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김선미 ( Sun Mie Kim ),( Seok Hyun Kim ),( Jung Ryeol Lee ),( Byung Chul Jee ),( Chang Suk Suh ),( Joong Yeup Lee ),( Ki Chul Kim,Md ),( Do Yeong Hwang ),( Jung Gu Kim ),( Shin Yong Moon ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-
Objective: To assess the effi ciency of anti-Mullerian hormone (AMH), follicle-stimulating hormone (FSH), estradiol, antral follicle count (AFC), endometrial thickness (EMT), and clinical fi ndings as predictive markers of menopause in late reproductive-aged Korean women. Methods: A cohort of 104 women, aged 45 to 55 years in their menopausal transition were selected. The participants were assessed twice (T1 and T2) at a mean interval of 13.1 months. At each time, their menstrual history was determined; pelvic ultrasonography was performed to evaluate AFC and EMT; blood sampling was done. A logistic regression analysis using the SPSS ver. 17.0 was performed, with the outcome measure of menopause at T2. Results: Of the 104 participants, 33 were postmenopausal based on their menstrual history at T2. Compared with women who stayed in the menopausal transition period, those who became postmenopausal at T2 differed signifi cantly with regard to the following factors at T1: FSH, estradiol, EMT, AFC, days from the last menstrual cycle, and interval between the last 2 cycles. However, AMH levels were not different between the groups. Of all the parameters, a longer number of days from the last menstrual cycle and time interval between the last 2 cycles were signifi cantly associated with the occurrence of menopause. Conclusion: This study indicates that AMH is not a predictive marker of menopause in late reproductive-aged women over a relatively short timeframe (range, 0.5 to 2.5 years). Time since the last menstruation at T1 was a better predictor of menopause.
불임환자에서 체외수정시술시 난소내 기질 동맥 Doppler 초음파검사 및 혈청 Glycodelin 측정의 임신 예측인자로서의 임상적 효용성
김선미 ( Sun Mie Kim ),황규리 ( Kyu Ri Hwang ),김진주 ( Jin Ju Kim ),문정애 ( Jung Ae Moon ),방영주 ( Young Joo Bang ),지병철 ( Byung Chul Jee ),구승엽 ( Seung Yup Ku ),서창석 ( Chang Suk Suh ),최영민 ( Young Min Choi ),김정구 ( J 대한산부인과학회 2005 Obstetrics & Gynecology Science Vol.48 No.3
목적: 불임환자의 체외수정시술 (IVF-ET)시 난소내 기질 동맥의 도플러 초음파검사 및 황체기 자궁내막의 주요 단백질 생산물인 glycodelin (placental protein 14, PP14)의 혈청 농도 측정의 체외수정시술 후 임신 예측인자로서의 임상적 효용성을 평가하고자 하였다. 연구 방법: 2003년 4월부터 2004년 3월까지 서울대학교병원 산부인과 불임클리닉에서 체외 수정시술을 시행받은 정상 난소 반응이 기대되는 불임환자 57명의 57주 Objective: To assess the clinical efficacy of intraovarian artery stromal Doppler ultrasonography and serum glycodelin (placental protein 14, PP14) as prognostic factors of pregnancy in vitro fertilization and embryo transfer (IVF-ET) cycles. Methods: Fif
김선미(Sun Mie Kim),김건우(Kun Woo Kim),이정렬(Jung Ryeol Lee),이효표(Hyo Pyo Lee),강순범(Soon Bum Kang) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.2
We report two cases of adenoid cystic carcinoma of Bartholin's gland. One of these patients had positive margin on operation and is scheduled for adjuvant radiotherapy. The other was first diagnosed 13 years ago and presented with her second recurrence without distant metastasis. Adenoid cystic carcinoma of the Bartholin's gland is a rare tumor of the vulva. When diagnosed, the treatment should be individualized to the patient. When the surgical margin is found to be positive, adjuvant radiotherapy seems to be beneficial.
김선미 ( Sun Mie Kim ),김석현 ( Seok Hyun Kim ),이정렬 ( Jung Ryeol Lee ),지병철 ( Byung Chul Jee ),서창석 ( Chang Suk Suh ),이중엽 ( Joong Yeup Lee ),김기철 ( Ki Chul Kim ),황도영 ( Yeong Hwang ),김정구 ( Jung Gu Kim ),문신용 ( S 대한산부인과학회 2012 Obstetrics & Gynecology Science Vol.55 No.2
목적: 폐경이행기 한국 여성에서 폐경 예측 지표로서 혈중 anti-Mullerian hormone (AMH), follicle-stimulating hormone (FSH), estradiol, 자궁내막 두께, 초음파상의 동난포 개수 및 임상적 증상들의 유용성을 평가하고자 하였다. 연구방법: 45-55세 사이의 폐경이행기 여성 104명이 참여하였으며 평균 13.1개월 간격으로 두 번에 걸쳐 방문하였다. 각 방문 시 최근의 월경력을 확인하고 골반 초음파검사를 시행하여 동난포 개수 및 자궁내막 두께를 측정하였으며 호르몬검사를 위한 혈액을 채취하였다. 최종 평가 지표는 두 번째 방문(T2) 시의 폐경 여부였으며 통계적 분석은 SPSS ver. 17.0을 사용하였다. 결과: 104명의 참여자 중 두 번째 방문시기에 폐경이 된 여성은 33명이었다. 두 번째 방문 시 폐경된 여성들은 그렇지 않은 여성들과 비교하여 첫 번째 방문 시의 FSH, estradiol, 자궁내막 두께, 동난포 개수, 최종 월경일로부터 경과일 및 최종 월경일과 그 이전 주기와의 기간에 있어 유의한 차이를 보였다. 그러나 AMH 수치는 두 그룹 간 유의한 차이를 보이지 않았다. 모든 인자들 중 최종 월경일로부터 경과일 및 최종 월경일과 그 이전 주기와의 간격이 폐경 발생과 유의한 상관관계를 보인 지표였다. 결론: 폐경이행기 여성에서 1년 정도의 짧은 간격을 두고 볼 때 AMH는 폐경을 예측하는 지표가 되지 못하였다. 첫 번째 방문 시 최종 월경일로부터 경과한 기간이 1년 후 폐경 예측의 더욱 유용한 지표이다. Objective: To assess the efficiency of anti-Mullerian hormone (AMH), follicle-stimulating hormone (FSH), estradiol, antral follicle count (AFC), endometrial thickness (EMT), and clinical findings as predictive markers of menopause in late reproductive-aged Korean women. Methods: A cohort of 104 women, aged 45 to 55 years in their menopausal transition were selected. The participants were assessed twice (T1 and T2) at a mean interval of 13.1 months. At each time, their menstrual history was determined; pelvic ultrasonography was performed to evaluate AFC and EMT; blood sampling was done. A logistic regression analysis using the SPSS ver. 17.0 was performed, with the outcome measure of menopause at T2. Results: Of the 104 participants, 33 were postmenopausal based on their menstrual history at T2. Compared with women who stayed in the menopausal transition period, those who became postmenopausal at T2 differed significantly with regard to the following factors at T1: FSH, estradiol, EMT, AFC, days from the last menstrual cycle, and interval between the last 2 cycles. However, AMH levels were not different between the groups. Of all the parameters, a longer number of days from the last menstrual cycle and time interval between the last 2 cycles were significantly associated with the occurrence of menopause. Conclusion: This study indicates that AMH is not a predictive marker of menopause in late reproductive-aged women over a relatively short timeframe (range, 0.5 to 2.5 years). Time since the last menstruation at T1 was a better predictor of menopause.
현성 요실금이 한국 중,노년 여성의 성기능에 미치는 영향
김지현 ( Jee Hyun Kim ),김윤환 ( Yun Hwan Kim ),김진주 ( Jin Ju Kim ),김선미 ( Sun Mie Kim ),전명재 ( Myung Jae Jeon ) 대한산부인과학회 2011 Obstetrics & Gynecology Science Vol.54 No.12
목적 본 연구는 현성 요실금이 한국 중 · 노년 여성의 성기능에 미치는 영향을 평가하기 위함이었다. 연구방법 2009년 5월부터 2010년 1월까지 서울대학교 헬스케어시스템 강남센터를 방문한 만 40세 이상 여성 건강검진 수진자 중 성적으로 활발하고 본 연구에 동의한 773명을 대상으로, 병력청취(Beck`s Depression Inventory 설문 포함), 신체검진, 혈액검사, Pelvic Floor Distress Inventory-20 (PFDI-20) 및 Female Sexual Function Index (FSFI) 설문조사를 시행하였다. 현성 요실금은 PFDI-16 또는 17 문항에 ``예``라고 답하고 ``약간 이상의 성가심``이 있다고 답한 경우로 정의하였고, 성기능장애는 FSFI 총점이 26.55점 이하인 경우로 정의하였다 결과 설문에 응한 총 773명의 여성 중 318명(41.14%)에서 현성 요실금이 있었다. 현성 요실금이 있는 군은 그렇지 않은 군에 비해 성기능장애의 빈도가 유의하게 높았다(62.26% vs. 49.45%, P<0.05). 다중선형회귀분석 결과 현성 요실금은 나이, 폐경 여부, 경제력, 흡연 유무, 확장기혈압, 우울증과 더불어 FSFI 총점에 유의한 영향을 미치는 인자로서 나타났다(standardized β = -0.108, P<0.05). 임상적 위험인자들을 보정한 FSFI 총점 평균은 현성 요실금이 있는 군에서 그렇지 않은 군에 비해 유의하게 낮았으며(24.59 vs. 25.74, P<0.05), 각 영역별 점수 역시 윤활액분비(4.70 vs. 4.84, P = 0.056)를 제외한 나머지 영역, 성욕(2.88 vs. 3.05), 성적흥분(3.75 vs. 3.96), 오르가즘(4.11 vs. 4.36), 성적만족도(4.15 vs. 4.33), 성교통(4.99 vs. 5.20)에서 모두 유의하게 낮았다(P<0.05). 결론 한국 중 · 노년 여성에 있어서 현성 요실금은 성기능에 영향을 미치는 중요한 위험인자이며, 요실금 치료 후 성기능이 개선되는지에 대한 후속 연구가 필요하다. Objective To evaluate the impact of symptomatic urinary incontinence (UI) on sexual function in middle- to old-aged Korean women. Methods From May 2009 to January 2010, a cross-sectional study was performed including middle- to old-aged, sexually active women who visited comprehensive screening clinic. We performed history taking, biometry, pelvic examination, laboratory test, Pelvic Floor Distress Inventory (PFDI)-20, and Female Sexual Function Index (FSFI). Symptomatic UI was said to be present when the score for the problem-specific PFDI-16/17 questions were ≥2. Participants obtaining a total FSFI score of 26.55 or less were defined as having female sexual dysfunction (FSD). Results Among 773 enrolled women, 318 (41.14%) had symptomatic UI. FSD was significantly frequent in symptomatic UI group than normal group (62.26% vs. 49.45%, P < 0.05). Symptomatic UI was associated significantly with a total FSFI score in multiple linear regression model (standardized ß = -0.108, P < 0.05). After adjustment of clinical risk factors for FSD by analysis of covariance analyses, symptomatic UI group had significantly lower scores than those of normal groups (24.59 vs. 25.74, P < 0.05), and this was observed in all sub-domains (desire 2.88 vs. 3.05; arousal 3.75 vs. 3.96; orgasm 4.11 vs. 4.36; satisfaction 4.15 vs. 4.33; pain 4.99 vs. 5.20, P < 0.05) except lubrication domain (4.70 vs. 4.84, P = 0.056). Conclusion Symptomatic UI is a risk factor for sexual dysfunction of middle- to old-aged women. Further studies should be followed to evaluate whether the treatment of symptomatic UI could restore the impaired sexual function.
진통 중에 발생한 라텍스 아나필락시스 ( anaphylaxis ) 1 예
김건우(Kun Woo Kim),김선미(Sun Mie Kim),고은미(Eun Mi Ko),심순섭(Soon Sup Shim),천대우(Dae Woo Chun),한수연(Soo Yeon Han),박중신(Joong Shin Park),전종관(Jong Kwan Jun),윤보현(Bo Hyun Yoon),신희철(Hee Chul Syn) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.2
Allergy to latex gloves has been described as an unusual complication during labor. However, IgE mediated hypersensitivity reaction to natural rubber have recently been identified as an international health problem. In this first case report in Korea, latex anaphylaxis during labor is described in an operating room nurse who has been continuously exposed to latex gloves. Because of the increasing frequency of latex allergy, obstetrician should take care and give more attention to the clinical history, as well as be aware of this possibility especially in high risk groups.
비스테로이드성 소염제의 장기 복용후 생긴 교원성 대장염 1 예
이동호,김유선,송인성,정현채,정운태,박동영,최규완,김정룡,김병관,문선희,황진혁,정준오,김찬규,김선미 대한내과학회 1997 대한내과학회지 Vol.53 No.4
Collagenous colitis is characterized clinically by chronic watery diarrhea and pathologically by increased subepithelial collagen deposition associated with an inflammatory infiltrate in the lamina propria. Its etiology is still unclear, although a variety of associated diseases such as rheumatic syndromes, scleroderma, and thyroid diseases have been reported. We report a case of collagenous colitis following the prolonged use of NSAIDs. A 72-year-old woman who has taken NSAIDs for many years due to some dermatologic problems was admitted to the hospital because of chronic watery diarrhea and colicky abdominal pain of 3 months duration. There was no abnormal physical finding except cachectic appearance due to weight loss of 10㎏ during 3 months. Stool examination for ova and parasites and fat was negative, and stool culture for bacterial pathogens was negative. In complete blood count, there were relative eosinophila and mild anemia. Total serum protein and albumin was low, and thyroid function, RA factor, FANA were all normal. Results of upper and lower gastrointestinal contrast radiographs were normal. Sigmoidoscopy revealed normal colonic mucosa but she had a thick subepithelial collagenous deposit and chronic inflammation in lamina propria on colonic biopsy. Based on the above findings, she was diagnosed as collagenous colitis. Diarrhea improved after withdrawing NSAIDs and the treatment with oral prednisolone. In the post-treatment biopsy, the thickness of the collagen hand was diminished. Collagenous colitis is now recognized as one of the common causes of chronic diarrhea of obscure origin and NSAIDs may play an etiological role in some patient with collagenous colitis.