고 Prolactin혈증 일란계분뇨일무월경증후군 치험 2례

이승철(SC Lee),이제호(JH Lee),신희철(HC Shin),김승욱(SW Kim) 대한산부인과학회 1982 Obstetrics & Gynecology Science Vol.25 No.1

Nowadays H-G-A syndrome and its management is one of matters of concern in obstetric and gynecologic field. Authors have experienced two cases of infertility with H-G-A syndrome which were managed successfully to induce regular ovulatory cycle or to become pregnant, with bromocriptine or clomiphene and human chorionic gonadotropin resepctively.

임신에 합병된 재생불량성 빈혈의 1례

이상윤(SY Lee),김배근(BK Kim),이승철(SC Lee),한승혜(SH Han) 대한산부인과학회 1971 Obstetrics & Gynecology Science Vol.14 No.8

임신에 합병된 재생불량성 빈혈의 1례를 경험하였기에 보고하는 바이다. The case report concerns a case of complete bone marrow aplasia of unknown etiology affecting a women in the 20wks. of pregnancy. Induced labor at 27wks., with the aid of whole blood transfusion, resulted in a premature delivery. The literatures have been reviewed on this subject.

남성가성반음양의 2예

주권량(KR Joo),이승철(SC Lee),이필한(PH Lee),신희철(HC Shin),이진용(JY Lee) 대한산부인과학회 1982 Obstetrics & Gynecology Science Vol.25 No.8

신환성 여성화 증후군은 남성가성반음양의 유전적인 변체로써 표현형이 정상여성이며, 음모 혹은 액와모가 없거나 소수이고 자궁은 없다.그러나 조직학적으로 하강되지 아니한 신환과 유사한 신환을 가지고 있으며 유전학적으로는 남성이다.신환성 퇴행화 증후군은 유전학적으로는 남성이나, 신환의 손상된 시기에 따라 외성기와 내성기가 다양하게 나타난다. 금번 저자들은 신환성 여성화 증후군 1예와 신환성 퇴행화 증후군 1예를 경험하였기에 문헌적 고찰과 함께 보고하였다. Testicular feminization is a hereditary variant of male pseudohermaphroditism manifested in phenotypically normal female with sparse or absent pubic and axillary hair; the absence of the uterus; presence of gonads that are histologically like undescended testis and genetically male sex chromosome. Testicular regression syndrome is genetically male and shows variable abnormalitis of genital development according to the stages of testicular damage. Two cases of male pseudohermaphroditism are presented with brief review of literatures.

부인과적 복강경술의 진단적 응용

장윤석(YS Chang),이효표(HP Lee),이진용(JY Lee),신면우(MW Shin),나건영(KY Na),이승철(SC Lee),신영관(YK Shin) 대한산부인과학회 1983 Obstetrics & Gynecology Science Vol.26 No.2

결론 진단목적으로 1,000예를 대상으로 복강경술을 시행하여 다음과 같은 결론을 얻었다. 1. 적응증은 원발성 및 속발성 불임증 환자가 735예(73.5%)로 가장 많았고 자궁외임신이 의심되는 환자가 96예(9.6%), 불확실한 종류가 55예(5.5%), 원발성 무월경이 52예(5.2%)의 순이었다. 최근 난관불임술을 받은 환자중 난관복원술을 원하는 환자의 수술전 난관상태평가를 위한 복강경술이 점차 증가하고 있다 (2.3%) 2. 자궁난관조영술소견과 복강경소견의 일치는 총 306예중 199예(65.0%)이었다. 3. 자궁외임신을 의심하였던 96예를 복강경술로 관찰한 결과 57예(59.4%)는 자궁외임신이 확인되었고 29예(30.2%)에서는 골반내에서 이상을 발견할 수 없었다. 4. 불확실한 골반내 종양을 가졌던 총 55예중 난소배종을 의심하였던 35예를 관찰한 결과 29예(82.9%)에서 난소배종을 확인하였고 2예는 만성골반염증을 동반한 골반유착이었고 1예는 난관수종이었다. 5. 자궁근종을 의심하였던 16예중 11예가 자궁근종임을 확인하였고 나머지 중 1예는 임신을 동반한 쌍각자궁이었고 1예는 자궁각임신등이었다. 6. 52예의 원발성 무월경환자에게 복강경술을 시행한 결과 Mayer-Rokitansky-Kuster-Hauser(M-R-K-H) 증후군이 20예(38.5%), gonadal dysgenesis가 18예(34.6%), uterine agensis가 7예(13.5%)등이었다. 7. 임상적 진단으로는 개복수술을 필요로 했던 371예중 복강경술을 시행함으로써 80예(21.7%)는 불필요한 개복수술을 피할 수 있었다. With the technological advances in optics and delivery of light, laparoscopy has become easier and safer to perform and has been widely used to assess the pelvic abnormalities and infertility by most gynecologists. A clinical analysis of 1,000 consecutive cases of diagnoatic laparoscopy performed from June, 1974 to January, l982 was made. The results obtained were summarized as follows. 1. Clinical indications for laparoscopy were primary and secondary infertility (73.5%), possible ectopic pregnancy (9.6%), obscure pelvic mass (5.5%) and primary amenorrhea (5.2%). Recently, pre-operative evaluation for tubal reanastomosis in the women with previous tubal sterilization has been gradually increased(2.3%). 2. The peivic abnormalities have found in 568 cases (77.3%) of 735 infertility cases. They were represented 277 cases (33.7%) of bilateral tubal occlusion, 143 cases (19,5%) of unilateral tubal occlusion and 100 cases (13.6%) of pelvic adhesion with or without tubal occlusion. Pelvic endometriosis was found only in 4 cases (0.5%) 3. The correlation of laparoscopic findings in 306 cases with hysterosalpingo -graphy was showed that agreement between laparoscopic and hysterosalpingographic findings was found in only 199 cases (65.0%) 4. In 52 cases of primary amenorrhea, there was 20 cases (38.5%) of M-R-K-H syndrome, and 18 cases (34.6%) of gonadal dysgenesis. 5. In 96 cases of suspicious ectopic pregnancies, 57 cases (59.4%) have been proved to be ectopic pregnancy. 6. In 35 cases of suspicious ovarian cyst, 29 cases (82.9%) were found to have ovarian cyst and in 16 cases of suspicious myoma uteri, 11 cases (68.6%) were found to have myoma uteri 7. In 21.7% of patients in whom laparotomy was contemplated on clinical impre- ssion, the use of laparoscopy precluded the need for major surgery.

초산부에서 Unengaged head의 추이

원유관(YK Won),김배근(BK Kim),김재건(JK Kim),이승철(SC Lee) 대한산부인과학회 1970 Obstetrics & Gynecology Science Vol.13 No.9

Sixty-four cases of unengaged head were found by x-ray pelvimetry and cephalometry at the onset of labor in 746 primiparae with vertex presentation who were admitted since January 1968 till December 1969. In order to compare unengaged group with engaged group, sixty cases of normal vaginal delivery were selected. The result were as follows: 1. The incidence of unengaged head was nine percent. 2. The cesarean section rate was 8.4% in engaged group and 34% in unengaged group. 3. There was no relationship between unengaged head and elderly primipara. 4. There was no great difference in baby weight of newborn between engaged group and unengaged group. 5. The difference of the anteroposterior diameter and the average skull diameter which was the mean value of the largest and the shortest diameters of the anteroposteriorand lateral films, was greater in engaged group than in unengaged group. 6. There was little prolongation of duration of labor in unengaged group than in engaged group. 7. Complications of mother and newborn were higher in unengaged group than in engaged group. 8. Careful revaluation of the whole cephalopelvic interrelationship is always called for in all engaged heads in primiparae at the onset of labor.

융모성 질환의 임상적 고찰

이승철,이영혜,이형열,공지원,정은신 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.2

1984년 1월부터 1990년 6월까지 6년 6개월간 전주예수병원 산부인과에서 임상병리학적으로 진단, 치료받은 융모성 질환 62예를 대상으로 검토, 분석하여 다음과 같은 결론을 얻었다. 1. 분만 총수 18,019명에 대한 융모성 질환의 발생빈도는 1:196이었다. 2. 호발연령은 20-29세로서 41.9%로 가장 많았고, 40세이사의 고연령층도 38.7%로서 높은 비율을 차지하였다. 3. 임신횟수는 2회이하가 43.6%로 가장 많았고, 분만횟수도 1회이하가 46.8%로 가장 많았다. 4. 임상증상으로는 질 출혈이 90.3%로 가장 많았고, 빈혈 38.7%, 자궁 이상확대 37.1%, 과오조 37.1%, 복통 24.2%등으로 나타났다. 5. 선행임신에는 저위험군에서는 유산이 73.9%로, 고위험군에서는 정상만삭 임신이 51.2%로 가장 많았다. 6. 임신수주에 비교한 자궁의 크기를 보면, 저위험군에서는 Normal-for-date가 38.1%, 고위험군에서는 Large-for-date가 35.9%로 약간 많았으나 위험군별로 큰 차이는 없었다. 7. 치료결과는 저위험군에서는 수술요법 및 평균 1.7회의 화학요법으로 100% 경쾌되었고, 고위험군에서는 수술요법 및 평균 3.4회의 화학요법을 시도하여 82.1%에서 경쾌되었다. 8. 화학요법의 독성에는 간세포기능장애, 혈액학적독성, 상피세포독성, 기타 위장관 증상 등이 있었고, 그중에서 간세포기능장애가 73.5%로 가장 많았다. 9. 차기임신은 정상 만삭분만이 66.7%, 자연유산이 9.5%, 자궁외임신이 4.8%였다. This report was written to evaluate the clinical characteristics and the outcome of management of trophoblastic disease which had been diagnosed at presbyterian mdical Center in Chonju. From January 1984 to June 1990, 92 cases were diagnosed of trophoblastic disease. Among them, we dealt retrospectively 62 cases which its chronice was satisfied. The results were as follows; The incidence of GTD was 1:196 and the incidence of H-mole was 1:265. Abnormal vaginal bleeding was a main symptom and sign for early detection and the periodic check of beta subunits of Human Chrionic Gondadotropin was needed for diagnosis and following-up of the disease. In the basis of Bagshawes prognostic scoring system, we divided the patient to two groups; the one was lower risk group below 7 score and the other was high-risk group above 7 score. Most common antecedent pregnancy of GTD was abortion in low-risk goup and full term pregnancy in high-risk group. We depended the management on the surgical method and/or chemotherapy. Overall rate of remission was 100% in low-risk group, 82.1% in high-risk group and subsequent pregnancies were not different from general population relatively.