임신을 동반한 단각 흔적 자궁의 파열 1 예

박준숙(JS Park),유정옥(JO Yoo),이지성(JS Lee),민부기(BG Min),박영선(YS Park),박영하(YH Park) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.7

흔적 자궁각을 동반한 자궁외임신 파열을 경험하였기에 문헌 고찰과 함께 보고하는 바이다. One case of spontaneous rupture of pregnant rudimentary uterine horn was observed at the department of obsterics and gynecology of Eulji General Hospital and a brief review of literatures on the female genital anomalies is presented in this paper

복막외 제왕절개술에 대한 임상적 연구

박준숙,이관구,오세익,황재웅,박종호 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.11

The safety and effectiveness of extraperitoneal C/S are controversial , so it has been per-formed for the purpose of training for selected cases . But we think this procedure have some benefit in selected cases. This study was based on retrospective investigation of 300 cases of extraperitoneal cesarean section among 332 cases at Eul Ji Medical hospital, during from Janu-ary, 1995 to December, 1996. The results were as follows; 1. The most prevalent age distribution was seen in the age group of 26∼30. 2. The indication for extraperitoneal cesarean section were dystocia(38.3%), previous cesarean section(32.6%), elderly primigravida(12.6%) in orders. 3. In the type of the anesthesia, general anesthesia was 70.7%, epidural anesthesia was 15% and spinal anesthesia was 14.3%. 4. The most common group of operation time was 36∼40minute(34.3%). 5. The post operative complications and maternal morbidities were breast engorgement(21%), peritoneal opening(19.6%), endometritis(4.3%) in orders. 6. Of all cases, the blood transfusion rates was 6%. 7. The most common group of hospital stay was 5∼6 days(82%). 8. In the body weight distribution of infants, the group of 3,000∼3,499gm was the most common(80.7%). 9. Of extraperitoneal cesarean sections, cases of the 5minute Apgar score more than 7 were the most common(99%). 10. The most common failure factor was abdominal and pelvic adbesion(82.3%) 11. There was no maternal death case.

쌍태임신중 일측태아 복벽기열 1 례

박준숙,이관구,오세익,성갑규,우명룡 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.11

Twin pregnancies have a higher rate of premature delivery than singleton pregnancies and a substantially higher perinatal mortality. Twin gestation complicted by a single anomalous fetus diffculties in obstetric management. Options available to patients include continuing the entire pregnancy, selective termination of the anomalous fetus, or termination of the entire pregnancy. The incidence of one anomalous fetus in twin pregnancy is rare. Gastroschisis is intestinal herniation through a defect in the anterior abdominal wall usual ly to the right of umblicus. There is no sac and the intestines are covered with a thickened inflammatory exudate. Most case of gastroschisis occur sporadically and chromosomal anomaly are less common. A case of one gastroschisis in twin pregnancies diagnosed by ultrasonography is reported with a brief review of the literature.

제왕절개술후 복벽반흔에 발생한 자궁내막증 3 례

박준숙,이종인,조동식,김선근,성갑규 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.7

Endometriosis in the abdominal scar following cesarean section is one of the very rare condition among the extrapelvic endometriosis. Three cases of scar endometriosis following cesarean section were experienced & treated completely after surgical excision and postoperative durg therapy. The case was reported with a brief review of the concerned literatures.

간이동결법에 의한 운동성 불량정액과 정자감소증 정액의 정자냉동보존

박찬무,박영하,박영선,박준숙,박준영,Kaneko, S,Iizuka, R 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.5

배우자간인공수정(AIH)시의 정자동결과 냉동보존의 응용을 목적으로, 융해시의 정자소생율 향상과 동결법의 간편화를 시도했다. 정자운동율 50%이하의 정액은 Continuous-step density gradient centrifugation method를 이용해 세정 농축한 결과, 정자수와 운동율이 향상되어 정자소생율의 지표가 되는 Fertility Index{FI=정자수(/ml)X운동율(%)X10-8}가 5.6배 향상되었다. 또한, Oligozoospermia중에서도 정자수가 10X106/ml이하인 정액은 Cushion method를 이용해 농축한 결과, 정자수는 4.2 ± 2.1배, 운동율은 2.3 ± 1.9배 증가되었다. 세정과 농축시킨 정자의 간이동결법에 의한 냉동보존에 있어서, 간이동결기내에 액체질소(-196℃)를 넣고 수분간 방치시켜, 액체질소증기에 의해 동결기 내부가 온도평형(-150℃)에 도달되도록 했다. KS-II 보존액을 혼합한 0.5ml의 세정 농축정자를 냉동보존용 serum tube에 넣고, 액체질소 수면위 2cm에서 옆으로 뉘여 동결시킨 후, 액체질소저장용기(Liquid Nitrogen container)에 옮겨 보관했다. 인공 수정시에 30℃의 온수에 융해시킨 결과, 각각 70 ± 12%, 64 ± 11%의 정자소생율을 얻을 수가 있었다. 융해후에도(Continuous-step density gradient centrifugation method의 경우는 원래정자의 평균 2배 이상의 FI가 유지되었다. 이상의 결과에서 운동성 불량정액과 Oligozoospermia의 AIH에 있어서 정자의 세정 및 농축과, KS-II 냉동보존액을 혼합시킨 후 간이동결법을 이용한 냉동보존법으로 원래정액 이상의 정자수와 운동율을 얻을 수 있음이 확인되었다. It is well known that the cryopreservation of human semen plays an important role in the field of clinical Artificial Insemination by Husband semen (AIH) and Donor semen (AID). However, semen dilution with cryopreservation medium and decrease in sperm motility during freeze-thaw processes make lowering semen qualities and survival rate. The author undertook this experiments to pursue the higher survival rate of cryopreserved semen and more simple method of freezing technique. To improve the qualities of cryopreserved semen after thawing, it is effective to concentrate the sperm from whole ejaculate by two method, continuous-step density gradient centrifugation method and Cushion method, as well as to achieve higher survival rate. A : Prior to freezing, the continuous-step density gradient centrifugation method was undertaken for semen with poor motility (below 50 %) sperm. As a result of this, the semen was given 5.8 times improvement of Fertility Index (sperm density (106/ml) X motility (%) X 10-8) B : The concentration of severe oligozoospermic semen by the Cushion method was improved the sperm density 4 times than the original semen. A simple liquid nitrogen vapor freezing was employed in the present study : the concentrated sperm was mixed with KS-II cryopreservation medium and them placed at 2 cm up the surface of liquid nitrogen. After freezed by liquid nitrogen vapor at -150℃, the specimen was stored in liquid nitrogen container. At the time of AIH, thawed with shaker in 30℃ water, the sperm survival rate of A and B were found to be 7-±12 % and 64 ± 11 %, respectively. The post thaw Fertility Index was as twice as that of the original semen by the continuous-step density gradient centrifugation method, and the survival rate was also high. It is consequently suggested that simple liquid nitrogen vapor freezing method using KS-II cryopreservation medium, after sperm washing and concentration, is the very simple and convenient method with good results for cryopreservation of sperm.

골반경 수술 95 예에 대한 고찰

박영권,양관철,양윤석,박준숙 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.6

저자들은 1992년 7월부터 1993년 12월까지 골반경수술을 시행한 95례를 분석하여 다음과 같은 결과를 얻었다. 1. 연령분포는 16세부터 45세까지로 다양하였으며 평균연령은 30.3세이었으며 호발연령군은 31세에서 35세(32%)이었다. 2. 시술환자의 출산력은 출산한 기왕력이 없는 경우가 35례(37%)로 가장 많았으며 출산한 경우도 대부분 2회이하였다(48례, 50.5%). 3. 수술의 적응증으로는 총 95례중 자궁외임신이 39례, 난소종양이 25례로서 이 두가지 적응증이 전체의 67%로 대부분을 차지하였다. 4. 수술방법은 난관절제술이 30례(31.5%), 난관종양 적출술이 29례(30.5%)로 가장 많았다. 5. 입원기간은 2일에서 6일사이였으며 평균 입원기간은 3.5일이었고 수술후 3일째 퇴원한 환자가 41례(43%)로 가장 많았다. 6. 수술시간은 15분부터 2시간 50분까지 수술의 종류, 방법, 난이도에 따라 다양한 차이를 보였는데 근래에 들어 많이 단축되어 평균 20분내지 30분 정도이다. 결론적으로 개복수술에 비하여 볼때 복강경수술의 장점은 시술에 앞서 진단적 내시경을 시행할 수 있고, 둘째 수술조직의 치유가 빠르며 수술후 주위조직의 유착형성이 적고, 수술후 통증이 적고 조기에 활동할 수 있어서 회복이 빠르고, 입원기간이 단축됨에 의료비가 절감되며, 궁극적으로는 일상생활의 복귀를 빠르게하여 생산성을 향상시킨다. 고가의 장비와 이를 잘 이용할 수 있는 시술자와 보조자 그리고 새로운 술기의 개발은 향후 이분야의 발전에 가장 중요한 요소로 작용할 것으로 보인다. 이미 선진국에서는 50-70%의 기존의 개복술을 이로 대치하고 있으며 국내에서도 앞으로 이러한 시술이 많이 확산되리라 예상된다. Ninety five cases of pelviscopic operation were performed at Eul Ji General Hospital from July, 1992 to December 1993. The results of this study were summarized as follows. 1. Age ranged from 15 to 45 years and the great incidence occured in 31 to 35 years group. 2. The mean number of parity was 1.2 and the twom times and below was 87.5%. 3. Major indications were of ectopic pregnancy 39 cases (41%), ovarian tumor 25 cases (26%), infertility 11 cases (12%). 4. The major types of surgery were salpingectomy 30 cases (31.5%), adnexectomy 29 dases (30.5%). 5. The mean duration of hospitalization was 3.5days. 6. The most common complication was infection at the puncture site in 3 cases. In conclusion, Pelviscopic surgery makes minimal incision, minimal postoperative adhension, and low morbidity rate, and early recovering brings short hospitalization, and reduction of medical cost. All things refered above, pelviscopic surgery which imposes a light physical and economic burden on patients is very useful method in hynecologic field.

베체트 증후군 1예

김경진,박종호,성갑규,우명룡,황재웅,양윤석,황인택,정지학,박준숙 乙支病院 1997 乙支醫報 Vol.20 No.1

난관 간질부임신 48 예의 임상적 고찰

김경진,안웅식,박준숙,우명용,김장환 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.7

1992년 1월부터 1997년 6월 30일까지 간질임신으로 수술받은 48명을 대상으로 임상 고찰을 알아보았다. 파열된 자궁각/간질임신의 경우에 파열되지 않은 간질임신 의 경우보다 혈압, 헤모글로빈, 수혈 등에는 통계학적 의 미가 있었다. 또한 골반경을 이용한 자궁각결찰술 및 국 소 MTX 주입법은 다음 임신에 대한 희망에 따라 결정되 어야 하겠지만 성공률은 100%였으며 β-hCG의 정상화 기간은 7.9일이었고 입원기간은 3일이었다. 따라서 hCG 및 초음파를 통한 조기 진단과 이 질환에 대한 경험의 축척만이 모성 유병률 및 사망률을 줄일 수 있다 하겠다. Ectopic pregnancy continues to be a leading cause of maternal morbidity and of reduced childbearing potential among women of reproductive age. Because of tubal rupture, it is still the main cause of pregnancy-related death during the first trimester, especially interstial tubal pregancy. The incidence of interstitial tubal pregnancy accounts for approximately 2 to 6 percentes and has been on the increase, and a rise in the proportion on unruptured tubal pregnancy has been reported. This change in presetation calls for a new approach. We experienced 814 cases of ectopic pregnancies. Among these, this study was undertaken for the clinical evaluation and statistical analysis on 48 patients with interstitial tubal preganancy who has been admitted and treated at Eul Ji medical center from January 1 1992 to June 30 1997. And we present the results of pelviscopic ligation with local methotrexate injection. The results of the study were as follows ; 1. The total number of ectopic pregnancies were 814 cases and among these interstitial pregnancies were 48 cases. The incidence was 5.9%. 2. The distribution of age was 18 to 45 years and the frequent age group was 31∼35 years. 3. Women that had two deliveries were 22 cases (45.8%), and nullipara was 16 cases (33.3%). 4. Women that experienced one or more abortions were 41 cases (85.4%), and no history of abortion was 7 cases (14.6%). 5. In the past history, PID in 10 cases (20.9%), previous adnexal operation in 6 cases (12.5%), and previous IUD use in 5 cases (10.4%). 6. The number of cases experiencing previous ectopic pregnancy were 4 cases (8.3%). 7. The clinical manifestation appeared in 39.6% from last menstrual period to the next 6∼8 wks. 8. On symtomatological analysis, lower abdominal pain and discomfort was encountered in 58.3%, amenorrhea in 20.8%, and vaginal spotting in 16.7%. 9. In unruptured group, the size of ectopic focus was above 10 cm in 10 cases (42%), 8∼9 cm in 7 cases (29%), and 6∼7 cm in 3 cases (13%). 10. The diagnostic positive rate was 73% in sonogram. 11. Among 48 cases, we conducted cornual resection in 39 cases and pelviscopic ligation with local methotrexate injection in 9 cases. 12. In pelviscopic ligation and local methotrexate injection group, the median resolution time was 7.9 days and successful rate was 100%. 13. There were no complications except transfusion.