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길기철 ( Ki Cheol Kil ),임시연 ( Si Yeon Lim ),고현선 ( Hyun Sun Ko ),김사진 ( Sa Jin Kim ),권동진 ( Dong Jin Kwon ),신종철 ( Jong Chul Shin ),김수평 ( Soo Pyung Kim ),이귀세라 ( Gui Se Ra Lee ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.3
Objectives: The purpose of this study is to investigate the clinical risk factors of emergency cesarean hysterectomy in patients with pregnancies complicated by placenta previa and whether the third trimester transvaginal ultrasonographic findings of placenta previa would predict emergency cesarean hysterectomy. Materials and Methods: Between January 1995 and March 2005, we retrospectively reviewed the records and compared between patients with pregnancies complicated by placenta previa who underwent cesarean hysterectomy and patients with pregnancies complicated by placenta previa who did not undergo cesarean hysterectomy. Results: There were 314 had placenta previa and 34 patients were performed cesarean hysterectomy (10.83%). There were significant differences on the basis of maternal age (31.53±4.41 vs 34.06±4.12, p<0.05), parity (0.81±0.70 vs 1.29±0.63, p<0.05), the number of cesarean section (0.36±0.56 vs 0.91±0.75, p<0.05), previous history of placenta previa and presence of placenta accreta, but not on the basis of gestational age, the number of antenatal vaginal bleeding, the number of abortions and emergency operation between two groups. On the basis of third trimester transvaginal ultrasonographic findings, significant differences were found on the distances from the internal os of cervix (1.18±3.66 vs 2.67±2.94, p<0.05) and thickness of lower placental edge. However, the presence of lacuna in the lower placenta was not associated with emergency hysterectomy. Conclusions: Patients with placenta previa are at a higher risk of undergoing cesarean hysterectomy when they are associated with placenta accreta, thick lower placenta edge, and positively longer distance to the internal os of cervix. The other clinical factors such as maternal age, parity, the number of cesarean section and previous history of placenta previa might be associated the risk of cesarean hysterectomy.
길기철 ( Ki Cheol Kil ),남선영 ( Sun Young Nam ),김수미 ( Su Mi Kim ),하재은 ( Jae Eun Ha ),류기성 ( Ki Sung Ryu ),이영 ( Young Lee ) 대한주산의학회 2009 Perinatology Vol.20 No.4
Fetal cardiac tumors are a rare condition and are histologically benign. Cardiac rabdomyoma is the most common cardiac tumor and may be associated with tuberous sclerosis. Clinical follow-up including monitoring of fetal well-being is warranted as long as the fetus remains asymptomatic and there is no evidence for hydrops fetalis. If obstruction to blood flow and/or early fetal compromise is noted, then the decision of whether to deliver early must be made. We report a case of fetal cardiac tumor diagnosed by antenatal ultrasonography and diagnosed as tuberous sclerosis with brain MRI scanning after birth.
자궁경부 종양 환자에서 세포진 검사, 질확대경조준하생검, 원추절제술의 진단적 정확도와 원추절제술 후 잔류 종양의 예측인자
길기철(Ki Cheol Kil),허수영(Soo Young Hur),이귀세라(Gui Se Ra Lee),양용재(Yong Jae Yang),이지현(Jee Hyun Lee),이희중(Hee Joong Lee),김사진(Sa Jin Kim),김은중(Eun Jung Kim),송승규(Seung Kyu Song),남궁성은(Sung Eun NamKoong),김수평(Soo P 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.9
Objective: This study was performed to evaluate the diagnostic accuracy of cytology, colposcopically directed biopsy and conization and to analyze predictive factors for residual tumor after conization in patients with cervical neoplasia. Methods: We reviewed 167 patients who had undergone cytology, colposcopically directed biopsy and conization followed by subsequent hysterectomy depending on their current disease status at the Department of Obstetrics & Gynecology, Catholic University of Korea Medical College, Holy Family Hospital from January, 1993 to August, 1998. The diagnostic accuracy of cytology, colposcopically directed biopsy and conization were investigated. Also, we investigated the significance of the margin status and the presence of HPV which were used to predict residual tumors in hysterectomy specimens after conization. Results: The results of each methods were analyzed with regard to the histopathologic findings of the surgical specimen. The accuracy rates of cytology, and colposcopically directed biopsy were 59.3% (99 of 167) and 71.3% (119 of 167), respectively. After conization, residual tumors were found in 30.1% of subsequent hysterectomized specimens (51 of 167). Underestimation by conization occurred in 2.0% of cases (1 of 51) and overestimation in 7.8% (4 of 51). Residual tumors were significantly more frequent in patients with positive conization margins than in those with negative margins (P<0.001). But the presence of HPV was not significant. Conclusion: These results suggest that diagnostic conization seems to be essential procedure in patients showing abnormal results by cytology and colposcopically directed biopsy, especially in those with CIN III or microinvasion, for the further proper management of cervical neoplastic lesion and margin status is useful in predicting residual tumor after conization.
임신 16주에 부분포상기태와 양측난포황체낭종이 함께 동반된 중증전자간증
길기철 ( Ki Cheol Kil ),이귀세라 ( Gui Se Ra Lee ),강영화 ( Young Wha Kang ),박동춘 ( Dong Choon Park ),최현주 ( Hyun Joo Choi ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.12
We present an unusual case in which a patient was diagnosed with the preeclampsia associated with a partial hydatidiform mole and bilateral theca-lutein cysts. The patient newly developed proteinuric hypertension at 16 weeks` gestation. Ultrasound findings showed small multiple cystic spaces in the placenta and a live singleton fetus. Triploid 69, XXX was confirmed at karyotype analysis. Intrauterine fetal death was found at 18 weeks` gestation and termination of pregnancy was performed, and a partial hydatidiform mole was confirmed at pathologic examination. Torsion of bilateral theca-lutein cysts was developed at postpartum one week. Detorsion and aspiration of the bilateral theca-lutein cysts were performed under the laparoscopy.
길기철(Ki Cheol Kil),강대호(Dae Ho Kang),이종건(Jong Kun Lee),백은정(Eun Jeong Baik),이영(Young Lee),나종구(Jong Gu Rha),김수평(Soo Pyung Kim) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.1
Pulmonary Embolism, one of the causes of maternal death, is a life threatening disease that needs early and accurate diagnosis. We have exprerienced a case of a fatal pulmonary embolism which was diagnosed by lung perfusion scan on the postoperative 1 day after cesarean delivery and was managed with heparin therapy. We present this case with a brief review of literatures.
길기철 ( Ki Cheol Kil ),정재은 ( Jae Eun Chung ),유시현 ( Sie Hyun You ),박미선 ( Mi Sun Park ),권동진 ( Dong Jin Kwon ),유영옥 ( Young Ok Yoo ),윤주희 ( Joo Hee Yoon ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.11
The incidence of all transverse vaginal septum is 1:2,100 - 1:72,000. The transverse vaginal septum is a developmental defect of vagina which may be fused incompletely between the Mullerian duct component and the urogenital sinus component of vagina. Serious complications may be hematocolpos, hematometra and hematosalpinx. Simple surgical excision or simple incision have been developed to treat congenital transverse vaginal septa, but also caused common complications such as secondary tissue contracture. Garcia technique using eight vaginal mucosa flaps was developed to avoid common complication of secondary vaginal stenosis. Here, we present a case of contracted transverse vaginal septum who has been performed a simple incision 13 years ago, successfully performed the modified Garcia technique without serious postoperative complication.