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단일공법 복강경하 질식자궁절제술 110예의 고찰 및 다공법과의 비교
박병준 ( Byung Joon Park ),김용욱 ( Yong Wook Kim ),노덕영 ( Duck Yeong Ro ),김태응 ( Tae Eung Kim ),류기성 ( Ki Sung Ryu ),김장흡 ( Jang Heup Kim ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.7
Objective: To evaluate the safety and feasibility of single-port access laparoscopically assisted vaginal hysterectomy (SPA-LAVH) using conventional laparoscopic instruments compared to multi-port access laparoscopically assisted vaginal hysterectomy (MPA-LAVH). Methods: We reviewed the medical records of 220 patients with uterine leiomyoma or adenomyosis who underwent 110 SPA-LAVH and 110 MPA-LAVH in Incheon St. Mary`s Hospital between April 2007 and November 2009. We performed SPA-LAVH with conventional rigid straight laparoscopic instruments in all cases. We also performed a new vaginal cuff closure method, Kim`s Vaginal Vault Suspension Method, named after the operator (Kim, YW) in both SPA-LAVH and MPA-LAVH. Results: There was no significant difference in patients` age, operating time, uterine weight, hemoglobin change, frequency of blood transfusion, and incidence of postoperative fever between the two groups. The patients` mean age was 46.1±7.0 years (SPA-LAVH) and 45.5±6.3 years (MPA-LAVH). The mean operating time was 87.2±21.0 minutes (SPA-LAVH) and 83.3±20.3 minutes (MPA-LAVH). The mean uterine weight was 261.4±139.7 g (SPA-LAVH) and 257.8±132.9 g (MPA-LAVH). The mean hemoglobin change was 1.1±0.7 g/dL (SPA-LAVH) and 1.2±0.6 g/dL (MPA-LAVH). Neither bowel injury nor urinary tract injury occurred during the operation in the two groups. One of the SPA-LAVH and one of the MPA-LAVH cases were converted to abdominal total hysterectomy. The mean hospital stay time was shorter with SPA-LAVH (2.6±0.6 days [SPA-LAVH] and 3.3±0.7 days [MPA-LAVH], P<0.05). Conclusion: SPA-LAVH using conventional rigid straight laparoscopic instruments can be offered as a safe and feasible alternative to MPA-LAVH.
이석우 ( Suk Woo Lee ),김미란 ( Mee Ran Kim ),권동진 ( Dong Jin Kwon ),김진홍 ( Jin Hong Kim ),김장흡 ( Jang Heup Kim ),유영옥 ( Young Oak You ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.8
Objective: Observational studies suggest that osteoporosis is associated with cardiovascular disease, although another study found that metabolic syndrome (MS) has protective effects on bone. Therefore, this study examined the relationship between metabolic syndrome and bone mineral density (BMD) in postmenopausal women. Methods: We divided postmenopausal women who visited St. Vincent Hospital of the Catholic University of Korea in 2006 and 2007 into groups with and without MS and measured their body mass index (BMI), waist-hip ratio (WHR), blood pressure, serum fasting glucose, lipid profile, and BMD of the lumbar spine and femoral neck. Results: Of the 151 subjects, 66 (43%) had MS and 85 (57%) did not. The women with MS had a higher BMD at the lumbar spine and femoral neck, although after adjusting for age and BMI, this correlation was lost. Significant positive correlations were observed between BMD of the lumbar spine and both high-density lipoprotein (HDL) cholesterol and serum fasting glucose, and BMD of the femoral neck was positively correlated with serum fasting glucose level. The components of MS were not correlated with BMD in these postmenopausal women after adjusting for age and BMI. Conclusion: In our study, the higher BMD in MS was explained by the higher BMI in postmenopausal women. After adjusting for age and BMI, however, MS had no protective effect on bone mass. MS may be another risk factor for postmenopausal osteoporosis.
폐경 후 여성에서 혈청 렙틴 농도와 대사증후군과의 관계
이석우 ( Suk Woo Lee ),조현희 ( Hyun Hee Cho ),김미란 ( Mee Ran Kim ),권동진 ( Dong Jin Kwon ),김은중 ( Eun Jung Kim ),유영옥 ( Young Oak You ),김장흡 ( Jang Heup Kim ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.3
Objective: Menopause status may lead to increases of body fat, abdominal obesity, and the incidence of metabolic syndrome (MS). Leptin is an adipokine that is secreted by adipocytes and plays an important role in regulating energy homeostasis and the reproductive system. This study examined the relationship among obesity, MS, and serum leptin levels in pre- and postmenopausal women. Methods: We divided 168 women who visited St. Vincent Hospital of the Catholic University of Korea in 2006 and 2007 into premenopausal vs. postmenopausal, obese vs. non-obese groups based on their body mass index (BMI) and the presence of MS. We measured serum follicle-stimulating hormone (FSH) level, serum estradiol level, BMI, the waist-hip ratio (WHR) and visceral fat area (VFA), serum fasting glucose, lipid profile, blood pressure, and serum leptin level. Results: Of 56 premenopausal and 112 postmenopausal women, there were 21 (37.5%) premenopausal and 51 (45.5%) postmenopausal women with MS. In the non-obese premenopausal and postmenopausal women, there were positive correlations between FSH, markers of abdominal obesity such as WHR and VFA, and serum leptin after adjusting for BMI in postmenopausal women. In the MS group, only WHR was correlated with the serum leptin level after adjusting for BMI in all groups. Conclusion: Increased serum FSH level and abdominal obesity lead to an increased serum leptin level in postmenopausal women. Further studies are needed to clarify the relationship between leptin and the metabolic syndrome, risk of cardiovascular disease in postmenopausal women.
복통을 호소한 20세 환자에서 발견된 인식되지 못한 질내 이물
오은경 ( Eun Kyeong Oh ),송재연 ( Jae Yeon Song ),조현희 ( Hyun Hee Jo ),권동진 ( Dong Jin Kwon ),임용택 ( Yong Taik Lim ),유영옥 ( Young Oak Lew ),김은중 ( Eun Jung Kim ),김장흡 ( Jang Heup Kim ),김미란 ( Mee Ran Kim ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.8
The foreign bodies in vagina cause intense inflammation. Genital complaints in patients could indicate the presence of a vaginal foreign object. Vaginal bleeding and blood-stained, foul-smelling discharge are considered to be the main clinical manifestations of vaginal foreign bodies, and toilet tissue reported as the most commonly found foreign body. The insertion of foreign bodies into the vagina is not uncommon but presentation as lower abdominal pain in an gynaecological clinic is rare. The causes of insertion are sexual stimulation, sexual abuse, accident of post-surgery and most cases find a solution after vaginal speculum examination. We describe a case of foreign body in the vagina of a patient presenting with chronic lower abdominal pain but undetectable and unrecognized in general examination.