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- 저자 : 최영렬(Young Ryoul Choi) (검색결과 3 건)
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이동민(Dong Min Lee),김성(Sung Kim),김호영(Ho Young Kim),김재연(Jae Yun Kim),최영렬(Young Ryoul Choi),유재경(Jae Kyoung Yoo),황인수(In Su Hwang) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.9
목적: HELLP 증후군에 합병된 고혈압성 임신에서 모성, 태아에 미치는 심각한 산과적 합병증의 영향에 대하여 알아봄에 있다. 대상: 1994년 6월부터 1998년 6월까지 본원에 입원, 치료한 임신성 고혈압 환자 302명중 HELLP 증후군에 이환된 16명의 환자를 대상으로 임상 경험(발병 시기, 전구 증상, 임상 병리 소견, 분만 방법, 태아 모성 합병증, 모성 사망의 경우)을 기술하였다. 결과: 발병 시기를 볼 때 분만전에 15례, 분만후에 1례가 발생하였는데 이중 13례가 27주에서 36주 사이에 3례가 37주 이후에 발생하였다. 모성 사망의 경우는 1례가 있었다. 전구증상에 대하여 살펴볼 때 상복부 동통은 12례, 오심, 구토는 10례, 두통 12례, 시력 감소는 5례가 있었다. 임상 병리 소견은 혈소판 평균 수치는 68700/mm3 (범위 48000-91000), 혈중 asparate aminotransterase 평균 수치 335 IU/L(범위 62-836), lactic dehydrogenase 평균 수치 910 IU/L(범위 558-5794), total bilirubin 평균 수치가 2.6 mg/dl(범위 0.7-10.4) 이었으며 모성 합병증에 대해서는 태반 조기 박리 1례, 범발성 응고 부전 2례, 폐부종 3례, 흉막 삼출 4례, 신부전 4례가 있었으며 태아 합병증에 대해서는 자궁내 발육 부전 9례, 태변 착색 3례, 사산아 2례, 신생아 사망 2례가 있었다. 분만 방법으로는 6례에서 질식 분만을 하였고 10례에서 제왕 절개 수술을 시행하였는데 이 중 3례는 계획으로 7례에서 응급제왕 절개 수술을 시행하였다. 결론: HELLP 증후군의 중요성에 대한 인식과 초기 진단을 위한 임상 병리 검사, 임상증상에 대한 주의 깊은 관찰로 모성, 태아의 이환 대한 적절한 처치가 필요하리라 사료된다. Objective: Our purpose was to describe the clinical progress and the maternal and fetal outcome in 16 pregnancies complicated by the HELLP(hemolysis, elevated liver enzymes, low platelet). Material: We reviewed the maternal and neonatal charts from 16 consecutive pregnancies complicated by the HELLP syndrome among 302 pregnancies complicated by preeclamsia and eclamsia managed at our hospital during the period of 4 years from June 1994 through June 1998. The HELLP syndrome was defined by previously published laboratory criteria. We assessed the time of onset, presenting symptom, laboratory finding, mode of delivery, fetal and maternal complication in each case. We also reviewed the clinical finding in detail in the case resulted in maternal death. Results: In regards to the time of onset, 15 cases (93.7%) occurred at antepartum period and only 1 case (6.2%) occurred at postpartum period. Among the 15 cases occurred at antepartum period, 13 cases (81.25%) developed at 27 to 36 weeks gestation and 2 cases (12.5%) developed at near term. In regards to the presenting symptom, twelve patients (75%) complained of right upper quardrant or epigastric pain. Of 16 patients, 12 patients (75%) experienced headache and 10 patients (62.5%) complained of nausea, or vomiting and 5 patients (31.2%) had visual disturbance. The laboratory finding of all 16 cases were as follow; the mean level of platelet: 68700/mm3 (range: 48000 to 91700), the mean level of serum asparate aminotransferase: 335 IU/L (range: 62 to 135), the mean level of lactic dehydrogenase: 910 IU/L (range: 558 to 5794), and the mean level of total bilirubin: 2.6 mg/dl (range: 0.7 to 10.4). To review the mode of delivery, cesarean sections were done on 10 patients (62.5%) including 7(43.7%) emergency and 3(18.7%) elective operations. However, 6 patients (37.5%) delivered vaginally. Maternal complications were as follow; abruptio placenta in 1 case (6.2%), DIC in 2 cases (12.5%), pulmonary edema in 3 cases (18.7%), pleural effusion in 4 cases (25%), renal failure in 4 cases (25%), and 1 case of death. Fetal and neonatal outcome was assessed; 9 cases of intrauterine growth retardation (56.2%), meconium stained in 3 cases (18.7%), 2 stillbirth (12.5%), and 2 neonatal death (12.5%). Conclusion: HELLP syndrome is associated with serious maternal and fetal morbidity and mortality.
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김성(Sung Kim),이동민(Dong Min Lee),김호영(Ho Young Kim),김재연(Jae Yun Kim),최영렬(Young Ryoul Choi),유재경(Jae Kyoung Yoo),윤길중(Gil Jung Yoon),황인수(In Su Hwang) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.11
The prenatal diagnosis of spine bifida include the combined use of maternal serum α-fetoprotein (MSAFP) screening and fetal sonography. Sonographically, spina bifida is characterized by direct signs of the visualization of the spinal defect, and indirect signs of the cranial markers : the lemon sign, the banana sign, and ventriculomegaly. These ultrasonographic signs are more accurate in defining the cranial malformations associated with spina bifida than evaluation of the spine. Recently, three cases of spina bifida which was diagnosed as splaying of the posterior ossification centers, meningomyelocele sac at the lumbosacral area, lemon sign, banana sign and ventriculomegaly by ultrasonography at 21+2 gestational weeks in a 32 years old nullipara, at 21+2 gestational weeks in a 26 years old nullipara, at 23+6 gestational weeks in a 26 years old multipara were experienced at our department. We present this cases with a brief review of literatures
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난소 내배엽 종양에서 수술 후 BEP 복합화학요법에 의한 완전관해 1 예
조대현,강지훈,이미선,송정호,최영렬,이재주,전성철 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.9
Endodermal sinus tumor (EST) has also been referred to as yolk sac carcinoma because they are derived from the primitive yolk sac. These lesions are the third most frequent malignant germ cell tumor of the ovary. Patient with EST have a median age of 18 years, but approximately one third of the patients are premenarchal at the time of initial presentation. Abdominal and/or pelvic pain is the most frequent presenting symptom, most EST secrete AFP. Radical surgery has not been helpful, but recent advances in treating the EST of the ovary with the combination chemotherapy after unilateral salpingo-oophorectomy result in improvement of the prognosis. We had experienced a case of endodermal sinus tumor of 36 years old woman. So, we report this case with brief review of the literature.
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