산전 초음파진단에 의한 골성형 부전증 1 례

이효선(HS Lee),박용균(YK Park),주갑순(KS Ju) 대한산부인과학회 1988 Obstetrics & Gynecology Science Vol.31 No.4

골성형 부전증은 매우 희귀한 유전적 질환으로서 다발성의 골절, 청색공막을 특징으로 하는 광범위한 결합조직 질환이다. 최근 고려대학교 부속 구로병원에서 산전 진단된 선천성 골성 형 부전증 1례를 경험하였기에 문헌적 고찰과 함께 보고하는 바이다. The osteogenesis imperfecta is a rare congenital disease characterized with multiple bone fracture, blue sclera and widespread connective tissue abnormality. We recently experienced a case of osteogenesis imperfecta diagnosed in utero by ultrasonogram and confirmed after delivery We present the case with the review of the literatures

임신부에서 실시한 Anti-HEV 측정에 대한 연구

주갑순(KS Ju),박용균(YK Park),조수용(SY hough),서호석(HS Suh),허준용(JY Hur),이갑노(KN Lee),신재철(JC Shin),문준(J Moon) 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.3

임신부를 대상으로 실시한 본 연구에서 E형간염에 대한 항체양성율이 9.9%로 나타난 것은 우리나라에도 E형 간염이 상당히 존재하는 것을 보여주고 있으나, 임신부들의 연령별, 임신횟수 및 분만횟수별 분포에서는 각군간 유의한 차이를 볼 수 없었고, 또한 대부분에서 임상증상이 발현하지 않는 즉 무증상 감염(subclinical infection)으로 지나가는 것으로 나타났다. 그러나 간염환자에서 A형, B형 및 C형 간염이 배제된다면 반드시 E형 간염에 대한 검사는 실시해야 할 것이며, 또한 임신중 E형 간염이 발생한 경우에 그 치사율이 매우 높은 것으로 알려져 있으므로 향후 임신과 E형 간염의 관게에 대한 지속적인 연구가 필요할 것으로 사료된다. Hepatitis E was formerly called enterically-transmitted, enteric, epimemic, waterborne, or fecal-oral non-A, non-B hepatitis. Another non-A, non-B hepatitis, namely hepatitis C poses serious problems of livers to cirrhosis ans gepatocellular carcinoma in the industrialized countries. On the other hand, hepatitis E may not be endemic in these countries but is prevalent in developing countries. Hepatitis E has its highest attack rate in young to middle aged adults, with highest case-fatality rates in pregnant women. But it is not clear whether the pregnncy itself caused more severe disease, whether pregnant women were more symptomatic because of other manifestations of pregnancy, or whether pregnant women(in developing countries) were nutritionally and medically disadvantaged, thus allowing more severe impact of the infection. This study was undertaken with the objective of searching the prevalence of hepatitis E in Korea and evaluate the effect of hepatitis E on pregnancy. A total of 313 pregnant women who visited the antenatal clinic were selected during the period from May, 1994 to July, 1994 at the department of Obstetrics and Gynecology, Guro hospital, Korea University and taken the test for IgG and IgM anti-HEV with the use of ELISA kit. The positive rate of anti-HEV was 9.9%(IgG ; 5.9%, IgM ; 3.0%, IgG and IgM ; 1.0%). The discrepancy among age or parity groups was not shown, and almost all of infected women have no clinical manefestations. So we concluded that hepatitis E exists in Korea but most infected cases are probaby subclinical infections. But it is considered the patient must take the test for anti-HEV in case hepatitis A, B and C are excluded, and further study in the effect of HEV on pregnancy should be performed.

Epidemilogy of Respiratory Distress Syndrome

홍성봉(SB Hong),박용균(YK Park),이규완(KW Lee),유동화(DH Yoo) 대한산부인과학회 1986 Obstetrics & Gynecology Science Vol.29 No.7

1980년 1월 1일부터 1984년 12월 31일까지 고려대학교 의과대학 혜화병원 산부인과에서 최근에 분만한 총 4,879예중 호흡곤란증후군이 발생한 46예를 대상으로하여 아래와 같은 결론을 얻었다 1 발생빈도는 0 94%이었다 2 성별로는 남아가 80 4%로 많았다 3 체중별로 보면 2500gm미만에서 67 5%가 발생하였다 4 제태기간에 따른 빈도롤 보면, 37주이하에서 69 5%의 높은 빈도를 보였고, 동기간의 전체 분만에서 보면, 정상 제태기간에서는 0 33%만이 발생한 반면 조산아의 경우 337예중 30예인 8 90%에서 호흡곤란증후군이 발생하였다 5 산모의 연령별로 보면, 동기간의 전체분만중 30∼34세군이 2 17%, 35∼39세군이 2 08%의 높은 빈도를 보였고, 25∼29세군은 0 93%의 빈도를 보였다 6 3회 경산에서 2 35%, 1회 경산에서 1 05%로 초산의 0 90%보다 높았다 7 제왕절개술에서 1 24%로 질식분만의 0 83%보다 높은 빈도를 보였다 제왕절개술의 경우 그 적응증은 uterine hypoperfusion이 52 9%로 반수이상을 차지했다 8 쌍태아의 경우는 17 4%이고, 제2아에서 50 0%로 높은 빈도를 보였으나 통계학적 의의는 없었다 9 계절별로 보면 가을, 봄이 34 8%, 30 4%로 여름(13 0%)보다 높은 빈도를 보였다 10 호흡곤란증후군에서는 89 1%로 신생아가 사망했고, 그 사망시기는 2일이내가 87 8%를 차지했다 This is a review of 46 cases of Respiratory Distress Syndrome in 4879 deliveries at Hae Wha General Hospital, Korea University from January 1, 1980 to December 31, 1984 The results were summerized as follows: 1 Overall incidence of RDS was 0 94% 2 The incidence of RDS in male baby was remarkably higher than that of female baby (80 4% in male baby & 19 6% in female baby ) 3 The rate of RDS in low birth weight (under 2500Gm)was 67 5% 4 The rate of RDS in preterm (before 37wks) was 69 5% The overall incidence of RDS in preterm(8 90%)was higher than that of term bady (0 33%) 5 The overall incidence of RDS by maternal age was 2 17% in the age group of 30-34 years old, 2 08% in the age group 35-39 years old, and 0 93% in the age group of 25-29 years old 6 The incidence of RDS in para 3 (2 23%) and para 1 (1 05%) women was higher than that of primiparous(0 90%) 7 The incidence of RDS was higher in C/S (1 24%) than vaginal delivery (0 83%), the most common indication for C/S was uterine hypoperfusion, i e placenta previa and abruptio placenta (41 1%, 5 9%) and fetal distress (5 9%) 8 The rate of twin delivery in RDS was 17 4% and second baby was prevalent (50 0%), but there was no statistical significance 9 The incidence was higher in autumn and spring (34 8%, 30 4%) than summer season (13 0%) 10 The mortality was 89 1% & among these 87 8% were died in first 2 days after birth

완전자궁내번증의 1례

이의진(EJ Lee),박동흥(DH Park),박용균(YK Park),이호덕(HD Lee) 대한산부인과학회 1971 Obstetrics & Gynecology Science Vol.14 No.4

완전자궁내번증의 1례를 보고하는 바이다. Inversion of the uterus is a serious postpartum complication with a high maternal mortality. It`s incidence is probably frequent than reported in the literatures and many deaths ascribed to postpartum shock and hemorrhage are undoubtedly due to the concealed variety of inversion.

선자세포종 1례

이원근(WK Lee),이의진(EJ Lee),박용균(YK Park),김혜자(HJ Kim) 대한산부인과학회 1971 Obstetrics & Gynecology Science Vol.14 No.3

저자는 선자세포종의 1예를 경험하였으며 차이는 다만 병리조직학적인 소견의 차이만 있을 뿐 증상, 예후, 치료등에 큰 차이를 볼 수 없었다. Authors presented a case of Adenoacanthoma which was revealed incidentally by endometrial biopsy obtained by curetting because of complaints of vaginal bleeding and the its literature was reviewed briefly.

흔적자궁각 임신파역 1 예와 그 임상적 고찰

최안나(AN Choi),지일운(IW Ji),허준용(JY Hur),서호석(HS Suh),박용균(YK Park),조수용(SY hough),주갑순(KS Ju) 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.4

저자들은 임신 15주에 흔적 자궁각파열 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. The uterus with rudimentary horn occurs as a result of arrested development of one of the Mullerian ducts. Pregnancy in rudimentary uterine horn is very rare. We experienced a case of ruptured rudimentary uterine horn pregnancy in second trimester. The patients was treated by resection of the ruptured horn. We report our case with brief review of literatures.

자궁경부와 자궁내막에 발생된 다발성 원발 악성종양 1 예

김창곤(CG Kim),오동규(DK Oh),이규완(KW Lee),박용균(YK Park),홍성봉(SB Hong),김인선(HS Kim) 대한산부인과학회 1987 Obstetrics & Gynecology Science Vol.30 No.3

c저자들은 자궁경부와 자궁내막에 발생된 매우 희귀한 다발성 원발 악성종양 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다 Since Bilorth described the first case in 1889, multiple primary malignant neoplasms seem to be increasing in frequency This may have come about with improved clinical awareness, increased life expectancy, increased use of chemotherapeutic agents, and degree of existing malignancy When discussing multiple primary cancer, it is clinically important to ascertain whether the patient with an initial cancer has an increased, decrease, or unchanged risk of developing a second cancer Recently we experienced a very rare case of multiple primary carcinoma involving the uterine cervix and the uterine endometrium Accordingly we present this rare case with a brief review of the literatures

선천성 심장질환의 진단에서 태아 심초음파검사의 진단적 유용성

박용원,조재성,최형민,이연혜,유용균 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.7

1991년 1월부터 1996년 12월까지 연세대학교 의과대학부속 세브란스병원 산부인과에 내원한 임산부 중 4-CV와 SAV, LAV를 모두 관찰하였고, 본원에서 분만한 5,598명의 산모를 대상으로 태아 심초음파의 진단적 정확도를 조사하여 다음과 같은 결과를 얻었다. 연구 대상 5,598명 중 선천성 심장기형은 54예로 1,000명당 9.6명의 빈도를 보였고, 산전 태아 심초음파의 진단적 정확도는 4-CV만을 사용한 경우에는 54명의 선천성 심장기형을 가진 태아 중 28예를 진단하여 민감도 는 51.9%, 양성 예측도는 100%였으며 4-CV와 LAV를 함께 사용한 경우에는 54명 중 35예를 진단하여 민감도는 64.8%, 양성 예측도는 94.6%였다. 선천성 심장기형의 진단에는 기존의 선별검사로서 이 용되던 4-CV가 진단적 한계가 있어, 등 여러 단면을 이용하게 된다. 그러나 4-CV, LAV, SAV 등의 모든 단면을 검사하는 것은 검사자의 숙련도, 기계의 해상력, 소요시 간 등의 문제점이 있다. 이상의 결과에서 4-CV, LAV, 그리고 SAV를 모두 사 용한 경우와 4-CV에 LAV만을 추가한 경우의 진단적 정확도는 유사하며, 따라서 비교적 용이하게 시행할 수 있 는 LAV를 기존의 4-CV에 추가하여 선천성 심장기형을 가진 태아의 산전 진단을 위한 선별검사시 사용하면, 좀 더 많은 선천성 심장기형을 가진 태아를 산전에 진단할 수 있을 것으로 사료된다. It is important to recognize congenital heart disease (CHD) prenatally, because CHD is the most common congenital major anomaly in neonates that contributes to significant perinatal morbidity and mortality. Previous studies have demonstrated the usefulness of the four-chamber view (4-CV) for the prenatal detection of cardiac anomalies. Our purpose was to determine whether the addition of long axis view (LAV) and short axis view (SAV) would detect more congenital cardiac anomalies. This study included 5,598 pregnant women who were obtained all 4-CV, LAV and SAV, and delivered in Severance hospital from Jan 1991 through Dec 1996. The diagnostic accuracy of each view was evaluated. Information of outcome was obtained from physical examinations, postnatal echocardiography and/or autopsies. The 4-CV detected 28 (51.9%) of the 54 fetuses with abnormal heart. Adding the LAV increased the sensitivity to 64.8% and adding the SAV increased the sensitivity to 57.4%. Adding the LAV and SAV increased the sensitivity to 64.8% and was same as adding only LAV. In conclusion, adding the only LAV to the standard 4-CV will result in the more prenatal detection of cardiac anomalies.

산전 초음파에 의해 진단된 외엽성폐격리증 1 예

박용원,조재성,최형민,신동환,이연혜,유용균,최은경,이현희 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.9

Pulmonary sequestration is a congenital anomaly of lung in which a portion of lung par-enchyma has no communication with the tracheobronchial tree and receives its blood supply via systemic artery. Sequestration represents a developmental anomaly of tracheobronchial branching with persistence and localized development of a separated branch fragment and retention of its embr- yonic systemic vascular supply. In the review of the literature, this disease is so rare that only 540 cases were reported worldwide. The anomaly is divided into 2 types;intralobar and extr- alobar. The ratio of intralobar type and extralobar type is about 3.5 : 1 and intralobar type is more common than the latter in all age groups. The intralobar type is contiguous with normal lung parenchyma and within the same visceral pleural envelope ; in contrast, the extralobar type is enclosed within its own pleural membrane, usually close to a normal lung but separated and discovered most commonly in the left hemithorax with rare cases in the abdominal cavity. Traditionally, this disease has been presented as an incidental lung mass in routine chest X-ray in the postnatal period and with confirmation by aortic angiography, but recently, pul- monary sequestration is diagnosed in the antenatal period along with the development of ant- enatal ultrasonography. Ultrasonography shows the pulmonary sequestration as a hyperecho- genic mass near the diaphragm with posterior echo-free shadow. We have experienced one case of pulmonary sequestration which was found by antenatal ultrasonography and confirmed by operation and histopathologic report in the neonatal period, and we present the case with a brief review of the literatures.

초음파상 한국 정상태아의 주수에 따른 신체 각부위의 표준평균치에 대한 연구

박용균 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.12

한국인 정상태아 주수에 따른 신체 각 부위의 성장 크기를 구하기 위하여 통계처리 가능하였던 총136명을 대상으로 실시하여 각 부분의 평규치와 표준편차를 얻을 수 있었다. 이중 다중회귀 분석한 결과 단일 측정으로 HC, AC, FL, HL, OFD, BPD2에서 임신연령을 평가하는 지표로 이용할 수 있었으며, HC/AC의 비를 구함으로써 임신연령을 예측할 수 있는 단일지표로 이용할 수 있었다. During the period from October 7, 1993 to Feb. 28, 1995, the length of GS(Gestational Sac), CRL(Crown Rump Length), BPD1(Biparietal Diameter, outer-inner), BPD2(Biparietal Diameter, outer-outer), OFD(Occipito frontal diameter), HC(Head Circumference), AC(Abdominal Circumference), FL(Femur Length), HL(Humerus Length), AFP(Amniotic Fluid Pocket), AFI(Amniotic Fluid Index) of fetuses in the Korean normal pregnancy were prospectively measured by sonography at the Department of the OB & Gyn and the Diagnostic Radiology in eleven major general hospitals. The subjects consisted of normal healthy pregnant women with the known last menstrual period regular menstruation who delivered normal fetus. The differences from various ultrasonic equipments was ignored. The mean values of the fetal measurements by gestational age were estimated. We presented statistically derived formulas and growth curves for the prediction of fetal gestational age with the use of fetal parameters mentioned above. With computer assistance, charts can be made with the computations already performed. With the use of these charts, the clinician has only to measure the desired parameter to find the estimated gestational age.