프로스타글란딘제제의 경구투여와 옥시토신을 병합사용한 유도분만

최진호 ( Jin Ho Choi ),구태본 ( Tae Bon Koo ),박일수 ( Il Soo Park ) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.9

Objective : Our purpose was to complete delivery during daytime through rapid and safe management with oral prostaglandin plus oxytocin, and to reduce the duration of induced labor, hospital stay and dispersion of human power. Methods : Ninety pregnancies requiring induction of labor between December 1998 and July 1999 were analyzed prospectively. Patients were assigned to receive either oral PGE_2 or oral PGE_1. In one group, labor induction was performed with 0.5 ㎎ of oral PGE_2 (group 1, n=46), was orally taken every one hour since 06:00 AM to 09:00 AM and intravenous oxytocin infusion (The beginning dose was 2 mU/min, the dose increased by 2 mU/30 min) beginning at 09:00 AM, and in the other group (group 2, n=44), 100 ㎍ of PGE_1 was orally taken at 11:00 PM the day before oxytocin infusion was commenced at 07:00 AM. If there was uterine contraction of more than 200 Montevideo units, intravenous oxytocin would not be given. Results : The mean time (±standard deviation) to active phase labor (cervical dilatation more than 3 ㎝ and uterine contraction more than 200 Montevideo units) with PGE_2 group was 335.16±157.89 minutes versus 534.16±211.79 minutes with PGE_1 group (p<0.001). The mean time from active phase to birth was 182.8±93 minutes in group 1 versus 236.4±88.8 minutes (p<0.001). These significances were due to the difference of time interval from taking prostaglandins to infusion of oxytocin between the two groups. The time zone of expected delivery was 13:28 PM to 15:48 PM and 10:22 AM to 13:18 PM (Confidence Interval 95%). The induction failure rates were 10.87% versus 9.09%. The induction failure rate was significantly different according to Bishop score (if <4, 15.3% versus if ≥4, 0%) and the cesarcan section rate was also (if <4, 40.7% ,versus if ≥4, 19.4%) in the two groups (p<0.05). There were no clinical or statistical differences in demographic data, clinical characteristics, maternal outcomes and complications, and neonatal outcomes. Conclusion : Both may be proper methods of inducing delivery during daytime and begun at outpatient office base.

자궁내막증환자에서 요관협착으로 인한 수신증

정민지 ( Min Ji Chung ),구태본 ( Tae Bon Koo ),이택후 ( Taek Hoo Lee ),전상식 ( Sang Sik Chun ),이윤순 ( Yoon Soon Lee ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.3

Endometriosis is a relatively common disease, affecting 5-10% of women of reproductive age. But, endometriosis affecting the urinary tract is very rare entity. Involvement of urinary tract by endometriosis occurs in about 1% of women with pelvic endometriosis. Ureteral endometriosis is mostly asymptomatic for a long time, and associated with nonspecific symptoms at clinical presentation and difficult preoperative diagnosis. The involvement of the ureter is rarely intrinsic by implantation of endometrial tissue in the wall of the ureter, but rather due to external compression by adjacent endometriosis and its attendant inflammation and fibrosis. We have experienced a case of right severe hydroureteronephrosis due to ureteral stricture from endometriosis. Laparoscopic nephrectomy was done due to renal atrophy. At the same time, laparoscopic total hysterectomy with right salpingo-oophorectomy was performed because of the uterine adenomyosis and right ovarian endometrioma. So, we report that with a brief review of literatures.

임신중 자궁부속기 종양

박진욱 ( Jin Wook Park ),구태본 ( Tae Bon Koo ),박일수 ( Il Soo Park ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.4

Objective : To evaluate the clinicopathologic features and clinical outcomes of adnexal tumors in pregnancy. Methods : After review of charts of 51 patients managed at Kyungpook National University Hospital from January 1996 to June 2002, data including c

제왕절개술에 대한 임상적 고찰

백종국 ( Jong Kuk Baeck ),박정윤 ( Jung Yun Park ),구태본 ( Tae Bon Koo ),박일수 ( Il Soo Park ) 대한주산의학회 2000 大韓周産醫學會雜誌 Vol.11 No.1

난소관련병변에서 복강체액내의 cytokine 농도

전상식(Sang Sik Chun),조영래(Young Lae Cho),구태본(Tae Bon Koo),서장수(Jang Soo Suh) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.2

Objective : Recent studies have shown that multifunctional cytokines have been implicated in the pathogenesis and pathophysiology of various ovarian lesions including ovarian cancer and endometriosis. This study was performed to determine the possibility of the clinical usefulness of peritoneal cytokines in patients with various ovarian lesions. Methods : Peritoneal fluid was obtained from patients with benign cystic adenoma(n=11), benign cystic teratoma(n=10), endometriosis(n=23), malignant ovarian tumor(n=11), and women without evidence of any pathology(n=7) at the time of laparotomy or operative laparoscopic surgery and were examined for the levels of IFN-γ, IL-1β, IL-5, IL-6, IL-10 and TNF-α using enzyme-linked immunosorbent assay(ELISA). Statistical analysis was performed with the one way ANOVA, Scheffe test or Mann-Whitney test. Results : The mean concentration of IL-6 and IL-10 was significantly higher in peritoneal fluid specimens with ovarian cancer than other benign pathology(p<0.05). Both IL-6 and IL-10 levels in peritoneal fluid specimens with endometriosis tended to be higher than normal, and the levels of IL-6 and IL-10 were significantly higher in peritoneal fluid of women with severe endometriosis compaired to women with mild endometriosis (p<0.05). Conclusion : This study supports the concept that regional immunologic dysfunction might be involved in the disease process of various ovarian pathology such as ovarian cancer and endometriosis. A larger study would help in evaluating the potential use of local peritoneal cytokines in differentiating ovarian cancer from other benign pathology, and demonstrating any association between concentrations of cytokines and severity of endometriosis.

조산통 혹은 조기양막파수 산모와 임신 중반기 무증상 산모에서 Ureaplasma urealyticum과 Mycoplasma hominis의 검출율

김미주 ( Mi Ju Kim ),최민혜 ( Min Hye Choi ),성원준 ( Won Joon Seong ),구태본 ( Tae Bon Koo ),박일수 ( Il Soo Park ) 대한주산의학회 2008 Perinatology Vol.19 No.4

목적: 본 연구의 목적은 조산 혹은 조기양막파수 산모와 임신 중반기 무증상 산모에서 Ureaplasma urealyticum과 Mycoplasma hominis의 검출률을 알아보고자 하였다. 방법: 2002년 2월부터 2002년 7월까지 조기 진통이나 조기 양막 파수가 있었던 산모(1군) 43명, 임신 18~24주의 무증상 산모(2군) 47명, 그리고 만삭의 산모(3군) 64명으로 총 154명의 산모를 대상으로 본 연구를 진행하였다. 환자들은 입원 당시 혹은 외래에서 자궁경부 swab (Dacron(R))을 시행하여, Ureaplasma urealyticum과 Mycoplasma hominis의 감염 여부를 MYCOFASTR(R) Evolution 2 (International Microbio Signes, France)의 지침에 따라 시행한 후 판정하였다. 결과: 무증상 임신 중기인 2군과 만삭분만 한 3군간에 자궁경부 swab 결과는 큰 차이가 없었다. 조산의 임박군인 1군 내에서 임신 주수에 따른 Ureaplasma urealyticum의 검출률은 임신 주수가 32주 이상인 군(15/20,75%)에서 32주 미만인 군(10/23, 43.4%)보다 유의하게 높았다(p<0.05). 무증상군인 2군에서 임신 중기 Ureaplasma urealyticum과 Mycoplasma hominis 노출군과 비노출군간에 조산률의 의미 있는 차이는 보이지 않았다. 결론: Ureaplasma urealyticum과 Mycoplasma hominis는 조산의 원인이라기 보다는 분만에 가까워지면서 검진율이 증가하므로 자연적인 경관의 숙화에 따른 숙주 방어력의 소실을 비롯한 다른 원인에 대하여 더 연구하여야 하겠다. Purpose: The purpose of this study was to examine the risk of preterm birth in pregnant women with Ureaplasma urealyticum and/or Mycoplasma hominis infection and the prevalence of these organisms in normal pregnancy. Methods: Between February 2002 and July 2002, we included 43 pregnant women prior to 37 weeks of gestation with definite gross leakage of amniotic fluid (n=16) (group 1), 47 healthy women without any obstetric problems between 18 and 24 weeks of gestation (group 2) and 64 women who delivered fullterm fetuses who had taken cervical swabs around 36 weeks gestation (group 3). Cervical swabs (Dacron(R)) were taken on admission in group 1 and at outpatients in group 2 and 3. Detections of U. urealyticum and M. hominis were done using commercial kits (MYCOFAST(R)Evolution 2, International Microbio Signes, France). Results: There was no significant difference between mid-gestation (group 2) and fullterm (group 3) in cervical swab result. In group 1, the detection rate of Ureaplasma uealyticum was higher in impending preterm birth over 32 weeks of gestational age (15/20, 75%) than 32 weeks or less (10/23, 43.4%) (p<0.05). In group 2, there was no significant difference in preterm birth rate between the exposed and the non-exposed to U. urealyticum and/or M. hominis in middle of 2nd trimester. Conclusion: U. urealyticum does not seem to be a predictor of preterm birth, and there seems to be some different mechanism according to gestational age. We couldn`t varify that M. Hominis and U. urealyticum were related to preterm birth, although U. urealyticum was highly detected in impending preterm birth.

난소종양에서 미세혈관밀도의 변화와 VEGF의 발현

박일수,구태본,김동자,박태인 대한부인종양 콜포스코피학회 2002 Journal of Gynecologic Oncology Vol.13 No.1

난소관련병변에서 복강체액내의 cytokine농도

전상식,조영래,구태본,서장수 경북대학교 병원 2001 경북대학교병원의학연구소논문집 Vol.5 No.1

목적:최근에 난소암을 비롯한 종양성 질환과 자궁내막증등의 부인과 내분비 질환에서 면역반응의 활성에 관여하는 cytokine에 대한 연구가 많이 되고 있어서 저자들은 난소관련병변들의 병인분석과 감별진단의 가능성 및 치료적 응용에 있어서 복강체내액에 cytokine의 이용가능성을 조사하여 보았다. 연구방법:조직학적으로 진단이된 양성난소낭선종 11예, 성숙낭성기형종 10예, 자궁내막증 23예, 그리고 난소암 11예를 대상으로 하여 복강내 체액을 채취하여 INF-γ, IL-1β, IL-5,IL-6, IL-10 및 TNF-α의 농도를 측정하였으며 통계처리는 일원분산분석법과 Scheffe 법 그리고 Mann-Whitney 법으로 하였다. 결과:난소암 환자에서 IL-6와 IL-10 의 농도는 다른 양성병변들에 비해서 의미있게 증가하였으며(p<0.05) 자궁내막증 환자에서 대조군에 비하여 IL-6와 IL-10 의 농도가 높았으며 특히 자궁내막증 병기Ⅲ과 Ⅳ인 경우에서 병기Ⅰ과 Ⅱ에 비교하여 IL-6와 IL-10 의 농도가 의미있게 증가되었다. 결론:복수내의 cytokine환경은 난소관련병변의 병인과 질병의 진행과정과 관계가 있을 것으로 사료되며 복강내체액의 cytokine 농도 측정은 난소암과 양성병변과의 감별진단 및 자궁내막증 환자으 중증도의 진단과 병인규명에 도움을 줄 수 있을것으로 생각된다. Objective: Recent studies have shown that mlitifunctional cytokines have been implicatrd in the pathogenesis and pathophysiology of various ovarian cancer and endometriosis.This study was performed to determine the possibility of the clinical usefulness of peritoneal cytokines in patients with various ovarian lesions. Methods: Peritoneal fluid was obtained from patients with begin cystiv adenoma(n=11), being cystic teratoma(n=10), endometriosis(n=23), malignant ovarian tumor(n=11), and women without evidence of any pathology(n=7)at the time of laparotomy or operative laparoscopic surgery and were examined for the levels of INF-γ, IL-1β, IL-5,IL-6, IL-10 and TNF-α using enzyme-linked immunosorbent assay(ELISA). Statistical analysis was performed with the one way ANOVA, Scheffe test or Mann-Whitney test. Results: the mean concentration of IL-6 and IL-10 was significantly higher in pertioneal fluid specimens with ovarian cancer than other bengin pathology (p<0.05).Both IL-6 and IL-10 levels in pertioneal fluid specimens with endometriosis tended to be higher than normal, and of IL-6 and IL-10 were significantly higher in pertioneal fluid of women with severe endometriosis compaired to women with mild endometriosis (p<0.05). Conclusion: this study supports the concept that regional immunologic dysfunction might be involved in the disease process of various ovarian pathology such as ovarian cancer and endometriosis.A larger study would help in evaluating the potential use of local peritoneal cytolines ln differentiating ovarian cancer from other benign pathology, and demonstrating any association between concentrations of cytokines and severity of endometriosis.