쌍태임신에 관한 임상통계학적 관찰

김종식(JS Kim),이종태(JT Lee),이동수(DS Lee),김동성(DS Kim) 대한산부인과학회 1979 Obstetrics & Gynecology Science Vol.22 No.2

대구 파티마병원 산부인과에서 1973년 1월 1일부터 1977년 12월 31일까지 만 5년간 본원에서 분만을 취급한 총 분만수 7,029명중 96예의 쌍태임신에 대한 임상통계학적 고찰을 통해 다음과 같은 결과를 얻었다. 1. 쌍태분만의 단태분만에 대한 비율은 1:73이었다. 2. 연령분포는 최소연령은 21세, 최고연령은 40세이었으며, 평균연령은 28세이었다. 쌍태분만중 초산부가 45.8%를 차지하였다. 3. 임신기간은 37주 이상이 81.6%이었고, 태아의 체중이 2,500gm 이상은 제1아는 60.4%, 제2아는 46.8%이었다. Apgar score가 1분 이내에 7∼10인 경우는 제1아에서 85.4%, 제2아에서 80.1%이었다. 4. 분만방법으로는 제1아는 흡인분만 54.2%, 자연분만 22.9%, 제왕절개술 7.3%, 그리고 제2아는 흡인분만 49.0%, 둔위만출술 15.6%, 제왕절개술 7.3%이었으며, 수술 적응증으로는 전치태반, 협골반과 자궁기능부전에 각각 2예로 가장 많았다. 6. 쌍태의 분만지속기간은 평균 11시간 8분이었고, 제1아 만출로부터 제2아 만출까지의 소요시간은 평균 8분이었다. 7. 태반분만은 13.5%에서 용수박리를 시행하였다. 8. 성별로는 양측 남성이 39예로 40.6%, 양측여성이 34예로 35.4%, 남녀 이성이 23예로 24.0%이었으며, 태반은 약 반수에서 단일융모막 및 이중양막(monochorionic & diamniotic membrane)을 보였다. 9. 합병증으로는 임신중독증이 56예로 40.9%로서 가장 많았고, 모성빈혈이 52예로 38.0%, 산후출혈이 28예로 42.4%이었다. 10. 주산기사망은 11예로서 그 사망률은 57.3%에 해당하였고, 그 원인은 미숙아가 364%로 가장 많았고 모체사망은 한 예도 없었다. A clinical review of 96 twin deliveries at the Dept. of Obstet. & Gynecol., Taegu Fatima Hospital for 5 years from Jan., I 1973 to Dec., 31, 1977 was presented. 1) The frequency of twin birth was one in 73 births. 2) The youngest was twenty-one year old woman and the oldest was forty year old one in twin deliveries. Average age was twenty-eight years. And in primipara 45.8 per cent of twin delivery occurred. 3) Delivery after 37th week of gestation occurred in 81.6 per cent and the babies weighing over 2,500gm. Revealed 60.4 percent. In the first twin and 46.8 per cent. In the second twin. Apgar score 7∼10 was shown in 85.4 per cent, and cephaliic-breech combination was 28.1 per cent. 5) The mode of delivery in twin pregnancy, the first twin baby was 54.2 percent in vaccum delivery, 22.9 per cent in spontaneous delivery and 7.3 percent in cesarean section and the second twin baby was 49.0 per cent in vaccum delivery, 15.6 per cent in breech extraction and 7.3 percent in cesarean section. 7 cases of cesarean section, 7.3 per cent was encountered, it`s main indication being such as placenta previa, contracted pelvis and uterine dysfunction. 6) In 13.5 per cent of the cases manual removal of the placenta was performed. 7) There were 39 cases of both males, 40.6%, 34 cases of both famales, 35.4%, and 23 cases of opposite sex, 24.0%, and in about half of the cases, the placenta with monochorionic and diamniotic membranes were seen. 8) As maternal complication of twin pregnancy, 40.9 per cent of toxemia, anemia in 38.0 per cent, postpartum hemorrhage in 42.4 per cent were noted. 9) There were 11 perinatal deaths, it revealing 57.3 of perinatal mortality rate of twins.

이완성 자궁출혈에 대한 임상적 고찰

조승욱(SW Cho),이종태(JT Lee),이호근(HK Lee) 대한산부인과학회 1982 Obstetrics & Gynecology Science Vol.25 No.3

Authers performed clinical study on 242 patients with postpartum atonic bleeding encountered at department of Obstetrics & Gynecology, Korea General Hospital, Seoul, Korea for 10 years and 8 months from November 1968 to June 1979. There were 9151 cases of vaginal deliveries during that period. The result are as follows; 1) an overall incidence of postpartum atonic bleeding was 2.64% among the 9151 vaginal deliveries, about 3 times of higher incidence was noted in twin pregnancy (8.05%) as compared with single pregnancy (2.59%), an incidence also increased significantly when the materal age was above 30th years and the parity was above 3 times. 2) The prolonged labor & delayed placenta delivery had a tendency toward developing postpartum atonic bleeding, also large sized baby & placenta produced significantly higher incidence of postpartum atonic bleeding. 3) when induction or augmentation of labor with oxytocin were carried out, higher incidence of postpartum atonic bleeding were developed. 4) Hypertensive disease in pregnancy & uterine dysfunction seemed to be associated more frequently with postpartum atonic bleeding. 5) 232 cases were treated with hysterotonics and transfusion, Operations were performed on 9 cases. 6) Puerperal fever and wound infection were complicated in the patient with postpartum atonic bleeding.

난소갑상선종의 1예

박승보(SB Park),이종태(JT Lee),백옥지(OJ Paik) 대한산부인과학회 1978 Obstetrics & Gynecology Science Vol.21 No.8

It is not uncommon to note fragment of thyroid tissue in the benign cystic teratomas, but the pure form of struma ovarii is rare. Authors report a case of pure form struma ovarii, which demonstrated neither malignant lesion nor thyrotoxic symptoms, found in the left ovary of a 36-year-old multipara with review of literature.

자궁근종에서 발생한 자궁평체근육종에 1예

이병찬(BC Rhee),박노선(NS Park),이종태(JT Lee),이정만(CM Lee) 대한산부인과학회 1980 Obstetrics & Gynecology Science Vol.23 No.7

본원 산부인과에서 39세된 경산부에서 비교적 희유한 자궁경활근육종 1예를 경험하였기에 약간의 문헌고찰과 아울러 보고하는 바이다. Sarcomatous change of leiomyoma is a rare entity, and observed in 39 years old multiparous housewife. The diagnosis was made by postoperative routine biopsy. We have met a case recently to report it as well as it`s review of literatures briefly.

자궁내구기능 부전증에 대하여

김태준(TJ Kim),강윤석(YS Kang),이종태(JT Lee) 대한산부인과학회 1980 Obstetrics & Gynecology Science Vol.23 No.8

We surveyd 76 cases with incompetent internal os of the cervix, who received the treatment at Korea General Hospital during the period from Nov. 1. 1968 to July 31. 1978. The result obtained were as follows; 1) I.I.O.C. encountered were approximately once in every 125 deliveries. 2) The most frequent age incidence were from 25 to 29 age group, and most of them had the previous history of 2 or more spontaneous abortion, one or more induced abortion and premature delivery. 3) The operation were carried out in 47 patients of 76 cases. A variety of operations, such as Shirodkar(42 cases), Shirodkar and trachelorrhaphy(2 cases), McDonald and trachelorrhaphy(1 case), McDonald after failed shirodkar(2 cases), were performed. 4) The most of patients were admitted to the hospital for about a week and the patients were placed in position with foot side of the bed elevated, also they were under close observation with the usage of progesterone, valium, gestanon, proluton depot and prophylactic antibiotics in all instances. 5) Forty-three patients undertaken surgery had been followed up to deliveries with 29 successful pregnancies, and a ovfer-all fetal salvage rate after successful operation was 67.44%. 6) The babies whose mother undertaken surgical procedures were born via vaginal route in 32(74.4%) and abdominal route in 11(25.6%). 7) The most common causes of abdominal delivery were due to cephalopelvic disproportion and feto-pelvic disproportion(6 cases), One cesarean section was carried out due to cervical dystocia following fibrotic band formation around the cervix after the surgery. 8) The most common cause of failed operation(12 cases) was hemorrhage(3 cases) and premature labor(3 cases). 9) The optimal time for operation was between the 17th and 20th week of gestation and the success rate of the surgery was 92.8%. 10) The surgical-success rate was inversely porportional to the degree of the dilation or effacement of the cervix. The surgical success rate was high in group of one Cm or less in diameter of cervical dilation.

소음성 난청의 관리를 위한 평가기준에 관한 연구

곽문석,이종태,박준환,이헌,이창희,손병철,김대환 인제대학교 1997 仁濟醫學 Vol.18 No.2

소음성 난청의 예방 관리를 위하여 실시하는 특수 건강진단의 건강관리기준(1994)은 여러번에 걸쳐 개정되어 왔으나 아직까지 소음성 난청의 평가기준으로서 미흡하며, 또한 장해보상을 위한 업무상재해인정기준(1993)과의 적용 방법이 다름은 청력 보존 프로그램의 성공적인 수행에 문제점이 되고 있다. 이에 저자들은 소음 특수 건강진단 대상자중 청력검사상 1,000Hz에서 30dB 이상 또는 4,000Hz에서 40dB 이상의 청력손실이 있는 자 1,133명을 대상으로, 소음성 난청으로 진단하기 위한 건강관리기준(1994)과 장해 보상을 위한 업무상재해인정기준(1993)을 적용하여 평가하고, 또한 외국의 기준들과 비교, 분석함으로써 향후 소음성 난청 관리를 위한 평가기준의 재설정시 기초 자료로 제시하고자 본 연구를 시행하였다. 그 결과 현행 소음성 난청 건강관리기준이 업무상재해인정기준에 의한 보상 대상자를 모두 포함하지 못함으로써 소음성 난청자 관리에 문제점이 있음이 조사되었고 향후 소음성 난청에 대한 건강관리기준과 업무상재해인정기준은 제도의 개선이 필요하였다. The authors investigated the different criteria of the noise induced hearing loss(NIHL) used in Korea, Japan, Poland, and American Academy of Ophthalmology and Otolaryngology(AAOO) and establishing the standard assessment and for management of the patient. This studies were underwent on 1,133 workers by twice audiometric examinations from March, 1995 to Februry. 1996. The results were as follows : 1.Common correlated frequency was 2,000Hz between mean hearing threshold level at each frequencies and age, hearing difficulty, tinnitus, duration of the noise exposure, and noise level of workplace(p<0.001). and the mean hearing threshold level of group with tinnitus was more higher than group without tinnitus by 3, 4, 6-divided classification and at 4,000Hz (p<0.05). 2.The prevalence rate by the criterion II was the highest. The criterion next to II in prevalence rate were criterion VII, VI, VIII, III, I, IV and V. 3.Among workers included criterion I, II, III, V, VI, VII, and VIII, all workers included criterion V compensated by the criterion IV. The criterion next to V in compensation rate were criterion I, III, VIII, VI, VII and II. 4.The criterion III, current evaluation criterion used in Korea for NIHL, did not include all workers compensated by the criterion IV. In conclusion, the criterion III, current health management criterion used in Korea for NIHL. did not include all workers compensated by the criterion IV. Thus, it is necessary that tht system, health management criterion and compensatory criterion are equally evaluated and we should keep up study of new evaluation criterion which satisfy the meaning of noise-specific health examination in the future.

일부 조선업종 근로자의 소음성 난청 유소견자의 관리 실태에 관한 조사 연구

손혜숙,문덕환,강종철,이종태,이채언 인제대학교 1998 仁濟醫學 Vol.19 No.2

소음 작업 근로자의 특수건강진단 결과 소음성 난청 유소견자로 판정된 근로자들의 증상 및 사후 관리 실태 및 보상 정도를 조사하여 사후 관리의 문제점 및 현행 소음성 난청 판정기준과 보상기준의 문제점을 파악하여 소음성 난청의 예방과 적극적인 사후 관리 제도를 수립하는데 도움을 주고자 본 연구를 실시하였다. 1993년과 1995년 사이에 특수건강진단결과 소음성 난청 유소견자로 판정받은 일부 대형 조선사업장의 197명의 근로자를 대상으로 하여 1996년 9월에서 12월까지 설문조사 및 순음청력검사 등을 실시하였다. 이들중 작업전환된 경우는 57명(28.9%)이었고 장해보상 신청후 산재보상을 받은 경우는 13명(6.6%)이었다. 일상 생활에서 이명(75.1%)과 TV시청(74.6%), 전화 통화(58.4%), 일상적인 대화(51.8%)의 방해로 인한 불편을 호소하였다. 이상의 결과로 보아 소음성 난청 유소견자에 대한 의학적 관리와 작업전환, 산재보상 등의 실질적인 사후관리 조치는 미흡한 것을 알 수 있다. 따라서 소음성 난청을 예방하기 위한 실질적인 청력보존 프로그램의 도입이 시급하며 보상기준과 진단기준의 차이로 산재보상을 받지 못하는 근로자들을 위하여 현행의 보상기준의 개선이 필요하다. Although noise induced hearing loss(NIHL) had been the most prevalent occupational disease in Korea since 1991, but their status of management was unsatisfactory. To study the status of management of workers diagnosed as NIHL from 1993 to 1994, 197 workers with NIHL in shipbuilding industries were reviewed. Questionnaire survey and audiometric test were performed and the results obtained were 35 follows ; 1.Among 197 workers with NIHL, 57 workers(28.9% ) were changed to different department and only 13 workers(6.6% had received compensation. 2.Mean hearing loss by frequency was the most prominent at 4,000Hz and 8,000Hz, mean hearing loss of workers by 3 divided method was 47.4dB (left ear) and 46.2dB(right ear) and that of 6 divided method was 51.9dB(left ear) and 54.9dB(right ear), respectively. 3.The workers with NIHL had problems in daily life which were conversation communication(51.8%), watching TV(74.6%), telephone communication(58.4% ), tinnitus(75.1%). In conclusion, the workers with NIHL had much problems in daily life because of tinnitus and hearing impairment but their status of management including medical treatment, change of department, compensation was unsatisfactory. Therefore, current diagnostic criteria and compensation criteria should be reevaluated and introduction of practical hearing conservation program seemed to be urgent to prevent NIHL.

선별 검사 코호트에서 복부 초음파로 진단된 지방간 관련요인

유병철,손혜숙,이종태,이용환 고신대학교보건과학연구소 2004 보건과학연구소보 Vol.14 No.-

Objectives : To observe prevalence and incidence rate of fatty liver, and investigate the factors related to the occurrence and disappearance of fatty liver diagnosed by abdominal ultrasonography. Methods : The data for abdominal ultrasonography, liver enzymes (aspartate aminotransferase : AST. alanine aminotransferase : ALT, γ-glutamyl transferase : GGT), serum lipids(total cholesterol, triglyceride, high density lipoprotein : HDL, low density lipoprotein : LDL), fasting blood sugar(FBS), body mass index(BMI), alcohol drinking, exercise, main foods were collected in 601 persons who were examined with health screening program in 2000 and 2002. Cross-sectional observation was done with the date in 2000 for the prevalence rates of fatty liver and its related factors. With 2 years follow-up data of cohort, the occurrence and disappearance rates and these relates factors were observed by multiple logistic regression. Results : The prevalence rate of fatty liver was 363/1.000 persons/year and the cumulative incidence was 47/1000 persons/year. In 42.1% of cases who was obese in 2000 and was normal in 2002, fatty liver was disappeared. The factors related to the occurrence of fatty liver were BMI and GGT and the factor related to the disappearance of fatty liver was triglyceride. Conclusion : For self care for fatty liver diagnosed by abdominal ultrasonography in health screening program, the most important lifestyle factor was weight control. The changing patterns of liver enzymes were corresponded with the change of status of fatty liver, so the levels of liver enzymes would be useful for the care and evaluation of fatty liver.

자궁경부암 병기결정에 있어서 전산화단층조영술의 효용성

최동희,김수녕,박찬규,김재욱,이종태,박찬,성혜리,이규영,유형식,정태섭 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.4

자궁경부암 병기결정에 있어서 전산화단층조영술의 효용성을 규명하고자 1985년 1월부터 1989년 3월까지 연세대학교 의과대학 산부인과학교실에서 침윤성 자궁경부암의 조직학적 진 단을 받고 입원, 병기설정을 위해 기초검사를 실시한 환자 472명을 대상으로 전산화단층조영 술과 경정맥 요로조영술, 방광경검사, 직장경검사와의 일치율, 양성예측도, 음성예측도, 민감 도 특이도를 비교하여 다음과 같은 결과를 얻었다. 1. 경정맥 요로조영술로 수신증이 진단된 경우는 III기 84명 18명으로 21.4%, IV기 7명중 6 명으로 85.7%, 전체 465명중 5.2%를 나타내었다. 2. 전산화단층조영술과 경정맥 요로조영술의 결과가 일치한 경우는 수신증이 나타난 경우가 19예, 나타나지 않은 경우가 412예로 98.9%의 일치율을 나타내었으며, 수신증에 대한 전산 화단층조영술의 양성예측도는 95% 음성예측도는 99%였다. 3. 방광침윤에 있어서 방광경검사와 전산화단층조영술의 일치율은 양성으로 일치한 경우 11 예, 음성으로 일치한 경우 157예로 92.3%였으며, 전산화단층조영술의 방광침윤에 대한 양성 예측도는 33.3%, 음성예측도는 100%였다. 4. 직장침윤에 있어서 직장경검사와 전산화단층조영술의 일치율은 양성으로 일치한 경우 1예, 음성으로 일치한 경우 415예로 95.2%였으며 전산화단층조영술의 직장침윤에 대한 양성예측 도는 6.3%, 음성예측도는 100%였다. Background / Aims : Hepatocellular carcinoma(HCC) is a drug - resistant tumor. The expression of a multidrug resistant gene, P- glycoprotein(P-gp) is a major mechanism of drug resistance. The aims of our study were, firstly, to observe the expression rate of P-gp in HCC tissue obtained by percutaneous P-gp and chemotherapetutic response ; and finally to investigate the correlation between p53 protein expression and P-gp expression. Subjects and Methods : We studied 29 cases IV HCC treated by systemic chemotherapy. Expression of P-gp and p53 were evaluated by immunohistochemical staining of HCC tissue with human monoclonal antibody, JSB-1(Anti P-gp) and DO-7(Anti p53 ), respectively. We analyzed the results of immunohistochemical staining of HCC tissues of patients in relation to chemotherapeutic response and other clinical characteristics. Results : The expression rate of P-gp was 27.6%. Partial response to anti-cancer chemotherapy was observed in 16.7% of the patients. Although we could not see a statistically significant association between P-gp expression and chemotherapeutic response, none of the responsive patients showed P-gp expression. P53 protein expression and chemottherapeutic response, none pf the responsive patients showed P-gp expression. P53 protein expression and P-gp expression. Conclusion : Although the number of our study subjects was small, chemotherapy responsive patients didn't show P-gp expression. P-gp expression might be used as a predictor pf response to potentially toxic anti-cancer cahmotherapy in HCC patients. Further study is warranted to confirm our results.