다발성 전이를 동반한 거대난소 내배엽동종양 1 례

김경리(GL Kim),강기주(GJ Kang),조혜원(HW Cho),박상원(SW Park),신반철(BC Shin),이규섭(KS Lee),김원희(WW Kim) 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.7

The endodermal sinus tumor(EST) is the second most frequent malignant germ cell tumor of the ovary, primarily affecting children and young adults. Earlier reports described that EST had the extremely poor prognosis and almost uniformly fatal outcome, but recently with adequate surgery, combination chemotherapy using cisplatin, vinblastine, bleomycin, actinomycin D, cyclophosphamide and meticulous monitoring with serum alpha-fetoprotein(AFP) titers determined by radioimmunoassay(RIA). its survival rates is markedly improved. The authors experienced a caes of huge endodermal sinus tumor of the ovary in 25-year old nulligravida complaining abdominal pain and abdominal distension that had begun one month earlier. The authors report this case with a brief review of the literatures.

Ham`s F-10 배양액에서 Hypoxanthine이 생쥐배아의 체외성장에 미치는 영향에 관한 연구

이규섭(KS Lee),김원희(WW Kim),최욱환(OH Choi),윤만수(MS Yoon),나용진(YJ Na),이후형(HH Lee) 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.3

In an effort to improve the invitro culture conditions of human gamates and embryos in our laboratory, this study was undertaken to assess the presence of hypoxanthine in Ham`s Nutrient Mixture F-10, a chemically defined, complex medium, commonly used for invitro fertilization of human as well as animal oocytes, affects embryogenesis in our two-cell mouse embryo bioassay. For the two-cell mouse embryo bioassay, embryos extracted from each female mouse oviduct were equally distributed and incubated weparately in Ham`s F-10 with or without hypoxanthine supplementation, and either without any protein supplementation or with additional pretein(4 mg/ml BSA or 10% human cord surum). Individual embryos were categorized as follows: 3-to 4-celll, 6-to 8-cel, morula, and blastocyst. Results were expressed as the proportion of embryoos in each test dish achieving or surpassing the specified developmental stage at 24 hours intervals for a period of 72 hours. The results were as follows: 1. At 72 hours of incubation, 52.6% of the embryos without hypoxanthine reached the blastocyst stage, compared with 37.6%(p0.05). 3. The addition of human cord serum supplementation to the Hams F-10 without hypoxanthine was revealed a high percentage(73.1%) of the 2-cell mebryos developed into blastocysts, compared with 58.9%(p

X선 골반계측에 관한 산과학적 고찰

박기홍(KH Park),박은정(EJ Park),김원희(WW Kim) 대한산부인과학회 1982 Obstetrics & Gynecology Science Vol.25 No.1

1977년 1월 1일부터 1979년 6월 30일까지 만 2년 6개월간 부산대학병원 산부인과에 내원하여 Colcher-Sussman X선 골반게측의 적응이 되었던 149례에 대하여 그당시에 측정하였던 골반의 각경선과 분만직후에 측정하였던 신생아체중 및 측두경을 이용하여 아두골반불균형과의 관계를 고찰하여 다음과 같은 결과를 얻었다. 1. 임신 37주 이후에 분만한 산모중 X선골반계측의 적응의 빈도는 17.7%였다. 2. 119레의 X선 골반게측을 요한 두위난산례에 있어 정상질식분만이 19.3%, 흡입 및 감자분만이 41.2% 제절율은 39.5%였다. 3. 골반입구의 전후경이 10.0 cm 이하일 때 제절율은 66.7%로서 10.0-10.4 cm군의 44.8%, 10.5 cm이상군의 32.0%와 현저한 차이가 있었다. 4. 골반입구의 횡경의 크기에 따른 분만방식의 차이는 현저하지 않았다. 5. 골반입구의 전후경과 신생아측두경의 차가 1.0cm이하군에서는 제절율이 51.8%이었고, 특히 신생아체중이 3,500 gm이상인 군에서는 60%로 나타났으며 1.0-1.9 cm군에서 제절율은 23.1%, 그리고 2.0 cm이상군에서는 11.8%를 나타내었다. 6. 중위골반의 횡경이 8.5 cm이하군 및 8.5-8.9 cm군에서는 제절율이 각각 100%, 75.0%로 현저히 높았고, 흡입 및 감자분만은 9.0-9.4 cm군과 9.5 cm이상군에서 각각 43.5%로 빈도가 높았다. 7. 중위골반의 횡경과 신생아의 측두경의 차이는 분만결과와 별관계가 없었다. 8. 골반입구부의 형태학적 분류는 남성형이 51.3%로 가장 빈도가 높았고, 태아두위는 좌측이 71.4%로 빈번하였다. 9. 유도분만목적으로 X선골반계측을 한 18레중 제절율은 11.1%였다. 10. X선골반계측에 의한 골반판정의 분만결과는 골반게측치가 질식분만에 적절하다고 판정된 65례 중 2례(3.1%)에서 제절술이 시행되었고, 경계부의 아두골반불균형으로 판정된 48레 중 23례(47.9%)에서 제절술이 시행되었다. This study was carried out retrospectively based on the clinical charts of 149 obstetrical patients who had X-ray pelvimetry for various indications from Jan. 1, 1977 to Jun. 30, 1979. Number of total deliveries at the Dept. of Ob.& Gyn., BNUH during that period was 841. The various diameters of the pelvis were measured by the Colcher-Sussman technique and the biparietal diameter and weight of baby were checked immediately after delivery. X-ray pelvimetry has been widely used over the years and has been generally accepted as oneof the clinical tools in evaluating cephalopelvic disproportion but since labor and its outcome are a very delicate and dynamic process, the author mainly concerned to relationships between pelvic diameter and fetal weight-size factors in this study. The results obtained were summarized as follows: 1. Incidence of X-ray pelvimetry on pregnant woman after 37 gestational weeks was 17.7% 2. 119 patients had X-ray pelvimetry because of prolonged labor with vertex presentation, among these patients, 23(19.3) were delivered by spontaneous vaginal delivery, 49 (41.2%) were by vacuum of forceps delivery, and the ramaining 47(39.5%) by c-section. 3. When the A-P diameter of the inlet was less than 10.0 cm, the c-section rate was 66.7%, while 10.0cm to 10.4 group and 10.5 cm or more group showed rates of 44.8% and 39.5% respectively. 4. Measurements of the transverse diameter of the inlet did effect little to the outcome of delivery. 5. When the difference of A-P diameter of the inlet and the biparietal diameter of the neonates head was less than 1.0cm, the c-section rate was 51.3%, however, when the difference was between 1.0cm and 1.9cm, the c-section rate was 23.1%, and 2.0cm or more, the rate was 11.8%. 6. When the transverse diameter of the midepelvis was less than 8.5 cm, all babies were delivered abdominally, but in the group in which the diameter was between 8.5 cm and 8.9 cm, c-section rate was 75%. In 9.0cm-9.4 as well as 9.5cm or more, vacuum or forceps deliveries were more frequent. 7. the difference between the transverse diameter of midepelvis and the newborn biparieta diameter was not significant to the outcome of delivery. 8. In the classification of pelvic shapes, android type was the most frequent and in the position of fetal head, left occiput was more frequent than right. 9. When the X-ray pelvimetry was indicated for electivey induction, the subsequent c-section rate was 11.1%). 10. Among 65 patients who was considered to have adequate pelvis according to X-ray pelvimetry, only 2(3.1%) ended up with c-section and among 48 patients who had possible borderline cephalopelvic disproportion, the c-section was done in 23 cases(47.8%).

Mclnodoe 수술후 인공질에 발생한 Condyloma Acumnata 1 례

장진석(JS Jang),김경리(GL Kim),강기주(GJ Kang),김원희(WW Kim) 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.3

Mayer-Rokitansky-Kuster-Hauser syndrome is an unusual Mullerian duct anomaly and commonly associated with developmental anomalies of other organs such as urinary tract and skeleton. McIndoe operation is the method of choice in making the artificial vagina in most of the cases. We experienced a case of condyloma acuminata on the well taken artificial vagina. This is to report this case with a brief review of the literatures.

자궁선근종에 대한 임상적 고찰

최욱환(OH Choi),신영주(WJ Shin),김원희(WW Kim) 대한산부인과학회 1982 Obstetrics & Gynecology Science Vol.25 No.6

저자는 1970년 1월부터 197년 12월말까지 만 10년간 부산대학교 부산병원 산부인과와 부산복음병원 산부인과에서 시행한 자궁적출술 668례중 병리조직검사상 자궁선근증으로 진단된 86례에 대하여 임상기록지를 통하여 관찰한 결과를 요약하면 다음과 같다. 1. 자궁선근증의 발생빈도는 동기간중 시행한 자궁적출술 전례의 12.8%이었다. 2. 자궁선근증의 발생연령분포는 22세에서 78세까지로 평균연령은 46.3세이었으며, 45-49세군이 가장 높은 빈도(26.7%)를 나타내었다. 3. 분만회수는 3-4회군이 가장 많았고, 경산부가 약95%이었다. 4. 자궁선근증으로 진단된 호나자의 주소는 월경과다가 63.6%로 가장 많았고, 월경통이 52.4%, 하복통이 45.4%등의 순서이었다. 5. 수술의 적응증은 자궁근종이 61.6%로 가장 많았고 자궁선근증이 18.6%, 만성자궁경부염, 기능성 자궁출혈, 난소종양이 각각 10%이었다. 6. 자궁선근증과 동반된 질환으로서 만성자궁경부염이 61.6%로 가장 많았고 자궁근종이 25.2%, 난소낭종이 16.2%등의 순위이었다. 7. 본 조사에서 자궁선근증과 자궁내막증이 동반된예는 관찰되지 않았다. 8. 자궁선근증의 수술전 진단의 정확도는 18.6%이었다. This retrospective clinical study was attempted to analyse 86 cases of adenomyosis among 668 hysterectomized cases in the Department of Obstetrics and Gynecology, Busan National University Hospital and Busan Gospel Hospital, during 10 years, from Jan., 1, 1970 to Dec., 31, 1979. The results obtained were summarized as follows; 1. 86 cases of adenomyosis were found in 668 hysterectomized uteri for various reasons, showing an incidence of 12.8%. 2. Age distribution were between 22 and 78 years, and average age was 46.3 and 44.2% of patients belonged in 40 to 49 year group. 3. Adenomyosis was far more frequently noted in parous women(95.4%) than nonparous women. 4. Menorrhagia was the most common symptom of adenomoysis, giving 63.6% of all cases; 5. Myoma uteri was the most common indication for operation, showing an incidence of 43%. 6. The common combined diseases in adenomyosis were chronic cervicitis and myoma uteri with the incidence of 61.6% and 25.5% respectively. 7. Endometriosis was not combined with adenomyosis in this study. 8. Preoperative diagnostic accuracy for adenomyosis was 18.6%.

자궁선근증에 대한 임상적 고찰

최욱환(OH Choi),이규섭(KS Lee),김원희(WW Kim) 대한산부인과학회 1981 Obstetrics & Gynecology Science Vol.24 No.8

저자는 1970년 1월부터 1979년 12월말까지 만 10년간 부산대학교 부속병원 산부인과와 부산 복음병원 산부인과에서 시행한 자궁적출술 668예 중 병리조직검사상 자궁선종증으로 진단된 86례에 대하여 임상기록지를 통하여 관찰한 결과를 요약하면 다음과 같다. 1. 자궁선근증의 발생빈도는 동기간중 시행한 자궁적출술 전례의 12.8%이었다. 2. 자궁선근증의 발생연령분포는 22세에서 78세까지로 평균연령은 46.3세이었으며 45-49세군 이 가장 높은 빈도를 나타내었다. 3. 분만횟수는 3-4회군이 가장 많았고 경산부가 약 95%이었다. 4. 자궁선근증으로 진단된 환자의 주소는 월경과다가 63.6%로 가장 많았고, 월경통이 52.4% 하복통이 45.4%등의 순서이었다. 5. 수술의 적응증은 자궁근종이 61.6%로 가장 많았고 자궁선근증이 18.6%, 만성자궁경부염, 기능성자궁출혈, 난소종양이 각각 10%이었다. 6. 자궁선근종과 동반된 질환으로서 만성자궁경부염이 61.6%로 가장 많았고 자궁근종이 25.2% 난소낭종이 16.2% 등의 순위이었다. 7. 본 조사에서 자궁선근종과 자궁내막증이 동반된 예는 관찰되지 않았다. 8. 자궁선근증의 수술전 진단의 정확도는 18.6%였다. This retrospective clinical study was attempted to analysise 86 cases of adenomyosis among 668 hysterectomized cases in the Department of Obstetrics and Gynecology College of Medicine, Pusan National University Hospital during 10 years from Jan.1,1970 to Dec. 31 1979. The results obtained were summarized as follows; 1. 86 cases of adenomyosis were found in 668 hysterectomized for various reasons, showing an incidence of 12.8% 2. Age distribution were between 22 and 78 years and average age was 46.3 and 44.2% of patients belonged in 40 to 49 year group. 3. Adenomyosis was far more frequently noted in parous women (95.4%) than nonparous women. 4. Menorrhagia was the most common symptom of adenomyosis giving 63.6% of all cases. 5. Myoma uteri was the most common indication for operation showing an incidence of 43%. 6. The common combined diseases in adenomyosis were chronic cervicitis and myoma uteri with the incidence of 61.6% and 25.5% respectively. 7. Endometriosis was not combined with adenomyosis in this study. 8. Preoperative diagnostic accuracy for adenomyosis was 18.6%.

NST에 반응성인 정상 및 고위험 임부의 태아심박 양상

윤만수(MS Yoon),신영주(WJ Shin),김원희(WW Kim) 대한산부인과학회 1983 Obstetrics & Gynecology Science Vol.26 No.3

저자는 1982년 3월 1일부터 5월 15일까지 부산대학교 의과대학 부속병원 산부인과 외래에 내원하였던 임부중 태아감시 기구를 이용한 non-stress test에 반응성이었던 정상임부 47례, 고위험 임부 39례를 대상으로하여 태아심박 양상을 비교하여 다음과 같이 요약한다. 1. non-stress test에 반응성인 경우 기준 태아심박수, oscillation빈도, 태동회수, 태동에 따른 태아심박수 증 가등은 정상임부와 고위험 임부간에 의의있는 차이를 나타내지 아니하였다. 2. oscillation진폭은 고위험 임부군이 정상임부군보다 의의있게 낮은 치를 나타내었다. 3. Fischer의 점수제를 수정 적용하였을때 정상임부 에서의 임신주수 및 초·경산부에 따른 점수치 사이에 의의있는 차이는 없었다. 4. 수정 Fischer점수는 정상임부가 11.0, 고위험 임부가 9.6으로 고위험 임부가 의의있게 낮은 치를 나타내었다. By means of fetal monitor, this study was carried out to evaluate the fetal heart rate pattern in 47 normal and 39 high-risk pregnant women with reactive non-stress test at various stage of gestation from 34th to 44th weeks, who visited out-patient department at Busan National University Hospital from March 1, 1982 tO May 15, 1982. The results of this study were summerized as follows: 1. There was no significant differences on comparative observations for beseline FHR, oscillation frequency, frequency of fetal movement, and FHR acceleration according to fetal movement between normal and high-risk pregnancy· 2. There was significantly lower value on comparative observations for oscillation amplitude in the high-risk pregnancy to normal pregnancy. 3. By using of modified Fischer`s scoring system, there was no significant differ- ences in the score value in normal pregnancy according to gestational age and score value between nullipara and multipara. 4. on comparative observations for the score value between normal and high­ risk pregnancy by using modified Fischer`s scoring system, there was significantly lower value in the high-risk pregnancy than in normal group (11.0 in normal pre- gnancy, 9.6 in high-risk pregnancy).

자궁근종의 비만세포에 관한 연구

이옥경(OK Ri),박은정(EJ Park),김원희(WW Kim) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.6

Author has counted the number of mast cells in the pathologic sections of 51 cases of leiomyoma of the uterus as well as 34 cases of normal uterine myometrium, both of which were obtained from the hysterectomy specimens operated at Pusan National University Hospital from January, 1981 to March, 1983. Cases were randomly selected and the sections were stained with Bismarck brown stain. The result of this study was as follows: 1. The number of mast cells were found to be fairly constant in normal myometrium. 2. The average number of mast cells in leiomyoma uteri tended to be lower than those of normal uterine myometrium. 3. There was no relationship between the number of mast cells and age or parity in normal uterine myometrium. 4. In leiomyoma, the size of the uterus had none to do with the number of mast cells but the higher the parity was, the increased number of mast cell was. 5. Myoma sections from the patients with menometrorrhagia had more mast cells than those from the patients with no menstrual abnormality.

체외수정 및 배아이식후 발생한 병합임신 1 례

이승환(SH Lee),김연주(YJ Kim),오대식(DS Oh),나용진(YJ Na),이규섭(KS Lee),김원희(WW Kim) 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.9

The coexixtence of intrauterine and extrauterine gestations is a rare obstetric phenomenon. The incidence of combined pregnancies has been considered to be very low, that is, 1/30,000 intrauterine pregnancies, but recently as increased numbers of women handled by assisted reproductive technology(ART), the presence of simultaneous intrauterine and ectopic gestations should no longer be considered a rarity. The authors experienced one case of the combined pregnancy following IVF-ET procedure confirmed by pathologic examination of surgical rexection of right ishmic pregnancy and intrauterine twin pregnancy by ultrasound. The authors report this case with a brief review of literatures.

정상임신에 있어서의 임신주수에 따른 태아두대횡경치에 관한 연구

이준덕(JD Lee),윤만수(MS Yoon),최종길(JK Choi),김원희(WW Kim) 대한산부인과학회 1983 Obstetrics & Gynecology Science Vol.26 No.2

결론 저자는 1980년 10월 1일 부터 1981년 9월 30일 까지 부산대학교 의과대학 부속병원 산부인과 외래에 내원하였던 정상임부 218명을 대상으로 실시 초음파 장치를 이용하여 태아두대회경치를 총 340회 측정하여 다음과 같이 요약한다. 1) 임신 재태기간 제 16주부터 42주 까지의 이신주수에 따른 태아두대횡경치는 y=0.23x+0.33(cm)(r=0.96, p<0.01)도 정도 성장하고, 임신 재태기간 제 16주부터 28주까지는 평균 주당 2.8mm로 제 29주 부터 42주 까지는 평균 주당 1.5mm의 증가율을 나타내어 임신이 진행할수록 태아두의 발육도가 둔화된다는 것을 알 수 있었다. 2) 태아두대횡경치 3.6cm에서 9.5cm까지 태아주령의 증가양상을 회귀직선 y=3.57x+3.35(주) (r=0.92, p<0.01)로 나타낼 수 있었고 이로서 임신주형을 예측할 수 있었다. By means of the real-time B-scan method,340 observations were made on 218 normal pregnant women with uncomplicated pregnancies at various stage of gesta- tion from 16th to weeks, who ⅵsited out-patient department at Busan Natio-nal University Hospital from October 1, 1980 to September 30, 1981. The results of observations for this study were summerized as follows: 1. Tlie regression line of biparietal diameter according to various stage of gestarion from 16th to 42nd weeks were y=0.23×+0.33(r=0.96, p 0.01), and the growth rate of biparietal diameter of 16th~28th gestational weeks (2.8mm/wk.) was faster than that of 29th~42nd gestational weeks (1.5mm/wk). 2. Regression line of gestational age according to specific biparietal diameter from 3.6 to 9.4cm were y=3.57×+3.35(weeks)(r=0.92, p 0.01), and the expec-ted gestational weeks could be calculated from the regression line.