자궁외 임신의 통계적 고찰

박문선(MS Park) 대한산부인과학회 1961 Obstetrics & Gynecology Science Vol.4 No.3

1959년 1월부터 1961년 6월까지의 서울대학교 부속병원 산부인과와 국립의료원 산부인과에서 입원가료한 외임환자 총수 124명에 대하여 임상적 통계적 관찰을 하여 다음의 결과를 얻었다. 1) 외임 124예중 난관임신 97.6%, 난소임신 1.6%, 복막임신 0.8%, 반복자궁외임신 6.5%이었다. 2) 호발연령은 평균 31.2세로서 120예중 26~35세가 65.8%이었다. 3) 117예중 미산부는 15.4%이었고 그 불임기간은 평균 4년 9개월이었으며 경산부는 84.6%로서 그 불임기간은 평균 3년 2개월이었다. 외임환자의 불임기간은 전체적으로 3년미만이 63%이었고 그중 가장 짧은 것은 45일, 가장 긴 것은 21년이었고 평균 3년 5개월이었다. 또 최종 임신종료가 인공유산이었던 자가 12.9%, 정상분만이 51.7%이었다. 4) 기왕증으로 인공유산 25예, 자궁외임신을 포함하여 충수절제술 등 복부수술 17예, 결핵성질환 10예이었다. 5) 하복부동통은 98.3%, 성기출혈은 89.2%에서 나타났으며 하복부동통과 성기출혈을 겸한 것이 87.5%이었고 최종월경 제1일부터 상기증상발견까지 일수는 31~50일 사이에 가장 많았고 (45.8%), 외출혈과 동통을 겸한 예중 외출혈선행예가 동통선행예보다 많아서 50.5%이었다. 6) 무월경은 87.5%에서 나타났으며 무월경 평균기간은 55.8일이었다. 7) 내진시 부속기종유가 촉지된 것이 65.5%, 하복부압통이 있는자가 86.5%이었다. 8) Douglas 와천자양성율은 93.7%이었다. 9) 이환측은 좌우대차 없었고 파열이 61.5%, 유산이 38.5%이었다. 10) 술식으로는 환측부속기척제를 한것이 41예, 환측난관제거를 한것이 77예이었다. 11) 124예중 사망예는 1명이었으며 그 이외는 전부 완결퇴원하였다. Clinical and statistical analysis on 124 patients treated for ectopic pregnancy at the Dept. of Obst. & Gynec. College of Medicine, Seoul National University and the Dept. of Obst. & Gynec. Medical center between Jan. 1959 and Jun. 1961 are presented. Results 1) This series comprised 121 tubal, (97.5 per cent) 2 ovarian, (1.6 per cent) and 1 abdominal pregnancy (0.8 per cent). A recurrence rate of 6.5 per cent was noted. 2) The average age of all patients was 31.2 years and 65.8 per cent of 120 patients were 26 to 35 years of age. 3) 15.4 per cent of 117 patients were nulligravid with the average length of sterility of 4 years and 9 months, and 84.6 per cent were multiparas with the average length of sterility of 3 years and 2 months. In 63 per cent of patients, the length of sterility was under 3 years and the average length of sterility of the entire series was 3 years and 5 months. (the shortest, 45 days; the longest, 21 years.) A history of artificial abortion of the last pregnancy was obtained in 12.9 per cent of patients, normal delivery in 51.7 per cent. 4) A history of the previous artificial abortion was noted in 25 cases. 17 cases had had previous abdominal surgery (8 cases, ectopic; 7 cases, appendectomy), 10 cases, tuberculous diseases. 5) Lower abdominal pain was present in 98.3 per cent of the cases; vaginal bleeding, 89.2 per cent. Abdominal pain combined vaginal bleeding in 87.5 per cent of the cases and in 45.8 per cent of cases, the onset of above symptoms was noted in 31 to 50 days after the date of the last normal menstrual period. Vaginal bleeding preceded the pain in 50.5 per cent of all patients. 6) Amenorrhea was present in 87.5 per cent of the cases and the average length of amenorrha was 55.8 days. 7) In 65.5 per cent of patients, an adnexal mass was palpated on pelvic examination. Lower abdominal tendernees was present in 86.5 per cent of cases. 8) The accuracy of culdocentesis was obtained from 93.7 per cent of patients performed. 9) The affected side of tubal pregnancy was as frequent on the right as on the left. In the operative findings, tubal rupture was noted in 61.5 per cent; tubal abortion, 38.5 per cent. 10) 41 patients were treated by salpingo-oophorectomy: 77 patients, by salpingectotmy. 11) Of 124 patients, one death occurred, a mortality rate of 0.8 per cent. Other patients were completely recovered.

제왕절개술에 의하여 분만돤 2두 ( 이두 ) ,2완 ( 이완 ) ,2각 ( 이각 ) 의 중복기형여아의 1예

박문선(MS Park),정용화(YW Chung),이병윤(BY Lee),김한종(HJ Kim) 대한산부인과학회 1964 Obstetrics & Gynecology Science Vol.7 No.5

정상 쌍태아로 오진되었던 2두, 2완, 2각의 중복기형여아의 제왕절개술에 의하여 분만된 예를 보고함과 동시에 이에 관한 문헌적 고찰을 하였다. A case of dicephalus dipus dibrachius delivered by cesarean section is presented. And a review of literature on double monsters is made briefly.

임신을 합병한 자궁경암의 1예

박문선(MS Park),김정자(JZ Kim),서병준(BJ Seo) 대한산부인과학회 1963 Obstetrics & Gynecology Science Vol.6 No.8

Cancer of the cervix is inferquently associated with pregancy. Because it is rare, there is uncertainty about the treatment of choice. Early diagnosis followed by immediate and adequate therapy is most important and to achieve it. A case of carcinoma of the cervix associated with the 15 weeks of pregnancy is presented. Patient received Wertheim hysterectomy with the fetus in utero, pelvic node dissection and postoperative Cesium deep therapy with tumor dose of 6,650 r. A brief review of literatures is presensented.

자궁경암환자의 Cesium 원격조사치료시 방사선장해와 뇨중 17 - Ketosteroids 배설량의 변동에 관하여

박문선(MS Park) 대한산부인과학회 1965 Obstetrics & Gynecology Science Vol.8 No.1

Observation of radiation sickness and leucocyte count were made in 20 cases of squamous cell carcinoma of the uterine cervix, receiving Cesium deep therapy over periods of about 40 days at the Dept. of Obst. & Gynec, Han-Il Hospital. In 7 cases of these, urinary excretion of 17-ketosteroids was determined according to the method of Drekter. The leucocyte count and the determination of urinary excretion of 17-ketosteroids were carried out before and during Cesium deep therapy. Fatigability, anorexia, nausea and vomiting, headache, dizziness, abdominal pain, insomnia, thirst, fever, pollakisuria and diarrhea were considered to be suggestive of radiation sickness. The following results were obtained: 1) As to the radiation sickness, diarrhea is noticed in 13cases, fatigability in 11 cases and anorexia in 10 cases, respectively. The highest incidence of these symptoms (60 percent) is seen on the tenth day of irradiation. 2) Leucocytic count is decreased gradually with increasing irradiation dosage of Cesium. 3) The urinary excretion of 17-ketosteroids begins to increase above the preirradiation level from the begining of irradiation and reaches its highest level on the tenth day of irradiation, after which a decrease is noted. It becomes lower than preirradiation level from the thirtieth day of irradiation.

자궁파열의 2예

박문선(MS Park),강영호(YH Kang),방호정(HJ Bang),유용근(YK Yoo) 대한산부인과학회 1964 Obstetrics & Gynecology Science Vol.7 No.2

자궁파열의 2치험예를 보고함과 동시에 본증에 관한 문헌적 고찰을 하였다. Uterine rupture remains a serious threat to the life of the mother and a greater hazard to the survival of the unborn infant. Two cases of uterine rupture are presented. One case was spontaneous rupture of the uterine scar of the previous cesarean section at the thirtieth week of pregnancy. The other case was rupture of normal uterus during labor which was induced by oxytocic stimulation. The literatures on the uterine rupture are reviewed.

사후 제왕절개술에 의한 신생아 생존의 1예

박문선(MS Park),이필형(PH Lee) 대한산부인과학회 1963 Obstetrics & Gynecology Science Vol.6 No.8

A case of maternal death at the 38th wks. of pregnancy due to chronic hypertensive disease with superimposed toxemia and a brief review of literature are presented. An infant delivered by post- mortem cesarean section 8 minutes after the patient was pronounced dead is living and well. This favorable outcome for infant lends support to the promise that postmortem cesarean section should be attempted whenever the opportunity presents itself.

자궁내 태아 사망 1예

박문선(MS Park),서병준(BJ Seo) 대한산부인과학회 1963 Obstetrics & Gynecology Science Vol.6 No.4

Fetal mortality makes up about one half of all perinatal mortality(Fetal plus neonatal deaths). One case of intrauterine fetal death observed on Aug. 25. 1962 at the Dept. of Ob. & Gy., Korea Electric Co. Hospital is presented and the literature is reviewed.

산부인과 영역에 있어서의 뇨중 Pregnanetriol의 동태에 관한 연구

박문선(MS Park) 대한산부인과학회 1965 Obstetrics & Gynecology Science Vol.8 No.7

Determinations of the urinary pregnanetriol according to the modified Bongievanni`s method were made in 5 normally menstruating women, 6 Climacteric women, 6 castrated women, 64 pregnant women, 4 hirsute women and a case of adrenocortical tumor. Pregnant women comprised 37 cases with normal pregnancy, 5 cases in labor and puerperium, 5 cases with hyperemesis gravidarum, 7 cases with spontaneous abortion. 5 cases with premature labor and 5 cases with toxemia of pregnancy. The following results were obtained: 1) A method for determination of pregnanetriol was presented. The method was reproducible with adequate recoveries and reasonably convenient for clinical use; Recovery average 79.9±1.1 per cent. 2) The urinary pregnanetriol levels of the normally menstruating women were as follows; 0.42± 0.10 mg / day in the follicular phase and 1.00±0.32mg/day in the luteal phase. 3) The urinary pregnanetriol levels of the climacteric women were 0.38±0.04mg day. 4) The urinary pregnanetriol levels, determined in the castrated women to investigate effects of castration on the excretion of pregnanetriol, showed a statistically significant decrease on the postoperative tenth day. There was no significant statistical difference between the urinary pregnanetriol levels of the castrated women and the climacteric women on the postoperative fifteenth day. 5) In normal pregnancy extending from the second month to the term of gestation the excretion of pregnanetriol was significantly higher than that in non-pregnant women. This elevation began about the second month of gestation. The excretion then decreased to a low value at the fourth month and again increased to a maximum at the term of gestation. The urinary pregnanetriol levels in normal pregnancy were as follows; the second month: 1.38±0.15mg/day the third month: 1.63±0.24mg/day the fourth month: 1.22±0.23mg/day the fifth month: 1.75±0.32mg/day the sixth month: 1.97±0.39mg/day the seventh month: 2.48±0.36mg/day the eighth month: 2.83±0.14mg/day the ninth month: 3.12±0.48mg/day the tenth month: 3.32±0.44mg/day In the normal puerperal women the excretion of pregnanetriol began to decrease from 4 hours after delivery and showed a marked decrease on the postpartum second day. 6) The urinary pregnanetriol levels of patients with hyperemesis gravidarum were 1.41± 0.24mg/day which gave insignificant differences as compared with the levels found in the second month and the third month of normal gestation. 7) In patients with spontaneous abortion and premature labor the urinary pregnanetriol levels showed a significant decrease as compared with that in the corresponding month of normal gestation. 8) The urinary pregnanetriol levels of patients with toxemia of pregnancy showed a significant decrease as compared with that in the corresponding month of normal gestation. 9) ACTH and dexamethasone were respectively given to each group (3 cases) of the castrated women to investigate effects of these two hormone on the excretion of pregnanetriol. The excretion of pregnanetriol showed a significant increase by the administration of ACTH and a significant decrease by the administration of dexamethasone. 10) There were no significant statistical differences between the urinary pregnanetriol levels of the hirsute women and the normally menstruating women. 11) In a case of Cushing`s syndrome associated with adrenocortical carcinoma the urinary pregnanetriol level was 2.88mg/day which decreased to 1.92mg/day after adrenalectomy. From the results of this study the possibility that the ovaries and the placenta as well as the adrenal glands may retain pregnanetriol production capacity could be confirmed.

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.

안와 상벽 개두술과 상외측 안와 개두술 이후에 축적된 안와주위 뇌척수액

권영훈,박정현,이종선,박문선,하호균 대한신경외과학회 2003 Journal of Korean neurosurgical society Vol.33 No.1