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도시지역 여자 중학생의 초경 및 월경장애에 관한 조사연구
임경택(KT Lim),김태진(TJ Kim),이기훈(KH Lee),황정혜(JH Hwang),오기석(KS Oh),전종영(JY Jun),한동운(DW Han),문옥륜(OR Moon) 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.4
This study was designed to obtain the menarche, the factors which influence on menarche and menstual patterns after menarche. For the data smpling, self administered questionaire survey was made in July, 1993. Among the 1089 middle school girls in urban area. 1. The mean age of menarche was 12.6 years old. And menarchel age ranged from 8.5 years old to 15.3 years old. 2. The girls at manarche was taller and heavier than those of the same age who had not experienced menarche. 3. The mean menstrual interval was 29.4 days, the mean duration was 5.8 days. The proportion of normal menstruation, polymenorrhea, oligomenorrhea, and amenorrhea were 80.7%, 11.5%, 5.5% and 2.1%. 4. The summer and winter were highly frequent seasons of the menarche. 5. Seventy eight percent of girls suffered from dysmenorrhea. 6. The percentage of subjects who took analgesia due to dysmenorrhea was 45.3%. 7. The premenstrual syndrome was experienced by 23.4%. 8. Only 5.8% of girls visited hospital with adolescent gynecologic problems. 9. The percentage of students had gynecologic concerns was 74%.
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SEMM방식에 의한 골반경 자궁적출술 ( CISH ) 의 임상적 경험 43 예
손찬우(CW Son),유은희(EH Yoo),고창원(CW Ko),이기훈(KH Lee),김희수(HS Kim),심재욱(JU Shim),이승호(SH Lee) 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.11
Classical intrafascial SEMM hysterectomy (CISH) is a synthesis of cervical conization, supracervical amputation and operative laparoscopy to constitute a new type of hysterectomy compatible with the concept of minimally invasive and organ preserving surgery. We have experienced of 43 cases of CISH at Cheil General Hospital from November, 1992 to April, 1994. There were three cases where CISH was stopped and total abdominal hysterectomy was done because of the following reasons: the size of the uterus being too large to apply endoloop around the cervico-corporeal junction, severe pelvic adhesion and subcutaneous emphysema. The average age of patients was 43 years old. Indication were 17 cases of uterine myoma(42.5%), 15 cases of adenomyosis(37.5%), 5 cases of ovarian tumor(12.5%), 2 cases of abnormal uterine bleeding(5.0%) and 1 case of endometiral hyperplasia(2.5%). In size of uteri, 8 gestational weeks size was the most common, being 14 cases(35.0%), and the size of uteri varied from 6 to 12 gestational weeks. We have performed subtotal hysterectomy preserving the cervix whereas squamo-columnar junction and endocervical glands being revomed to prevent potentia occurrence of cervical cancer in future. The cervical shell connected by uterine ligaments was preserved to maintain the normal pelvic floor to minimize postoperative infection and to accelerate early recovery. Initially, the mean operation time was 310 minutes. With accumulation of operators experience it was reduced to 198 minutes. The hemoglobin was reduced by 1.66 gm/dl and the hematocrit by 4.57%. There were 2 cases of massive bleeding during operation and 3 cases of minimal cervical bleeding, 2 cases of dysuria, 1 case of febrile morbidity and 1 case of severe headache postoperatively. The average hospitalization was 6 days. The average days of return to domestic activity was 21.5 days. In conclusion, CISH was compatible with minimally invasive and organ preserving surgery and showed shorter operation time with subsequent quick recovery of patients and the reduction of complications. Moreover, hospitalization can be shortened. The important factors in maximizing these advantages of CISH were the experience of the operator, the size of the uterus, and the degree of the pelvic adhesion.
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