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여성 대변실금에 대한 연구 - 분만력, 분만방법을 중심으로 -
윤혜원(Hae Won Yoon),배철성(Cheol Seong Bae) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.12
목적: 대변실금이란 가스 또는 대변의 불수의적인 배출을 말하며 질식분만은 대변실금을 일으키는 가장 중요한 원인이다. 본 연구는 분만력 및 분만 방법에 따른 대변실금의 빈도를 조사, 분석함으로써 산과의로 하여금 분만 방법의 선택에 신중을 기함으로써 이의 예방 및 개선을 도모하고자 시행되었다. 연구방법: 1996년 1월부터 1998년 12월까지 동국대학교 포항병원 산부인과에 입원, 분만한 산모 213명 및 분만 경험이 없는 외래를 방문한 환자 40명을 대상으로 대변실금의 빈도를 조사하였다. 분만 경험이 있었던 군은 첫 질식분만군, 2회 이상의 질식분만군, 첫 제왕절개술만으로 분만한 군, 첫 질식분만후 제왕절개술로 분만한 군으로 나누어 빈도를 조사하였다. 대변실금의 정도는 가스가 힘없이 슬슬 나오는지, 가스를 참을 수 없고 대변이 속옷에 가끔 뭍는지, 변의를 느끼면 참을 수 없는지, 변이 늘 속옷에 뭍는지 등으로 나누어 질문하였다. 또한 대변실금을 호소하는 경우 산과적 합병증을 분석하였다. 결과: 대변실금 빈도는 분만 경험이 없는 경우보다 분만 경험이 있는 경우 현저히 증가하였으며(P<0.05), 첫 질식분만한 군(6.8%, 3/44)과 첫 제왕절개술만으로 분만한 경우(2.1%, 1/48)보다 2회 이상 질식분만한 군(11.7%, 9/77)과 첫 질식분만후 제왕절개술로 분만한 군(18.1%, 8/44)에서 유의성 있게 증가함이 밝혀졌다(P<0.05). 대변실금을 호소하는 경우 산과적 합병증으로는 분만 2기의 연장, 항문괄약근의 파열, 흡입분만, 거대아 등으로 나타났다. 결론: 대변실금을 예방하기 위해서는 난산의 예방이 중요하며 첫 질식분만후 또는 첫 질식분만후 제왕절개술로 분만한 후 대변실금을 호소하는 경우에는 다음 분만시 분만 방법이 신중히 고려되어야 한다. Objectives: To evaluate the effect of parity & delivery method on female fecal incontinence. Method: Based on 213 cases of 4 different delivery method and 40 cases of one non-delivery group, a retrospective analysis of the prevalence of female fecal incontinence, between January 1996 and December 1998, was done. With delivery mode, 4 different groups were: first vaginal delivery group , two or more vaginal deliveries group, first cesarean section group, and first vaginal delivery followed by cesarean section group. All subjects were examined by questionaire or phone about the experience of fecal incontinence after delivery. In cases of fecal incontinence , we reviewed the obstetric complications with medical records. Result: There was no fecal incontinence in the non-delivery group. The incidence of fecal incontinence in the two or more vaginal delivery group(11.7%, 9/77) and the first vaginal delivery followed by cesarean section group(18.1%, 8/44) was higher than the first vaginal delivery group(6.8%, 3/44), and the first cesarean section group(2.1%, 1/48)(P<0.05). The obstetric complications in fecal incontinence cases were: a prolonged second stage, anal sphincter laceration, vacuum extraction, a large baby etc. Conclusion: Fecal incontinence was significantly correlated with the number of vaginal deliveries and obstetric complications during delivery. Fecal incontinence after the first vaginal delivery or vaginal delivery followed by cesarean section are very important factors in choosing the next delivery method.
임신 주기에 따른 산소라디칼 생성계 및 해독계 활성도의 변화
김종호(Jong Ho Kim),심재철(Jae Chul Sim),배철성(Cheol Seong Bae),윤혜원(Hae Won Yoon),이영기(Young Gee Lee),박윤기(Yoon Ki Park),이두진(Doo Jin Lee),이승호(Sung Ho Lee) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.2
N/A Objective; This study was conducted to evaluate the effect of pregnancy on the activities of oxygen hee radical generating and scavenging system in the female rats. Material & Method; Rats weighing 200-220 gm were grouped to non-pregnant, 2nd trimester and 3rd trimester of pregnancy. The experiment was carried out following overnight fasting. Animals were anesthetized by administration of pentothal sodium, and blood was drawn via abdominal aorta. After exsanguination, the liver, kidney, heart, lung, with or without placenta tissues were excised immediately. The excised tissue was frozen in liquid nitrogen rapidly, and stored in liquid nitrogen for analysis. Results; The gain in body weight was higher in pregnant rats than in normal rats. Lipid peroxidation was not significantly different among all groups in the liver, kidney, heart, lung, and placenta tissue. Xanthine oxidase activity of the kidney in the 3rd trimester of pregnancy was lower than that of non-pregnant rats. Superoxide dismutase activity of the liver was significantly decreased in the 2nd and 3rd trimester of pegnancy compared with that of non-pregnant rats, and that of lung was also decreased than that of non-pregnant rats. Catalase activity of the kidney was decreased in the 2nd and 3rd trimester of pregnancy compared with that of non-pregnant rats. Glutathione content of the liver was markedly decreased in the 2nd and 3rd trimester of pregnancy compared with that of non-pregnant rats. Conclusion; In conclusion, these results suggest that oxygen free radical will not increase in the liver, kidney, heart, lung, and placenta during normal pregnancy, but in the cases of overproduction of oxygen free radical, the liver, kidney, and lung will have me chance of tissue damage because of decreased activity of some anti-oxidant enzymes and/or decreased amount of anti-oxidant materials.
박태형(Tae Hyoung Park),박영복(Young Bok Park),배철성(Cheol Seong Bae),윤혜원(Hae Won Yoon),강명수(Myung Soo Kang) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.10
Meigs' syndrome is defined as a hydrothorax with ascites and a pelvic tumor, both of which resolve on removal of the tumor. Pseudo-Meigs' syndrome is a variant not possessing the original tumor cell types described by Meigs. Both these syndromes should be considered in otherwise healthy women who present with either new or recurrent hydrothorax and ascites. Pseudo-Meigs' syndrome occurs with the clinical triad of (1)ascites, (2)pleural effusion and (3)Brenner tumors, struma ovarii, benign thecomas, extreme ovarian edema, uterine leiomyomas or other benign pelvic tumors. A case of Pseudo-Meigs' syndrome associated with Brenner tumor is presented with a brief review of literatures.
김종호(Jong Ho Kim),최석철(Suck Chul Choi),양회생(Hoe Saeng Yang),심재철(Jae Chul Sim),배철성(Cheol Seong Bae),윤혜원(Hae Won Yoon),강민아(Min A Kang) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.3
N/A Objective: The objective of this study was to determine the relationship between the fetal doppler flow velocimetry and birth weight in low risk pregnancy population. Methods: From December 1995 to May 1996, We prospectively performed doppler study in 254 uncomplicated, term pregnant women, who visited Pohang Hospital, Dongguk University. Using pulsed color doppler, we measured umbilical artery RI, middle cerebral artery RI and middle cerebral-umbilical artery RI ratio within one week before delivery. Results: The result was that low birth weight group (below 2500gm) had very significant lationship with umbilical artery RI(P<0.01), middle cerebral artery RI(P<0.05) and middle cerebral-umbilical artery RI ratio(P<0.05), but there was no significant relationship in these blood flow indices between normal birth weight group (2501gm- 3999gm) and macrosomia group (above 4000gm). Conclusions: We concluded that application of doppler ultrasonopaphy in the assessment of fetal weight is somewhat helpful for identification of low birth weight, not for macrosomia.