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임산부 간접흡연과 저체중아 및 조산아 출생에 관한 코호트 연구
이보은,홍윤철,박혜숙,이종태,김정연,김영주,김상훈,강중구,김주오,하은희,Lee, Bo-Eun,Hong, Yun-Chul,Park, Hye-Sook,Lee, Jong-Tae,Kim, Jeong-Youn,Kim, Young-Joo,Kim, Sang-Hyun,Kang, Jung-Goo,Kim, Joo-Oh,Ha, Eun-Hee 대한예방의학회 2003 예방의학회지 Vol.36 No.2
Objectives : This study was performed to examine the relationship between maternal exposure to environmental tobacco smoke (ETS) and pregnancy outcomes (low birth weight or preform baby) in a prospective cohort study. Methods : We made a pregnant women's cohort, and followed the pregnancy outcomes, between May 1st 2001 and August 31st 2002. We surveyed 2,250 women who visited our hospital during their 35th gestational week, with a self-administered questionnaire. The final total of mother-infant pairs analyzed in this study was 1,712. We used a multiple logistic regression analysis to analyze the effect of maternal ETS on the incidence of preform or low birth weight, and a linear regression analysis for the birth weight and gestational age. Results : Higher exposure to ETS (>=1 hours/day) during pregnancy was more negatively associated with the gestational age and birth weight, than no exposure to ETS (no or less than 1 hour). Maternal exposure to ETS was associated with preform baby(adjusted odds ratio (AOR) 1.7; 95% confidence interval (CI) 0.9, 3.3) and low birth weight (AOR 2.3; 95% CI 0.9, 5.5). In addition, we found that maternal ETS may reduce the birth weight by 70g after adjusting for potential confounding factors. Conclusions : This study suggests that maternal exposure to ETS during pregnancy may increase the frequency of low birth weights and preform births.
박봉주 ( Bong Ju Park ),김주오 ( Ju Oh Kim ),조홍만 ( Hong Man Cho ),심주현 ( Joo Hyun Sim ) 대한고관절학회 2011 Hip and Pelvis Vol.23 No.2
폴리에틸렌의 마모나 잠금 장치의 파손 없이 발생한 이극성 인공 고관절물의 분리를 보고하고자 한다. 84세 남자 환자로 4개월 전 우측 고관절의 대퇴 경부 골절로 본원에서 인공 고관절 반치환술을 시행 받은 환자로, 의자 높이에서 넘어지며 발생한 고관절의 통증으로 내원하였다. 시행한 방사선학적 검사상 이극성 컵으로부터 인공 대퇴 골두가 완전히 분리되어 있는 소견을 보였다. 대퇴 주대에는 해리를 의심할 만한 소견을 보이지 않아 같은 크기의 이극성 컵과 인공 대퇴 골두로 재 치환술을 시행하였으며, 제거된 이극성 컵에서 분리를 일으킬만한 폴리에틸렌의 마모나 잠금 장치의 파손은 관찰 되지 않았다. 재 치환술 후 6개월 추시에서 환자는 경미한 고관절의 통증을 호소하나 일상 생활에 많은 제한을 보이지는 않았다. We report a rare case of a complete disassembly of the inner head from the bipolar cup without polyethylene wear and locking system failure. An 84-year-old man who had a femur neck fracture of the right hip underwent a replacement of the bipolar prosthesis 4 months ago. He fell down from a height of a chair and felt a sudden sharp pain in the right hip. Roentgenograms revealed that the inner head was dislocated from the outer cup; subsequently, a revision surgery was carried out. When the outer head was removed from the acetabulum, the bearing insert and locking ring were not deformed. Because there was no evidence of loosening of the femoral stem, identicallysized bipolar cup and metal head replacement was performed. At a 6 months follow-up, he had mild hip pain but had returned fully to daily living.
김송이 ( Song E Kim ),홍서유 ( Seo Yoo Hong ),김주오 ( Joo Oh Kim ),신정환 ( Jung Whan Shin ),김대운 ( Dae Woon Kim ),신영진 ( Young Jin Shin ) 대한주산의학회 2002 Perinatology Vol.13 No.1
목적:을지 의과대학 산부인과 교실에서 시행된 산후 응급 자궁적출술의 증례들을 관찰 분석하고자 한다. 연구방법:1996년 5월부터 2000년 12월까지 산후 자궁적출술을 시행받은 37례를 대상으로 빈도, 연령별 및 분만횟수별 분포, 적응증, 위험인자, 수술방법, 수혈량, 합병증 그리고 태아의 예후를 후향적 연구로 분석하였다. 결과:산후 자궁적출술의 총 빈도는 1,000분만당 2.3례였고 분만방법에 따른 빈도는 질식분만후 0.03%, 제왕절개술 분만후 0.52%로 제왕절개 분만후 산후 자궁적출술의 빈도가 더 높았다. 또한 연령이 증가할수록 그리고 분만횟수가 많을수록 산후 자궁적출술의 빈도는 높았다. 수술의 적응증은 전치태반과 유착태반을 포함한 태반요인(54.1%), 자궁무력증(37.8%), 자궁근종(5.4%), 자궁파열(2.7%)의 순서로 나타났다. 위험인자에 대한 산후 자궁적출술의 비교 위험도는 태반요인에 대해 97.6(95% 신뢰구간 52.17~184.06), 제왕절개술에 대해 16.3(95% 신뢰구간 4.94~52.31), 그리고 기왕제왕절개술에 대해 2.4(95% 신뢰구간 1.21~4.76)로 태반 요인이 높은 비교위험도를 나타내었으며 95% 신뢰구간에서 볼 때 의의가 있었다. 수술방법은 대부분 전자궁적출술(92%)로 이루어졌고 평균 수혈량은 17.1pints 였다. 합병증은 전체의 43.2%로 나타났는데 주로 폐부종, 무기폐, 기흉등의 호흡기계 합병증, 범발성 혈관내 응고장애, 감염 및 비뇨기계 합병증이었으며 산모사망의 예는 없었다. 태아사망은 2례(5.3%)에서 있었고 신생아 이환율은 26.3%로 10례에서 발견되었다. 결론:산후 자궁적출술의 주된 원인은 전치태반 또는 유착태반 등의 태반요인이다. 산후 자궁적출술은 산모의 생명이 위협을 받는 상황 아래서 시행될 수 있는 최선의 방법이나 산모의 이환율이 높으므로 산전관 리부터 위험요인에 대한 세심한 관리와 처치가 필요하다. Objective:To analyze incidence, indications, risk factors, complications, and neonatal outcomes of emergency postpartum hysterectomies performed at EulJi University Medical Center. Methods:A retrospective study of all cases of postpartum hysterectomies between May. 1996 and Dec. 2000. was carried out. Results:37 cases of postpartum hysterectomies during this period were performed, for overall incidence of 2.3 per 1000 deliveries. Incidence after vaginal delivery and cesarean section was 0.03% and 0.52% respectively. The rate of postpartum hysterectomy increased with increasing age and parity. The main indications were placental disorders(54.1%) including placenta previa and adherent placenta, uterine atony(37.8%), uterine myoma(5.4%) and uterine rupture(2.7%) in order. The relative risk of postpartum hysterectomy according to the risk factors was 97.6(95% confidence interval 52.17-184.06) for placental disorders, 16.3(95% confidence interval 4.94-52.31) for cesarean section and 2.4(95% confidence interval 1.21-4.76) for previous cesarean section. The mean amount of transfusion was 17.1 pints. Although no maternal mortality had occurred, 16 patients(43.2%) had complicaions including respiratory complication(13.5%), hemorrhagic complication(10.8%), infection(8.1%) and urologic injury(8.1%). Regarding fetal outcome, 2 of 38 infants(1 case, twin) were stillborn (5.3%) and 10 infants(26.3%) were suffered from various illness including prematurity, sepsis, meningitis, and brain hemorrhage. Conclusion:The data identifies placental disorders are the leading cause of postpartum hysterectomy. Although postpartum hysterectomy is a necessary life-saving operation, maternal morbidity remained high.
조산 예측인자로서 자궁경관 분비물내 인슐린 유사 성장인자 결합 단백질 - 1
신봉규(Bong Kwy Shine),김상준(Sang Jun Kim),박원일(Won Il Park),김주오(Joo Oh Kim),김대운(Dae Woon Kim),홍서유(Seo You Hong),윤혜선(Hye Sun Yoon) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.12
N/A Objective : The phosphorylated isoforms of insulin-like growth factor-binding protein-1 (IGFBP-1) were produced by the decidua. The aim of this study was to evaluate whether the presence of phosphorylated IGFBP-1 (phIGFBP-1) in cervical secretions of pregnant women with preterm uterine contractions can predict an increased risk of preterm delivery and infectious complications. Method : The prospective study of 32 pregnant women who admitted under the diagnosis of preterm labor with intact membrane at gestational age of 24+0 to 36+0 weeks. Phsphorylated IGFBP-1 was qualitatively assayed using immunochromatography in cervical swab samples at the time of admission. The interval between the test and delivery, gestational age, duration of tocolysis, birth weight, CRP, ESR and the presence of neonatal infection were compared between positive and negative groups. Results : There was no differnce in age, obstetric histories and gestational age and Bishop score at the time of admission between two groups. Eight pregnacies out of 13 positive group and two pregnacies out of 19 negative group resulted in preterm birth. The sensitivity and specificity of the phIGFBP-1 test to predict preterm birth were 80.0% and 77.3%, respectively. The mean getational age and interval between the test and delivery were 38.36 weeks and 45.0 days and 35.78 weeks and 35.46 days in negative and positive group respectively. The birth weight of the babies was significantly higher in negative group. The duration of tocolysis was longer in positive group with marginal statistical significance. The CRP, ESR and WBC count were not different. One postpartum sepsis, one neonatal death and one necrotizing enterocolitis were complicated in positive group. Conclusion : The presence of phIGFBP-1 is an usful marker to predict preterm birth in case of regular uterine contraction with intact fetal membranes
체외 수정으로 임신된 쌍태아 중 발육 부전을 가진 태아에서 발견된 제대 막양 부착
박원일(Won Il Park),남종윤(Jong Yun Nam),김주오(Joo Oh Kim),주종은(Jong Eun Joo) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.10
To date, velamentous insertion of umbilical cord has not been a topic of interest. It has regarded as a phenomenon without clinical significance rather than a disease. Furthermore, antenatal diagnosis of velamentous insertion has been thought as an impossible task. Recently, some investigators raised the clinical importance of velamentous insertion of umbilical cord, especially in multiple gestation. Below we report on a case of velamentous insertion of umbilical cord in discordant twins conceived by in vitro fertilization. The aim of this report is to emphasis the clinical significance of velamentous insertion of umbilical cord in twin gestation. The velamentous insertion of umbilical cord can cause twin-twin transfusion syndrome (TTTS) and pseudo TTTS. Besides, the possible correlation between the high incidence of velamentous insertion of umbilical cord and discordancy in twin pregnancy obtained by in vitro fertilization is also discussed in this report in conjunction with the case.
자연적으로 임신된 쌍둥이 임신에서 단일융모막성이 주산기 결과에 주는 영향
신중식 ( Joong Sik Shin ),양재혁 ( Jae Hyug Yang ),류현미 ( Hyun Mee Ryu ),김문영 ( Moon Young Kim ),한정열 ( Jung Yeol Han ),안현경 ( Hyun Kyong Ahn ),정진훈 ( Jin Hoon Chung ),임하정 ( Ha Jung Lim ),김주오 ( Joo Oh Kim ),최준식 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.12
목적 : 본 연구의 목적은 자연적으로 임신된 쌍둥이 임신에서 태반의 단일융모막성이 주산기 결과에 영향을 주는 예후 인자로 작용하는지를 알아보기 위하여 시도되었다. 연구 방법 : 1998년 1월부터 2002년 12월까지 삼성제일병원 산부인과에서 분만된 1145쌍의 쌍둥이 임신의 데이터 베이스를 분석하였고, 이 중 371쌍의 자연 쌍둥이 임신을 연구군으로 정하였으며 임신부와 신생아의 의무기록을 검토하였다. 융모막성은 분만 후 조직검사를 통하여 확인하였으며 Objective : The Purpose of this study was to evaluate monochorionicity as a risk factor for adverse perinatal outcomes in spontaneously conceived twins. Methods : Using an established database, the study included pregnant women with spontaneously conceive