적혈구 효소활성화에 의한 정상분삭 임부와 신생아의 Riboflavin 및 Pyridoxine 영양상태에 관한 연구

신희철(HC Shin) 대한산부인과학회 1980 Obstetrics & Gynecology Science Vol.23 No.4

정상만삭임부와 신생아 각각 32예를 대상으로 riboflavin 및 pyridoxin의 영양상태를 평가하고 산모와 신생아간의 상관관계를 보기 위하여 본실험을 시행하였다. 저자의 실험은 EGR 및 EAST의 활성과 이들의 보조효소인 flavin adenine dinuclootide 및 pyridoxal-5-phosphate의 첨가에 의 한 효소활성증가를 측정하고 riboflavin과 pyridoxine의 양을 간접적으로 알 수 있는 Bayomi 및 Rosalki 등의 최근의 법을 도입 하여 다음과 같은 성적을 얻었다. 1. EGR 활성계수의 평균치는 산모에서 1.62±0.29, 신생아에서는 1.25±0.17이었다. 2. EAST 활성계수의 평균치는 산모에서 1.74±0.18, 신생아에서 1.39±0.11이었다. 3. EGR에서는 산모 활성계수와 신생아 활성계수간의 상관관계는 0.84(P<0.010), 그리고 회귀직선의 식은 y=0.515+0.46x이었으며 산모활성계수와 신생아 활성계수간의 비와의 상관계수, 회귀직선의 식은 각각 r=0.62(P<0.01), y=0.803+0.303x이었다. 4. EAST에서는 산모 활성계수와 신생아 활성계수간에는 상관계수, 회귀직선의 식이 각각 R=0.26(P<0.05), y=1.038+0.184x이었고 산모의 활성계수와 산모활성계수, 신생아 활성계수비간에는 상관계수 r=0.68(P<0.01), 회귀직선 y=0.25+0.518x이었다. 5. 산모의 효소활성계수만을 이용하여 신생아의 활성계수를 추정할 수 있는 방법을 고안시도한바 통계학적으로 유의한 상관관계 를 볼 수 있다. Riboflavin and pyridoxine nutriture of 32 healthy normal full term pregnant women and their neonates were evaluated using erythrocytic enzyme levels in order to establish riboflavin and pyridoxine profiles of Korean mothers and their neonates. It was attempted in this study to assess the riboflavin and pyrodoxine status in tissue by determination of erythrocyte glutathone reductase and erythrocyte aspartate aminotransferase activities, and their activation by their respective coenzymes, flavinadenine dinucleitide and pyridoxal-5-phosphate. Following results were obtained: 1. Mean activity coefficient of EGR was 1,62+_0.29 in mothart and 1.25+_0.17 in neonates. 2. Mean activity coefficient on EAST was 1.72+_0.18 in mothart and 1.39+_0.11 in noenates. 3. In case of EGR, correlation coefficient from regression line of the activity coefficient of neonate on that of mothe was= 0.84(P<0.01) and it shows statistically significant dependency. 4. In case of EAST, activity coefficient of neonate was independent to the activity coefficient of mother but the ratio of activity coefficient of mother th that of neonate shows dependency upon activity coefficient o mother.

노령산모 임신과 출산에 관한 연구

신희철(HC Shin),김관수(KS Kim) 대한산부인과학회 1984 Obstetrics & Gynecology Science Vol.27 No.9

The majority of papers written on the subject of the pregnancy in women over forty have stressed the decline in physiological activity and efficiency in this group of patients, coupled with an increased incidence of medical complications giving rising to a high fetal mortality. Relationship between maternal age and the frequency of dysfunctional labor paterns was assessed retrospectively in a population of 5604 gravid women. Five hundred women among 5108 gravidas aged below 35 were used as a control group. The results obtained are as followings: 1. The pregnant women aged over 40 were 54 cases among total 5604 gravid women. The incidence of distribution ranged between 40 and 49 yrs among pregnant women aged over 40. 3. Concerning antepartal complications the incidence of PROM was 16.7% in pregnant women aged over 40 comparing with 9.4% in the control group. The incidence of hypertensive disorder was 11.2 comparing with 5.6% in the control group. 4. There were increased incidence of both low and high birth weight infants. 5. Neonal mortality rate was 148 comparing with 56 in the control group.

Doppler 초음파를 이용한 정상임신주수에 따른 태아제대동맥 혈류속도파형의 변화양상

신희철(HC Shin),윤보현(BH Yoon),김승욱(SW Kim) 대한산부인과학회 1989 Obstetrics & Gynecology Science Vol.32 No.3

서울대학교병원 산부인과를 내원한 정상임산부의 제대동맥에서 doppler초음파검사를 시행하 고 임신의 결과가 정상으로 확인된 104명의 임산부에서 시행된 188회의 검사결과를 임신주 수에 따라 분석하였다. 제대동맥의 혈류속도파형은 최고수축기속도(A)와 이완기속도(B)의 비 (A/B ratio), pulsatility index(PI), resistance index(RI)의 3가지 지표를 사용하여 분석하였다. 임신 14주이하에 검사가 불가능하였던 경우는 없었으며 임신이 진행됨에 따라서 A/B ratio, PI, RI모두 감소하여, 임신이 진행됨에 따라서 태반의 저항이 감소하여 제대정맥의 이완기말 의 혈류속도파형의 변화양상이 확립되었으며 앞으로 태아의 산전건강평가에 유용한 지표로 사용될것으로 여겨진다. Time-velocity waveforms or sonograms obtained by pulsed doppler ultrasound from the umbilical artery were analysed in the fetuses from 104 normal pregnancy women. One hundred eighty-eight determinations were carried out from the 13th to the 41th weeks of pregnancy. The ratio of peak systolic to end-diastolic flow velocity pulsatility index of a ratio overcomes the obstcle of not knowing the angle between the incindence beam and the direction progressively, indicating a gradual fall in resistance in the umbilical-placental circulation in normal pregnancy. The analysis of umbilical artery blood flow velocity waveforms provieds a new and non-invasive measure of fetoplacental blood flow resistance and has the potential of being an important aid in prenatal care.

장상 임신주수에 따른 태아 흉부 하강대동맥 혈류속도파형의 변화양상

신희철(HC Shin),윤보현(BH Yoon),김승욱(SW Kim) 대한산부인과학회 1989 Obstetrics & Gynecology Science Vol.32 No.9

서울대학교병원 산부인과를 내원하여 태아의 흉부하강대동맥 doppler 초음파 검사를 시행받 고 임신의 결과가 정상으로 확인된 특별한 질환이 없는 79명의 정상임산부에서 시행된 135 회의 검사결과를 임신주수에 따라 분석하였다. 임신이 진행됨에 따라 태아 흉부하강 대동맥의 수축기의 최고혈류속도와 이완기말의 혈류속 도는 임신 32주 이후에는 거의 비슷하였다. 임신 전기간을 통하여 임신주수에 따른 혈류속 도파형의 A/B ratio, PI, RI치의 큰 차이는 볼 수 없었다. 본 연구결과 한국인 정상 태아의 임신주수에 따른 흉부하강대동맥의 혈류속도파형 양상이 설정되었으므로 앞으로 태아의 흉부하강대동맥 혈류가 변화될 것으로 여겨지는 여러상황에 서 유용한 지표로 사용될것으로 생각된다. Blood flow velocity waveforms from the fetal descending thoracic aorta were obtained by a combination of realtime and pulsed doppler unltrasonic equipment, a spectral analyzer. In 79 normal pregnancy, 135 determinations were carried out from the 14th to the 41th week of gestation. Both peak velocity(A) and end diastolic velocity(B) increased with advancing gestation. but end diastolic velocity remained unchanged from the 32 th week of gestation. The A/B ratio , pulsatility index (PI) and resistance indes(RI) had a relatively constant level throughout the second and third trimester of pregnancy. The reference values obtained from this study may be useful as a basis for new basic reseach and clinical application in prenatal care.

양측유두자극법에 의한 Contraction Stress Test

신희철(HC Shin) 대한산부인과학회 1987 Obstetrics & Gynecology Science Vol.30 No.11

Manipulation of the nipple during pregnancy has been used for ripening of cervix in the postdate pregnancy or initiation of contraction for the contraction stress test(CST). Recently, the use of nipple stimulation, rather than oxytocin infusion has been recommended to produce contraction in CST(BST), the former having advantages inducing easy acceptibility to patient, shorter testing time, and both patient and staff convenience. The authers studied the efficacy of nipple stimulation for inducting contraction in CST. In Seoul National University Hospital, Department of Obstetrics and Gynecology, the CST by bilateral nipple stimulation(BST) was performed on the 150 pregnant women who visited OPD for antepartum evaluation between March1, 1985 and July 31, 1986. It was confined to the patient whose gestational age exceeds 32 wks and who does not fall on the contraindication of CST. Among the 150 CSTs performed, 72(48%) had a negative CST, 6(4%) had a positive CST, 18(12%) had a suspicious CST and 3(2%) and 6(4%) had a pattern that was read as hyperstimulation and abnormal uterine contraction, respectively, and 45(30%) did not attain adequate contractions by using bilateral nipple stimulation. Adequate contractions were produced in64% of tests as calculated from above, and 80% of such satisfactory tests were distributed within 6 minutes in stimulation-contraction interval.

난소의 Strumal Carcinoid 1예

신희철(HC Shin),강순범(SB Kang),김강회(KH Kim),이청수(CS Lee) 대한산부인과학회 1981 Obstetrics & Gynecology Science Vol.24 No.11

Strumal carcinoid is a recongnized but very rarely encountered ovarian tumor characterized by an intimate mixture of thyroid tissue and carcinoid. Most of them arose in dermoid cyst or in mature solid teratoma. Recently we experienced a case of strumal carcinoid postoperatively and present with a brief review of literature.

Fetal Monitor를 사용한 Contraction Stress Test의 임상적 이용에 관한 연구

신희철(HC Shin) 대한산부인과학회 1981 Obstetrics & Gynecology Science Vol.24 No.4

During the past decade . There has been significant improvement in the obstetrician`s ability to acheive antenatal surveillance of the high risk pregnancy. The function of antepartum fetal heart rate testing should be to identify fetuses at risk for intrauterine demise so that intervention was be undertaken before irreversible fetal compromise ensues. This study was performed in an attempt to evaluate the significance of contraction stress test in antepartum fetal surveillance. Contraction stress test of 203 pregnant women who were admitted at obstetric wards of Seoul National University Hospital from 1st of July, 1980 to 31th of December, 1980 was analyzed and the results were as follow; 1. Indications for CST were normal pregnancy (38.7%), preeclampsia and eclampsia (36.9%), premature rupture of membranes (9.4%) previous obstetric history (6.4%), postdatism(2.6%) 2. A total 266 contraction stress tests were performed on 203 patients. The results were negative in 161 (79.3%) positive in 11 (5.4%) equivocal in 13 (6.4%). unsatisfactory in 18 (8.9%) of these 203 patients. 3. the incidence of abnormal fetal heart rate during labor was negative in 19(12.4%) for 153 patients, positive in 7 (70%) of 10 patients, equivocal 4 (36.4%) in 11 patients and unsatisfactory 3 (20%) in 15 patients.

태아호흡운동 및 Nonstress Test와 태아상태와의 상관성에 관한 연구

신희철(HC Shin),이효표(HP Lee),나건영(KY Na),한종수(JS Han) 대한산부인과학회 1983 Obstetrics & Gynecology Science Vol.26 No.11

Fetal breathing movements and nonstress test were measured in the same observation period in 103 patients with 67 in highrisk pregnancies and 36 in normal pregnancies. The presence of FBM was noted in a higher proportion of tests with a reactive NST(78.0%) than a nonreactive NST(66.7%}. Conversely, NST was reactive in higher proportion of tests with a FBM present (89.9%) than a FBM absent (83.3%). A significant relationship existed between either test and the outcome of pregnancy as judged by the 5-minute Apgar score or the incidence of fetal distress in labor. Combining two normal tests did not improve the accuracy in predicting outcome; but the combination of both tests, when abnormal, produced a significant in predicting fetuses likely to have an abnorma1 outcome. The combination of the normal with the abnormal test had a predictive accuracy similar to a single normal test in predicting a normal 5-minute Apgar. This combination was associated with an incidence of fetal distress in labor intermediate between that seen with either the normal or abnormal test when a1one. Neither a single test nor the combination of tests is helpful in identifying the smal1-for-gestational age (SGA) infants. This was not helpful in identifying the meconium stained infants These data indicate antepartum fetal evaluation may be improved when more than one biophysical variable is used

난소에 발생한 내배엽동 종양 1예

신면우(MW Shin),신희철(HC Shin),남주현(CH Nam),박세웅(SW Park),이건용(KY Lee),신영실(YS Shin) 대한산부인과학회 1981 Obstetrics & Gynecology Science Vol.24 No.5

Endodermal sinus tumor is a rare and highly malignant gonadal neoplasm. Schiuer, in 1939 recongnized the unigue microscopic charcteristics of this neoplasm peculiar epithelial and endothelial relationships resembling mesonephric glomeruli and termed nesonepheoma ovarii, But Teilum in 1959 recongnized the histology to be reminiscent of yolk sac and allaxtaic interreationships in the rat placenta so called endodermal sinus of Dural and termed endodermal sinus tumor of the ovary. Until now, approximately 150 cases of pure endodermal sinus tumors or mixed germ cell tumors with endodermal sinus with endodermal sinus pattern have been reported. In this reports We present a patients with an endodermal sinus tumor of the ovary and review the classical and current word literature on this tumor

A Clinical Study on the Therapeutic Efficacy and Local Talerance of Intramuscular Bactrim in Pelvic Infections

서호석(HS Suh),신희철(HC Shin),신면우(MW Shin) 대한산부인과학회 1979 Obstetrics & Gynecology Science Vol.22 No.3

It can be stated from the present investigation that: 1) There is no significant difference in therapeutic efficacy among the various dosage forms and duration of treatment, provided that administration lasts for not less than 5 consecutive days when given bid. 2) With the usual recommended dosage forms, i.e. group 1, local tolerance is relatively good. 3) General tolerance is quite satisfactory in the group with the dosage regimen of bid for 5 days. 4) Local reaction caused by intramusclar application of Bactrim hardly exceeds that of ampicillin.