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전대준(Dae Joon Cheon),강은희(Eun Hee Kang),추형식(Hyung Sik Chu),채희동(Hee Dong Chae),김정훈(Chung Hoon Kim),강병문(Byung Moon Kang),장윤석(Yoon Seok Chang),목정은(Jung Eun Mok) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.11
N/A Objective: To compare the pregnancy outcomes of transvaginal multifetal pregnancy reduction (MFPR) according to the gestational period when the procedure was performed Methods: From January l995 to February 1998, total 27 patients with multiple pregnancy were included in this study. The patients were grouped to early MFPR group (<8 weeks, n=16) and delayed MFPR group (>8 weeks, n=ll) according to the gestational age that MFPRs were performed. All MFPRs were performed by transvaginal sonography-guided fetal aspiration or mechanical trauma. The complete pregnancy loss rate before 24 weeks of gestation, spontaneous loss of embryo, procedure-related complication, gestational age at delivery, and pregnancy complication were compared between the two groups. Statistical analysis of data was performed using Students t-test and Fishers exact test as appropriate. Statistical significance was defined as p<0.05. Results: There was no significant difference in the complete pregnancy loss rate between the early MFPR group (6.3%) and the delayed MFPR group (27.3%). The incidence of partial spontaneous loss of embryo in the two groups were not differed significantly (6.3% vs. 18.2%). The procedure-related complication of the delayed MFPR group (36.4%) seemed to be higher than that of the early MFPR group (6.3%), however there was no statistical difference (p=0,07). Especially, all 3 patients in whom the MFPR was performed after 10 weeks suffered from the procedure-related complication. The mean gestational age at delivery of the two groups were not differed significantly (36.3+2.8 weeks vs. 37.0+1.3 weeks). There was also no significant difference in the mean birth weights of the two groups (2378.8+563.7 gm vs. 2427.1+436.2 gm). Conclusion: Although there was no statistically significant difference, the early transvaginal MFPR might be a safe and useful method without significant adverse complications compared to the delayed MFPR.
장미윤(Mi Yoon Chang),전대준(Dae Joon Cheon),오동렬(Dong Yul Oh),이용성(Yong Sung Lee),이상훈(Sang Hun Lee) 대한약학회 1999 약학회지 Vol.43 No.6
Human and bovine dopamine transporters (DAT) demonstrate discrete functional differences in the dopamine (DA) transport and cocaine binding. The functional analyses on the chimeras of human and bovine DAT have revealed that the region from the 133rd to 186th residue (encompassing the 3rd transmembrane domain(TM)) is responsible for the substrate transport and cocaine binding. The present studies have been done to find out the specific amino acid(s) which is essential for the binding of cocaine to DAT by interchanging the amino acids in that region between human and bovine DAT. When isoleucine, the 152nd residue of chimera B3 (bovine DAT sequence), was transformed back to valine, the human DAT residue at the identical position, the cocaine binding was remarkably recovered to 98% of the human DAT values. In addition, the cocaine binding of the human DAT was decreased by 57% by substituting isoleucine for valine at position 152. When isoleucine at position 152. When isoleucine at position 152 of the chimera B3 was converted to the other amino acids to provide an possible molecular basis for the functional role of the 152nd residue, only the conversion to alanine among the amino acids tested significantly increased the cocaine binding by 34%, but these effects were not as much as those by the conversion to valine. In conclusion, valine at position 152 is a crucial amino acid for the interaction of cocaine to the DAT.
산후 출혈로 제왕절개 자궁적출술을 시행받은 41 예의 임상적 고찰
박영세,장영우,문태식,구자남,전대준,노정석,박준혁 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.10
목적: 제왕절개 자궁적출술을 시행받은 환자를 대상으로 발생 양상 및 임산부 예후 등을 분석함으로써 사망률 및 이환율 감소에 도움이 되고자 본 연구를 시행하였다. 연구 방법: 1987년 1월부터 1997년 12월까지 울산대학교병원에서 시행한 41예의 제왕절개 자궁적출술에 대해 분만대장 및 의무기록을 검토하여 분석하였다. 결과: 총 19,485예의 분만 중 제왕절개 자궁적출술의 빈도는 0.21%이었다. 4,917예의 제왕절개술에 의한 분만 중 32예(0.65%)에서, 14,568예의 질식 분만 중 9예(0.063%)에서 제왕절개 자궁적출술이 있었다. 산모의 연령과 분만력이 증가함에 따라 제왕절개 자궁적출술의 빈도는 증가하는 양상을 보였다(각각 p<0.05). 제왕 절개 자궁적출술의 적응증 중 유착태반(41.4%)이 가장 많았고, 자궁이완증(36.6%), 자궁파열(9.8%), 자궁근종이 동반된 임신(4.9%)의 순이었다. 수술 후 합병증은 수술 후 발열(26%), 빈혈(17.1%), 요로감염(14.6%), 파종성 혈관내 응고(7.3%), 방광 손상 등이었다. 임산부 사망은 1예가 있었으며, 사망원인은 패혈증 및 울혈성 심부전이었다. 부분 자궁적출술을 시행한 13예 중 9예(69.2%)에서 수술 후 합병증이 있었고, 전자궁적출술을 시행한 경우는 78.6%(22/28)에서 합병증을 보여서 두 수술 방법간에 유의한 차이는 없었다(p>0.05). 결론: 제왕절개 자궁적출술의 경우 수술 후 합병증이 많은 관계로 임산부 사망과 이환을 야기하곤 한다. 그러므로 적절한 산전진찰을 통한 위험군의 예측과 수술 시행 여부에 관한 정확한 판단이 요구된다고 사료된다. Objective: To evaluate the causes and maternal outcomes in patients who received cesarean hysterectomy operation. Methods: Forty one patients received cesarean hysterectomy at Ulsan university hospital for the 11 years, from January 1987 to December 1997. Results: The incidence of cesarean hysterectomy was 0.21% (41/19,485 deliveries). Cesarean hysterectomy was performed in 32 of 4,917 cesarean sections (0.65%) and in 9 of 14,568 vaginal deliveries (0.062%). The higher the age and parity of patients, the higher the incidence of cesarean hysterectomy were noted (p$lt;0.05, respectively). The most common indication of cesarean hysterectomy was placental disorders (41.4%), and that was followed by uterineatony (36.6%), uterine rupture (9.8%), uncontrolled bleeding with placenta previa (4.9%) and uterine myoma with pregnancy (4.9%). The postoperative complications were febrile morbidity, urinary tract infection, bladder injury, disseminated intravascular coagulopathy and wound disruption. There was one maternal death, the cause was sepsis and congestive heart failure. There was no significant difference between two operation methods in the aspect of postoperative complications (p>0.05). Conclusion: Postoperative complication still remains the main cause of maternal mortality and morbidity. Therefore, careful prenatal care, momentary judgement of right operation time must be conjunction with maternal lifesaving.