인공임신중절술에 합병된 패혈성 Shock

강영호(YH Kang) 대한산부인과학회 1967 Obstetrics & Gynecology Science Vol.10 No.9

Ten cases of septic shock complicated by induced abortion, who were admitted to Han-Il Hospital since January, 1964 till May, 1967 are presented. 1) Duration of pregnancy was within sixteen weeks of gestation in seven cases. 2) Method of interruption: six cases after the use of Laminaria and four cases after the combination of Laminaria and Bougie. 3) The most frequent symptoms were high fever, tachycardia, chills, lower abdominal pain, dyspnea, nausea, vomition, oliguria and anuria. 4) The responsible corganisms were gram-negative bacteria, E. Coli in three cases among six cases in which culture was done. 5) The ost frequent complications. were acute renal failure in seven cases, and metabolic acidosis in three cases. 6) Whe the diagnosis of septic shock had been made, vigorous therapy including massive doses of antibiotics, corticosteroids, vasopressor, and uterine emptying was instituted after appropriate cultures had been obtained. 7) Six cases were expired. 8) The primary site of infection was the genital tract, originated from the use of poorly disinfeted Laminaria. It is thought that Laminaria should be discarded for cervical diliation and the indications of induced abortion restricted strictly in Medical or Obstetrical indications. 9) Septic abortion must be treated so early and adequately to prevent further developing of shock, acute renal failure and metabolic acidosis.

흡입축만법에 대하여 ( 흡입분만, 흡인분만 )

강영호(YH Kang),박문선(MS Park),유용근(YK Yoo),서병준(BJ Seo) 대한산부인과학회 1963 Obstetrics & Gynecology Science Vol.6 No.3

The authors used Vacuum Extractor in 50 cases of deliveries at Han-II Hospital between May and August, 1962. 1) The indications for interference were; to shorten the period of 2nd stage and supplement for obstetrical anesthesia in 27 instances(54%), fetal distress in 5, prolonged 2nd stage in 4, toxemia 1, maternal disease 1, adruptio placentae 1, premature rupture of membrane 1, expulsion of a dead fetus 1. 2) Vacuum Extraction was successful in all the cases of multipara(24cases) and partial success in 4 cases of primipara(among 26 cases). We believe that the Vancuum Extractor has not yet reached the level of development neccessary to replace the obstetric forceps. 3) Maternal and fetal injuries were minimal. There were 5 cases of scalp adrasion, scalp avulsion 1 and abnormal enlargement of caput 2.

자궁경암의 골전이

강영호(YH Kang),서병준(BJ Seo),안병선(BS Ahn) 대한산부인과학회 1965 Obstetrics & Gynecology Science Vol.8 No.1

A group of 7 patients with metastatic lesions of bone from carcinoma of the cervix had been studied at Han-Il Hospial between July. 1962 and June, 1964. 1) Bone metastases were found in 7 of 146 patients of cervical cancer, i.e., 4.8 percent. 2) Clinical stagings were: 1 in stage III, 3 in stage IV, and 3 in recurrent cancer. 3) Clinical suspicions were derived from bone pain, increased erythrocyte sedimentation rate and elevated serum alkaline phosphatase level. 4) Sites of metastases were pelvis 4, pelvis and femur 2. and vertebra 1. All the lesions were osteolytic form. 5) Whth Cesium-137 external irradiation palliative effect including relief of pain was obtained in two cases.

임신말기에 있어서의 Oxytocin 자궁감수성시험과 자궁경부상태

강영호(YH Kang),홍성효(SH Hong) 대한산부인과학회 1966 Obstetrics & Gynecology Science Vol.9 No.3

Oxytocin sensitivity test and cervical conditions were studied together as devised by Smyth and Cocks respectively, 250 times on 150 pregnant women near and at term being selected at random from those using the prenatal clinic, and 46 patients near and at term and other 4 patients between 28 and 34 weeds to whom inductions by oxytocin drip were performed from Oct. 1964 to Oct. 1965 at Hanil Hospital. The indications of induction were postmaturity 17 cases, elective inductions for normal pregnant women near and at term 14, toxemia of pregnancy 7, early rupture of the membrane 3, previous dystocia due to an over large fetus 3 and antepartum hemorrhage 2, and 2 cases of early rupture of the membrane and 2 cases of fetal death between 28 and 34 weeks. 1. Of 46 patients who reponded to 0.02 i.u. or less of oxytocin 34(73.9%) went into labor spontaneously within 48 hours but about 89.4% of 104 patients responsive to 0.03 i.u. or more after 48 hours. But in cases responsive to 0.03 i.u. or more of oxytocin the use of serial determinations was valuable to find out individual variations. 2. An intimate correlation between the oxytocin sensitivity and the maturity of the cervix could be obtained considering that 86.6% of 172 cases responsive to 0.05 i.u. or less of oxytocin had cervical conditions of Cocks type Ⅰ and Ⅱ, but 65.4% of 78 cases responsive to 0.06-0.10 i.u. had type Ⅲ and Ⅳ. 3. All 14 cases (100%) having Cocks type Ⅰwent into labor by oxytocin drip within 24 hours irrespective of the level of response to oxytocin and the average induction-labor interval was 9.5 hours. With half ripe cervix (Cocks type Ⅱ) and a positive response to 0.01-0.04 i.u. 87.5% of primigravidae(7 of 8 cases) and 85.7% of multigravidae (6of 7 cases) went into labor by oxytocin drip within 40 hours, but with the same cervical ripeness and a positive response to 0.05-0.10 i.u. only 28.6% of primigravidae (2 of 7 cases) and 57% of multigravidae (4 of 7 cases) went into labor within 40 hours. 4. Sacral ora of cervicies were noted in 15.3% of 150 pregnant women who went into labor spontaneously and 21.7% of 46 ptients to whom inductions were performed. Average duration of the first stage of labor of spontaneously delivered cases was 19 hours in primigravidae aud 13 hours in multigravidae having sacral os owing to a longer latent phase whereas 13 hours and 7.5 hours respectively in the group having normal positions of the cervix. Of the induction group having sacral os, average induction-labor interval in cases having Cocks typeⅠwas 14 hours and in cases having Cocks type Ⅱ 48.4 hours despite of 10.1 hours and 27.5 hours respectively in the group having normal positions of the cervix. It was convinced that the oxytocin sensitivity test gives a forecast to the oneset of labor and its reliability is more increased if the cervicial conditions are added, and the cervical conditions provide a more applicability to achieve the success of induction but if the oxytocin sensitivity is taken account the success rate will be increased within as reasonable time.

Kymograph식 난관통기법

강영호(YH Kang),정용화(YW Chung) 대한산부인과학회 1970 Obstetrics & Gynecology Science Vol.13 No.5

The study reported in this article was undertaken to evaluate the reliability of tubal insufflation as a test of tubal patency. By the several experments and comparison with H. S. G. & findings at laparotomy in 144 infertile patients, following conclusions were obstained: 1) Tone of the kymogram correlated with flow-rate of CO2 and diameter of the fallopian tube. Oscillations of the curves were thought to be originated from valve-action of the gas-outflow. 2) Stenotic or adhesive curves were doubtful findings. 3) The findings on H.S.G. did not correspond with the findings of tubal insufflation in 48.1 per cent of the cases. 4) Coincidence rate of patency to findings at lapartomy: H.S.G. was 70 per cent and tubal insufflation 57.5 per cent. 5) complications were observes less frequently in tubal insufflation than in H.S.G. 6) Several different kinds of tests presently available cannot be used alone to evaluate tubal patency and function, since each will provide certain infornations the other test do not reveal. As a screening tubal patency test, tubal insufflation should be used during the initial study of the infeertile females. If any abnormalities are found or if a pregnancy does not occur after a reasonable time, a H.S.G. should be done. This procedure will give more specific and detailed information in regard to tibal patency and function.

자궁 내막의 조직화학적 연구

강영호(YH Kang) 대한산부인과학회 1971 Obstetrics & Gynecology Science Vol.14 No.6

자궁 내막의 조직화학적 연구를 타학자들의 성적과 비교하여 성steroid가 표적장기인 자궁에 대한 작용기서를 고찰하였다. The endometrium is one of the most dynamic structrues in the human body, characterized a complete life cycle within a short span of time. During the past 50 years meticulous, detailed descriptions have appeared of the cyclic morphologic changes of the human endometrium and their dependency on steroid. although there can be no doubt about the role of estrogen in promoting endometrial growth and progesterone in influencing differentiation, little is known of the mechanisms b which such changes are accomplished. Investigators have reported observations on one to several enzyme system present in the endometrium. If we are to achieve a better understanding of metabolic peculiarities of the endometrium, then a wider enzyme profile should be investigated. The work reported here was carried out to investigate and describe various histochemical observations on; (I) normal rat`s endometrium, (II) the influence of sex steroids on ovariectomized rabbit endometrium, (III) normal human endometrium. Histochemical procedures: Periodic Acid Schiff(PAS) reaction for glycogen, alkaline phosphatase(ALP) and acid phosphatase(ACP) using Gomori`s method with fresh frozen sections, DNA & RNA with Methylgreen Pyronin and Feulgen & Rossenbeck method. (I) Normal rat`s endometrium Cyclic variations of histochemical substances were observed in glandular epithelium and surface epithelium, in relation to the various stages of the estrous cycle. (II) The influence of sex steroids on rabbit endometrium (Histochemical observations in ovariectomized rabbit stimulated for 2 days with estrogen or progesterone) Estrogen has the capacity to increase the amount of ALP activity and RNA. Because of the relationship of estrogen to both endometrial proliferation and ALP activity, it was suggested that the known effects of estrogen may be dependent on its ability to elicit an increased response in ALP activity and that this may be a fundamental function of estrogen. Progesterone, on the other hand, seems to augment the activity of ACP and glycogen, producing an environment suitable for the survival and implantation of the fertilized ovum. (III) Normal human endometrium Thiry-nine hysterectomy specimens were obtained for histochemical procedures and semiquantitative estimates were graphically illustrated throughout the endometrial cycle. Glycogen was present in abundant quantities during the entire secretory phase. ALP activity reached a peak during the late proliferarive phase, especially in the luminal tips of the glandular epithelial cells and was present in decreasing amounts during secretory phase. ACP activity was low during the proliferative phase and was present in increasingly larger amounts as the progestational phase of the cycle progressed. RNA is present in larger amounts during proliferation and conversely during the secretory phase. DNA was relatively constant in nuclear distribution throughout the whole cycle. In a general way the proliferative or "growth" phase of the endometrial cycle is characterized histochemically by the presence of large amounts of RNA and ALP activity, and small amount of ACP activity and glycogen. Conversely, the progestational or "differentiated" phase of the endometrial cycle is characterized by small amounts of RNA and ALP activity, and large amounts of ACP activity and glycogen.

Krukenberg 종양의 2예 ( 난소 )

강영호(YH Kang),방호정(HJ Bang),서병준(BJ Seo) 대한산부인과학회 1963 Obstetrics & Gynecology Science Vol.6 No.8

Two cases of krukenberg tumor, 22-and 65-year-old, whose primary sites stomach, are presented. And its definition, history, incidence, pathology, clinical symptoms, and treatment are reviewed briefly.

흡인분만법의 적응증 및 합병증

강영호(YH Kang),신웅호(WH Shin) 대한산부인과학회 1967 Obstetrics & Gynecology Science Vol.10 No.5

The edectric vacuum extractor was used in 706 cases of deliveries at han-Il Hospital since May 1962 till Dec. 1966. 1.The most common indication was prophylactic use for shortening of the period of 2nd stage in 483 cases(68.3%). Others were prolonged 2nd stag and/or ineratia in 124 cases, fetal distress in 36, relative C.P.D. in 16, malrotation in 6, maternal disease in 25, second twin in 4, and frank breech in 4. 2. Maternal injuries were minimal and 15 cases of cervical laceration(2.1%) occurred. 3. There were 7.2% of cephalhematoma, 8.4% of scalp injuries, and 10.9%(77 cases) of total head injuries. These head injuries were decreased by skillful practice. 4. There were 4 cases of neonatal death. 5. Remote prognosis by follow-up study was good in whole cases.

고환염전을 동반한 진성반응양 1 례

강영호(YH Kang),박종규(JK Park),왕영미(YM Wang),최경애(KA Choi),이규주(KJ Lee) 대한산부인과학회 1988 Obstetrics & Gynecology Science Vol.31 No.5

저자들은 최근에 12세된 소아환자에서 성염색체가 46,XX이며 염전된 고환과 난소고환을 가 지고 있는 진성반응양 1례를 경험하였기에 문헌적 고찰과 함께 보고하는 바이다. True hermaphroditism in which contains both ovarian nad testicular tissue in same individual is a rare disease. Recently authors have experienced a cases of ture hermaphroditism who had a testis on the right gonad and an ovotestis on the left with a karyotype of 46,XX, which are presented with a brief review of literatures

한국인 만삭 태반에 관한 통계적 관찰

강영호(YH Kang) 대한산부인과학회 1963 Obstetrics & Gynecology Science Vol.6 No.3

In order to determine the ranges of normal placental weight and placental cocfficient and to observe the aspects of their variations among Korean, study was done from Jan. 1, 1961 to June 30, 1962 on 240 cases of normal paturients. The conclusions of the study were summarized as follows. 1) The normal range of placental weight was 523±105 gm., upper limit 733gm., lower limit 313 gm. 2) The normal range of fetal weight was 3,278 ± 439 gm., upper limit 4,156 gm., lower limit 2,500 gm 3) The normal renge of plaental coicient was 0.159±0.025 and any term infant with a placental cofficent less than 0.109 and greater than 0.209 may be considered to have "adnormally small or large placenta." 4) Placental weight, fetal weight and placental coefficient according to gestational age, parity and fetal sex were discussed. 5) The logest diameter of the placent was 20±2.5cm., the shortest 17±2.1 cm., and the thickness 1.9±0.4 cm. 6) The length of the cord was 51±10.1 cm. and insertion of the cord to the placenta; lateral 62% central 24%, marginal 10.2% and veamentous 0.8%.