산부인과 감염증에 있어서 Amoxicillin의 치료효율에 관한 임상적 연구

이진용(JY Lee),강길전(KC kang) 대한산부인과학회 1977 Obstetrics & Gynecology Science Vol.20 No.11

1977년 6월부터 동년 9월까지 서울대학교 의과대학부속병원 산부인과 외래 및 입원환자중에서 염증성질환으로 판명된 37예를 대상으로 amoxicillin 1일 1gm을 5일 내지 10일간 투약한바 다음과 같은 결과를 얻었다. 1. 치료성적 가) 급성/아급성 골반복막염환자의 경우 치료효과는 55.6%였다. 나) 자궁부속기염환자의 경우 치료효과는 87.5%였다. 다) 유산후 감염예에서 치료효과는 60%였다. 라) 비특이성 질염, 수술후 합병된 골반봉직염, 방광염의 경우 치료효과는 전예에서 만 족스러웠다. 2. 약의 부작용 및 독성 약진이 2.7%에서 발현되었으나 그 이외에는 모두 경미한 것으로서 무시할 수 있는 정도 였고, 또한 약의 독성은 인정할 수 없었다. Amoxicillin is a new derivative of 6-amino-penicillanic acid. Though the antibacterial spectrum of amoxicillin is similar to that of ampicillin, the abstrption of amoxicillin from the gastrointestinal ttract is kmoyn to be better than that of ampicillin, resulting in higher blood level. A clinical study has been conducted to determine the effectiveness of amoxicillin in 37 cases of pelvic infections following the administration of daily 1 gm of amoxicillin for 5 to 10 days. Excellent cure rates were obtained in cases of nonspecific vaginitis , postoperative pelvic cellulitis and cystitis, whereas those of acute/subacute pelvic inflammatory disease, adnexitis and postabortive endometritis were ranged from 55.6% to 87.5%. The toxicity and side effect were negligible.

체외수정시술 및 생식세표 난관내이식

이진용(JY Lee) 대한산부인과학회 1989 Obstetrics & Gynecology Science Vol.32 No.7

이와 같이 생체내(in vivo)에서 일어나는 자연적인 수정과정을 생체외(in vitro)에서 인위적으로 재혀ㅈ시키는 것이 체외수정이다 체외수정 시술이 발전함에 따라 배아를 다른 여서의 자궁에 이식하는 등 여러법적 율리적인 문제가 발생한다 국내에서도 최근 다음과 같은 윤리요강이 제창된 바 있다 즉 체외수정시술은 첫째 시험관아기 프로그램이외의 방법으로는 임신이 불가능한 경우에만 시행한다 둘째 법룰적 부부사이에만 시행한다 셋째 유전자조작을 시행하지 않는다 넸째 최고의 시설 및 기술로 배아를 신중히 취급된다 다섯째 환자 개인의 비밀을 보장한다 정상 여성이 헌번의 월경주기에 약 25%만이 임신이 되어 만삭에 이르는 등 인간의 생식력은 불충분하다고 여겨진다 체외수정시술은 채취된 난자의 수와 질 수저오디어 적절히 부열된 난자의 수 이식된 배아의 수등에 의하여 그 효율이 측정된다고 할 수 있는데 현재임신성공율은 25%-30%를 넘지 못하고 있지만 향후 생식내분비학적 지시과 체외수정시술 분야의 경험과 기술이 급속히 발전함에 따라 조속한 시일내에 크게 향상될 것이다

정상임신의 조기진단에서 UCG-Slide test, Beta-Clone test 및 Pregna STIC test의 유용성에 관한 연구

이진용(JY Lee),김암(A Kim) 대한산부인과학회 1986 Obstetrics & Gynecology Science Vol.29 No.4

정상임신의 조기진단에서 UCG-Slide test, Beta-Clone test 및 Pregna STIC test의 유용성 Latex Agglutination Inhibition Test (UCG-Slide test) Monoclonal Antibody-based Latex Agglutination Inhibition Test(Beta-Clone test), and Monoclonal Antibody-based Enzyme Immunoassay Dipstick Test(Pregna STICK test) in the Diagnosis of Early Pregnancy Early screening for the presumptive diagnosis of pregnancy is safe for the mother, for fet us, and for the medical staff. Endocrine test is one of the most widely used tests for the diagnosis of pregnancy. This study was carried out to compare rhe sensitivity of latex agg lutination inhibition test(UCG-Slide test) with those of latex agglutination inhibition te st(Beta-Clone test) and enzyme immunoassay dipstick test(Pregna STICK test), which employ a monoclonal antibody reactive to beta-hCG. Urinary hCG was qualitively measured with abov e 3 tests in 158 healthy pregnant women, whose gestational age ranged from the 5th to the 8th week. The results obtained were as follows: 1. The positive rate of UCG-Slide test was 0% in the 5th week, 78% in the 6th week, 85% in the 7th week, and 91% in the 8th week. 3. The positive rate of Pregna STICK test was 67% in the 5th week, 95% in the 6th week, and 100% in the 7th and 8th week. 4. The false positive rate of above 3 tests was 0%. 5. Pregna ncies not detected by UCG-Slide test but with Beta-Clone test, was 38% in the 5th week, 7 0% in the 6th week, 71% in the 7th week, and 33% in the 8th week. 6. Pregnancies not detec ted by Beta-Clone test but with Pregna STICK test, was 40% in the 5th week, 83% in the 6 th week, and 100% in the 7th and 8th week.

이상임신환자의 요중 Estriol 치 변동에 관한 연구

이진용(JY Lee) 대한산부인과학회 1973 Obstetrics & Gynecology Science Vol.16 No.6

The 24 hour urinary estriol level was measured in 39 cases of normal pregnancy and 115 cases of abnormal pregnancy, using modified Brown`s method and the following results were obtained. 1. The urinary estriol excretion in normal pregnancy showed increasing tendency with weeks of gestation, with a mean of 13.5±7.2mg/24hr at 28-32 weeks, 20.3±11.7mg/24hr at 33-37 weeks, and 24.1±8.8mg/24hr at 38-42 weeks of gestation. In normal term pregnancy, 95% confidence interval for 24 hour urinary estriol level ranged from 16.4 to 31.9mg. 2. The mean urinary estriol level in post-term pregnancy was 21.0±7.7mg. indicating some decrease compared with the same level at term. 3. The mean urinary estriol levels in severe preeclampsia, eclampsia, and chronic hypertension superimposed with toxemia of pregnancy were 17.8±9.6mg, 16.2±8.3mg, and 14.9±5.9mg respectively at 38-42 weeks of gestation and these were significantly lower (p<0.01) than those obtained from normal pregnancy of same gestational period. 4. In pregnancies with placenta previa and hydramnios, the low level of urinary estriol was observed. 5. The urinary estriol levels were less than 0.5mg in all pregnancies where the intrauterine fetal death has been confirmed. 6. Two cases of anencephaly were subjected to this study and the urinary estriol level was 1.2mg in one and 0.2mg in the other case. 7. The lower limit of 95% confidential interval for the urinary estriol determined within a week prior to delivery in abnormal gravidas who gave birth to apparently normal babies was 12.0mg after 33 weeks of gestation, with a mean of 17.0mg at 33-37 weeks and 16.9mg at 38-42 weeks, while the mean levels in abnormal gravidas whose babies died were 0.8mg and 12.1mg at the same gestational period, indicating 52.9 per cent and 28.4 per cent decrease respectively.

High-risk Pergenancy에 있어서 생화학적 및 효소학적 방법에 의한 태아상태 추정

이진용(JY Lee) 대한산부인과학회 1973 Obstetrics & Gynecology Science Vol.16 No.11

산과학의 발전과 함께 모성사망율은 현저한 감소를 보이고 있으나 아직도 주산기사망율은 과거에 비하여 별로 개선된 바 없이 높은 상태를 유지하고 잇다. 따라서 현재 산과학이 추구하는 바는 태아의 자궁내 환경에 관한 연구 즉 임신과 분만중 적용가능한 태아감시 수단의 개발 및 발전이라고 할 수 있다. 임신은 여러 대사과정에 현저한 변화를 가져오고 특히 이상임신의 경우 그 정도는 심하여짐으로 태아생 존과 밀접한 관련을 갖는 대사들의 변화상을 정확히 측정함은 주산기태아사망 또는 이환율을 감소시킬 수 있을 뿐만 아니라 mental retardation, cerebral palsy 등의 산후 문제해결에도 도움이 될 것이다. 현재 자궁내 태아상태를 추정하기 위하여 태아-태반기능검사로 응용되고 있거나 응용이 시도되고 있는 방법은 다음과 같다. A. Physical Test: 1) abdominal measurement, 2) amniotic fluid volume. B. Physiologic studies: 1) fetal phonocardiography and electrocardiography, 2) fetal electroencephalography, 3) diagnostic ultrasound, 4) X-ray, 5) radioactive sodium clearance, 6) atropine transfer. C. Fetal blood studies: 1) acid-base state, 2) lactate and pyruvate, 3) electrolyte composition, 4) glucose, 5) formed elements of blood, 6) amino acid and lipids, 7) immunologic proteins. D. Studies of amniotic fluid: 1) creatinine concentration, 2) optical density of bilirubin pigment, 3) amniotic fluid osmolality, 4) fat cell concentration, 5) lecithin and sphingomyelin ratio, 6) uric acid concentration, 7) triglycerides level, 8) amilase level, 9) prealbumin fraction, 10) estriol level, 11) arylsulfatase activity. E. Maternal blood and serum studies: 1) diamine oxidase, 2) heat stable serum alkaline phosphatase, 3) leukocyte alkaline phophatase, 4) oxytocinase, 5) lactic dehydrogenase, 6) serum proteins. F. Hormone studies: 1) chorionic gonadotropin, 2) progesterone, 3) estrogen (E3), 4) chorionic somatomammotropin.

Bromocriptine 투여 산욕부에 있어서 유즙분비억제 효과와 혈중 Prolactin치변동에 관한 연구

이진용(JY Lee),오정성(JS Oh) 대한산부인과학회 1978 Obstetrics & Gynecology Science Vol.21 No.12

A comperative study on the effectiveness of bromocriptine and steroid hormones in suppressing puerperal lactation was carried out in 35 puerperal women, evaluating clinical findings of milk secretion, breast engorgement and pain, and determining serum prolactin levels. The bromocriptine group of 18 cases received 2.5mg of bromocriptine twice daily for 2 weeks, and the steroid group of 17 cases received a single injection of a Depot consisted of 10mg of 17 -estradiol cyclopentyl propionate and 250mg of testosterone propionate immediately after birth. An additional 7 patients who breast-fed their babies were included in this study to observe the baseline levels of serum prolactin during the postpartum period. In the steroid group milk secretion was observed in 59% of the patients on the 5th day and 41% on the 7th day, whereas in 11% on the 5th day and none of the cases on the 7th day in the bromocriptine group. In the bromocriptine group rebound lactation was observed in 17%, however, it was mild and stopped in all with further treatment for 1 week. The baseline serum prolactin levels in both the lactating and steroid treated groups were above 200 ng/ml during the 1st postpartum week. However, bromocriptine suppressed serum prolactin levels below 50ng/ml within approximately 3 days. In terms of lactation, engorgement and pain the bromocriptine therapy was significantly better than the estrogen and testosterone combined therapy.

혈중 Prolactin치가 정상인 다낭성난소질환 환자에 대한 Lisuride치료 효과에 관한 연구

이진용(JY Lee),윤병구(BK Yoon),문신용(SY Moon),장윤석(YS Chang) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.11

Polycystic ovarian disease(PCOD) represents a spectrum of disease involving contributions from the hypothalamus pituiary adrenal glands ovaries and extries and extraglandular tissues The precise etiolgy of PCOD however remains elusive Recent studies have suggested that a central deficiency or defect of dopamine may also contributes significantly to the inapprropriate gonadotropin secretion so commonly associated with PCOD To evaluate this hypothesis 0,2 to 04mg of the dopamine agonist lisuride hydrogen maleate was sdministered daily to patients with PCOD Prolactin levels were normal in all cases and there was no evidence of galactorrhea All patient had failed to ovulate while on clomiphene citrate Eight patents were treated for a total of nine cycles Ovulation occurred in one cylcle an no patient conceived In one ovaulatroy cycle LH level rose initially and then dropped to below baseline postovulation In eight anovulatory cycles LH levels did not show consistent change In both ovulatory and noovulatory cycles FSH levels remained loe These preliminary data suggest 1)lisuride apperars capable of altering gonadotropin secretion in PCOD and 2)variable results on LH level in PCOD may reflect the diverse etiology of pathophysiology of PCOD and/ of choosing inappropriate dosages of lisuride

전치태반을 합병한 제대난막부착의 1례

이진용(JY Lee),이효표(HP Lee),신경자(KJ Shin),신면우(MW Shin) 대한산부인과학회 1971 Obstetrics & Gynecology Science Vol.14 No.4

전치태반을 합병한 제대난막부착의 1례를 보고하는 바이다. Velamentous insertion of the cord is a relatively infrequent condition of the cord insertion in which the vessels at the placental end of the cord are separated and pass between the chorion and the amnion for some distance before entering the placenta, occuring in about one percent of term pregnancies. But it attracts some attentions clinically because there is the possibility of rupture of umbilical vessels during labor resulting in fetal asphyzia or even death. It is frequently combined with abnormalities of placental formation or location. A case of velamentous insertion of the cord accompained by total placenta previa on which cesarean section was performed at 38 weeks of gestation is presented with brief review of literatures.

만삭임신 자궁근에 잇어서 3H E1-SO4 및 3H E2-17B의 대사에 관한 연구

이진용(JY Lee) 대한산부인과학회 1976 Obstetrics & Gynecology Science Vol.19 No.8

만삭 임신부로부터 얻은 자궁근조직 절편을 3H E1-SO4 및 3H E2-17B이 첨가된 Krebs-Ringer용액으로 각각 2시간 동안 superfusion하고 조직에 의한 estrogen 의 흡수률과 대사성 변화를 in vitro에서 관찰하였다. 조직의 estrogen흡수률은 수매질로 3H E1-SO4를 사용하였을 경우 5.05+-2.21%이였고, 3H E2-17B를 사용하였을 경우 8.30+-1.34%이었다. 3H E1-SO4를 수매질로 하여 superfusion한 실험레에 잇어서 3H E1-SO4 의 24.01+-7.70%는 free estrogen으로 가수분해 되었다. 자궁근 조직의 핵분설은 선택적으로 free estrogen을 함 유하고 잇었고 그 양은 전 수매질의 1.51+-0.48%에 해당하였다. 또한 superfusion 과정중 3H E1-SO4 0.33+-0.04%는 3H E2-17B로 전환되었음을 확인하였다. 한편 3H E2-17B를 수매질로 하여 superfusion한 예에 있어서는 3H E2-17B 의 6.58+-0.68% 가 3H E1으로 산화되었고 또한 수매질의 3.71+-0.93%는 estrogen sulfate로 전환되었음을 확 인하였다. 이러한 일련의 실험결과는 임신중 자궁근 조직도 17B-hydroxysteroid oxidoreductase와 sulfatase/sulfokinase activity를 보유하며, 자궁근 수준에서도 hormone의 필요에 따라서는 그 자체내 함유하는 효소능을 활용하여 적극적으 로 estrogen 대사에 관여할 수 있다는 사실을 보여 주였다. During the menstrual cycle and during pregnancy estrone sulface is one of the major estrogens circulating in blood However the physiological sighnificance of estrone sulfate has not been well elucidated although baird et al. have suggested estrone sulfate as a possible precursor for free estrogens The interest in this problem was stimulated by studies which demonstracted that human uterine tissue contains enzyme systems, capable of metabolizing free and conjugated estrogens This study followed the metabolic fate of tritiated estrone sulfate and estradiol 17B under in vitro conditions in human myometrium obtained at term pregnancies. In addition, the tissue uptake and subcellular distribution of radiolabeled estrogens were analysed.

Human Menopausal Gonadotropin을 이용한 배란유도 및 임신률에 관한 연구

이진용(JY Lee),고경심(KS Ko),윤보현(BH Yoon),김정구(JK Kim),문신용(SY Moon),장윤석(YS Chang) 대한산부인과학회 1986 Obstetrics & Gynecology Science Vol.29 No.1

Human Menopausal Gonadotropin , 배란유도 , 임신률 Ovulation induction with Human Menopausal Gonadotropin and Human Chorionic Gonadotropin is a form of hormone replacement therapy. HMG is a purified gonadotropin preparation extracted from the urine of postmenopausal women. Each ampule contains 75 IU of follicle stimulating hormone and 75 IU of luteinizing hormone. This study is a clinical trial to induce ovulation with HMG-HCG. For induction of ovulation, HMG-HCG was used clinically to the infertile women, who visited the Infertility Clinic in the Department of Obstetrics and Gynecology, S.N.U.H. from Feb. 1982 to Feb. 1985. The results were as follows: 1.HMG-HCG was given to 32 anovulatory women who were failed in ovulation with clomiphene citrate, one women with poor cervical mucus and one women with habitual abortions, in 111 treatment cycles. 2. The combinations of both clomiphene citrate and HMG-HCG were tried in 9 cycles(8.1%). 3. The mean ampules of HMG used in treatment were 28.5 ampules, of pregnancy, 21.9 ampules, and of ovarian hyperstimulation, 20.5 ampules, respectively. 4. The ovulation rate was 77.5%. 5. The pregnancy rate was 38.2%. 6. There was a significant improvement of pregnancy rate using USG and E2 rapid assay as monitoring methods. 7. The abortion rate was 33.3%. 8. The multiple pregnancy rate was 20.0%. 9. There was one congenital anomalous baby(e.g. transposition of great arteries) out of 9 newborns. 10. The rate of ovarian hyperstimulation, including mild and severe forms, was 16.2%.