임신주수에 따른 신생아 신체측정치의 정상분포

신영우(YW Shin),계영선(YS Kye),김성환(SW Kim),문형(H Moon),김두상(DS Kim) 대한산부인과학회 1983 Obstetrics & Gynecology Science Vol.26 No.6

1. 본 보고의 신생아 체중은 36주에서 평균이 2,660 ±406gm이었으며, 제10, 90백분위수에 해당하는 측 정치는 각각 2,140gm, 3,179gm이었다. 또 40주에 서 평균체중은 3,240±398gm이었고, 제10, 90백분 위수 측정치는 각각 2,730gm, 3,749gm이었다. 2. BPD는 36주에서 평균이 9.00±0.5cm이었으며 제 10, 90백분위수 측정치는 각각 8.36cm, 9.64cm이 었다. 40주에서 평균 BPD는 9.46±0.45cm이었고, 제10, 90백분위수 측정치는 각각 8.88cm, 10.03cm 이었다. 3. 두위는 36주에서 평균이 32.8±1.56cm이었고, 제 10, 90백분위수 측정치는 각각 30.8cm, 34.0cm 이었다. 40주에서 평균두위는 34.5±1.39cm이었으 며, 제 10, 90백분위수 측정치는 각각 32.7cm, 36.3 cm이었다. 4, 북위는 36주에서 평균이 27.5±2.34cm이었고 제10, 90백분위수 측정치는 각각 24.5cm, 30.5cm이 었다. 40주에서 평균복위는 31.2±2.24cm이었고 제 10, 90백분위수 측정치는 각각 28.3cm, 34.1cm이 었다. 5. 흉위는 36주에서 평균이 30.2±2.34cm이었고 제10, 90백분위수 측정치는 각각 27.2cm, 33.2cm이 었다. 40주에서 평균흉위는 33.0±1.64cm이었으며 제10, 90백분위수 측정치는 각각 33.9cm, 35.1cm이 었다. 6. 두위대 복위비의 평균치는 36주에서 1.20±0.091 이었으며 제10, 90백분위수 측정치는 각각 1.08, 1.31 이었다. 40주에서 평균치는 1.11±0.067이었고 제 10, 90백분위수 측정치는 각각 1.02, 1.20이었다. 이상과 같이 신생아 신체측정치들에 대한 주수별 정 상분포도를 작성하였으며 우리 상황에 맞는 분포도를 기준으로 자궁내 태아발육지연이나 과숙아의 산전진단 과 적극적인 산과적 처치를 함으로써 주산기 사망율과 이환율의 감소가 기대되는 바이다. The anthropometric measurements including birth weight, biparietal diameter, head circumference, chest circumference, abdominal circumfernce, and HC/AC, have been proved to be valuable ln prognostic evaluation of the newborns. There are, however, no available nomograms of the anthropometric measurements except birth weights for the Korean infants. This study was carried on to construct the nomo- grams for the Korean infants of the anthropometric measurements according to the duration of pregnancy. The study group comprised 2,142 newborn infants delⅳered at the Department of Obstetrics and Gynecology, Hanyang Unⅳersity Hospital during the period from Jan. 1, 1981 to Dec. 31, 1981. Results were as follows: 1. The birth weights for the lOth, 50th, and 9Oth percentile according to the gestational ages were 2,140gm, 2,660gm, and 3,179gm at the 36th week; and 2,730gm, 3,240gm, and 3,749gm at the 40th week respectively 2. The BPDs for the lOth, 50th, and 90th percentile according to the gestational ages were 8.36cm, 9.00cm, and 9.64cm at the 36th week: and 8.88cm, 9.46cm, and 10.03cm at the 40th week respectively. 3. The head circumferences for the lOth, 50th, and 9Oth percentile according to the gestational ages were 30.8cm, 32.8cm, and 34.Ocm at the 36th week; and 32.7cm, 34.5cm and 36.3cm at the 40th week respectively. 4. The abdominal circumfereces for the 1Oth, 50th, and 90th percentile according to the gestational ages were 24.5cm 27.5cm, and 30.5cm at the 36th week; and 28.3cm, 31.2cm, and 34.1cm at the 40th week respectively 5. The chest circumferences for the 10th, 50th, and 90th percentile according to the gestational ages were 27.2cm, 30.2cm, and 33.2cm at the 36th week; and 30.9cm, 33.0cm, and 35.1cm at the 40th week respectively. 6. The ratios of HC/AC for the 10th, 50th, and 90th percentile according to the gestational ages were 1.08, 1.20, and 1.31 at the 36th week; and 1.02, 1.11, and 1.20 at the 40th week respectively.

말기 악성 Brenner 종양의 치험 1예

신호문(HM Shin),유중배(JB Yoo),신영우(YW Shin),한영호(YH Han),김문신(MS Kim),김두상(DS Kim),이태형(TH Lee) 대한산부인과학회 1984 Obstetrics & Gynecology Science Vol.27 No.1

조직학적으로 확진된 4기 악성 Brenner 종양 1예에 수술 및 화학치료를 가하고 이와 병행하여 second-look Laparotomy로서 debulking하고 third-look laparotomy로서 완치를 확인하였기 보고한다. Malignant Brenner tumor is a relatively rare tumor of the obary. We had experienced a rare case of malignant Brenner tumor, Stage Ⅳ. A Brief review of the litertures and a discussion concerning malignant Brenner tumor are presented in this paper.

자궁외임신의 중요한 원인의 하나로서의 난관불임술

라영호(YH Rha),변용진(YJ Byen),신영우(YW Shin),김창학(CH Kim),이응수(ES Lee) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.3

Although it was an observation during a short period of time, among 27 women who received surgery under the impression of ectopic pregnancy and confirmed pathologically as tubal pregnancy in our hospital in 1982, 9 women, that is 33.3%, were turned out to have received tubal sterilization before. The methods had been largely LTS. And with the positive history of previous sterilization, many of them were in some troubles in both being sent to a gynecologist and being diagnosed as ectopic pregnancy. Through this study, we insist that if a woman of her reproductive age presents herself in front of a physician with amenorrhea, lower abdominal pain and/or vaginal spotting, the possibility of tubal pregnancy would be much higher if she has a positive history of tubal sterilization.

임신중독증의 모성사망에 대한 고찰

조양현(YH Cho),이수자(SJ Lee),한승희(SH Han),민보은(BE Min),신영우(YW Shin) 대한산부인과학회 1979 Obstetrics & Gynecology Science Vol.22 No.9

1969년 1월부터 1977년 12월까지 9년간 일신 부인병원에서 사망한 산모 149명 중 임신중독증으로 인하여 사망한 71예를 대상으로 임상적으로 분석하여 다음과 같은 결과를 얻었다. 1. 산과입원수에 대한 임신중독증의 발생빈도는 35.3%였다. 2. 모성사망율은 1,000생아 출생당 3.6이었고, 그중 임신중독증으로 인한 사망은 1.7%이었다. 3. 모성사망 149예중 75.2%가 직접적 사인, 20.8%는 간접적 사인, 4.0%는 비관련성 사인으로 사망하였다. 4. 모성사망 149예중 71예는 임신중독증으로 인한 사망이었고 이중 임신중독증이 직접 선행 사인이었던 예가 61예, 중요한 기여인자였던 예가 10예였다. 5. 임신중독증의 가장 빈번한 사인은 심부전증과 뇌혈관질환이었고, 이 두 질환이 약 72%를 차지하였다. 6. 연령은 25∼29세군에서 51.7%로 가장 많았으나 사망률은 고위험을 임신군인 35세 이상군에서는 높았다. 7. 초산산모에서 39.4%로 가장 많았으며 5회 이상 경산에서 사망률이 가장 높았다. 8. 산전진찰을 1회로 받지 않았던 예가 95.8%로 대부분을 차지하였다. 9. 병원도착후 24시간내에 사망한 예가 57.7%였다. 10. 자간증과 전자간증에서는 정기적 산전진찰을 받은 예에서는 그 발생빈도가 현저히 감소하나 비분류 고혈압에서는 큰 변화가 없었다. The 149 maternal deaths which occurred at Ⅱ Sin Women`s Hospital between Jan. 1969 and Dec. 1977 are reviewed. 76 of these deaths were associated with toxemia of pregnancy, and in all but 5 cases toxemia was related to the cause of death. The detailed results of the review are as follows 1) The incidence of toxemia in all obstetric admissions was 35.3%. 2) Overall maternal mortality rate was 3.6/1000 live births and of these 1.7/1000 live births were due to toxemia. Over the period of review there was a consistent decrease in the maternal mortality rate except for a peak in 1972. 3) Of 149 maternal deaths 75.2% were due to direct obstetric causes, 20.8% were due to indirect obstetric cuses, 4.0% were not related to obstetrics. The major direct obstetric causes were toxemia, 47.7% hemorrhage 14.8% and infection 8.7%. 4) In 71 of the 149 maternal deaths toxemia was related to the cause of death, either as a direct antecedent cause, 61 cases, or as a significant contributing factor 10 cases. 5) In the toxemic deaths the most common causes of death were cardiac failure and C.V.A. which comprised 72.1% of cases. 6) Various factors were studied in toxemic related death. a) Age distribution : 31.0% were in the 25-29 age group but this group also comprises the largest percentage percentage of obstetric admissions. Compared to the overall distribu of obstetric admissions the highest mortality was in the over 35 age group. b) Partiy : 39.4% were primipara but compared the distribution of parity in the obstetric admissions the highest mortality was in para 5 and over. c) Antenatal care : 95.8% of patients had not received any antenatal care at this hospital. d) Time of death : 57.7% died within 24 hrs of arrival at the hospital. 7) The incidence of toxemia in all obstetric admissions was reviewed it was noted that the incidence of eclampsia and preeclampsia decreased with regular antental care, but the incidence of unspecified hypertension was not related to the degree of antenatal care.

만삭임부에서 발견된 병합임신 1 예

배동한,신영우,조태승,서수형,이창희 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.3

결론적으로 병합임신은 날로 증가되는 추세에 있고 또 산모와 태아에게 동시에 매우 위험한 결과를 야기시킬 수 있으므로, 전형적이지 않은 양상의 다태임신이나 자궁외임신 또는 유산 의 경우에서는 항상 이의 가능성을 염두에 두어 조기진단 및 치료가 필요하다고 생각되며, 조기에 정확히 진단함으로써 개복수술로 자궁외임신을 제거하여 파열 및 복강내 출혈을 방지하여 모성 이환율 및 사망율을 감소시키고 자궁내 태아의 생존율을 높일 수 있다. 최근에 본원에서는 만삭임부의 제왕절개수술시 우연히 발견된 난관 팽대부위의 자궁외임신 병소는 기왕출혈과 응고된 임신성 탈락막 주위에 태낭과 배태(embryo)가 괴사된 소견을 보임 으로써 건성괴저(mummification)가 된 것으로 자궁내 병합된 정상 임신만이 만삭까지 발육성장되고 좌측 난관팽대부 임신부위는 임신 전반기 3개월이전에 발육이 중지되어 건성괴저가 일어난 매우 희귀한 경우로 사료되어 간단한 문헌고찰과 함께 보고하였다. While ovulation is recently induced with clomiphene citrate, HCG and HMG, the incidence of simultaneous intrauterine and extrauterine pregnancies is increased concurrently. The incidence of combined pregnancy associated with ovulation inducing drugs is ascertained. During cesarean section of term pregnant woman who underwent in vitro fertilization left tubal mass was found and turned out to be ectopic pregnancy histopathologically after salpingectomy. Ina review of the world`s literature on combined intrauterine and extrauterine pregnancies only 13 cases reached term and were delivered and the infants survived the neonatal period.

Anti-M에 의한 태아적아구증

배동한,김민관,신영우,이은찬,이정명,김휘준,김창진 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.3

저자들은 임신중반기에 3차례의 태아수종으로 자궁내 태아사망을 경험한 임부의 4번째 임신에서 IgG anti-M이 이 임부의 연속적인 태아수종의 원인임을 알게되어 이를 문헌고찰과 함께 보고하는 바이다. Erythroblastosis fetalis resulting from anti-M antibody seems to be and extremly rare phenomenon. Generally, anti-M is regarded as a naturally occurring cold agglutinin. However, there have been several reports of the presence of anti-M, which was of IgG class and caused incompatibility between mother and child. Cases of neonatal anemia and intrauterine death have also been reported. We have experienced a case of anti-M antibody as a cause of intrauterine death and reported that with a brief review of related literatures.

불임환자의 치료를 위한 선택적 난관조영술과 비수술적 난관 재개통술에 대한 임상적 연구

배동한,김민관,신영우,조태승,김달수,김표년 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.3

저자들은 1991년 5월부터 1993년 8월까지 불임을 주소로 순천향대학교 천안병원 산부인과에 내원하여 자궁난관조영술을 시행한 18명의 환자에서 선택적 난관조영술 및 난관 재개통술을 시행하여 29예의 폐색난관중 24예(82.7%)의 난관에서 재개통이 이루어졌고 그중 4명에서 임신이 되어 분만이 이루어졌거나 임신 중에 있음이 확인되어 향후 이를 임상에서 사용한다면 불임치료의 진단과 치료를 병행하여 간단히 실행할 수 있는 유용하고 효과적인 방법으로 사료된다. Selective salpingography and non-surgical fallopian tube recanalization was performed in 18 patients with infertility and tubal obstruction documented with hysterosalpingography, in the Department of Obstetrics and Gynecology of Soonchunhyang University, College of Medicine, Chun-an hospital. In the 18 patients, 29 obstructed tubes were detected in previous hysterosalpingography. Recanalization of obstructed tube was successful in 24 (82.7%) of 29 tubes without serious complication. Four patients who had proximal tubal obstruction conceived without receiving any other therapy, and the average time from procedure to conception was 4.5 month. All pregnancies were intrauterine. The authors conclude that nonsurgical fallopian tube recanalization with selective salpingography provide more information than hysterosalpingography and is an effective treatment for infertility caused by proximal tubal obstruction.

악성 난소 종양 진단을 위한 Pulastility Index, New Scoring System 및 CA-125에 관한 비교연구

배동한,정한국,김민관,서수형,신영우,조태승 대한부인종양 콜포스코피학회 1993 Journal of Gynecologic Oncology Vol.4 No.3

It has been reported that there are some differances between malignant and benign tumor in the wave form of the intratumoral or surface arterial blood flow. Transvaginal Doppler ultrasound with color flow imaging was used in 24 women with ovarian tumor before explorative laparotomy. The impedence of wave forms were analysed using values nf pulsatility index (PI). Transvaginal sonographic (TUS) scoring system and CA 125 were also checked before operation. The sensi tivity of Pl was 100%, compared with those of TVS scoring system (75%) and CA 125 (63%) even though the specificity of PI (81.3%) was less than those of TVS scoring system (87.5%) and CA 125 (93.8%). But, in the early stage of cancer the sensitivity of PI (100% ) is quite higher than those of TVS scoring system (60%) and CA 125 (40%). Based on the results transvanginal Doppler color flow imaging may he a useful clinical tool in the differential diagnosis of malignant, ovarian tumor.

혈성 심낭 삼출물의 원인에 따른 심낭 삼출물과 혈청의 생화학적 분석에 대한 연구

하재경,홍택종,전국진,이동원,김정수,오준혁,송성국,이태근,김준홍,신영우 대한순환기학회 2003 Korean Circulation Journal Vol.33 No.3