초음파 아두대횡경치와 대퇴골길이에 의한 태아연령에측의 정확도에 관한 통계적 비교

노의선(YS Rho),고승권(SK Koh),김현식(HS Kim),이용우(YW Lee),남주현(CH Nam),정좌구(JK Chung) 대한산부인과학회 1987 Obstetrics & Gynecology Science Vol.30 No.3

월경력이 정확한 임신 제 25주에서 42주까지의 임부 269명을 대상으로, 태아연령을 예측하기 위하여 초음파를 이용한 BPD와 FL를 측정하여 다음과 같은 결론을 얻었다 1 임신주수와의 상관관계를 비교하여 볼 때 FL(r2=0 8955)가 BPD(r2=0 8255)보다 태아연령을 예측하는 척도로서 더 유의함을 알 수 있었다 2 FL가 GA의 상관관계를 나타내는 방정식중 직선방정식(r2=0 8955, t=48 7, P<0 01) 보다는 2차방정식(r2=0 9006, t=3069, P<0 01)이 태아연령의 예측에 더 정확한 model이었다 그러나 BPD에서는 직선방정식과 2차방정식(r2=0 8273, t=1 679, P>0 05)간에 태아연령예측의 정확도에서 유의한 차가 없었다 3 FL와 BPD를 함께 조합하여 산출한 새로운 방정식은 GA=-5 77+(1 8126) FL-(0 008372) FL2-(0 7453) BPD+(0 002966) BPD2으로써 r2=0 9106이었다 즉 태아연령의 예측에 있어서 FL나 BPD를 단독으로 사용하는 것보다 둘을 조합하였을때가 더 정확한 예측이 가능함을 알 수 있었다 4 GA에 대한 logarithmic function을 도입하여 산출한 회귀방정식은 LogGA =2 0068+ (0 0576) FL-(0 000288) FL2-(0 0172) BPD+(0 000065) BPD2으로 r2=0 9285로써 태아연령예측에 가장 적합한 공식이었다 Ultrasonic measurements of biparietal diameter(BPD) and femur length(FL) for estimation of gestational age(GS) were performed in 269 pregnant women between the 25th and 42nd weeks of gestation The results were as follows: 1 Femur length(r2=0 8955) was found to provide a more accurate index than BPD(r2=0 8255) for prediction of gestational age in the linear regression equation 2 The linear quadratic function for describing the relation between FL and GA was a more accurate model than the linear function(r2=0 9006, t=3 69, P<0 01) But no significant improvement in the accuracy for predicting GA was observed using the linear quadratic function in the relation between BPD and GA(r2=0 8283, t=1 679, P>0 05) 3 Combining the FL and BPD, the the new regression equation is GA=-5 77+(1 8126) FL-(0 008372) FL2-(0 7453) BPD+(0 002966) BPD2(r2=0 9106, P<0 01) It was found that this formula provided more accurate prediction of GA than that of using either FL or BPD 4 The multiple regression of log(GA) on EL, FL2, BPD and BPD2, Log(GA)=2 0068+(0 0576) FL-(0 000288) FL2-(0 0172) BPD+(0 000065) BPD2 showed the highest coefficient of determination(r2=0 9285) So it is concluded that this is the most accurate formula for prediction of GA

거대아에 대한 임상적 고찰

이진숙(JS Lee),고희주(HJ Ko),김영석(YS Kim),조용(Y Joe),노의선(YS Rho),김용필(YP Kim) 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.4

Macrosomia predisposes the fetus to birth asphyxia and trauma. The result of such conditions, though seldom lethal, may lead to long-term sequelae. Among the total number of 10,692 full-term deliveries at our hospital between January 1,1985, and July 31, 1993, there were 415 study cases with a birth weight 4,000g or more. Their obstetric problems and neonetal outcome, maternal factors predisposing to macrosomia were studied and result obtained were summarized as follows. 1. The incidence of macrosomia weighting 4,000 g or more was 3.88% and that of macrosomia weighing 4,500 g or more was 0.45%. 2. There were 51.08% (212 cases) of primiparas and 48.92% (203 cases) of multiparas in parity distribution. 3. In the sex ratio of macrosomia, male was more common (male: female=178.5:100). 4. The highest age distribution of mother was found between 25 to 29 years of age. 5. The most frequent occurance of macrosomia by gestational age was at 40-41 weeks of pregnancy. 6. The cesarean section rate was 47.95% and the most common indication for cesarean section was cephalopelvic disportion. The cesarean section rate was 1.78 times high comparing with that of overall. 7. The frequent maternal diseases at the time of delivery were anemia (26.02%) and preeclampsia(3.12%) in oder. 8. The most common complication of intrapartum and postpartum period was postpartum bleeding (3.61%). There was no maternal death. 9. Postpartum oral glucose tolerance test was done in 130cases. Abnormal value was found in 23 cases (17.69%). 10. Noenatal complication occured in 12 macrosomic infants (2.89%) of the total of 415 babies. Severe depressed infants (Apgar score 1 to 3 at 1 minute) was 1.20% (5 cases), congenital anomaly was 1.20% (5 cases), brachial nerve palsy was 0.48%(2 cases). 11. The perinatal motrality rate was 0.24% (1 case). The cause of perinatal death was fetal death in utero.

난소 난포막세포종 2 예

조용(Y Joe),정영호(YH Jeong),노의선(YS Rho),김용필(YP Kim),권순욱(SW Kwon) 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.3

Theca cell tumor is an essentially benign neoplasm derived from the theca cells of the ovarian stroma. They occur in women of all age groups but are usually diagnosed in women in their 50s and 60s. Detection of a pelvic mass may be the first clinical sign of the tumor, or it may be accompanied by clinical manifestations of increased estrogenic activity. Less commonly these neoplasms appear to produce androgens. We experienced two cases of ovarian thecomas and now present these cases with brief review of literatures.

광인대내 평활근육종 1 례

권순옥 ( SU Kwon ),김용필 ( YP Kim ),노의선 ( YS Rho ),전동호 ( DH Jeon ),정영호 ( YH Jeong ) 대한산부인과학회 1991 Obstetrics & Gynecology Science Vol.34 No.8

A 44-year old woman with initial diagnosis of intraligamentary myoma had undergone enucleation of the tumor and total abdominal hysterectomy with bilateral salpingo-oophorectomy. The intraligamentary mass was not connected with the uterus but adhered to the base of the urinary bladder. Its histopathologic finding was a leiomyosarcoma of the broad ligament. There was no evidence of the disease in the uterine tissue. A mitotic count revealed three mitosis per 10 high power fields. A leiomyosarcoma of the broad ligament not related with the uterus of the ovary is extremely uncommon. So er report this case with brief review of literatures.

난소종양 및 Residual Ovary Syndrome에 대한 임상병리학적 고찰

고승권(SK Koh),조창현(CH Cho),노의선(YS Rho),남주현(CH Nam),정좌구(JK Chung),권순욱(SW Kwon) 대한산부인과학회 1987 Obstetrics & Gynecology Science Vol.30 No.1

1976년 1월 1일부터 1985년 12월 31일까지 본 한림대학부속 한강성심병원에서 체험하였던 411예의 난소종양에 대하여 임상병리학적 고찰을 한 바 다음과 같은 결과를 얻었다. 1. 난소종양을 크게 비종양성 난소낭종, 양성 난소종양 및 악성 난소종양으로 대분하였을 때, 전 난소종양중 비종양성 난소낭의 빈도는 34.3% 이었으며 이중 단순낭이 30.5%, 황체낭이 28.4%의 순이었다. 연령별 분포를 보면 20대에서 48.9를 차지하여 가장 많았으며, 평균연령은 30.6세이었다. 2. 양성 난소종양은 전 난소종양의 58.2%이었으며 그중 낭성 기형종이 61.1%로 가장 많았다. 연령분포는 역시 20대에서 41.4%로 가장 많았으며, 평균연령은 32.6세이었다. 3. 악성 난소종양은 전 난소종양의 7.5%이었으며 점액성 낭선선암이 41.9%, 장액성 낭선선암이 22.6%를 차지하였다. 연령분포는 20대가 29.0%, 40대가 19.4%의 순이었으며, 평균연령은 37.3세이었다. 4. 난소 종양환자에서의 분만경력을 살펴보면 분만경험이 없었던 경우가 가장 많았으며 평균 분만횟수는 비종양성 난소낭에서 1.5, 양성 난소종양에서 1.8, 그리고 악성 난소종양은 역시 1.8이었다. 5. 난소종양의 수술방법으로는 비종양성 난소낭종 및 양성 난소종양환자의 74.2%에서 낭종적출술 또는 일측 자궁부속기절제술, 14.7%에서 전자궁 및 일측 자궁부속기절제술, 10%에서 전자궁 및 양측 자궁부속기절제술을 각각 시행하였으며 수술방법에 따른 각각의 평균연령은 27.5세, 39.3세, 48.8세이었다. 6. 악성 난소종양환자중 41.9%에서 일측 자궁부속기절제술, 19.4%에서 전자궁 및 일측 자궁부속기절제술, 19.4%에서 전자궁 및 일측 자궁부속기절제술, 35.5%에서 전자궁 및 양측 자궁부속기절제술을 시행하였고, 각각의 평균연령은 31.9세, 40.0세, 43.2세이었다. 일측 자궁부속기절제술을 시행한 경우는 20세이전의 미혼여성이며 임상분류상 제 1기 난소암 이거나, Borderline malignancy인 경우 및 과거에 전자궁적출술 및 일측 자궁부속기절제술을 받은 경우가 대부분이었다. 7. 동 기간에 일측 및 양측 난소를 남기고 전자궁적출술을 시행하였던 917예이었으며, 과거에 남긴 난소에서 종양이 발생하였던 "residual ovary syndrome"이 4예로서 그 빈도는 0.43%이었다. A clinico-Pathological study was made on a series of 411 cases of ovarian tumors, which admitted to the Department of Obstetrics and Gynecology, Hangang Sacted Heart Hospital,Hallym University during the period from January 1, 1976 to December 31, 1985. The results obtained were as follows: 1. Among 411 cases, the incidence of non-neoplastic ovarian cysts, benign ovarian tumors and malignant ovarian tumors were 34.3%(141 cases), 58.2%(239 cases) and 7.5%(31 cases) respectively. 2. Among the non-neoplastic ovarian cysts, simple cyst(30.5%, 43 cases) ranked first, followed by corpus luteum cyst(28.4%, 40 cases), and lutein cyst(22.0%, 31 cases). The highest incidence of non-neoplastic ovarian cysts showed in 3rd decade group(48.9%). The mean age of non-neoplastic ovarian cysts was 30.6 years. 3. In benign ovarian tumors, cystic teratoma(61.1%, 146 cases) was most common, followed by mucinous cystadenoma(23.4%, 56 cases) and serous cystadenoma(12.1%, 29 cases) in order of frequency. The highest frequency of benign ovarian tumors was found in 3rd decade group(41.4%). The average age of genign ovarian tumors was 32.6years. 4. As to the frequency of malignant ovarian tumors, mucinous cystadenocarcinoma was found in 41.9%(13 cases), serous cystadenocarcinoma in 22.6%(7 cases). The highest incidence of malignant ovarian tumors including borderline malignancy was observed in 3rd decade group(29.0%). The age of malignant ovarian tumors averaged at 37.3 years. 5. In the frequency of parity, nulliparous was most common(35.0%). The mean parity of non-neoplastic ovarian cysts, benign ovarian tumors, and malignant tumors were 1.5, 1.8 and 1.8 respectively.

수술적 인공유산이 실패한 임신초기 환자에서 Misoprostol 을 사용한 1 예

정민영(MY Jung),박주진(CJ Park),김유곤(YK Kim),노의선(YS Rho),김용필(YP Kim),장봉림(BR Jang),박양서(YS Park) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.11

Suction curettage is a relatively safe procedure to induce abortion of first trimester pregnancy with a very low complication rate. But, in order to do that, cervix should be dilated enough to pass operating devices. We experienced a case of first trimester pregnancy terminated successfully using transvaginal misoprostol when suction curettage was failed due to severely cervical stenosis after LEEP conization.

양측 난관임신 1 예

박재정(JJ Park),전동호(DH Jeon),황성한(SH Hwang),노의선(YS Rho),권순욱(SW Kwon) 대한산부인과학회 1991 Obstetrics & Gynecology Science Vol.34 No.5

A case of bilateral tubal pregnancy which was experienced in our hospital recently, is presented with brief references.

임신중 자궁경부의 Glassy Cell Carcinoma 1 예

윤창영(CY Yoon),박주진(CJ Park),이성원(SW Lee),조용(Y Joe),노의선(YS Rho),김용필(YP Kim) 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.1

Cervical cancer during pregnancy is rare and difficult to diagnose and treat. Accurate identification of the extent of cancer is more difficult during pregnancy because induration of the base of the broad ligaments, which in nonpregnant women characterizes tumor spread beyond the cervix, may be less prominent during pregnancy. If careful study of the cervix by cytology, colposcopy, and directed biopsy and occasionally by cone biopsy indicates that the disease is intraepithelial, the pregnancy may be allowed to go to term with normal vaginal delvery, and treatment deferred until the postpartum period. For more advanced cancer, the disease should be treated without regard to the pregnancy unless the pregnancy is 24 weeks or more. After 28-32 weeks, the baby can be delivered by classical cesarean section and treatment then instituted. Glassy cell carcinoma is a poorly differentiated carcinoma characterized by sheets of cells having 1) a moderate amount of cytoplasm with a ground-glass or granular appearance, 2) a distinct cytoplasmic membrane, and 3) a large nucleus containing prominent single or multiple nucleoli. Therapy is the same as for invasive squamous cell carcinoma and adenocarcinoma of the same stage, but the prognosis is not as good. We report a case of glassy cell carcinoma of the cervix during pregnancy.

선천성 복벽결손을 동반한 양막대증후군 1 예

정우철(WC Jung),한성태(ST Han),정민영(MY Jung),김영석(YS Kim),이성원(SW Lee),조용(Y Joe),노의선(YS Rho),김홍기(HK Kim) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.3

The amniotic band syndrome is a collection of fetal malformations associated with fibrous bands that appear to entangle or entrap various fetal parts in utero, leading to deformation, malformation, or disruption. The fibrous bands are mesodermic in origin and thought to be emanated from external surface of ruptured amniotic membrane. Misdiagnosis and inappropriate family counseling are common features. We experienced one case of amniotic band syndrome in 32 years old primigravid woman who had twin pregnancy after ovulation induction with Pergonal. We report the case with a brief review of literatures.

초음파로 산전 진단된 선천성 낭성선종양폐기형 1 례

허진숙(JS Hur),정영호(YH Jeong),김용필(YP Kim),노의선(YS Rho),권순욱(SW Kwon),박충기(CK Park),이민철(MC Lee) 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.9

Congenital cystic adenomatoid malformation of the lung (CCAM) is a rare benign pulmonary disorder characterized by an excessive overgrowth of respiratory structure. Few cases of antenatal diagnosis of this malformation has been reported. We experienced a case of CCAH which was detected ultrasonographically in the second trimester and present this case with review of related literatures.