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전명권,조용균,최훈,김복린,이홍균 인제대학교 1993 仁濟醫學 Vol.14 No.4
지연임신의 산전 태아 감시 방법으로 비수축성 검사(NST) 및 양수지수(AFI)와 같이 태아 제대동맥과 뇌 동맥의 Doppler velocimetry의 유용성을 검토하였다. To assess alterations in vascular resistance as measured by Doppler ultrasound in the postterm fetus, 40 postterm (>287 days gestation) patients were studied. Velocity recordings were obtained from the internal carotid artery and umbilical artery to calculate the systolic to diastolic(S/D) ratio. Patients were divided into two groups. Group 1 consisted of 29 patients with normal antepartum fetal surveillance that included reactive nonstress test and amniotic fluid index(using the four-quardrant technique) equal to or greater than 5cm. Group 2 consisted of 11 patients with antepartum compromise on the antepartum fetal surveillance tests. There was significantly greater(p<.05) morbidity in group 2 compared to group 1, but no siginificant differences in the umbilical S/D ratio in the two groups. However, in group 2, 5(45.5%) patients had abnormally low cerebral S/D ratios(<3.5) and 6(54.5%) patients had abnormally low cerebral placental resistance ratios(<1), compared to only 1(3.5%) and 2(6.9%) for those respective ratios in group 1(p<.05). In the uncompromised postterm fetus, cerebral vascular resistance exceeds 3.5 and cerebral placental resistance ratio exceed 1 ; and lowering of cerebral vascular resistance(S/D ratio<3.5) and cerebral placental resistance ratio(<1) are associated with antepartum compromise and adverse pregnancy outcome in the postterm fetus and may be a compensatory brawn-sparing ettect in response to fetal stress.
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전명권 인제대학교 1990 仁濟醫學 Vol.11 No.2
상계백병원 산부인과로 내원한 정상 임부 169명을 대상으로 ACUSON-128 Pulsed duplex Doppler(ACUSON Corporation, 1220 Charleston Road, Mountain View, CA 94039)를 이용하여 제대동맥의 혈류파형을 측정하여 임신 주수에 따른 Systolic/Diastolic ratio의 nomogram를 작성하였으며 앞으로 비정상 임부의 혈류파형 연구에 기준으로 삼고자 한다. The assessment of fetal well-being has been tried by Doppler wavefrom analysis of the umbilical artery. Nomograms relating S / D ratio of the umbilical artery to gestational age has been published, but there were some differences among them due to some influencing factors(ex. eqipment, technique, and methods of analysis etc.) So we need our nomogram for our future study. To increase the accuracy of Doppler study, this nomogram was made by measurement at the placental insertion of the umbilical cord with ACUSON-128 pulsed duplex Doppler and analysis of the consecutive 3 to 6 waveforms. We intend to evaluate the significance of Doppler waveform study for the assessment of some pathologic conditions.
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질내 초음파로 자궁내막 두께측정에 의한 자궁내막 병변 관찰
전명권,조용균,--,--,최훈 인제대학교 1993 仁濟醫學 Vol.14 No.2
질출혈로 내원한 폐경 직전 혹은 후 여성에서 질내 초음파를 이용하여 자궁내막의 두께를 측정하여 자궁내막 병변를 관찰하고, 소파수술에 의한 조직검사와 비교해 봄으로써 불필요한 진단적 소파수술을 감소시켜 보고자 하였다. In 50 women with perimenopausal or postmanopausal bleeding, maximum endometrial thickness was measured by vaginosonography and then curettages were done for histologic diagnosis. If the endometrium was < 6mm thick, no abnormal endometrium was found ; atrophic endometrium(n=23), proliferative endometrium(n=2), and secretory endometrium(n= 1). But all abnormal endometriums were associated with an endometrial thickness of at least 6mm ; endometrial polyp(n=8), endometrial hyperplasia(n=10), and endometrial cancer(n=2). If the cutoff limit of 5mm for endometrial abnormality had been used in this study, 52% of the curettage procedures could have been avoided.
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전명권,김복린,이홍균 인제대학교 1991 仁濟醫學 Vol.12 No.4
산전 태아 사망 원인을 첫째 불분명한 원인, 둘째 불가피한 원인, 셋째 가급적 피할 수 있는 원인 등으로 구분하여 그 중에서 가급적 피할 수 있는 원인을 분석하여 앞으로 산전 태아 사망을 감소시켜 보고자 한다. In order to reduce the prenatal death, we reviewed the causes of late abortions and stillbirths. For each cause an assessment of potential avoidability was made using the following definition : If any factor was identified that might have altered the outcome, the case was judged potentially avoidable. All other mortality was classified as either unavoidable or undetermined (if sufficient data were not avililable). We experienced 91 cases of prenatal deaths and the common causes were as follows in order: Unexplained IUFD, Idiopathic preterm delivery, IUGR, congenital malformation, preeclampsia, cord complication, and abruptio placenta. In 31.9% of prenatal deaths, at least one potentially avoidable factor could be identified that might have altered the outcome, while 69.4% was unavoidable and 6.6% undetermined. The causes of the potentially avoidable deaths(31 cases) were the incorrect viability assessment/management plan, 4(12.9%); asphyxia, 13(41.9%); IUGR, 9(29%); syphilis, 3(9.7%); and hypovolemic shock, 2(6.5%). We hope that a better obstetrical care program will be provided with the suggestion of the patterns of potentially avoidable prenatal death.
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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.
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이경복,전명권,김용봉,박성관 인제대학교 1989 仁濟醫學 Vol.10 No.4
자충탈은 질축을 따라서 자궁경부와 자궁이 하강하는 것을 일컫는데 노령기 여성에서 흔하다. 저자들은 최근 3년간 본 교실에 입원하여 수술을 시행받는 자궁탈 환자 50예를 대상으로 임상적으로 조사 분석하였다. This study was undertaken for the clinical evaluation and statistical analysis on the 50 patients with uterine prolapse who had been treated at the Seoul Paik Hospital from Jan. 1, 1985 to Dec. 31, 1987. The results obtained were as followed : 1.The incidence of uterine prolapse was 2.59%. 2.The highest group of age distribution at the time of operation was 51 to 60 years(44%). 3.The highest group of degree of uterine prolapse was the 3rd degree(68%). 4.The highest group of parity was over 4(82%). 5.The feeling of a prolapsed mass was the most common symptom(74%). 6.Out of 50 cases of uterine prolapse, 33 cases (66%) were treated by vaginal hysterectomy with anterior and posterior repair, the remainder were treated by vaginal hysterectomy with anterior repair. 7.The postoperative pathologic findings were hyperkeratosis and parakeratosis 23 cases(46%), acanthosis 15 cases(30%), cervicitis 8 cases (16%), leiomyosis 1 case(2%), and adenomyosis 1 case(2%).
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