형광현미경에 의한 자궁암 세포 검사

안재영(JY Ahn),송찬호(CH Song) 대한산부인과학회 1970 Obstetrics & Gynecology Science Vol.13 No.6

The authors have compared the relative accuracy of cervicovaginal screening for malignant cells using a fluorescent method and the traditional Papanicolaou method. Duplicate smears were takenfrom 3,181 random patients in the clinics of the Department of Obstetrics and gynecology, stained by the traditional Papanicolaou method and Acridine orange method popularized by Riva and Tutner. Different members of the Department of Pathology read the regular smears while the fluorescent method was used by the authors. The patients with abnormal smear(ClassⅢ, Ⅳ, andⅤ) were subfected to tissue diandiangosis by either multiole biopsy or cold knife conization. 1. Among the 3,181 patients, an abnormal smear was found in 76 patients(2.39%)by the flourescent method and 89 patients(2,79%) by the Papanicolaou method. 2. Tissue diagnosis was obstained in 36 patients out of 76 abnormal smears found by the fluorescent method and 41 patients out of 89 abnormal snears found by the Papanicolaou method. Analysis revelaled that the ratio of being to maligant was 12:24 by the fluorescent method and 20:21 by the Papanicolaou method. 3. The study shows that in our hands the false positive and false negative rate was slightly lower in the fluorescent method than in the Papanicolaou method. 4. Uther evidence is presented to show that the fluorescent method is quicker and easier as a screening method and has a real place in the screening for cervical cancer. 5. In addition to its cancer detection, it is also useful in diagnosing cause of vaginal dischange such as trichomonas and monilia.

자궁경관 임신의 보존요법후 성공적인 임신 1 예

이기호(KH Lee),임대성(DS Lim),신수재(SJ Shin),김성도(SD Kim),안재영(JY Ahn) 대한산부인과학회 1989 Obstetrics & Gynecology Science Vol.32 No.1

본 증례는 33세경산부가 불완전 유산이라는 진단하에 소파수술을 받던중 대출혈을 일으켜 본원으로 이송되어 초음파를 이용 자궁경관임신으로 진단한후 보존요법의 하나인 자궁경부 결찰과 함께 질폐색을 시도하여 치료에 성공한 후 임신되어 남아를 분만한 경우로 다음에 임신을 원하는 경우에는 우선 일차적으로 보존요법을 시행해 보는 것이 바람직하다고 생각 되어 진다. Cervical pregnancy is a rare form of ectopic gestation in which the ovum implants within the cervix below the internal os. The exact cause of the cervical pregnancy is not known, however permanent injury to the uterine mucosa is suspected . Because of uncontrolled profuse painless vaginal bleeding total hysterectomy is mostly perfomred in the management of cervical pregnancy . We present a case of cervical pregnancy in 33years old mulipara who delivery a healthy male infant after conservative treatment , and literatures on the cervical pregnancy were briefly reviewed.

자궁내 태아사망에 관한 임상적 고찰

박순홍(SH Park),박정원(JW Park),송혜섭(HS Song),김성도(SD Kim),안재영(JY Ahn) 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.8

1983년 1월 1일부터 1992년 12월 31일까지 만 10년간 서울고려병원 산부인과에서 입원하여 분만한 9,834예중 임신 20주이후에 태아의 체중이 500 gm이상인 자궁내 태아사망 101예의 임상기록을 기초로 관찰분석하여 다음과 같은 결론을 얻었다. 1. 산전관리를 한번도 받지않은 경우는 50.5%였다. 2. 자궁내 태아사망의 발생빈도는 1.08%였다. 3. 연령분포는 21세에서 48세까지의 분포를 보였으며 그중 26-30세군이 53.5%로 가장 많았다. 4. 출산력은 초임부가 57.5%로 가장 많았고, 1회분만이 27.7%이었다. 5. 자궁내 태아사망의 기왕력이 있었던 경우는 3예(2.9%)였으며, 자연유산의 기왕력은 14예(13.8%)였다. 6. 자궁내 태아사망의 임신주수별 분포는 임신 20-24주에서 35.7%로 가장 많았다. 7. 태위는 두위가 76.4%로 가장 많았고, 남아와 여아의 비는 1.24:1이며 태아체중이 2,500 gm미만인 경우는 71.5%였다. 8. 사망태아의 분만방법은 유도분만이 53.5%로 가장 많았고, 개복수술이 25.7%, 자연분만이 20.8%였으며, 개복수술의 적응증은 유도분만의 실패, 제왕절개술의 기왕력, 자궁파열, 전치태반 및 태반조기박리 순이었다. 9. 자궁내 태아사망의 원인은 원인불명이 40.9%, 임신중독증 18.9%, 전치태반 8.9%, 제대합병증 6.9%이며, 태반조기박리 5.9%, 융모양막염 4.9%, 자궁파열 4.9%, 모체질환 3.9%, 선천성기형 2.9%, 매독 1.9%순이었다. 10. 자궁내 태아사망의 모성합병증은 20.8%을 나타냈고 이중 출혈이 42.9%로 가장 많았고 그외 자궁경부파열(20.8%), 발열(19.7%), 창상감염(14.2%)순이었다. 11. 자궁내 태아사망과 DIC와의 관계는 혈소판이 10만/mm^3으로 감소한 경우는 12.5%, 섬유소원이 150 mg/dl이하인 경우는 4.8%, FDPs가 40 micro g/ml이상인 경우는 10.9%, Partial thromboplastin time이 50초 이상 연장된 경우는 1.7%였으며, prothrombin time이 14초이상 연장된 경우는 없었다. 12. 산모의 혈액형이 A형 Rh양성이 35.7%로 가장 많았다. The intrauterine fetal death is defined as the intrauterine death after 20 weeks gestation or attainment of more than 500 gm body weight prior to the complete expulsion or extraction from its mother. This is a clinical analysis of 101 cases of the intrauterine fetal death among 9834 deliveries of Seoul Koryo General Hospital during 10 years period from Jan, 1983 to Dec, 1992. The results of this study are as follows: 1. The 50.5%of the cases had not received any antenatal care. 2. The incidence of the intrauterine fetal eath was 1.08%. 3. The age distribution of mothers with the intrauterine fetal death was between 21 to 48 years and was highest in the 26-30 years range(53.5%). 4. As for the parity distribution of mothers with intrauterine fetal death, the nulliparous group(57.5%) was most common and the next group was para-1(27.7%). 5. There were 3 cases(2.9%) with previous history of the intrauterine fetal death and 14 cases (13.8%) with the previous history of the spontaneous abortion. 6. The most common gestational weeks when intrauterine fetal death was detected was 20 to 24 weeks gestational period(35.7%). 7. The most common presentation was cephalic(76.4%) and the sex ratio of male verus female was 1.24:1, and the 71.%% of dead fetus weighted less than 2500 gm. 8. The mode of delivery for the intrauterine fetal death showed that the induction of labor was most common(53.5%) and the laparotomy was 25.7% and the spontaneous delivery was 20.8%. The most common indication of laparotomy was the failure of induced labor and the others were the previous cesarean section status, the uterine rupture, placenta previa and placenta abruption,in that order. 9. The most common cause of intrauterine fetal death was unexplained cases(40.9%) and the others were preeclampsia(18.9%), placenta previa(8.9%), cord complcations(6.9%), placenta abruption(5.9%), chorioamnionitis(4.9%), uterine rupture(4.9%), maternal illness(3.9%), congenital anomaly(2.9%) and syphils(1.9%), in that orders. 10. The incidence of maternal complication was 20.8% and the most common complication was hemorrage (42.9%), and the others were cervical laceration(23.8%), fever(19.1%), wound infection(14.2%), in that orders. 11. The DIC studies of intrauterine fetal death were as follows: the platelet count was decreased below the level of 100,000/mm^3 in 12.5% of the cases, the fibrinogen levels were decreased below the level of 150 m/dl in 4.8% of the cases, the FDPs were increased above the levels of 40 micro g/ml in 10.9% of the cases, the partial thromboplastin time was prolonged above 50 sec in 1.7% of the cases and the prothrombin time was not prolonged above 14 sec. in any case. 12. The most common blood type was Rh positive A type(35.7%).

난소임신 2예

한치동(CD Han),신수재(SJ Shin),정승균(SK Chung),김성도(SD Kim),안재영(JY Ahn) 대한산부인과학회 1984 Obstetrics & Gynecology Science Vol.27 No.3

Primary ovarian pregnancy is comparatively rare in ectopic pregnancy and the Spiegelberg`s criteria should be fulfiled for the diagnosis of ovarian pregnancy. Thw cases of ovarian pregnancy were seen in recent years at Korea General Hospital and presented with a brief literature.

전신성 홍반성 낭창과 동반된 임신 1례

정승균(SK Chung),한치동(CD Han),신수제(SJ Shin),김승도(SD Kim),안재영(JY Ahn) 대한산부인과학회 1984 Obstetrics & Gynecology Science Vol.27 No.10

저자들은 고려병원 산부인과에서 임상적, 이학적 소견이 전신성홍잔성낭창과 일치하고 안면 피부조직거마상, L.E.세포, A.N.A.검사에서 확진된 28세의 다산부의 임신과정을 관찰할 수 있었다. Systemic lupus erythematosus (S.L.E) is an autoimmune disease occuring most frequently in woman during the reproductive age and it has been known that this disease is often complicated by renal disease up to 75% of cases. Recently we encountered a case of S.L.E. associated with pregnancy which was confirmed by skin biopsy, positive L.E. cell, and A.N.A. test. Authors report clinical course, therapy on the patient with brief review of concerned literatures.

Prostaglandin F₂α의 양막외주입에 의한 중기임신중절

신수재(SJ Shin),정승균(SK Chung),한치동(CD Han),김성도(SD Kim),안재영(JY Ahn) 대한산부인과학회 1984 Obstetrics & Gynecology Science Vol.27 No.6

Although much research is being carried out all over the world, midtrimester abortion still presents many difficult medical problem. It is well known that prostaglandin E and F are effective in uterine contraction in both pregnant and nonpregnant uterus. The use of prostaglandin F₂α administered by extraamniotic infusion through Foley catheter for the induction of abortion was studied in 35 patients between 17 and 33 weeks gestation, and this method had been proved to be safe and effective mean of the termination of the pregnancies at midtrimester. The results were as followings: 1. The range of age was between 24 and 42. 2. Nulliparas were 17 cases and multiparas were 18 cases. 3. Intrauterine fetal death were indicated in over the half. 4. The mean duration from infusion to the delivery of the fetus was 15.70 hours. The mean duration for the multiparas was 14.17 hours, and the mean duration for the primipara was 15.25 hours. 5. The mean total dosage of prostaglandin F₂α was 5.692mg in primiparas and 4.479mg in multiparas. 6. The abortion was successfully induced in 88.2% of primiparas and 88.9% of multiparas within 24 hours. 7. The successful abortion rate by the balloon size of the Foley catheter were 86.4% in the group of 30~40cc balloon size and 100% in the group of 80~100cc balloon size within 24 hours. 8. The duration of the oxytocin infusion after the expulsion of Foley catheter were 4.59 hours in the group of 30~40cc balloon size and 1.32 hours in the group of 80~ 100cc balloon size. 9. The most common side effect was consisted of gastrointestinal symptom such as nausea, vomiting and diarrhea. Other side effects were included transient pyrexia, chilling and facial flush. 10. The main complication in this series was incomplete abortion, which occurred in 6 patients. Others were excessive bleeding over 500ml, endometritis and cervical laceration.

임신말기 산모의 chlamydia Trachomatis감염률 조사

오승재(SJ Oh),박성철(SC Park),신경숙(KS Shin),윤경(K Yun),안재영(JY Ahn) 대한산부인과학회 1986 Obstetrics & Gynecology Science Vol.29 No.1

1985년 1월부터 1985년 7월까지 7개월간 서울 고려병원 분만실에 내원한 환자 중 무작위로 선별된 297예의 임신말기 산모와 60예의 신생아를 대상으로 산모에서는 분만전 자궁 경부에서 검체를 채취하였고 신생아에서는 결막(conjunctiva)과 인후(throat)에서 검체를 채취하여 McCoy 세포를 사용한 chlamydia 배양법을 시행하여 다음과 같은 결과를 얻었다. 1. 무작위로 선별된 297예의 임신말기 산모 중 chlamydia 배양검사에 의한 양성율은 20.8%이었다. 2. 연령별로는 20~24세의 군이 가장 높은 양성율을 보였고, 임신주수에서는 35~38주에서 양성율이 높았다. 3. 경산부와 초산부사이에 양성율의 차이는 없었고, 기왕력에 유산 경험이 있는 산모가 경험이 없는 산모보다 높은 양성율을 보였다. 4. 신생아 체중과의 관계에서는 신생아 체중이 적을 수록 산모의 양성율이 높은 경향을 보였으며 조기 파막의 유무와 산모의 양성율과는 관계가 없었다. 5. 무작위로 선별된 60예의 신생아 중 chlamydia 배양검사에 의한 양성율은 20.0%이었으며, 17예의 양성 산모에서 태어난 신생아 중 12예에서 양성 반응을 나타내 70.0%의 신생아 이환율을 보였다. Detection test of chlamydia trachomatis in the cervix of randomly selected 297 term pregnant women and 60 new born infants was performed using Mc Coy cell culture during the period from January 1985 to July 1985. The following results were obtained: 1. The positive detection rate of chlamydia trachomatis in 297 cases of term pregnancy was 20.8%. 2. There was a tendency of increasing positive rate both in age group of 20 to 24 and in gestational week of 35 to 38. 3. No significant difference in positive rate was found in group of primipara and multipara, however, patient with past history of abortion showed much higher positive rate as compared with patients without history of abortion. 4. There were tendency of higher positive rate in term pregnant mothers delivered infants with lower birth weight and there was no significant difference in positive rate between the spontaneous premature rupture of membrane and intact membrane at time of delivery. 5. The positive detection rate ofchlamydia trachomatis in the conjunctiva and throat of 60 new born infants was 20.0% and 12 positive new-borns were born of 17 positive term pregnant women that comprised 70.0% of infectivility to the infants.

임신중 고혈압성 질환의 임상적 고찰

김주욱(JW Kim),원광연(KY Won),조재동(JD Cho),김성도(SD Kim),안재영(JY Ahn) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.6

A clinical study was undertaken on 631 cases of hypertensive disorders in pregnancy who were admitted to Korean General Hospital for the period of 10 years from Jan. 1973 to Dec. 1982, during which time, there were 11,307 deliveries in total. The results were as follows: 1) The incidence of hypertensive disorders in pregnancy was 5.6% of total deliveries. 2) The ratio of mild preeclampsia was 54.5%; severe preeclampsia, 40.9%; eclampsia, 3.3%; chronic hypertensive vascular disease with toxemia, 0.6%; chronic hypertensive vascular diseases without toxemia, 0.5%; and unclassfied, 0.2%, respectively. 3) The frequency of disease was higher in the age group above 40 years old and below 19 years old age. 4) According to parity, the higher frequency was noted in primipara and grand multipara of 4 or above. 5) Among four seasons, the disease was more frequently seen in spring time. 6) The incidence of hypertensive disorders in twin pregnancy was 21.8%, which is about four times higher than overall incidence. 7) The disease was more prevalent in women who did not take antenatal care. 8) Average fetal weight was lower than those born in normal mothers. 9) Among the associated diseases, twin pregnancy was 17 cases, abruptio placentae 9 cases and essential hypertention 7 cases. 10) Average hemoglobin level was 11.7gm% which revealed 0.7gm% higher than that of normal mothers.

거대아의 임상적 고찰

안재영,김성도,황성한,엄수하,윤형근,정수영 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.2

1980년 1월1일부터 1989년 12월31일까지 서울고려병원 산부인과에서 분만한 총 10,082명 의 신생아중 출생시 체중이 4,000gm이상인 신생아 및 그 산모를 대상으로 조사 분석하여 다 음과 같은 결론을 얻었다. 1. 출생시 체중이 4,000gm이상인 거대아의 빈도는 4.30%이었고, 출생시 체중이 4,500gm이상 인 거대아의 빈도는 0.35%이었다. 2. 연령별 분포에서 가장 높은 빈도는 25세에서 29세 집단에서 보였다. 3. 거대아에서의 성비는 175:100(남:여)이었다. 4. 가장 빈번히 사용된 분만방법은 제왕절개술이었고(54.27%) 수술의 주 적응증은 아두골반 불균형으로 63.14%였다. 5. 거대아중 68.2%에서 임신 제 40주이후에 분만이 되었다. 6. 분만횟수의 증가에 따른 거대아의 빈도의 증가는 보이지 않았다. 7. 임신 기간중의 평균 체중증가는 15.2kg이었고 임신전 평균체중은 56.96kg이었다. 8. 분만후 당부하검사와 HbAlc검사를 총 434례의 거대아 중 124례에서 시행하였다. 비정상 당부하검사율은 11.29%이었으며 HbAlc는 의미가 없었다. 9. 가장 흔한 모성 합병증은 빈혈이었으며 빈혈이 있는 산모중 10.83%에서 수혈을 시행하였다. Macrosomia is one of the important problems in obstetrics and perinatology. We studied 434 cases of large babies weighing 4,000gm or more among 10,082 cases of total deliveries during past 10 years from Jan. 1980 to Dec. 1989. The results were as follow: 1. The incidence of macrosomia weighing 4,000gm or more was 4.30% and that of macrosomia wighing 4,500 or more was 0.35%. 2. The highest age distribution of mother was found between 25 to 29 year of age. 3. The sex ratio of macrosomia was 175:100(M.F.). 4. The most frequent mode of delivery was cesarean section and the most common indication for cesarean section was cephalopelvic disproportion. 5. 66.82% of macrosomia were born after 40 weeks of pregnancy. 6. There was no tendency of the increase in the incidence of macrosomia as the parity increase. 7. Mean weight gain during pregnancy was 15.2kg and mean weight of pregravida was 56.96kg. 8. Postpartum oral glucose tolerance test and HbAlc were done in 124 cases. Abnormal oGTT rate was 11.29% and HbAlc was not significant. 9. Most common maternal complication was anemia. 10.83% of them were transfused.

정상 만삭분만에서의 황체홀몬값의 측정

안재영,이숙환,김종민,양성우,정수영 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.11

1988년 7월과 8월사이에 서울고려병원 산부인과에서 임신주수 38주에서 42주사이에 정상분만한 산모와 태아를 대상으로 혈장에서 황체홀몬의 농도를 측정, 비교 검토해서 다음과 같은 결론을 얻었다. 1. 남아(8명)을 분만한 예에서 모체 말초혈관, 제대동맥 그리고 제대정맥의 황체홀몬 값은 각각 192.31±73.12ng/ml, 301.04±179.62ng/ml, 443.91±194.03ng/ml이고, 여아(9명)에서는 각각, 206.23±52.65ng/ml, 447.11±115.25ng/ml, 738.76±113.04ng/ml이었다. 2. 모체 말초혈관, 제대동맥 그리고 제대정맥에서의 황체홀몬값은 태아의 성별에 관계없이 제대정맥에서 가장높고 모체 말초혈관에서 가장 낮은치를 보였다. 3. 모체 말초혈관과 제대정맥에서의 황체홀몬값의 비교는 제대정맥이 모체 말초혈관보다 여아에서 3.5배(p$lt;0.01), 남아에서 2.3배(p$lt;0.01)이 높았다. 4. 모체 말초혈관과 제대동맥의 황체홀몬의 값의 비교는 데재동맥이 모체 말초혈관보다 여아에서 2.1배(p$lt;0.05), 남아에서 1.5배(p$lt;0.01) 높은값을 보였다. 5. 제대정맥에서의 황체홀몬값은 여아가 남아보다 1.6배(p$lt;0.01)높았고, 제대동맥에서도 여아가 남아보다 1.5배(p$lt;0.05) 높은값을 보였다. 6. 제대동맥과 제대정맥의 황체홀몬값의 차이는 여아(291.65ng/ml)가 남아(142.87ng/ml)보다 의의있게 높게 나타났다. We performed the study on selected 17 patients who had normal pergnancies and delivered spontaneously at term, at Seoul Koryo General Hospital from July 1988 to August 1988. The plasma concentration of progesterone was measured in maternal peripheral vein, umbilical artery and umbilical vein at the time of delivery of full term pregnancy. The results obtained were as follows: 1. In 8 cases of male delivery, the mean progesterone concentration were 1921.31±73.12ng/ml in maternal peripheral blood, 301.04±179.62ng/ml in umbilical artery and 443.91±194.03ng/ml in umbilical vein, whereas in 9 cases of female delivery, the mean progesterone concentration of 206.23±52.62ng/ml in maternal peripheral blood, 447.11±115.25ng/ml of umbilical artery and 738.76±133.04ng/ml in umbilical vein were detected respectively. 2. At term pregnancy, plasma progesterone concentration of umbilical vein was higher than that of umbilical artery. Also, plasma progesterone concentration was higher in umbilical artery than in the maternal peripheral blood. 3. The mean progesterone concentration in umbilical vein of both female and male fetuses were 3.5 times and 2.3 times higher than those in maternal peripheral blood, respectively. 4. The mean progesterone concentration in umbilical artery of both female and male fetuses were 2.1 times and 1.5 times higher than those in maternal peripheral blood, respectively. 5. The mean progesterone concentration in umbilical vein of female fetuses was 1.6 times higher than that of male fetus, and in umbilical artery of female fetuses, the mean progesterone concentration was 1.5 times higher than that of male fetuses. 6. The umbilical venous-arterial difference of progesterone concentration was significantly higher in female than in male fetuses.