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나연식 ( Yeon Sik Na ),정지윤 ( Ji Youn Chung ),문종수 ( Chong Soo Moon ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.12
Endocervicosis refers to the presence of benign mucinous glands of endocervical type in ectopic site. It is rare and usually detected incidentally by histologic examination. The urinary bladder is the most common site, but peritoneum, small bowel, abdominal scar, outer wall of the cervix, vagina, and lymph nodes have been documented. Because this is the first documented report of endocervicosis arising in the rectus muscle in korea, we report this with a brief review of the concerned literatures.
GG-06 : Single port laparoscopic surgery experiences in Chunchoen sacred heart hospital; 37 cases
모아진,나연식,조용,노의선 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-
the aim of this study is to evaluate the use of single port laparoscopic surgery in gynecologic disease and to examine it`s impact on surgical outcomes. the medical records of 37 cased patients who underwent single port laparoscopic surgery performed by a single surgeon for gynecologic disease from December 2012 to May 2013 were retrospectively reviewed. operation inclued hysterectomy (6 cases), adnexectomy (30 cases)and staging operation (1caes). the indicatons for surgery included adnexal lesion (22cases) uterine fibroid (3 cases), preinvasive cervical disease (6 cases) ectopic pregnancy (3 cases) and borderline ovaina tumor (1 case). there was no serious postoperational complication. single port laparoscopic surgery can be applied to most gynecologic surgery without on clinical outcomes.
백민현,한지현,김주연,심승혁,나연식,이신화,박정열,김종혁,김용만,김영탁,남주현,김대연 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.98 No.-
We evaluated the usefulness of pre-operative serum CA-125 and Hormone receptors in the management of women diagnosed with uterine papillary serous carcinoma (UPSC). We hypothesized that elevated pre-operative levels of serum CA-125 and hormone receptor(HR) negative group will correlate with higher disease stage and poorer prognosis. Patients diagnosed with UPSC and treated in our institution were identified from 1989 to 2012, over a period of 23 years. All required information were extracted from EMR(electric medical records). We used Receiver operator characteristic curves (ROC) to find the optimal cut off value and quantify marker performance in UPSC. Disease free survival(DFS) and overall survival(OS) were analyzed using Kaplan-Meier method. Multivariate analyses were performed with a Cox proportional regression method. A total of 67 patients met the study criteria. Mean pre-operative serum CA-125 levels were significantly higher in patients with more advanced stage. CA-125 correlated strongly with stage. On the ROC, a cut-off of 39 IU/mL provided the best sensitivity and specificity (48% vs. 100% respectively) for extra-uterine disease. DFS and OS were longer in patients with CA-12539 U/mL.(P=0.0003) Also DFS and OS were relatively longer in patients with positive HR group but had no statistical significance.(P=0.2851) Pre-operative serum CA-125 levels correlate with stage of disease in patients with UPSC. This may be important for management planning, prognostication and counseling in these women.
박성호 ( Sung Ho Park ),나연식 ( Yon Sik Na ),정지윤 ( Ji Yoon Jung ),양성천 ( Seong Cheon Yang ),최수란 ( Su Ran Choi ),김성주 ( Sung Joo Kim ),장봉림 ( Pong Rheem Jang ),권용일 ( Yong Il Kwon ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.2
목적: 자궁외임신에 대한 임상 및 역학적 특성을 분석하고 그 조기진단과 적정한 치료법을 확인하기 위해 본 연구를 시행하였다. 연구 방법: 2000년 1월부터 2007년 12월까지 한림대학교 의료원의 자궁외임신 환자의 의무기록지를 조사하였다. 결과: 자궁외임신의 빈도는 13.6개의 분만당 1건이었고 호발 연령은 26~30세였다(29.5%). 위험인자는 과거 복부나 골반수술 병력(37.0%), 인공유산 병력(30.8%) 골반염 병력(12%), 난관불임술 병력(9.6%) 순이었다. 증상은 무월경(88.7%), 하복통(81.2%), 질출혈(60%) 순으로 나타났으며, 증상 발현은 마지막 생리시작일 후 6~8주가 47%로 가장 높은 빈도를 보였다. 혈색소는 10 gm/dL 이상이 79%였고 8 gm/dL 이하가 3.9%였다. 발생부위는 난관에 89%, 자궁각에 7.2%, 난소에 1.1%, 자궁경부에 2.7%였다. 수술은 복강경이 755예(71.6%), 개복술이 273예(25.9%), 소파수술이 26예(2.5%)에서 행해졌다. 수술 시 난관 절제가 82.4%로 가장 많았고, Methotrexate(MTX) 치료는 13예 (1.21%)에서 성공적으로 행해졌다. 결론: 자궁외임신의 조기진단은 혈청 β-hCG와 질초음파를 함께 이용하는 것이 가장 유용하다고 생각되며 치료는 복강경수술이 개복술에 비해 입원기간 및 합병증을 낮출 수 있어 향후 치료에 더욱 중요한 역할을 하리라 생각된다. Objective: The study was designed to ascertain a proper method of early diagnosis and treatment of ectopic pregnancy by analyzing its clinical and epidemiological characteristics. Methods: The medical records of patients who were diagnosed to ectopic pregnancy at Hallym medical center during the period from January 1, 2000 to December 31, 2007 have been reviewed. Results: The incidence of ectopic pregnancy was 7.3% (1,067) out of 14,519 deliveries. The most frequent age group was 26~30 (29.5%). Risk factors they had were previous histories of abdominal or pelvic surgery (37.0%), artificial abortion (30.8%), pelvic inflammatory disease (12%), and tubal sterilization (9.6%). Most frequent clinical symptoms were amenorrhea (88.7%), lower abdominal pain (81.2%), and vaginal spotting (60.0%). Percentage of patients with hemoglobin level over 10.0 gm/dL was 79% and below 8.0 gm/dL 3.9%. The clinical symptoms of ectopic pregnancy most commonly occurred after 6~8 weeks from last menstrual period (47%). Ectopic gestation was implanted on the fallopian tube in 89%, cornus in 7.2%, ovary in 1.1% and the cervix in 2.7%. Laparosopic surgeries were performed in 755 cases (71.6%) and laparotomies in 273 cases (25.9%) and dilatation and curettages in 26 cases (2.5%). Salpingectomy was performed most frequently (82.4%). Methotrexate (MTX) treatment was successful in 13 cases (1.21%). Conclusion: The early diagnosis of ectopic pregnancy is most useful when serum β-hCG and vaginal sonography are used together. Laparoscopy would be a preferred method because of its short hospitalization period and low complication rate compared with laparotomy in ectopic pregnancy treatment.