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이찬,이유미,이정노,이은혜,이병희 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.7
자궁의 동정맥기형은 드문 질환이지만 대량의 질출혈을 유발할 수 있다. 과거에는 자궁적출술이 유일한 진단법이자 치료법이었으나 최근에는 여러 가지 영상 기술의 발달로 인해 자궁 동정맥기형의 비침습적인 진단이 가능하게 되었으며 특히 카테타를 통한 자궁동맥 색전술은 최상의 치료법으로 인정받고 있다. 저자들은 자궁동맥의 코일 및 아교 색전술로 완치된 자궁 동정맥기형 1예를 경험하였으므로 관련 문헌 고찰과 함께 보고하는 바이다. Uterine arteriovenous malformations [AVMs] are rare cause of massive vaginal bleeding. In the past, hysterectomy had been the only method of diagnosis and treatment. With advent of many imaging modalities, noninvasive diagnosis of AVMs is possible and the transcatheter embolization has been accepted as a treatment of choice. We describe a case of uterine AVM presented with intractable vaginal bleeding and successful transcatheter embolization with coils and glue.
이사영(SY Lee),오봉환(BH OH),김봉희(BH Kim),박현준(HJ Park),김길동(GD Kim),이승학(SH Lee),이미영(MY Lee) 전력전자학회 1998 전력전자학술대회 논문집 Vol.- No.-
This paper presents PWM method which modulates two third period only during one cycle of power converter. This method is compared with the convention! sinusoidal modulation method applying to the power converter with large capacity necessitating low switching frequency. The presented modulation method enables to reduce power semiconductor rating, minimize switching loss, and improve the current wave form.<br/> <br/>
이종학,김종화,백원영,신반철,백상호,이순애,김명옥,이봉희,최완성 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.12
사람 태반에서 GnRH가 존재하는가 또한 자체합성되는가를 형태학적으로 확인하고 나아가서 GnRH 또는 GnRH mRNA가 태반내의 어느 부위에 주로 위치하며 이들의 분포가 임신시기에 따라 어떠한 변화가 있는지를 조사하기 위하여 임신중의 각 시기별 태반조직을 실험대상으로 GnRH에 대한 면역조직화학과 GnRH mRNA에 대한 in situ hybridization을 시행한 결과 다음과 같은 소견을 얻었다. 1. 사람 태반 조직내의 cytotrophoblast, syncytiotrophoblast, villous stroma 세포에서 GnRH peptide와 GnRH mRNA가 동정되었다. 2. GnRH peptide와 GnRH mRNA의 양성반응은 임신 전기간에 걸쳐 cytotrophoblast와 syncytiotro phoblast에서 거의 비슷하게 나타났으며 villous stroma에서는 임신이 진행함에 따라 점차적으로 강하게 나타났다. 이상의 소견으로 볼때 사람의 태반내에 국소적으로 GnRH 또는 GnRH 유사물질이 생성되어 존재하며 이들은 임신의 유지에 필요한 호르몬의 합성 및 분비에 조절인자로 작용할 가능성이 있으며 부분비(paracrine) 또는 자가분비(autocrine)역할을 할 것으로 사료된다. Localization of the GnRH and its mRNA was performed in the human placentas by immunohistochemistry and in situ hybridization techniques. Human placentas in first, second, and third trimester of normal pregnancy were obtained. These placentas were fixed with 4% paraformaldehyde and embedded in OCT compund, and sectioned by cryostat. For immunohistochemical study, avidin-biotin peroxidase complex(ABC) method and immunofluorescence method were employed and for in situ hybridization histochemistry, digoxigenin-dCTP labeled cDNA and ^35S labeled RNA probes were used and followed by autoradiography. GnRH and its mRNA were localized in the cytotrophoblast, syncytiotrophoblast, and villous stromal cells of the human placental villi. The distribution and intensity in GnRH immunohistochemistry were showed to be similar to those in GnRH mRNA in situ hybridization histochemistry. GnRH immunoreactivity and its mRNA signals were identified nearly constantly in both the cytotrophoblast and syncytiotrophoblast cells throughout gestation. However, those in the villous stromal cells were shown to be gradually increased with placental development, although not in the cells of early placenta. These results suggest that the local GnRH or GnRH-like substance may be synthesized in the human placental villi and may, thus, represent a local paracrine or autocrine role in endocrine control mechanism within the placenta.
초음파검사에 의한 한국인 태아의 임신주수별 태아성장지표의 정상치에 관한 연구
이재훈,김승욱,이진용,신희철,윤보현,전종관,이성구 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.10
본 연구는 1993년 서울대학교 의과대학 교육연구재단 산부인과학교실 지정연구기금의 보조로 이루어진 것임. Fetal weight and other fetal growth parameter gestational age tables have been calculated for 442 singleton fetuses by ultrasonic measurement. Twin pregnancies, stillborn and malformed infants were excluded as were those born to mothers with diabetes mellitus, preeclampsia, eclampsia and any medical and surgical illness during pregnancy that have any possibilities of altering fetal growth. The 5th, 10th, 25th, 50th, 75th, 90th and 95th percentiles were determined for 25-42th nearest weeks of gestation and compared with preexisting reportes by postnatal study. The results were as follows. 1. Fetal weight calculated by ultrasonic measurement in our prenatal study showed significant difference compared with that in previous postnatal studies before 37th nearest week of gestational age. 2. There were no significant growth velocity deceleration after 40th nearest week of gestational age. It is concluded that any growth standards based on prenatal study by ultrasonic measurement of fetal grwth parameters can be used as our standard without significant problems.
이현,신희철,윤보현,전종관,이재학,이용찬 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.11
Holoprosencephaly is a complex developmental abnormality of the brain arising from failure of cleavage of the prosencephalon during the fifth week of development. The prognosis of holoprosencephaly is generlaly grave. With recent development of high resolution ultrasonography, it is possible to detect fetus with holoprosencephaly antenatally. To ascertain clinical manifestations, we reviewed the records of 7 fetuses antenatally diagnosed as holoprosencephaly at Department of Obstetrics and Gynecology of Seoul National University Hospital from Nov. 1993 to Apr. 1996. The incidence of holoprosencephaly is 7/4,857(0.14%). Mean gestational age at diagnosis and delivery was 29 weeks of pregnancy(range from 17 to 37 weeks) and 30 weeks of pregnancy (range from 17 to 40 weeks), respectively. Modes of delivery were 1 cases of normal fullterm spontaneous delivery, 2 cases of preterm delivery, 2 cases of stillbirth, and 1 case of abortion. One case was lost after work-up for diagnosis and associated anomalies including targeted ultrasonography, fetal echocardiography, and karyotyping. Perinatal mortality was 83%(5/ 6) and only 1 case survived. Of 7 cases, 5 cases were alobar type and 2 cases were semilobar type. The frequency of associated anomaly was as follows: 5 cases of facial anomaly which were cyclopia, proboscis, single nostril, arhinia, and midline cleft lip and palate; 3 cases of cardiovascular anomaly; 2 cases of lung anomaly; 2 cases of limb anomaly; 1 case of gastrointestinal anomaly; 1 case of abdominal wall defect. Abnormal karyotypes were identified in 4 cases(57.1%) which include 2 cases of trisomy 13, 1 case of 46,XY, -13, M(+), and 1 case of 46, XX, 18p-. Fetus with holoprosencephaly shows a high incidence of associated anomaly and abnormal karyotyping. To predict prognosis accurately, it is desirable to confirm the diagnosis and type of holoprosencephaly and to find associated anoamly with high-resolution ultrasonography and to undergo fetal karyotyping.
이효표,김재원,박노현,이진용,오성일,이배훈,김문홍 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.7
Associated congenital anomalies of both reproductive and urinary tracts are frequent, because wolffian and mullerian developments are closely related. The combination of uterus didelphys, obstructive hemivagina, ana ipsilateral renal agenesis is a rare but specific syndrome. The most common clinical presentation is pelvic pain and/or dysmenorrhea shortly after menarche, in association with the finding of a vaginal or pelvic mass. An accurate and prompt diagnosis is of importance to permit treatment and to assure the future fertility of the patients. The simple and curative treatment of the condition is incision of the obstructing vaginal septum providing adequate drainage of the retained blood. We report three cases of uterus didelphys with an obstructed bemivagina and ipsilateral renal agenesis with a brief review of concerned literatures.