침윤성 기태의 초음파 소견

서경윤,진동근,최주혁,천소희,장동규,민기옥,문희봉,고영미,김창이 대한산부인과초음파학회 2003 대한산부인과초음파학회지 Vol.5 No.2

난소암의 조기진단 및 선별검사

심재철,황지영,김도균,이형종,양회생 東國大學校醫學硏究所 2004 東國醫學 Vol.11 No.1

난소암은 대부분 증상발현이 늦고 이학적 소견이 불분명하여 병의 경과가 진행된 상태에서 발견되는 경우가 많아 부인과 암 중 사망률과 유병율이 증가하는 추세에 있다. 따라서 난소암 환자의 생존율을 높이기 위해서는 새로운 치료 기술의 개발 못지 않게 난소암 조기 진단법의 개발이 중요한 과제이다. 이를 위해 난소암의 고위험군인 1) 난소암 가계의 여성 2) 이보다 낮은 고위험인자를 가진 여성 즉 미산부, 조기 초경, 늦은 폐경, 폐경 후 여성, 과배란 유도를 한 여성, 유방암, 자궁내막암, 대장암 등의 과거력이 있는 여성 등을 선별하여 조기 검진하는 것이 필요하다. 정기적인 골반 내진, CA125 등의 종양표지물질, 질식 초음파, 질식 초음파 도플러 검사 등이 난소암의 조기 진단 및 선별 검사에 도움이 된다. Ovarian cancer manifestates indefinite physical exam results and usually asymptomatic which results in late diagnosis, therefore is the leading cause of death in all gynecologic cancers and the mortality rate and prevalence rate is increasing. Therefore, in order to increase the survival rate of the ovarian cancer patients, early diagnosis as well as improvements in treatment technology is important. Early detection through selected patients who are at high risk for ovarian cancer such as previous family history, nulliparas, early menarch, late menopause, postmenopausal women about to receive superovulation, breast cancer, endometrial cancer and colorectal cancer history should be needed. Routine pelvic examination, tumor markers along with TVUSG and doppler can aid the early diagnosis and screening of ovarian cancer.

질식 초음파로 진단된 태아 양측성 신장 무발생

임경란 ( Kyoung Ran Yim ),김현철 ( Hyeon Chul Kim ),문명진 ( Myoung Jin Moon ),강석호 ( Suk Ho Kang ),안은희 ( Eun Hee Ahn ),장성운 ( Sung Woon Jang ),신승주 ( Seung Joo Shin ),김광일 ( Kwang Il Kim ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.11

Fetal bilateral renal agenesis is a lethal congenital anomaly characterized by bilateral pulmonary hypoplasia, deformities and death due to severe oligohydramnios. This syndrome is associated with malformations of genitourinary tract, cardiovascular system, vertebral bodies or imperforated anus in more than half of the affected individuals. An early and reliable prenatal diagnosis is extremely important because it may offer options for pregnancy termination as early as possible. The criteria for the ultrasonographic diagnosis of bilateral renal agenesis are severe oligohydramnios, nonvisualization of the bladder, empty renal fossae. But poor sonographic resolution of severe oligohydramnios makes it difficult to diagnose the disease. We present a case of bilateral renal agenesis diagnosed at the 18th weeks gestation by using Transvaginal Ultrasonography and Color Doppler.

조기진통 임신부에서 7일 이내의 조기분만의 예측에 있어 질식 초음파를 통한 자궁경부길이 측정의 유용성

정희라 ( Hee Ra Jung ),이경 ( Kyung Lee ),김명환 ( Myoung Hwan Kim ),고지경 ( Ji Kyung Ko ),이철민 ( Chul Min Lee ),조용균 ( Yong Kyoon Cho ),최훈 ( Hoon Choi ),김복린 ( Bok Rin Kim ) 대한주산의학회 2009 Perinatology Vol.20 No.3

Purpose: To investigate the usefulness of transvaginal ultrasonographic measurement of cervical length in patients with preterm labor for prediction of preterm delivery within 7 days. Methods: Cervical length was measured by transvaginal ultrasound in 140 women with singleton pregnancies presenting with preterm labor and intact membranes from 24(+0) to 33(+6) weeks of gestation. Other potential predictive factors, such as Bishop score, previous history of preterm delivery, and parity were assessed. Results: The mean gestational age at presentation was 30.5±14.7 (range, 24.0 to 33.6) weeks and the mean cervical length was 29.0±0.9 (range, 31.0 to 52.1) mm. Delivery within 7 days occurred in 7.9% (11/140). Receiver-operating characteristics (ROC) curves established a cervical length of 25 mm as the most relevant cut off level for prediction of delivery within 7 days. Interval between admission and delivery was significantly short when ultrasonographic cervical length was less than or equal to 25 mm. Logistic regression analysis demonstrated that the significant independent risk factors were cervical length ≤25 mm (OR: 24.64, 95% C1: 2.97~204.20, P=0.003). Conclusion: Ultrasonographic cervical length measurement is a useful tool for prediction of progression to preterm delivery within 7 days with patients with preterm labor.

복강경하 질식 자궁절제술에 대한 초음파절제기와 양극성 전기 응고기의 비교

임주성 ( Lim Ju Seong ),정혁 ( Jung Hyuk ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.7

Objective : This study was to evaluate the effectiveness and value of Ultrasonic surgical system on Laparoscopic assited vaginal hysterectomy (LAVH). Methods : Retrospective study of 42 cases of LAVH with bipolar coagulator and 85 cases of LAVH with ultrasonic surgical system in Dept of OB/GYN, Chosun University Hospital from January 2001 to December 2002 was carried out and postoperative results were compared between 2 methods. Statistical analysis was performed using x^2 test and student t-test as appropriate. Statistical significance was defined as p<0.05. Results : The mean age of patients (bipolar coagulator vs ultrasonic surgical system) was 49±3 vs 48±4 years. The mean operating time was 54±13 min vs 37±6 min. The mean weight of uterus was 320±135 g vs 315±121 g. The mean hemoglobin drop was 2.42±0.85 g/dL vs 1.97±0.74 g/dL. Conclusion : In case of LAVH of myoma or adenomyosis using bipolar coagulator or ultrasonic surgical system. The advantages of ultrasonic surgical system were shortening of operation time, less bleeding during operation and less smoke caused by high temperature coagulation.

자궁강내 병변 확인을 위한 식염수 주입 초음파의 유용성

양혜진 ( Hye Jin Yang ),지병철 ( Byung Chul Jee ),구승엽 ( Seung Yup Ku ),서창석 ( Chang Suk Suh ),김석현 ( Seok Hyun Kim ),최영민 ( Young Min Choi ),김정구 ( Jung Gu Kim ),문신용 ( Shin Yong Moon ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.7

Objective: To evaluate the efficacy of saline infusion sonography (SIS) for the evaluation of uterine cavity pathologies. Methods: A total of 107 patients underwent hysteroscopy from June 2003 to October 2005 was included in this retrospective study. The mean age of the patients was 42.0±8.8 (range 28-62 years old). Two-dimensional ultrasonography (2D-USG) and SIS was performed in all patients prior to hysteroscopy. The findings obtained by 2D-USG and SIS were compared with the final diagnosis from hysteroscopy. Results: The sensitivity and specificity of SIS were 70.0% and 96.1% for submucosal myomas, and 88.3% and 63.8% for endometrial polyps, respectively. In contrast, the sensitivity and specificity of 2D-USG were 53.3% and 93.5% for submucosal myomas, and 35.0% and 83.0% for endometrial polyps, respectively. The overall diagnostic accuracy of SIS was 88.8% for submucosal myomas and 77.6% for endometrial polyps. The corresponding figures for 2D-USG was 82.2% (p=0.9437) and 56.1% (p=0.9934), respectively. The diagnostic accuracy of 2D-USG and SIS for uterine cavity pathologies was 36.4% and 71.0% respectively. Conclusion: SIS raised the diagnostic accuracy for uterine cavity pathologies compared with 2D-USG only. SIS seems to be an acceptable and safe method to evaluate uterine cavity pathologies

초기 임신에 있어서 질식 초음파에 의한 태아 심박동수의 의의

차동현 ( Dong Hyun Cha ),이윤호 ( Yoon Ho Lee ),김종석 ( Jong Seok Kim ),서승현 ( Seung Hyun Suh ),박병주 ( Byung Joo Park ),김종화 ( Jong Wha Kim ) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.7

Objective : Fetal heart rate in embryos(6-8 gestational weeks) have been significantly related to fetal outcome, but have rarely been studied. We attempted to identify fetal heart rate during 6-8 gestational weeks. Our purpose was to determine the lower limit of the heart rate associated with a favorable outcome and to evaluate the prognosis for those embryos with slow heart rates in early period. Methods : We prospectively studied 798 singleton pregnancies between Jul. 1997-Dec. 1999 visiting our hospital. Gestational age was calculated from the beginning of the last menstrual period in the case of regular cycle and was confirmed by the crown-rump length. Other cases were measured by crown-rump length or mean gestational sac diameter. Color doppler sonography was used to calculate the fetal heart rate in beats per minute as the mean of 3 waves.Results : Mean fetal heart rate (±SD) were 114.08±15.40 bpm for group 1, 126.49±18.78 for group 2, 139.83±19.92 for group 3, and 149.58±23.34 for group 4(p<0.001). Prognosis in the first trimester improved as heart rate increased to 100 bpm in group 1 and 120 bpm in group 2. In group 3 and 4, most of fetus with heart rates below 110 bpm died.Conclusion : The fetal heart rate during 6-8 gestational weeks is associated with fetal outcome at the end of the first trimester and we can identify the fetuses that are in risk.

임신 제2 삼분기에 질식 초음파로 자궁경부무력증이 예견된 임신부에서 아응급 자궁경부원형결찰의 임상적 유용성

황종윤 ( Jong Yun Hwang ),김숙희 ( Sook Hee Kim ),조준식 ( Jun Sik Cho ),이동헌 ( Dong Heon Lee ),박선정 ( Sun Jung Park ),김선권 ( Sun Kwon Kim ),심재윤 ( Jae Yoon Shim ),원혜성 ( Hye Sung Won ),이필량 ( Pil Ryang Lee ),김암 ( A 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.10

Objective : To investigate the clinical efficacy of urgent cerclage on perinatal outcome in cervical incompetence predicted by transvaginal ultrasonography in second trimester. Methods : We reviewed the medical records of 27 pregnant women who received ur

조기진통 임신부에서 조기분만의 예측에 있어 질식초음파를 이용하여 측정한 자궁경부길이의 유용성

최수란 ( Choe Su Lan ),양순하 ( Yang Sun Ha ),이지수 ( Lee Ji Su ),서용수 ( Seo Yong Su ),김종화 ( Kim Jong Hwa ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.11

Objective : The aim of this study is to evaluate the value of vaginal ultrasonographic cervical length in prediction of preterm delivery in patients with preterm labor. Methods : One-hundred twenty-nine women in preterm labor at 24-34 weeks of gestation w

비정상 초기 임신에서 β-hCG 식별대와 질식 초음파의 진단 정확도

차동현 ( Dong Hyun Cha ),이윤호 ( Yoon Ho Lee ),김종석 ( Jong Seok Kim ),김중열 ( Joong Yul Kim ),원형재 ( Hyung Jae Won ) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.6

Objective : To evaluate the accuracy of combined transvaginal ultrasound and β-hCG discriminatory zone for diagnosing intrauterine pregnancy, abortion, and ectopic pregnancy in early abnormal pregnancy.Methods : Initial ultrasound findings and β-hCG level were compared with final pregnancy outcome in 164 early pregnant women who visit our hospital with vaginal bleeding or abdominal pain. The sensitivity, specificity, and predictive value by the combination of two diagnostic tools were calculated. Statistic analysis of collected data used χ2 of SPSS(9.0).Results : Of 90 women with normal outcome, 64(71.1%) had a gestational sac 5mm, and in 47 cases, the hCG level was above 1,800 mIU/ml. Transvaginal ultrasound was non-diagnostic in 47(28.6%) of 164 women, and especially, 43(53.1%) of 81 cases with β-hCG levels below 1,800 mIU/ml. The portion of accurate ultrasound diagnosis was significantly higher in women above 1,800 mIU/ml (85.5%, 71 of 83 cases) compard with levels below 1,800 mIU/ml (37.0%, 30 of 81 cases) : P < 0.001; Relative Risk(RR) 2.31; CI 95%. Sensitivity of transvaginal ultrasound diagnosis of intrauterine pregnancy, abortion, and ectopic pregnancy was 90.2%, 79.3%, and 66.7% in women who presented with β-hCG levels above 1,800 mIU/ml, and 41.0%, 23.5%, and 75% below 1,800 mIU/ml, respectively. And, negative predictive value was 83.9%, 89.7%, and 98.8% in each of intrauterine pregnancy, abortion, and ectopic pregnancy above 1,800 mIU/ml, and 64.6%, 60%, and 97.3% below 1,800 mIU/ml, respectively. Conclusion : The sensitivity, specificity, and predictive value of transvaginal ultrasound for diagnosing abnormal early pregnancy were poor except cases of ectopic pregnancy when β-hCG levels were low than discriminatory zone. Ultrasound impressions were well related with β-hCG levels.