자연파열된 낭포성 과립막세포종1례

최동수(DS Choi),박현석(HS Park),한종설(JS Han),주갑순(KS Ju) 대한산부인과학회 1982 Obstetrics & Gynecology Science Vol.25 No.6

갱년기환자에서 불규칙적인 자궁내출혈 및 하복통을 주소로 입원중 파열된 자궁외 임신과 같은 증상으로 응급수술후 과립막세포종으로 진단된 임신과 같은 증상으로 응급수술후 과립막세포종으로 진단된 환자 1례를 경험하였기에 문헌적 고찰과 아울러 보고하는 바이다. Granulosa cell tumors are usually solid and estrogenic but they are seldom cystic, moreover ruptured spontaneously. A case of spontaneously ruptured cystic functioning granulosa cell tumor in a 55 years old wamon is presented with a brief review of the literatures.

난소 미분화 기형종 1 례

최욱(W CHOI),최동수(DS Choi),목정은(JE Mok) 대한산부인과학회 1986 Obstetrics & Gynecology Science Vol.29 No.6

저자들은 본 대학 부속병원에서 난소 미분화(악성)기형종 1례를 경험하고 외래 추적관찰중에 있기에 문헌고찰과 함께 보고하는 바이다. Immature teratoma of the ovary is an uncommon and highly lethal ovarian germ cell tumor. This tumor represents approximately 1% of ovarian teratomas and occurs primaily in young adults. Immature teratomas may be composed of elements from all three germ layers the ectoderm, mesoderm and endoderm. These tumors are characterized by the presence of variable amounts of incompletely differentiated tissue. Treatment consists of complete excision of tumor at early stage, followed by adjunctive combination chemotherapy. The two most important prognostic parameters are known as stage of disease and histologic grade. The purpose of this paper is to report our experience with a patient with immature teratoma of the ovary in our hospital, with a brief literature review.

질에 발생한 자궁내막증 1 예

최은봉(EB Choi),최동수(DS Choi),오보훈(BH Oh),목정은(JE Mok) 대한산부인과학회 1986 Obstetrics & Gynecology Science Vol.29 No.12

본원에서는 희귀한 질의 이소성 자궁내막증 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다 A case of endometriosis arising in vagina is presented with a brief review of the literatures

자궁부속기에 발생한 융모암 2예

류회현(HH Lieu),최동수(DS Choi),오보훈(BH Oh),목정은(JE Mok),양문호(MH Yang) 대한산부인과학회 1981 Obstetrics & Gynecology Science Vol.24 No.9

Choriocarcinoma arising in the tube or mesosalpinx constitutes an exceedingly rare phenomenon which is still the only malignant neoplasm generally accepted as curable after systemic spread has occured. Two cases of exterauterine choriocarcinoma one case arising in a tube the other arising in mesosalpinx, are presented with the brief review of literature. Authors were not able to find Korean reports of mesosalpingeal choriocarcinoma

수혈후 불규칙항체에 의한 급성 신부전증 치험 1 례

고광덕(KD Ko),최동수(DS Choi),소혜경(HK So),김세일(SI Kim),송승규(SK Song) 대한산부인과학회 1989 Obstetrics & Gynecology Science Vol.32 No.6

저자들은 수혈받은 경험이 없는 산모에서 빈혈교정을 위한 수혈을 시행한 뒤 불규칙항체의 한 급성신부전증 1례를 경험하였기에 문헌적 고찰과 함께 보고하는 바이다. One postpartum woman was transfused with 2 pints of packed cells for correction of anemia after routine cross matching. During the transfusion the patients was suffered from minor transfusion reaction but was tolerable immediately after transfusion she complained of dyspenea, chiling, irritablility also fever hemoglobinuria, oliguria and fall in hematocrit valuses are developed. On detailed recross matching test irregular antibody was detected we treated her for renal failure with CAPD etc. On 20th hospital day, she was discharged without complications.

거대한 남성화 Sertoli-Leydig Cell Tumor의 1 례

박문형(MH Park),최동수(DS Choi),오보훈(BH Oh),목정은(JE Mok) 대한산부인과학회 1987 Obstetrics & Gynecology Science Vol.30 No.2

18세의 여학생에서 발생된 희유한 거대한 남성화 Sertoli-Leydig Cell Tumor의 1례를 경험하였으며, 수술후 현재 경과를 관찰중인 바 간단한 문헌고찰과 함께 보고하는 바이다 Sertoli-Leydig cell tumors of the ovary are sex cord stromal tumors, similar to that seen in the various phases of testicular development in the male It is the most common type of all virilizing ovarian tumors We experienced a huge virilizing Sertoli-Leydig cell tumor with heterologous elements in 18 years old girl and followed up for 1 year, so we present it with brief review of literature

경구용 PGE2, 질용 PGE2 및 DHA - S 의 자궁경관 숙화에 관한 비교 관찰

우장상(CS Woo),최동수(DS Choi),서병희(BH Suh),이재현(JH Lee) 대한산부인과학회 1983 Obstetrics & Gynecology Science Vol.26 No.7

저자들은 Bishop score가 4 이하인 유도분만의 적응이 되는 만삭산모 60명(초산부 10명, 경산부 30명)을 각각 20명(초산부 10명, 경산부 10명)씩 무작위로 나누어 경구용 PGE2, 질용 PGE2, DHA-S를 사용하여 다음과 갈은 결과를 얻었다. 1. 대상자의 평균연령은 26.6세, 경구용 PGE2군 26.6세, 질용 PGE2군 25.7세, DHA-S군 27. l세이었다. 2. 임신주수의 범위는 38~44주이었으며, 평균 임신 주수는 경구용 PGE2군 41.7주, 질용 PGE2군 41.5주, DHA-S군 41.2주이었다. 3. 유도분만전의 Bishop score는 경구옹 PGE2군. 2.0 (초산부 2.1, 경산부 1.9), 질용 PGE2군 2.9(초산부 2.7. 경산부 3.1), DHA-S군 2. 9(초산부 3.1, 경산부 2.6) 이었다. 진롱발현시 Bishop score는 경구용 PGE2군 4.7(초산부 4.4. 경산부 4.9), 질용 PGE2군 5.3 (초산부 4.7, 경산부 5.9)과 DHA-S군 5.9(초산부 5.6, 경산부 6.2)를 나타내었다. 4. 진통발현시 Bishop score의 증가는 유도분만전에 비해서 경구용 PGE2군 2.7(초산부 2.3, 경산부 3.0), 질용 PGE2군2.4(초산부 2.0. 경산부 2.8). DHA-S군 3.0(초산부 2.5, 경산부 3.6) 이었다. 5. 유도시작에서 진통발현까지의 소요시간은 경구용 PGE2군 11.6시간(초산부 11.8시간, 경산부 11.3시간) 질용 PGE2군 5.8시간(초산부 4.7시간, 경산부 6.8시간), DHA-S군 7.0시간(초산부 8. 2시간, 경산부 5.7시간)이었다. 6. 진통발현부터 분만까지의 소요시간은 경구용 PGE2군 12.9시간(초산부 17.3시간, 경산부 8.5시간), 질용 PGE2군 7.0시간(초산부 9.9시간, 경산부4.0시간), DHA-S군 8.8시간(초산부 13시간, 경산부 4.5시간)이었다. 7. 출생시 태아의 체중은 경구용 PGE2군 3.14g, 질용 PGE2군 3.19kg, DHA-S군 3.27kg이었고, 분만된 신생아의 apgar score는 각각 1분과 5분에서 8.7 및 9.9. 7.5 및 9.9, 8.6과 9. 9이었다. 8. 투약도중 나타난 부작용은 경구용 PGE2군 2예에서만 단지 오심과 구토가 있었을 뿐, 질용 PGE2군과 DAH-S군에서는 어떠한 부작용도 관찰할 수 없었다. 9. 정상질식분만 경우는 경구용 PGE2군 15예 (초산부 6예, 경산부 9예), 질용 PGE2군 15예 (초산부 5예, 경산부 10예), DHA-S군 11예(초산부3예, 경산부 8예)이었고, 나머지는 모두 질식흡인 분만하였다. Prostaglandin E2, and Dehydroepiandrosterone Sulfate on the Unfavorable Cervix It is Now generally accepted that the uterine cervix plays an active role during pregnancy and parturition and that dilatation and effacement is not simply s result of uterine contractions, but also depends on an active ripening process within the cervix. Abnormalities in this process may cause considerable obstetric problems, possibly endangering the fetus as well as the mother. Various methods of cervical priming and/or induction of labor has been used by Prostaglandin E2-intravenously, orally, oromucosally, extraamnionically, intravaginally, and intracervically, and Dehydroepiandrosterone sulfate on the unfavorable cerxix. A compaisron was made between methods of ripening the unfavorable cervix(oral prostsglandin E2, intravaginal prostaglandin E2, Dehydroepiandrosterone sulfate) to 60 pregnant women (30 primipara and 30 multipara) between 38th and 44th weeks of pregnancy who were admitted to the Department of Obstetrics and Gynecology of Kyung Hee University Hospital from March to May 1983. 60 pregnant women were devided randomly 20 women (10 primipara and 10 multipara) in each group and their apgar score was 4 or less. The results were as follows. 1. Mean initial Bishop score was 2.0(primipara 2.1, multipara 1.9) in oral PGE2 group, 2.9 (primipara 2.7, multipara 3.1) in Vaginal PGE2 group, and 2.9 (primipara 3.1, multipara 2.6) in DHA-S group. Mean Bishop score after onset of pain was 4.7 (primipara 4.4, multipara 4.9) in oral PGE2 group, 5.3 (primipara 4,7, multipara 5,9) in vaginal PGE2 group, and 5,9 (primipara 5.6, multipara 6.2) in DHA-S group 2. Mean increase in Bishop score was 2.7 (primipara 2.3, multipars 3.0) in oral PGE2 group, 2.4 (primipara 2.0, multpara 2.8) in vaginal PGE2 group, and 3.0 (primipara 2.5, multipara 3.6) DHA-S group. 3. Mean induction-labor pain interval was 11.6 hrs (primipara 11.8 hrs, multipara 11.3 hrs) in oral PGE2 group, 5.8 hrs (primipara 4.7 hrs), multipara 6.8hrs in vaginal PGS2 group, and 7.0 hrs (primipara 8.2, hrs, multipara 5.7 hrs) in DHA-S group, Mean labor pain-delivery interval in each group was 12.9 hrs (primipara 17.3 hrs, multipara 8.5 hrs}, 7.0 hrs (primipara 9.9 hrs, multipara 4.0 hrs), and 8.8 hrs (primipara 13 hrs, multipara 4.5 hrs). 4. Mean weight of baby was 3.14kg (primipara 3.06kg, multipara 3.23kg) in oral PGE2 group, 3.19kg (primipara 3.05kg multipara 3.32kg) in vaginal PGE2 group, and 3.27kg (primipara 3.33kg, multipars 3.20 kg) in DHA-S group. 5. Mean Apgar score at l minute and 5 minutes was 8.7 and 9.9 in oral PGE2 group, 7.5 and 9.9 in vaginal PGE2 group, and 8.6 and 9.9 in DHA-S group 6. Normal vaginal delivery was 15 cases (primipara 6. multipara 9) in oral PGE2 group, 15 cases (primipara 5, multipara 10) in vaginal PGE2 group, and 11 cases (primipara 3, multipara 8) in DHA-S group Remained women were delivered by Vacuum. 7. side-effects during induction were appeared in 2 cases of oral PGE, group (Nausea and Vamiting), and any side effects were not observed in vaginsl PGE2 group and DHA-S group.

모성 건강관리 평가에 관한 임상적 연구 ( 제1보 )

이재현(JH Lee),오보훈(BH Oh),최동수(DS Choi) 대한산부인과학회 1981 Obstetrics & Gynecology Science Vol.24 No.9

1980년 2월1일부터 12월31일까지 11개월동안 경희대학교 의과대학 부속병원 산부인과에 분 만을 목적으로 입원한 산모 1547명을 대상으로 국제 출산력연구소(IFRP)에서 개발한 모성 기록표에 의거하여 작성된 내용을 조사분석하여 다음과 같은 결론을 얻었다. 1. 산모의 평균연령은 28.05±3.92세이며 25-29세군이 853례(55.72%)로 가장 많았고, 임신 및 분만의 위험이 높은 35세이상 군과 19세이하군이 100예(6.53%)이었으며 기혼이 경우가 96.34%로 대부분을 차지하였고 미혼인 경우가 0.20%이었으며 평균교육기간은 11.69±1.43년 이었다. 2. 산모의 평균생아출산횟수는 0.68±0.95회이었고, 생아출산력이 없는 경우는 802명(54.2%) 으로 가장 많았으며 1회 생아 출산한 산모가 31.6%, 2회 출산 9.5%, 3회 출산 2.9%, 4회 출 산 1.0% 순이었으며, 5회 이상 생아출산한 산모도 0.7%로 나타냈다. 최종전 임신결과를 보면 만삭분만 32.4% 인공유산 19.3%, 자연유산 7.3%, 조산 1.7%, 사산 1.0%의 순이엇다. 3. 대상산모 591례의 평균혈색소치는 9.24±2.01gm%이었고, 임신빈혈이 있는 경우가 319례 (54.0%), 빈혈이 없는 경우가 272예(46.0%)이었으며, 임신기간 37주이전에 분만한 산모군과 출산아 체중이 2500gm미만인 산모군에서 빈혈의 발생빈도가 현저히 증가하였다. 4. 평균임신기간은 39.87+-2.65주이었으며 조산아의 출산빈도는 20대 산모군 (8.63%)에 비해 10대 산모군 (16.67%)과 40대 산모군에서 각각 2배이상의 높은 빈도를 나타내었으며, 분만횟 수별 조사안의 출산빈도는 다경산부 (19.24%)에서 초산부(8.85%)나 경산부 (8.73%)에 비해 현저히 증가하였다. 5. 분만방법의 유형별 분포를 보면, 자연질식분만 53.08%, 흡입분만 29.89% 겸자분만 1.35% 제왕절개 14.87%이었으며 이중 흡입분만비율은 초산부 (42.27%)에서 경산부 (15.05%)에 비해 현저히 높앗다. 1. The mean age of 1531 cases was 28.5±3.92. the age group 25-29 was most common with 55.7% (853 cases ) and the age group of over 35 and under 19 in high risk pregnancy was 6.53% (100cases). The group of currently married status occupied the majority of cases (96.3%) and never married : 0.2%. the mean education years was 11.68±1.43 2. The mean live births in obstetric history was 0.68+-0.95. No history of live births was most common with 54.2%(802 cases) one live birth represented 31.6% two births : 9.5% 3 births : 2.9% 4 births : 1.0% and 5 or more births : 0.7%. 3. Mean hemoglobin level of 591 caes was 9.24±2.01gm% : 319 cases (54.0%) were in anemic condition and 272 cases (36.0%) were not in anemic condition. The incidence of anemia increased remarkably in the delivery groups of gestational age under 37 wks, and in infants weighting less than 2500gm. 4. Mean gestational age was 39.87±2.65wks. According to the incidence of premature delivery by matenal age, the delivered groups of ages under 19 (16.67%) and over 40(23.07%) were twice as high than groups of ages 20-29 (8.63%) and by parity the delivered group of the grand multipara (19.24%) was markedly increased from the primipara (8.8%) or multipara(8.73%). 5. The methods of delivery of 1479 cases were as follows ; spontaneous vaginal delivery : 53.08% , vacuum delivery :29.89%, forceps delivery : 1.35% , C-section : 14.87% , and among them , vacuum delivery was used more commonly in the primipara (42.27%) than the multipara (15.05).

임신과 동반된 난소종양의 임상적 고찰

이헌영,박태철,김수평,이종건,최동수,나종구,윤희종,나욱열 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.12

1. 임신중 부속기종양은 25∼29세에서 가장 흔하였으며(49.5%), 다산보다 초산부(65.7^)에서 흔히 발견되었다. 2. 임신중 난소종양의 진단은 임신 제 2기(11.4%), 제 3기(3.8%)에서보다 임신 제 1기(82.85%)에서 가장 많이 내려졌다. 3. 임신중 난소종양은 편측성이 92.38%, 양측성이 6.66%였으며, 양측성으로 진단내려진 7예중 4예가 기형종이었다. 4. 임신중 부속기종양의 가장 흔흔 합병증은 105예중 56예(53.3%)에서 발생한 복부동통이었으며, 이중에서 54예가 임신 제 1기에 발생한 것이었다. 22예만이 증상이 없는 경우였다. 5. 전체 105예중 81예는 수술요법을 시행하였고, 24예는 보존적 요법을 시행하였다. 수술로 제거된 81예중 58예에서 종양의 크기가 6cm이상이었고, 23예에서는 6cm이하였다. 6cm이상의 종양중 89.2%는 수술로 제거되었고, 6cm이하의 종양중 42.5%만이 보존적요법으로 치료되었다. 6. 수술요법을 시행한 81예중 53예에서 복부동통이 수반되었으며, 복부동통과 연관된 53예중 36예에서 종양의 크기가 6cm이상이었다. 7. 임의적 수술을 시행한 경우는 종양의 크기가 6cm이하에서 3예, 6cm이상의 경우에서는 17예였다. 종양의 크기에 무관하게 복부동통이 수술의 가장 흔한 적응증이었으며, 증상이 없는 경우에서 임의적 수술은 대부분 종양의 크기에 관계되었다. 8. 임신중 종양제거술을 시행한 81예에서 임신이 만삭까지 유지된 경우가 45예(55.5%), 조기진통이 온 경우가 9예(11.1%), 자연유산된 경우가 12예(14.8%), 그리고 인공유산을 시행한 경우는 6예(7.4%)였다. 그리고 나머지 9예(11.1%)는 추적관리가 되지 않았다. 9. 수술 후 호르몬요법(프로제스테론)을 받은 군과 받지않은 군에서의 임신예후는 별반 차이가 없었다. 10. 가장 흔한 조직학적 진단은 단순 낭종이었으며(40.74%), 양성 난종성 기형종이 30.86%, 난소 주위 낭종이 11.11%를 차지하였다. 11. 단순 초음파촬영상 낭종형으로 보인 경우가 70.37%, 혼합형이 28.39%, 고형형이 1.23%였다. 양성낭종성 기형종 26예중에서는 20예에서 혼합형 영상으로, 5예에서 낭종성 영상으로, 1예에서 고형형 영상으로 보였다. One hundred five cases in which hospitalization and/or surgical intervention during pregnancy were required for definite therapy of adenxal mass or follow-up were reviewed. The results were as follows: 1. The adnexal masses occurring in pregnancy were the more common at 25 to 29 years old-pregnant women(49.5%) and more common in nulliparous pregnant women(65.7%) than in multiparous women. 2. The preoperative diagnoses were made more commonly in the first trimester(82.85%) than in the second trimester(11.4%) and the third trimester(3.8%). 3. The adnexal masses were found to be unilateral in 92.38% and bilateral in 6.66%. The four cases of the seven cases occurring bilaterally were diagnosed pathologically as dermoid cyst. 4. The most common complication of the adnexal mass in pregnancy was abdominal pain occurring in fifty-six cases(53.5%) and 54 cases of them were related to the first trimester. Only 29 patient(27.61%) were free from complications. 5. The surgical excision was performed from 81 women and the expectant therapy was performed from 24 women. Fifty eight of 81 masses surgically removed, were$gt;6cm in diameter and the remained 23 masses were$lt;6cm in diameter. 89.2% of masses$gt;6cm in diameter were surgically removed and 42.5% of masses$lt;6cm in diameter were conservatively treated. 6. 53 cases of 81 cases surgically removed were related to abdominal pain as a complication. 36 cases of 53 cases complicated with pain, were masses$gt;6cm in diameter. 7. The elective surgery was undergone in 3 masses$lt;6cm in diameter and 17 masses$gt;6cm in diameter. Regardless of the size of the mass, the abdominal pain was the most common indication of the surgery, but the elective surgery was most commonly related to the size of the mass. 8. Among 81 cases in which the adnexal mass was removed, delivery occurred at term in 45 cases(55.5%), premature delivery in 9 cases(11.1%) and spontaneous abortion in 12 cases(14.8%), and criminal abortion in cases(7.44%) and the prognosis of pregnancy in the remained 9 cases(11.1%)couldn't be monitored. 9. There was no significant difference in the prognosis of pregnancy after surgery between the progesterone-treated and non-treated group. 10. The histologic diagnoses of the surgically removed adnexal mass were simple cyst(40.74%),benign cystic teratoma(30.86%)and paraovarian cyst(11.11%). 11. The sonographic evaluation revealed that 70.37% were cystic appearance, 28.39%, mixed appearance and 1.23%, solid appearance. 20 cases of the benign cystic teratoma showed mixed appearance while 5 cases and 1 showed cystic appearance and solid appearance respectively.