폐경기 자궁 액체 축척 여성에서 자궁두께에 따른 조직학적 소견

김흥열,김흥배,어완규 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2

Objectives : The aim of the study was to assess the hitologic appearance according to endometrial thickness in postmenopausa endometrial fluid accumulation women. Methods : A group of 20 postmenopausal women with an endometrial fluid accumulation confirmed by ultrasonography and underwent Dilatation & Curettage. The patients were divided into two groups according to the endometrial thickness(ET). Sixteen women had thin endometrium (<4mm) and four women had the thick endometrium (≥4mm). Results : When ET was ≥ 4mm, proliferative endometrium was found in 2 patients (50%), atrophic endometrium was in I patient (25%) and endometritis was in I patient (25%). When ET was < 4mm, atrophic endometrium was found in 14 patients (87%), A majority of patients with ET of less than 4mm in ultrasound had atrophic endometrium. The incidence of intrauterine pathology increased with the increasing thickness of endometrium as abserved by ultrasound. Conclusion : The presence of endometrial fluid accumulation in postmenopausal patients without any symptoms seems to be a benign condition. Normal endometrium of less than 4mm observed by ultrasound in postmenopausal women without vaginal bleeding dose not necessarily need further surgical investigation.

복강경하 질식 전자궁적출술과 질식 전자궁적출술의 임상적 비교

최종열,이천준,김흥열 고신대학교 의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Objective : To compare the advantages and disadvantages between laparoscopically assisted vaginal hysterectomy (LAVH) and total vaginal hysterectomy (TVH). Methods : We reviewed the medical records of patients who underwent LAVH and TVH from January 2004 to December 2006. We investigated the difference between LAVH group and TVH group in relation to age, weight, parity, previous abdominal operation, indication for hysterectomy, uterine weight, combined operation, operation time, postoperative hemoglobin change, gas out day, postoperative discharge day, and complications. Results : The most common indication of both group was uterine leiomyoma and/or adenomyosis, especially carcinoma in situ of uterine cervix or cervical cancer Ia1 were more frequent indication in LAVH group than TVH group (p=0.018). Operation time of LAVH group was significantly more longer than TVH group, 173.21 mins vs 127.36 mins respectively (p<0.001), and postoperative discharge day of LAVH group was more longer than TVH group, 5.59 days vs 4.86 days respectively (p=0.034). But there was not statistically significant difference between TVH group and LAVH group in relation to others: age, weight, parity, previous abdominal operation, uterine weight, combined operation, postoperative hemoglobin change, gas out day, and complications. Conclusion : Both LAVH and TVH have many following advantages compared with abdominal hysterectomy: less pain, shorter hospital day, cosmetic advantages, and lower mobidity. TVH even can be done safely in cases of large uterus or previous abdominal operation, but disadvantages of that are limited operation field and no visible abdominal cavity. In comparison, LAVH offers a view of abdominal cavity and can perform adnexal operation or adhesiolysis, but disadvantage of that is high cost. Thus the study in relation to appropriate selection of hysterectomy will be necessary to satisfy patient and lower cost.

여성의 갱년기 치료요법

김홍열 고신대학교 의학부 1993 高神大學校 醫學部 論文集 Vol.9 No.2

Menopause is an event common to all women. For some women, it is not difficult, but for many it arrives with complication, both physiological and psychological. Although there is perhaps no gynecologic disorder in which the indication for hormone therapy is more rational than in the treatment of typical climacteric symptoms, especially the vasomotor group, it must be remembered that many symptoms frequently observed in menopausal women are not directly due to the endocrine readjustments of this period but are more logically explained as due to environmental and psychogenic factors. Estrogen therapy is indicated for the control of acute symptoms of the hot flush and insomnia. If treated soon after onset with adequate dosage, the symptoms can usually be controlled rapidly. As the menopausal woman is not totally estrogen deficient, but only relatively deficient in respect to reproductive capacity. some women will not need constant low-dose estrogen replacement therapy as indicated in the premature menopausal patient. Prophylactic estrogen therapy for the prevention of arteriosclerotic cardiovascular disease may be needed. For the patient at risk for osteoporosis, low-dose prophylactic estrogen therapy may be needed. The action of estrogen on bone is to prevent calcium resorption, and there is little evidence that it will stimulate new bone formation. The two cardinal principles of hormon therapy are most important in such long-term treatment, as little "as necessary to control symptoms over as short as possible a duration" Consequently, today a healthy fifty-year-old women can resonably expect to live for another thirty to forty years.

유년형 난소 과립막 세포종 2예

어완규,김흥열,김홍배 고신대학교 의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2

난소의 성기삭-간질 종양은 전체 난소 종양의 약 5~8% 를 차지하는 드문 종양으로서 그 중 약 70%는 과립막 세포종이다. 대부분 30세 이전에 발생하는 유년형 과립막 세포종은 전형적인 성인형 과립막 세포종에 비해서 임상적 및 병리학적 측면에서 매우 다른 양상을 나타낸다. 유년형 과립막 세포종은 대부분 좋은 예후를 나타내지만, 종양이 진행된 경우에는 병기, 종양의 크기, 피막 파열 여부, 핵의 비정형 정도, 유사분열 정도와 관련되어 나쁜 임상적 예후를 나타낸다. 유년형 과립막 세포종은 병기가 낮은 경우 수술이 최상의 치료 방법이지만, 병기가 높거나 재발된 종양에 대한 치료 방법은 아직 명확하지 않다. 저자들은 난소의 유년형 과립막 세포종 2예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Sex cord-stromal tumors of the ovary are rare neoplasms that account for about 5~8% of all ovarian malignancies, and about 70% of those are granulosa cell tumors. Juvenile granulosa cell tumor (JGCT), which occurs most frequently in the first two decades, has distinct differences from adult granulosa cell tumor (AGCT) with regard to clinical and pathological features. The prognosis of JGCT in children is good in most cases, but tumor with more advanced disease has worse clinical outcome correlated with its stage, tumor size, presence of ruptures, grade of nuclear atypia, and degree of mitotic activity. The best treatment choice for low stage JGCT is surgery, but those for advanced stage JGCT or recurrent tumor have not yet been determined clearly. We present two cases of JGCT with brief review of literatures.

참쑥잎의 정유성분 조사

이진희, 홍열, 임흥빈 충북대학교 연초연구소 2008 煙草硏究 Vol.21 No.-

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폐경 후 자궁 출혈과 내막암에 관한 상관관계

오영림,김흥열,정민형,지용일 고신대학교 의과대학 2011 고신대학교 의과대학 학술지 Vol.26 No.1

OBJECTIVES: To investigate correlation between risk factors of endometrial carcinoma and histopatholgic findings of endometrium. METHODS: We reviewed medical records of 148 postmenopausal women with abnormal uterine bleeding, who underwent endometrial biopsy from January 2009 to April 2010. Women who had hematologic disease, or had non-uterine pelvic diseases were excluded. Hormone therapy was performed in indicated subjects. Age, body mass index (BMI), associated diseases, endometrial thickness checked by transvaginal sonography, whether hormone therapy was used were reviewed according to endometrial histopathology. RESULTS: Mean age of the subjects was 58.9 +/- 8.4years old. Among the endometrial histopathologic findings, atrophic endometrium was the most common finding (32.7%), followed by hyperplastic endometrium (17.8%), endometrial carcinoma (10.4%), and endometrial polyp (9.2%). BMI was not correlation of the prevalence of endometrial carcinoma and endometrial hyperplasia. Mean endometrial thickness was 9.8 +/- 5.56 mm, while it was 14.0 +/- 5.89 mm in endometrial hyperplasia, and 16.0 +/- 6.56 mm in endometrial carcinoma. The prevalence of endometrial cancer was high in those whose endometrial thickness was more than 10 mm (P < 0.001). The prevalence of endometrial hyperplasia in those whose postmenopausal bleeding was related to hormone therapy was higher than of women in whom hormone therapy was not performed. However, there were no statistical significance. CONCLUSIONS: Postmenopausal bleeding must be considered as indicative of malignant disease until proven otherwise. Endometrial biopsy should be performed to exclude endometrial carcinoma in postmenopausal women whose endometrial thickness measured by transvaginal sonography is thick.

부산지역 여대생들을 대상으로 한 성의식 실태 조사

오영림,김흥열 고신대학교 의과대학 2009 고신대학교 의과대학 학술지 Vol.24 No.2

Objective: This survey aims to analyze unmarried women's attitude toward sex in Busan. We researched sexual experiences, experiences regarding sex education, attitude toward sex, experiences of contraception/contraceptive awareness and use to indicate the direction of the future. Methods: The respondents were 456 unmarried college girls from 17 to 25 years old. The question about general characteristics, general characteristics, general sexual awareness, coitus history and contraception were given to them. The survey were undergone from June to December, 2007. Result: The age distribution of 456 respondents was 156 (34%) of age 17-19, 257 (56%) of age 20-22 and 40 (9%) of age 23-25, 84% of respondents were christian and it was the most common religion. 4% of respondents were found to have sexual experience. The mean age of first intercourse was 20.4 and thee average number of coitus was 20.1 and the average number of sexual partner was 1.53. Among single females aged 17-25, 0.02% were found to have a sex partner currently. They were found to have sexual intercourse 7.3 times per month on average. Most respondents got sex education at educational institutions like middle school (78%) and high school (71%), However, only 11% were satisfied with the contents of sex education. About a half of respondents got sex history were worried about pregnancy and 59% were found to always use contraceptives. Condom (85%), periodic abstinence (46%), coitus interruptus (31%) and oral contraceptives (8%) were commonly used contraceptive methods. Conclusion: As unmarried womens get older, gradually opened sexually. Therefore, more practical sex education about effective contraception to prevent unwanted pregnancy is necessary according to our survey.

측백나무 잎의 정유성분 조사

임동균, 홍열, 임흥빈 충북대학교 연초연구소 2008 煙草硏究 Vol.21 No.-

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생강나무 잎과 가지의 정유성분 비교

고건우, 홍열, 임흥빈 충북대학교 연초연구소 2008 煙草硏究 Vol.21 No.-

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국내산 당귀의 정유성분 조사

이태항, 홍열, 임흥빈 충북대학교 연초연구소 2008 煙草硏究 Vol.21 No.-

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