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남상륜,원철,김종철,최재성 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.9
융모막하 혈종은 초기 임신에 드물지 않게 발견되며 임신 초기 질 출혈의 중요한 원인중 하나이다. 중요한 예후인자로는 혈종의 크기가 관련이 있는 것으로 보고되고 있다. 그래서 이러한 환자를 치료하는데는 태반과 태아에 대한 초음파적 추적검사로 정확한 정보를 얻는 것 이 필요하며 환자의 육체적, 정신적 안정이 치료 결과에 중요하다. 이에 저자들은 임신중기 에 발생한 큰 융모막하 혈종 1례의 경험을 문헌고찰과 함께 보고하는 바이다. The subchorionic hematoma is not a rare finding in early pregnancy. It may be an important cause of bleeding during pregnancy and monitoring of the placenta and fetus by ultrasound can be used to obtain precise information in order to manage patients with bleeding. A subchorionic localization of the hematoma was not associated with a higher incidence of spontaneous abortion than a subplacental localization of the hematoma. We experienced the occurrence of a large subchorionic hematoma in a 29 years old, multiparous woman who had low abdominal pain and vaginal bleeding in 16 weeks of gestation. The patient was managed conservatively and had a successful outcome at term. So we report the case with the brief review of literatures.
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남상륜,송찬호,임상혁,송근일,서영석,박선국 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.6
Traditionally, preeclamptic women who meet established criteria for severe disease are delivered expeditiously. Although delivery is always appropriate thrapy for the mother, it may not be for the fetus remote from term. The purpose of this investigation was to evaluate the differences of pregnancy and neonatal outcome of severe preeclampsia and normal pregnancy, especially before 34 weeks gestational age, and to determine whether aggressive or expectant management of severe preeclampsia before 34 weeks is more beneficial to maternal and fetal outcome. A hundred and twenty consecutive pregnancies complicated by severe preeclampsia and a hundred and twenty normal pregnancies were stuided. The results were as follows: 1. The incidence of severe preeclampsia was 3.9%(130 of 3328). The 26~30 year old age group was most common, 43%(52 patients). 2. In case of study between severe preeclamptic patients and normal pregnant patient, there was no differences regarding gestational age at delivery, birth weight, cesarean section rate, incidence of RDS, perinatal death. The 1min/5 min Apgar scores of severe preeclampsia is significantly lower than control group(6/7 vs 7/8, p$lt;0.05). Neonates with SGA (small for gestational age) were found in 29% neonates of patients with severe preeclampsia, which is significantly higher than normal pregnancy group(6%, p$lt;0.05). 3. There was no significant difference between expectant(n=10) and aggressive(n=21) management group less than 34 weeks gestation regarding the gestational age of admission and delivery, blood pressure, proteinuria, serum creatinine, hemoglobin, hematocrit, pletelets, liver enzymes, and LDH. Only the prolongation of gestational age in the expectant management group is significantly higher than in the aggressive management group(7 vs 2 days, p$lt;0.05). 4. The neonatal and pregnancy outcome of expectant(n=10) and aggressive management group(n=15) were as follow: The birth weight in the expectant management group is lower than in the aggressive management group(1316.7±668.8g vs 1576.2±428.7 g, p$lt; 0. 05). The incidence of SGA in the expectant management group is higher than in the aggressive management gorup(50% vs 27%, p=not significant). There was no significant difference between expectant and aggressive management group regarding the 1 min/ 5 min Apgar score, the cesarean section rate, and the frequency of respiratory distress syndrome, cerebral hemorrhage, renal failure, sepsis, DIC of neonates.
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체외수정용 배양액이 정충의 활동성에 미치는 영향에 관한 연구
남상륜,강길전,윤지열,심재균,홍영수 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.10
양수와 Ham's F-10 배양액에 10%, 20%, 50%의 농도로 정상 여성, 남성, 산모 및 제대혈청, 네가지를 첨가하여 24시간 후에 정충의 운동성을 관찰한 결과 다음과 같은 결론을 얻었다. 1. 양수에 각종의 혈청을 첨가할 경우, 50%의 농도에서 10%보다 유의하게 좋은 운동성을 보였으나 20%와는 차이가 없었고, 정상 산모혈청의 경우는 10%에서 20%, 50%로 농도가 증가할수록 정충의 운동성 역시 유의하게 증가하였다. 2. Ham's F-10배양액에 제대혈청이나 정상 여성 또는 남성혈청을 첨가할 경우에는 혈청의 농도에 따른 운동성의 차이가 없었지만, 산모혈청의 경우는 10%보다 20%나 50%의 농도에서 정충의 운동성이 유의하게 좋았다. 3. 양수에 네가지 혈청을 동일 농도로 첨가할 경우, 혈청의 종류에 따른 정충의 운동성 차이는 없었다. 4. Ham's F-10 배양액에 10%의 혈청을 사용할 경우, 정상 여성이나 남성혈청을 사용하는 것이 산모혈청보다 좋았고, 20%의 농도에서는 산모혈청 및 제대혈청보다 좋았으나 50%의 농도에서는 정충의 운동성에 유의한 차이가 없었다. 5. 10%농도의 남성혈청이나 20%의 제대혈청 또는 정상 여성혈청을 첨가할 경우 Ham`s F-10 배양액이 양수보다 우수한 기본배양액이었으며 다른 경우에는 유의한 차이가 없었다. 이와 같은 결과로 미루어 Ham`s F-10 배양액의 사용이 양수의 사용보다 정충의 운동성을 유지시키는데 좋으며 이때 혈청의 첨가가 반드시 필요한데 이때 10%의 남성혈청이나 20%의 여성혈청을 사용하는 것이 가장 바람직할 것으로 생각된다. This study was undertaken to evaluate the effects of various culture media on sperm motility. The two basic culture media evaluated were Ham's F-10 medium and normal amniotic fluid, which were supplemented with four kinds of serum from normal women, men, umbilical cords and pregnant women at the concentration of 10%, 20% and 50%. Sperms were added to them and were observed for their motility after 24 hours of culture. The results were as follows: 1. The sperum motility was significantly better when those serums were supplemented at the concentration of 50% than at 10%. 2. The change of concentration of serums from normal umbilical cords, women and men did not alter sperm motility when supplemented to Ham's F-10 medium. 3. There was no difference in sperm motility when those serums were supplemented to amniotic fluid at the same concentration. 4. When those serums were supplemented to Ham's F-10 medium at the same concentration, the media supplemented with normal men's and women's serum showed better results than with pregnant women's werum at the concentration of 10%, and even than umbilical cord serum at 20%. 5. Ham's F-10 medium was the better for sperm motility when 10% men's serum or 20% of umbilical cord`s or women's serum was supplemented to than to amniotic fluid. Our results indicate that Ham's F-10 medium is better basic medium to preserve sperm motility than amniotic fluid and necessitate to supplement with serum, especially 10% men's serum or 20% women's serum.
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