자궁내 태아사망의 임상적 고찰

이권해,이정재,조현철,이석민,이임순,이해혁,김권대,이순곤,남계현 순천향의학연구소 1999 Journal of Soonchunhyang Medical Science Vol.5 No.2

Objective: This study was designed to evaluate diagnosis and complication, prognosis during clinical study of cases of intrauterine fetal death. Methods and materials: This is a clinical study of 56 cases of the intrauterine fetal death among 8064 deliveries at Seoul Sunchunhyang university hospital during 5 years from January, 1994 to December, 1998. Results: The incidence was 0.7%. The age distribution of mothers was 18 - 44 years and was highest in the 25 - 29 years range(46.4%). The parity was the most highest in the nulliparous group(51.8%). The most common gestational weeks was 20 - 28 weeks gestational period(46.4%), and most common presentation was cephalic(73.5%). The most common weights of the intrauterine fetal death was from 5,00gm to 1,000g(48.2%). The mode of the most common delivery was the induction of delivery(57.2%). The etiologic factors were: unknown(42.9%), preeclampsia(17.9%), chorioamnionitis(14.3%), congenital anomaly(12.5%), abruptio placenta(7.1%), cord complication(3.6%), placenta previa, death of one for twin. There were 2 cases of maternal complication(DIC, Uterine atony). Conclusion : Intrauterine fetal death should be diagnosised early and treated properly to reduce risk of the maternal complication.

조산의 예측 지표로서의 fetal fibronectin의 유용성

정집광,이해혁,이정재,이석민,이순곤,남계현,이임순,이권해 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Objective: The purpose of this study was to evaluate clinical efficacy of fetal fibronectin as a marker to predictor of preterm labor. Materials & Methods: The study group consisted of sixty-eight healthy pregnant women, at gestational age between 24 and 36 weeks, who visited our department with vaginal discharge from April, 1995 to December, 1997. For comparison, we divided all of the pregnant women into two groups by the result of ROM-Check^®, positive groups(N=21) and negative groups(N=47). When preterm labor appeared, 50mg of ritodrine hydrochloride(Yutopar^®) mixed I liter of 5% dextrose solution was administered slowly intravenously. Results: 1) The gestational age at delivery and the interval time from admission to delivery in the positive groups were significantly shorter than those of the negative groups(p<0.05). 2) The positive groups had significantly lower birth weight and Apgar scores than the negative groups(p<0.05). 3) Among the negative groups, in case of tocolytics administration, the interval time from admission to delivery significantly delayed more than that time in case of no tocolytics administration(p<0.05). Conclusions: The detection of the fetal fibronectin in vaginal discharge had a useful method as a predictor of preterm labor. Tocolytics was more effective in the negative groups than in the positive groups.

폐경기 여성에서 1년간 호르몬 대치 요법이 혈청 지질에 미치는 영향

이해혁,남계현,김승형,이임순,이권해,최승도 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.2

Cardiovascular disease is one of the most common cause of death in postmenopausal women. After the onset of menopause, the risk of cardiovascular disease is increased. Several risk factors of cardiovascular disease are well known to us. Among the risk factors, the changes of lipid profiles are roles for cardiovascular disease. Estrogen appears to protect the development of cardiovascular disease, by several mechanism. Especially the protective effect is believed to be mediated by the changes of lipid profiles. Decreased high-density lipoprotein (HDL)-cholesterol and increased low density lipoprotein (LDL)-cholesterol are important factors for development of cardiovascular disease. The purpose of this study was to evaluate the effect of hormone replacement therapy on the lipid profiles to include total cholesterol (TC), high density lipoprotein(HDL)-cholesterol, low density lipoprotein(LDL)-cholesterol, and triglycerides. We measured lipid profiles in 31 postmenopausal women and gave each conjugated equine estrogen (CEE, 0.625mg, day 1-30) plus medroxyprogesterone acetate (MPA, 5mg, day 1-12) for 12months. The levels of serum TC, LDL-cholesterol, and triglycerides were decreased significantly (p<0.05) and HDL-cholesterol was increased significantly (p<0.05) after 12months of hormone replacement therapy. These data suggest that hormone replacement therapy appears to protect agianst the development of cardiovascular disease by the changes of lipid profiles.

제왕절개 자궁적출수술의 임상적 고찰

정갑인,남계현,이해혁,이순곤,이권해,김동희 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.2

Objective: This study was evaluated twenty-six cases of emergency Cesarean hysterectomy to analyse incidence, age distribution, parity, indications, complications, amount of blood transfusion and fetal morbidity. Methods and Materials : This study was carried out on twenty-six cases who underwent emergency Cesarean hysterectomy at department of obstetrics and gynecology, Soonchunhyang University Hospital from January 1987 to November 1997. Results: 1. The incidence of Cesarean hysterectomy was perfomed in 26 cases among total 19,277 deliveries(0.1%). 2. The indications of Cesarean hysterectomy were uterine atony, placenta previa, adhesive placenta and bleeding tendency. 3. There was matenal death in one case and main cause of death was massive bleeding due to disseminated intrabascular coagulopathy. 4. The complications of Cesarean hysterectomy were disseminated intravascular coagulopathy, bladder injury, postoperative infection, wound disruption and postoperative hemoperitoneum. 5. Two cases of fetal and neonatal mortality were intrauterine fetal death and neonatal death. Conclusion : The incidence of Cesarean hysterectomy was increased by increasing parity and maternal age.

자궁선근증의 고찰

조환성,이해혁,정성윤,김성욱,이순곤,남계현,이임순,이권해 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Objective: This study was designed to estimate the frequency and risk factor for edenomyosis Methods: The clinical records of 623 women undergoing hysterectomy were retrieved in the Department of Obstetrics and Gynecology, Soonchunhyang University Hospital, during 5 years, from Jan. 1995 to Dec. 1999. Results: The following result were obtained. 1. Adenomyosis was found in 247 of 623 patients(39.6%) 2. The highest incidence was 40-49 years of age group, an incidence of 46.6% and mean age was 44.7 years. 3. Adenomyosis was more frequently observed in parous women than non-parous women, such as 93.1% and 6.9%, respectively. 4. Dysmenorrhea, metrorrhagia, pelvic pain and vaginal bleeding were common symptom of adenomyosis, an incidence of 28.7%, 19.0%, 18.2% and 16.2%, respectively. 5. Myoma was the most combined disease in adenomyosis, showing the incidence of 54.7%. 6. Grossly, the size of uterus was enlarged more than 10 weeks gestational size in adenomyosis, an incidence of 61.9%. 7. Preoperative diagnostic accuracy of adenomyosis was 6.9%. Conclusion: The results show that deeply understanding of the common symptoms and epidemiology of adenomyosis improve the preoperative diagnostic accuracy.

임신 종결 후 발생한 자궁 동정맥 누공에서 자궁동맥색전술로 치료한 1예

김종민,이해혁,김태희,남계현,심일구,이권해,김형문,이임순,장종호 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Arteriovenous fistula of uterus is rarely reported disease. This vascular malformation is very dangerous condition because Dilatation & curettage can cause massive uterine bleeding without accurate diagnosis. The diagnosis is made by angiography, gray scale ultrasonography, color and duplex doppler ultrasonography, computed tomography, and magnetic resonance imaging is helpful. Especially color and duplex doppler ultrasonography is allows convincing detection and diagnosis of arteriovenous fistula. Recently transcatheter uterine artery embolization is treatment of choice. We have experienced a case of arteriovenous fistula of uterus. Which is presented with a brief review of literature.

골반 내 농양 1예

조인숙,이해혁,김태희,이권해,남계현,이임순,김정식,박성진 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Pelvic inflammatory disease (PID) is a disease that affects young, sexually active, reproductive age women. Most pathogens are Chlamydia trachomatis and Neisseria Gonorrheae transmitted sexually. One of serious acute complication of PID is tubo-ovarian abscess (TOA) that involves the fallopian tube, ovary and adjacent structures (eg, bowel, pelvic peritoneum). The microbiology of TOAs is polymicrobial with anaerobic organisms and causal organisms of PID. Common anaerobic organisms are Peptostretococcus spp, Bacteriodes spp, Prevotella spp, Escherichia coli and aerobic streptococci. Treatment is necessary to admission for intravenous broad-spectrum antibiotics and surgery is often reserved for patients with suspected rupture or patients who fail to respond to antibiotics. So, we reported this case found pelvic abscess due to ruptured tube-ovarian abscess.

난소 임신 10예의 분석

김용진,이충일,이해혁,남계현,이임순,이권해 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.2

Ovarian pregnancy is an uncommon form of the ectopic pregnancies. The ovarian vascularity results in maternal hemorrhage early in the first trimester, which disrupts the pregnancy and usually ruptures the ovary with sufficient hemoperitoneum to require emergency operation. This report presents 10 cases of ovarian pregnancy by retrospective review between January 1986 and December 1995 at the Department of Obstetrics and Gynecology, Soonchunhyang University Hospital. There was 19,849 deliveries and 637 ectopic pregnancies during same period. It showed that the incidence of ovarian pregnancy was 3.21 % of all ectopic pregnancies. The clinical features of ovarian pregnancy revealed that abdominal pain was the major symptom, and history of amenorrhea was obscure. Because of life-threatening course, the early diagnosis and treatment of ovarian pregnancy is important. The clinical diagnosis of ovarian pregnancy was more difficult than that of tubal pregnancy.

여호와의 증인 환자에서 산과적 출혈 후 무수혈 치료 2예

김재령,여소진,이해혁,김정식,김태희,남계현,이권해,이임순,박진화,황경호 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Jehovah's Witness comprise a unique obstetric population. Their refusal of blood stems from an interpretation of a literal translation of the Bible, and it is this belief that puts them at an increased risk of morbidity and mortality if hemorrhage occurs. We report two cases of a Jehovah's Witness who bled massively due to obstetric hemorrhage, refused blood transfusion and had profound anemia. The patients were treated with recombinant human erythropoietin, parenteral iron and oxygen. And they were treated on an intensive care unit with intermittent positive pressure ventilation. We reviewed with literature considering the therapy for acutely anemic patients who refuse transfusion to decrease the duration of the most severe anemia.

일록춘폐흡충 항원성분에 단백질분해효소의 영향 1. 단백질분해효소억제제 첨가 일록춘폐흡충 항원성분

이민구,이옥란,남해선 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.1

We were study for influence of proteinase in adult worm extract antigenic protein components of Paragonimus iloktsuenensis by use of proteinase inhibitor, E-64 ([L-3-transcar-boxyoxiran-2-carbonyl]-L-leucyl-agmatin). Examined antigens were no-added antigens with proteinase inhibitor(E-64) and added antigens with E-64, and these antigenic proteins were separated by SDS-PAGE. The results are summarized as follows : Added antigens were more made up 5 to 20 protein(polypeptide) bands in molecular weight from 40Kda to 200Kda than no-added antigens. Especially, stain density of protein bands were strong markedly on molecular weight 45Kda, 60Kda and 83Kda in added antigens compared with no-added antigens. On the other hand, in molecular weight level below 40Kda, there were similar numbers or stain density of protein bands between added antigens and no-added antigens, but the protein band of 32Kda was more strong stain density in no-added antigens than in added antigens. In conclusion, adult worm extract antigens of P. iloktsuenensis were affected by intrinsic proteinase of P. iloktsuenensis in SDS-PAGE. There are regarded as the protein component of molecular weight 45Kda was affected most by proteinase in SDS-PAGE, and the protein component of molecular weight 32Kda was affected partially by proteinase inhibitor.