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중증임신전자간증 임산부에서 임신 후반기 발생한 심장근육병증을 동반한 급성폐부종
조혜연 ( Hye Yon Cho ),전현아 ( Hyun Ah Jun ),문철용 ( Cheol Yong Moon ),권형준 ( Hyoung Jun Kwon ),김선숙 ( Sun Suk Kim ),송지은 ( Ji Eun Song ),이근영 ( Keun Young Lee ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.12
Women with severe preeclampsia or eclampsia who develop pulmonary edema most often do so postpartum and some of these women have cardiac failure. Peripartum cardiomyopathy is defined as a cardiac failure occurring in the latter part of pregnancy or in the peripartum, without obvious cause and prior evidence of heart disease. It is very rare but the mortality rate is as high as 10~50%. Here, we describe a case of a woman who has undergone emergency Cesarean section due to complicated severe preeclampsia with acute pulmonary edema and peripartum cardiomyopathy at 33+1 weeks of gestation.
조상선 ( Sang Son Cho ),김윤하 ( Yoon Ha Kim ),김종운 ( Jong Woon Kim ),조혜연 ( Hye Yon Cho ),송태복 ( Tae Bok Song ) 대한산부인과학회 2011 Obstetrics & Gynecology Science Vol.54 No.4
Spontaneous retroperitoneal hematoma in pregnant woman is extremely rare entity which has not been reported. Although this condition can lead to lethal situation, there is no definite diagnostic tool and treatment for patients with retroperitoneal hematoma. We present a case of spontaneous retroperitoneal hematoma in a pregnant woman who recovered without any operation or intervention.
김윤하 ( Yoon Ha Kim ),조혜연 ( Hye Yon Cho ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.8
임신부 90% 이상에서 여러 이유로 임신 중에 약물을 복용하게 된다. 실제로 임신 중 약물투여가 그 임신부와 태아에게 어떠한 영향을 미치는 지 결정하는 것은 매우 힘든 일이다. 때로는 임신부와 태아 건강을 위하여 필수적으로 약물을 투여하는 경우도 있다. 이럴 때는 전문가의 적절하고 정확한 정보가 필요하다. 임신부가 약물을 복용했거나 할 때는 이에 대한 위험성과 이점을 반드시 전문의와 상의하여 불필요한 유산을 방지해야 한다. 여기서 임신 중에 흔히 접하는 약물사용에 대하여 자세하게 정리하고 한다. More than 90% of pregnant women take drugs or use social drugs (such as tobacco and alcohol) or illicit drugs at some time during pregnancy. In general, drugs, unless absolutely necessary, should not be used during pregnancy because many can harm the fetus. The wrong informations of the drugs make an unnecessary termination. Sometimes drugs are essential for the health of the pregnant woman and the fetus. In such cases, appropriate and correct informations of drugs must be taken by specialist. Pregnancy women should talk with her doctors about the risks and benefits of taking the drugs. This article suggests general informations about using drugs in pregnancy.
P16(INK4A)와 Galectin-3의 면역 염색발현과 자궁경부 신생물의 진행과의 관련성 연구
김선숙 ( Sun Suk Kim ),조혜연 ( Hye Yon Cho ),강성원 ( Sung Won Kang ),김홍배 ( Hong Bae Kim ),박성호 ( Sung Ho Park ) 대한산부인과학회 2011 Obstetrics & Gynecology Science Vol.54 No.4
목적: 이 연구의 목적은 자궁경부의 신생물의 진행에 따른 p16(INK4A)과 galectin-3의 면역 염색 발현 정도를 비교하여 자궁경부 병변의 진단상의 도움이 될 수 있는지를 확인하고자 하였다. 연구방법: 2005년부터 2009년 사이의 총 87개의 포르말린에 포매된 자궁경부조직(정상, 20; low grade intraepithelial lesions [LSILs], 17; high grade intraepithelial lesions [HSILs], 26; 침윤암, 24)을 이용하여 p16(INK4A)와 galectin-3 면역화학염색을 시행하여 발현정도를 비교하였으며 p16(INK4A)와 galecen-3염색정도에 따라 점수를 준 후에 병변의 진행정도와 점수를 비교 평가하였다. 결과: p16(INK4A)와 galectin-3의 평균발현 정도는 정상에서 0.1과 1.70, LSILs에서는 1.35와 2.17, HSILs에서는 3.42와 3.11, 침윤암에서는 3.79와 3.08이었다. p16(INK4A)와 galectin-3의 발현빈도는 자궁경부신생물의 진행 정도에 따라 증가되는 소견을 보였다(P<0.05). 결론: p16(INK4A)와 galectin-3의 발현정도는 면역화학염색 시행 시 자궁경부 신생물의 진행에 따라 증가되었다. 따라서 p16(INK4A)와 galectin-3의 면역화학염색은 자궁경부신생물의 진행을 진단하는데 도움이 될 수도 있으리라 생각된다. Objective: The aim of this study is to investigate whether the expressions of p16(INK4A) and galectin-3 are associated with the progression of cervical neoplasia and to evaluate its usefulness as a diagnostic tool. Methods: Eighty-seven formalin-fixed paraffin-embedded cervical specimens (20 normal, 17 LSILs, 26 HSILs, 24 invasive cervical cancers) collected between 2005 and 2009 were selected. We examined the expression of p16INK4A and galectin-3 using immunohistochemical stains with the scoring system. Results: The mean proportion of p16(INK4A) and galectin-3 was 0.1 and 1.70 in normal lesions, 1.35 and 2.17 in LSILs, 3.42 and 3.11 in HSILs, 3.79 and 3.08 in invasive cancers. The mean proportion of p16(INK4A) and galectin-3 was correlated significantly with the degree of neoplasia (P<0.05). Conclusion: The increased immunohistochemical staining expressions of the p16(INK4A) and galectin-3 are associated with the progression of cervical neoplasia. Therefore immunohistochemical staining of p16(INK4A) and galectin-3 can be a useful biomarker for the diagnosis of a progression of cervical neoplasia.
김은경 ( Eun Kyoung Kim ),송태복 ( Tae Bok Song ),김윤하 ( Yoon Ha Kim ),조혜연 ( Hye Yon Cho ),김종운 ( Jong Woon Kim ),김철홍 ( Chul Hong Kim ),조문경 ( Moon Kyoung Cho ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.12
Ureteral injury is usually iatrogenic in origin, in particular as a result of laparoscopic or gynecological surgery. Ureterouterine fistula constitute a rare subset of iatrogenic genitourinary fistulas. The most common presentation of ureterouterine fistula is in women who have had a cesarean section. The management options include conservative therapy (spontaneous healing), endourologic (stented repair) or open surgical operation (ureteroneocystostomy or ureteroureterostomy). Herein, we report on a case of ureterouterine fistula in a 33-year-old woman who underwent a cesarean section. The 17th day after the operation, she complained watery vaginal discharge. Clinical and urographic assessments revealed an iatrogenic ureterouterine fistula and an ureteroneocystostomy was performed after 3 months.
주우철 ( U Chul Ju ),김윤하 ( Yoon Ha Kim ),김종운 ( Jong Woon Kim ),조혜연 ( Hye Yon Cho ),송태복 ( Tae Bok Song ) 대한산부인과학회 2011 Obstetrics & Gynecology Science Vol.54 No.3
The uterine myoma is the most common benign tumor in gynecologic field, but rarely occurs in the vagina, especially in pregnancy. The vaginal myoma usually arises from the anterior vaginal wall and may be confused with a variety of gynecologic problems, like the cystocele or uterine prolapse. By ultrasonography in antenatal care, the more cases of uterine myoma and those adverse effects during pregnancy are more frequently detected, but this case of vaginal myoma is not. The patient, was diagnosed for cystocele at first, had Cesarean section delivery at gestational age 37+5 weeks and anterior colporrhaphy, but the protruded vaginal mass was recurrent. So, the patient was managed surgically by transvaginal myomectomy and the final diagnosis was myoma. We experienced this case of suburethral myoma of the vagina in pregnancy, so report this case with brief review of literature.
임신 중 비타민 C와 비타민 E 투여 후 임신부 정맥혈장과 제대정맥혈장내 지질과산화물, 항산화능 및 항산화 비타민 농도
김윤하 ( Yoon Ha Kim ),김종운 ( Jong Woon Kim ),김철홍 ( Chul Hong Kim ),조문경 ( Moon Kyoung Cho ),김석모 ( Seok Mo Kim ),강우대 ( Woo Dae Kang ),조혜연 ( Hye Yon Cho ),양성렬 ( Sung Yeul Yang ),안봉환 ( Bong Whan Ahn ),송태복 ( 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.11
목적: 임신 중 비타민 C와 비타민 E 투여 후 만삭임신부 정맥혈장과 제대정맥혈장내 지질과산화물, 항산화능 및 항산화비타민 농도의 변화를 알아보고자 하였다. 연구 방법: 초임부 또는 이전 자간전증이나 만삭전 조기양막파열 기왕력이 있었던 임부에게 무작위로 임신 15주에서 20주 사이부터 만삭 (임신 37주 이후) 분만 전까지 하루에 비타민 C 1,000 mg 과 비타민 E 400 IU를 투여했던 실험군 20명과 투여하지 않았던 대조군 20명을 대상으로 하였다. 비타민 투여 전과 분만직전 임부의 상완정맥혈액과 분만 후 제대정맥혈액을 채취하였다. Thiobarbituric acid (TBA) 반응을 이용하여 지질과산화물 농도를 측정하였고 Cao 등의 방법으로 항산화능을 측정하였으며, high performance liquid chromatography (HPLC)를 이용하여 아스코르빈산, 요산, 레티놀, 알파-토코페롤, 감마-토코페롤 및 베타 카로텐 농도를 측정하였다. 결과: 실험군에서 비타민 투여 후 임부 혈장내 지질과산화물 농도는 감소하였고, 항산화능 농도와 알파-토코페롤 농도는 증가하였다. 실험군의 제대정맥 혈장내 농도는 대조군에 비해 지질과산화물 농도는 낮았고, 항산화능 농도와 알파-토코페롤 농도는 높았다. 결론: 임신 중 비타민 C와 비타민 E 섭취로 임신부 정맥혈장과 제대정맥혈장내 지질과산화물은 감소하고 항산화능은 증가하였으며, 비타민 C 농도는 변화가 없었지만 비타민 E 농도는 증가하였다. 이는 임신부 혈액내 산화제-항산화제 불균형을 초래하는 산화적 스트레스로 생기는 산과적 질환의 예방적 목적으로 비타민 섭취가 이용될 수 있으며 태아의 항산화능에도 영향을 줄 수 있으리라 사료된다. Objective: This controlled trial investigated the effect of supplementation with vitamins C and E on the lipid peroxide, antioxidant ability, and antioxidant vitamin levels in full term maternal and umbilical venous plasma. Methods: Forty pregnant women were randomized in this study. They were nulliparous or multiparous women with history of preeclampsia or preterm premature rupture of membranes (PPROM). Twenty women were given vitamin C (1,000 mg/day) and vitamin E (400 IU/day) from 15~20 gestational weeks to delivery. The others were not given, as a control group. Maternal venous blood was obtained before vitamin supplementation and just before delivery. Umbilical venous blood was obtained after delivery. Lipid peroxide level and oxygen-radical absorbance capacity (ORAC) were measured by thiobarbituric acid reaction and Cao`s method, respectively. Ascorbic acid, uric acid, β-carotene, retinol, α-tocopherol, and γ-tocopherol were measured by high performance liquid chromatography. Results: Supplementation with vitamins C and E was associated with decrease in lipid peroxide levels and increase in ORAC values and α-tocopherol levels in maternal venous plasma. And it was also associated with decrease in lipid peroxide levels and increase in ORAC values and α-tocopherol levels in umbilical venous plasma. Conclusion: Supplementation with vitamins C and E may be beneficial in the prevention of oxidant-antioxidant imbalance origin diseases such as preeclampsia, PPROM. And it also may affect antioxidant ability of the fetus.