다발성 선천성 기형을 동반한 복벽균열증 1 예

김구상(KS Kim),이재관(JK Lee),손수영(SY Son),차상헌(SH Cha),이효표(HP Lee) 대한산부인과학회 1986 Obstetrics & Gynecology Science Vol.29 No.7

c저자들은 조산부로 임신 35주에 사망한 다발성선청성기형을 수반한 복벽균혈증 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다 Gastroschisis associated with multiple congenital anomalies is an extremely rare complication of pregnancy A case of gastroschisis associated with multiple congenital anomalies such as hydrocephalus, absence of left thumb, rudimentary right thumb, bilateral manus vara, bilateral rockerbottom feet, bilobed testes, bilateral agenesis of radius, congenital cardiac defects (ventricular septal defect, membraneous mitral valve) which we experienced recently in Seoul National University Hospital is reported here, with a brief review of the literature

선행 제왕절개 후의 경질분만에 대한 임상적 연구

조숙,김구상,고승권,한신교,정강우,김우성 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.11

The rate of cesarean section has been increased over the past twenty years. Recently, however, several problems with cesarean section have been reported. Many attempts to reduce the rate of cesarean section have been performed. One of them is vaginal delivery subsequent to cesarean section: Trial of Labor(TOL). We attempted TOL from August 1986 to April 1996 at Seongnam Inha hospital. It was a voluntary program for patients with a documented previous low-transverse cesarean section and no recurring indications. One hundred one cases from 1,706 pregnant women with previous cesarean section state were recruited in this study. Ninty five cases(94.1%) among 101 cases succeeded in vaginal delivery. The success rate of TOL was not influenced by the indication for previous cesarean section. There was no maternal death or uterine rupture in TOL. PG E2 or Oxytocin was administered for the induction or augmentation of labor in 20 cases and vaginal delivery was successful in 17 cases without complication. In conclusion, vaginal delivery subsequent to cesarean section may be safe, be encouraged in the patient with previous section under the adequate indication.

난관복원술에 관한 연구

조숙,강병문,김구상,고승권,김용관,손원풍,장영우 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.6

1987년 6월부터 1991년 6월까지 78예의 난관복원술을 시행하였다. 그중 49예에서 자궁내 정상임신이 되고 5예에서 자궁외임신이 되어 각각 63%와 6.4%의 성공율과 자궁외임신율을 보였다. 대부분의 임신(93%)은 수술후 1년이내에 이루어졌다. 수술후 난관의 길이와 접합부위의 양측 난관직경이 양호한 정도(favorability)가 통계학적으로 유의하게 임신의 가능성을 예측할 수 있는 인자였다. 자궁외임신 5예는 모두 접합부위의 난 관직경의 favorability가 불량한(-/-) 경우에서만 발생하였다. There has been increasing demand for tubal ligation reversals with increasing divorce rate and child loss by accident. After the introduction of microsurgical tubal ligation reversal technique by Garcia, many reports have been made about the factors which may influence the outcome of tubal ligation reversals, i.e. importance of hemostasis and avoidance of desiccation, postoperative tubal length, type of tubal sterilization, and site of anastomosis. We have reviewed 78 cases of tubal ligation reversals for determination of factors that were important in achieving pregnancy.

난소의 원발성 이행상피암 2 예

조숙,강병문,김구상,고승권,손원풍,장영우,황용하 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.7

저자들은 최근 난소의 원발성 이행상피암 환자 2예를 경험하였기에 간단한 문헌고찰과 함께 증례를 보고하는 바이다. Primary transitional cell carcinoma of the ovary has only recently recognized as one histologic subtype of ovarian carcinomas because of the favorable response to che-motherapy and improved patient survival. We eexperienced two cases of primary ovarian transitional cell carcinoma, and report these cases with a brief review of the concerned literatures.

자궁내 태아사망에 대한 임상적 연구

조숙,강병문,김구상,고승권,김인화,한신교 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.8

1985년 8월부터 1994년 12월까지 만 9년 5개월간 인하대학교 부속 인하병원 산부인과에서 입원하여 분만한 10446예중 임신 20주 이후에 자궁내 태아사망 172예를 대상으로 연구분석 하여 다음과 같은 결론을 얻었다. 1. 자궁내 태아사망의 발생빈도는 1.65%였다. 2. 연령은 18세에서 38세까지로 분포상 25세-29세군이 101예(58.7%)로 가장 많았다. 3. 출산력은 미산부가 98례(56.9%)로 가장 많았고 출산력은 증가시 감소하였다. 4. 기왕력에서 자궁내 태아사망은 5예(2.9%)이고 자연유산은 28예(16.3%)에서 있었다. 5. 발생이 가장 많은 임신주수는 37-40주로 28.5%를 차지하였고, 태위는 두위가 77.3%였으며, 남아와 여아의 비는 1.16:1이었고, 태아체중은 2500g미만인 경우가 73.2%를 차지하였다. 6. 분만방법은 유도분만이 60.4%로 가장 많았고 자연분만 27.9%, 수술적 분만 11.6%이었다. 7. 원인은 원인불명이 38.9%로 가장 많았고 다음므로 임신중독증으로 23.8%이었다. 8. 모성합병증은 58.1%로 산전과 산후 발열이 37.0%로 가장 많았고, 다음으로 출혈이 34% 이었다. 9. 혈소판 수가 100000/mm^3로 감소한 경우가 8.5%였고 부분 트롬보프라스틴 시간이 50초 이상 연장된 경우가 1.2%이었으며, 트롬보프라스틴 시간이 14초이상 연장된 경우는 8.8%이 었다. 혈장 섬유소원치가 150mg/dl이하인 경우는 6.3%이었고 FDPs가 40ug/m 이상으로 증가 한 경우는 10.5%이었다. 10. 산전진찰은 한 번도 받지 않은 경우는 4.8%이었고 3회 이상 산전경험이 있는 경우가 대 부분인 90.1%이었다. A clinical study was made on 172 cases of IUFD among 10446 deliveries at Inha University Hospital for 9 years and 5 months between August 1985 and December 1994. The results obtained were as follows; 1. The incidence of intrauterine fetal death(IUFD) was 1.65%. 2. The age distribution of mother with IUFD was between 18 to 38 year old and was higest in the 25 to 29 years old age group (58.7%). 3. The parity of mothers with IUFD was most highest in nulliparous groups(56.9%) and there was a decreased tendency with high parity. 4. There were 5 cases (2.9%) with previous history of IUFD and 28 cases(16.3%) with previous history of spontaneous abortion. 5. The most common gestational weeks when IUFD was detected, was 37-40 weeks(28.5%) and the most common presentation was cephalic(77.3%) the sex ratio of male versus female fetus ws 1.16 : 1, and most (73.2) of IUFD weighted less than 2,500gm. 6. The mode of delivery for IUFD showed that induced labor was most common(60.4%), spotaneous delvery was 27.9% was laparotomy was 11.6%. 7. The etiologic factors of IUFD was unexplained causes(38.9%), preeclmpsia(23.8%), cord problem(16.8%) in order. 8. There was 98 cases (58.1%) of the maternal complications. The most common complications was intrapartum or postpartum fever (37.7%), followed by hemorrhage (34.7%), wound infection(10.2%) and disseminated intravascular coagulation (7.1%). 9. The result of DIC studies were as followings : the platelet count was decreased below the level of 100000/mm^3 in 8.5% of the cases, the prothrombin time was prolonged above 14 seconds in 8.8% and partial thromboplastin time was prolonged above 50 seconds in 1.2% the serum fibrinogen level was decreased below 150mg/dl in 6.3% the FDP level was increased aboved the levels of 40 umg/ml in 10.5% 10. Only 4.5% of the mother with IUFD had not received any antenatal care, most of the cases (90.1%) had received more than 3 times.

양막대증후군 1예 A Case of Amniotic Band Syndrome

조숙,강병문,김구상,주인숙 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.1

저자들은 34주된 다발성기형아에서 경험한 양막대증후군 1례를 분석관찰하고 문헌고찰과 함께 보고하는 바이다. The amniotic band syndrome is a collection of fetal malformations associated with fibrous band that appear to entangle or entrap various fetal part in utero, leading to deformation, malformation and disruption. In spite of its rare incidence, its clinical presentation and prognosis are so prodound that deserve to attention to appropriate diagnosis and genetic counseling. A case of 34 weeks fetus with multiple congenital malformation due to amniotic band is reported, including a description of the placenta.

자궁경부의 침윤성 편평세포암종과 동반된 방광의 부신경절종 증례보고

조숙,강병문,김구상,고승권,한지연,김준미 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.8

Paraganglioma of the urinary bladder is a very rare disease which probably account for less than 0.06% of all bladder tumors. We report a case of paraganglioma of the urinary bladder which is synchronously occured with wquamous cell carcinoma of the uterine cervix with a brief review of the literature.

난소의 뮬러관 선육종 1 예

조숙,강병문,김구상,주영채 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.4

저자들은 31세의 환자에게서 난소의 뮬러관 선육종 1예를 경험하였기에 간단한 문헌고찰과 함께 보고한다. Ovarian Mullerian adenosarcoma have been described rarely in the literature due to the problem in diagnosis and nomenclature. We have experienced a case of ovarian M llerian adenosarcoma and it is reported with brief riview.

자궁내막증 환자에서 월경주기에 따른 혈청 CA-125에 관한 연구

조숙,강병문,김구상,고승권,한지연 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.6

1994년 5월부터 1995년 2월까지 자궁내막증의증환자의 양성부인과 질환으로 복강경, 골반경이나 개복술을 시행한 환자 50명을 대상으로 월경기와 난포기에 혈청 CA-125를 측정하고 자궁내막증과 대조군으로 나누어 비교 분석하여 다음과 같은 결론을 얻었다. 1. 자궁내막증 환자군의 월경기 혈청 CA-125의 평균값은 132.4±143.3U/ml, 난포기 혈청 CA-125의 평균값은 66.8±61.9U/ml로 월경기의 혈청 CA-125가 난포기의 혈청 CA-125보다 유의하게 증가되어 있었다(p$lt;0.05). 2. 대조군의 월경기 혈청 CA-125의 평균값은 26.68±13.2U/ml, 난포기 혈청 CA-125의 평균값은 117.57±9.48U/ml로 대조군에서도 월경기의 혈청 CA-125보다 증가되어 있었다(p$lt;0.05). 3. 자궁내막증 환자군은 월경기와 난포기 모두에서 대조군보다 높은 혈청 CA-125값을 보였다(p$lt;0.05). 4. 월경기 혈청 CA-125와 난포기 혈청 CA-125의 비는 자궁내막증 환자군에서 2.1±1.5, 대조군에서 1.6±0.5로 두 군간에 통계학적으로 유의한 차이는 없었다(p$gt;0.05). 5. 월경기 혈청 CA-125로 자궁내막증을 screening할 때의 민감도는 82%로, 난포기 혈청 CA-125로 자궁내막증을 screening할 대의 50%보다 높은 민감도를 보였다. CA-125 값은 월경주기에 따라 다른데, 자궁내막증의 screening에 혈청 CA-125를 이용할 때에는 월경 중에 검사하는 것이 민감도를 증가시키므로 월경중의 검사가 좋을 것으로 사료된다. The propose of this study is to estimate the change of serum CA-125 levels during menstrual and follicular phases and to evaluate the screening sensitivity for endometriosis using CA-125 levels in menstrual and follicular phases. Serum CA-125 levels were measured in menstrual and follicular phases in fifty patients, who were divided into two groups: endometriosis patients(21 women) and control group(29 women). The results were as follows: 1. Serum CA-125 levels in menstrual phase were greater than that levels in follicular phase in endometriosis patients. 2. Serum CA-125 levels in menstrual phase were greater than that levels in follicular phase in control group. 3. In patients with endometriosis, serum CA-125 levels were grater in both menstrual and follicular phases than control group. 4. There was no significant difference in the ratio of menstrual to follicular CA-125 levels between the two groups of patients. To improve the screening sensitivity for endometriosis, we conclude that the measurement of serum CA-125 level in menstrual phase is more useful.