기능성 자궁출혈의 원인적 분류

민부기(BG Min) 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.5

N/A

부인과영역에 있어서 자궁내관경에 대한 임상적 관찰

민부기(BG Min),홍석호(SH Hong),유성현(SH Yoo),박영선(YS Park) 대한산부인과학회 1982 Obstetrics & Gynecology Science Vol.25 No.2

Hysteroscopy has added a new dimension to the management of patient with common clinical problems, increasing the accuracy of diagnosis and serving as an adjunct in treatment of intrauterine conditions. Here, we have studied differential aspects of approching in the hysteroscopic observation to the uterine cavity with 95 cases. The study was conducted at department of Obstetrics and Gynecology, Eul-Ji General Hospital in period of 20 months from Dec., 1978 to June., 1980. 1. The most popular age group for hysteroscopy was in age of 31-35 years. 2. As the anesthesia for hysteroscopy, general analgesia was used successfully in 72 cases, and paracervical block was used in remainder cases. 3. The time required for diagnostic hysteroscopy was taken 10-15 minutes in 36 cases(37.9%). 4. The most common indications for hysteroscopy were abnormal uterine bleeding in 43 cases, intrauterine adhesion in 23 cases and infertility in 18 cases. 5. On the abnormal uterine bleeding in women during the reproductive ages, cervical and endometrial polyp were most common in 13 cases of the 32 cases. 6. On the abnormal uterine bleeding in postmenopausal women, endometrial hyperplasia was most common in 5 cases of the 11 cases. 7. Intrauterine adhesions were classified into the 3 types as diffuse, 11 cases, central type 5 cases, and marginal type 7 cases. 8. On hysteroscopic finding of infertile women, unexplained infertility with normal uterine cavity was most common in 10 cases of the 18 cases. 9. Abnormal uterine cavity of infertile women was seen in 8 cases of the 18 cases. 10. Complicaions on hysteroscopy were occurred in 9 cases of all 95 cases, as uterine perforation, infection and profuse uterine bleeding.

한국여성 폐경에 관한 연구 (II)

민부기(BG Min),구병삼(BS Koo) 대한산부인과학회 1986 Obstetrics & Gynecology Science Vol.29 No.9

남한 지역의 폐경여성 3,210예를 대상으로 폐경증후군의 증상, 월경주기의 변화, 초경년령에 따르는 폐경연령과의 관계, 생식생리 기간을 분석 관찰한바 다음과 같은 결론을 얻었다 1 폐경증후군의 증상을 호소하는 건수를 개체별로 분석해 보면 3,210예중 326예인 10 2%에서 무증상을 나타냈고 1가지 증상만 호소한 경우는 1,693예인 52 7%로 가장 빈번하였고 2가지 증상을 호소한 경우는 848예인 26 4%로 나타났으며 또한 3가지 증상을 가진 경우는 343예인 10 7%이었다 2 폐경 증상별로 빈도를 분석하여 보면 3,210명의 폐경여성 중에서 무증상의 여성 326명을 제외한 2,884명의 증상건수는 4,616건이었으며, 이중 전신경약이 1,598건인 34 6%로 가장 빈번하였고 홍조현상은 1,501으로 32 51%이며, 우울증상이 920건인 19 93%, 발한이 312건인 6 76%이고, 기타증상은 283건으로 6 13%였다 3 폐경 여성에 있어서 월경주기에 대한 변화는 3개월간의 불규칙이 1,220예인 38 1%이었고 6개월간 불규칙이 1,247예인 38 84이며 12개월이상인 경우는 743예로서 23 15%였다 4 초경연령과 폐경방생 연령의 관계를 관찰하여보면 13세에 초경이 일어났던 경우에 폐경은 231예에 47 27세의 평균연령을 관찰할 수 있었으며, 14세의 초경군은 371예에서 47 86세의 폐경 평균연령을 나타냈다 15세와 16세의 초경군에서는 859예와 849예에서 각각 47 47세와 47 91세의 유사한 연령을 보이고 있으나 19세의 초경연령군은 폐경연령이 48 65세로 다른 초경연령군에 비해 높은 연령을 나타냈으며 20세이후의 초경군에서는 45 69세의 폐경 평균연령으로 가장 낮은 연령을 보였다 5 초경연령으로부터 폐경이 일어날 때까지 생식생리 기간을 분석해 보면 1,538예인 47 91%에서 30∼34년간의 간격을 나타냈으며 40세이상의 기간은 93예인 2 90%에서 볼수 있었고 19세이하의 간격은 27예로 0 84%로 나타났다 6 그러나 초경연령과 생식생리 기간과의 상관관계는 Y=-0 8918X + 47 163이고 또한 초경연령과 폐경연령과의 상관관계는 Y=0 0312214954X + 48 04920383으로 표시할 수 있으며, 상관관계 r=0 0152259로서 서로 유의성이 없음을 보여주고 있다 In the menopause, the ovarian function is declined because of decrease in the oocytes and defective synthesis of steroid hormones Hence, there is low estrogen production, various symptoms and signs of postmenopausal syndrome may be developed gradually And the authors has studied for the analysis of symptoms and signs, changes of the menstruation interrelation between menarche and menopause and duration of reproduction in postmenopausal women These present data were derived from analysis has surveyed by interviewing and questionaires for the postmenopausal women of 3210 cases during 6 years from 1978 to 1983 And this concepts are going to suggest the results as follow 1 Of the 3210 cases of postemenopusal women who complained the various symptoms and signs for the postmenopausal syndrome, 326 cases (10 2%) has not any symptoms, 1693 cases (52 7%) had one symptom only, is most common And 848 cases (26 4%) had 2 symptoms, 343 cases had 3 symptoms or more 2 On analyse the frequency of the symptoms and signs of the postmenopausal syndrome, except the asymptomatic women of the 326 cases in postmenopause, general weakness is 34 6%, 1598 numbers of all 4616 symptoms in 2884 cases, flushing is 32 51%, 1501 numbers, depression is 19 93%, 920 numbers and perspiration is 6 76%, 312 numbers 3 The changes of menstruation according to the menstrual interval is irregular for the 3 months in 38 1%, 1220 cases, irregularity for the 6 months is 38 84%, 1247 cases and irregularity for the 12 months or more is 23 15%, 743 cases 4 With the demonstration of the correlation between menarchal age and occurring age of menopause, the onset of the menopausal age in the group had menarche at 13years is average 47 27 years, and menarchal group at 14 years has occurred menopause at 47 86 years And menarchal age group of 15 years and 16 years are similar as showing 47 47 years and 47 91 years respectively in menopausal age But menarchal age group of 19 years revealed highest age, 48 65 years, as compare with other m

거대 자궁근종의 1예

민부기(BG Min),최경숙(KS Choi),김학수(HS Kim),노옥균(OK Rho),구병삼(BS Koo) 대한산부인과학회 1978 Obstetrics & Gynecology Science Vol.21 No.12

A case of huge multiple leiomyomatosis of uterus with secondary degeneration which was encountered in 41 year old nulliparous woman(nun) is reported and literatures concerned are reviewed briefly.

한국여성의 폐경에 관한 연구 ( 제 1 편 )

민부기(BG Min),구병삼(BS Koo) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.7

The climeateric that is sometimes associated with symptomatology is the phase in the aging process of women making the transiton from the reproductive stage of life to the non-reproductive stage. During this climacteric phase, physiologic and sexual functionis decreased or lost . The menopause is defned the ceaastionof menstruationfor consecutive 12 months. The age of onset menopause may make a difference by the individual women and moreover it does apperar to depend on various factous; socioeconomic, cultural background, genetic and health status In the same country, the age of menopause does not appear signifcant difference for generation as being shown in that of menarchal age initiationg menstruation But it is influenced by racial, geographic, climate, and natural factors The present data were derived from large independent studies carried out by the interviewing many randomized women of the 3,378 cases during 6 yeays fro 1978 to 1983 This cases were consisted of women living in gity, country, villages and various area in Korea. The study is attempted form understanding of physilolgy ofwomen, in sexual , maturation, and menopausal status Furthermore, it is indicated for the clinical diagnosis, family planning , and health status of the people The authors noted the following results about the age of onset of menopause, indicating the reproductive physilolgy of women, 3378 cases living on various area in Korea 1. With the observation of menopasal age of 6 areas in Korea,the mena age is 48.8yrs, in Seoul, 48.2yrs. in Kyonggi area, 49.1yar. at Kangwon, 48.2yrs. in Chungchong, 47.4yrs. at Kyongsang, and 48.2 yrs. in Junla 2. With percentile distribution of menopausal age according to distinction of age. onste of menoparuse is occurred in 5% at age 45,80% at age 50, and 98.4% at age 55. The mena age of menoparuse is noted 47.6years ]3. By the observationof menopausal age according to distinctionof parity, the mena age of menopauses 47.8yrs. at multiparity, 47.9yrs. at primiparity, 48.2yrs. at para 2, 47.7yrs, and 47.9yrs at para 3 and para 4 or more group. And therefore, there is tend to lowering of menopausal age para 4 or more group than other group 4. In relation with the menopausal age and cohabitation with a family the mean age is noted 46.8yrs at single group, 47.5yrs at group of living with a husband and 48.5yrs at group of living with children. And thereform, menopause if occurred earlier in the single group than the other group. And there is a signifcant difference in menopausal age between the single group and the other group 5. In relation with the education an the menopause, the mena age was noted 47.4yrs at no-educational group. 47.6yrs at primary educational group, 46.8yrs at middle school There is tend to rising of mena age at primary eductaional group than middle school 6. There is no signifcant difference for onset of menopausal age among the 6th decades, 7th decades and 8th decades at the postmenopausal women. The mean ages of the 6th decades 7th decades and 8th decades of the postmenopausal women were noted at 48.2 yrs 48.1yrs. and 48.0 yrs. respectively.

분만및 유산후 복강경 불임술에 관한 임상적 연구

구병삼(BS Koo),민부기(BG Min),최경숙(KS Choi) 대한산부인과학회 1977 Obstetrics & Gynecology Science Vol.20 No.11

본 대학 산부인과학교실에서는 출산후 불임수술을 원하는 여성을 대상으로 복강경불임술을 시행하였으며 1974년 5월부터 1976년 12월까지 실시된 총 2707예중 특히 임신한 여성에서 임신중절과 동시에 불임수술을 하였던 260예와 본원 산부인과에서 분만한 후 입원하고 있는동안 불임수술을 시행했던 31예의 산욕기여성들을 대상으로 임상적 연구와 문헌고찰을 한바 다음과 같은 성적을 보고하는 바이다. 1. 연령분포는 유산군의 불임술에서 24세에서 44세까지의 범위이며 30∼34세가 85예 (41.3%)로 가장 많았고 산욕기군의 경우 25세에서 39세 사이의 범위이며 25세∼29세가 14예(45.2%)로 가장 많았다. 2. 자녀수는 1회에서 6회이상의 분포를 보였으며 94예(39.7%)에서 3명의 자녀수를 갖는 군이 가장 많았다. 3. 유산경력은 산욕기군에서 14예(45.2%)가 유산경험이 없었으며 유산군에서 44예 (21.4%)에서 1회의 유산경험이 있었고 30예(14.6%)에서 6회이상의 유산경험을 가졌다. 4. 교육정도를 보면 중학교학력을 가진 사람이 112예(47.3%)로 가장 많았다. 5. 유산군에서 기왕피임력은 112예(54.4%)에서 전혀 피임을 하지 않았다. 6. 유산군에서 기왕개복수술력을 보면 206예중 26예(12.62%)이었으며 그중 충수돌기절 제술이 13예(50%)로서 가장 많았다. 7. 유산군에서 임신중절방법은 조기임신일 때 월경조절법(M.R.)이 131예(63.6%)로 과반 수 이상을 나타냈고 임신 제1기에서 자궁크기가 8주 이상일 때는 흡인소파술을 행하였 다. 8. 회음성형술을 동시에 시행한것이 6예이었으며 이중 4예가 국소마취하에 시행되었다. 9. 본 시술을 위한 마취방법에 있어서는 거의 다 국소마취를 하였고 이중 184예(77.6%) 에서 Demerol 100mg과 Valium 10mg을 정주하였다. 10. 기복을 형성키 위해 이산화탄소의 소요량을 보면 유산군에서 104예(50.5%)가 1∼2 ℓ를 사용하였으며 산욕기군에선 3ℓ이상을 사용한 예가 48%나 되었다. 11. 복강경불임술의 술기에 있어서 대부분 전기소작법에 의해 시행되었고 적은수에서 Falope ring에 의해 시행되었다. 12. 수술시간소요를 보면 유산군에서 82.5%가 15분이내이었으며 산욕기군에선 14예 (45.2%)에서 16∼20분의 시간이 소요되었다. 13. 유산군에서 시술후 회복되어 귀가시간을 보면 132예(64.1%)에서 2∼4시간이었다. 14. 복강경을 통하여 본 난관의 상태는 유산군에선 173예(84.0%)가 정상이었고 산욕기 군에선 24예(77.4%)가 난관에 현저한 부종이 있었다. 15. 산욕기군의 합병증을 보면 6예(19.4%)에서 합병증이 일어났으며 2예의 난관관막출 혈, 3예의 자궁저부소창상, 1예의 절창을 통한 강막의 탈출이 있었다. Many gynecologist have performed the various timing of laparoscopic sterilization including in non-pregnant, postabortal and postpartum period. Here we have studied differential aspects of approaching in the lapaaroscopic sterilization comparing period (31 cases). the study was conducted at Department Obstetric-gynecology, Korea university medical School in period of 31 months from May, 1974 to cecember, 1976. 1. Most popular age group for the postabortal cases were in age of 30 to 34 years and the postpartum cases seem to be younger than postabortal cases as shown age of 25 to 29 years. 2. Number of living children regardless of parity were mostly with 3 kids. 3. There were no history of induced abortion in the group of postpartum patients but the group of the postabortal patients showed 21.4% have had a abortion and 14.6% with history of more than 6 induced abortion. 4, Majority cases of educational back ground showed in 47.3% of middle school. 5. There were no history of contraception in 54.4% for the postabortal group. 6. It has been knoun as contraindicated laparoscopic procedure with history of abdominal laparotomy. However, our cases of postabortal patients showed 26 cases had laparotomy previously, mostly, for the appendectomy(50%). 7. Induced abortion were performed performed by the way of menstrual regulation in early pregnancy and suction curettage in first trimester of pregnancy if uteri was larger than 7-8 weeks of gestatiomal size. 8. Six cases of perineoplasty were done coincidentaly sith alparoscopic sterilization. 9. the anesthesia for the prodedure were done with pethidine 100mg plus diazepam 10mg intravenously in 77.6% (184 cases) 10. the 93.5% of sterilization were done by electro-cauterization with cutting method and only 6.5% performed by cold technique using Silastic bands. 11. The 93.5% of sterilization were cone by electro-cauterization with cutting method and only 6.5% performed by cold technique using Silastic bands. 12. It took less than 15 minutes to complete laparoscopic tubal sterilization in 82.5% for postabortal cases and 16 to 20 minute in (45.2%) for postpartum. 13. Postoperative observation in the hospital were required 2-4 hours in 64.1% and longest one required 2-6 days in 8 cases (3.9%) of postabortal patients. 14. Tubal findings on laparoscopic sterilization appeared normal in 84.0% (173 cases) for the postabortal group and engorged in 77.4% (24 cases) for the postpartum. 15. As the complications, 2 cases of mesosalpingeal hemorrhage, 3 cases of miner trauma in uterus and 1 cases of omentum protrusion through incision were encountered.

인간 융모 성선자극홀몬 ( hCG ) 에 의한 생쥐의 뇌 소교세포에서 산화질소 ( NO ) 의 생성

김형민(HM Kim),문영회(YH Moon),민부기(BG Min) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.8

Nitric oxide ( NO ) is now recognized as a mediator of several biological and immunological functions , but unlike classical neurotransmitters , NO simply diffuse of the postsynaptic cell and around affecting cells. Human chorionic gonadotropin ( hCG ) , produced by placental trophoblasts may act as stimulator on NO synthesis in oocytes of mouse`s ovary. How-ever, in the various organs or cells , the action of hCG on NO synthesis is unknown. We have examined that the effect of hCG on NO synthesis in microglial cells of murine`s brain , using the Griess method. And this study was evident that hCG did not induce NO produc-tion without recombinant interferon gamma ( rIFN-γ) , whereas hCG ( 10∼500 IU/ml ) with rIFN-γ effectively produced NO in microglial cells of brain. As result , NO production in microglial cells increased most significantly in dose of 100 IU/ml of the hCG and the pro-duction of NO was dependent on the dose of hCG ( Table 1 and Fig. 1 ). And NG-monomethyl-L-arginine ( NGMMA ) , competitive inhibitor of NO synthase , reduced the NO production by hCG stimulation with rIFN-γ in microglial cells of murine. Conclusively , this study sugge-sted that hCG stimulate NO production at microglial cells in brain , which may be an important factor for mediating immune and neuroendocrinologic regulation in nervous system.

폐경 전 단순자궁적출술이 골밀도에 미치는 영향

이찬근(CG Lee),김기석(KS Kim),민부기(BG Min),김흥곤(HG Kim),이희섭(HS Lee),홍기연(GY Hong) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.4

Hysterectomy is one of the most common gynecologic surgical intervention, although there are large variation in the frequency both among and within nation. The future function of ovaries retained after premenopausal hysterectomy has been questioned. Several studies have described increased severity of menopausal symptoms and earlier onset of menopause attributed to reduced ovarian estrogen production. Bone tissue is very sensitive to steroid hormones. Estrogen deprivation as seen at the menopause and after premenopausal oophorectomy causes rapid bone loss. Also, minor disturbances in ovulatory function can influence bone metabolism. A reduction in ovarian function after hysterectomy may therefore cause advanced bone loss and increase risk of subsequent osteoporotic fractures. The purpose of this study was to investigate whether premenopausal hysterectomy has an effect on bone mass in women. This study was performed on 50 women who had undergone premenopausal hysterectomy and 50 women with natural menopause 50 to 60 years old. Bone mineral densities in lumbar spine (L2-4), proximal femur, and total body were measured by dual energy x-ray absorptiometry. The women who had undergone premenopausal hysterectomy had generally lower mineral densities in all bone compartment compared with those with intact uterus, apart from 1.2% to 9.3% lower bone mineral densities. In conclusion, premenopausal hysterectomy did not influence bone metabolism significantly, but further study is necessary continuously.

Achondrogenesis Type I 1 예

국승무(SM Kuk),최성규(SK Choi),민부기(BG Min),최찬(C CHoi),문형배(HB Moon) 대한산부인과학회 1988 Obstetrics & Gynecology Science Vol.31 No.9

본 산부인과학교실에서는 임신 35주의 경산부에서 양수과다증이 동반되었던 Achondrogenesis 1례를 경험하였기에 문헌적 고찰과 함께 보고하는 바이다. Achondrogenesis is a lethal form of congenital chondrodysplasia characterized by extreme micromelia and a marked discrepancy between head and trunk size associated with deficient ossification of vertebrae and pelvis. There are two type of Achondrogenesis, both of which are belived to be autosomal recessive disorders. In Achondrogenesis Type I , both enchonral and membranous ossification are imparied, and in Achondrogenesis Type II , only endochondral ossification is abnormal . We report a case of Achondrogenesis Type I based on grossly radiologic and qutopsy findings with review of literatures.

선천성 자궁근층내양포1예

구병삼(BS Koo),박준상(JS Park),민부기(BG Min),김방철(PC Kim) 대한산부인과학회 1978 Obstetrics & Gynecology Science Vol.21 No.2

A Case of congenital intramural cyst of uterus is presented. This is the first case reported in Korea. The origins of congenital intramural cyst of the uterus may be paramesonephric, or mesonephric, and classified by its location, and histologic pattern. Here, we discuss about the diagnostic criteria, origin, and histological characteristics of congenital intramural cyst by a review of literature. And we classify the previously reported congenital intramural cyst of uterus and authors case.