태아성별(胎兒性別)에 따른 양수중(羊水中) Testosterone과 F.S.H.의 동태(動態)에 관(關)한 연구(硏究)

고민환,신면우,Koh, Min-Whan,Shin, Myon-Woo 대한생식의학회 1979 Clinical and Experimental Reproductive Medicine Vol.6 No.1

To determine whether hormone analysis of amniotic fluid could be used for accurate determination of fetal sex, we measured testosterone(T) and follicle-stimulating hormone in 19 amniotic fluid samples. The mean T in amniotic fluid of 8 women earring male fetuses was 310 pg. per milliliter and of 11 women earring female fetuses was 150 pg. per milliliter (P<0.05${\ast}$). The mean amniotic fluid FSH of 1.16 mI.U. per milliliter for 7 women with male fetuses was over trifold lower than that for subjects with female fetuses. The mean amniotic fluid FSH of female fetuses was 3.85 mI.U. per milliliter (P<0.01${\ast}$) Measurement of T & FSH in amniotic fluid may be an adjunct method for fetal sex determination.

성경험이 없는 여성에서 발생한 황색육아종성 난소염 1예

고민환 ( Min Whan Koh ),김진희 ( Jin Hee Kim ),김미진 ( Mi Jin Kim ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.7

황색육아종성 염증은 드물게 발생하는 만성 육아종성 염증의 한 형태로 조직학적으로 포말 조직구가 림프구, 형질세포, 중성구와 함께 관찰되는 것을 특징으로 한다. 신장에서 주로 발생하는 것으로 알려져 있으며 질, 자궁 경부, 자궁 내막 및 난소 등의 여성 생식기에서 발생한 경우는 극히 소수만이 보고되고 있다. 1,3,9-12 황색육아종성 난소염은 주로 골반 감염성 질환과 연관이 있는 것으로 생각되며13,17 그 외에도 자궁내막증, 부적절한 항생제 치료, 지질 대사의 이상, 대식세포의 기능이상 등과도 관련이 있다고 알려져 있으나 확실한 병인이나 임상적 진단에 있어서는 아직 명확하게 밝혀지지 않았다. 10-19 저자들은 골반염증성 질환의 가능성은 적으나 출혈성 난소 낭종과 연관이 있는 것으로 생각되는 성경험이 없는 23세 여자에서 발견된 황색육아종성 난소염 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Xanthogranulomatous inflammation is an uncommon form of chronic granulomatous inflammation that is characterized by the presence of lipid-filled histiocytes with lymphocytes, plasma cells and neutrophils. It is best known to occur in the kidney.1,3 Other organs in which xanthogranulomatous inflammation has been reported are the gallbladder, stomach, anorectal area, bone, urinary bladder, testis, epididymis and female genital tract.2,4-12 Only a few cases of xanthogranulomatous oophoritis have been reported to date.10,14-19 Infection has been thought to be the main etiologic factor in the pathogenesis of xanthogranulomatous lesion.13,17 The pathogenesis of xanthogranulomatous inflammation remains still unclear. Other proposed causes are abnormality in lipid metabolism, endometriosis and ineffective clearance of bacteria by phagocytes.13,16-7 We describe a case of a xanthogranulomatous oophoritis in a 23-year-old virgin which associates with hemorrhagic ovarian cyst and minimal association of pelvic inflammatory disease.

앞 질벽에 발생한 과립세포종

고민환 ( Min Whan Koh ),배제준 ( Jei Jun Bae ),김미진 ( Mi Jin Kim ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.8

외음부 비종양성 상피세포질환

고민환(Min Whan Koh) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.2

N/A N/A

급성 골반 복막염의 복강경 조기 배농치료의 임상적 효과

고민환 ( Min Whan Koh ),배연경 ( Yeun Kyoung Bae ),최윤영 ( Yoon Young Choi ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.8

목적 : 급성 골반염으로 진단된 젊은 가임기 여성에서 기존의 항생제만의 치료와는 달리 조기에 복강경 시술을 통하여 골반염의 진단 및 조기 배농치료를 하여 그 임상적 효과를 평가하고자 하였다. 연구 방법 : 임상적 급성 골반염이 진단된 환자들 중 복강경 수술을 시행한 30명을 연구군으로, 기존의 고식적 주사 항생제 치료를 받고 퇴원한 환자 34명을 대조군으로 하여 수술 전후 및 치료 전후 환자들의 증상의 변화, 체온, 백혈구 수치, 혈구침강계수, C-반응성 단백수치의 변화를 측정하여 치료결과를 평가하고 비교하였다. 결과: 평균재원기간은 각각 7.8일 및 6.9일로 유의한 차이가 없었으며, 활력증후의 변화는 입원당시 발열을 보인 환자들을 대상으로 37℃이하 정상체온으로 돌아오기까지의 기간을 분석한 결과 연구군의 경우 수술 후 더글라스와 혈종이 생겼던 1예를 제외하고 모두 수술 후 3일째 정상체온을 보였으며, 대조군의 경우 재원 5일 이상 되어도 정상체온으로 떨어지지 않은 경우가 6명(27%)으로 유의한 차이를 보였다. 그러나 급성골반염의 전형적 증상들의 현저한 호전을 보인 경우는 재원 4일째 각각 66%, 67%로 두 군간의 차이가 없었다. 검사실 결과 비교시 입원당 시 백혈구 증가증을 보였던 환자군들 중 재원 3일째 10,000/㎕ 이하의 정상수치를 보인 경우가 연구군 83%, 대조군 73%로 차이를 보였으나 통계적으로 유의하지 못했으며 염증반응 지표로 활용한 혈구침강계수, C-반응성 단백수치 결과의 변화도 통계적으로 유의한 차이는 없었다. 결론: 본 연구에서는 복강경 수술군이 항생제 치료군과의 비교시 발열의 현저한 호전을 보인 것 외에는 술 후 임상적 경과는 유의한 차이가 없었지만, 합병증 없이 비교적 빠른 호전을 보이는 경향이 있고 조기 복강경 개입은 복강경으로 확인한 골반강 및 복강의 병적 소견에 대한 진단과 동시에 적절한 처치가 가능하여 후유증 예방에 유용하므로 급성골 반복막염의 1차적 치료법으로 복강경하 배농치료는 효과가 있을 것으로 사료된다. Objective: The purpose of this study was to evaluate the clinical efficacy of the early pelviscopic intervention in the acute pelvic inflammatory disease of reproductive aged female. Methods: A clinical evaluation for 30 women who underwent pelviscopic pus drainage in the pelvic inflammatory disease from September 2001 to December 2004 was done. This study group was compared with the control group that 34 cases of intravenous antibiotics treatment performed and we evaluated the clinical and laboratory findings were recorded for all patients before and after treatment. Results: The mean hospital stay was 7.8 days and 6.9 days respectively (p=0.25). There was statistical difference in regarding to febrile status period, that is febrile status was significantly improved in pelviscopy group. The febrile status of the study group was normalized within postoperative third day except 1 case that postoperative hematoma was formed in cul de sac, but it was not normalized within hospital fifth day in 6 cases (27%) of the control group (p=0.05). But there was no statistical difference between the two groups in regarding to clinical symptom free period except febrile status, WBC count change, and ESR/CRP count change. Conclusion: In this study, no significant difference was found between the two groups in regarding to clinical progress. But this study suggested that the early pelviscopic pus drainage was effective first line treatment method for the acute pelvic inflammatory disease with less complications and relatively rapid clinical improvement. However further study with more expanded cases that early pelviscopic intervention was done for the prevention of long term complications of pelvic inflammatory disease will be needed.

임신에 동반된 자연파열 간 피막하 혈종

고민환(Min Whan Koh),박성준(Sung Jun Park),이강혁(Kang Hyuk Lee),장영진(Young Jin Jang),이태형(Tae Hyung Lee) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.1

Spontaneous rupture of subcapsular liver hematoma in pregnancy is rare but potential life threatening complication of preeclampsia. We experienced a case of spontaneous rupture of subcapsular hematoma of liver that was treated with conservative method. So, we present the case with a brief review of literatures as first report in Korea.

전사춘기 외음부 섬유종

고민환 ( Min Whan Koh ),배제준 ( Jei Jun Bae ),김미진 ( Mi Jin Kim ) 대한산부인과학회 2005 Obstetrics & Gynecology Science Vol.48 No.11

11세 여아의 소음순에 발생한 체모압박증후군 증례보고

이대형 ( Dae Hyung Lee ),고민환 ( Min Whan Koh ) 대한산부인과학회 2012 Obstetrics & Gynecology Science Vol.55 No.3

Hair tourniquet syndrome refers to the strangulation of appendages by a thread of human hair. This condition can lead to ischemic injury of these appendages. Thus, to avoid constrictive injury, prompt recognition and treatment are very important. Affected areas include fingers, toes, and genitalia. Hair tourniquet syndrome involving the labium minora is extremely rare. We here report a case of hair tourniquet syndrome involving the labia minora in an 11-year-old girl.

신생여아의 음핵크기 및 음핵비대와 남성호르몬치와의 상관관계

이강혁(Kang Hyuk Lee),고민환(Min Whan Koh) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.9

N/A Objective : To determine clitoral size of Korean newborn and androgen hormone levels in clitomegalic newborn. Methods : The clitoral sizes of 236 Korean female newborn and mother were measured from January in 2000 to March in 2001. Androgen hormone levels were obtained in 11 infants with clitomegaly in order to evaluate the relationship between clitoral hypertrophy and androgen levels. Results : The mean clitoral size of the 236 newborn was 3.82±1.47 mm in length and 2.95±1.79 mm in width. The mean clitoral size of the 236 postpartum women was 15.8±1.03 mm in length and 3.27±1.12 mm in width. In the premature infants the clitoral length and width were 4.45±1.79 mm and 3.53±1.51 mm respectively. In the normal birth weight infants they were 3.70±0.75 mm and 2.02±0.84 mm respectively. In clitomegalic infants the clitoral size was 5.8±0.7 mm in length and 3.7±0.4 mm in width. The serum testosterone level was 1.620±0.015 nmol/L and dihydrotestoteronesulfate (DHEAS) level 8.44±0.01 nmol/L. Conclusion : There was no significant correlation between gestational age and clitoral size, but significant negative correlation was found between birth weight and clitoral size. In 11 clito-magalic infants serum androgen was normal level. Also, there was no different clitoral size between clitomagalic infant mothers and normal infant mothers. These results suggest that there would be no significant correlation between infantile clitomegaly and androgen level.

골반염의 감별진단에 관한 복강경의 유용성 골반염으로 오인된 충수돌기염 4예

이대형 ( Dae Hyung Lee ),고민환 ( Min Whan Koh ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.12

The pelvic inflammatory disease (PID) occurs when microbacteria ascend via vagina to the upper genital organs such as endometrium, tubes, ovaries and even pelvic peritoneum as a result of infected intercourse. That could be presented as perihepatitis, parametritis, intraperitoneal pelvic inflammatory disease, not to mention endometritis, salpingitis and tubo-ovarian abscess. Symptoms and signs of PID resembles those of several abdominal diseases such as acute appendicitis, acute gastroenteritis, ectopic pregnancy, and adnexal torsion. Especially differentiation of acute appendicitis from PID is very important because acute appendicitis must be treated by operation but PID could be treated by surgery or antibiotics only even though their symptoms and signs are very alike. So, diagnostic pelviscopy for PID is very important for differential diagnosis and further management. We experienced and report four cases of appendicitis that could not be diagnosed differentially from PID which managed with the emergent pelviscopy successfully.