여성성선과 갑상상선과의 상호관계 : 제1편, 제1보 : Estrogen 투여가 갑상선에 미치는 조직학적 변화

박정희(JH Park) 대한산부인과학회 1958 Obstetrics & Gynecology Science Vol.1 No.1

① Estrogen 소량군 (5㎍ 7일간계속투여)에서는 려포의 증가, 려포의 축소, Colloid는 희박하고 상피세포는 비교적 원형인 갑상선기능항진상을 보았고. ② Estrogen 다량군 (100㎍ 10일간계선투여)에서는 려포수의 감소, 려포의 증대, Colloid의 축적, 상피는 편평상을 정하는 갑상선기능저하상을 보았고. ③ 거세 30일이상 경과하면 Estrogen 다량군과 같은 갑상선기능저하상을 정하나 Estrogen 투여로 그 기능의 부활상을 보았다. The interrelationship between the thyroid gland and the female sex gland is too complicated and delicate to produce a concerted opinion about it at present. There have been many clinical or experimental researches on this interrelationship, but some assert the restraint, the other acceleration, or still other no relation at all, thus giving no detailed infermation. The writer intends to report the histological changes of the thyroid gland caused by the application of estrogen for the purpose of clarifying the interrelationship and mutual functional mechanism between the estrogen and the several endocrine glands and especially various aspects of its relation with the thyroid gland. For experiment, healthy mature mice with the weight of about 20 glams were divided into the following five groups, each group consisting of five mice except for the control group consisting of ten. First group - Control group, consisting of normal mice. Second group - Small amount of estrogen (10㎍s.) was applied every day for 7 days. Third group - Large amount of estrogen (100㎍s.) was applied every day for 10 days. Fourth group - After castration, bred for 35 days, and thereafter thyroidectomy. Fifth group - After castration, medium amount of estrogen (60㎍s.) was applied every day for 10 days. Throughout all the five groups, tissue specimen were embedded in paraffin, and 5 μ shreds were made, and stained with hematoxilin-eosin. Results of the experiment are:- 1) In the group where small amount of estrogen (5㎍s.) was applied for 7 days, follicles increased as compared with the control. Follicles have relatively shrunk, colloid was somewhat thin, epithelial cells round or flat, with no hypertrophy of interstitial tissue and no hyperemia. 2) In the group where large amount of estrogen (100㎍s.) was applied every day for ten days, there appeared the decrease of the number of follicles and the hypertrophy of follicles, and colloid was thickly accumulated, epithelial cells flat, with a conspicuous hypertrophy of interstitial tissues and a little hyperemia. 3) In the group where 35 days had passed after castration and then thyroidectomy was done, the number of follicles decreased, follicles showed a hypertrophy or had a medium size, colloid was accumulated thickly, and epithelial cells were flat, with a little and not so conspicuous hyperplasia of interestitial tissues. 4) In the group where after castration a medium amount of estrogen(60㎍s.) was applied for 10 days, there appeared the increase of the number of follicles and the shrinkage of follicles, and colloid was relatively thin, epithelial cells flat, with no conspicuous hyperplasia of interstitial tissues and a conspicuous hyperemia. These findings induce the following conclusions:- 1) In the groups where the amount of estrogen was small there appeared the increase of the number of follicles, the shrinkage of follcles, thin colloid, many of round epithelial cells and the hyperfunction of thyroid gland. 2) In the groups where amount of estrogen was large, there appeared the decrease of the number of follicles, the hypertrophy of follicles, the accumulation of colloid, flat epithelial cells, and hypofunction of thyroid gland. 3) 30 days after the castration, there occurred the decrease of thyroid gland, but the application of estrogen caused the activating figure of its function

속발성무월경 환자에 대한 임마혈청과 융모성성선자극 홀몬으로 야기한 인공배란 1례

박정희(JH Park) 대한산부인과학회 1958 Obstetrics & Gynecology Science Vol.1 No.1

인류에서는 배란유발이 곤란하나 최근 임마혈청과 융모성 성선자극 hormone의 주기적병용법에 의한 양호한 성적이 발표되어 있다. 저자도 31세 환자로서 속발성무월경(약 7개월), 원발불임(불임기간 약 8년)을 주소로한 1예에서 먼저 Depot-cyren(3회 주사, 간격 10일) 주사 후 Progesterone(50mg) 5일 연용하여 Estrogen 소퇴출혈을 야기시키었다. 그후 무배란성 주기를 반복하므로 Anteron(임마혈청)을 1회 1,000 I.U. 씩 2일 간격으로 4~5회 주사한 후 Physex(융모성 성선자극 홀몬)를 1회 1,000 I.U. 씩 1~2일 간격으로 3회 사용하여 배란유발에 성공하였다

임신 중독증에 관하여 ( 1964 - 1966 )

박정희(JH Park),조행원(HW cho),우신희(SH Woo),박금자(KZ Park) 대한산부인과학회 1968 Obstetrics & Gynecology Science Vol.11 No.10

Toxemia of pregnancy is still leading cause of maternal mortality during 3 years period from 1964 to 1966, 438 cases of toxemia of pregnancy have been encountered among total deliveries of 1040 cases in Ewha Womans University Hospital, Seoul. 1) The incidence of toxemia was varies, ranging from 3.4 to 12.2%(7% in average). Severe Preeclampsia was 50.5% of the toxemias, mild one of 44% and eclampsia of 5.3% It showed no any tendency to decrease for past 3 years. Both primigravidas and multigravidas were equally the same as 3.6% in the frequency of toxemia. February was the peak in the incidence. Toxemia was apt to occur in multiple preganancy, approximately 4 times single pregnancy. 2) Toxemic maternal death was 3 cases (0.68%); 2 eclampsias and 1 preeclampsia. The cause of death was that 2 cases died of pulmonary edema, one case of cerebral hemorrhage. Prognosis of eclampsia in general was poor. Over all toxemic death during past 4 years(1964-1968.3)was still high as leading cause of meternal death(55%). 3) Fetal death was 5%. The longer duration of gestation, the higher fetal death(40% loss during 38-41weeks) born in toxemia. 4) Fetal weight born in toxemia was 2850gms, and 390gms lesser than those born in non toxemic mother. 5) The majority of toxemias were lacking prenatal cares except 18% of the cases. Both the quantitative and qualitative prenatal care was re-emphasized. 6) Complications of the toxemia were 9 cases of postpartum hemorrhage & 4 abruptio placentae. 7) Most of the toxemic cases (2/3) were delivered well conservatively or spontaneously or whith low forceps aided. Cesarean section was performed on 8% of the cases usually following 24-48 hours, intensive medical treatment, such as Magnesium Sulfate, Serpacil, Apresolin, diuretics or sedatives etc. The stillbirths(1.6%) were succesfully induced by means of intrauterine catheter insertion. Oxytocic induction was rarely insituteed(only 1 case).

골반강내농양 ( Pelvic abscess ) 22예에 대한 관찰

박정희(JH Park) 대한산부인과학회 1958 Obstetrics & Gynecology Science Vol.1 No.1

과거 2개년간의 Pelvic abscess를 조사한 즉, 다음과 같다.종래 Parametrial abscess는 분만 유산후에 발생한다고 하였으나, 화학요법의 발전으로 분만후발생은 희소하고, 대다수 수술조작후에 발생하였다. 골반복막상부, 골반강내에 발생하는 것은, 종래의 보고와 같이 난관유농증, 골반복막염후에 발생함이 대다수이며 다음에 주목할 것은 우리나라 자궁탈민간요법후에 발생하는 것이 차위를 점하는 것이다. Ⅱ. 증상급 진단 하복부의 동통은 전 예이며, 발열은 37~38℃군이 13예, 38~39℃ 이상이 3예였다. 즉 비교적 경도 내지 중등도의 발열로 내원하는 자가 약 반수이상이다. 진단은 하복통과 발열, Leucocytosis, 내진상의 종유의 특유한 소견으로 진단할 수 있으나, 불명할 시에는 Douglas 와천자로 확진할 수 있다. Ⅲ. 자연방치시의 농양의 운명 골반복막염후에 발생하는 농양은, 대개는 Douglas abscess이며, 따라서 방치하면, 직장에 파개하거나, 혹은 자연흡수하거나, 혹은 일단 경쾌하였다가 후에 재연하거나 한다. 연이나 Parametrial abscess를 방치하면 직장, 방광, 질경관내에 파개하거나, 혹은 자궁전척후의 질단단으로부터 농이 배출하거나, 혹은 자연흡수되거나, 혹은 피낭되어 장기간 농양이 존속하거나 한다. 저자의 자연방치예 13예를 보면Parametrial abscess가 주위장기에 파개하기 쉽다. Ⅳ. 요법 이상 자연방치예 13예를 제외한 9예에 대하여서는 자궁척제, 부속기척제겸 복벽상 Drainage··········3예 복강내농낭을 절개한 후 복벽상 Drainage··········5예 후질절개··························1예 천배농은 5예였으나 후에 재발하였다. 22 cases of pelvic abscess have been observed during past 2 years, 1956-1957, and following observations are found.Ⅰ. Etiology According to the development of chemotherapy, now a few cases of parametrial abscess may be caused by the labor, even though classical description of parametrial abscess has been mentioned to find largely after labor. Here most cases were seen after operative management, of those many are occured after pyosalphinx and pelvic peritonitis, next larges figures were found in the cases according to cauterizing manages for prolapses uteri by laymen. Ⅱ. Symptoms and diagnosis All cases complained of lower abdominal pain, and fever was seen in 13 cases with 37-38℃, in 6 cases with 38-39℃, in 6 cases with over 39℃. So the slight or moderate fever is noticeable in more than half of these Cases. The upper and lower abdominal pain, fever, leucocytosis and tumor sign by vaginal examination are helpful in diagnosing, however, in uncertain cases, test puncture in Dauglas portion should be performed by conformation.Ⅲ. The fate of abscess without treatment ; As the most cases of the abscess after pelvic peritonitis are Dauglas abscess, so this has broken into rectum, or spontaneously absorbted, or slightly subsided but relapsed afterwards. However, parametrial abscess without treatment, have been broken into rectum, bladder, vagina or cervix uteri. Also it found during total histerectomy that pus was drained from the stump of vagina. Some occasion the abscess were absorbed naturally or remained with capsule formation for long period. Treatment. the 9 cases have been treated as following ; 3 cases Hysterectomy, Salpingo-Oophorectomy, Drainage on abdominal wall ; 6 cases, Abdominal drainage after incision of abdominal abscess ; Ⅰ case, incision on posterior vaginal wall. 5 among the above 9 cases have been tried by puncture drainage for treatment, but relapsing were occured

자궁근종과 임신

이한규(HK Lee),박정희(JH Park) 대한산부인과학회 1958 Obstetrics & Gynecology Science Vol.1 No.1

자궁근종에 임신을 합병하는 예는 문헌상 극히 희유한 것이며 또한 그 진단의 곤란성 및 임신, 분만지속에 대한 영향, 임신으로 인한 근종의 각종변성 변화의 초래 등 오인의 많은 관심을 갖게 하는 것이다. 필자는 최근 수년간에 본증에 관한 5예를 경험한 바 있으므로 이를 보고하는 동시에 상기한 제문제에 대하여 재검토하는 바이다.

제왕절개술후 감염과 Hygiene 질내 전처치의 가치

강신명(SM Kang),조행원(HW cho),우복희(BH Woo),박정희(JH Park) 대한산부인과학회 1968 Obstetrics & Gynecology Science Vol.11 No.7

During 1967 puerperal infection following Cesarean section has been evaluated with or without using the pre-operative vaginal application of 1% Hygiene solution(Amphoteric surface active agent) on the 50 section, among, 600 total deliveries in Ewha Womans University Hospital, Seoul. In order to reduce the post-Cesarean section infection 1% Hygiene solution was routinely applied preoperatively into vagina and it was throughly cleaned out. Particularly it has been focused to those who were potentialy infected pre-operatively. 1. The post-Cesarean section infection(38`C or over excess 48 hours) has been significantly reduced to 28% of the cases by using pre-operative vaginal application of 1% Hygiene solution in comparison with the 48% in the control group. 2. There were 2 wound infections or pus formation (8%) due to staphylococcus infection in the control group of Cesarean section, however none in the sections with pre-operative vaginal application of 1% Hygiene solution. 3. In the potentially infected section cases (mostly due to staphylococcus aureus) the incidence of endometritis can be reduced to 50% of the control group`s frequency by using pre-operative vaginal application of 1% Hygiene solution.

산욕기에 발생한 허혈성 뇌경색 1 예

박정희,고덕영,조태일,홍경희,이준형,박종두,박현중 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.9

본 병원에서 23주 2일된 자궁내 태아 사망아를 질식분만한 경산부에 있어서 분만 2일째에 Grade 1의 폐동맥 역류와, 심실조기 수축을 동반하는 부정맥과 패혈증에 의해 우측 중대뇌동맥 폐색에 의해 발생하였다고 생각되는 허혈성 뇌경색을 경험하였기에 간단한 문헌 고찰과 함께 보고하는 바이다. We present a case of ischemic cerebrovascular accident which occurred at puerperium in a 29 year-old multiparous woman followed by vaginal delivery of a dead fetus of 23 weeks` gestation.

점상연골 이형성증 (Rhizomelic Type) 1 례

박정희,이의진,고경수,오도산,김형석,이준형,박종두 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.7

Chondrodysplasia Punctata has been reported recently by an antenatal sonographic findings. It is a rare congenital disorder of bone in infant, which is characterized by radiographic manifestation of premature depositionof punctata calcific density in epiphyseal area, preformed in cartilage. Chondrodysplasia punctata has two different types: a rhizomelic, and nonrhizomelic type(Conradi-Hunermann syndrome). We present a case of rhizomelic chondrodysplasia punctata which has been delivered by Cesarean section.

우측 난소의 평활근육종 1 예

박정희,조태일,이준형,박종두,강유미 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.8

저자들은 1998년 1월 본원 산부인과에서 극히 희귀한 49세 여성의 우측 난소에서 발생한 평활근육종 1예를 경험하였기에 간단한 문헌 고찰과 함께 이를 보고하는 바이다. A diagnosis of leiomyosarcoma of the ovary was made in a 49 year old female presenting with abdominal pain and palpable mass. On clinical examination, a hard, large mass was found occupying the pelvic cavity. We experienced this infrequent malignant tumor. The authors report this case with the clinicopathologic findings and brief review of literature.

Methotrexate 투여한 침윤천공-전치태반 1 례

박정희,고덕영,홍경희,이준형,박종두,김형용,박현중 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.9

Placenta previa-percreta is a rare but highly morbid condition usually diagnosed clinically, intraoperatively. The cause of placenta accreta is considered to be deficient decidualization and absence of the fibrinous layer of Nitabuch. The condition is usually, but not always, seen in women having previous trauma, eg, cesarean section, manual removal of placenta, or curettage. Magnetic resonance imaging(MRI) might allow antepartum diagnosis of the this condition. Management included cesarean supracervical hysterectomy and bilateral hypogastric arterial ligation, and adjuvant methotrexate administration. We experienced a case of placenta previa percreta at 40 weeks gestational age. Here we present the case with brief review of literature.