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최욱환,김창훈,장미경,차문석 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.3
1984년 1월 초부터 1988년 6월까지 부산대학교 산부인과 외래에 월경이상, 유루증, 불임증 등으로 내원한 환자중 고 PRL혈중을 보인 127례의 환자에서 고PRL혈중의 임상적인 특성과 bromocriptine으로 치료한 환자에서 월경재개, 유루증소실, 배란유도, 임신유발 및 임신의 산과작 결과에 대해 연구 검토하여 다음과 같은 결과를 얻었다. 1. 환자의 연령분포는 평균연령이 29.4%±5.26세였고, 2630세군이 48.8%로 가장 호발 연령군이었다. 2. 환자의 주소로는 일차성불임증이 69례(54.3%), 유루증 64례(50.4%), 무월경이 47례(34.6%), 이차성불임이 37례(29.2%), 희발월경이 16례(12.6%)이었다. 3. 유루증을 보인 환자군에서의 혈중 PRL평균치는 유루증을 보이지않은 환자군과 통계학적으로 유의한 차이를 보이었으며(P$lt;0.05), 또한 유루증과 월경이상이 동반된 환자군에서의 혈중PRL평균치는 유루증단독증상을 보인 환자군과는 통계학적인 유의한 차이를 보이었다(P$lt;0.01). 4. 무월경 환자군에서의 혈중PRL평균치는 정상월경을 보인 환자군과 통계학적으로 유의한 차이를 보이었으나(P$lt;0.05), 정상월경과 희발월경군 상호간에는 통계학적인 유의한 차이를 보이지 않았다(P$gt;0.05). 5. Bromocriptine치료로 유루증 53례중 45례(84.9%)에서 평균 10.0 ± 1.93주의 치료로 유루증소실을 관찰하였다. 혈청PRL치는 평균 9.1 ± 0.99주의 치료로 85례중 65례(76.5%)에서 정상치로 감소하였다. 무월경을 보인 39례에서 평균 8.1 ±0.92주의 치료로 30례(76.9%)에서 월경의 재개를 관찰하였다. 무배란성주기를 보인 19례에서 평균 11.4 ± 1.98주의 치료로 배란을 확인하였다. 6. 임신된 22례의 평균치료기간은 38.8 ± 16.39주며, 3개월내에 45%, 1년내에 72.7%가 임신이 되었고, 자연임신된 4례도 관찰할 수 있었다. 7. Bromocriptine치료로 임신된 22례의 산과적 결과는 만삭분만이 18례(81.8%), 조기분만이 2례(9%), 자궁외임신이 1례(4.5%), 자연유산이 1례(4.5%)이었다. One hundred and twenty seven hyperprolactinemic patients who visited out-patient department at Pusan National University Hospital from Jan. 1, 1984 to June 30, 1988, with chief complaints of galactorrhea, amenorrhea, oligomenorrhea, and infertility were studied to evaluate the clinical characteristics and resolution of amenorrhea, galactorrhea, and anovulation, induction of pregnancy and pregnancy outcome after bromocriptine treatment. The results of this study were as follow; 1. Average age of all hyperprolactinemic cases was 29.4 years, and the most prevalent age group was 26 ~ 30 years (48.8 %). 2. Primary infertility was the most common chief complaints, giving 54.3 % of all cases, galactorrhea in 50.4 %, amenorrhea in 34.6 %, secondary infertility in 29.1 %, oligomenorrhea in 12.6 %, headache in 9.4 % and visual disturbance in 2.4 % respectively. 3. The serum prolactin levels were significantly increased in the patient group with galactorrhea compared to the patient group without galactorrhea (P $lt; 0.05) and also increased in the patient group with menstrual abnormalities and galatorrhea compared to the patient group with galactorrhea only (P $lt; 0.01). 4. The serum prolactin levels were significantly increased in the patient group with amonorrhea comapred to the patient group with regular menstruation (P $lt; 0.05). 5. By bromocriptine treatment, the average time tot he restoration of menstruation was 8.1 ± 0.92 weeks and complete cessation of galactorrhea occurred in averaged time of 10.0 ± 1.90 weeks. Ovulation was restored in 11.4 ± 1.98 weeks after treatment. 6. By bromocriptine treatment, 22 cases (29.7 %) among all studied cases were concepted and the average time to the conception was 38.8 ± 1.79 weeks, and ten cases (45 %) among all concepted cases occurred in first 3 months, 16 cases (72.2 % among all concepted cases occurred within one year. 7. The outcomes of 22 pregnancies induced by bromocriptine treatment were term delivery in 18 cases, preterm delivery in 2 cases, ectopic pregnancy in 1 cases, and spontaneous abortion in 2 cases.
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최욱환,주종길 부산대학교 병원 암연구소 2008 부산대병원학술지 Vol.- No.24
Objective: Pelvic actinomycosis is a rare disease, which makes chronic granulomatous suppurative pelvic abscess caused by an anaerobic Gram positive organism. Actinomyces israelii are usually associated with intra-uterine devices, and it is difficult to diagnose exactly before operation. Pelvic actinomycosis is frequently confused with gynecologic malignancy, leading to misdiagnosis and overtreatment. We have experienced 13 cases of pelvic actinomycosis and so provide the advice for treatment of pelvic actinomycosis. Methods: We reviewed retrospectively 13 cases which had visited to Department of Obstetrics and Gynecology, Pusan National University Hospital from January 1998 to January 2008. Results: The mean age of patients was 41.2 years old. Main symptoms were abdominal pain, palpable mass and diarrhea. Twelve cases had used the intrauterine devices for 1-20 years. In one case, patient had not used intrauterine device. A case was diagnosed preoperatively by endometrial biopsy and the others suspected to be tuboovarian abscess or malignancy, and then their diagnoses were confirmed by operation. All cases were treated by operation following antibiotics therapy, and 1 case by antibiotics without operation. All cases were completely cured. Conclusion: In treatment of pelvic actinomycosis, accurate preoperative diagnosis is most important for decreasing complication such as bowel, bladder, and other pelvic organ injury. If the diagnosis was established during operation, postoperative high dose antibiotic therapy will be needed for several months.
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최욱환 부산대학교 병원 암연구소 2006 부산대병원학술지 Vol.- No.20
Pregnancy induced hypertension is classified into gestational hypertension, preeclampsia and eclampsia. The diagnosis of gestational hypertension is made in women whose blood pressure reaches 140/90 mmHg or greater for the first time during pregnancy but in whom proteinuria is not identified, and the blood pressure has returned to normal by 12 weeks' postpartum. The final diagnosis is usually made several weeks after delivery. Eclampsia is termed when the oneset of convulsions in a woman with preeclampsia that cannot be attributed to other causes. Preeclampsia is one of the most common cause of death and disability in mothers and infants. It is diagnosed by the development of hypertension, proteinuria, or both after 20 weeks of gestation in a woman with previously normal blood pressure. Once the diagnosis of preeclampsia has been made, the management options are limited. So much attention has focused on the prediction of preeclampsia and development of preventive strategies. Many methods like rollover test, increased vascular reactivity to intravenous infusion of angiotensin Ⅱ, serum inhibin, maternal serum a-fetoprotein, fibronectin, soluble fms-like tyrosine kinase and Doppler velocimetry of the uterine vessels have been used to predict preeclampsia. But none of these predictive tests is used alone in clinical practice because they do not meet the criteria as a good predictor. For the prevention of preeclampsia, many strategies like diet therapy, use of antioxidant, low-dose aspirin and diuretics were used. But no single strategy has yet proven beneficial for the prevention of preeclampsia. The author have reviewed the current prediction, prevention and treatment of preeclampsia.
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