임신과 동반된 Eisenmengers Syndrome

황익하,임경주,김두표,이남기,이봉규,윤경옥 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.10

저자들은 비교적 희귀한 질환인 Eisenmengers syndrome 1례를 경험하였기에 이에대한 문헌적 고찰과 함께 보고하는 바이다. We have experienced 1 case of pregnancy with Eisenmengers Syndrome in Incheon Christian Hospital. Eisenmengers Syndrome may be defined as severe pulmonary hypertension due to a gigh pulmonary vascular resistance, associated with reversed or bidirectional shunt through a large communication between the two circulation at Aorto-Pulmonary, Ventricular or Atrial level. It is clear that women with this condition tolerate pregnancy poorly. We report this rare case with a brief review of concerned literature.

복강경 난관불임술 후 발생한 속발성 복강임신 1 예

황익하,전선희,김두표,임전주,송희진,이장현,윤용복,박상욱 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.1

Abdominal pregnancy is a very rare and life threatening variant of ectopic pregnancy with high maternal mortality and perinatal mortality. In most instances abdominal pregnacy is secondary, result from tubal abortion and from rupture of tubal pregnancy or a previous uterine incision. The conceptus then reimplants onto the peritoneal surfaces, omentum, and bowel. We experienced a case of abdominal pregnancy after laparoscopic tubal sterilization diagnosed at emergency laparotomy and reported it with brief review of a literature.

임신 10 개월의 흔적자궁각 임신

황익하,김두표,이남기,이봉규,윤경옥 대한산부인과학회 1991 Obstetrics & Gynecology Science Vol.34 No.2

1. G2P1L1D0A0인 31세된 기혼환자로, 흔적자궁임신이 10개월까지 유지되어 반복제왕절개술을 시행하여 1.95 kg, A/S 1`-5, 5`-7의 여아를 분만하였다. 2. 치료는 임신된 흔적자궁각, 부착된 자궁부속기 및 원형인대를 절단제거한 후 절단부를 결찰하였으며 원형인대를 주자궁과 연결하였다. Pregnancy in a rudimentary uterine horn is very rare case. We experienced a case of rudimentary uterine horn with 40 weeks gestation. After delivered a living female baby weighing 1.95 kg with A/S 1`-5, 5`-7 by cesarean section, excision of rudimentary uterine horn was performed. And some articles concerned to this subject are reviewed briefly.

복강임신

황익하,전선희,김두표,임전주,김병수,이정래,박덕련,송희진 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.10

Abdominal pregnancy is extremely rare, which is one of the most dangerous conditions, obstetrically. Abdominal pregnancies are classified as either primary or secondary. Primary abdominal pregnancy is much less common. The diagnosis is very difficult. Frequently the diagnosis is made during pregnancy. We experienced a case of abdominal pregnancy in first trimester and reported it with brief review of a literature.

난소암환자의 혈청내 변형 Ribonucleoside에 관한 연구

황익하,김용석,한중수,고재경 한양대학교 의과대학 1990 한양의대 학술지 Vol.10 No.1

In order to investigate whether the modified ribonucleosides in serum could be used as specific tumor markers for serous cystadeno-carcinoma(SCACa) and mucinous cystadenocarcinoma(MCACa) of ovary, analysis of serum samples from normal female controls and patients with these ovarian carcinoma was performed using reversed phase HPLC. For this study, a rapid and precise chromatographic method for the determination of very small amounts of modified nucleosides in serum by HPLC has been developed. The ribonucleosides were prefractionated with boronate affinity gel column. 1. The concentration of total modified nucleosides in serum of patients with SCACa was increased by 28% as compared to normal control level. Patients with SCACa had significantly higher concentrations of pseudouridine (Ψ), 5-methylcytidine(m??C), 4-thiouridine(s??U), 1-methylguanosine(m¹G), 4-acetylcytidine(ac⁴C), N², N²-dimethylguanosine(m²₂G) and N??-methyladenosine(N??A) than normals. Among these elevated nucleosides, positive rates ofΨ, m??C, s⁴U and ac⁴C as markers for this cancer were observed to be 55%, 91%, 100% and 55%, respectively. 2. When compared to normal control value, total modified nucleoside content in serum of patients with MCACa was increased to as high as 18%. Contents of Ψ, m??C, 7-methylguanosine (m??G), s⁴U, ac⁴C, 2-methylguanosine(m²C), m²₂G and N??A were significantly increased in serum of patients with MCACa. And positive rates of m??C, s⁴U and N??A were observed to be 76%, 100% and 65%, respectively, as markers for MCACa. 3. The concentrations of adenosine and cytidine in serum were significantly decreased but those of uridine and inosine in serum were increased significantly in both patients with SCACa and MCACa of ovary. The results suggested that serum levels of Ψ, m??C, s⁴U, and ac⁴C for the ovarian SCACa and those of m??C, s⁴U and N??A for the ovarian MCACa could be used as diagnostic or biochemical markers.

15 ( s ) - 15 Methly Prostaglandin F2α질정에 의한 중기 임신 중절 및 만삭유도분만에 관한 연구

황익하(IH Whang),김세광(SK Kim),송찬호(CH Song),곽현모(HM Kwak) 대한산부인과학회 1978 Obstetrics & Gynecology Science Vol.21 No.2

1976년 9월부터 1977년 2월까지 연세대학교 의과대학 부속 세브란스병원 산부인과에 중기 임신중절이나 유분만을 목적으로 입원한 환자중 임신중절 18예, 유도분만 7예, 총 25예에 대하여 15(s)-15 methyl prostaglandin F2α 질정을 사용하여 중기 임신중절 및 유도분만을 시행하여 다음과 같은 결론을 얻었다. 1. 성공률은 중기 임신중절의 경우 94.4%였고 유도분만의 경우 100%였다. 2. 평균 소요시간은 중기 임신중절의 경우 17.71시간이었으며 유도분만의 경우 14.01시간이었다. 3. 질정의 평균 사용량은 중기 임신중절의 경우 11.82mg, 유도분만의 경우 9.28mg이 사용되었다. 4. 부작용으로는 오심과 설사가 각각 21예(84%)로 가장 빈번하였으며 구토가 15예(60%)이었다. 그 중 설사가 평균 발생횟수 4.33회로 가장 많이 발생하였으며 1。C 이상의 발열반응은 5예(20%)에서 볼 수 있었다. 5. 질정 삽입중 현저한 혈압 및 맥박의 변화는 없었다. 6. 이상의 결과로 보아 15(s)-15 methyl prostaglandin F2 질정은 중기 임신중절이나 유도분만에 매우 효과적인 방법이나 부작용의 빈도가 높은 문제점이 있다. A Study of 15(s)-15 Methyl Prostaglandin F2α Vaginal Suppositories for Midtrimester and Induction of Labor The study is a clinical analysis of 25 cases who were admitted to the Dept. of Ob. & Gyn. of Severance Hospital from September 1976 to February 1977. The results of study were as f ollows: 1) The abortion was successfully induced in 17 cases (94.4%) of 18 cases and succe ssful induction-delivery was 100%. 2) The mean abortion time was 17.71 hours and the mean induction-delivery time was 14.01 hours. 3) The mean total dosage of 15(s)-15 methyl prost aglandin F2 was 11.82mg in mid-trimester abortion and 9.28mg in induction-delivery. 4) Th e most common side effects consist of gastro-intestinal symptoms such as neusea (84%), diar rhea (84%), vomitting (60%) and temperature elevation (2%). 5) No significant changes occurr ed in blood pressure and pulse rate.

자궁외임신의 임상통계학적 고찰

최대경,황익하,전선희,김두표,김병수,이남섭,이정래,박덕련,송희진 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.11

1991년 1월1일부터 1994년 12월31일까지 4년간 인천 기독병원 산부인과에 자궁외임신으로 진단되어 입원 치료한 환자 120예를 대상으로 임상적 고찰을 하였던 바 다음과 같은 결과를 얻었다. 1. 총분만건 수에 대한 자궁외임신의 빈도는 1:46.1이었다. 2. 빈반연령은 25-29세의 연령군이었다. 3. 초산부는 35.0% 미산부는 32.5%였으며 대상의 73.3%가 인공유산 경험이 있었다. 4. 과거력상 가능한 유발유인을 보면 1회이상이상의 인공유산 경험이 있은 경우가 73.3%, LTS수술 13.3%, 골반염증성 질환이 9.7%의 비율로 나타났다. 5. 마지막 생리 제1일부터 증상이 나타나기까지의 기간을 보면 6-8주가 42.5%로 가장 많았다. 6. 증상에 따른 분석을 보면 하복부 동통이 93.3%에 나타났으며 질출혈이 85.8%환자에서 나타났다. 7. U-HCG test상 92.3%의양성율을 보였다. 8. 착상부위는 난관부가 96.7% 자궁각 부위에 2.5% 난소부위가 1.7%를 차지하였다. 9. 치료의 51.7%는 환측 난소 난관절제술이 차지하였으며 환측 난관절제술을 31.2%의 환자에서 시행하였다. 10. 120례 중 사망한 례는 없었다. This study was done for a clinical evaluation and statistical analysis of 120 cases who were admitted and treated at Department of Obstetrics and Gynecology, Inchon Christian hospital from January 1, 1991 to December.31 1994. The main results were as follows ; 1. The incidence of ectopic pregnancy was 1 to 46.1 deliveries. 2. The most frequent age group was in 25-29 years of ages 3. Primigravida was 11.7%, nullipara was 32.5% and 73.3% of cases have been experienced artificial abortion. 4. In the past history of possible predisposing factors, 73.3% had artificial abortions 13.3% had laparascopic tubal sterilization PID was in 9.7%. 5. THe most frequent interval between LMP and the onset of symptoms was 6-8 wks in 42.5% 6. On symptomatological analysis, low abdominal pain was encountered in 93.3%, vaginal spotting and bleeding in 85.83%. 7. Of 120 patients tested urine HCG test positive result was in 92.3%. 8. Implantated site were tubal pregnancy in 96.7% cornual pregnancy in 2.5% ovarian pregnancy in 1.7%. 9. Unilateral salpingoophorectomy was applied in 51.7% of cases for treatment and unilateral salpingectomy was in 31.2%. 10 There was no fatal case in 120 ectopic pregnancy.

자간증에 관한 임상적 고찰

김세광(SK Kim),황익하(IH Whang),이상용(SR Lee),홍순배(SB Hong),박찬규(CK Park),정순오(SO Chung) 대한산부인과학회 1978 Obstetrics & Gynecology Science Vol.21 No.9

1965년 1월부터 1976년 12월까지 만 12년간 연세대학교 의과대학 부속 세브란스병원 산부인과에 입원, 분만하였던 산모 총 21,704명중 224예의 자간증을 대상으로 의무기록부의 자료를 중심으로 임상통계학적으로 분석을 하여 다음과 같은 결과를 얻었다. 1) 총분만수에 대한 자간의 발생빈도는 1000분만당 10.3이었고, 연도별로는 특기할만한 변화가 없었다. 2) 임신자간, 분만자간, 산욕자간의 빈도는 각각 70.1%, 19.2%, 10.7%였다. 3) 연령별 분포는 분만수가 제일 많은 25-29세군에서 38.9%로 가장 많았다. 4) 경산회수별 분포는 초산부가 66.5%, 경산부가 33.5%였다. 5) 계절별로는 동계에 29.4%로 가장 많았고 춘계, 추계, 하계의 순이었다. 6) 임신기간에 따른 분포는 37-40주군이 66.5%로서 가장 많았고, 평균임신기간은 37.7주였다. 7) 산전관리를 받지 않았던 경우가 86.1%로 대부분을 차지하였다. 8) 경련회수는 1회가 29.5%로 가장 많았으며, 경련과 분만사이의 시간은 25-72시간군이 38.5%로서 가장 많았다. 9) 동반된 질환은 조기파막이 27.1%로서 가장 많았고, 빈혈이 22.9%, 쌍태아와 만성고혈압성 혈관질환이 각각 14.3%였다. 10) 분만방식은 질식분만이 88.9%, 제왕절개술이 11.1%였으며, 질식분만중 자연분만이 49.1%로서 가장 많았으며 제왕절개술의 적응증중 아두골반불균형이 6.2%로서 가장 많았다. 11) 질식분만의 마취는 회음부 차단마취가 52.2%로서 가장 많았으며, 국소마취와 전신마취가 각각 12.9%, 1.4%였으며, 제왕절개술시의 마취방법은 대부분이 전신마취였다. 12) 모성사망율은 자퇴하거나 전과시킨 경우를 제외하고는 자간증의 병발증으로 인하여 4명의 사망환자를 기록하여 모성사망율은 100,000 생아출생당 19였으며, 모성사망의 원인으로서는 패혈증, 뇌졸증, 폐부종 및 급성신부전증이었다. 13) 출생시 태아체중에 따른 예후는 사산이 11예, 신생아사망 8예로서 사산율은 1,000 출생당 48.2, 신생아사망율은 1,000 생아출생당 36.9로서 그 주산기사망율은 1,000 출생당 83.3이었다. 14) 태반의 무게는 600-699gm 군이 41.7%로서 가장 많았다. 15) 입원시에 혈압은 수축기혈압이 160-199mmHg군이 48.3%, 이완기혈압이 110-129mmHg군이 49.5%로서 가장 많았다. 16) 입원시 혈색소는 12.0-13.9gm%군이 49.1%로 가장 많았고, 10.0gm% 미만인 경우도 7.1% 있었으며, 혈구용적지표는 36.0-41.9%군이 48.7%로서 가장 많았다. 17) 혈액의 주요 화학적 검사소견인 Na, In order to study a variety of epidemiological and clinical aspects of ecalamptic patients, a retrospective survey of obstetric records of 224 eclamptic patients, who were admitted between 1965 and 1976, was carried out in the Yonsei University Medical Center. The results were as follows: 1. The incidence of eclampsia was 10.3 per 1,000 deliveries. 2. The distribution of antepartal, intrapartal, and postpartal eclampsia was 70.1%, 19.2%, and 10.7% respectively. 3. 38.9% of the patients were in the age 25-29, which was most prevalent childbirth group. 4. 66.5% of the patients were primigravids. 5. 29.4% of the patients occurred in winter which was followed by spring, autumn, and summer in order. 6. 66.5% were in the gestational period 37-40 weeks. The average duration of gestation was 37.7 weeks. 7. 86.1% of the patients received no antenatal care. 8. 29.5% of the patients had a single convulsion, which was most frequent number of convulsion. 38.5% of the patients convulsed within 25-72 hours before and after delivery. 9. Among the associated diseases, the incidence of SPRM was 27.1% and anemia, twins, chronic hypertensive vascular disease were 22.9%, 14.3%, 14.3% respectively. 10. 88.9% of the patients were delivered vaginally, 11.1% were performed cesarean section. Among the vaginal delivery, 49.1% delivered spontaneously. The most frequent indication for cesarean section was CPD(6.2%). 11. 52.2% of the patients received pudendal blocks. In case of cesarean section the majority had general anesthesia. 12. The maternal mortality from eclampsia managed in YUMC was 19 per 100,000 live births. 13. The stillbirth rate was 48.2 per 1,000 births and the neonatal mortality rate 36.9 per 1,000 live births. The overall perinatal mortality rate was 83.3 per 1,000 births. 14. 41.7% of the patients were in the placental weight 600-699, grams. 15. 48.3% of the patients were in the systolic BP 160-199mmHg on admission and 49.5% the diastolic BP 110-129mmHg. 16. 49.1% of the patients were in the hemoglobin level 12.0-13.9gm%

子宮頸管 妊娠 3例

朴勝昌,李正一,朱活,黃益夏,趙東濟 中央醫學社 1983 中央醫學 Vol.45 No.3

Three cases of cervical pregnancy which was recently experienced in our depa-rtment are presented with a brief review of related literature.

난소임신 5예

김두표,이남기,정진영,황익하,유석권,임경주 대한산부인과학회 1987 Obstetrics & Gynecology Science Vol.30 No.4