폐경후 여성에서 지속적 복합 호르몬대체요법시 Medroxyprogesterone Acetate가 혈중 지질대사에 미치는 영향

김정욱(JW Kim),김병석(BS Kim),장전호(JH Chang),전현아(HA Jeon),이경희(KH Lee),박만철(MC Park),이용우(YW Lee),윤종률(JL Yoon) 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.5

This study evaluates the impact on serum lipid and lipoproteins of adding continuously medroxyprogesterone acetate to conjugated equine estrogens in postmenopausal women. That is whether concomitant progesterone administration opposes beneficial effect of estrogen on lipoproteins whiles reducing the incidence of endometrial hyperplasia and cancer, or not. We studied on 31 menopausal women who had never hormonal therapy and no history of stroke, diabetes or any other cardiac, hepatic or renal disorker. Group A patients(n=16) were castrted postmenopausal women for at least 1 year and were given daily conjugated equine estrogen 0.625 mg for 6 months. Group B patients(n=15) received daily conjugated equine estrogen 0.625 mg and medroxprogesterone acetate 2.5 mg for at least 6 months. pre- and post-treatment evaluation of serum lipoprotein concentration demonstrated significant declines in total cholesterol(10.35% and 12.34%) and low-density lipoprotein cholesterol(24.21% and 28.13%) and significant increases high-density lipoprotein(16.18% and 11.69%) and triglyceride(23.59% and 25.40%) within group A and group B(P

Prostaglandin E2 질정에 의한 자궁경부 숙화 및 분만유도 효과

김정욱(JW Kim),고경수(KS Ko),이달경(DK Lee),이승기(SK Lee),이희경(HK Lee),이의진(EJ Lee) 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.9

In order to determine the clinical usefullness of PGE2 vaginal suppositories and oxytocin intravenous injection, PGE2 tablet(3mg) was administrated intravaginally to the 45 pregnant women and oxytocin intravenously to the 45 pregnant women . All the involved pregnant was between 38 and 42 weeks gestation, and who had below 4 points, by Bishop`s score(From March to December 1995). Results were obtatined as follows; 1. There was no significant differences on age distribution gestational period, cervical status in each group . 2. Sucess rate with labor induction was not significantly different in each group . 3. In induction failure group , PGE2 vagivnal suppository group was significantly better than oxytocin group incervical ripening over 3points by Bishop`s score(p<0.05). 4. There were no significant differences in Cesarian section rate, blood loss , 5-min Apgar score. 5. Side effects were minimal. That were vomiting(1 case), fetal bradycardia(2cases)in vaginal suppository group and fetal bradycardia(3 case) in oxytocin group. But there was no significant difference in each group . This study also shows that the PGE2 vaginal suppository is simple to use, acceptable to the patient has almost no side effect, effective in cervical ripending , An PGE2 vaginal suppository group have no significant differences on duration of labor compared with oxytoxin induction group.

Thanatophoric Dwarfism의 1 례

김상용(SY Kim),이도훈(DH Lee),이달경(DK Lee),김정욱(JW Kim),김영찬(YC Kim),이의진(EJ Lee) 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.9

Thanatophoric dwarfism was described by Maroteaux, Lamy and Robert in 1967, who differentiated it from achondroplasia. It is a short limb dwarfism with characteristic X-ray features and usually results in death shortly after birth. We present a case of thanatophoric dwarfism which has been diagnosed during antenatal period with review of literatures.

임신시 고혈압증 질환의 임상적 고찰

김병석(BS Kim),김정욱(JW Kim),장전호(JH Chang),전현아(HA Jeon),이경희(KH Lee),박만철(MC Park),이용우(YW Lee) 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.5

A Clinical study was undertaken on 326 cases of hypertensive disorders in pregnancy who were admitted to department of Obstetrics & Gynecology, Hangang Sacred Heart Hospital, College of Medicine, Hallym University for the period of 5 years from January 1, 1990 to December 31, 1994, during which time, there were 3,775 deliveries in total. The results were as follows; 1. The incidence of hypertensive disorders in pregnancy(HDIP) was 8.64% of total deliveries. 2. Using the classification of American Committee on Maternal Welfare, the incidence of HDIP was as follows; mild preeclampsia 25.46% severe preeclampsia 69.33% eclasmpsia 5.21% 3. The highest number of HDIP was observed in the age group of 25-29, but the frequency of disease was higher in their group above 35 years old and below 19 years old. 4. 65.64% of patients were nulliparity. 5. Among four blood type, the frequency of disease was higher in O blood group and follwed by AB, B, A in orders. 6. There was slightly higher male predominance in fetuses of the HDIP, but a significant difference was not see. 7. 58.28% of the patients were transferred from local private clinic and general hospitals. 8. The incidence of HDIP in twin pregnancy was 15.38%. 9. The incidence of HDIP in unmarried pregnancy was 35.94%. 10. As the gestational age and the body weight, the preterm and the lower birth weight higher incidence in HDIP group than non-HDIP group. 11. 39.96% of the patients were delivered vaginally, 20.55% spontaneous, 16.87% induced, 1.54% with vacuum, and 61.04% of the patients were performed cesarean section, 5.52% elective, 55.52% emergency. 12. As to maternal complication, hypoalbuminemia 37.74%, anemia 29.75%, preterm labor 23.31%, abruptio placenta 5.21% disseminated intravascular coagulation(DIC) 4.6%, postpartal bleeding 4% were found. 13. As to fetal complication, intrauterine growth retardation was foun in 28.57%, stillbirth in 5.36%, neonatal death in 3.87%, Apgar score in 5 min

제대 염전과 일측 태아의 자궁내 사망을 동반한 일 양막성 쌍태 임신 1 예

김형용(HY Kim),박현중(HJ Park),신용각(YG Shin),박채웅(CW Park),정찬우(CW Jung),김정욱(JW Kim) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.6

Monoamniotic twin pregnancies are relatively rare, occurring in 1 to 3 percentage. They are of particular concern to the obstetrician because the associated perinatal mortality is high.B Major cause of fetal death are umbilical cord entanglement, congenital abnormalities, and twin-twin transfusion syndrom, preterm delivery. A case of single fetal death in a monoamniotic twin with the entanglement of umbilical cord is reported with a brief review of the literatures.

Estrogen 과 Progesterone이 대장균의 백서질 및 방광점막 상피세포 점착에 미치는 영향

이영기(YK Lee),박정옥(JO Park),김정욱(JW Kim),박완석(WS Park),이승호(SH Lee) 대한산부인과학회 1989 Obstetrics & Gynecology Science Vol.32 No.1

난소적출술을 시행한 암컷 흰주에 난소호르몬을 투여했을 때와 수컷 흰쥐에 estrogen을 투 여했을 때 각각의 대조군과 비교해서 어느정도의 대장균 점착이 방광 및 질상피세포에 일어 나는가 하는 연구결과 다음과 같은 결론은 얻었다. 1. 양측난소적출술을 시행한 암컷 흰쥐에 난소호르몬을 투여했을 때 대조군보다 유의한 대 장균 점착의 증가가 있었다. 2. 암컷과 수컷사이의 대장균 점착은 암컷의 경우 유의하게 많이 점착되었으며 암컷 방광상 피의 경우 약제를 투여한 주수에 따라 유의한 증가가 있었으나 질상피의 경우 주수에 따른 유의한 차이는 없었다. 수컷 흰쥐에 있어서 estrogen을 투여한 경우 대조군보다 유의한 증 가가 있었으나 투여 주수에 따른 유의한 차이는 없었다. 3. 임신중 증가된 비뇨기계 감염의 원인으로서 난소호르몬이 중요한 영향을 끼친다고 볼 수 있으며 progestereone을 단독 투여한 경우에서 보다 많은 대장균 점착을 보인것과 질상피세 포보다 방광상피세포에서 더 많은 대장균 점착을 보인 점에 대해서는 앞으로 더 연구가 되 어야 할 과제라 사료된다. The effect of exogenous ovarian hormones administered to male and oophorectomized female rats was investigated with regard to in vitro adherence of escherichia coli to exfoliated bladder and vaginal epithelial cells. The results were summarized as follows; 1. In female rats tendency of E. coli adhencrence to vaginal and bladder epithelial cells was significantly greater in ovarian hormone administered rats than in control group . 2. In ovarian hormone administered female rats, E.coli attached in significantly greater number to the bladder epithelial cells, E.coli adherence was oberved in greatest number in progesterone administered rats followed by estrogen administered group , and combined progesteren and estrogen administered group in descending order. 4. Duration of hormone administration correlated with the degree of E.coli adherence in female bladder epithelial cells however on influence was noted in female vaginal epithelial cells, neither in other hormone administraion. 5. In male rats, E.coli adherence was observed in significantly greater number in Estrogen administered rats, but the duration of administrtion gave no significantly effects. 6. Enhanced E.coli adherence was significantly greater in female rats than in male rats.

방광 침습을 동반한 전치 침투 태반 1 예

박현중(HJ Park),김형용(HY Kim),신용각(YG Shin),김호성(HS Kim),김정욱(JW Kim),강유미(YM Kang) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.5

Placenta previa percreta is an uncommon and life threatening complication of pregnancy due to massive hemorrhage. And, the direct invasion of placenta to adjacent organ and/or the difficulty of surgery may raise maternal morbidity. To decrease the maternal mortality and morbidity, antepartum diagnosis and proper management is important to prevent catastrophic bleeding and the injury of adjacent organ. We experienced a case of placenta previa percreta at 38weeks of gestational age. Here, we present the case with brief review of literature.

소파술 및 자궁내시경을 위한 자궁경관 확대에 있어서 경구 미소프로스톨의 유용성

조기식(GS Cho),김평국(PK Kim),김정욱(JW Kim),홍성일(SI Hong),강영호(YH Kang),김태균(TK Kim) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.6

Objective: Recently, prostaglandins were used for cervical ripening and dilatation in pregnant women. However, its use in non-pregnant women is not well established. We compared pregnant versus non-pregnant woman for cervical ripening effect of oral misoprostol. Endometrial curettage and hysteroscopy are widely performed procedure in obstetrics and gynecology department. Difficulty in entering the internal os may be encountered, especially in nulliparous woman. The use of cervical priming agent is effective in reducing complications during cervical dilatation. We have used osmotic dilator[laminaria] for cervical dilatation prior to endometrial curettage and hysteroscopy. But laminaria is occasionally dangerous and uncomfortable to patient. We propose a new cervical priming agent[oral misoprostol] which is safe, cheap, comfortable and effective for cervical dilatation in both pregnant and non-pregnant woman. Methods: One hundred of patient requiring D&C and hysteroscopy were recruited for this study. The patients were received misoprostol 200μg orally 12 hours before D&C and hysteroscopy. The effect of oral misoprostol was evaluated by number of Hegar dilator at operation room. Results: The mean Hegar dilator number with resistance[H] was 9.69, without resistance[M] was 7.9. In pregnant women, H = 10.2, M = 8.3. In nonpregnant women, H = 9.18, M = 7.5. In nullipara, H = 9.76, M = 7.88. In primipara, H = 10.1, M = 7.88. In multipara, H = 9.52, M = 7.98. Of total 100 cases, four cases were difficult to perform D&C and hysteroscopy because Hegar dilator number with resistance[H] was below 8. Overall success rate was 96%. Conclusion: This study suggests that oral misoprostol is effective for cervical dilatation before curettage in both pregnant and non-pregnant women.

폐경 후 여성에서 골밀도에 관한 연구

정현아(HA Jung),김기환(KH Kim),김형우(HW Kim),김정욱(JW Kim),박종성(JS Park),이경희(KH Lee),박만철(MC Park),이용우(YW Lee) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.7

To examine the influence of the duration of menopause on bone loss, 60 healthy women, aged 34~74 years in 1995 were studied. After exclusion of past or present hormonal replacement therapy or past history of chronic disease, 60 women formed the final study population. Bone masses were measured at 3 sited of femur(femoral neck, Wards triangle & trochanter) and in the L2~L4 lumbar spine by Dual energy X-ray bone densitometry(DEXA). Correlation analysis and multiple linear regression analysis were used to analyze the relationships of gynecological variables(age, body mass index:BMI), and years since menopause(YSM) with bone mineral density(BMD) of lumbar spin and the three different sites of femur. The coefficients of correlation(r) of the bone mineral density(%) at the lumbar spine and the three different sites of femur with YSM were ranged -0.37~-0.48(p<0.01). Only YSM was independently related to BMD(%) data at all sites, except Wards triangle by multiple linear regression analysis(p<0.01). In conclusion, the menopause and the duration of menopause have a great effect on bone mineral loss.

자궁외임신 환자의 치료에 있어서 골반경수술과 개복술의 비교 연구

이도훈(DH Lee),김상용(SY Kim),이달경(DK Lee),이승기(SK Lee),김정욱(JW Kim),이의진(EJ Lee) 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.6

Recently, pelviscopic surgery trends to increase in world-wide in department of gynecology. Especially, in treatment of ectopic pregnancy, pelviscopic surgery is as effective and safe as treatment with laparotomy and has the advantage of decrease in hospital stay, cost and delay in return to normal activity and of cosmetic effect. To evaluate the efficacy of pelviscopic surgery in ectopic pregnancy, we have reviewed 137 patients treated by pelviscopic surgery and laparotomy from January 1993 to September 1994. The results were as follows. 1. A total of 137 patients were randomized to either pelviscopic surgery(N=95, 69.34%) or laparotomy(N=42, 30.66%). 2. There were no significant differences between the pelviscopic surgery and laparotomy groups in age, weight, parity, gestational age, past history and chief complaint, hematocreits, blood pressure but the estimated blood loss was significantly (p<0.01) lower in patients undergoing pelviscopic surgery. 3. In all ectopic gestaions, the most common site is ampullar portion(83.21%) and the most common operative procedure is salpingectomy(90.51%). 4. The mean operating time was not significant between pelviscopic surgery (60.9 +-21.3mins) and laparotomy(62.8+-20.9). But the length of hospital stay was significantly (p<0.01) shorter after pelviscopic surgery(3.6+-1.0 days) than after laparotomy (7.0+-0.7 days). 5. There were no intraoperative complications in the both groups.