임신 18주 이전 자궁부속기 종양의 수술적 처치 시 개복수술과 복강경수술의 비교연구

황호명 ( Ho Myong Hwang ),이창호 ( Chang Ho Lee ),태철민 ( Cheol Min Tae ),오병찬 ( Byung Chan Oh ),조성남 ( Sung Nam Cho ),정영주 ( Young Ju Jeong ),김종덕 ( Jong Duk Kim ),김관식 ( Kwan Sik Kim ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.9

목적 : 임신 중 진단된 자궁부속기 종양의 개복수술과 복강경수술의 결과를 비교해 봄으로써 복강경수술의 안전성 및 장단점을 살펴보고자 하였다. 연구 방법 : 1996년 1월부터 2002년 7월까지 전북대학교병원에서 임신 중 진단된 자궁부속기 종양으로 수술이 시행된 54예를 후향적으로 분석하였다. 복강경수술은 17명의 환자에서 시행되었고, 개복수술은 37명에서 시행하였다. 의무기록을 토대로 재태연령, 수술시간, 수술방법, 병리조직검사 결과, 그리고 임신의 Objective : To evaluate the safety and benefit of laparoscopic surgery compared with laparotomy for the management of adnexal tumor during pregnancy. Methods : We reviewed 54 cases of adnexal tumor during pregnancy which were managed surgically at Chonbuk

조기양막파수 환자에서 산전 Betamethasone 1 회 요법과 다회 요법의 신생아 및 임산부 감염 유병률 비교

황호명(Ho Myong Hwang),장인석(In Seck Jang),정영주(Young Ju Jeong),조성남(Sung Nam Cho) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.8

N/A Objective : The optimal management of cervical intraepithelial neoplasia (CIN) after loop electrosurgical excisional procedure (LEEP) remains controversial and reliable predictive factors of residual disease after LEEP have not been consistently identified. This study was performed to identify predictive factors for residual disease after LEEP in patients with CIN. Methods : From June 1996 to May 2000, 166 patients who received subsequent hysterectomy after LEEP according to indication in Dept. of Obstet. And Gynecol. At Chonbuk National University Hospital. The age of patients, the severity of disease, the status of resection margin, and high-risk HPV infection were analyzed for predictive values of residual disease. The student t-test and chi-square test were used for statistical analysis. Results : 1. The residual disease after hysterectomy was negative in 68.1% (113/166) and positive in 31.9% (53/166). 2. The mean age of patients with no residual disease was 45.7 years (range;27-67) and that of patients with residual disease was 49.7 years (range;32-67), showing significant difference (p=0.008). 3. Thirty-three out of 129 cases (25.6%) with negative resection margin and 20 out of 37 cases (54.1%) with positive resection margin in LEEP had residual disease, showing significant difference (p=0.001). 4. Residual disease after hysterectomy was more frequent in patients with more high grade lesions in LEEP, but there was no statistical significant difference (p>0.05). 5. There was no significant difference in the possibility of positive residual disease after hysterectomy between HPV-positive group and HPV-negative group (p=0.84). Conclusion : The negative resection margin in LEEP does not always guarantee that there is no residual disease. More aggressive treatment plan (wide conization or hysterectomy) should be considered in patients who has higher possibility of residual disease such as old age and positive resection margin in LEEP.

세침흡인 세포검사로 진단된 복벽의 자궁내막증 -2예 보고-

정명자,정연준,황호명,장규윤,문우성,강명재,이동근,Chung, Myoung-Ja,Jeong, Yeon-Jun,Hwang, Ho-Myong,Jang, Kyu-Yoon,Moon, Woo-Sung,Kang, Myoung-Jae,Lee, Dong-Geun 대한세포병리학회 2004 대한세포병리학회지 Vol.15 No.1

The incidence of endometriosis in post-operative abdominal scars is rare. We describe two cases of abdominal endometriosis diagnosed by fine needle aspiration (FNA). Both patients presented with subcutaneous masses at previous cesarean section scars with cyclic symptoms of pain. The cytologic smears were cellular and comprised two distinct cell populations consisting of epithelial and stromal components. An epithelial component consisted of flat sheets of polygonal cells and the second stromal component showed crowded clusters of spindle cells or isolated single cells. Hemosiderin-laden macrophages were found in the background. FNA offers a safe and effective tool for diagnosis of abdominal wall endometriosis.

자궁경부 상피내종양의 치료로서 환상투열요법 시행 후 잔류병변의 예측인자

임태건(Tai Gun Im),황호명(Ho Myong Hwang),정영주(Young Ju Jeong),오병찬(Byung Chan Oh) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.8

N/A Objective : The purpose of this study was to determine whether unexplained elevation of second- trimester maternal serum beta-human chorionic gonadotropin (β-hCG) is associated with adverse pregnancy outcomes. Method : Between January 1998 and December 1999, we evaluated 2112 pregnant women undergoing second trimester triple marker screening test who delivered at our hospital. Inclusion criteria were singleton pregnancy, confirmed gestational age, and hCG level greater than 2.0 MoM. The exclusion criteria were fetal anomaly, abnormal karyotype, MSAFP level greater than 2.0 MoM, uE3 level less than 0.4 MoM, and referred patients with pregnancy-induced hypertension (PIH). A group of randomly selected women with normal maternal serum hCG and AFP levels served as control. Results : Women with unexplained elevation of hCG level showed increased risks for PIH (p<0.001) and preterm delivery (p<0.003). There were no significant diffrences between study and control groups with respect to placental abruption, fetal distress, PROM, intrauterine fetal death, and apgar score. Conclusion ; Pregnancies with unexplained elevation of hCG levels should be regarded as high-risk pregnancies and managed accordingly. The combination with these biomarkers such as VEGF, plasminogen activating factor I and AT-III as a screening test for PIH may be useful.

돌출성 유경 점막하 근종의 질식 근종절제술 : Twisting - off Method

이유성(You Sung Lee),이창호(Chang Ho Lee),고희정(Hee Jung Go),백은경(Eun Kyeong Baek),김재덕(Jae Duk Kim),황호명(Ho Myong Hwang),두재균(Jae Kyun Doo) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.7

목적 : 돌출성 유경 점막하 근종을 가진 환자들에 있어 파악기구를 이용한 근종절제술의 효용성에 대해 연구하였다. 연구 방법 : 환자를 쇄석위로 자세를 취하게 한후 질내를 소독하고 자궁경부주변블록 (paracervical block)을 시행한 후 파악기구 (grasping insturment: kelley clamp, tenaculum, ring forcep)로 근종을 잡아 비틀어 (twistingoff)제거하였다. 출혈이 있는 경우 거즈나 탐폰을 삽입하였다. 결과 : 총 33명의 환자 모두에서 성공적으로 시술이 시행되었으며, 대부분의 환자에서 출혈은 경미하였고 9건에서 질내에 거즈 혹은 탐폰을 삽입하여 지혈하였으며, 1명은 다량의 출혈로 응급 자궁적출술을 시행하였다. 1주일 뒤 추적검사상 이상소견을 보이는 경우는 없었고 평균 18주간의 추적검사상 재발하거나 합병증이 발생한 경우는 없었다. 결론 : 자궁을 보존할 필요가 있는 돌출성 유경 점막하 근종 환자에서 twisting-off method는 간단하면서도 안전하게 시술될 수 있고, 환자의 이환률 감소, 비용절감 등에서도 효과적이다. Objective : To evaluate the efficacy of the twisting-off method in transvaginal removal of the pedunculated submucous myoma Methods : After paracervical block and vaginal dressing with Povidone iodine, the myoma was grasped at its widest diameter and twisted to avulse it from its attatchment. Several kinds of grasping instruments, ie. kelley clamp, tenaculum, ring forcep, was used. If there was bleeding from its detachment site, vaginal gauze or tampon was inserted for bleeding control. Results : The procedure was perfomed successfully on all 33 patients (100%). In most patients, bleeding was scanty in amount. But in one patient, emergency hysterectomy was performed because of massive uterine bleeding. The myoma varied greatly in size. Largest volume was 62.24 ㎤, and mean volume was 13.79 ㎤. Pathology revealed classic leiomyomas in most cases. Some showed endocervical polyp or endometrial polyp. Follow up examination was done, and its mean interval was eighteen weeks and no patient was recurred. Conclusion : The transvaginal removal of pedunculated submucous myoma utilizing grasping instruments may be an effective and safe procedure and the complication is minimal. Twisting-off method was may be a safe alternative to abdominal myomectomy and hysterectomy. Reproductive capacity can be preserved, also.

불임 여성에서 복식 자궁근종절제술 후 임신에 미치는 인자에 관한 연구

김재덕 ( Jae Duk Kim ),박정규 ( Jeong Kuy Park ),박선희 ( Sun Hee Park ),양미애 ( Mi Ai Yang ),문창식 ( Chang Sik Moon ),김현영 ( Dong Hyu Cho ),조동휴 ( Hyun Young Kim ),황호명 ( Ho Myong Hwang ),장인석 ( In Suck Jang ),두재균 ( 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.3

목적 : 불임 환자에 대한 치료로써 복식 자궁근종절제술의 효과와 임신성공률에 영향을 주는 요인들에 대해 알아보고자 하였다. 연구 방법 : 1995년 1월부터 2001년 12월 사이에 전북대학교 병원 산부인과에서 불임 또는 습관성 유산이 있는 39명의 여성을 대상으로 복식 자궁근종절제술을 시행하였다. 결과 : 대상 환자 39명 중 31명에서 임신이 되었으며, 그 평균 연령은 32.3세였다. 자궁근종과 더불어 다른 관련 요인이 있는 경우와 없는 경우의 임신 Objective : To determine the effect of myomectomy as a treatment for infertility and to define the factors that influence reproductive outcomes Materials and Methods : During the period from January 1995 to December 2001, on 39 patients who suffered from