복식 선택적 유산술에 관한 임상연구

문정주(JJ Moon),이남희(NH Lee),정미은(ME Jung),조지영(JY Cho),전정희(JH Jeun) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.8

Over the past 30 years , there has been an increase in the incidence of multifetal pregna-ncies , primarily because of the introduction of ovarian stimulants for ovulation induction and assisted reproductive technology ( ART ) in infertile patients. It is well established that multifetal pregnancies are associated with an increased frequency of the maternal complications and gre-ater perinatal morbidity and mortyality. The adverse outcome of multifetal pregnancies is dire-ctly proportional to the number of fetuses , primarily as an consequence of prterm delivery. Re-duction in the number of fetuses in multifetal pregnancies has been proposed as a way to impr-ove the perinatal outcome in this situation. Therefore , selective fetal reduction ( SFR ) is sugges-ted as a therapeutic option for continuation of pregnancy with fetuses mature enough to survi-ve. In this paper , we report our infertility clinic experiences with 6 patients who carried mult- ifetal pregnancies including 1 quintuplet , 1 quadruplet, and 4 triplets. from January, 1991 to May, 1996, transabdominal SFR was accomplished by fetal intrathoracic KCl injection at 9∼10 weeks of gestation. After the prcedure , 4 patients remained as twin pregnancies, and 2 patients as single pregnancy. There have been 3 sets of twin deliveries and the 2 sets of single delivery. One case was aborted. Two patients were delivered after 37 weeks of gestation , 2 patients were at 35 weeks , and 1 patient at 24 weeks. All babies have been healthy after birth in patients after 35 weeks gestation. There was no fetal anomaly related to the procedure in the 6 cases.< BR> We concluded that transabdominal SFR is a rather safe and useful procedure that may improve the outcome of multifetal pregnancies.

Streptomycin 과 Bacteriophage의 살균작용

박종진(JJ Park),문병해(BH Moon),오성택(ST Oh),장호선(HS Chang) 대한산부인과학회 1984 Obstetrics & Gynecology Science Vol.27 No.13

The author investigated, by using the Klebsiella phage-host cell system, the bactericidal activity of the mixture of streptomycin (SM) and bacteriophage(phage). The following results were obtained. the bactericidal activity of SM plus phage was stronger than that of SM or phage alone. The bacteria cultured for 3 hours under aeration were a little more killed by SM plus phage that cultured overnight. Under the condition of similar cell number, more phage dose than a level was necessary for expecting the stronger bactericidal activity of SM plus phage than that of SM alone. At 21st hour of reaction time, the viable bacteria in the SM plus phage-tube and SM alone-tube were smilarly decreased and, at 30th hour, the viable bacteria in both tubes were again increased. Hower, the increasing grade in SM plus phage-tube was lower than that in SM alone-tube and, the more the phage was added, the more inhibited the increasing of viable bacteria. The SM did not give any special influence to the phage itself.

[S8-3] Dietary Supplement Intake of Children

YA Jang,JJ Moon,HS Lee,HJ Lee,Y Lee,DH Kim,JY Lee,HY Lee,YJ Kang,JW Hong,HS Nam,EJ Lee,C-I Kim 한국식품영양과학회 2008 한국식품영양과학회 학술대회발표집 Vol.2008 No.10

만삭임신 시 조기파수 환자에서 진통유발을 위한 Prostaglandin E2의 평가

조유진(YJ Jo),이종진(JJ Lee),문현창(HC Moon),서성진(SJ Seo),조성남(SN Cho) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.7

Objective: The management of premature rupture of the membranes in healthy pregnancy women at term without uterine activity is a matter of debate. A retrospective study comparing three management methods for patients at term with premature rupture of membranes was performed. Methods: This study was undertaken to compare the effectiveness of intravaginal prostaglandin E2 [PGE2] of term labor with oxytocin induction and expectant management in healthy 140 pregnant women with spontaneous rupture of membranes before the onset of labor from Jan. 1, 1996 to Dec. 31, 1997 at the Department of Obstetrics and Gynecology, Chonbuk National University, Medical School. Results: The time interval to delivery was shorter in prostaglandin and oxytocin groups versus control group with statistical significance[P<0.05]. The incidence of maternal infection was lowest in prostaglandin group versus oxytocin and control groups with statistical significance[P<0.05]. Overall cesarean section rate was low in prostaglandin group versus oxytocin and control groups without statistical significance. No adverse effects were observed in prostaglandin group. Conclusion: Vaginal PGE2 suppository can be used successfully to induce labor after premature rupture of membranes at term with greater ease of adminstration when compared with oxytocin.

흔적 자궁각을 수반한 단경단막 자궁 1 예

안덕보(DB Ahn),최진주(JJ Choi),문재민(JM Moon),송승규(SK Song) 대한산부인과학회 1973 Obstetrics & Gynecology Science Vol.16 No.1

특별한 증상 및 합병증 없이 4회의 정상임신 및 분만과 3회의 인공유산을 경한한 흔적각을 동반한 단경단각자궁 1예를 보고함과 동시에 문헌적 고찰을 하였다. Congenital anomalies of the uterus are so infrequently encountered. A case of uterus unicornis unicollis with a rudimentary uterine horn has been presented with a brief review of literature about anomaly of the female genital tract.

정상 및 임신성 고혈압 임신의 태반 내 Gelatinases의 발현 양상에 관한 연구

노정래(JR Roh),오원종(WJ Oh),최정주(JJ CHoi),문종수(JS Moon),황종대(JD Hwang),양순하(SH Yang) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.6

Objectives : The aim of this study was to compare activities of gelatinases and their regulators in normal and preeclamptic placenta tissue. Methods : The activities of gelatinase A and B were evaluated by gelatin zymography in eight preeclamptic and 8 normal placentas. The levels of MMP-2, MMP-9, TIMP-1, TIMP-2 and MTI-MMP were measured by Northern blotting and gelatin zymography. Results : Densitometric measurements of gelatin zymogram revealed decreased activities of 92 kDa proMMP-9 and 72kDa proMMP-2 activity in preeclamptic placentas compared to normal placentas. The activities of 62 kDa active MMP-2, however, were not different between normal and preeclamptic placentas. The level of MMP-2 and MMP-9 mRNA was lower in preeclamptic placenta than in normal placenta. On the other hand, there was no difference in MT1-MMP and TIMP-2 mRNA level between normal and preeclamptic placenta. To the contrary of our expectation, increased level of poMMP-2 and proMMP-9 activities in placenta was associated with labor. conclusions : Decreased activities of gelatinases may contribute to defective trophoblastic invasion of maternal tissues in preeclampsia. The MT1-MMP ssems to be a main determinant of gelatinase activities in human placenta. The mechanism that regulates activities of other MMPs in human placenta needs further investigations.

자궁경부종양의 조기진단에 있어 자궁경부 확대촬영술의 역할에 관한 연구

김수연(SY Kim),문혜성(HS Moon),김승철(SC Kim),손영수(YS Son),안정자(JJ Ahn),우복희(BH Woo) 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.11

The traditional approach to cervical cancer screening depends on the use of the Papanicolaou smears as an independent test. Despite widespread clinical acceptance and use of this test, cervical cancer remains a disease of prime importance. The false negative rate of Papanicolaou smears, reported to range from 18 to 45%. So cervicography is introduced in an attempt to improve the sensitivity of screening methods for cervical neoplasia. In order to find out the role of cervicography in early diagnosis of cervical neoplasia, this study included 400 patients who visited the department of Obstetrics and Gynecology, Ewha Womans University Mokdong Hospital from May 1, 1995 to April 30, 1996. All women simultaneously underwent Pap smear and cervicography. Women positive for either cytology or cervicography were recalled for colposcopically directed punch biopsy of all abnormal cervical areas. The results obtained were as follows; 1. Pap smears were normal in 85.5%(342 cases) and abnormal(above class III) in 14.5% (58 cases) among 400 cases. 2. Cervicographic findings were negative in 79.5%(318 cases) and abnormal in 20.5%(82 cases) among 400 cases. 3. The ratio of sensitivity(Rse) and the McNemar stastics indicate that cervicography is significantly more sensitive than cytology in detecting cervical lesions(Rse=1.43, χ2=11.9, p<0.01). However, the test seems to detect the same number of high grade lesions, resulting in an equal sensitivity(RSe=1.2, χ2=3.3, p>0.05). Hence the superiority of cervicography in detecting cervical lesions is concentrated on the low grade lesions. 4. The approximated specificities of cytology and cervicography were 97.4% and 96.3% respectively when all cervical lesions were cinsidered. And there was no stastiscal difference between the approximated specificities for detecting cervical lesions(χ2=0.5, p>0.05). But if only high grade lesions are considered, the approximated specificities of cytology and cervicography were 95.5% and 90.6%, respectively(χ2=5.9, p<0.05). Hence the cytology is significantly more specific than cervicography in detecting high grade lesions. 5. Positive predictive values of Pap smear and cervicography were 84.5% and 85.4%, respectively when all cervical lesions were considered. But in cases of high grade leisons, positive predictive values of Pap smear and cervicography were rather decreased to 72.4%,a nd 59.8%, respectively. 6. When the transformation zone is visible, cervicography was more sensitive than cytology considering all cervical lesions(REs=1.6 vs RSe=0.7). This was the same result as that of high grade lesions(RSe=1.3 vs RSe=0.6). From the above results, cervicography may complement smear testing, improving the effectiveness of cervical screening by allowing a more sensitive detection of cervical neoplasia, especially of low grade cervical lesion. In addition, cervicography can be considered as a technique for `minimal lesion finding` or also using the triage tool for women at high risk.

냉동보존후 생쥐 배아의 발생에 관한 연구

이경순(KS Lee),문신용(SY Moon),안정자(JJ Ahn) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.7

Cryopreservation has proved to be a highly successful method for long term storage of viable embryos and it is necessary for human embryo cryopreservation in assisted reproductive technology to reduce the risk of multiple gestation and severe ovarian hyperstimulation syndrome as well as contributing to an overall increase in pregnancy rates. Mouse embryo cryopreservation was carried out in order to establish the most ideal developmental stage of embryo for cryopreservation. F1 hybrid mouse embryo were collected according to its developmetnal stage; 1-cell, 2- cell, 4-cell, morula and blastocyst. 1-cell stage embryo were cryopreserved by slow coolingrapid thawing method using PROH(1,2 propanediol) and 2- cell stage embryo and 4-cell stage embryo were cryopreserved by the same method using PROH or DMSO(dimethyl sulfoxide). And morula and blastocyst stage embryo were cryopreserved by the same cooling method using glycerol. The frozen-thawed embryo showed significantly lower(p<0.05) hatched rate than fresh embryos. The better hatched rate was obtained when the 2-cell embryos were cyropreserved using PROH as a cryoprotectant(p<0.05). In the case of the 4-cell stage embryos, the results showed no difference in the post thaw survival rate but a better blastocystic development in the DMSO group(49.6%:38.9%)(p>0.05). The proportion of frozen embryos developing to hatched blastocysts was significantly decreased in 1-cell stage embryos and blastocysts compared to the 2-cell, 4-cell and morula stage embryo(p<0.05). According to in vitro development of mouse embryo, the highest hatching rate was obtained from 4-cell stage embryo(43.5%), so the ideal cell stage for embryo cryopreservation is 4-cell stage embryo using DMSO as a cryoprotectant.

소아 외음부질염 원인균의 특성 : 1980 년대와 1990 년대의 비교 ( Etiologic Agents of Vulvovaginitis in Pediatric Age Group Comparison between 1981=1991 and 1992-1996 )

이재억(JA Lee),문형(H Moon),황윤영(YY Hwang),조수현(SH Cho),김진조(JJ Kim),한동익(DI Han) 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.10

This study was designed to evaluated a difference of the etiologic organisms of vulvovaginitis in pediatric age group in the 1980s and the 1990s. We compared the results of the culture for vaginal discharge and the antibiotics sensitivity test from 266 patients under the age of 18 who visitied the Hanyang University Hospital from March 1981 through March 1991(Group 1) with those from 56 patients under the age of 18 who visited the hospital from April 1991 through April 1996(Group 2). The prevalent age was from 2 to 10 in both group. The most commonly isolated etiologic organism in both groups was gram-positive coagulase negative staphylococcus(25.2% and 26.7%, respectively), and the second most commonly isolated etiologic organism was E.coli(20.1% and 16.9%, respectively).Candida albicans was isolated in 2.8% of patients in Group 2, whereas it was not detected in Group 1. In Group 2 the incidence of E.coli was significantly reduced (30.4% vs 8.7%, p=0.01), and the incidence of lactobacillus was increased(0.0% vs 8.7%, p=0.01) and Candida albicans(0.05% vs 18.2%, p=0.01) were increased in Group 2 in age group of 11 to 18. amikacin was the most sensitive antibiotics for Gram-negative and Gram-positive organisms in both groups, gentamicin for Gram-negative organism in Group 1, and chloramphenicol for Gram-negative in Group 2. These results indicate that E.coli infection in pediatric age group of 2 to 5 was reduced in 1990s whereas Enterococci infection in pediatric age group of 11 to 18 was increased in 1990s. Therefore it is suggested that the improvement of the hygiene and sanitation of genital organ in pubertal girls is needed through education.

자궁근층내로 감입된 대망 1 례

나도수(DS Nah),박영준(YJ Park),김진조(JJ Kim),유중배(JB Yoo),문형(H Moon) 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.6

A case of described where omentum impacted and fenestrated through the anteior uterine wall after induced abortion at the private clinic. The patient had been aborted six times in the past, involving the two recently. And it is postulated that the uterus had been perforated on one of these occasions. We experienced one case of omental impaction in the uterine myometrium after induced abortion and so we present it with brief review of literature.