미분화 배세포종의 1예

박금자(KZ Park),정광화(KW Zeong) 대한산부인과학회 1966 Obstetrics & Gynecology Science Vol.9 No.3

A case of right ovarian dysgerminoma in 26, years old, para-2, woman is presented and a brief review on the literatures are made.

재발한 포상기태 1예

박금자(KZ Park),최낙상(NS Choi),안복식(BS Ahn) 대한산부인과학회 1966 Obstetrics & Gynecology Science Vol.9 No.7

This paper Summarizes the case in which the recurrence of hydatidiform mole was observed 3 months after the evacuation of moles by means of D&C in a Korean woman with the Obstertrical history of 5 child birth and 2 induced Abortion in her past life. Patient was treated by hysterectomy and her followed uneventful post-operative course.

Kallman Syndrome ( Hypogonadotropic hypogonadism with hyposimia ) 1예

박금자(KZ Park),김재욱(JU Kim),양영호(YH Yang) 대한산부인과학회 1984 Obstetrics & Gynecology Science Vol.27 No.9

연세대학교 의과대학 부속 세브란스병원 산부인과학교실에서는 1983년 10월 원발성 무월경 및 후각장애를 동반한 희귀한 질환인 Kallmann Syndrome (hypogonadotrophic hypogonadism with hyposmia)환자를 경험하였기에 문헌 고찰과 함께 이를 보고하는 바이다. Hypogonadotrophic hypogonadism results in absent or incomplete pubertal development and may be associated with inherited abnormalities, such as anosmia, hyposmia, cleft palate, and/or cranio-facial deformities. This disorder is characterized by low plasma gonodotropin and gonadal steroid concentrations and appears to be due to a deficiency of gonadotropin-releasing hormone. In 1944 Kallmann et al.described a syndrome of hypogonadism and anosmia. The original clinical observations in three pedigrees revealed eight individuals with this combined defect. The hypogonadotropic hypogonadism with anosmia probably is the expression of a disorder of hypothalamic regulation involving the control of those releasing factors needed for effective pituitary function. Additionally, it is interesting to note that there is some evidence for a relationship between olfactory acuity( perhaps to defect hormones) and the gonadal and adrenal system in laboratory test animals. We experienced a patient with Kallmann syndrome (hypogonadotrophic hypogonadism and hyposmia) and presented the case with a review of literature.

제왕절개술의 임상 및 통계학적 고찰

박금자(KZ Park),김재욱(JU Kim),곽인평(IP Kwak),윤태기(TK Yoon),노일병(IB Roh) 대한산부인과학회 1981 Obstetrics & Gynecology Science Vol.24 No.11

1972년 1월1일부터 1980년 12월31일까지 만 8년간 연세대학교 의과대학 부속 세브란스병원 에서 입원하여 1000gm 이상의 태아를 분만한 16194예의 산모중 2875예의 제절예와 8쌍의 쌍태아를 포함한 2901예의 출산아를 대상으로 다음과 같은 결론을 얻었다. 1. 제절의 빈도는 19.1%였고 이중 일차제절은 13.5%였다. 2. 적응중은 아두골반불균형의 38.8%로 가장 많았다. 3. 수술합병증은 모성이환이 17.1%로 가장 많았으며 출혈 4.3% 그의 마취로 인한 경우, 기 타 합병증의 순이었다. 4. 선행제왕절개술시에 자궁반혼파열은 총 2875예의 제절환자중 23예였으며 자궁체부 중절 개술시 15.38%로서 자궁협부 횡절개술시 0.25%에 비해 상당히 높은 파열빈도를 보였다. 5. 제왕절개술시 자궁적출술을 병행하였던 경우는 총 2875예중 21예로 0.7%를 차지하였으며 그 원인은 자궁이완과 기왕자궁반흔파열이 대부분이었다. 6. 모성사망율은 0.2%였으며 주산기 사망률 은 35.2%였다. In recent years the use of cesarean section has increased remarkably, in large measure because of the widespread emphasis that is directed toward reconition of the impairment, acutual or suspected of fetal well-being as well as because of maternal complications. Fetal distress is diagnosed over three times more often than in previous studies as a result of improved methods of fetal heart monitoring and fetal scalp blood sampling. Moreover traumatic vaginal and forceps deliveries are no longer performed and the role of the vaginal delivery of the breech is being challenged. It is obvious that an absolute and relative increase in the primary cesarean section rate has occured for three indications, cephalopelvic disproportion fetal distress, and breech presentation. The availability of safe and adequat anethesia, whole blood and even anitibiotics may have been sighnificant factors in increasing the cesarean section rate. Much progress has been made in reducing cesarean section complications. However cesarean section can potentially represent a serious major operation with all of its risks in spite of such efforts. This retrospective study was carried out for the further prevention and reduction of complications. It was based on the clinical records of 2875 patients who had cesarean section and 2901 newborn babies, including 8 pairs of the twins, delivered at the Dept. of Ob and Gyn. Yonsei University College of Medicine, from Jan. 1 1972 to Dec 31. 1979. 1. overall incidence of cesarean section was 19.1% for the period . The primary sectiorate was 13.5%. 2. Among the indication for the cesarean section, cephalopelvic disproportion was the most prevalent. 3. Of the postoperative complications maternal morbidity was the most common (17.1%) and the others were hemorrhage (4.3%) and anesthesia problems. 4. Of 23 women who had rupture or dehiscence of the previous cesarean section scars, the rupture of the low flap incision was 0.2% in contrast to the classical incision 15.38%. 5. The incidence of cesarean hysterectomy was 0.7%. Among the indication uterine atony and previous uterine scar rupture or dehiscence were common. 6. Maternal mortality was 0.2% and the perinatal mortality rate 35.2 for 1000 births.

Congenital Tdrenal Hyperplasia 에 기인한 여성반음양환자 치유 1예

박금자(KZ Park),양영호(YH Yang) 대한산부인과학회 1984 Obstetrics & Gynecology Science Vol.27 No.1

1983년 4월 본 대학에서 congenital adrenal hyperplasia로 인한 여성 반음양 1예를 치유하였기에 문헌고찰과 더불어 보고하는 바이다. The most common single cause of female pseudohermaphroditism is the adrenogenital syndrome, resulting from congenital virilizing adrenal hyperplasia. Prompt recognition and treatment of the associated adrenal imblance ane most important. If the condition is not treated, the virilization continues into adulthood. This report will be presented an experience with a case who was female hermaphroditism due to congenital adrenal hyperplasia at Yonsei University College of Medicine, on April, 1983.

임신 중독증에 관하여 ( 1964 - 1966 )

박정희(JH Park),조행원(HW cho),우신희(SH Woo),박금자(KZ Park) 대한산부인과학회 1968 Obstetrics & Gynecology Science Vol.11 No.10

Toxemia of pregnancy is still leading cause of maternal mortality during 3 years period from 1964 to 1966, 438 cases of toxemia of pregnancy have been encountered among total deliveries of 1040 cases in Ewha Womans University Hospital, Seoul. 1) The incidence of toxemia was varies, ranging from 3.4 to 12.2%(7% in average). Severe Preeclampsia was 50.5% of the toxemias, mild one of 44% and eclampsia of 5.3% It showed no any tendency to decrease for past 3 years. Both primigravidas and multigravidas were equally the same as 3.6% in the frequency of toxemia. February was the peak in the incidence. Toxemia was apt to occur in multiple preganancy, approximately 4 times single pregnancy. 2) Toxemic maternal death was 3 cases (0.68%); 2 eclampsias and 1 preeclampsia. The cause of death was that 2 cases died of pulmonary edema, one case of cerebral hemorrhage. Prognosis of eclampsia in general was poor. Over all toxemic death during past 4 years(1964-1968.3)was still high as leading cause of meternal death(55%). 3) Fetal death was 5%. The longer duration of gestation, the higher fetal death(40% loss during 38-41weeks) born in toxemia. 4) Fetal weight born in toxemia was 2850gms, and 390gms lesser than those born in non toxemic mother. 5) The majority of toxemias were lacking prenatal cares except 18% of the cases. Both the quantitative and qualitative prenatal care was re-emphasized. 6) Complications of the toxemia were 9 cases of postpartum hemorrhage & 4 abruptio placentae. 7) Most of the toxemic cases (2/3) were delivered well conservatively or spontaneously or whith low forceps aided. Cesarean section was performed on 8% of the cases usually following 24-48 hours, intensive medical treatment, such as Magnesium Sulfate, Serpacil, Apresolin, diuretics or sedatives etc. The stillbirths(1.6%) were succesfully induced by means of intrauterine catheter insertion. Oxytocic induction was rarely insituteed(only 1 case).

선천성안면기형 1예

추연상(YS Choo),박금자(KZ Park),최낙상(NS Choi),안복식(BS Ahn) 대한산부인과학회 1966 Obstetrics & Gynecology Science Vol.9 No.10

A case of congenital malformation of fetal face with polydactyl associated with hydramniosis which was observed at Dept. of Obst. & Gynec. of In-Chon Provincial Hospital is presented. And a brief review on clinical course and malformed fetus in this case is presented.

복합임신 1예

김재욱(JU Kim),박금자(KZ Park),장상식(SS Chang),안명옥(MO Ahn),황동훈(DH Hwang) 대한산부인과학회 1981 Obstetrics & Gynecology Science Vol.24 No.12

연세대학교 의과대학 부속 세브란스 병원 산부인과학교실에서 24세 경산부에서 희귀한 복합 임신 1예를 경험하였기에 간략한 문헌고찰과 아울러 증례를 보고하였다. Combined intrauterine and extrauterine pregnancy have been considered comparitively rare and uncommon condition of more than usual interest since the first description by Duverney in 1708. The diagnosis of this uncommon entity is frequency missed causing an increase in maternal morbidity and jeopardizing the mother. We present a case of combined intra-and extrauterine pregnancy with a brief review of literature available

항생제 ( Ampicillin ) 가 수유부의 혈중 Prolactin치와 유즙분비에 미치는 영향에 관한 연구

송찬호(CH Song),박금자(KZ Park),김재욱(JU Kim),곽현모(HM Kwak) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.2

The most of the puerpara who had antibiotics during the early post-partum period complaine of the insufficient secretion of breast milk. This study aims to evaluate the effect of antibiotic(ampicillin) on the serum prolactin levels and postpartum lactation. 30 healthy puerperal women were selected among the patient who delivered at term at the Department of Obstetrics and Gynecology Yonsei University Medical Center from March 1983 to February 1984. To compare the serum prolactin levels and volumes of breast secretion, patients were divided into three groups: normal control group, bromocriptine group(bromocriptine 5mg daily for 14 days) and antibiotic group(ampicillin 2.0gm daily for 7 days). Each group consisted of 10 patients. The blood samples were taken at the time of delivery, 2nd, 3rth, 5th and 15th postpartum day. Prolactin was determined by radioimmunoassay(Abbott-Laboratory, USA). The volume of milk secreton was measured and degree of breast engorement and pain were clinically assessed. The results were as follow: 1. Mean serum prolactin levels at the time of delivery, 2nd, 3rd, 5th and 15th postpartum day of normal control group were 438±80.1ng/ml, 299.2±45.4ng/ml, 332.3±54.9ng/ml, 230±85.1ng/ml and 140.5±35.2ng/ml. The volume of milk secretion was about 300ml on the 3rd postpartum day and 400ml on the 5th day in the normal control group. 2. Mean serum prolactin levels of bromocriptine group were 286.4±116.3ng/ml, 2033±93.6ng/ml, 49.9±30.1ng/ml, 45.3±33.3 ng/ml and 19.5±10.1ng/ml respectively. Breast engorgement and pain were significantly suppressed. 3. Mean serum prolactin levels of antibiotic group were 458.3±103.0ng/ml, 397.3 ±55.4ng/ml, 371.7±82.0ng/ml, 261.9±56.6ng/ml and 116.8±40.9ng/ml respectively. The amount of milk secretion, engorgement and pain of breast were suppressed.

정상 임산부의 진통중 Estradiol , Estriol, Progesterone , B-hCG, hPL 및 Cortisol의 변화

송유봉(SY Bong),박연환(YH Park),조동제(DJ Cho),박금자(KZ Park),송찬호(CH Song) 대한산부인과학회 1987 Obstetrics & Gynecology Science Vol.30 No.2

1983년 3월부터 1984년 2월까지 만 1년간 연세대학교 의과대학부속 세브란스병원 산부인과에 분만하기 위하여 입원한 산모중, 정상임신 만삭에 자연진통후 정상질식분만한 산모 10명을 대상으로, 진통중 모체 말초혈액내의 estriol, estradiol, progesterone, hPL, B-hCG, cortisol을 측정한 결과, 다음과 같은 결론을 얻을 수 있었다 1 Estriol 및 estradiol은 초기진통시에 비하여 진통이 활성화된 후 증가하는 경향을 보였으며, 자궁경관이 완전개대시 estriol은 유의하게 감소 하였다 2 Progesterone은 진통이 활성화되고 진행됨에 따라서, 점차적으로 감소하는 경향을 보였다 3 Progesterone/Estradiol의 비율은, 초기 진통시 20 4에 비해, 진통이 활성화된 후 14 3 및 13 4로서 유의하게 감소한 것을 볼 수 있었다 4 B-hCG 및 hPL은 진통중 유의한 변화를 보이지 않았다 5 Cortisol은 진통이 진행함에 따라 점차 증가하는 경향을 보였다 The human placenta produces, the protein hormones, chorionic gonadotropin and placental lactogen as well as steroid hormones, progesterone and estrogens Some evidence has been accumulated that trophoblast also synthesizes hCT, hCG,B-endorpin,a -MSH, GnRH and TRH Assuming that quantitative determinations of hormones in maternal blood during labor may give information on the hormone production, hormonal changes at the end of the pregnancy and their role in the process of the parturition, various placental hormone assays during labor were undertaken This study was consisted of 4 determinations of estriol, estradiol, progesterone, human placental lactogen,B -hCG and cortisol concentrations in the peripheral blood of 10 normal pregnant women who had been admitted for delivery at the dept of Obstetrics and gynecology, Yonsei University, Medical center from March, 1983 to February, 1984 at given intervals before, during and immediate after delivery The results were as follows: 1 As the labor progressed, the estriol level was significantly increased 2 As the labor progressed, the progesterone level was decreased, but this tendency was not significant 3 As the labor progressed, the progesterone/estradiol ratio was significantly decreased 4 As the labor progressed, the changes of the B-hCG and hPL level were inconsistant 5 As the labor progressed, the cortisol level was gradually increased