산부인과영역 난관질환에서 선택적 난관조영술의 임상적 응용

문준(J Moon),박용군(YK Park) 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.11

The selective salpingogram is a simple and non-invasive method for the diagnosis and treatment of various tubal diseases. Describing the procedure of selective salpingogram, cervical canula is initially inserted into the uterus and supported by ballooning. And then, a 6F catheter is inserter into the tubal ostium with the aid of a J-shaped guid wire and the guide wire is advanced into the tube under fluroscopy. In previous studies, they applied this method for the treatment of proximal tubal obstruction only, but we used this method for both treatment and diagnosis of the tubal obstruction, treatment of the unruptured tubal pregnancy by injection of PG F2a and GIFT. We recanalized the 130 cases(87.8%) among the proximal tubal obstruction group and pregnancy rate of recanalized patients was 31.4%. Using this method, we found the 28 cases of fimbrial obstruction, which could not be detected by conventional hysterosalpingogram. We used this method for the treatment of cases with unruptured tubal pregnances by local PGF2a injection. The successful rate of this treatment was 66.7%. In conlcusion, we suggest that we use the selective salpingogram as a safe and simple method for the treatment & diagnosis of various fallopian tubal diaseases.

반흔 자궁내막증 2 예

문준(J Moon),이희경(HK Lee),선우태원(TW Sunwoo),주갑순(KS Ju) 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.9

Scar endometriosis is one of the rare conditions among the pelvic endometriois. It occurs most commonly after pelvic operation. & episiotomy. Two cases of scar endometriosis following Cesarean section & epsiotomy were presented here in a brief review of the literatures.

상피성 난소암에 있어서 DNA Flow Cytometry의 임상적 의의

문준(J Moon),이상희(SH Lee),김해중(HJ Kim),이규완(KW Lee),구병삼(BS Koo),김인선(HS Kim) 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.6

We investigated the clinical significance of DNA content and proliferative activity or tumor cell populations as flow cytometry analysis from twenty epithelial malignant turmor of the ovary and seven boderline malignant tumors of the ovary. The DNA aneuploidy was found in nine cases of twenty malignant epithelial tumors(45.0%) of the ovary and one case of seven boderline tumors of the ovary(14.3%). The S-phase fraction(SPF) of malignant ovarian tumor(11.9+-5.7%) was significantly higher than that of boderline ovarian tumor (6.5+-6.0%). The DNA aneuploidy and S-phase fraction were significantly correlated with FIGO stge and tumor grade. The DNA aneuploidy rate and S-phase fraction were higher in the advanced and poorly differentiated epithelial malignant ovarian tumors. Analyzing the result of flow cytometry, the malignant epithelial ovarain tumors were separated into the three groups, aneuploidy group with a SPF greater than 18% aneuploidy group with a SPF less than 18% and diploidy group. All cases of the aneuploidy group with a SPF greater than 18% showed advanced stage(stage III-IV) and poorly differentiated grade(grade III). From our results we suggested that the flow cytometric DNA pattern correlate with the aggresive potential of a malignant epithelial ovarian tumor and provide additional information about tumor prognosis.

한국여성에서 자궁경부암을 조기진단하는데 있어 자궁경부의 세포학적 검사와 중합효소 연쇄반응을 이용한 인유두종 바이러스 16번, 18번 검색의 효능성에 관한 연구

오민정(MJ Oh),문준(J Moon),김영태(YT Kim),서호석(HS Suh),주갑순(KS Ju) 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.1

Cervical cancer is the most common gynecologic malignancy and leading cause of death in Korean women. Although the precise etiologh of cervical cancer is unknown, epidemiologic studies suggest that venereally transmitted infectious agents could play an important role in the etiology of cervical cancer. Recently, human papillomavirus(HPV) has been reported to be associated with neoplastic change. A very sensitive polymerase chain reaction(PCR) capable of amplifying specific DNA sequence by up to a millionfold was developed for detection of HPV DNA. The purpose of this study is to investigate the efficacy of cervical cytoloty and PCR for detection of HPV type 16, 18 and to study the possible role pf PCR as complementary test for identification of high-risk group which can not be detected by cervical cytology alone. This study included 102 cases, 85 cases showing normal cytology and 17 cases showing abnormal cytology. The results were as follows; 1. Positive rates of HPV type 16 and 18 were 11.8% and 1.2%, respectively, among 85 cases showing normal cytology. 2. Positive rates of HPV type 16 and 18 were 41.2% and 23.5%, respectively, among 17 cases showing abnormal cytolog. Especially, overall positive rate of HPV type 16 and/or type 18 was 83.3% among 6 cases diagnosed as invasive cervical cancer. According to these results, concurrent use of HPV detection by PCR from cervical scrapes with cytologic examinatio seems to be a complementary method for prevention of cervical cancer.

자궁경부병변에 있어서 Loop Electrosurgical Excision Procedure ( LEEP ) 의 진단 및 치료적 의의

박지영(JY Park),문준(J Moon),김선행(SH Kim),서호석(HS Suh),강재성(JS Kang),조수용(SY hough),주갑순(KS Ju),박용균(YK Park) 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.8

A group of 88 patients with abnormal cervical cytology underwent the Loop Electrosurgical Excision Procedure during the period from March, 1993 to January, 1994 at Korea University Kuro Hospital. This study was performed to assess the efficacy of LEEP in the diagnosis and treatment of abnormal cervical lesions. 1. The age distribution (in the years of age per decade) undergoing LEEP were 3.4% in the 2nd, 37.5% in the 3rd and 30.7% in the 4th decade, in which the 3rd and 4th decade took most of the age distribution. And the 5th and 6th decade took only 20.5% and 7.9% respectively. 2. The concordance rate of LEEP histology with cervical cytology was 59.1% (52 cases). In comparison to cervical cytology, the higher LEEP histologic rate was 26.1%(23 cases), and lower LEEP histologic rate was 14.8%(13 cases), respectively. 3. Of the 35 women with CIN III, only 5 women were reported with positive margin. Therefore a single therapy with LEEP proved effective in 30 women with CIN III(85.7%). 4. In 27 women with CIN III showing negaive margin, there was no evidence of persistent or recurrent disease during the 6 month follow-up. And in 3 women with CIN III showing positive margin who underwent LEEP a second time, there was also no recurrence. 5. The average wideth and depth of specimens was 26.5+-8.3 mm and 9.8+-2.1 mm, respectively. LEEP was also able to provide enough and proper specimen for pathologists, because the burned tissue diameter was less than 0.3 mm. 6. Complications of LEEP include discomfort in 8 women(9.1%), dizziness in 5 women (5.7%) and vaginal bleeding in the area of procedure in 12 women(13.6%). Of these women with vaginal bleeding, no one needed trasfusion, but those who needed hospital revisitation were 3(3.4%). With these results, it can be condluded that cervical conization with LEEP was advantageous with a shorter duration of surgery, simple to use under a local setting, reduced operative bleeding and less need for pain relieving medication. LEEP also provides good pathologic specimen, and hence, it can be considered a useful method in the diagnosis and treatment of abnormal cervical lesions.

질확대경 조준하생검과 최종 자궁경부조직의 조직병리학적 비교분석에 관한 연구

서호석(HS Suh),신재철(JC Shin),문준(J Moon),허준용(JY Hur),박용균(YK Park),조수용(SY hough),주갑순(KS Ju) 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.12

Two hundred and fifty two patients taken colposcopically directed biopsy were performed conization, simple hysterectomy or radical hysterectomy depending on their current disease status. This study was designed to compare the rate of agreement or disagreement with the diagnosis of colposcopically directed biopsy and surgical specimen. The results of colposcopically directed biopsy were analyzed with regard to the histopathologic findings of the surgical specimen. The complete diagnostic agreement of colposcopically directed biopsy with surgical specimen was 77.8%(196 of 252) and the diagnostic accuracy less than one degree was 97.6%(246/252). Assuming that the histopahologic diagnosis of the surgical specimen is finally correct, the false positive rate and false negative rate of the direceted biopsy were 2.1%(5/135) and 0.9(1/108) respectively. There was no case in which invasive cancer was missed through colposcopically directed biopsy. So we concluded that the colposcopically directed biopsy can take place of conization in the diagnosis of cervical neoplasia and considerd that the histopathologic discrepancy between the colposcopically directed biopsy and the surgical specimen of cervix would be probably caused by inappropriate direction and entire resection of the lesions by the biopsy itself.

한국 10 대 여성의 초경에 관한 연구

신재철(JC Shin),이찬(C Lee),문준(J Moon),오민정(MJ Oh),김탁(T Kim),구병삼(BS Koo),홍명호(MH Hong),박영주(YJ Park) 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.5

Onset of menstruation is important landmark in female development. Menarche is an identifiable event in the gradual couse of pubertal development. It is generally accepted that age at menarche is affected by nutrition, body composition and socioeconomic factors including socioeconomic status, family size, public and individual health. The age at menarche had been getting earlier during the past century. This secular trend has been regarded as a positive indicator of a population`s status of health. But recent studies have indicated an halted or upward trend in the age of menarche, perhaps a reponse to some environmental deterioration. In this study, we examined the age at menarche, the secular trend of age at menarche and the comparison whti other countries. We also investigated a various factors that affect the time of menarche. The subjects survey were 11,424 adolescent girls from 6 large cities in Korea who asked a carefully planned questionnaires between September 1994 and August 1995. In the girls survey, the age at menarche ranged from 9 to 20 years with a mean of 13.2 years. About 60% had menarche before the age of 14 years, and over 97% of them before the age of 16 years. In middle schoolgirls, the mean age at menarche was 12.96 years, and a great number of them experienced menarche beween the 6th grade of the elementary school and 2nd grade of the middle school. But 3.7% of them had notyet menstruated. In high schoolgirls, the mean menarcheal age was 13.28 years, and a great number of them experienced menarche between the 6th grade of the elementary school and 3rd grade of the middle school. According to birth year, the age at menarche was 16.0 years for 1930 in Korea and has been gradually earlier to 13.2 years for 1980. The extent of getting younger at menarche was 6.6 months per 10 years. The timing of menarche was strongly linked to height and body weight of girls. Highly sigificant correlations between parental age and daughter`s age at menarche was seen. The daughters of farmers and fishers ahd the higher age of menarche than the daughters who had other paternal occupation. The girls who had high parental educational background experienced a early onset of menstruation, and early onset of menarche was significantly associated with family conflict. Irregular menstruation was reported by 33.3%, oligomenorrhea by 1.2%, and polymenorrhea by 6.7% of participants. Premenstrual syndrome was seen by 77.8% of girls. In conclusion, we found that the downward trend in menarcheal age was still going on in Korea. So when using age of menarche as a indicator of children`s health, the development of Korea has been positive until now. The factors that affect age at menarche were body size, parental age, paternal occupation, parental educational background and family relationship.

수중 LED 램프의 방열 구조 해석에 관한 연구

박찬희(C.H. Park),성경아(K.A. Sung),박상규(S.G. Park),문준(J. Moon),이형수(H.S. Lee),김연술(Y.S. Kim),이희관(H.K. Lee),양균의(K.E. Yang) 한국정밀공학회 2011 한국정밀공학회 학술발표대회 논문집 Vol.2011 No.6월

초기임신에서 태아 심박동수의 변화양상과 그 의의에 관한 연구

허준용(JY Hur),김동오(DO Kim),박지영(JY Park),문준(J Moon),서호석(HS Suh),박용균(YK Park),조수용(SY hough),주갑순(KS Ju) 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.7

The resolution power of transvaginal sonography has recently been rapidly improved so that it is now an essential method in evaluating the normal fetal growth in an early intrauterine pregnancy. Even though there were many studies on the values and structures which used in estimating the gestational age and wellbeing of the fetus, such as gestational-sac, crown rump length, fetal heart beat and b-hCg, there was still no significant correlations definitely clarified between the changes of the fetal heart beat and the consequent outcome of the pregnancy. Therefore, we studied on the changes of the fetal heart beat in normal early pregnancy and the impact of the abnormal factors on the fetal heart rate. The results are summrized as following. 1. The fetal heart rate was 123.9+-11.9, 140.1+-14.6, 162.2+-10.9, 173.1+-12.7, 174.5+-7.2, 169.3+-10.8 and 164.9+-10.9/min in the 6th, 7th, 8th, 9th, 10th, and 12th weeks of pregnancy respectively in the normal pregnancy groups while, in the threatened groups the fetal heart rate showed 123.2+-12.2, 140.1+-16.1, 160.7+-11.7, 167.4+-11.5, 171.3+-13.8, 165.8+-14.5 and 166.0+-8.5/min in the same corresponding weeks of pregnancy. 2. The fetal heart rate showed a tendency to increased during sixth to tenth weeks of pregnancy but ot slightly decrease during tenth to twelfth weeks of pregnancy. This results showed statically significantl increase of fetal heart rate during the sixth to ninth week of pregnancy(p<0.05). But there was no statiscal significance in the rest of the weeks(p>0.05). 3. The correlation analysis between fetal heart rate and gestational age resulted r(correlation coefficient) equals 0.81 which means there is high correlations between them. 4. There was no significant difference of fetal heart rate between the groups of pregnancy and threatened abortion(p<0.05).

산후출혈로 인한 대량수혈로 생긴 합병증치험 1 례

이경호(KH Lee),김현수(HS Kim),고희경(HK Koh),정경우(GW Jeong),오민정(MJ Oh),문준(J Moon),김탁(T Kim),서호석(HS Suh) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.2

Postpartum hemorrhage is a major cause of maternal morbidity. In developing nations, where maternal mortality rates are five to ten per 1,000 live birth, postpartum hemorrhage remains a leading cause of maternal death. Most cases of postpartum hemorrhage are due to uterine atony, retained placenta, maternal soft-tissue trauma, or a combination of these factors. Hemorrhage is thus often perceived as a sporadic, unpredictable event, making it difficult to counsel patients rationally. We report a case of massive transfusion and its complication following massive bleeding after vaginal delivery.