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- 저자 : 송하균 ( Ha Kyun Song ) (검색결과 2 건)
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산전진단된 Down증후군 30례의 초음파소견과 임상적 고찰
송하균 ( Ha Kyun Song ),류현미 ( Hyun Mee Ryu ),노성훈 ( Sung Hoon Roh ),박선희 ( Sun Hee Parks ),김문영 ( Moon Young Kim ),김은성 ( Eun Sung Kim ),한호원 ( Ho Won Han ),최수경 ( Soo Kyung Choi ),이영호 ( Young Ho Lee ),유시준 ( S 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.12
Obstetric record and prenatal ultrasound findings were reviewed in 30 fetuses which have been proved Down syndrome(trisomy21)during 7 year period. Elderly gravida above 35 years old were 15 cases among 30 cases(50%) Eleven cases(65%) among 17 were maternal serum screening positive for Down syndrome. In 11 out of 15 women below 35 years old, obtained fetal karyotyping because of abnormal ultrasound finding(73%) which reviewed nuchal translucency(5 cases) in early pregnancy. When modified Benacerraf scoring(Thickened nuchal fold 2, Major abnormality 2, Short femur 1, Short humerus 1, Pyelectasis 1, Hyperechogenic bowel 1, Choroid plexus cyst 1, Nuchal translucency 2, We added a nuchal translucency over 3 mm to our modified system) was applied in ultrasound finding, 18 case had score above 2. Sensitivity and specificity was respectively 60%, 99% by ultrasound screening for Down Syndrome using modified Benacerraf scoring above 2. In the future, it may be possible to combine sonographic scoring system, maternal age, and the triple marker serum evaluation to refine further the prediction of risk of Down syndrome.
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김태진,심재욱,박인서,임경택,이기헌,박종택,노성훈,송하균,안현경,함경렬,강옥림,전종수 대한부인종양 콜포스코피학회 1997 Journal of Gynecologic Oncology Vol.8 No.2
Microinvasive carcinoma of the uterine cervix(FIGO stage IA) has been reported as highly curable disease even with conservative surgery such as conization and simple hysterectomy. Nevertheless, the surgical management for microinvasive carcinomas has been proposed varying from conservative surgery to radical hysterectomy with pelvic nodes dissection according to different diagnostic criterias for microinvasive carcinoma. We reviewed 512 patients who had been diagnosed as microinvasive carcinoma of the uterine cervix at the Department of Obstetrics and Gynecology, Samsung Cheil Hospital and Women's Healthcare Center from Jan. 1988 to Dec. 1995. Among them, 376 patients were included in this study satisfying guided criterias such as proper management and follow up more than at least one year, and they were analyzed retrospectively based on the clinicopathologic characteristics, pattern of surgical management and postoperative status. The majority of patients were diagnosed at 4th and 5th decades of their lives(271/376, 72.1%). The main presenting symptoms were abnormal vaginal bleeding including postcoital spotting and leukorrhea, but considerable numbers of patients were asymptomatic(108/376, 28.7%). The majorities of patients had findings of erosion and inflammation in the cervix, but grossly normal appearing cervices were encountered in considerable numbers(97/376, 25.8%). Satisfactory colposcopic evaluations for abnormal findings were observed in 145 cases among 164 colposcopically examined patients. Abnormal findings such as aceto-white epitherium, erosion, mosaicism, atypiacal vessels were frequently observed. Overall diagnostic accuracy of Pap smear and colposcopically directed biopsies were 59.3% and 61.6%, respectively. Significant correlations were statistically observed between the rates of diagnostic accuracy and the depth of stromal invasion. Findings of positive lymph-vascular space invasion and confluent pattern of invasion were observed in 8.2% and 16.2% of cases, respectively. Both findings were observed more frequently in advanced depth of stromal invasion with statistical significance. The findings of positive lymph-vascular space invasion and/or confluent pattern of invasion in conized specimens with negative margin were also significantly correlated with relation to residual lesion in the hysterectomy specimens. The surgical managements were performed varying from conization to radical abdominal hysterectomy with pelvic nodes dissections. The conservative surgeries were performed in 218 cases and there were tendenciesnto perform conservative surgery in cases which correspond to SGO or JSOG criterias for microinvasive carcinoma. No positive node was observed in 1,294 pelvic lymph nodes dissected. There was no case of surgery-related death in this series. Including one case of central recurrence, 8 cases required postoperative treatment due to occult lesions. Among them, 5 cases did not correspond to JSOG criteria for microinvasive carcinoma and another 2 cases had positive cone margin. Accordingly we emphasized again the significance of the regular screening procedures for early detection of cervical lesions and liberal use of diagnostic conization in suspected microinvasive carcinoma cases to evaluate the exact pathologic characteristics. In addition, we suggest the JSOG criteria as a criteria for conservative surgery in microinvasive carcinoma based on the results in this study.
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