임신성 고혈압성 질환에 있어서 신사구체여과 값의 측정

박혜동(HD Park),이명우(MW Lee),최인호(IH Choi),김윤호(YH Kim),김수평(SP Kim) 대한산부인과학회 1981 Obstetrics & Gynecology Science Vol.24 No.1

저자들은 정상임신, 전자간증 및 자간증에서 신사구체여과치의 변화를 알아보기 위하여 1979년 3월1일부터 1980년 2월 28일까지 가톨릭의대부속 성모병원에 입원하여 치료받은 임 신성 고혈압성질환 환자중, 그 기록과 이화학적 검사기록이 확실한 경증 전자간증 20예, 중 증전자간증 26예, 자간증 20예와 산모 및 태아가 모두 건강하였던 초임부 20예 및 경산부 20예를 대조군으로 삼아 혈청 creatinine값은 spectrophotometry로 측정하였다. 24시간뇨중 creatinine값은 folin-Wumethod에 의하여 측정하여 신사구체여과치를 산출 비교관찰한 바 다 음과 같은 결과를 얻었다. 1. 혈청 creatinine의 평균값은 대조군에서는 0.93±0.18mg/dl, 경증 전자간증에서는 0.95±0.16mg/dl, 중증 전자간증에서는 1.07±0.21mg/dl이었고, 자간증에서는 1.19±0.20mg/dl 이엇다. 2. 24시간뇨중의 Creatinine의 평균값은 대조군에서는 76.75±9.33mg/dl이었고, 경증 전자간증 에서는 68.90±7.91mg/dl, 중증 전자간증에서는 65.85±8.91mg/dl이었고, 자간증에서는 59.45±5.65mg/dl이었다. 3. 24시간뇨량의 평균값은 대조군에서는 2207.5±313.4ml, 경증 전자간증에서는 1978.5±336.3ml 중증 전자간증에서는 1838.4±369.1ml이었고, 자간증에서는 1645.0±238.9ml 이었다. 4. 신사구체여과치의 평균값은 대조군에서는 128.72±19.83ml/min, 경증 전자간증에서는 99.62±13.01ml/min, 중증 전자간증에서는 78.69±9.53ml/min이었고, 자간증에서는 57.51±6.09ml/min이었다. 이상의 결과로 보아 중증 전자간증 및 자간증에서는 신사구체여과치의 감소가 현저한 것을 알 수 있었다. Renal funciton is reflected by many features such as glomerular filtration rate, excretion of water, electrolytes and metabolites. Renel function in normal pregnancy is altered as well as in pregnancy-induced hypertension. Glomerular filtration rate is the basis of most critical tests for renal function, which is probably a simple reflection of renal plasma flow. Although various reports have been made on decreased of GFR in hypertensive disorders in pregnancy compared to normal pregnancy, their decreasing values were contradictory . In this study , the rate of decrease of GFR in relation to classification of toxemia was evaluated . The results were as follows; 1. The mean serum creatinine value was 0.93±0.18mg/dl in control group, 0.95±0.16mg/dl in mild preeclampsia , 1.07±0.21mg/dl in severe preeclampsia and 1.19±0.20mg/dl in eclampsia. 2. The mean creatinine value of 24 hours urine was 76.75±9.33mg/dl in control group, 68.90±7.91mg/dl in mild preeclampsia , 65.85±8.91mg/dl in severe preeclampsia and 59.45±5.65 mg/dl in eclampsia 3. The mean total volume of 24 hours urine were 2207.5±313.4ml in control group, 1987.5±336.3 ml in mild preeclampsia , 1838.4+-369.1 ml in severe preeclampsia and 1645.0±238.9 ml in eclampsia. 4. The mean GFR were 128.72±19.83ml/min in control group, 99.62±13.01ml/min in mild preeclampsia , 78.69±9.53 ml/min in severe preecampsia and 57.51±6.09ml/min in eclampsia. GFR of severe preeclampsia and eclampsia showed significant difference from that of control group.

신뢰도 핸드북의 DataBase 아키텍처

박희도 ( Park,Hd·lee ),이웅근 ( Wg·jang ),장중순 ( Js·park ),박상철 ( Sc ) 한국품질경영학회 2019 한국품질경영학회 학술대회 Vol.2019 No.-

Purpose: Efficient management of reliability handbooks when developing reliability prediction software. Methods: The reliability handbook information is analyzed and divided into characteristics.Generate tables by characteristics and design Architecture. Results: Multiple reliability handbooks can be designed in the same DataBase Architecture Conclusion: Other prediction software includes handbook information inside the software, making it impossible for users to check the information in the handbook themselves. This can lead to problems where users are not informed about the reliability prediction basis of the component. Using the DB structure proposed in this paper, the information in the reliability handbook can be DB, giving the user the problem of checking the handbook in writing. In addition, different types of failure rate handbooks can be written in the same structure to operate efficiently from a software perspective.

임신한 질횡경막증의 1예

최형달(HD Choe),박원길(WK Park),박상무(SM Park),이태호(TH Lee) 대한산부인과학회 1973 Obstetrics & Gynecology Science Vol.16 No.9

A case of tranverse vaginal septum with pregnancy, concealing cervix, bilateral openings of a few millimeters in diameter, is presented with a brief review of the concerned literatures.

소뇌 충부에 발생한 거대 미성숙 기형종 : 치험 1례

박강화,조철민,김형동,최순섭,허기영 釜山醫師會 2001 釜山醫師會誌 Vol.37 No.12

정상산모와 임신성 고혈압산모에서의 혈장내 Atrial Natriuretic Peptide (ANP)

박일수,조영래,이태호,손효돈 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.1

정상산모와 임신성 고혈압산모(PIH)의 혈장내 ANP농도의 변화를 규명하기 위하여 1989년 3월 1일부터 5개월간 본원 산실에서 분만한 정상산모 20명과 PIH산모 18명을 관찰대상으로 하고 비임신 정상여성 17명을 대조군으로 하여 조사한 바 그 성적을 다음과 같이 요약한다. 정산산모의 혈장 ANP농도는 30.8±18.7pg/ml로서 정상 비임신 대조군의 19.7±8.2pg/ml보다 높았으나 유의차는 없었고, PIH산모의 혈장 ANP농도는 71.3±37.1pg/ml로서 정상산모나 정상 비임신 대조군보다 유의하게 높았다(p$lt;0.05). 중증 PIH산모의 혈장 ANP농도는 95.2±33.1pg/ml이고 경증 PIH산모의 농도는 47.4±23.4pg/ml로서 그 차이는 유의하였다(p$lt;0.05). 정상산모와 경증 PIH산모에서 분만 1주후의 혈장 ANP농도는 정상 비임신 대조군의 수치와 거의 비슷하였으며, 중증 PIH 산모는 분만 2주후에 혈압이 정상화되면서 ANP치가 정상 비임신 대조군의 수치와 거의 일치하였다. PIH산모에서 혈장 ANP농도는 수축기혈압과 유의한(p$lt;0.05) 상관관계(R=0.52633)가 있었으며 이완기혈압과는 무관하였다. Atrial natriuretic peptide (ANP) with potent natriuretic, diuretic, and smooth muscle relaxant activities is synthesized and secreted from atrial myocytes. Although the precise mechanism involved in the mediation of ANP secretion is unclear, atrial pressure and atrial stretch consequent to volume expansion appears to be one of the most important stimuli for ANP release. A striking hemodynamic changes occur in women during pregnancy that may alter plasma ANP concentration. We measured plasma ANP concentrations by specific radio-immunoassay method in 20 normal pregnant women and 18 pregnancy induced hypertensice (PIH) women. The mean plasma ANP concentration in normal pregnant women was higher (30.8 ± 18.7 pg/ml) than in young normal nonpregnant controls (19.7 ± 8.2 pg/ml), but not statistically significant. In PIH women, the mean concentration of plasma ANP was significantly higher (p $lt; 0.05) than in both normal pregnant women and normal nonpregnant controls. The mean plasma concentrations of ANP in severe and mild PIH women were 95.2 ± 33.1 pg/ml and 47.4 ± 23.4 pg/ml, respectively, and there was statistical (p $lt; 0.05) difference between two groups. The mean plasma ANP concentration in normal pregnant and mild PIH women fell to nonpregnant levels at postpartum one week (13.1 ± 6.0 and 22.8 ± 13.1 pg/ml). In contrast, the mean concentration of plasma ANP of postpartum one week in severe PIH women was still higher (34.9 ± 12.0 pg/ml) than that of nonpregnant controls, but fell to nonpregnant level as blood pressure returned to normal. When plasma ANP concentrations in PIH women were compared with the simultaneously measured blood pressure, a positive correlation (p $lt; 0.05) was found between plasma ANP concentrations and the systolic blood pressure, but no positive correlation was found plasma ANP concentrations and the diastolic blood pressure.

원발성 Krukenberg종양 1 례

박일수,이태호,이영미,남윤성,손효돈,이택후 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.5

수술시 동결절편검사상 Krukenberg종양으로 진단되어 이후 원발병소에 대한 조사를 하였으나 원발병소를 확인할 수 없었던 원발성 난소 Krukenberg종양이라고 생각되어지는 1예를 경험하였기에 간단한 문헌고찰과 함께 그 증례를 보고하는 바이다. Krukenberg tumor is one of the malignant ovarian cancers, which has characteristic pathologic findings. We have experienced a case of primary Krukenberg tumor that we could not find the primary focus at any other organs. So we report this case with a brief review of concerned literature.

체외수정시술을 시행한 한국인 산모에서 질식 초음파를 이용한 임신 제 1 삼분기의 정상 두정둔부 길이에 대한 연구

박중신,신희철,문신용,윤보현,전종관,채희동,윤지성,허창영 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.9

The crown-rump length(CRL) remains the most accurate parameter used for gestational dating. We aimed to establish the early fetal growth with CRL range in Korean women. The CRL of 48 singleton pregnancies which resulted from in vitro fertilization and e mbryo transfer(IVF-ET) at SNUH were assessed two to six times in the first trimester by transvaginal ultrasonography. All women included in this study went on to deliver norma l infants at 37 completed weeks or after weighing over 2.5 kg. And we also studied the relationship between CRL(in millimeters) and gestational age(in days), and found that the following second-order polynomial might be applied either to expect CRL using the menstrual gestational age, or to estimate gestational age using measured CRL(r²=0.980, p=0.0001). CRL=0.0175(GA)²-1.049(GA)+19.17 GA =7.5593(CRL-3.45)^½+29.97 Finally we compared our data with some of published articles which assessed CRL in spontaneous and induced pregnancies. In conclusion, this study establish the early fetal growth with CRL range in Korean women on the basis of exact ovulation timing using high resolution transvaginal ultrasonography. And these data will be of great use in the evaluation of fetal growth in the first trimester.

자궁근종에 대한 임상통계학적 연구

양희동,남철,서호성,김창수,장병곤,박세준 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.6

1989년 1월 1일부터 1994년 12월 31일까지 만 6년간 부산의료원 산부인과에 입원하여 수술을 받고 자궁근종으로 확진된 245예를 대상으로 임상 및 병리학적 연구를 하여 다음과 같은 결과를 얻었다. 1. 자궁근종의 빈도는 18.1%이었다. 2. 연령분포는 40~49세가 60%로 가장 많았고 평균연령은 43.9세이었다. 3. 임신경험이 한번도 없었던 경우가 6.9%이었고, 평균임신 횟수는 4.9회, 평균분만 횟수는 2.9회이었다. 불임인 경우는 8.2%에서 관찰되었으며 이중 원발성은 7.8%, 속발성은 0.4%이었다. 4. 발생부위는 체부가 96.3%, 경부가 3.7%이었고, 조직학적으로는 근내형이 58%, 혼재형이 18.7%, 장막하형 13%, 점막하형 10.2%의 순이었다. 5. 주소가 동통인 경우가 85.3%, 이상자궁출혈인 경우가 52.2%, 종류감이 19.2%순이었다. 6. 평균 혈식소치는 10.9g/dl이었으며, 혈식소치가 10g/dl이하인 경우가 33.5%이었다. 7. 자궁근종의 크기는 절제된 자궁 또는 자궁근종의 무게는 201~300g인 경우가 53.4%로 가장 많았고 평균 무게는 274.4 g이었다. 8. 자궁근종의 이차변성은 11.8%에서 보였으며, 초자양변성이 4.8%로 가장 많았다. 9. 자궁근종과 합병된 병변은 84.9%이었고, 이중 만성 경부염이 39.6%로 가장 많았다. 10. 월경과다증은 45.7%에서 나타났으며, 월경과 다증과 자궁근종의 조직학적 발생부위, 자궁선근증 사이에는 유의한 상관관계가 있었다(p$lt;0.05). 그러나 자궁무게와 월경과다증 사이에는 유의한 상관관계가 없었다(p$gt;0.5). 11. 월경곤란증은 39.2%에서 나타났으며, 월경곤란증은 자궁근종의 발생부위, 조직학적 발생부위, 자궁의 무게와 유의한 상관관계가 없었으나(p$gt;0.5), 자궁선근증이 병합된 경우에 유의한 상관관계를 보였다.(p$lt;0.05). 12. 수술방법은 78.4%가 복식전자궁적출술 및 자궁부속기적출술, 15.1%에서 복식전자궁적출술만을 시행하였으며, 복식부분자국적출술 2.9%, 자궁근핵적출술 1.6%, 질식자궁적출술이 2%에서 시행하였다. 13. 술후 합병증은 17.5%에서 나타났으며, 상처감염이 34.9%로 가장 많았으며 수술에 따른 심각한 합병증이나 사망은 1례도 없었다. From January, 1989 to December, 1994, 245 cases of uterine myoma were treated at the department of Obstetrics and Gynecology, Pusan Medical Center. A clinico-statical study on these 245 cases of uterine myoma was performed to understand the clinical characteristics of uterine myoma. The following results have been obtained: 1. The incidence of uterine myoma among 1,352 cases of major gynecologic surgery during this period was 18.1%. 2. Uterine myomas were observed most frequently in the age group 40 to 49 years, and the mean age was 43.9 years old. 3. The parity was 2.9 in average, the infertility was observed in 20 cases(8.2%) in while the primary infertility was 7.8%, the secondary 0.4%, respectively. 4. The corporeal myomas were observed in 236 cases(96.3%), whereas cervical myomas were 9 cases(3.7%). The intramural types were observed in 142 cases(58%), combined types in 46 cases(18.7%), subserous types in 32 cases(13.1%), submucous types in 25 cases(10.2%), respectively. 5. The most of frequent chief complaint was pain which was observed in 209 cases(85.3%), the next abnormal uterine bleeding in 137 cases(52.2%), palpable mass in 47 cases(19.2%), respectively. 6. The mean value of preoperative Hb was 10.9gm/dl, and transfusion was performed in 43 cases(17.5%). 7. The mean weight of the resected uterine myoma was 274.9 gm. 8. The secondary changes in uterine myomas were found in 29 cases(11.8%) and the most common change was hyaline degeneration(4.8%). 9. The most common associated conditions with myomas were chronic cervicitis(39.6%). 10. Hypermenorrhea was observed in 112 cases(45.7%) and there were significant correlations between the presence of hypermenorrhea and the type of myoma(p$lt;0.05), adenomyosis(p$lt;0.05) but no correlation with the weignt and location of myoma(p$gt;0.5). 11. There were no significant correlations between the dysmenorrhea and the weight of myoma, location of myoma, and types of myoma(p$lt;0.5). The incidience of dysmenorrhea was significantly higher in cases with adenomyosis than that in cases without adenomyosis(p$lt;0.05). 12. Total abdominal hysterectomy was performed in 37 cases(15.1%), total abdominal hysterectomy with unilateral adnectomy in 109 cases(44.5%), total abdominal hysterectomy with both adnexectomy in 83 cases(33.9%), vaginal hysterectomy in 5 cases(2%), and myonectomy in 4 cases(1.6%), respectively. 13. The postoperative com;lications were found in 43 cases and the most common complication of these was wound infection seen in 15 cases(34.9%).

Advanced Mixed Germ Cell Tumor 1 예

박일수 ( IS Park ),이태호 ( TH Lee ),이영미 ( YM Lee ),남윤성 ( YS Nam ),손효돈 ( HD Sohn ) 대한산부인과학회 1991 Obstetrics & Gynecology Science Vol.34 No.12

난소의 혼합생식세포종은 그 어휘의 혼동으로 인해 분류가 정확치 못하여 실제보다 더 적은 수가 보고되어 왔고 또한 희귀하여 많은 연구가 요구되는 바 현재 그 특성 및 치료방법이 점차 밝혀지고 있으며 그 예후가 개선되고 있어 저자들은 조선대학교 부속병원 산부인과에서 미분화세포종, 내배엽동종, 태생암, 융모상피암으로 구성된 혼합생식 세포종양을 경험하였기에 문헌고찰과 함께 보고흔 바이다. Malignant mixed germ cell tumors of the ovary are those neoplasms composed of more than one malignant germ cell component. We have experienced a case of mixed germ cell tumor composed of choriocarcinoma, embryonal carcinoma and immature teratoma. So we present this case with a brief review of concerned literature.

대량수혈로 인해 조절되지 않는 거대 후복막강출혈을 복강내 Radiotapes 폐색으로 조절한 1 예

정인배,한혁동,차동수,김대현,이영진,김영국,박천식 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.4

저자들은 대량수혈후 생긴 범발성 혈관내 혈액응고나 응고기전의 장애로 인해 지혈되지 않는 복강내 출혈이 복강내 radiotapes 폐색으로 조절될 수 있다는 것을 경험하였기에 문헌과 함께 보고하는 바이다. In traabdominal packing with radiotapes for surgically uncontrolled hemorrhage from retroperitoneal injuries exacerbated by the hypothermia, acidosis and caogulopathy regained popularity over the past decase. In this case, intraabdominal radiotapes packing was done for uncontrollable hemorrhage from retroperitoneal injury after cesarean section. As a result intraabdominal packing helped achieve hemostasis of coagulopathy due to massive transfusion in the face of surgically uncontrolled bleeding.