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임희순 ( Hee Sun Lim ),문영주 ( Yong Ju Moon ),정재은 ( Jae En Jung ),김민정 ( Min Jung Kim ),황성진 ( Sung Jin Hwang ),김진홍 ( Jin Hong Kim ),김장흡 ( Jang Heub Kim ),조현희 ( Hyun Hee Jo ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.5
Adenofibromas of the uterine cervix, which are classified as benign tumors of mixed epithelium and mesenchymal cells, are extremely rare. Most common symptom is usually abnormal genital bleeding. It is very difficult to diagnose preoperatively. Recommended method of treatment is total hysterectomy, because it usually recurs. We experienced a case of adenofibroma of the uterine cervix with increased CA125, so report it with a review of the literature.
임신 제 1삼분기 소파술 후 혈복강 및 자궁종괴로 나타난 감입태반
문정민 ( Jeong Min Moon ),임희순 ( Hee Sun Lim ),김종옥 ( Jong Ok Kim ),박은경 ( Eun Kyung Park ),이용석 ( Yong Seok Lee ),이해남 ( Hae Nam Lee ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.3
Placenta increta is one of lethal complications of pregnancy characterized by invasion of placenta villi into the underlying myometrium and usually presented in early postpartum period with difficult placental removal and massive bleeding. Placenta increta may complicate first and early second-trimester pregnancy loss causing profuse post-curettage hemorrhage but the lesion is rarely found and hard to diagnose. We experienced a case of hemoperitoneum caused by implanted chorionic villi on the uterine serosa regurged from uterine cavity, 6weeks after artificial abortion at gestational age of 5 weeks and 5 days.
자연 분만력의 횟수가 하부 비뇨생식기의 기능에 미치는 영향
문영주 ( Yong Ju Mon ),임희순 ( Hee Sun Lim ),정재은 ( Jae Eun Jung ),조현희 ( Hyun Hee Cho ),김미란 ( Mee Ran Kim ),유영옥 ( Yong Ok Lew ),김은중 ( Eun Jung Kim ),김장흡 ( Jang Heub Kim ),김진홍 ( Jin Hong Kim ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.4
목적: 자연분만력이 하부 비뇨생식기의 기능과 대변실금의 유병율에 어떠한 영향을 받는지 알아보고자 한다. 연구방법: 검진을 위해 산부인과 외래를 방문한 여성 중 연구에 동의한 여성을 대상으로 POP-Q (Pelvic Organ Prolapse Quantitation) stage를 측정하고 하부 비뇨기계 기능을 평가하기 위한 Bristol female lower urinary tract symptom (BFLUTS) 설문지, 그리고 변실금의 정도를 파악하기 위한 self-report questionnaire for fecal incontinence and constipation assessment 설문지를 사용하였다. 대상은 35~45세 사이의 폐경 전 연령군만 포함하였으며, 골반내장기에 대한 수술력이 있는 경우, BMI 25 이상의 비만 여성이나 만성 폐질환, 흡연자, 심혈관계 질환의 병력이나 대장질환이 있는 여성, 만성변비환자로 약물을 복용하거나 수술을 받은 과거력이 있는 여성은 대상에서 제외하였다. 결과: POP-Q에서 측정하는 8개 측정지점을 분석한 결과, Aa, Ba, Ap, Bp, Tvl 에서 자연분만력이 0인 환자 군과 1 이상인군 사이에 유의한 차이를 보였다 (P<0.05). 변실금의 발생율은 자연분만력 0회인 경우 4%, 1회인 경우 29%, 2회인 경우 32%, 3회 이상인 경우 26%로 나타났다. 분만력이 0회인 경우, 분만력이 1회 이상인 군에 비해 유의하게 변실금의 발생율이 낮은 것으로 나타났으나 (P<0.05), 분만 횟수에 따른 차이는 보이지 않았다. 요실금 증상 (BFLUTS-IS)의 유병율은 분만력이 높아질수록 증가하는 것으로 나타났다 (Pierson correlation coefficient 0.9, P<0.05). 성생활의 장애 유무를 묻는 BFLUTS-Sex 질문에서는 분만력이 증가할수록 성생활에 장애를 느끼는 환자의 비율이 증가하는 것으로 나타났다(Pierson correlation coefficient 0.7, P<0.05). 결론: 본 연구의 결과 자연분만력이 요실금 및 변실금의 발생율과 밀접한 관계가 있음을 알 수 있으며, 골반저 장애 및 성생활 장애의 주된 원인으로 작용함을 알 수 있었다. Objective: The purpose of this study was to evaluate if the number of normal vaginal deliveries influences lower urogenital system function and the incidence of incontinence. Materials and methods: The POP-Q (Pelvic Organ Prolapse Quantitation) examination was performed in 217 premenopausal women who visited our hospital for routine check up. They were asked to fill in the Bristol female lower urinary tract symptom (BFLUTS) and self-report questionnaire for fecal incontinence and constipation assessment questionnaires. Exclusion criteria included patients with a history of pelvic surgery, BMI >25, chronic lung disease, cardiovascular disease, colon disease or smoking. Results: There was a significant difference between the vaginal delivery group and none vaginal delivery group in the point Aa, Ba, Ap, Bp and Tvl in POP-Q (P<0.05). The patients were classified into four groups (0, 1, 2, above 3) according to the number of vaginal deliveries, and the incidences of fecal incontinence were 4%, 29%, 32%, 26% in each group, respectively. The incidence of fecal incontinence was significantly lower (P<0.05) in those who did not deliver vaginally, while no difference was observed in the number of vaginal deliveries. The BFLUTS-IS (incontinence symptom) score was higher in the patients with higher number of vaginal deliveries (P<0.05). There were also more patients with sexual dysfunction as was shown by the BFLUTS-sex questionnaire (P<0.05) in those patients with higher number of vaginal deliveries. Conclusion: We observed that the number of vaginal delivery is significantly associated with the incidence of fecal and urinary incontinence, and also that it was a major cause of disorders of the pelvic floor and sexual dysfunction.
조윤성 ( Yun Sung Jo ),권지영 ( Ji Young Kwon ),임희순 ( Hee Sun Lim ),문영주 ( Young Joo Mun ),이상형 ( Sang Hyoung Lee ),제동성 ( Dong Sung Jae ),한구택 ( Gu Taek Han ),류기성 ( Ki Sung Ryu ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.12
Myoma is the most common tumor in gynecologic field. As ultrasonography because popular in antenatal care, the more cases of myoma and those adverse effects during pregnancy are more frequently detected. The management of myoma during pregnancy is conservative, but in rare circumstances, surgical intervention including myomectomy may be required. We have experienced a case of protruded subserosal myoma with the uterine cervix in midtrimester of pregnancy. The patient was managed surgically by transvaginal myomectomy and had successfully maintained pregnancy. We report a case of protruded subserosal myoma through pelvic floor in pregnancy with brief review of literatures.