Treacher Collins 증후군 1 례

김복린,김명주,박경미,김종국,신원춘 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.5

본 저자 등은 Treacher Collins 증후군 1례를 경험하였기에, 간단한 문헌고찰과 함께 보고하는 바이다. Treacher Collins syndrome is rare, genetically transmitted congenital malfomation syndrome which has an incidence of 1/50,000 live births and involving primarily the facial bones. It is inherited as an autosomal dominant trait with variable expressivity. The chief features of this syndrome including the following: hypoplasia of the facial bones especially the malar bones and mandible, antimongoloid slant of the palpebral fissures, coloboma of outer third of lower eyelid, malformation of the auricles with external ear canal defects and frequent conductive deafness, cleft palate. We experienced a case of Treacher Collins syndrome in a male infant with the chief complaints of hypoplastic mandible, antimongoloid palpebral fissure and ear malformation. We report the case with a brief review of literature.

난관 문합술시 수술 전 자궁 난관 조영술의 진단적 효과에 관한 연구

김복린,최훈,이홍균 인제대학교 1996 仁濟醫學 Vol.17 No.2

난관 불임 수술 후 복원을 위하여 난관 문합 수술을 하는 경우 수술 전 자궁 난관 조영술의 진단적 가치를 알아 보기 위해 본 연구를 하였다. 연구 결과 난관 폐쇄 부위에 대한 수술시 자궁 난관 조영술의 정확도는 간질성 폐쇄의 경우 67%, 협부의 경우 91%, 난관 팽대부의 경우 85%를 보여 주어 수술 전 자궁 난관 조영술이 난관의 폐쇄 부위의 확인, 난관의 상태 및 수술 후 임신 성공율을 예측하기에는 불완전하여 추가로 복강경을 이용하는 것이 진단에 도움이 된다. The effectiveness of the Hysterosalpingography(HSG) in the investigation of women requesting reversal of tubal sterilization has never been established. We reviewed the preoperative hysterosalpingography performed on 31 women (61 tubes) for knowing effectiveness of HSG. We observed that interstitial, isthmic and ampullary obstruction by HSG correctly correlated with subsequent surgical findings in 67%, 91%, and 85% of tubes, respectively. We concluded that the preoperative hysterosalpingography is not enough for getting information of the preoperative evaluation of candidates for tubal reanastomosis.

폐경여성에서 자궁내막의 질초음파 검사의 유용성

김복린,최훈,이홍균 인제대학교 1998 仁濟醫學 Vol.19 No.2

자궁 출혈이 있는 폐경 이후의 여성에서, 정확한 진단을 위해 자궁내막 소파술을 시행하기 전에 질초음파 검사를 시행하여 자궁내막 두께를 측정하여 자궁내막암 및 전암단계 즉 자궁내막 폴립과 자궁내막 증식증의 발생 상태를 알아내기 위한 선별 검사로써 질초음파 검사의 유용성을 평가하고자 하였다. 연구 결과, 병리조직 검사상 자궁내막암 또는 전암단계의 경우, 자궁내막의 평균 두께(±SD)는 17.8±5.1mm로 나타났으며 자궁내막 두께의 유소견 기준을 5mm로 하였을 때 질초음파 검사를 이용하여 자궁내막의 병변을 찾을 수 있는 민감도는 96.3%, 특이도는 64.3%, 양성 예측도는 63.4%, 또한 음성 예측도는 96.4%로 확인되었다. Objectives: To evaluate the usefulness of transvaginal sonographic measurement of endometrial thickness in women with postmenopausal bleeding and to compare with histologic results obtained by endometrial curettage. Methods: We studed 69 patients retrospectively. Before the endometrial curettage was performed, we measured the thickness of the endometrium between the two basal layers of the anterior and posterior wall in the longitudinal plane and compared endometrial thickness to the histopathologic diagnosis of the curettage specimens. Results: In women with normal histologic results, the mean endometrial thickness(±SD)was 5.67±0.8 mm as compared with 17.8±1.1mm in those women with abnormal histologic result. By using of cut off level of 5mm of endometrial thickness, the sensitivity of ultrasonography to detect abnormal endometrial histologic findings was 96.3%, the specificity was 64.3%, the positive and negative predictive values were 63.4% and 76.8%, and diagnostic accuracy was 76.8%. Conclusion: The trnsvaginal ultrasonographic measurement of endometrial thickness before the endometrial curettage was performed is useful method for screening the patients with endometrial abnormality in women with postmenopausal bleeding.

생쥐배아의 동결보존 및 융해후 생존과 발생에 관한 연구

김복린,최훈,조용균,이홍균 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.4

Objectives : To evaluate the survival and development of early stages of mouse embryo after cryopreservation using two types of cryoprotectant. Methods and Materials: We obtained two cell stage embryos and four to eight cell stage embryos from mated F1 hybrid female mice superovulated by PMSG and hCG. Embryos were freezed as slow-freezing method and thawed as rapid-thawing methods using two types of cryoprotectants, PROH and DMSO. And we compared of the survival rate after thawing and cultured the embryos for 72 to 96 hours and compared the development of mouse embryos. Results : The survival rate of 2 cell stage embryos was significantly higher than 4-8 cell stage embryos(69.5% versus 65.1% in PROH, 73.3% versus 69.9% in DMSO)(p<0.01) and the development rates of 4-8 cell stage embryo were higher than that of 2 cell stage embryos in both PROH and DMSO. As for cryoprotectant, the survival rate of 2 cell staged embryos in PROH was significantly higher than that of embryos in DMSO(69.5% versus 63.6%, p<0.05). but the development rate was not different significantly in both PROH and DMSO. The survival rate of 4-8 cell stage embryos was 65.1% in PROH and 69.9% in DMSO and the development rate in DMSO was significantly higher compared to embryos in PROH(69.2%, 49.5% versus 52.4%, 55%, p<0.02) Conclusions : The survival rate of 2 cell stage embryos was higher than that of 4-8 cell stage embryos was better than 2 cell stage embryos. As for using cryoprotectant, PROH is more effective in 2 cell stage embryos and DMSO is more effective in 4-8 cell stage embryos.

조산의 역학적 연구 : 1980년부터 5년간, 서울백병원을 중심으로

김복린 인제대학교 1985 仁濟醫學 Vol.6 No.2

조산은 주산기 사망 및 신생아 이환율의 가장 중요한 원인이므로 조산의 역학적 조사를 통하여 환경적 요인과 모체의 원인을 알아내기 위하여 문헌 고찰과 함께 보고하는 바이다. Preterm delivery is one of the most important causes of perinatal death and neonatal morbidity. The word preterm is now used to describe infants born before 37 weeks' gestation and the term low birth weight describes infants weighing less than 2500gm at birth. A population of 307 preterm delivery was studies epidemiologically and the results of this study are as follows; 1) the incidence rate is 3.64%, and 78.8% among the preterm delivery pt. is 24-32 age group. 2) in delivery method, vaginal delivery is 70.3%, C-section 19.2%, and breech extraction 10.5% and the case of less than 28 gestational weeks is 9.8%, 29-32 weeks' is 24.7% and 33-36 weeks' is 65.5%. 3) the etiology of preterm delivery is PROM, placenta previa, severe preeclampsia and eclampsia, IIOC, hydramnios, and congenical anomaly of fetus, etc but in the group of 102 patients (33.2%) is unknown causes. 4) the over all perinatal mortality rate is 17.9%.

Clomiphene Citrate 배란유도시 자궁내막 두께 및 초음파상의 양식의 변화에 관한 연구

김복린,최훈 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.3

Objective : To investigate the effects of clomiphene citrate(CC) on the endometrium and the difference of echogenic pattern using transvaginal ultrasonography during ovulation induction. Methods and Materials : We studied retrospectively thirty-eight women given 50㎎ of clomiphene citrate between days 5 to 9 of the menstrual cycle for induction of ovulation and also studied thirty-five women with regular ovulation as control group. A1 patients were checked endometrial thickness on late proliferative days and midsecretory days, echogenic pattern of the endometrium on midsecretory days. serum estradiol level on late proliferative days before ovulation and serum progesterone level on midsecretory days. Results : There was significant difference in endometrial thickness between CC treated group(7.4±1.3㎜, mean±SD, n=38) and control group(8.6±1.6㎜, mean±SD, n=35) on late proliferative days, but there was no difference in endometrial thickness between CC treated group(10.9±2.3㎜, mean±SD, n=38) and control group(11.2±2.1㎜. n=35) on midsecretory days. The echogenic patterns were different between two groups on midsecretory days. Grade 3 echogenic pattern on midsecretory days was significantly higher in CC treated group and the incidence of pregnancy was higher in patients with grade 3 echogenic patterns compare to the nori-pregnant patiens. Serum estrdiol level was higher in CC treated group (527±332pg/㎖) compare with control group(251±38pg/㎖) on late proliferative days and there was no difference in serum progesterone level between two groups on midsecretory days. Conclusion : Our results indicated that clomiphene citrate affected the endometrial growth and morphologic development on late proliferative days and also altered echogenic pattern of the endometrium on midsecretory days. Incidence of pregnancy was higher in the emdometrium showed a grade 3 echogenic pattern on midsecretory days and the grade 3 echogenic pattern of endometrium during CC treatment is more comfortable for implantation of embryos.

자궁경관 무력증에 관한 임상적 연구

김복린,이홍균 인제대학교 1984 仁濟醫學 Vol.5 No.2

The incompetent cervical os has been considered a cause of second trimester abortion and prematurity. The etiology of this condition is obscure and the diagnosis has generally relied on clinical findings and historical information from the patient. Fifty-one cases of cervical incompetence were taken cervical cerclage operation and the over·all fetal salvage rate after cerclage operation was 82.4%. The decision of appropriate time and method for treatment of cervical incompetence during pregnancy is very difficult, but we considered that cervical incompetence is ideally treated by a prophylactic cerclage operation at 14 to 20 weeks' gestation and thought that cerclage procedures with tocolytic agents, absolute bed rest and other managements are needed to increase fetal salvage and effectiveness of the management of incompetent cervix.

임신중 양수용량의 평가와 임신성과에 관한 연구

김복린,전명권,이홍균 인제대학교 1991 仁濟醫學 Vol.12 No.1

양수과소증이 있는 경우에는 주산기 이환율 및 사망율이 증가하므로 본저자들은 반복적으로 양수의 양을 측정하여 양수지표가 5cm이하인 경우와 5cm이상인 경우를 비교 관찰하였다. Antepartum assessments of amnionic fluid volumes using a semiquantitative four quadrant technique, the amnionic fluid index, and their realtionship to nonstress test patterns and pregnancy outcomes were retrospectively analyzed in 109 high risk pregnancies. We found an inverse relationship between the amnionic fluld and nonstress tests, decelerations on fetal heart rate monitoring, meconium satining, cesarean section fur fetal distress, and low Apgar score. The pregnancy outcome and incidence of perinatal morbidity were significantly related to decresed amnionic fluid volumes.

정상 임신의 임신 주수에 따른 양수지표 변화에 대한 연구

김복린,유태환,최훈,이홍균 인제대학교 1996 仁濟醫學 Vol.17 No.3

임신중 정상적인 양의 양수를 유지하는 것은 성공적인 임신성과를 얻는데 중요한 요소이다. 따라서 임신 전 기간 동안 반복해서 양수지수를 측정함으로써 양수 과소증 및 양수 과다증을 찾아내어 고위험 임신에 대한 적절한 처치를 하기 위하여 428명의 정상 임신부에서 양수지수를 측정하여 임상적으로 유용하게 이용하기 위한 연구를 하였다. Amniotic fluid index(AFI), the four-quadrant sum of amniotic fluid pockets was studied prospectively in 428 normal pregnancies. Until 27weeks, the AFI increases progressively and after 28weeks, the AFI declines at a progressively increasing rate. The mean of AFI was 13.1mm in term pregnancies and in postdates pregnancies, AFI were decreased rapidly. We concluded that ultrasonographic measurement of AFI is relatively accurate in identifying normal amniotic fluid

포상기태의 임상적 연구 : 서울 백병원을 중심으로

김복린,전명권,김호성,이홍균 인제대학교 1989 仁濟醫學 Vol.10 No.4

서울백병원 산부인과에서 1981년부터 7년간 진단 치료 및 추적 관리를 시행하였던 48예의 포상기태 환자를 대상으로 환자의 발생 빈도, 연령, 임신력, 증상, 치료 방법 및 그 결과에 대하여 분석 조사하였다. Korea is one of the areas with high incidence of gestational trophoblastic disease. Forty-eight cases of H-mole were analized at department of obstetrics and gynecology, Seoul Paik hospital from January, 1981 to December, 1987 and the results were as follows ; 1) Incidence of H-mole at our hospital was one per 205 deliveries (0.49%). 2) Among 48 cases with follow-up, age group of 26 to 30 was most frequent (47.9%) and the most frequent group according to parity was nulliparous group (45.8%). 3) Antecedent pregnancies prior to H-mole were artificial abortion (39.6%), term pregnancy (31.3%), spontaneous abortion (6.2%) and Molar pregnancy (4.2%). 4) Most frequent symptom was vaginal spotting and bleeding (77.1%) and hyperemesis (6.3%), abdominal discomport (4.2%) and enemia (2.1%) were noted. 5) Among 48 cases of R-mole patients, 45 patients (93.7%) were treated with D & E and 3 patients (6.3%) were treated with hysterectomy initially. Among 45 patients treated with D & E, 39 patients (81.2% of cases) were treated with D & E only, 5 patients (10.4%) were treated with D & E and chemotherapy. Among 3 patients treated with hysterectomy initially, 2 patients (4.2%) were treated with hysterectomy only and 1 patient (2.1%) was treated with hysterectomy and chemotherapy.