은 분포를 나타내었다. 3. 출산력 별로 보면 미경산부에서 54.3%로 가장 많았고 다음은 1회 분만군이었다. 4. 자궁내 태아사망의 기왕력은 30예(12.9%)에서 있었고, 자연유산의 기왕력은 41예(17.8%)에서 있었다. 가장 많은 혈액형은 A형(31.7%)이었다. 5. 자궁내 태아사망의 발견이 가장 많았던 주수는 37∼40주(23.0%)였으며, 태위는 두위가 65.7%로 가장 많았다. 남아와 여아의 비는 1.24 : 1이었으며, 태아 체중은 2,500gram미만이 75.1%이었다. 6. 분만방법은 유도분만이 44.8%로 가장 많았고, 자연분만은 42.0%, 개복수술은 16.1%이었다. 7. 자궁내 태아사망의 원인은 원인불명이 40.4%, 임신중독증이 14.7%, 태반조기박리가 10.8%, 제대문제 9.0%, 선천성기형 8.7%, 융모양막염 4.8%, 전치태반 3.0%, 모체질환, 자궁기형 등이었다. 8. 자궁내 태아사망의 모성 합병증은 67예(29.0%)에서 나타났고, 이중 발열(17.3%), 출혈(10.4%)이 가장 많았고 요로감염, 자궁복구부전, 창상감염, 자궁경관 열상 등의 순서였다. 9. 자궁내 태아사망과 DIC와 관계는 FDP가 연구군의 5.0%에서 40㎍/ml이상으로 증가되었고, fibrinogen은 10.9%에서 150mg%이하로 감소되었으며, prothrombin time이 40.0%인 경우는 3.7%에서 보였고, partial thromboplastin time이 45초이상 연장된 경우는 2.7%에서 있었다. 10. 산전관리를 한 번도 받지 않은 임산부는 22.0%였으며, 37.0%의 경우는 1∼2번, 27.7%의 산모는 3∼4번의 산전진찰을 받았다. The intrauterine fetal death is difined as the intrauterine death after 20 weeks gestation or attainment of 500 gram body weight prior to the complete expulsion or extraction from it`s mother. This is clinical study of 231 cases of the intrauterine fetal death among 15,838 deliveries of Presbyterian Medical Center during 5.5 year period from Jan, 1985 to Jun, 1990 using as a base the medical records. The results of this study were as follows. 1. The incidence of the intrauterine fetal death was 1.46%. 2. The age distribution of mothers with the fetal death in uterus was 18∼42 years and was highest in the 25∼29 years range(52.6%). 3. The parity of mothers in the intrauterine fetal death was the most highest in nulliparous group (54.3%) and the next group was para-1 (29.6%). 4. There were 30 cases (12.9%) with the previous history of the intrauterine fetal death and 41 cases (17.8%) with the previous history of the spontaneous abortion. The incidence of antepartum maternal anemia was 25.5% (59 cases) and the largest blood group was Rh positive A type (31.7%). 5. The largest incidence according to the gestational age was 37 to 40 weeks gestation group (23.0%). The sex ratio of male versus female fetus was 1.24 : 1. The most common presentation was cephalic (65.7%) and the 75.1% of dead fetus weighted less than 2500 gram. 6. The mode of delivery for the intrauterine fetal death showed that the induction of labor was most common (44.8%) and the spontaneous delivery was 42.0%, laparotomy cases were 13.4%. The most common indications of laparotomy were placenta previa, previous cesarean section state and placenta abruption. 7. The etiologic factors of the intrauterine fetal death : Unexplained causes (40.4%), toxemia (14.7%), abruption placenta (10.8%), cord accidents (9.0%), congenital anomaly (8.7%), amnionitis (4.8%), placenta previa (30%), twin (30%), postterm (26%) syphilis (1.7%) and other maternal chronic illness. 8. There were 67 cases of maternal complications. The most common was fever (17.3%) and the others were hemorrhage (10.4%), urinary tract infection (5.1%),uterine subinvolution(3.5%), wound infection(2.2%)and etc, in that orders. 9. The DIC studies of IUFD were as follows:The FDP was increased above the levels of 40 ug/ml in 5% of cases. The fibrin levels were decreased below the levwl of 150 mg% in 10.9% of cases .The platelet count was decreased below the level of 150,000/mm in 4.9% of the cases.The prothrombin time was below the level of 40% in 3.7 of the cases and partial thromboplastin time was prolonged above 45 sec in 2.7 % of the cases. 10. The 22.0% of the cases had not received any prenatal care, 37.2% of the cases received prenatal care only 1 or 2 times, and 27.7% had received 3 or 4 times.

Swyer Syndrome 1 례

나중렬,이용호,정윤돈,정수경,이응석,이정구 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.5

순수 생식선 이형성증은 매우 희귀한 예로 저자들은 본원에 내원한 18세의 여성에서 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. A 18-year-old female was referred on January, 1998 for primary amenorrhea. Physical examination revealed eunuchoid body proportions, no breast development and no pubic and axillary hair. No somatic abnormalities could be detected. Peripheral blood karyotype was 46, XY. Exploratory laparotomy revealed a hypoplastic uterus, bilateral tubes and bilateral streak gonads. It is well known that patients with gonadal dysgenesis in whom a Y chromosome component exists are at risk for developing gonadoblastoma or dysgerminoma. So, bilateral gonadectomy was performed and hormone replacement therapy was instituted. We report a case with review of the literature.

추체 아탈구에 동반된 외상성 제1-2 흉추간반 탈출증-증례보고-

강동호,김은상,정진명,한종우 대한신경외과학회 2003 Journal of Korean neurosurgical society Vol.33 No.1