외음암의 8예

이영혜(YH Lee),최영균(YK Choi),최영중(YJ Choi),한의정(EJ Han),이희정(HJ Lee) 대한산부인과학회 1980 Obstetrics & Gynecology Science Vol.23 No.3

저자는 본원 산부인과에서 1964년 11월부터 1974년 11월까지 10년간 8예의 외음암을 경험하였기에 그 병례와 문헌을 간단히 고 찰하였다. We have exprienced eight cases of vulva carcinoma in this hospital from 1964 to 1974. One was carcinoma in situ, six were invasive eoidermoid carcinoma and one was adenocarcinoma of Bartholin`s gland. This paper is dealing with study of the cases and brief review of literature.

난소과립막세포종의 1례

백영철(YC Bark),이영혜(YH Lee),안정모(JM An),제구화(KW Je) 대한산부인과학회 1984 Obstetrics & Gynecology Science Vol.27 No.9

저자들은 58세의 경산부에서 발생한 과립막세포종 1례를 경험하였기에 간단한 문헌고찰과 함께 이를 보고하는 바이다. Granulosa cell tumor is a rare malignant feminizing and usually solid tumor of the ovary. A case of 58 years old multiparous woman who has a granulosa cell tumor of the left ovary, is presented with a brief review of literatures.

Testicular feminization syndrome 1례

최영균(YK Choi),이영혜(YH Lee),최영중(YJ Choi),정신호(SH Chung) 대한산부인과학회 1978 Obstetrics & Gynecology Science Vol.21 No.1

저자들은 최근 전주예수병원 산부인과에서 testicular feminization syndrome 1예를 경험하였기에 간단한 문헌적 고찰과 함께 그 증례를 보고하는 바이다. Testicular Feminization is a hereditary syndrome characterized by in dividuals with testes who present a female phenotype. We presented a case of testicular feminization syndrome with nearly normal size of blind vagina associated with bilateral inguinal gonads, who received laparatomy with resection of tsetes, with brief review of literatures.

임신자궁의 염전 1예

조정호(JH Cho),이병렬(BY Lee),박승창(SC Park),이영혜(YH Lee) 대한산부인과학회 1982 Obstetrics & Gynecology Science Vol.25 No.11

임신자궁의 엽전은 희귀한 병발증으로 산모나 태아에게 치명적인 손상을 주기 때문에 신속한 치료를 필요로 한다. 저자들은 임신자궁의 염전 1예를 경험하였기에 문헌적 고찰과 함께 증례를 보고하였다. Pathologic torsion of the pregnant uterus, a fairly common occurrence in veterinary medicine, is an unusual and deceptive clinical entitiy in human obstetrics. The first documented case of pathologic torsion was reported by Virchow in 1863. Since that time, uterine malrotation has been described many times, but usually in the nongravid state, and is associated with definite pathology.

선천성 부신성 증후군

최영중(YJ Choi),최영균(YK Choi),이영혜(YH Lee),한의정(EJ Han) 대한산부인과학회 1977 Obstetrics & Gynecology Science Vol.20 No.1

최근 실질적으로 나타난 선천성 부신피질증식증에 의한 여성반음양을 경험하기에 문헌과함께 보고하는 바이다. Patient. Kim. S.R, was examined together with her younger sister (kim. J.R) because of enlargement of clitoris, fusion of labioscrotal folds and musculine configuration. The child has been brought up as a girl. The patient developed in a way similar to her younger sister. Sex chromatin in oral mucosa smear: positive. Chromosome study: cytogenenetically normal 46/XY, female. Baseline urinary 17 KS was 37.3㎎/24hours. After three day`s treatment with dexamethasone, the output oh 17KS was 4. 55㎎/24 hours. Retroperitoneal pneumogram including tomography revealed to marked enlargement bilateral adrenal gland. Vaginogram showed uterus measured 3×2 ㎝ and distended vagina 6㎝ in length. Two case of female pseudohermaphroditism with virilization delveloped in sisters is presented a brief review of the concerned literatures.

기생성 류피낭포의 1례

김영식(YS Kim),황수경(SK Hwang),박승창(SC Park),이영혜(YH Lee) 대한산부인과학회 1983 Obstetrics & Gynecology Science Vol.26 No.11

This is a case report of parasitec dermoid which is very rare complication of dermoid. We experienced a case of parasitic dermoid of 28-yser-old multiparoys house wife so we presented it with brief review of concerning literatures.

자궁내 태아사망의 임상적 고찰

이영혜,이형열,정두수,서승식,최주원,정은신 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.5

1986년 1월 1일부터 1990년 6월 31일까지의 만 5년 6개월동안 전주예수병원 산부인과에서 입원 분만한 15,838예중 자궁내 태아사망 231예를 임상적으로 연구하여 다음과 같은 결론을 얻었다. 1. 자궁내 태아사망의 발생빈도는 1.46%이었다. 2. 연령분포는 18세에서 42세까지의 분포를 보였으며, 25∼29세군이 52.6%로 가장 많은 분포를 나타내었다. 3. 출산력 별로 보면 미경산부에서 54.3%로 가장 많았고 다음은 1회 분만군이었다. 4. 자궁내 태아사망의 기왕력은 30예(12.9%)에서 있었고, 자연유산의 기왕력은 41예(17.8%)에서 있었다. 가장 많은 혈액형은 A형(31.7%)이었다. 5. 자궁내 태아사망의 발견이 가장 많았던 주수는 37∼40주(23.0%)였으며, 태위는 두위가 65.7%로 가장 많았다. 남아와 여아의 비는 1.24 : 1이었으며, 태아 체중은 2,500gram미만이 75.1%이었다. 6. 분만방법은 유도분만이 44.8%로 가장 많았고, 자연분만은 42.0%, 개복수술은 16.1%이었다. 7. 자궁내 태아사망의 원인은 원인불명이 40.4%, 임신중독증이 14.7%, 태반조기박리가 10.8%, 제대문제 9.0%, 선천성기형 8.7%, 융모양막염 4.8%, 전치태반 3.0%, 모체질환, 자궁기형 등이었다. 8. 자궁내 태아사망의 모성 합병증은 67예(29.0%)에서 나타났고, 이중 발열(17.3%), 출혈(10.4%)이 가장 많았고 요로감염, 자궁복구부전, 창상감염, 자궁경관 열상 등의 순서였다. 9. 자궁내 태아사망과 DIC와 관계는 FDP가 연구군의 5.0%에서 40㎍/ml이상으로 증가되었고, fibrinogen은 10.9%에서 150mg%이하로 감소되었으며, prothrombin time이 40.0%인 경우는 3.7%에서 보였고, partial thromboplastin time이 45초이상 연장된 경우는 2.7%에서 있었다. 10. 산전관리를 한 번도 받지 않은 임산부는 22.0%였으며, 37.0%의 경우는 1∼2번, 27.7%의 산모는 3∼4번의 산전진찰을 받았다. The intrauterine fetal death is difined as the intrauterine death after 20 weeks gestation or attainment of 500 gram body weight prior to the complete expulsion or extraction from it`s mother. This is clinical study of 231 cases of the intrauterine fetal death among 15,838 deliveries of Presbyterian Medical Center during 5.5 year period from Jan, 1985 to Jun, 1990 using as a base the medical records. The results of this study were as follows. 1. The incidence of the intrauterine fetal death was 1.46%. 2. The age distribution of mothers with the fetal death in uterus was 18∼42 years and was highest in the 25∼29 years range(52.6%). 3. The parity of mothers in the intrauterine fetal death was the most highest in nulliparous group (54.3%) and the next group was para-1 (29.6%). 4. There were 30 cases (12.9%) with the previous history of the intrauterine fetal death and 41 cases (17.8%) with the previous history of the spontaneous abortion. The incidence of antepartum maternal anemia was 25.5% (59 cases) and the largest blood group was Rh positive A type (31.7%). 5. The largest incidence according to the gestational age was 37 to 40 weeks gestation group (23.0%). The sex ratio of male versus female fetus was 1.24 : 1. The most common presentation was cephalic (65.7%) and the 75.1% of dead fetus weighted less than 2500 gram. 6. The mode of delivery for the intrauterine fetal death showed that the induction of labor was most common (44.8%) and the spontaneous delivery was 42.0%, laparotomy cases were 13.4%. The most common indications of laparotomy were placenta previa, previous cesarean section state and placenta abruption. 7. The etiologic factors of the intrauterine fetal death : Unexplained causes (40.4%), toxemia (14.7%), abruption placenta (10.8%), cord accidents (9.0%), congenital anomaly (8.7%), amnionitis (4.8%), placenta previa (30%), twin (30%), postterm (26%) syphilis (1.7%) and other maternal chronic illness. 8. There were 67 cases of maternal complications. The most common was fever (17.3%) and the others were hemorrhage (10.4%), urinary tract infection (5.1%),uterine subinvolution(3.5%), wound infection(2.2%)and etc, in that orders. 9. The DIC studies of IUFD were as follows:The FDP was increased above the levels of 40 ug/ml in 5% of cases. The fibrin levels were decreased below the levwl of 150 mg% in 10.9% of cases .The platelet count was decreased below the level of 150,000/mm in 4.9% of the cases.The prothrombin time was below the level of 40% in 3.7 of the cases and partial thromboplastin time was prolonged above 45 sec in 2.7 % of the cases. 10. The 22.0% of the cases had not received any prenatal care, 37.2% of the cases received prenatal care only 1 or 2 times, and 27.7% had received 3 or 4 times.

여성 골반내 종양의 임상 및 병리학적 고찰

이영혜,이형열,서승식,공지원,최주원,정은신 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.10

1989년 1월 1일부터 12월 31일까지 1년간 여성 골반내에서 발생한 종양으로 전주 예수병원 산부인과에 입원하여 수술을 받은 300예를 대상으로 임상적 및 병리학적 연구로 다음과 같은 결과를 얻었다. 1. 연령별 분포는 41∼50세가 38.65로 가장 많았고, 평균 연령은 42.1세이었다. 2. 분만횟수는 3∼4회가 37.3%로 가장 많았다. 3. 임상증상은 하복부 동통이 30.6%로 가장 많았고 이상자궁출혈과 이물촉진이 그 다음 순이었다. 4. 종양 종류로는 자궁근종이 가장 많았고 양성난소종양이 다음 순이었다. 5. 41∼50세에는 자궁근종이 51.8%로 가장 많았다. 6. 21∼30세에는 양성 난소종양 및 비종양성 난소낭이 가장 많았다. 7. 11∼20세에는 악성 난소종양이 가장 많았다. 8. 악성종양은 4.6%이었다. 9. 수술방법은 복식 전자궁절제술 및 자궁부속기절제술이 68.3%로 가장 많이 시행되었다. 10. 수술시간은 80%가 30분에서 1시간 30분사이 이었다. 11. 수술후 합병증은 빈혈이 23%로 가장 많았다. 12. 수술전 자궁근종으로 진단된 경우 82.5%에서 수술후 자궁근종으로 진단되었다. 13. 수술전 난소 종양인 경우 80%에서 수술후 난소종양이었다. 14. 수술전 악성 난소종양을 의심한 경우 44%에 서 수술후 악성난소종양이었다. A clinico-pathological studies were made on a series of 300 patients having a diagnosis of pelvic mass/uterine myoma, who were admitted, operated and confirmed histopathologically at the Department of Obstetrics and Gynecology, Prebyterian-Medical Center, Chun Ju, from January 1. 1989 to December 31.1989. The results were as follows; The average age was 42.1 years old with the highest frequency in 5th decade. The most common chief complaint of pelvic mass was lower abdominal pain or discomfort, revealed in 30.6% of the cases. Among the pelvic mass, leiomyoma was most frequently revealed in 56.0% and benign ovarian tumor was revealed in 25.3%. Leiomyomas were observed most frequently in the age group 41 to 50 years. Benign ovarian tumor or functional cyst was the most prevalent finding in women aged 21∼30 years. In the age group in 11 to 20 years, malignant ovarian tumor was most frequently observed. The incidence of malignant tumor was 4.6% among all pelvic mass. Total abdominal hysterectomy with unilateral or bilateral salpingo-oophorectomy was most frequently performed in 68.3%. Leiomyomas were found in 82.5% of 194 patients with a preoperative diagnosis of leiomyma. Ovarian tumors were found in 80% of 100 patients with a preoperative diagnosis of ovarian tumors. Malignant ovarian tumor were found in 44% of 25 patients with a preoperative diagnosis of malignant ovarian tumor.

미숙분만에 관한 역학적 고찰

이영호,이봉구,이영혜,장부용,이형열,오병전,정두수 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.2

1986년 1월부터 1988년 6월까지 2년 6개월간 본원 산부인과에서 분만한 총 6275예의 분만중 미숙분만 519예에 대한 통계학적분석을 실시, 여러 위험인자에 대한 빈도를 조사하여 다음과 같은 결론을 얻었다. 1. 미숙분만율은 1986년 7.7%, 1987년 7.2%에서 1988년 10.0%로 최근 증가추세를 보이고 있다. 2. 최근 5년간 borderline preterm delivery는 54.5%를 차지하였으며, moderately preterm delivery는 32.2%, extremely preterm delivery는 13.3%를 차지하였다. 3. 미숙분만 산모의 연령분포는 35세이하 7.8%에 비해 35세이상에서 20.5%로 현저히 높았다. 4. 미숙분만 산모의 분만횟수는 분만횟수 4회이상 산모에서 28.9%로 초산부나 1회 경산부의 7.6%에 비해 현저하게 높았다. 5. 미숙분만 산모의 유산횟수는 유산경험이 없는 경우 6.6%에 비해 3회이상의 경우 17.1%로 현저히 증가되었다. 6. 산모의 교육정도와 미숙분만과 관련성은 교육기간이 길수록 적게 나타났다. 7. 미숙분만율과 최초 산전진찰시기와는 연관 관계가 없었다. 8. 분만과거력에 있어서는 과거 미숙분만 및 만기 유산력이 있는 경우 전체분만에 비해 8.2배의 높은 율을 보였으며, 과거 사산 및 주산기 영아 신생아 사망 예에서 1.9배로 높았으나, 제왕절개 수술력은 관련이 없었다. 9. 조산의 발생과 직접적 연관이 있는 원인으로는 다태임신, 선천성 태아기형, 전치태반, 태반조기박리, 자궁내 태아사망, 이상태위, 자궁경관내구무력증, 자궁기형, 양수조기파수 등이 있으며, 임신자간증 및 중증 자간전증의 경우는 의인성으로 조산을 시킨 경우도 있었으나 상당수 연관이 있었다. 10. 산모의 전신질환에는 결핵, 만성고혈압 등이 연관이 있고 심장질환, 신장질환 등에서는 별로 연관니 없었다. 11. 저 Apgar score(6) 신생아 발생율은 extremely preterm newborn에서 1분 71.2%, 5분 65.4%를 보였다. Although neonatal intensive care of the preterm newborn has improved the chances of healthy survival of infants, prematurity is still the major cause of neonatal mortality and morbidity. In order to investigate the various risk factors of preterm birth and contribute to prevention of preterm birth hereafter, we performed statistical analysis on 519 cases of preterm birth delivered at Department of Obstetrics and Gynecology, Presbyterian Medical Center from January 1986 to June 1988 per 6275 total delivery cases. The results of the study were as follows: 1. The incidence rate of preterm births was 7.7 % on 1986 and 7.2 % on 1987, and 10.0 % on 1988, increasing trends recently. 2. The rate of borderline preterm birth was 54.5 % and moderately preterm birth was 32.2 %, and extremely preterm birth was 13.3 % during 5 years, recently. 3. The rate of preterm birth to total birth by maternal age was 7.8 % in maternal age of under 35 years and 20.5 % in maternal age of over 35 years. 4. Number of preterm birth was increased as number of parity, and preterm birth rate to total birth by parity was 7.6 % in para 0.1, and 28.9 % in para above 4. 5. Number of preterm birth was increased as number of abortion, and preterm birth rate to total birth by abortion number was 6.6 % in no abortion group and 17.1 % in experienced abortion over 3 times. 6. Number of preterm birth was lesser in more 13 years education periods group than under 9 years education periods group. 7. There was no significant relationship of the preterm birth incidence rate and first antenatal care time. 8. As compared with previous obstetric history, preterm birth was 8.2 times more in cases with previous preterm birth and late abortion and 1.9 times more in cases with past still birth and postnatal death, but not related to past cesarean section. 9. Obstetric risk factors related to preterm birth was multiple pregnancy, congenital malformation, placenta previa, abruptio placenta, IUFD, abnormal presentation and IIOC, uterine anomaly, PROM and preeclampsia severe form and eclampsia. 10. High risk maternal disease was tuberculosis and chronic hypertension, but heart disease and renal discase was not related. 11. Incidence of low Apgar score($lt;6)rate was 71.2% at 1 minute and 65.4% at 5 minute on extremely preterm newborn.

조산 억제제로서의 Ritodrine Hydrochloride (Yutopar) 의 임상적효과

이봉구,이영혜,오병전,서승식,공지원 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.4

저자들은 1986년 1월부터 1987년 4월까지 조기진통의 진단하에 전주예수병원 산부인과에 입원한 산모에서 Ritodrine투여를 시행하고 분만시까지 추적된 25명의 산모를 대상으로 연구 분석하여 다음과 같은 결과를 얻었다. 1. 산모들의 연령 임신주수 임신력에서는 유의한 차이가 없었으며, 자궁경부개대 및 자궁경부 소실상태나 tocolysis score치는 치료성적과 유의한 관계를 보였다. 2. 1주일이상의 분만지연 혹은 임신37주이후의 분만을 치료성공의 기준으로 했을때 치료성공률은 32%이었으며, 평균 분만지연일은 25일이었다. 3. Ritodrine투여시 임산부의 혈압과 태아의 맥박수는 유의한 차이를 보이지 않았으나 임산부의 맥박수는 유의하게 증가하였다. 4. 치료 실패요인은 심한 모체 빈맥 감염 질출혈과 무반응 예로 구분되는데 무반응 예가 전체 실패 예의 76%로서 가장 많았다. 5. Ritochine투여로 인한 신생아의 Apgar score의 저하는 없었다. Preterm delivery accounts for 70 % of the perinatal mortality and morbidity and is therefore the principal target of obstetric dept. The beta-adrenergic agonist such as ritodrine hydrochloride (Yutopar) has demonstrated a significant prolongation in the duration of pregnancy and a decrease in immediate neonatal morbidity through several placebo-controlled studies in recent years. This study was conducted for the evaluation of the effectiveness of ritodrine hydrochloride on 25 patients selected in 104 patients admitted with preterm labor from January, 1986 to April, 1987. The results of this study were as follows: 1. There was no significant difference in clinical characteristics such as maternal age, gestational weeks, gravity and parity. But the high tocolysis score, progressed cervical dilatation and good cervical effacement were noted in the failure group. 2. The total success rate of tocolysis was 32 % and the mean time gained by ritodrine was 25 days. 3. There was no significant difference in maternal blood pressure and fetal heart rate during ritodrine infusion but the maternal tachycardia was noted. 4. The causes of treatment failure were severe maternal tachycardia, infection, vaginal bleeding and unresponsiveness. The unresponsiveness cases were 76 % of the total failure group. 5. The mean Apgar score of neonate born before 34 weeks of gestation was 4.8 (1-min)/7.3(5-min) and 7.2(1-min)/9.1(5-min) after 34 weeks gestation. There was no decrease in Apgar score from ritodrine infusion.