질힝중격막 교정후 정상 질식 분만 2례

김윤호(YH Kim),남궁성은(SE Namkoog),정구윤(KY Chung),오원섭(WS O) 대한산부인과학회 1972 Obstetrics & Gynecology Science Vol.15 No.8

최근 2년간 2례의 질횡중격막을 가진 환자를 경험한 바 이중 1례는 임신전, 1례는 임신중에 절제 및 성형수술을 시행하였다. 2례 모두 정상 질식분만을 기도하여 자연분만으로 정상인 남녀아를 분만하였고 분만중 약간의 질 열상외엔 다른 합병증은 없었으며 분만 제3일에 정상퇴원 하였다. 이상의 2례를 경험하였기에 보고함과 아울러 문헌적 고찰을 하였다. This report describes two cases of transverse septum of the vagina. The first patient became pregnant after surgical correction of it and the second one was also diagnosed as having the transverse septum of the vagina by the 9th month of pregancy, when it was surgically repaired. They underwent vaginal delivery and were spontaneous delivered of a full term of normal babies. After the delivery, there were no vaginal wall laceration in both cases. They were discharged on the 3rd pospartum day without any complication.

자궁탈을 동반한 과립 난포막 세포종 1예

김창이(CY Kim),황세영(SY Hwang),최진주(JJ Choi),김윤호(YH Kim) 대한산부인과학회 1973 Obstetrics & Gynecology Science Vol.16 No.1

자궁탈을 동반한 과립 난포막 세포종 1예 A case of granulosa theca cell tumor combiend with uterine prolapse in a 57 year old postmenopausal woman was presented and a brief review of literature on granulosa theca cell tumor was made.

난관폐쇄성 불임증 진단에 있어서 자궁난관 조영법과 복강경검사의 비교관찰

김장흡(JH Kim),함재홍(JH Ham),박혜동(HD Park),김윤호(YH Kim),송승규(SK Song) 대한산부인과학회 1981 Obstetrics & Gynecology Science Vol.24 No.2

1974년 1월1일부터 1979년 12월31일까지 6년동안 가톨릭의과대학 부속성모병원 불임크리닉 에 등록된 여성불임환자 1857예중 자궁난관조영술과 복강경검사를 모두 시행한 91예를 비교 검토하여 다음과 같은 결론을 얻었다. 1. 난관의 소통성 또는 폐쇄여부 및 폐쇄부위의 진단에 있어서는 복강경검사와 자궁난관조 영술이 거의 일치된 소견을 보였다. 2. 난관주위의 유착을 동반한 난관폐쇄의 진단에는 복강경검사가 자궁난관조영술 보다 결정 적으로 우월하였다. 3. 난관인자 이외의 불임환자에 있어서는 복강경검사가 난소 및 골반질환 진단에 도움이 됨 에 반하여 자궁난관조영술은 자궁내 질환의 진단에 보다 유용하였다. 4. 자궁난관조영술은 9.1%의 위양성 및 8.0%의 위음성 진단율을 보였다. 5. Buscopan Compositum을 이용한 전처치가 난관폐쇄의 위양성 진단율을 저하시키는데 도움이되었다. In present days, many diagnostic methods and tools are used in research for infertlity, but there is no simple and reliable test for tubal patency. Among them diagnostic reliability of hysterosalpingography (HSG) and laparoscopy is a source of marked controversy. The results were as follows ; 1. As for tubal patency and the site of tubal occlusion, findings of the laparoscopy and HSG agreed with each other. 2. As for the tubal occlusion and/or peritubal adhesions, the use of laparoscopy was definitely superior to HSG. 3. As for the factors other than tubal occlusion and/or peritubal adhesion pelvic and ovarian disease were the most common abnormalities discovered by laparoscopy , whereas all intrauterine factors were easily detectable by HSG. 4. HSG showed false positive results in 8 cases (9.1%) and false negative results in 7cases (8.0%) 5. Premedication with Buscopan Compositum was of benefit in decreasing the incidence of false positive tubal occlusion in HSG.

난소선암을 동반한 자궁경부선암 1예

서우갑(UG Suh),김윤호(YH Kim),최명학(MH Choi) 대한산부인과학회 1975 Obstetrics & Gynecology Science Vol.18 No.4

저자들은 난소선암을 동반한 자궁경부선암 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Adenocarcinoma of the cervix combined with ovarian Adenocarcinoma is a rare case. Adenocarcinoma of the cervix arises from the columnar epithelium of the endocervix and constitues 4-5% of all cervical cancers. It usually arises in the endocervical canal and may be found localized to the isthmic region in an occasional hysterectomy specimen. The lesion may have a higher incidence of radioresistance and thus indicate surgery as primary treatment more often. Adenocarcinoma of the cervix is characterized by its gland architecture which may present various degrees of differentiation. If both ovary and endometrium are involved, it is impossible to know which is the primary tumor or if there is a multicentric malignant trend of uterine and ectopic endometrium. A case of cervical Adenocarcinoma combined with an ovarian Adenocarcinoma is presented with a brief review of literature available.

지상아를 동반한 쌍태임신의 1예

서우갑(UG Suh),김윤호(YH Kim),최명학(MH Choi),김승조(SJ Kim) 대한산부인과학회 1975 Obstetrics & Gynecology Science Vol.18 No.2

본대학 산부인과에서 임신 제 37주의 지상아를 동반한 1난성쌍생아 분만을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Fetus papyraceus is a rare complication of multiple pregnancy. Recently we had a chance to study a case of fetus papyraceus in monochorial twin pregnancy at the obst. and gynec. Dept of Catholic medical college. A case of fetus papyraceus is presented with brief review of literature.

진결절로 인한 자궁내 태아 사망 1례

길송학(SH Kil),김윤호(YH Kim),권오석(OS Kwon) 대한산부인과학회 1970 Obstetrics & Gynecology Science Vol.13 No.7

I will give a report on the pregnancy which delivered a macerated male fetus whose weight was only 2kg because of true knot. The woman who was in 40 weeks gestation was admitted to our hospital 2 weeks after cessation of fetal movement.

정상월경주기 및 남성화 호르몬 기능이상자에서의 방사면역측정법을 이용한 혈청 Testosterone

최성기(SK Choi),김윤호(YH Kim),나종구(Rha CG),정병래(BL Chung) 대한산부인과학회 1975 Obstetrics & Gynecology Science Vol.18 No.6

In this study serum testosterone levels of 4 normal women through full menstrual cycle , 4 female patients with various androgenic disorders and a healthy adult man were measured by modified Midgley method of double antibody technique using radioimmunoassay kit obtained from Serono Immunochemical Company. The results were as follows; 1. The recovery of testosterone after extraction with ethanol was 89.2%. However, ethanol and benzene was improper as extractive solvent because of difficulty in its separation and evaporation. The recoveries of testosterone with ether, petroleum ether and benzene were 68.9%, 15.6% and 67.7% respectively thus it was found that ethyl ether is most suitable for extraction of testosterone. 2. The mean serum testosterone level after extraction of female patients with androgenic disorders was 2.06+-1.09 ng/ml, while that without extraction was above 4 ng/ml. The difference in testosterone value between before and after extraction was sighnificantly 3. The mean serum testosterone level through menstrual cycle in normal women was 1.27 ng/ml. The average serum testosterone levels in menstrual phase and premenstrual phase were 0.97 ng/ml and 1.06 ng/ml, respectively. On the other hand, the level in ovulatory phase was 1.96 ng/ml, which is sighnificantly higher than those in menstrual and premenstrual phase.

자궁경부암 전구병소와 트리코모나스 감염증

이용선(YS Lee),김윤호(YH Kim),김승조(SJ Kim),김선무(SM Kim),남궁성은(SE Namkoog) 대한산부인과학회 1979 Obstetrics & Gynecology Science Vol.22 No.6

저자들은 Trichomonas vaginalis 감염과 자궁경부암과의 연관성을 조사하기 위하여 1978년 1월부터 1978년 12월까지의 카톨릭의과대학 부속 성모병원에서 Trichomonas vaignalis에 심하게 감염된 48명을 대상으로 질확대경 검사를 실시하였고 이중 30명은 조준 생검을 시행하여 관찰한 결과 다음과 같은 결론을 얻었다. 1. Trichomonas vaginalis 감염으로 인한 자궁경부의 변화는 질확대경상 특이한 변화를 나타낸다. 2. Trichomonas vaginalis 감염시 악성변화의 가능성이 많은 질확대경진 분류상 제Ⅳ형의 병변상을 가장 많이 볼 수 있었다. 3. Trichomonas vaginalis 감염시 병리조직변화는 상피층의 혈관증식, 세포내 공포의 증가, 기저세포 증식과 자궁경관내 세포의 편평상피 화생을 많이 볼 수 있다. 4. Trichomonas vaginalis 감염과 자궁경부암 발생간에는 연관성이 있는 것으로 생각된다. Trichomonas vaginalis, first described by Donn , 1836, for many years has been associated with lesions of the female genital tract. The frequent coexistence of trichomonal cervicitis and cervical cancer has caused much speculation concerning a possible etiologic relationship. It is our purpose for this study to evaluate the relationship between trichomonas-induced inflammatory change and carcinogenesis in the uterine cervix. From January 1978 through December 1978, colposcopic examinations were taken in a series of 346 patients. Among them, we selected the trichomonal cervicitis, 30 cases, who were taken colposcopic examination and biopsy for the evaluation of the trichomonal cervicitis and its relationship to cervical precancerous lesion. The results were as follows; 1. The presence of large areas of "double-crested capillaries" is a very strong indication of active trichomonal infection. 2. The trichomonal cervicitis is found in 30 patients; 15(50.0%) of whom are cases of class Ⅳ colposcopic classification, and 2 of class Ⅴ that are precancerous lesion. 3. Increased vascularity of the squamous epithelium appeared to be by far the most sensitive index of structural alterations associated with trichomonas. Intracellular vacuolization, squamous metaplasia of endocervical lining cell and basal cell hyperplasia were also noted. 4. There is evidently and association between cervical carcinoma and infestation with Trichomonas vaginalis, although a direct causal relationship is unproved. * This paper was supported by Clinical Research Fund of Catholic Medical Center & Roche Far East Research Foundation. ** Prof and Chairman, Dept of Obstetrics and Gynecology. *** Assistant Prof., Dept of Clinical Pathology.

특이 및 비특이 방사면역 측정법을 이용한 융모상피암의 치료판정

남궁성은(SE Namkoog),박종각(JK Park),김윤호(YH Kim),최성기(SK Choi) 대한산부인과학회 1976 Obstetrics & Gynecology Science Vol.19 No.7

저자들은 우리나라 여성에서 발생빈도가 높은 융모상피암의 치유판정 기준을 정하기 위하여 1971년 3월부터 1975년 12월까지 만 5년간 가톨릭 의과대학 부속 성모병원 산부인과학교실 융모성 질환 크리닉에 가입된 환자 132예중 융모상피암 32예를 관찰하였고 내분비학적 관리 를 받은 32예의 융모상피암환자중 추적이 가능하엿던 13예를 대상으로 하여 gravindex를 이 용한 요중 hCG 의 반정량 측정법과 항 hCG 및 항 hCG B-subunit에 의한 혈중 hCG 방사 면역 측정법을 이용하여 융모상피암 환자의 예후 및 치유판정에 대하여 다각적인 검토를 시 행한바 다음과 같은 결론을 얻었다. 1. 반정량 측정법에 의한 요중 hCG의 최초 역가는 예후 양호에서는 52802 IU/L ,불량에서는 161355 IU/L 로서 후자에서 높은 역가를 보였다. 2. 반정량 측정법에 의한 요중 hCG의 음전화치까지의 소요시기는 예후 양호예에서는 27.6 일, 불량예에서는 59.3일로서 후자에서 더 걸림을 알 수 잇었으며 쇠퇴 양상은 전자에서 급 격 또는 순조롭게 하강하나 후자에서는 완만하거나 지연됨을 알 수 있었다. 3. 비특이혈중 hCG측정에 의한 융모상피암환자의 치유 기준치는 정상 월경주기의 평균 난 포기 hLH 값에 해당하는 hCG값을 기준으로 할 수 있었다. 4. 특이 혈중 hCG RIA 측정에 의한 치유 기준치는 blank값과 같은 10 mIU/ml로 정할 수 있 었다. 5. 치유판정에 영향을 주는 인자로는 혈중 hLH값, 폐경기 및 거세여부, 음전화까지의 기간, 기초체온 측정상 배란 현상 및 골반내 혈관 촬영소견, 세포반응의 관찰 등의 보조적인 방법 과 혈관 촬영소견, 세포반응의 관찰 등의 보조적인 방법과 각종 임상적 개선 소견을 활용하 여야 함을 알 수 잇었다. 6. 이상을 종합하여 내분비학적 관리 원칙을 정할 수 잇었다. 1. The mean value of the initial urinary titer of hCG by semi-quantitative test was 52802 IU/ml in the group of good prognosis and 161355IU/ml in the group of poor prognosis. 2. In the group with good prognosis, the mean duration of days after which the semiquantitative test became negative was 27.6 days. For the group with poor prognosis it was 59.3 days, more than twice the duration. When the decline pattern was compared, in the group with good prognosis and decline was sudden. 3. The remission value of the non-specific serum hCG titer was set a value of 26m IU/ml, which was an average value of the follicular phase of 26 mIU/ml in the hLH level of the normal menstrual cycle. 4. The remission value of the specific serum hCG titer was set at 10m IU/ml, which was the same as a mean blank value on the basis of lower limit of reliable measurement. 5. As factors affecting the decision, whether there was a remission, it has been included clinical improvement, laboratory findings as serum hLH level in the women of menopause and castration, duration of days after which urine or serum hCG value became negative ovulation pattern of BBT chart pelvic angiogram and cellular response. 6. The results of the study allowed establishment of principles for prognostic decision on remission.

임신성 고혈압성 질환에 있어서 신사구체여과 값의 측정

박혜동(HD Park),이명우(MW Lee),최인호(IH Choi),김윤호(YH Kim),김수평(SP Kim) 대한산부인과학회 1981 Obstetrics & Gynecology Science Vol.24 No.1

저자들은 정상임신, 전자간증 및 자간증에서 신사구체여과치의 변화를 알아보기 위하여 1979년 3월1일부터 1980년 2월 28일까지 가톨릭의대부속 성모병원에 입원하여 치료받은 임 신성 고혈압성질환 환자중, 그 기록과 이화학적 검사기록이 확실한 경증 전자간증 20예, 중 증전자간증 26예, 자간증 20예와 산모 및 태아가 모두 건강하였던 초임부 20예 및 경산부 20예를 대조군으로 삼아 혈청 creatinine값은 spectrophotometry로 측정하였다. 24시간뇨중 creatinine값은 folin-Wumethod에 의하여 측정하여 신사구체여과치를 산출 비교관찰한 바 다 음과 같은 결과를 얻었다. 1. 혈청 creatinine의 평균값은 대조군에서는 0.93±0.18mg/dl, 경증 전자간증에서는 0.95±0.16mg/dl, 중증 전자간증에서는 1.07±0.21mg/dl이었고, 자간증에서는 1.19±0.20mg/dl 이엇다. 2. 24시간뇨중의 Creatinine의 평균값은 대조군에서는 76.75±9.33mg/dl이었고, 경증 전자간증 에서는 68.90±7.91mg/dl, 중증 전자간증에서는 65.85±8.91mg/dl이었고, 자간증에서는 59.45±5.65mg/dl이었다. 3. 24시간뇨량의 평균값은 대조군에서는 2207.5±313.4ml, 경증 전자간증에서는 1978.5±336.3ml 중증 전자간증에서는 1838.4±369.1ml이었고, 자간증에서는 1645.0±238.9ml 이었다. 4. 신사구체여과치의 평균값은 대조군에서는 128.72±19.83ml/min, 경증 전자간증에서는 99.62±13.01ml/min, 중증 전자간증에서는 78.69±9.53ml/min이었고, 자간증에서는 57.51±6.09ml/min이었다. 이상의 결과로 보아 중증 전자간증 및 자간증에서는 신사구체여과치의 감소가 현저한 것을 알 수 있었다. Renal funciton is reflected by many features such as glomerular filtration rate, excretion of water, electrolytes and metabolites. Renel function in normal pregnancy is altered as well as in pregnancy-induced hypertension. Glomerular filtration rate is the basis of most critical tests for renal function, which is probably a simple reflection of renal plasma flow. Although various reports have been made on decreased of GFR in hypertensive disorders in pregnancy compared to normal pregnancy, their decreasing values were contradictory . In this study , the rate of decrease of GFR in relation to classification of toxemia was evaluated . The results were as follows; 1. The mean serum creatinine value was 0.93±0.18mg/dl in control group, 0.95±0.16mg/dl in mild preeclampsia , 1.07±0.21mg/dl in severe preeclampsia and 1.19±0.20mg/dl in eclampsia. 2. The mean creatinine value of 24 hours urine was 76.75±9.33mg/dl in control group, 68.90±7.91mg/dl in mild preeclampsia , 65.85±8.91mg/dl in severe preeclampsia and 59.45±5.65 mg/dl in eclampsia 3. The mean total volume of 24 hours urine were 2207.5±313.4ml in control group, 1987.5±336.3 ml in mild preeclampsia , 1838.4+-369.1 ml in severe preeclampsia and 1645.0±238.9 ml in eclampsia. 4. The mean GFR were 128.72±19.83ml/min in control group, 99.62±13.01ml/min in mild preeclampsia , 78.69±9.53 ml/min in severe preecampsia and 57.51±6.09ml/min in eclampsia. GFR of severe preeclampsia and eclampsia showed significant difference from that of control group.