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구병삼,김진홍,유동화,박상진 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.3
고려대학교병원 산부인과에서 4회 경산부인 39세의 여성에서 거대한 광인대내 자궁근종 및 4회 경산부인 41세의 여성에서 거대한 장막하 자궁근종을 치유한바 있어 이에 문헌 고찰과 아울러 보고하는 바이다. Two cases of huge uterine intraligamentary and subserosal myomas were presented, and literatures concerned are reviewed briefly.
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복강경하(腹腔鏡下)에서의 Hysterosalpingogram
구병삼,Ku, Pyong-Sahm 대한생식의학회 1980 Clinical and Experimental Reproductive Medicine Vol.7 No.1
Hysterosalpingograms (H.S.G.) have been done for several decades to determine causative factors in female infertility. However, the H.S.G. only reverals uterine cavity and tubal patency or inpatency. The author prefers to find more details in regard to the status and condition of the female reproductive organs and their surrounding tissue as they pertain to infertility. H.S.G. in combination with laparoscopic examination reveals the following results. Preparation and method of performance of H.S.G. during laparoscopy in a healthy reproductive age women are as follows. When laparoscopy is not contraindicated, NPO is ordered with routine bowel preparation. Analgesics administered by injection prior to procedure are valium 10mgs and pethidine 50-100mgs. The radiographic procedure is the same as for any HSG technique. During laparoscopy a solution of 3 to 10 ccs. of 60% hypaque sodium is used. Fluroscopic scout films are obtained A-P and oblique views as well as a delayed check film. 1. Age distribution of primary and secondary infertility in this studies involving tubal factors was as follows: 20-29 age group showed 46% incidence and in the 30-39 age group, 50% incidence. Duration of infertility in this study group was the following: 1-2 years showed 26.7%, 3-5 years 53.8%, and 6-9 years 13.3%. 2. Indications of laparoscopic examination were as follows: Secondary infertility in 35% of the cases, obscure tubal occlusion on previous H.S.G. in 25%, unknown origin in 11.7%, and the remaining cases included pelvic pain, small masses, dysmenorrhea, and uterine anomaly. The laparoscopic examination showed clearly the reproductive organs and the surrounding tissues in the pelvic cavity. The abnormal tubal findings there revealed were tuberculous salpingitis and hydrosalpinx in 10% each, endometriosis and peritubabl adhesions in 6.7% each, biconuate uterus in 3.3%. The remaining 58.3% of the cases showed normal findings. Laparoscopic observation for possible myoma nodules, streak ovary, and peritubal adhesions was also done at this time. 3. Comparative tubal findings in combined H.S.G. and laparoscopic examination revealed the following. Bilateral tubal occlusion was present in 14% (7cases) on laparoscopic examination but on H.S.G. 38% (19 cases) were noted. However, tubal occlusion and peritubal adhesions were found in 26% (13 cases) upon laparoscopy and only 8% (4 cases) on H.S.G. examination alone. Normal pelvic findings were present in 60% (27 cases).
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인공수태(人共受胎)의 합병증(合倂症)과 난점(難點)에 관(關)한 연구(硏究)
구병삼,Ku, Pyong-Sahm 대한생식의학회 1987 Clinical and Experimental Reproductive Medicine Vol.14 No.1
Alternative methods were used in the field of infertility as the latest means for the treatment of misconception. Artificial insemination, which has been commonly used already, IVF-ET and GIFT are also used as artificicial method for conception presently. Appling such methods to the patient, following three categories should be considered; first, there should be an understanding and an agreement from the patient, second, if possible, reduce the cost of hospital expense and relieve physical and emotional problems of the patient, and third, increcrsing the pregnancy rate. Under these considerations, complication and pitfalls of artifical inseminations are a big burden to the physian and the patient. Though the conicicental complications are relatively very rare, detailed laboratoy tests, carefull examinations, and follow-up studies are necessary. In the distribution of the age groups, 40.3% was in the 25 to 29 years group, 30 to 34 years was 45%. 35 to 39 years was 8% and only 3.2% was above the 40 age groups. The range of infertile periods were from 1 to 17 years, and half of the patients were over 5 years, the other group 20% in 3 years and 2 to 4 years were 10%. Among 159 cycles of artificial insemination, there were complications such as infection(1.9%) and discomfort(5%) and abnormal bleeding (0.6%). During pregnancy, clinical abortion (1.9%) and toxemia (2.5%) were shown. Sex of new born infants were, male (68%) and female (31%). Fortunately, there were no cases of psychological complication and genetic abnormality. Indications of artificial insemination for male factors were aspermia (2.5%), azoospermia (28.8%), oligospermia (26.4%) and asthenozoospermia (1.8%), for female factors were irregular cycle (11.7%) and dysmucorrhea.
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구병삼,Gu, Byeong-Sam 한국건강관리협회 1985 건강소식 Vol.9 No.3
오늘날 수많은 생명의 몰락을 방지하기 위해서, 새로운 의학 세계에 도전하는 소위 첨단의학인 유전공학의 기초 이론은 '인류 복지를 위해서'라는 큰 과제를 가지고 있다.<편집자주>
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