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김영아 ( Young Ah Kim ),김한성 ( Han Seong Kim ),장두영 ( Doo Young Chang ),전경철 ( Kyug Chul Jun ),전명권 ( Myung Kwon Jeon ),이응수 ( Eung Soo Lee ) 대한산부인과학회 2011 Obstetrics & Gynecology Science Vol.54 No.2
Calcinosis circumscripta is defined by calcification in soft tissues. Clinically, calcinosis circumscripta is described as firm, white dermal papules, plaques, or subcutaneous nodules found in various sites. They commonly ulcerate, extruding a chalky white material that is frequently identified as hydroxyapatite. Calcinosis circumscripta most commonly involves the hand and wrist of middle-aged woman. The etiology and pathogenesis of calcinosis circumscripta are unknown. We experienced a case of calcinosis circumscrpita of salpinx which was suspected ovarian tumor. Calcinosis circumscripta is extremely rare in gynecologic area. Here we report the case with review of literature.
김영아 ( Young Ah Kim ),김한성 ( Han Seong Kim ),권혜성 ( Hye Seong Kwon ),신상현 ( Sang Hyun Shin ),장두영 ( Doo Young Chang ),최형민 ( Hyung Min Choi ),전명권 ( Myung Kwon Jeon ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.12
목적: 골반강 외 자궁내막증 조직에서 새로운 세포고사 저해 단백질인 survivin의 발현을 정상자궁내막과 난소 자궁내막종으로 비교 조사함으로써 골반강 외 자궁내막증의 병태생리에 세포고사가 어떻게 작용하는지 알아보고자 하였다. 방법: 본 연구는 수술 후 조직검사에서 골반강 외 자궁내막증으로 진단된 14예를 복강경으로 진단되어 제거한 난소 자궁내막종조직 13예와 자궁내막증이 없고 자궁근종으로 자궁을 적출한 정상자궁내막 34예를 대조군으로 하여 연구를 시행하였다. 면역조직학적 염색은 survivin은 rabbit antihuman polyclonal antibody를 이용하여 시행하였다. 결과: 골반강 외 자궁내막증에서 survivin의 발현은 선세포와 기질세포에서 핵내 발현은 정상자궁내막보다 증가하며 통계학적 차이를 보였다. 그러나 세포질 내 발현은 오히려 정상자궁내막이 통계학적 차이를 보이며 증가하였다. 난소 자궁내막종에서 survivin의 발현은 선세포와 기질세포에서 핵내 발현은 정상자궁내막보다 의미 있게 증가하나, 선세포와 정상자궁내막의 증식기 비교에서는 통계학적 차이를 보이지 않았다. 세포질 내 발현은 정상자궁내막이 통계학적 차이를 보이며 증가하였다. 골반강 외 자궁내막증과 난소자궁내막증에서 survivin의 발현의 차이는 없었다. 결론: 골반강 외 자궁내막증 환자에서 세포고사를 저해하는 survivin의 발현이 증가하는 것은 survivin이 골반강 외 자궁내막증의 병태 생리와 관련이 있을 것으로 생각된다. Objective: To examine survivin expression in extrapelvic endometriosis. Methods: The study group consisted of 14 cases with extrapelvic endometriosis which were confirmed histologically. The control group (total, n=47) was divided into 2 groups. Group I included normal endometrium (n=34) obtained from hysterectomy specimens with myoma and without endometriosis. Group II included ovarian endometrioma (n=13) obtained from laparoscopy. Expression of survivin was immunohistochemically confirmed. Results: In extrapelvic endometriosis, the expression of nucleus in glandular epithelium and stromal cells were significantly stronger than normal endometrium. But cytoplasm expression of glandular epithelial cells and stromal cells in extrapelvic endometriosis showed statistically lower in comparison with normal endometrium. In ovarian endometrioma, the expression of nucleus in glandular epithelial cells and stromal cells was significantly stronger than normal endometrium. But the expression of nucleus in glandular epithelial cells with ovarian endometrioma was stronger than during proliferative phase but was not significant. Also cytoplasm expression of ovarian endometrioma was lower than normal endometrium. There was no difference in survivin expression between extrapelvic endometriosis and ovarian endometrioma. Conclusions: In extrapelvic endometriosis, survivin expression was stronger than normal endometrium except cytoplasm. Our findings suggest that increased survivin expression may contribute to survival of extrapelvic implants.
임신력이 없는 여성에서 발생한 양측 수신증을 동반한 골반방선균증
신상현 ( Sang Hyun Shin ),장두영 ( Doo Young Chang ),전경철 ( Kyoung Chul Chun ),전명권 ( Myung Kwon Jeon ),김영아 ( Young Ah Kim ),이응수 ( Eung Soo Lee ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.5
Pelvic actinomycosis is well-known to be associated with the longstanding use of intrauterine devices, sometimes related with a pregnancy history and an obstetric and/or gynecologic surgery. It can extend to the retroperitoneum and may also be associated with ureteral obstruction. In this case, pelvic actinomycosis in the form of bilateral tubo-ovarian abscess extending to the retroperitoneum resulting in bilateral hydronephrosis occurred in a nulligravida woman who had only few prior sexual intercourses. Apparently, pelvic actinomycosis can occur without any specific history. Moreover, such could possibly give rise to hydronephrosis by direct extension to the retroperitoneum.
자궁내막증의 정상부위 내막에서 Survivin과 Bcl-2 발현
김윤진 ( Yun Jin Kim ),김영아 ( Young Ah Kim ),김한성 ( Han Seong Kim ),서운희 ( Woon Hee Suh ),김경구 ( Kyung Koo Kim ),장두영 ( Doo Young Chang ),전명권 ( Myung Kwon Jeon ),이응수 ( Eung Soo Lee ) 대한산부인과학회 2005 Obstetrics & Gynecology Science Vol.48 No.2
목적: 새로운 고사 (apoptosis) 저해 단백질인 survivin과 Bcl-2의 발현을 정상자궁내막과 자궁 내막증의 정상부위 내막에서 비교 조사하고자 하였다. 연구 방법: 실험군은 총 30명으로 복강경으로 자궁내막증이 진단된 환자의 정상부위 내막군 16명 (Study group I: 증식기 12명, 분비기 4명)과 자궁선근종 (Study group II: 증식기 8명, 분비기 6명)으로 자궁을 적출한 환자 14명을 대상으로 하였다. 대조군은 자궁 Objective: To examine expression of survivin and Bcl-2 in eutopic endometrium with endometriosis and without endometriosis by immunohistochemical stain. Methods: Expression of survivin and Bcl-2 was immunohistochemically investigated in eutopic endometriu
복부-골반 전산화 단층촬영으로 진단된 Fitz-Hugh-Curtis 증후군의 임상양상
신상현 ( Sang Hyun Shin ),김영아 ( Young Ah Kim ),장두영 ( Doo Young Chang ),전경철 ( Kyung Chul Jun ),전명권 ( Myung Kwon Jeon ),김경아 ( Kyung Ah Kim ) 대한산부인과학회 2011 Obstetrics & Gynecology Science Vol.54 No.1
목적: 복부-골반 전산화단층촬영으로 Fitz-Hugh-Curtis 증후군이 진단된 환자의 임상양상을 분석하고자 하였다. 연구방법: 2005년 3월부터 2010년 7월까지 본원에 복통으로 내원하여 Fitz-Hugh-Curtis 증후군으로 진단된 62명을 대상으로 하였다. Fitz-Hugh-Curtis 증후군 진단이 내려지는 과정, 이학적 소견, 영상소견, 치료 내용, 예후 등을 분석하였다. 결과: 환자들의 연령 분포는 13세에서 48세로 평균 28.56±8.77세였다. 결혼한 여성은 28명(45.2%)이었다. 증상은 복통(74.2%)이 가장 흔하였고, 질 분비물 증가(19.4%), 오심과 구토(3.2%), 발열(1.6%) 순으로 나타났다. 복부 압통의 위치는 우상복부가 41.9%로 가장 많았다. 그 다음으로 전체복부(37.1%), 우하복부(24.2%), 하복부(16.1%), 심와부(6.5%)로 나타났다. 배양검사는 50예에서 시행했으며 균 동정은 13예(26%)에서 보였다. Chlamydia trachomatis 중합효소연쇄반응 검사는 34예에서 시행했으며 70.6%가 양성으로 나왔다. 조영제 주입 후간 피막의 조영이 증가되는 소견은 100%에서 보였다. 복막 비후 15예(24.2%), 체액 축적 17예(27.4%)에서 관찰되었다. 약물치료를 받은 56명 중 49명(87.5%)에서 호전되었으며, 통증이 완전히 없어질 때까지 기간은 평균 7.60±6.48일이 걸렸다. 항생제 주사를 평균 5.25±2.91일 사용하였으며, 경구용 항생제는 14.66±7.14일 동안 사용하였다. 약물치료에서 호전되지 않거나 악화되는 7명(12.5%)은 복강경 수술을 받았다. 결론: 임상적으로 가임기 여성이 우상복부 혹은 우상복부와 하복부 부위 통증을 호소할 경우 Fitz-Hugh-Curtis 증후군을 의심하는 것이 중요하다. 이어 부인과적으로 골반 내 감염 유무를 확인하면서 C. trachomatis균 검사와 복부 전산화 단층촬영술을 실시하여 종합적으로 판단하는 것이 Fitz-Hugh-Curtis 증후군을 신속하고 정확하게 진단하는 길로 생각된다. 또한 치료 후에 재발방지를 위한 환자 교육과 꾸준한 추적관찰이 필요하다. Objective: To analyze the clinical characteristics in patients of Fitz-Hugh-Curtis syndrome diagnosed by abdomino-pelvic computed tomography (CT). Methods: We retrospectively examined the clinical courses of 62 patients who visited with abdominal pain from March 2005 to July 2010. The clinical manifestations, physical examination, laboratory manifestations, CT findings, treatments, and prognosis were analyzed. Results: The mean age of the patients ranged from 13 to 48 years and their average age was 28.56±8.77. Twenty-eight of them (45.2%) were married but all the subjects had sexual experience. The chief complaints requiring a visit to the hospital were abdominal pain (74.2%), vaginal discharge (19.4%), nausea and vomiting (3.2%), and fever (1.6%). On physical examination, location of tenderness was right upper-quadrant tenderness (41.9%), whole abdomen (37.1%), right lower-quadrant (24.2%), lower abdomen (16.1%), and epigastric area (6.5%). The isolation of bacterial pathogens was found in 26% (13/62) of them. Polymerase chain reaction tests for Chlamydia trachomatis were positive in 34 patients (70.3%). All 62 cases showed liver capsular enhancement on CT in the early arterial phase. Peritoneal thickening (24.2%) and fluid collection (27.4%) were observed in the perihepatic area. of 56 patients, 49 patients (87.5%) improved following antibiotic therapy and conservative care. Seven patients did not respond to antibiotic therapy, their symptoms improved after laparoscopic surgery. Conclusion: For women of reproductive age with acute pain in the upper right abdominal alone or together with pain in the lower abdomen, Fitz-Hugh-Curtis syndrome should be suggested during examination. Moreover, in cases suspected to be Fitz-Hugh-Curtis syndrome, gynecologic examination, abdomino-pelvic CT, and tests for C. trachomatis could provide a more rapid and accurate diagnosis. Also, education and continuous follow up after therapy would be needed.
김경구 ( Kyung Koo Kim ),주미 ( Mee Joo ),장두영 ( Doo Young Chang ),김영아 ( Young Ah Kim ),전명권 ( Myung Kwon Jeon ),이응수 ( Eung Su Lee ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.12
Neuroendocrine carcinomas of the uterine cervix are very rare cervical neoplasms. It has frequent distant metastasis at diagnosis and high recurrent rate against multimodality therapies such as surgery, chemotherapy and radiation therapy. In 1997, four ca
형우진 ( Woo Jin Hyung ),김민우 ( Min Woo Kim ),김민경 ( Min Kyung Kim ),장두영 ( Doo Young Chang ),전명권 ( Myung Kwon Jeon ),이응수 ( Eung Soo Lee ) 대한산부인과학회 2005 Obstetrics & Gynecology Science Vol.48 No.2
Pelvic actinomycosis is a rare chronic anaerobic infectious disease, which occurs most commonly in association with an IUD. It is difficult to diagnose the disease initially. In most cases, the diagnosis is made postoperatively because of its diverse clin
근치자궁절제술 및 양측 골반림프절절제술 후 발생한 유미복수
박상혜 ( Sang Hae Park ),이승수 ( Seung Soo Lee ),신상현 ( Sang Hyun Shin ),장두영 ( Doo Young Chang ),김영아 ( Young Ah Kim ),전명권 ( Myung Kwon Jeon ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.10
Chylous ascites is a disorder caused by various diseases and conditions that interfere with the abdominal or retroperitoneal lymphatics. There are several gynecologic reports on chylous ascites with radiation therapy and para-aortic lymph node dissection. However, the report of chylous ascites caused by performing only pelvic lymph node dissection was extremely rare. In most cases after surgical trauma, it is resolved after dietary managements but it may be associated with serious nutritional and immunologic consequences due to the constant loss of protein and lymphocytes. The authors experienced a 42-year-old woman with cervical cancer Ib1 who presented with chylous ascites after a radical hysterectomy and bilateral pelvic lymph node dissection. She was successfully managed by fasting and low fat diet. We report this case of chylous ascites following pelvic lymph node dissection with a brief review of literature.