자궁조영술에 의한 자궁강내에 있어서의 자궁내 장치에 관한 연구

안동원(DW Ahn),유한기(HK Yoo),박세교(SK Park),곽현모(HM Kwak) 대한산부인과학회 1973 Obstetrics & Gynecology Science Vol.16 No.7

1) 자궁조영술에 의해 관찰된 자궁강 내의 자궁내장치의 위치는 총 80예중 정상위치가 65예, 비정상위치가 15예로서 하방 이동위치가 5예였고, 형태만곡이 10예였다. 2) 부작용의 빈도는 정상위치군에서 보다 비정상위치군에서 약간 높은 경향을 보였다. 3) 루프의 탄력성은 루프의 무게가 무거운 것일수록 강하였으나 착용기간에 따라 변화하지 않았다. The history of intrauterine contraceptive devices (IUD) reaches back over several decades. However, IUD was unsatisfactory for contraception until the late 1950`s. Since jack lippes used a linear polyethylene loop in 1959, various good results have been reported by the use of other IUDs. The new plastic IUDs have been use widely over the world but it is not clear as to the mechanism of contraception or of the side effects. The study of hysterographic examination with IUD has been undertaken to observe the position of IUDs (Lippes loop) in the uterine cavity and some relationships between the position and the side effects(symptoms). Eighty cases of IUD wearers were selected randomly in the Family Planning Clinic of SEverance hospital and hysterographic examination was performed with 10% hypaque solution. The elasticities and compositions of fresh loops as controls and of long used loops removed after hysterography as tudy material were analyzed at the National Institued of health. The results were as follows: 1. IUDs with normal position were found in 65 cases and with abnormal position 15 cases in hysterography. Among the IUDs with abnormal position, distrotion, of its shape appeared most frequently. The symptoms seemed to occur more frequently in abnormal positions than in normal positions. 2. The weight of the loop was not changed by the duration of wearing, and the ratio between barium sulfate and polyethylene content remained constant. In general, the heavier loops were the more elastic. There was no correlation between the duration of wearing and the elasticity of the IUD. Further study is needed to porve conclusively whether malposition of the IUD cases side effects of not.

임산부 매독의 임상적 고찰

안동원(DW Ahn),신호영(HY Shin),유한기(HK Yoo),박세교(SK Park) 대한산부인과학회 1973 Obstetrics & Gynecology Science Vol.16 No.1

The prevalence of syphilis was sharply decreased throughout the world since the introduction of penicillin in 1943. However, recent information seemed to be increased in incidence of syphilis since 1960 and syphilis has become a major public health problem in the many countries. In Korea, current status of syphilitic infection in pregnancy could hardly be assesed accurately, because there are a few reports of confident statistical data. However some reports showed syphilitic infection in pregnancy is also gradually increasing since 1962. In order to know the current pattern of syphilis in pregnant women, 9944 women who were delivered at Severance Hospital for a period of 5 years and 7 months from January 1966 to July 1971 were analyzed. The results are as follows: 1. During the 5 years and 7 nomths, estimated prevalence of syphilis in pregnant women in Severance Hospital was 2.0% of 9944 total number of women. 2. Only 17.9% of syphilis in pregnant women received the test before 7 months gestation. 3. The most prevalent syphilis was most prevalent in women 30 years of age with primigravida. 4. The incidence of premature was 31% in term of the duration of the gestation, and 26.5% in term of birth weight. 5. the perinatal mortality was 27.5% with 15 stillbirths (13.3%) and 16 (14.2%) neonatal deaths. 6. Amongs syphilis cases : 39.8% was stillbirth or premature, 8.8% was neonatal deaths and 10.6% was congenital syphilis.

자궁난관조영술상 자궁형태가 불임에 미치는 영향

전종영(JY Jun),양영호(YH Yang),안동원(DW Ahn),천영철(YC Chun),김재욱(JU Kim) 대한산부인과학회 1979 Obstetrics & Gynecology Science Vol.22 No.5

1974년 1월부터 1977년 12월까지 만 4년간 불임을 주소로 연세대학 의과대학 산부인과 외래로 내원하여 자궁난관조영술을 시행한 예중 양축난관이 정상이며 다른 불임의 원인을 발견할 수 없었던 117예를 대상으로 자궁난관조영술을 사용하여 Hay의 분류방법으로 자궁상을 분류하여 다음과 같은 결과를 얻었다. 1. 원발성 불임은 61예이며 속발성 불임은 56예이었다. 2. 연령분포와 불임기간은 양군에서 큰 차이가 없었다. 3. 자궁기형의 발생빈도를 보면 원발성 불임군에서는 62.3%이었고 속발성 불임군에서는 55.4%로서 이중 경한 자궁기형의 발생빈도는 원발성 불임군의 자궁기형에서는 68.4%, 속발성 불임군의 자궁기형에서는 77.4%로 나타났으며, 원발성 불임군과 속발성불임군에서 자궁기형의 발생빈도에 큰 차이가 없는 것으로 보아 자궁난관조영술에 의한 자궁기형, 특히 경한 자궁기형은 원발성 불임의 원인이 되지 않는 것으로 보이나 더 많은 예의 추후 연구가 필요한 것으로 사료된다. Presented is a series of 61 primary infertility patients and 56 secondary infertility patients with patent Fallopian tubes and no obvious cause for infertility. The uterine contour in hysterosalpingography was classified by Hay`s classification. The results revealed 62.3% and 55.4% uterine amonalies, and 68.4% and 77.4% minor anomalies among uterine anomalies in primary and secondary infertility patients respectively. The results do not show that a cause and effect relationship has been established between uterine anomalies, particularly minor uterine anomalies and primary infertility because there is no significant difference in incidence of uterine anomalies between primary and secondary infertility patients.

복강경 불임술에 대한 정신의학적 연구

민성길(SK Min),김경희(KH Kim),안동원(DW Ahn),곽현모(HM Kwak) 대한산부인과학회 1979 Obstetrics & Gynecology Science Vol.22 No.2

피임 목적으로 복강경 난관 결찰술을 받은 102명의 여성을 대상으로 수술 전에 비하여 수술 후 6개월만에 어떤 정신과적 후유증이 발생하는가를 조사 연구하여 다음과 같은 결과를 얻었다. 여성의 불임술은 전체적으로 보아 어느 정도 우울, 불안, 건강염려증 등 정신증상과 그에 수반되는 신체증상들 즉 성욕감퇴, 소화장애, 월경장애, 요통, 심계항진, 두통, 피로 등을 유발시켰다고 생각되나, 그 정도는 병적 상태가 아닌 매우 경미한 상태였고, 또한 대부분 수술에 대해 만족하는 등 정신과적으로 비교적 안전한 방법임이 입증되었다. 예후가 나쁜 악화군을 따로 구별하여 호전군과 비교해 보았을 때, 나쁜 예후는 개인력과 가족력에 있어 이에 정신과적 문제가 존재하고 있음과 관련되었다. 즉 너무 일찍 수술하였을 때, 과거 다른 피임법을 사용해 본 경험이 없었을 때 수술동기에 있어 자원이 아닌 타의에 의했을 때 및 결혼과 성생활에 문제가 있었을 때 예후가 나빴다. 그러나 학력, 직업, 종교, 자녀수 및 유산회수 등도 유의한 정도는 아니나 영향을 주고 있었다. 수술을 후회하는 경우가 약 20%에 달했는데, 그 정도는 심하지 않았고, 더구나 복원수술을 고려하는 사람은 전무하였다. 후회하는 이유는 아들이 없거나 하나 뿐이어서 이제 더 이상 아들을 못가지리라는 점과, 불임술이 곧 여성으로서의 기능상실을 의미한다고 믿거나, 수술에 대한 비상식적인 기대가 충족되지 않은 것 등이었다. 이는 남아선호 경향과 의학적 무지 때문으로 생각된다. 이에 저자들은 이러한 후유증을 극소화 또는 예방하기 위해서는 지원자에 대해 수술전에 적절한 정신과적 평가가 선행되어야 할 필요가 있음을 결론 지었으며 그 기준에 대해 논의하였다. A psychiatric study was conducted on the female sterilization with randomly selected 102 women who had been given the laparoscopic tubal ligation for contraceptive reason at Yonsei University, Medical Center from April to September in 1977. Each patient was interviewed evaluated her emotional state by two psychiatrists twice, before and six months after the operation. Results indicated that the contraceptive laparoscopic tubal ligation was a relatively safe procedure in psychiatric aspects and that most patients were satisfied with the result of operation. However, some patients complained that various psychiatric symptoms had developed or aggravated after the operation as sequele. Those were depression, anxiety, hypochondria, fear, impaired intellectual functioning, irritability and associated psychosomatic disturbances such as decreased libido, indigestion, menstrual disturbance, headache, palpitation, backache and fatigability. But those symptoms were not of neurotic severity but of very mild one. It was also revealed that the poor outcome were associated with patient` already existing psychiatric problems in their personal life, premorbid personality and their motivation for the operation. Among them the most significant factors were too early operation in young age, involuntary operation, less experience with other contraceptive methods, neurotic personality and various difficulties in their marital and sexual life. Other factors such as religion, number of children and occupation were also discussed. About 20% of the patients regretted for the operation but no one considered the repairing operation. The main reason of regret for the operation were that they had no son or would never have son any more in the future, and that the tubal ligation would mean the loss of feminity and sexual function. These seemed to reflect the boy-preferring tendency in korean society and their poor medical knowledge. So we concluded that, to minimize or prevent these sequele, preoperative psychiatric evaluation is

유착태반

박세교(SK Park),유한기(HK Yoo),신호영(HY Shin),안동원(DW Ahn) 대한산부인과학회 1973 Obstetrics & Gynecology Science Vol.16 No.3

Seven cases of palcental adhesion which were treated at Severance Hospital during last 11 years were summarized clinically with review of references. 1) Incidence of placental adhesion was 1 : 1,925 deliveries. Six out of seven cases were placenta accreta and the rest one was placenta increta histopathologically. 2) All cases were multiparous, and one was a case of previous cesarean secion, one combined with placenta previa and one appeared in case of spontaneous abortion on mid trimester. 3) All cases were treated with total hysterectomy following failure of treatment with manual separation or curettage of placenta. Those placentas were attached to posterior wall of the uterus except for one to anterior wall. 4) Postoperative infection appeared in two cases as postoperative complication.

쌍태 임산부에 있어서 산전관리 유무에 따른 모체합병증에 관한 연구

장상식(SS Chang),이경림(KR Lee),조동제(DJ Cho),안동원(DW Ahn),박찬규(CK Park) 대한산부인과학회 1982 Obstetrics & Gynecology Science Vol.25 No.3

1967년 1월 1일부터 1976년 12월 31일까지 만 10년간 연세대학교 부속 세브란스 병원 산부인과에 입원하여 분만한 264예의 쌍태임산부에서 산전간호유무 및 횟수(제1군: 산전간호 0회, 제 2군: 산전간호 1-3회, 제 3군: 산전간호 4회이상)가 모체합병증에 미치는 영향을 통계학적으로 분석하여 다음과 같은 결과를 얻었다. 1. 촹괄적인 산전 모체합병증에서 임신자간전증이 42.43%로써 수위를 차지하였으며, 제 1군 10.61%, 제 2군 8.33%, 제 3군 4.55%로써 산전간호를 잘 받은 군에서 통계학적으로 의의있는 낮은 빈도(p<0.01)를 나태내었다. 2. 분만중 모체합병등은 자궁수축부전이 7.9%로 제일 만항ㅆ고 제대탈출이 2.65% 태아곤란증이 1.89%였으며, 각군간의 통계학적으로 의의있는 차이가 없었다. 3. 분만후 모체합병증은 산후빈혈이 23.11%로써 가장 높았으ㅕ, 제 1군 7.96%, 제 2군 6.06%, 제 3군 9.09%였으며, 자궁이완성츨혈은 10.23%로 제 1군 3.41%, 제 2군 3.03%, 제 3군 3.79%로 나ㄴ타났으나 역시 본 연구에서는 각군간의 통계학적으로 의의있는 차이는 볼수 없었다. 결론적으로, 철저한 산전간호를 통하여 쌍태임신의 조기진단과 쌍태임신에서 발생할 수 있는 합병증을 방지 및 조기에 진다, 치료함은 물론 가능한 한 임신 30-37주 사이에 입원, 아전가료를 취함으로써 산전간초의 연장으로서 모체 및 태아의 안녕을 도모할 수 있을 것으로 사료된다. A total of 264 twin pregnancies, among 20335 deliveries, at the university of Yonsei Medical Center during 10 year period from Jan. 1, 1967 through Dec. 31, 1976, were reviewed to determine the effects of antenatal care on twin gestations in terms of maternal complications. Twin pregnancies were complicated by pregnancy induced hypertension, anemia, SPRM, premature labor, & etc. more often than were the single pregnancy. The maternal complication rates in pregnancy induced hypertension, anemia, and atonic bleeding were significantlyp