The Effect of Omeprazole-cholestyramine resinate and the Change in Signaling pathway on Reflux Esophagitis incduced Surgically in Rats

IW Kim,BJ Kil,YM Choi,YS Min,CY Shin,TS Lee,YW Lee,IH Huh,UD Sohn 대한약학회 1999 大韓藥學會 總會 및 學術大會 Vol.48 No.-

한국 임산부의 혈청매독검사에 관한 고찰

양인환(IW Yang),김철영(CY Kim) 대한산부인과학회 1967 Obstetrics & Gynecology Science Vol.10 No.2

It is well known that syphilis in pregnancy is injurious to mother and fetus. The prevention of prenatal syphilis y treatment of the infected mother with penicilin during pregnancy is one of the major triumphs in modern medicine. Siphilis in pregnancy has decreased in almost all countries in the world. The trepoema pallidum, the causative agent, is very sensitive to penicillin and registant strains have not been found yet. Neverthless there is still a vast reservoir of infection and an alarming amount of undiscovered syphilis in the population. Recent information, obtained by the Medical Clinics of North America for the years 1960 to 1961 shows that the total number of reported cases of infective syphilis has risen three times in United States. In Korea, there is little documentary evidence of increase of syphilis since 1963. The diagnosis and treatment of syphilis in pregnancy are the same as for any syphilitic person, except that here werare not only concerned with curing the pregnant woman but also hope to avoid congenital syphilis in the baby. In some cases we may be pressed for time and forced to modify our general rules of diagnosis and treatment, in an effort to avoid the birth of a syphilitic infant. In order to know the current pattern of syphilis among pregnant women, 2838 women who delivered at Severance Hospital from 1962 to June, 1966, were analysed and the following retults were obtained. 1. During the 4½ years from Jan. 1962 to June. 1966, the rate of positive V.D.R.L. test`s was 5.2%. The rate of biological false positive test among the positie V.D.R.L. tests was 54%. 2. 51% of the gravidas reeived a V.D.R.L. test during or after delivery. Only 20% of the positive cases received the test prior the 7th month of gestation. 3. The majority of the patients with positive v.D.R.L. and R.P.C.F. test were primigravidas 25-30 years in age. 4. 92% of the syphilitic pregnnt women had latent syphilis. 5. Either a stillbirth or a premature delivery was noted in 48% of the positive R.P.c.F. untreated cases. 83% of the premature infants died during the neontal period. There were no deaths among the term infants. 6. Emphasis is placed upon the necessity of finding and treating all cases of syphilis during pregnancy. 7. In addition to general deucations about syphilis, it is reommented that pre-marital seroligic tests for syphilis be requird by law.

경동맥 내막-중막 두께와 관상동맥질환의 심한 정도와의 상관관계

박기락,김기영,윤상미,배장호,성인환 대한순환기학회 2003 Korean Circulation Journal Vol.33 No.5

제왕절개술로 분만한 산모에서 합병된

노재숙,김학순,정은환,지일운,민경준,오예근 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.7

폐동맥 색전증의 발생은 예측이 불가능하며 질환의 진행 속도가 빨라 신속한 처치가 이루어지지 않을 경우 매우 치명적인 임산부 사망의 주요 원인이다. 폐동맥 색전증은 특징적인 임상증상 및 징후가 동반되는 경우가 흔치 않으므로 조기진단이 어렵다. 그러나, 위험요인을 가지고 있는 산모에서 의심되는 증상 발현 시 신속한 진단과 치료로 치명적인 합병증을 예방할 수 있다. 그러므로, 본 저자들은 제왕절개술 후 폐동맥 색전증이 의심된 산모에서 신속한 헤파린 투여와 폐관류 스캔으로 조기 진단과 치료가 가능했던 임상 경험을 문헌 고찰과 함께 보고하는 바이다. Pulmonary embolism is one of the most fatal maternal complication, that abruptly happens and rapidly progresses, and has been a major cause of maternal death recently. Early detection of pulmonary embolism is difficult, because there is not any specific clinical symptoms and signs. However, fatal complication might be preventable, if we could diagnose and treat it earlier in high risk group. Therefore, We present here three cases of pulmonary embolism following cesarean section, which were promptly diagnosed by lung-perfusion scan and treated successfully with heparin infusion.

자궁선근증의 임상 및 병리학적 고찰

김용문(YM Kim),박일왕(IW Park),강윤석(YS Kang) 대한산부인과학회 1979 Obstetrics & Gynecology Science Vol.22 No.8

Authors observed ninety one patients with adenomyosis during the periods November 1968 through April 1977 in Korea General Hospital, Seoul. A clinical and pathological analysis were performed and results were as follows. 1. 91 instances of adenomyosis were found in 490 hysterectomies for various reasons, showing an incidence of 18.6%. 2. Age distributions were between 24 and 53 years, and 53.8% of patients were found in 36 to 45 years old age group. Average age was 41.7% years old. 3. Adenomyosis was the most frequently found in parous women who had four children. 4. Menometrorrhagia was the most common symptom of adenomyosis, 43.8% of all cases. 5. Myoma of the uterus was the most common combined disease in adenomyosis, an incidence of 29.7%. 6. The most common type of degree of involvement by adenomyosis was moderate involvement, an incidence of 43.9%. 7. Endometrial findings of adenomyosis showed secretory endometrium in the highest incidence, 42.9% of all cases. 8. Adenomyosis combined with external endometriosis was 6 cases(6.6%). 9. Additionally, 16 cases of external endometriosis was found in 1100 exploratory laparotomies excluding cesarean sections, an incidence of 1.45%.

산전 초음파로 진단된 태변성복막염 1 예

노재숙,김학순,정은환,지일운,민경준,오예근 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.6

태변성복막염은 임신후반기나 초기 신생아시기에 산전의 장폐색과 장천공으로 인해 발생하는 복막의 화학적 복막염의 일종이다. 복강내로 무균의 태변이 방출되어 특징적인 석회화나 복수가 나타나고 산전에 초음파로 진단이 가능하다. 태변성복막염을 산전초음파로 진단하여 적절하게 치료함으로써 신생아의 치명율이나 이환율을 낮출수 있다. 저자들은 임신 39주에 산전초음파로 진단한 태변성복막염을 경험하여 문헌고찰과 함께 보고하고자 한다. Meconium peritonitis is a chemical or foreign body reaction of the peritoneum resulted from the prenatal small bowel perforation associated with or without obstructive lesions and malformation during late intrauterine or early neonatal periods. Extravasation of sterile meconium into the peritoneal cavity causes an intense peritoneal reaction resulting in characteristic calcification and ascites which might be observed by the prenatal ultrasonographic examination. Prenatal ultrasonographic detection of the meconium peritonitis allows the preparation for the proper management which should reduce the mortality and morbidity of the neonate. Recently, a case of prenatal meconium peritonitis diagnosed by ultrasonography at 39th gestational weeks was experienced at our department. We represent this case with a brief review of literature concerned.

자궁외임신의 기대요법

노재숙,김학순,정은환,지일운,강지연 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.9

To evaluate the role of expectant management in ectopic pregnancy, all patients with ectopic pregnancy were included to this study if their vital signs were stable. Ectopic pregnancy was diagnosed with transvaginal ultrasound, serum beta-hCG titer, and endometrial biopsy. Patients with ectopic fetal pole and/or fetal heart beat were treated with methotrexate and were excluded. Patients with unstable vital signs were treated laparoscopically and were excluded. Twelve (80%) of 15 patients were spontaneously recovered without any surgrcal or medical treatment. The initial serum beta-hCG level of successful group was significantly lower than that of failed group (547 mIU/ml, range 55∼1332 vs. 1,700 mIU/ml, range 1,653∼6,171; p=0.0117). Expectant management is a useful form of treatment for selected cases of ectopic pregnancy.

도플러 제대동맥 혈류파형검사로 산전진단된 무심쌍태아 1 예

이제호,김승욱,정재현,노정래,양순하,지일운 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.12

Sonographic prenatal diagnosis and management of a twin pregnancy complicated by acardia of one twin is presented. Doppler umbilican artery velocimetric studies demonstrated reversed blood flow of umbilican artery in malformed twin and markedly different umbilical artery systolic to end-diastolic(S/D) ratio in the twins. Because of suspected fetal distress of normal twin, preterm cesarean delivery of both twin was perfomed at 31st week of gestation and resulted in survival of the healthy normal twin.

배란장애를 동반한 다낭성 난소증후군에서 혈중 Inhibin A , B와 성선자극호르몬의 연관관계

노재숙,김학순,지일운,손보라 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.7

목적: 상당수의 PCOS 여성은 배란장애를 동반하지만, 일부는 정상주기를 보이는데, 이러한 임상적 차이를 가져오는 내분비학적인 원인에 대해서 알려진 바는 별로 없다. 본 저자는 이전의 연구에서 배란장애 동반여부에 따른 inhibin 중합체의 농도는 차이가 없음을 확인하였으므로, inhibin A, B 각각의 농도를 측정하여 배란장애가 동반된 PCOS에서 inhibin A, B가 성선자극호르몬과 어떠한 관련이 있는지 비교 분석하고자 한다. 연구방법: 경질초음파 검사상 일측 혹은 양측 난소에 8mm 이하의 소낭포가 10개 이상 보이면서, 내분비학적으로는 혈중 LH의 기저농도가 5.8 IU/L이상이거나 LH/FSH비가 1.2이상인 40예를 PCOS 대상군으로 정하였다. 월경주기가 규칙적인 경우는 난포기[월경주기 3∼5일째]에, 희발월경이나 무월경인 경우는 주사용 황체호르몬제재 200 mg을 근주하여 소퇴성 출혈 3일째에 채혈하여 LH와 FSH, E2, prolactin, TSH, T, DHEA-S, inhibin A 그리고, inhibin B 의 농도를 측정하여 각 호르몬의 농도를 비교하였다. 결과: 대상군 40예중 정상주기군이 15예이었고 배란장애군이 25예[63%]로 PCOS의 상당수가 배란장애를 동반하였다. FSH의 농도는 양군간에 차이가 없었으나, LH의 평균값은 각각 6.6 IU/L 과 9.9 IU/L로 배란장애군에서 유의하게 증가하였으며[p = 0.0149], LH/FSH 비도 배란장애군에서 1.3으로 정상주기군의 0.8에 비해 증가되어 있었다. 또한 T의 농도도 배란장애군에서 유의하게 증가되어 있었다[p = 0.0252]. 그러나, E2 이나 DHEA-S는 양군간에 차이가 없었으며, inhibin A, B의 경우도 의미있는 차이를 발견할 수 없었다. 정상주기군에서는 inhibin A, B가 성선자극호르몬과 어떠한 연관관계도 나타내지 않았으나, 배란장애군에서는 FSH가 inhibin A와 의미있는 역상관관계를, LH/FSH비가 inhibin A, B와 의미있는 정상관관계를 나타내었다. 결론: 배란장애가 동반된 PCOS에서 inhibin A와 FSH 사이에 역상관관계, inhibin B와 LH/FSH 사이에 정상관관계가 나태난다는 것은, PCOS에서 배란장애가 일차적으로는 뇌하수체의 LH 분비이상에 의한 것이고, 이차적으로는 비대해진 난포막 세포로부터 분비된 inhibin A, B가 FSH의 생물학적 활성을 떨어뜨리거나 분비를 낮춤으로써 뇌하수체의 LH, FSH 분비 불균형을 더욱 악화시킨 결과로 추측된다. Objectives: Normal and abnormal follicular growth and steroidogenesis depend on gonadotropins as well as intraovarian peptides. Inhibin also affect follicular development and steroidogenesis and may play a role in dominant follicle selection and follicular atresia. Therefore, we studied the differences of serum inhibin A, inhibin B and gonadotropin levels according to the regularity of menstrual cycle in the women with polycystic ovary syndrome[PCOS]. Materials and Methods: Women who showed typical appearance of polycystic ovaries by transvaginal ultrasonography and had basal serum levels of luteinizing hormone $gt; 5.8 IU/L or LH/FSH ratio $gt; 1.2 were selected. Patients with abnormal prolactin level or thyroid function were excluded. Among PCOS, fifteen women had had normal regular menstrual cycles[25∼35 days] for at least 6 months before the study, and the others had been oligo-amenorrheic. Blood samples were obtained on the cycle day 3∼5 after normal menstrual or progesterone withdrawal bleeding. Serum levels of inhibin A, inhibin B, luteinizing hormone[LH], follicle stimulating hormone[FSH], estradiol[E2], testosterone[T] and dehydroepiandrosterone-sulfate[DHEA-S] were compared and analysed between the two groups. Statistical analysis was performed using Student`s t-test and the Spearman correlation coefficient. Results: Serum LH, T levels and LH/FSH ratio were significantly greater in the group with oligo-amenorrheic, cycle than those in regular cycle. Basal levels of inhibin A and B were not different between the two groups. A significant negative correlation between inhibin A and FSH level was seen in the group with oligo-amenorrhic cycle[P$lt;0.005], but not in the group with regular cycle. Also significant positive correlation was noted between inhibin B level and LH/FSH ratio in the group with oligo-amenorrheic cycle[P$lt;0.001], but not in the group with regular cycle. Conclusion: In oligo-amenorrheic PCOS, higher LH[or LH/FSH] may cause hypertrophy of thecal cells and stimulate androgen and inhibin secretion. In addition, higher androgen can be converted into estrogen by extraovarian tissues. Thus, inhibin A, B and steroids [T, estradiol] may exaggerate disparity in basal LH and FSH levels, and be directly associated with ovulatory disturbance in PCOS, otherwise, in which the endocrine or paracrine influence of inhibin A, B might be enhanced.

모체혈액내에 존재하는 태아세포 분리시기에 관한 연구

문영규,지일운,지관자,김석찬 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.12

In the future, fetal cells in the maternal blood may be a source of material for routine screening for prnatal diagnosis in the first trimester for any woman who wishes to be tested. In order for this to become a reality, the timing of the appearance of fetal cells in the maternal circulation must be defined accurately. So, our work have focused on $quot;when during gestation can fetal cells best be recovered$quot; and whether they are then present and available in sufficient numbers for analysis throughout the pregnancy. Samples were collected from 162 women pregnancy between 7 and 25 weeks of getation and we analyzed the nRBC ratio(%) within total isolated nucleated cells by differential counts(Diff-Quik stained). In this study, we have some conclusions; The results of our study of fetal cell isolation was very encouraging(sucessful rate: 91.35%). It is possible to isolation of nRBC in all pregnant women during 9~25 weeks of pregnancy, although the best period for fetal cell recover was 11~15 weeks of gestation.