Methemoglobin 血症 1例

김학혜,고광애 中央醫學社 1974 中央醫學 Vol.26 No.6

One case of methemoglobinemia was reported, 3 years old girl ingested unknown drug' by accident. But she was completely recovered by ascorbic acid and methlene blue therapy on 2nd hospital day.

百日咳에 대한 임상적 관찰

金鶴惠,李菊子 金原出版 1974 小兒科 Vol.15 No.5

천식에 동반된 cough syncope 1예

김학혜,최순자,박종무 대한소아과학회 1971 小兒科 Vol.14 No.7

미숙아에서 광선치료에 의한 혈청 빌리루빈 감소 효과에 관한 연구

金鶴惠 梨花女子大學校 韓國生活科學硏究院 1976 韓國生活科學硏究院 論叢 Vol.17 No.-

광선치료는 1958년 Cremer가 과빌리루빈증을 치료 감소시키는 방법으로 신생아 황달에 시행한 이후 Polleri, Lucey등이 심한 황달이 예견되는 신생아 및 미숙아에게 광선치료 방법을 적용하여 황달을 예방할 목적으로 연구를 계속하여 왔다. 미숙아에서 황달의 출현 문제에 대해서 특별한 관심을 모우고 있는 것은 혈청 빌리루빈치가 15mg/100ml 정도에 있어서도 핵 황달을 합병 유발하는 결과를 초래할 수 있기 때문이다. 저자는 미숙아를 대상으로 하여 광선치료군(20명)과 대조군(20명) 사이의 혈청빌리루빈치를 측정 비교하여 광선 치료효과 여부를 관찰한 결과 양군의 제1일의 빌리루빈치는 별 차이가 없었으나(p>0.05), 제2일부터 6일까지는 혈청빌리루빈 농도의 유의한 감소를 나타내고 있다. (P<0.01∼P<0.05). 광선치료군에서 혈청 빌리루빈치가 15mg/100ml 이상인 경우는 단 한예도 없었으며, 10∼15mg/100ml는 16예(14.7%), 10mg/100ml이하인 경우가 93예 (85.3%) 였으나, 대조군에서는 15mg.100ml이상인 경우가 10예(11.3%), 10∼15mg/100ml가 41예(38.7%), 10mg/100ml이하인 경우가 53예(50%)였다. 광선치료군의 최고 빌리루빈치는 12.5mg/100ml이었고, 대조군의 최고치는 18.2mg/100ml이었다. Evaluation of phototherapy preventing hyperbilirubinemia in the premature newborn babies was conducted with 20 babies as control weighing 1500-2500gm. Premature babies treated with phototherapy were exposed to light apart from the light sources about 100 Cm above the infant, startjng in the first 12 hr, of life. The infants were undressed except the a eye coveres and diapers. In this study, such patients as ABO incompatibility, Coombs test positive, sepsis, respiratory distress, asphxia, hypoglycemia, were excluded. Blood samples were collected by heel punture, and bilirubin value was determined by the method of hsia et al. The following results were obtained: The serum bilirubin level on 2nd to 6th day of life, in the control group was significantly different from the phototherapy group at same preiod, with p value 0.01-0.05. The highest total bilirubin value was 18.2mg/100ml in control group, while the highest total bilirubin value in phototherapy group was 12.5mg/100ml. There is no evidence that photodecomposition products of bilirubin might be the toxic effect. By taking advantage of this alternate route of elimination of bilirubin in the newborn infants, it should be possible to reduce greatly the need for exchange transfusion for hyper-bilirubinemia of prematurity.

양수(羊水)의 단백함량 및 단백분획에 대한 검색

金鶴惠,金原准 최신의학사 1974 最新醫學 Vol.17 No.12

The amniotic fluid performs several important mechanical functions. It acts as protective cushion, equalizes pressure and prevents adherence of the amnion thus allowing for changes in fetal position. Immunological and biochemical functions of the amniotic fluid, however, are obscure at the present time. Amniotic fluid consists of 9899% water and 1^-2% solids. About one half the solids are organic and about one half the organic solids are proteins. The paper electrophoretic patterns of amniotic fluid protein, which'was separated into 5 major bands, were similar to that of maternal serum. Recent developments of electrophoresis technique permit more detailed analysis to be made. Fischbacher and Quinlivan (1970) reported that the resolution of the proteins in human amniotic fluid into 21 bands by disc electrophoresis was considerably more than the 4 or 5 previously obtained by paper or cellulose acetate electrophoresis. The present study was undertaken to compare the relative distribution of protein fractions in amniotic fluid, taken during the final stage of delivery, with the relative distribution in the corresponding cord and maternal serum obtained immediately after birth. The results obtained are summarized as follows; 1. The total amount of protein in the amniotic fluid is 264±32.Omg/dl, compared with 7.5±0.2g/dl in the maternal serum and 6.8±0.2g/dl in the umbilical cord serum. 2. By means of disc electrophoresis, the proteins of the amniotic fluid were separated into 14 fractions which were less than that of the serum. Albumin and betas-globulin were main fractions in the amniotic fluid, but gamma globulin was slightly lower than that of maternal serum. 3. The antigenicity of the protein of the amniotic fluid was entirely the same as both maternal and cord serum according to double diffusion in agar gel.

Neonatal Hepatitis 1예

김학혜 中央醫學社 1977 中央醫學 Vol.32 No.1

For the experiment on the LDH isoenzyme pattern in the normal human fetal appendages (aminon, amniotic-fluid, chorion, umbilical cord), each composition and mean percentage distribution of LDH isoenzyme activities were examined by analysis of quantitative and qualitative studies from early pregnant stage to late stage by agar-gel electrophoresis. The obtaining results were as following: 1) LDH isoenzyme patterns in normal fetal appendages were classified 5 sub unit by technique of modified electrophoresis on the microscopic slides. 2) LDH isoenzyme patterns of normal amnion, amniotic fluid and umbilical cord showed anaerobic fraction type from early to late pregnant stage and their mean activity rates were increased by increasing of gestational age. 3) The fraction type of LDH isoenzyme in the chorionic tissue of the placenta showed intermediate fraction type with the highest activity rate at LDH III from early pregnant stage to thee ending of pregnant 9th month, but transformations to evident aerobic type were observed in the term placenta. The mean activity of LDH iseonzyme in each sub unit in the chorionic tissue of the term placenta was as follows: LDH I : 14.72% LDH II :18.20% LDH III : 27.06% LDH IV : 24.5% LDH V :15.47% 4) The perfect autoregulation of each tissue or organ metabolism was observed by amicable settlement of LDH isoenzyme sub unit which was mixed harmoniously for physiologic function in normal fetal appendages.

신생아 연하성 폐염에 관한 임상적 고찰

김학혜 中央醫學社 1976 中央醫學 Vol.30 No.1

Reported a clinical study of 82 cases of newborn infants with aspiration pneumonia who admitted to pediatric department, Ewha Woman’s University Hospital from 1968 Jan. to 1974 Dec. Obtained following results 1) Sex incidence was male 48(45.8%), female 34(41.5% , no difference. 2) 23(38%) of these infants were born prematurity, 20(24.4%) were born at term, 3(3. 7%) were post mature. 3) 26.5% of the infants were delivered by cesarean in production of aspiration. 4) Abnormality during pregnancy of mother revealed toxemia (53.8%), placenta previa (15.4%), viginal bleeding (23.1%) abruptio placenta (7.7 %) , and premature rupture of membranes (29.3%). 5) The chief complaints on admission were cyanosis (70. 7 °% ), weak crying (52.3%), grunting (34.1%), subcostal retraction (21.9 % ), respiratory difficulty (14.6%), apneic spell (10.9%), and meconium stained (23.1%) in orders. 6) Positive gastric juice culture were E. coli (42.9%), Staphylococus aureus(32.2 %), Streptococcus, Pseudomonas, Aerobacter, Proteus in orders. 7) 23 patients showed under 6 points in one min. Apgar score. 8) Breathing was faster than 80 per min. in 28(34. 1%) cases and was 40 to 80 per min. in 39(47.6%). 11 patients died. 9) Treatment of infants involved isolation in an incubator, artificial ventilation, oxygenation, administration of antibiotics. 13 died among 82 cases.

신증후군을 동반한 선천성 매독 1예

김학혜 中央醫學社 1977 中央醫學 Vol.32 No.1

For the experiment on the LDH isoenzyme pattern in the normal human fetal appendages (aminon, amniotic-fluid, chorion, umbilical cord), each composition and mean percentage distribution of LDH isoenzyme activities were examined by analysis of quantitative and qualitative studies from early pregnant stage to late stage by agar-gel electrophoresis. The obtaining results were as following: 1) LDH isoenzyme patterns in normal fetal appendages were classified 5 sub unit by technique of modified electrophoresis on the microscopic slides. 2) LDH isoenzyme patterns of normal amnion, amniotic fluid and umbilical cord showed anaerobic fraction type from early to late pregnant stage and their mean activity rates were increased by increasing of gestational age. 3) The fraction type of LDH isoenzyme in the chorionic tissue of the placenta showed intermediate fraction type with the highest activity rate at LDH III from early pregnant stage to thee ending of pregnant 9th month, but transformations to evident aerobic type were observed in the term placenta. The mean activity of LDH iseonzyme in each sub unit in the chorionic tissue of the term placenta was as follows: LDH I : 14.72% LDH II :18.20% LDH III : 27.06% LDH IV : 24.5% LDH V :15.47% 4) The perfect autoregulation of each tissue or organ metabolism was observed by amicable settlement of LDH isoenzyme sub unit which was mixed harmoniously for physiologic function in normal fetal appendages.

과숙아의 임상적, 통계적 관찰

金鶴惠 梨花女子大學校 韓國生活科學硏究院 1977 韓國生活科學硏究院 論叢 Vol.19 No.-

연장임신에 의한 후유증은 태반이 만삭을 지나면 그 성장이 중단되고 자궁긴장도가 상승되어 혈액공급이 감소되고 임신태반이 퇴행성 변화를 일으켜서 자궁과 태반 사이에 혈액순환을 감소시키므로 충분한 영양분과 산소의 공급을 받지 못해서 저산소증에 빠지게 된다. 저자는 1972년 1 월부터 1975년 12월말까지 이대부속병원 신생아실에 입원했던 659명의 과숙아를 대상으로 임상적, 통계적 관찰을 하였다. (1) 과숙아의 출산빈도는 10.5%였고, 남녀의 차이는 없었다. (2) 임산부의 연령이 비교적 높고, 초산인 경우에 많은 비율을 차지하였다. (3) 재태연령에 따르는 출생시 체중은 저체중아보다는 거대아의 빈도가 높았고, 신장은 재태연령이 연장될수록 약간 증가하는 경향이 있다. (4) 이상증상의 출현은 재태연령 42주군에서보다 43주 이상군에서 높게 나타났다. (5) 태반의 태변오염, 석회화가 임신기간이 연장될수록 높은 율을 나타내고 있다. (6) 임신중독증은 과숙아에서 만삭아보다 낮은 율을 나타내고, 과숙아에 행한 제왕절개술은 만삭아와 비슷하게 나타났다. I have observed 659 postterm infants, out of total 6,290 newborn infants who were born at Ewha Womans University Hospital from Jan. 1972 to Dec. 1975. The results obtained were: (1) Incidence of postterm infants was 10.5%. (2) Sex ratio of postterm infants was not statistically significant. (3) Prolonged pregnancy was found more frequently among primigravidas and maternal age advanced. (4) The longer the pregnancy the heavier is the baby. The birth height is not significantly taller than that of full term infant. (5) The chief symptom and sign on admission were long nail (48%), dry craked peeling on skin (29.4%), old look, poor nutrition, relatively long height in general appearance (22.5%), anoxia (7.9%), no crying (7.1%), negative Moro reflex (6.8%), green stained skin and cord(6.5%), grunting (6.4%) in orders. (6) Placental meconium stained and calcification according to gestational age were increased by the gestational period of 43 weeks. (7) The toxemia is a ploblem in postterm infant and is not reflected in this series. There was no difference between the 2 group on the manner in which delivery was effected. The cesarean section rate was about the same; 18.2% of the postterm infant and 18.5% of the full term infant.

離乳 食品에 依한 臨床的 實驗的 硏究

崔純子,金鶴惠,李賢淑,朴鐘茂,張賢基,金仁培 대한소아과학회 1971 小兒科 Vol.14 No.5