임신주수에 따른 신생아 체중 변화

최유덕(Yu Duk Choi),이경훈(Gyoung Hoon Lee),김용욱(Yong Wook Kim),이광범(Kwang Beom Lee),서은정(Eun Jung Seo),손문성(Moon Sung Son),안현경(Hyun Gyoung Ahn),석원익(Won Eik Seok),최영진(Young Jin Choi),김광준(Gwang Jun Kim),김석영(Suk 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.10

N/A Objective : The birth weight distributions are obtained to be classified according to the duration of pregnancy, and then compared with other results already published in literature to verify the difference. Methods : A total of 17,291 deliveries in Gachon medical center hospital from January 1996 to December 1999 is retrospectively reviewed. The data of 28∼42th week of gestation are analysed, and the 10th, 25th, 50th, 75th and 90th percentiles of birth weight are determined for each week and also according to sex and parity. Furthermore the 10th, 50th, 90th percentiles are compared with those from other reports. Results : 1. The 10th, 50th, 90th percentiles of birth weight classifed according to gestational age are as follow : in 28th week of pregnancy, 1,068, 1,240 and 1,812 g; in 32th week, 1,470, 1,890 and 2,266 g; in 36th week, 2,170, 2,720 and 3,240 g; in 40th week, 2,910, 3,370 and 3,870 g; in 42th week, 2,977, 3,475 and 4,023 g. 2. The mean birth weight of the male neonates is greater than that of the female ones from 37th week to 41th week (p<0.01). 3. Comparisons of 10th, 50th, 90th percentiles of birth weight with Park groups show that there is an increase of birth weight by 100∼144 g. Conclusion : Comparison of the birth weight-gestational age table with ones published by other groups shows that infants tend to be heavier.

초극소 치골상 복식절개하 질식 자궁절제술에 대한 검토

최유덕 ( Yu Duk Choi ),이순표 ( Soon Pyo Lee ),석원익 ( Won Ik Seok ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.2

목적 : 복식 자궁절제술이 금기에 해당하는 양성질환에 시도한 새로운 질식자궁 절제 수술법의 안정성과 효용성에 대한 검토를 목적한다.졓米?및 방법 : 2002년 2월 1일부터 2002년 7월 10일까지 가천의대 길병원 산부인과에서 무작위 연속적으로 초극소 치골상 복식절개하 자궁절제술 (MAVH)을 시행 받은 75명의 환자를 대상으로 수술의 안정성과 유용성을 후향적으로 분석하였다. 연구 방법 : 치골상부 치모선에 평행으로 약 2-2.5 cm 정도의 극소절개 Objective : To review the safety and effectiveness of a new vaginal hysterectomy method, Minilaparatomically Assisted Vaginal Hysterectomy (MAVH), tried on benign diseases with?indication of abdominal hysterectomy. Materials & Methods : The analysis of th

초음파로 산전 진단된 Ebstein 심기형

김광준(Gwang Jun Kim),김용욱(Yong Yook Kim),최유덕(Yu Duk Choi),최태행(Tae Haeng Choi),손문성(Moon Sung Son),김재유(Jae Yoo Kim),신종호(Jong Ho Sin) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.1

We experienced a case of Ebstein's anomaly prenatally by fetal sonography. Ebstein's anomaly is a rare congenital heart defect characterized by abnormally downward displacement of the septal and posterior leaflets of the tricuspid valve. In the absence of tricuspid regurgitation, this condition may be completely asymptomatic. On the other hand, symptomatic newborns often develop life-threatening congestive heart failure. A 30-year-old multiparous woman was referred for the evaluation of fetal cardiac defect at 26th gestational week from a private clinic. Fetal ultrasonography showed markedly enlarged right atrium and downward displacement of tricuspid valve into the right ventricle. After discussion with the patient, the pregnancy was terminated and Ebstein's anomaly was confirmed by autopsy.

원인불명의 임신중기 인간융모성 성선자극호르몬 상승과 임신예후와의 관계

최태행 ( Tae Haing Choi ),박문철 ( Moon Cheol Park ),김광준 ( Gwang Jun Kim ),최유덕 ( Yu Duk Choi ) 대한주산의학회 2000 大韓周産醫學會雜誌 Vol.11 No.2

양수 DNA를 이용한 취약 X 증후군의 산전진단

김광준(Gwang Jun Kim),김석영(Suk Young Kim),황병철(Byung Cheul Hwang),박환용(Whan Yong Park),최유덕(Yu Duk Choi),황유진(Yu Jin Whang) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.3

N/A Background : The fragile X syndrome is the most common cause of inherited mental retardation, is almost always caused by abnormal CGG trinucleotide amplication within the FMR1(fragile X mental retardation) gene located in Xq27.3. Methods : DNA samples were obtained from the amniotic fluids of known carrier mother and 35 mothers without risk factors of the fragile X syndrome. Polymerase chain reaction(PCR) and Southern blot analysis were performed to evaluate the number of CGG repeats in the FMR1 gene. Results : The DNA samples from the carrier mother gave a large fragment over 300 repeats by PCR. All 35 control samples showed fragments sized under 35 repeats. Conclusion : Prenatal diagnosis of the fragile X syndrome could be done with mid-trimester amniotic fluid using PCR and Southern blot method.

제왕절개 자궁적출술의 임상적 고찰

김용욱(Yong Yook Kim),김석영(Suk Young Kim),황병철(Byung Chul Whang),이종민(Jong Min Lee),최유덕(Yu Duk Choi),한양석(Yang Seok Han),이지성(Ji Sung Lee),노성혁(Seong Hyeok Noh),김장수(Jang Su Kim),최태행(Tae Haeng Choi),최용민(Yong Mi 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.7

목적 : 가천의대부속 길병원에서 시행되었던 제왕절개 자궁적출술의 빈도, 적응증, 임상경과 등을 조사, 분석하기 위함이다. 연구방법 : 1995년 1월부터 1999년 12월까지 시행된 제왕절개 자궁적출술을 임상기록지를 중심으로 후향적으로 조사분석하였다. 결과 : 총 31,481예의 분만 중 제왕절개 자궁적출술의 빈도는 0.4%이었다. 17,829예의 제왕절개술에 의한 분만 중 100예(0.6%)에서, 13,652예의 질식분만 중 22예(0.2%)에서 제왕절개 자궁적출술이 있었다. 산모의 연령과 분만력이 증가함에 따라 제왕절개 자궁적출술의 빈도는 증가하는 양상을 보였다(P=0.001). 제왕절개 자궁적출술의 적응증 중 자궁무력증이 50예(41.9%)로 가장 많았고, 유착태반을 동반한 전치태반이 25예(20.5%), 유착태반이 14예(11.5%), 임신을 동반한 자궁근종이 11예(9.0%), 유착태반은 아니었으나 전치태반이 지혈이 안되어 자궁하부에서 지속적인 출혈이 있었던 것이 9예(7.4%), 자궁파열이 7예(5.7%), 자궁절개확장으로 인한 혈관손상이 6예(4.9%)의 순 이었다. 수혈량은 2예를 제외한 대부분의 환자에서 2pints에서부터 78pints까지 다량의 수혈을 요하였다. 주산기에 사망했던 경우는 자궁내 태아사망 3예(2.5%), 신생아 사망 4예(3.3%)로 주산기 사망률은 5.7%이었다. 수술 후 합병증은 방광손상, 요관손상, 수술 후 발열, 범발성 혈관내 응고장애, 혈종, 창상파열, 울혈성심부전, 질 봉합부 출혈이었다. 산모 사망은 2예로 그 원인은 모두 방광후벽까지 감입된 전치태반으로 인한 과도한 출혈과 범발성 혈관내 응고장애이다. 결론 : 제왕절개 자궁적출술은 분만중 산모의 생명보존을 위해 필수적이다. 이 수술 수기는 대개 수술 전후의 이환율과 상당히 연관된다. 그러므로 산부인과 의사는 위험성이 있는 환자를 파악하고, 합병증을 예견할 수 있어야 된다. Objective : To study the prevalence, indications, and outcome of cesarean hysterectomy in women delivered at the Gil Medical Center, Gacheon Medical School. Method : This is a retrospective study of all cases of cesarean hysterectomy performed between January 1995 and December 1999. Results : The incidence of cesarean hysterectomy was 0.4% (122/31,481). Cesarean hysterectomy was performed in 100 of 17,829 cesarean sections (0.6%) and in 22 of 13,652 vaginal deliveries(0.2%). The higher the age and the parity of patients, the higher the incidence of cesarean hysterectomy was noted. The most common indication of cesarean hysterectomy was uterine atony(50 cases, 41.9%), followed by 25 cases of placenta previa with adhesive placenta(20.5%), 14 cases of adhesive placenta(11.5%), 11 cases of uterine myoma with pregnancy(9.0%), 9 cases of uncontrolled bleeding with placenta previa(7.4%), 7 cases of uterine rupture(5.7%) and 6 cases of extension of uterine incision(4.9%). All patients who had cesarean hysterectomy received transfusion from 0 pint to 78 pints. Live births were 115 cases(94.3%) and 3 infants were still birth(2.5%). Four infants were dead during early neonatal period(3.3%), so perinatal mortality rate was 5.7%. The postoperative complications were bladder injury, ureteral injury, febrile morbidity, disseminated intravascular coagulopathy, hematoma, wound disruption, postpartum cardiomyopathy, and vaginal stump bleeding. There was two maternal deaths due to acute, severe hemorrhage and DIC. Conclusion : Cesarean hysterectomy remains a necessary procedure for life saving during abdominal and vaginal deliveries. The procedure itself is usually associated with considerable perioperative morbidity. Obstetricians should identify patients at risk and anticipate the procedure and complications.

복강경하 질식 전자궁적출술 (LAVH) 570예에 대한 임상적 고찰

최장열 ( Jang Yeul Choi ),송정인 ( Jung In Song ),황병철 ( Byung Chul Whang ),이순표 ( Soon Pyo Lee ),최유덕 ( Yu Duk Choi ),박찬용 ( Chan Yong Park ),윤성준 ( Seong Jun Yoon ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.10

목적 : 복강경하 질식 전자궁적출술을 시행받은 부인과 환자에 있어서 환자들의 특징과 임상 결과를 보고하여 그 효율성을 평가하기 위하여 후향성 연구를 시행하였다. 연구 방법 : 2001년 9월부터 2004년 2월까지 가천의과대학교 길병원 산부인과에서 골반경하 질식 전자궁적출술을 시행받은 570명의 환자를 대상으로 하였다. 평균 나이, 출산력, 체중, 이전 수술 기왕력, 수술 적응증, 수술 결과, 그리고 수술 합병증 등을 비교하였다. 결과 : 평균 나이는 Objective : To evaluate the clinical outcome and characteristics of laparoscopy assisted vaginal hysterectomy (LAVH) in gynecologic patients. Methods : From September, 2001 to February, 2004, total 570 cases of patients were performed LAVH at Gacheon medi

월경성 객혈

김지현 ( Ji Hyun Kim ),주영탁 ( Yeong Tak Joo ),안옥주 ( Ock Ju Ahn ),전승욱 ( Seung Wook Jeon ),문영 ( Young Moon ),최장열 ( Jang Yeul Choi ),최유덕 ( Yu Duk Choi ) 대한산부인과학회 2005 Obstetrics & Gynecology Science Vol.48 No.2

Endometriosis is relatively common gynecologic diseases, but pulmonary endometriosis is exceedingly rare among various types of external endometriosis. Patients with pleural pulmonary endometriosis present with chest pain, dyspnea, pneumothorax or pleural

양막파수가 안된 양수과소증 임신에서 경복부 양수주입술이 주산기 예후에 미치는 영향

김광준 ( Gwang Jun Kim ),윤성준 ( Sung Jun Yoon ),최수란 ( Su Ran Choi ),이순표 ( Soon Pyeu Lee ),황병철 ( Byung Chul Whang ),최유덕 ( Yu Duk Choi ),이의돈 ( Eyi Don Lee ) 대한주산의학회 2002 Perinatology Vol.13 No.1

연구배경:양수과소증은 양막파열, 태아기형, 태반기능의 부전과 연관되어 발생할 수 있으며, 그 예후가 좋지 못한 것으로 알려져 있다. 이에 대한 치료법으로 양수주입술이 고안되었으나 그 효과에 대해서는 논란의 여지가 있으며, 장기적인 효과에 대해서는 연구가 부족한 실정이다. 목적:환자-대조군연구를 통해 양수주입술의 장기적 효과를 확인하고자하였다. 대상 및 방법:양수과소증으로 진단받은 73명의 단태임신 산모를 대상으로 하였으며 양막파열이 되었거나, 초음파검사상 중증태아기형이 확인된 경우는 제외시켰다. 양수 주입술 시행에 동의하여 양수주입을 시행한 21명을 연구군으로, 52명을 대조군으로 하였고, 양수주입은 31차례 시행되었다. 진단 시 평균 양수지수는 양수주입군 4.2(±1.6), 대조군 4.6±1.4로 유의한 차이가 없었으며, 그 외 산모의 나이, 제태연령, 분만력등에서 두 군간 차이가 없었다. 결과:주입된 양수의 양은 평균 536ml(200~700)이였고, 소요시간은 61(±39.2)분이였으며, 주입후 양수지수는 평균 양수지수는 4.2에서 10.0으로 유의하게 상승되었다. 하지만 임신 결과 지표는 두 군간 유의한 차이를 보이지 않았으며 다음과 같다: 1) 출생시 평균 제태기간은 양수주입군 36.3(±3.5)주, 대조군 37.2(±2.9)주였다. 2) 평균 체중은 양수주입군 2.54(±0.9)kg, 대조군 2.51(±0.8)kg였다. 3) 신생아 활력지수가 6점이하인 경우는 양수주입군이 1분-3/17, 5분-0/17, 대조군이 1분-6/44, 5분-1/49였다. 4) 수술적 분만빈도는 양수주입군이 0.79, 대조군이 0.65였다. 5) 두 군 모두 2예의 태아사망이 있었다. 결론 : 양수과소증에서 경복부 양수주입술의 장기적 효과는 관찰되지 않았다. Objective:The aim of this study was to evaluate the peripartum efficiency of amnioinfusion in oligohydramnios without preterm premature rupture of membrane. Methods:73 singleton pregnant women with oligohydramnios were enrolled in this study. Women with preterm premature rupture of membrane were excluded. 21 women were treated with transabdominal amnioinfusion 31 times and 52 women were closely observed without amnioinfusion. Mean amniotic fluid index, mean gestational age, mean maternal age and the parity at the time of diagnosis was not statistically different in both groups. Results:Mean amounts of infused artificial amniotic fluid was 536ml(200-700), the mean time consumed was 61(±39.2)min. After infusion, mean amniotic fluid index was increased significantly from 4.2(±1.6) to 10.0(±2.9). But we found no statistically significant differences in pregnancy outcomes. The outcomes are as follows:1)Mean gestational age at birth was 36.3(±3.5) weeks in amnioinfusion group and 37.2(±2.9) weeks in control group. 2) Mean birth weight was 2.54(±0.9)kg versus 2.51(±0.8)kg. 3) The proportions of poor Apgar score at 1 minute and 5 minute were not significantly different. 4) Cesarean section rate was 0.79 versus 0.65. 5.There were two still births in both groups. Conclusion:Transabdominal amnioinfusion in oligohydramnios has little effects in improving longterm pregnancy outcomes.

자궁경부의 선양기저세포종양과 선양낭종성종양

정희환(Hee Hwan Chung),이종민(Jong Min Lee),이지성(Ji Sung Lee),김용욱(Yong Yook Kim),노길남(Gil Nam Roh),최유덕(Yu Duk Choi),하승연(Seung Yeon Ha),조현이(Hyun I Cho) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.8

Adenoid basal carcinoma and adenoid cystic carcinoma of the uterine cervix are rare tumors that have often been regarded as a single entity. But adenoid basal and adenoid cystic carcinomas of the cervix differ from each other in their histology, treatment, and prognosis. We experienced 2 cases of these neoplasms, with 1 case in each category. Whereas adenoid basal carcinoma is a slow-growing, locally invasive lesion amenable to simply hysterectomy, adenoid cystic carcinoma is an aggressive tumor associated with regional lymph node involvement and late distant metastases. This study reviews the literature and formulates a program for the management of these rare lesions.