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- 저자 : 김암 ( Ahm Kim ) (검색결과 71 건)
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한국 선천성 기형 모니터링 체계 구축을 위한 다기관 공동연구
김암 ( Ahm Kim ),김소라 ( So Ra Kim ),양순하 ( Soon Ha Yang ),한정열 ( Jung Yeol Han ),김문영 ( Moon Young Kim ),양재혁 ( Jae Hyug Yang ),조용균 ( Yong Kun Cho ),김성수 ( Sung Soo Kim ),윤보현 ( Bo Hyun Yoon ),고경심 ( Kyung Sim 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.11
Objective: Our purpose was to establish a birth defects monitoring system in Korea by multi-center study. This novel study was initiated in 1999, and extended to detect the frequencies and trends of birth defects in Korea. Methods: Six centers participate
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김암 ( Ahm Kim ),마진영 ( Jin Young Ma ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.1
Premature labor remains one of the most intractable risk factors that contribute to perinatal morbidity and mortality. Tocolytics, antibiotics and corticosteroid have been used as the typical management for preterm labor. Various treatment of women with signs and symptoms of preterm labor has failed to decrease in the incidence of preterm births in the world. The management of preterm labor remains very controversial problems today. There are no clear first-line tocolytic drugs and antibiotics to prolong gestation period and improve perinatal outcome. But in Royal College of Obstetricians and gynecologists (RCOG) recommend that atosiban and nifedipine appear to be preferable as they have fewer side effects and seem to comparable effectiveness. So far there is insufficient evidence for any firm conclusions about whether or not maintenance tocolytic therapy following preterm labor is valuable. In conclusion, clinical circumstances and physician preferences should dictate treatment. Individual approach or combined treatment for preterm labor may be helpful in determining which treatment is suitable to each patient.
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중증 자간전증을 예측하기 위한 임신 중기 양수내 8 - isoprostane 농도 측정의 효용성
김소라(So Ra Kim),이필량(Pil Ryang Lee),구본상(Bon Sang Koo),김종수(Jong Soo Kim),정지윤(Ji Youn Chung),원혜성(Hye Sung Won),김암(Ahm Kim) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.10
Objective : The objective of this study is to investigate whether the amniotic fluid 8-isoprostane levels at the time of genetic amniocentesis is a marker for severe preeclampsia. Methods : A case-control study was conducted to compare mid-trimester concentrations of amniotic fluid 8-isoprostane in women with normal pregnancies (n=22) and in those who subsequently developed severe preeclampsia (n=22). Amniotic fluid was also obtained by amniocentesis from another women who already developed severe preeclampsia (n=22) after 20 weeks of gestation. The 8-isoprostane levels were measured by enzyme-linked immunoassay. For statistical analysis, nonparametric tests and receiver-operating characteristic curves were used where appropriate. Statistical significance was considered when probability was <0.05. Results : The levels of midtrimester amniotic fluid 8-isoprostane were found to be significantly decreased in the women who subsequently developed severe preeclampsia in comparison with those who underwent normal pregnancies (p<0.05). The levels of 8-isoprostane in preeclamptic amniotic fluid were found to be significantly decreased with respect to that in midtrimester amniotic fluid (p<0.05). No relationship was found between the midtrimester amniotic fluid 8-isoprostane levels and preeclampsia with small-forgestational-age. After the onset of severe preeclampsia, however, the amniotic fluid 8-isoprostane levels were significantly decreased in women with small-for-gestational-age. The midtrimester amniotic fluid 8-isoprostane level of 170 pg/ml had a sensitivity of 72.7% and a specificity of 63.6% in the prediction of severe preeclampsia. Conclusion : The midtrimester amniotic fluid 8-isoprostane levels may predict the later occurrence of severe preeclampsia. This study not only presents a new information that 8-isoprostane is detected in human amniotic fluid, but also provides a convincing evidence that a subclinical process from faulty placentation in early gestation is important for the occurrence of preeclampsia. Further studies are warranted to determine which mechanism causes such decrease in amniotic fluid 8-isoprostane in preeclampsia.
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임상 ; 당뇨병 산모에서 출생한 신생아의 선천성 기형 진단에서의 산전 정밀 초음파 검사의 역할
김영아 ( Young A Kim ),임진아 ( Gin A Lim ),이병섭 ( Byong Sop Lee ),심재윤 ( Jae Yoon Shim ),원혜성 ( Hye Sung Won ),김애란 ( Ai Rhan Kim ),김기수 ( Ki Soo Kim ),이필량 ( Pil Ryang Lee ),김암 ( Ahm Kim ),피수영 ( Soo Young Pi ) 대한주산의학회 2010 Perinatology Vol.21 No.3
Objective: Infants of diabetic mothers have higher incidence of congenital malformations compared with those of non-diabetic mothers. We investigated the usefulness of prenatal level II or “targeted” ultrasonography (TUS) as a diagnostic tool to identify congenital abnormalities in infants of diabetic mothers. Methods: We retrospectively reviewed the medical records of 218 mothers diagnosed as pregestational or gestational diabetes in whom prenatal TUS was performed in Asan Medical Center between 2004 and 2009. The prenatal TUS findings were compared with the congenital abnormalities found in the infants (n=226) of the diabetic mothers by physical examination and ultrasonography (including echocardiography). Maternal risk factors associated with congenital anomalies were also investigated. Results: The incidence of congenital anomalies was 14.2% (n=32) in prenatal TUS and 15.5% (n=35) postnatally, respectively. Only 7 cases (3.6%) out of the 194 infants with normal prenatal TUS findings were found to have congenital abnormalities diagnosed postnatally. All of the abnormalities in these 7 infants could be detected or suspected by physical examination after birth. Maternal fasting glucose level >120 mg/dL and insulin therapy were significant risk factors for predicting congenital abnormalities in infants of diabetic mothers. Conclusion: Prenatal TUS performed by experienced obstetricians had a good reliability in the diagnosis of congenital anomalies in infants of diabetic mothers. Need for universal screening of ultrasound or echocardiography in these infants should be questioned especially in the cases in which prenatal TUS was performed.
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김지선 ( Ji Sun Kim ),원혜성 ( Hye Sung Won ),백수진 ( Su Jin Baek ),최은선 ( Eun Sun Choi ),심재윤 ( Jae Yoon Shim ),김성훈 ( Sung Hoon Kim ),김정훈 ( Jung Hoon Kim ),이필량 ( Pil Ryang Lee ),김암 ( Ahm Kim ) 대한주산의학회 2008 Perinatology Vol.19 No.1
Objective: The aims of this study were 1) to evaluate the indications of chorionic villus sampling CVS and the positive predictive value for fetal chromosomal abnormalities, 2) to evaluate the reliability of CVS at Asan Medical Center, 3) to find out the risk factors of procedure-related fetal loss, 4) to find out the risk factors of culture failure, and 5) to compare transabdominal with transvaginal approaches. Methods: Medical records of the 429 out of 461 patients in whom the CVS for prenatal cytogenetic diagnosis were performed were reviewed retrospectively for the period of June 1998 to June 2006. Results: (1) The most common indications of CVS were abnormal ultrasonic findings including increased nuchal translucency (153/429, 35.7%), a previous history of cytogenetically abnormal baby (125/429, 29.1%), old maternal age (100/429, 23.3%), family history of genetic disease (22/429, 5.1%), and parental abnormal karyotype (11/429, 2.6%). (2) The positive predictive value of abnormal karyotyping according to the indication of CVS was highest in the cases showing abnormal USG findings, including increased fetal nuchal translucency (28.3%). (3) The trial success rate of CVS was 99.5%(427/429). Culture failure rate was 1.9%. (4) Of the 427 cases, normal karyotype was revealed in 349 cases (81.7%), abnormal karyotype in 66 cases (15.2%), maternal cell contamination in 6 cases (1.4%), and pseudomosaicism and confined placental mosaicism (CPM) in 6 cases (1.4%). (5) Procedure-related fetal loss rate was 1.6% (7/419). (6) The significant risk factor of fetal loss was presence of preprocedure vaginal bleeding. (7) The significant risk factor of culture failure was a small amount (less than 10 mg) of tissue. (8) The gestational age at procedure was significantly different between transabdominal and transvaginal methods. In the transabdominal approach group, the incidence of fundal location of placenta was significantly more common. Conclusion: If CVS is performed by an expert operator and at a good quality of genetic laboratory, CVS is a very safe and reliable procedure for prenatal genetic diagnosis.
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정상 자궁 동맥 Doppler 파형을 보이는 자궁내 성장지연 임신에서 양수내 Nitric Oxide 및 제대혈액 내 태아 성장인자의 농도 측정
김소라 ( So Ra Kim ),김종수 ( Jong Soo Kim ),정지윤 ( Ji Youn Chung ),원혜성 ( Hye Sung Won ),이필량 ( Pil Ryang Lee ),이인식 ( In Sik Lee ),김암 ( Ahm Kim ) 대한주산의학회 2002 Perinatology Vol.13 No.2
Objective:Our purpose was to evaluate the relationship between amniotic fluid nitric oxide(NO) and fetal blood IGF-I, IGFBP-1, and cortisol in pregnancies complicated by intrauterine growth restriction(IUGR), but showing normal uterine artery doppler waveform. Methods:From July 1999 to March 2000, 18 pregnant women with IUGR and 18 normal pregnancies were studied. Both group showed normal uterine artery doppler waveform. Amniotic fluid samples were collected to measure NO, and fetal blood samples were collected from umbilical vein to measure fetal growth factors. The definition used to identify cases of IUGR depended on three criteria: clinical evidence of suboptimal growth, ultrasonographic evidence of deviation from an appropriate growth percentile, and individualized birth weight ratios <10th percentile. Results:Overall median NO values in amniotic fluid were lower in IUGRs than in controls, but there was no statistical significance. However, IUGR newborns showed significantly lower(p<0.05) concentrations of IGF-I, and greater(p<0.05) concentrations of IGFBP-1 and cortisol than did controls. Conclusion:These result suggest that cord blood IGF-I, IGFBP-1, and cortisol, but not amniotic fluid NO may act major regulating factor in idiopathic IUGR without placental insufficiency.
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