자궁 동정맥기형의 색전술 1 예

이은혜(EH Lee),이찬(C Lee),이병희(BH Lee),이유미(YM Lee),이정노(JN Lee) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.7

Uterine arteriovenous malformations [AVMs] are rare cause of massive vaginal bleeding. In the past, hysterectomy had been the only method of diagnosis and treatment. With advent of many imaging modalities, noninvasive diagnosis of AVMs is possible and the transcatheter embolization has been accepted as a treatment of choice. We describe a case of uterine AVM presented with intractable vaginal bleeding and successful transcatheter embolization with coils and glue.

한국형 자궁경부 촬영진 ( New Cervicography ) , 세포검사 그리고 HPV-DNA 검사를 이용한 새로운 자궁경부암 검진 모델 ( Model ) 개발

김승조(SJ Kim),박찬규(CK Park),이효표(HP Lee),남궁성은(SE Namkoong),강순범(SB Kang),서호석(HS Saw),이재관(JK Lee),김수녕(SN Kim),김재원(JW Kim),배석년(SN Bae),김찬주(CJ Kim),이근호(KH Lee),이선영(SY Lee),김인호(IH Kim),이찬(C Lee),이정노(JN Lee) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.5

Objective : The false negative rate of conventional cytology is reported to range from 18 to 45%. It is necessary to develop more effective screening strategies that would ideally be more accurate than conventional cytology. This study is designed to investigate the potential of conventional cytology, cervicography, HPV-DNA testing and their combinations as primary screening techniques for cervical neoplasia. The purpose of this project is to develop the models and guidelines for screening tools of cervical cancer of the uterus by evaluating sensitivity, specificity and cost-effectiveness of all the screening methods. Study design : We conducted a screening of random sample of women who visited the department of OB-Gyn. of five different major university hospitals such as Catholic University Hospital, Korea University Hospital, Seoul National University Hospital, Yeonsei University Hospital and Pochon CHA University Bundang CHA Hospital, from May 1, 1996 to April 30, 1999. In a cohort women with an age range of 20 to 70 who underwent routine cytologic screening at Catholic University, Hospital Bundang CHA General Hospital and local clinics from April 1, 1996 to Decomber 31, 2000. cervicography (n=417,125) and testing for HPV-DNA (n=1,347) by the hybrid capture assay were studied for the ability of the cervical cancer screeuing. A new cervicography system with Kim's classification which was developed by Prof. Kim Seung Jo as an adjunctive method for the cervical cancer screening was applied in this cohort study. And then, accuracy, effectivencess, cost-effectiveness of the single or combined screening method were analysed. Result : Sensitivity and specificity of Pap smear were ranged from 55.6% to 83.1% and 72.8% to 88.3% respectively. The combination of Pap smear and cervicography had sensitivity from 89.7% to 98.6%, specificity from 68.2% to 93.2%. With combination of Pap smear, HPV DNA test and cervicography, sensitivity became also highest accuracy among all screening methods from 92.8% to 98.8%. Considering medical charges for diagnosis and social cost occurred by false positive and false negative results, the most cost-effective diagnostic modality was thought to be the combination of Pap smear and cervicography(91,433 won). In patients who were diagnosed as LSIL, colposcopic examination confirmed progression to high grade intraepithelial lesion(HSIL) in 10.7% patients, persistence of LSIL in 55% patients during the 3 year follow-up period. Accuracy of the screening for cervical cancer and CIN can significantly be improved by cytology with new cervicography rather than cytology alone. We concluded that cervicography can be important adjunctive tests for cervical cytology, improving the effectiveness of cervical screening by allowing a more sensitive detection of cervical neoplasia.

반복자연유산 환자에서 발견된 응고인자 12 부족증 1례

남윤성,김인현,윤태기,이정노,차광열,Nam, Y.S,Kim, I.H.,Yoon, T.K.,Lee, C.N.,Cha, K.Y. 대한생식의학회 1999 Clinical and Experimental Reproductive Medicine Vol.26 No.2

Activated factor XII (FXIIc: Hageman factor) is a central component of the contact activation system of blood coagulation, fibrinolysis, and kinin formation. Although patients deficient in FXIIc (up to 50% of normal) do not show increased bleeding tendency, thrombotic complications were reported in 8% to 10% among these patients. The reduced generation of bradykinin resulting in diminished release of tissue plasminogen activator is proposed as a cause of thrombosis in factor XII (FXII)-deficient patients. Similarly, in patients with elevated levels of circulating antiphospholipid antibodies, hemostasis may be impaired resulting in excessive thrombophilia. Both vascular and placental thromboses because of antiphospholipid antibodies or FXIIc deficiency have been reported to be associated with recurrent fetal loss. We have experienced a case of factor XII deficiency in woman with recurrent spontaneous abortion. So we report this case with a brief review of literatures.

골반경 자궁경상부적출술에있어서 Non - coring 술식의 유용성

김종욱(J . W . Kim),신명철(M . C . Shin),박원식(W . S . Park),조진호(J . H . Cho),이정노(C . N . Lee) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.11

We suggest the benefits of cervical non-coring technique among the many methods of hysterectomy for benign gynecologic diseases, rather than coring in laparoscopic supracervical hysterectomy (LSH). From Oct. 1992 to Jun. 1996, 300 cases of LSH with coring method and from Mar. 1995 to Jan. 1998, 103 cases with non-coring method have been done in CHA General Hospital, Seoul, Korea and Pundang CHA General Hospital, Seongnam, Korea, and we made a comparative study of two groups. The modified SEMM method of classical intrafascial supracervical hysterectomy (CISH) was used in coring group, and the only LSH was used in non-coring gmup. The pelvic adhesiolysis and salphingo-oophorectomy were done in both groups, if needed, The mean operation time was 104 minutes in non-coring group and 156 minutes in coring poup. The mean hemoglobin loss was 0.92 g/dL in non-coring group and 1.17 g/dL in coring group. During the postoperative follow up period (2-35 months), there was no specific bleeding and no menstruation in non-coring group. In addition, there was no case of abnormal cervical findings. However, very thin spotting or brownish vaginal discharge, which is different from dysfunctional uterine bleeding (DUB), was found in only 15 cases among follow up 74 cases of non-coring group. Although the follow up period is short and non-coring cases are small, our study shows tbat the LSH without coring might be a better and easier alternative hysterectomy method in benign gynecologic diseases.

Quinclorac의 作用性에 대한 硏究

洪錫英(Hong, S. Y.),李仁中(I. J. Lee),金吉雄(K. U. Kim),申東賢(D. H. Shin),李正魯(C. N. Lee) 韓國雜草學會 1993 Weed&Turfgrass Science Vol.13 No.1

말초혈액과 생식선에서 SRY유전자 양성을 보인 Swyer증후군 1례

남윤성,이숙환,한정희,조성원,윤태기,이정노,차광열,Nam, Y.S.,Lee, S.H.,Han, J.H.,Cho, S.W.,Yoon, T.K.,Lee, C.N.,Cha, K.Y. 대한생식의학회 1999 Clinical and Experimental Reproductive Medicine Vol.26 No.2

Male sexual differentiation involves a cascade of events initiated by the presence on the Y chromosome of the of the SRY (sex determining region of Y chromosome) gene, which causes the indifferent gonad to develop into a testis. Hormonal products of the testis, predominantly testosterone and Mullerian inhibiting subtance (MIS), then control the sexual differentiation of the developing fetus. SRY is a transcription factor; however, target genes for its action have yet to be identified, because the DNA recognition sequence for SRY is found in many genes. Therefore the study of intersex disorders is being used to identify other genes active in the pathway of sexual differentiation. Patients with 46,XY gonadal dysgenesis, or Swyer's syndrome, have streak gonads, normal stature, and a sexually infantile phenotype with Mullerian structures present. The inheritance is usually sporadic but can be autosomal dominant or X-linked recessive. Unlike 45,X patients, stigmata of Turner syndrome are rare. As many as 20 to 30% of patients are at risk for malignant gonadal tumor formation and should undergo gonadectomy soon after the diagnosis is made. We have experienced a case of Swyer syndrome which showed a positive SRY gene in peripheral blood and gonad. So we report this case with a brief review of literatures.