흰쥐 자궁근의 K-경축에 미치는 Caffeine 및 Carbachol의 영향

한종설,이재현 대한산부인과학회 1984 Obstetrics & Gynecology Science Vol.27 No.10

중기임신 양수천자로 인한 합병증

한종설,목정은,주갑순 慶熙大學校 醫科大學 1977 慶熙 醫大 論文集 Vol.2 No.1

난소 임신 2례

한종설,주갑순목정은,경희대학교 의과대학 산부인과학교실 慶熙大學校 醫科大學 1979 慶熙 醫大 論文集 Vol.4 No.1

난소임신의

한종설,목정은 대한산부인과학회 1978 대한산부인과학회 학술대회 Vol.41 No.-

폐경기환자의 심리특성에 관한 연구

한종설(Jong-Seol Han),오강섭(Kang-Seob Oh) 대한스트레스학회 1998 스트레스硏究 Vol.6 No.2

조기진통진단에 있어 혈중 부신피질 자극호르몬 방출인자의 유용성에 관한 연구

김성도,한종설,송혜섭,최병익,이교원,조필제,김범영,최익준 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.9

Human placenta synthesizes bioactive corticotropin releasing factor(CRF), a 41 amino acid peptide, which displays identical immunological, biological, and chemical characteristics to hypoth- alamic CRF. Placental CRF enters the maternal circulation and stimulates release of local placental prostaglandin E2 and F2α that have a central role in the mechanisms controlling uterine con- tractility and cervical softening. A large number of clinical investigators has suggested that place- ntal CRF may be involved in mechanisms leading to labor. As well as CRF`s rises in term preg- nancy, maternal serum CRF levels are also elevated in pregnancies complicated by preterm labor. So the clinical use of maternal serum CRF levels as a predictor of preterm labor was proposed. Therefore, we have carried out a prospective study on the efficacy of maternal serum CRF levels in diagnosis of preterm labor. In this study, the subjects consisted of 30 women admitted for the treatment of preterm labor and another 30 women with normal pregnancies between 28 and 36 completed weeks of gestation, and their serum CRF levels were assessed. The results were as follows: 1. In both groups, serum CRF levels were increased as being associated to gestational ages, especially in late pregnancy. 2. In a comparative study between two groups, the serum CRF values of pregnancies complicated by preterm labor were significantly higher than their values of control group(p$lt;0.05). 3. In pregnancies complicated by preterm labor, the serum CRF values of preterm delivery were not significantly elevated comparing with their values of other pregnancies complicated bypreterm labor(p$gt;0.05). 4. In pregnancies complicated by preterm labor, the serum CRF values of infection group were significantly lower than their values of non-infection group(p$lt;0.05).

노령초산부에 관한 임상통계학적 고찰

김성도,한종설,송혜섭,최병익,왕성리,조필제 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.12

With the changing life patterns for women in current society, increasing number of women has a tendency to postpone childbearing. Advanced maternal age has become a topic of widespread public interest, but the obstetric literature has not been as abundant in addressing this concern. This study was designed to evaluate the effects f maternal older age on reproductive performance. The 150 cases of elderly primiparas at the department of Obstetrics and Gynecology, Kangbuk Samsung Hospital from January 1990 to December 1995 were compared with 155 cases of randomly chosen young primiparas during the same period. The results were as follows; 1. There were 150 cases of elderly primiparas among the total 7649 deliveries, and incidence of the elderly primipara was 1.9%. 2. Maternal age was distributed from 35 to 44 years of age. The majority(65.3%) were in the age between 35 and 36 years. For the past 6 years, no difference was found in the distribution of year. 3. There was a significantly increased induced abortion rate and breech presentation in elderly primipara. 4. Among antenatal complications, premature rupture of membrane was the highest incidence in elderly primipara(22.7%) and control group(19.4%). The incidence of myoma was 16 cases(10.7%) in elderly primipara specifically. 5. There was a significant difference in the duration of gestational age. The preterm delivery rate was significantly increased in elderly primipara 9 cases(6.0%) compared with control group 4 cases(2.6%). 6. Concerning the modes of delivery, there was a significantly increased rate of cesarean section(78.7%) in elderly primipara. The most frequent indication for cesarean section was elderly primipara(59.3%). Other indications were cephalopelvic disproportion, breech presentation, placenta previa and failure to progress in frequency order. 7. The mean duration of labor was 8.5 hours in elderly primipara, and there was no statistical difference between the two groups. 8. There were no statistical differences between the two groups in birth weight and Apgar score. In elerly primipara, there was 1 case of intrauterine fetal death and no congenital malf- ormation. 9. Among the postpartum complications, there was a significant increase in anemia in elderly primipara 47 cases(31.3%).

자간전증 산모에서 증가된 혈장 호모시스테인의 위험인자로서의 임상적 유용성 연구

김성도,한종설,송혜섭,이교원,김범영,최익준,신봉식,장우섭,조현구 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.10

목적: 자간전증이 있는 미산부에서 혈중 호모시스테인 농도가 증가하는지를 조사하여 혈중 호모시스테인이 자간전증에서 위험인자로서의 임상적 유용성이 있는가에 대하여 연구하였다. 연구 방법: 1997년 10월부터 1998년 4월까지 강북 삼성병원 산부인과에 분만을 위해 입원한 미산부중 자간전증이 있었던 미산부 20명(중증: 9명, 경증: 11명; 20명 중 13명: 조기발병 자간전증미산부)을 환자군으로 정하고 자간전증이 없었던 미산부 20명을 대조군으로 선정하여 이들 40명 모두의 혈액을 채취한 다음 high performance liquid chromatography로 혈장 총호모시스테인 농도를 측정하였고, 방사선면역측정법으로 엽산과 비타민 B12 농도를 측정하였다. 결과: 자간전증이 있었던 미산부에서 호모시스테인 농도는 12.61±3.06 μmol/L로서 자간전증이 없었던 정상 미산부에서의 6.63±1.72 μmol/L보다 통계적으로 유의하게 높았고(p<0.05), 조기에 자간전증이 발병했던 13명의 미산부에서 호모시스테인 농도는 12.71±3.41 μmol/L로서 자간전증이 없었던 정상 미산부에서의 6.63±1.72 μmol/L보다 통계적으로 유의하게 높았다(p<0.05). 엽산의 경우 환자군에서 6.86±2.96 nmol/L로서 대조군에서의 8.17±3.26 nmol/L와 통계적으로 유의한 차이가 없었으며, 비타민 B12 경우에도 환자군에서 237.8±73.1 pmol/L로서 대조군의 277.4±68.9 pmol/L와 통계적으로 유의한 차이가 없었다. 환자군에서 혈중 호모시스테인 농도가 중증군에서 13.79±3.23 μmol/L, 경증군에서 11.65±2.68 μmol/L로 두 군간에 통계적으로 유의한 차이가 없었다. 결론: 자간전증이 있는 미산부에서 분만당시에 측정한 혈중 호모시스테인은 증가하며, 자간전증을 예측할 수 있는 위험인자로 유용될 수 있을 것으로 사료된다. 호모시스테인이 자간전증 발병에 어떤 역할을 하는지, 그리고 자간전증을 어떻게 예방할 수 있는지에 대한 더 많은 연구가 필요할 것으로 사료된다. Objective: This study was designed to determine whether homocyst(e)ine is elevated in nulliparous pregnant women with preeclampsia, and to evaluate a clinical usefulness of elevated plasma homocyst(e)ine with preeclampsia as a risk factor. Methods: Of 40 nulliparous pregnant women studied from October, 1997 to March, 1998, 20 had preeclampsia (severe: 9, mild: 11; 13 early onset preeclampsia of 20) and 20 were normal pregnant controls. We measured plasma homocyst(e)ine levels by high performance liquid chromatography , and folic acid and vitamin B12 concentrations by radioimmunoassay at the time of their delivery. Results: Mean (standard deviation) plasma homocyst(e)ine levels in the two groups, 20 nulliparous women with preeclampsia and 13 nulliparous women with early onset preeclampsia, were significantly higher than in the 20 nulliparous women without preeclampsia, respectively (12.61±3.06 versus 6.63±1.72 μmol/L, P<0.05; 12.71±3.41 versus 6.63±1.72 μmol/L, P<0.05). Folic acid and vitamin B12 concentrations were not significantly different between two groups, respectively (folic acid, 6.86±2.96 versus 8.17±3.26 nmol/L; vitamin B12, 237.8±73.1 versus 277.4±68.9 pmol/L). Mean (standard deviation) plasma homocyst(e)ine levels were not significantly different between severe and mild preeclampsia(13.79±3.23 versus 11.65±2.68 μmol/L). Conclusion: Homocyst(e)ine levels are elevated in nulliparous pregnant women with preeclamsia at the time of their delivery and might be useful to predict the preeclampsia as a risk factor. Further studies are required to determine what role homocyst(e)ine may play in the etiology of preeclampsia, and to investigate how to prevent preeclampsia.

양수천자를 받은 임신 및 출산아의 추종관찰

朱甲順,韓鍾卨,李在玄 慶熙大學校 1979 論文集 Vol.9 No.-

The follow-up studies on the outcome of pregnancy and infant having amniocentesis during midpregnancy were analized. Only 483 pregnant women gave the informations for the follow-up study among 1453 patients having amniocentesis during midpregnancy from Jan. 1976 to Dec. 1978 at the department of Obstetrics and Gynecology, Kyung Hee University Hospital. The results were as follows: 1. The 483 pregnant women having amniocentesis gave fullterm delivery in 457 (94.62%), premature delivery in 8 (1.86%), immature delivery in 2 (0.41%) missed abortion in 1 (0.21%), induced abortion in 3 (0.41%) and on pregnancy in 10 (2.07%). 2. Of 473 births, 4 still births, 9 neonatal deaths and 4 infant deaths were encountered. 3. Artificial inductions of the pregnancy were carried out in 3 cases such as a 47 XYY syndrome of the fetus, an anencephalus and a patients who had vaginal leakage of amniotic fluid after amniocentesis. 4. A total of 29 patients complained as follows: Abdominal pain in 15, amniotic leakage in 5, vaginal spotting in 4, amniotic fluid leakage with abdominal pain in 4 and vaginal spotting combined with vaginal leakage in 1. 5. The risks involved in amniocentesis for prenatal diagnosis are in our experience small, so that even the use of relative indication for sampling is justified. However, even if there are no increased statistical risk, there should be carried out by experienced obstetricians. 6. Of 278 term deliveries, 63 (22.66%) cases had permanent contraceptions such as tubal ligations or vasectomies and 100 (35.9%) cases are on temporary contraceptives after delivery.

Methotrexate로 치료 실패한 자궁경부 임신의 보존적 수술 치료 1 예

김성도,한종설,송혜섭,이교원,이상준,최익준 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.4

자궁경부 임신은 생명을 위협하는 자궁외 임신의 드문 종류로써 수정란이 자궁경관내구 이하의 경부 점막에 착상한 것이다. 대부분의 환자들이 낮은 출산률을 갖고 있으므로 최근 치료의 동향은 그들의 임신 기능을 보존하는 것이다. 보존적 치료시에 가장 주의해야 할 것은 임신산물 제거후의 생명을 위협할 정도의 대량출혈이다. 우리는 태아 심박동이 관찰되는 상태에서 보존적 치료인 methotrexate와 leucovorin을 사용하였으나 치료에 실패하고 소파수술및 도뇨관을 사용 하여 자궁경부 임신을 성공적으로 치료했음을 보고한다. 착상부위에서의 출혈은 자궁 경부내의 Foley 도뇨관으로 조절하였다. 계속적인 임신을 원하는 자궁경부 임신 환자의 간단하면서 효과적인 치료는 소파수술 후에 자궁경부내에 도뇨관을 넣어서 확장시켜 두는 것이다. Cervical pregnancy is a rarely life-threatening form of ectopic pregnancy in which the blastocyst implants within the cervical mucosa below the internal os of the uterine cervix. The majority of patients with a cervical pregnancy are women with low parity, thus, the current treatment trend is to preserve their reproductive function. The main problem of conservative surgical treatment is life-threatening hemorrhage after pregnancy evacuation. We report a case of cervical pregnancy that fail to respond to methotrexate and leucovorin. The fetal heart beat was still detectable, thereafter we successfully treated the cervical pregnancy by dilatation and curettage and Foley catheter ballooning. Hemorrhage from the implantation site was controlled by intracervical placement of a Foley catheter balloon. Placement and inflation of Foley catheter in the cervix after cervical dilatation and curettage appears to be a simple and effective means of managing cervical pregnancy in patient who wishes to retain future fertility potential.