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원석용,고민환,이태형,은미정,김정숙,김옥경 영남대학교 기초/임상의학연구소 2001 Yeungnam University Journal of Medicine Vol.18 No.2
To determine mean clitoral and glans size of Korean female newborn Materials and Methods: The size of glans and clitoris of 68 Korean female newborns born at Yeungnam University Medical Center were measured from May in 1999 to August in 1999. Results: The mean size of the 68 newborns were 2.38±1.14 mm in glans length, 2.55±1.48 mm in glans width and 4.66±1.93 mm in clitoral length. In the premature infants the mean clitoral size was 1.92±1.58 mm in glans length, 1.78±1.24 mm in glans width and 3.86±2.16 mm in clitoral length. In the full term infants 2.53±1.12 mm in glans length, 2.75±1.58 mm in glans width and 4.94±1.89 mm in clitoral length, In low birth weight infants clitoral size was measured 1.55±1.10 mm in glans length, 2.04±2.03 mm in glans width and 3.29±1.87 mm in clitoral length. In normal birth weight infants 2.53±1.13 mm in glans length, 2.68±1.48 mm in glans width and 4.92±1.91 mm in clitoral length. In high birth weight infants 1.54±0.50 mm in glans length, 1.63±0.53 mm in glans width and 3.18±1.04 mm in clitoral length. Conclusion: There was no significant correlation between gestational age and clitoral size or glans size, but significant negative correlation was found between birth weight and clitoral size or glans size.
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농양을 합병한 거대 자궁근종 수술 후 발생한 하지정맥 혈전증과 폐 색전증
이동혁 ( Dong Hyeok Lee ),원석용 ( Seok Yong Won ),정우연 ( Woo Yeon Jung ),배연경 ( Yeon Kyoung Bae ),고민환 ( Min Whan Koh ),이태형 ( Tae Hyung Lee ) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.11
Pulmonary thromboembolism (PTE) is a serious postoperative complication. Prompt diagnosis of PTE is important but it is difficult because clinical manifestations of PTE are not obvious in most cases. If a patient had tachypnea, cold sweating and hypoxemia
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장태기,고민환,이태형,이은지,원석용 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.11
Incarceration of the gravid uterus is a rare but serious complication of pregnancy. Reported is the case of a gravid 2, para 0, abortus 1 with known uterine subserosal myoma(5.3 ×5.5cm sized) 26-year-old woman presented with acute dysuria and urinary retention. The patient was 14 weeks and 3 days pregnant and presented several week history of urinary frequency and sensation of incomplete bladder emptying. Examination revealed a retroflexed uterus with cervical opening pointing toward the anterior abdominal wall. An ultrasound revealed a thin, elongated maternal bladder and a uterus incarcerated between the sacral promontary and the pubis. The incarceration was successfully reduced by tenaculum traction of the cervical posterior lip without surgical intervention and had a normal infant of appropriate weight at term.
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유도분만 성패 예측을 위한 자궁경부 태아 Fibronectin 측정의 임상적 가치
전경숙(Kyung Sook Jeon),이태형(Tae Hyung Lee),고민환(Min Whan Koh),원석용(Seok Yong Won),이현우(Hyun Woo Lee),이동혁(Dong Hyuk Lee),이종섭(Jong Sup Lee) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.2
목적 : 유도분만을 시행한 만삭임부에서 자궁경부와 질 분비액내 태아 fibronectin 검출여부를 확인하여 유도분만의 경과와 성패를 예측하고자 함. 연구 방법 : 1999년 9월 1일부터 12월 31일까지 4개월간 영남대학교 의료원 분만실에서 유도분만을 시행한 만삭임부 58명을 대상으로, monoclonal antibody FDC-6 assay에 의한 ELISA method (Azeda Biochemical)로 자궁경부와 질 분비 내 태아 fibronectin 검출여부를 확인하여 유도분만의 경과와 성패를 Bishop score와 함께 평가하였다. 결과 : 자궁경부 분비 내 태아 fibronectin 검출율은 분만유도 전 진통이 없었던 임부군과 불규칙 진통이 있었던 임부군에서 각각 75.0% (33/44)와 85.7% (12/14), Bishop score 4이하인 임부군과 5이상인 임부군에서 각각 76.3% (29/38)와 80.0% (16/20)로 각각 통계적으로 유의한 차이가 없었다 (표 2). 자궁경부 태아 fibronectin이 검출된 임부군과 검출되지 않은 임부군의 비교에서 자궁경부 숙화를 위해 소요된 경구 PGE2 평균 갯수가 각각 2.7±2.56정과 4.1±2.42정, 분만유도 시작 후 분만까지의 평균 소요시간이 각각 12.5±6.56시간과 16.3±6.14시간, 제왕절개 분만율은 20.0% (9/45)와 38.4% (5/13)로 각각 통계적으로 유의한 차이가 없었으며 (표 3, 4), Bishop score 5이상 임부군과 4이하 임부군의 비교에서도 각각 통계적으로 유의한 차이가 없었다 (표 4). 자궁경부 태아 fibronectin이 검출되고 Bishop score가 5이상인 임부군과 태아 fibronectin 검출되지 않고 Bishop score가 4이하인 임부군의 비교에서, 경구 PGE2의 평균 사용 갯수와 분만유도 후 분만까지의 평균 소요 시간은 각 군간 통계적으로 유의한 차이가 없었으나 (표 5), 제왕절개 분만율은 태아 fibronectin이 검출되고 Bishop score가 5이상인 임부군이 6.3% (1/16)로 태아 fibronectin이 검출되지 않고 Bishop score가 4이하인 임부군의 44.4% (4/9)보다 낮았다 (표 6, p=0.040). 결론 : 저자의 연구에서 자궁경부 태아 fibronectin 검출여부에 의한 단독평가로는 유도분만의 경과를 예측할 수 없었으나, 자궁경부 태아 fibronectin 농도 측정과 Bishop score를 함께 이용할 경우 유도분만의 성패 예측에 있어 임상적 유용성을 높일 수 있을 것으로 확인하였다. Objective : To determine whether the presence of fetal fibronectin in the cervicovaginal secretion could be used as a clinical marker to predict the outcome of labor induction. Methods : The study group comprised 58 term pregnant women with intact amnionic membranes, 44 without labor and 14 with irregular labor. All patients had been admitted for induction of labor during Sept. 1, 1999 to Dec. 31, 1999 at the Department of Obstetrics and Gynecology of Yeungnam University Hospital. Fetal fibronectin was assayed with the cervicovaginal secretion. We analyzed the variables of labor outcome by the presence (positove) or absence (negative) of fetal fibronectin and the modified Bishop score. Results : Cervicovaginal fetal fibronectin was detected in 75.0% (33/44) of the women without labor and 85.7% (12/14) with irregular labor, and 76.3% (29/38) with Bishop score 4 or less and 80.0% (16/20) with score 5 or above. There was no statistical differences in the positive rate of fetal fibronectin between the women without labor and those with irregular labor, and the women with Bishop score 4 or less and those with Bishop score 5 or above, respectively. The mean oral PGE2 tablets used for cervical ripening, the mean time interval from the beginning of labor induction to delivery, and the mean cesarean delivery rate were 1.97±2.56 tabs and 3.12±2.42, 10.12±6.56 hours and 13.88±6.14, and 20.0% and 38.4%, in the women with positive fetal fibronectin and those with negative respectively, and 1.83±2.50 and 2.42±2.60, 10.11±7.17 hours and 11.28±6.26 hours, and 10.0% and 31.6% in the women with Bishop score 5 or above and those with Bishop score 4 or less, respectively. There were no statistical differences in the mean values between the women with positive and negative fetal fibronectin, and between Bishop score 5 or above and Bishop score 4 or less, respectively. There were no statistical differences in the mean oral PGE2 tablets used for cervical ripening (2.00±2.65 vs. 4.40±1.82) and the mean time interval from the beginning of labor induction to delivery (10.11±7.53 vs. 16.17±5.38), between the women with positive fetal fibronectin and Bishop score 5 or above and those with negative fetal fibronectin and Bishop score 4 or less, respectively. However, the cesarean delivery rate was significantly lower in the women with positive fetal fibronectin and Bishop score 5 or above than those with negative fetal fibronectin and Bishop score 4 or less (6.3% vs 44.4%, p=0.040). Conclusion : The assesment of cervicovaginal fetal fibronectin and Bishop score could be useful in predicting the success or failure of labor induction. But it was not helpful to predict the easiness of labor induction by the presence or absence of fetal fibronectin in the cervicovaginal secretion and/or modified Bishop score.
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