한 人口學徒의 回顧

金鐸一(T. I. Kim) 한국인구학회 1988 한국인구학 Vol.11 No.1

체외수정시술시 재수정에 의한 인간난자의 수정율과 난분할율에 관한 연구

김탁(T Kim),김선행(SH Kim),구병삼(BS Koo) 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.8

Faliure of fertilization of human oocytes in vitro may be due to incomplete follicular or oocyte maturation or sperm abnormalities. We investigated the fate of reinseminating oocytes with either the husband`s or donor`s spermatozoa on occasions when fertilization falls following the initial insemination from Feb, 1989 to Dec.1989 in the department of Obstetrics and Gynecology, Hae Wha hospital, Korea University. The performance of reinsemination after 22 hours does not have a role as a diagnostic fertilization test. The fertilization rate by reinsemination was 15.3%. Although overall fertilization rate is increased about 7% by reinsemination, none of these conceived. Therefore, it is suggested that there could be problem in viability after embryo transfer. Since there is limitation to decide maturity precisely at intial insemination, it is required to have more detail standards for classification in oocyte maturity. In conclusion, considering this matter, reinsemination procedure may not contribute in the improvement of clinical result at this moment.

Bochdalek공을 통한 선천성 횡경막 탈장증 1 예

김탁(T Kim),김진홍(CH Kim),나중열(JW Rha),홍성봉(SB Hong) 대한산부인과학회 1988 Obstetrics & Gynecology Science Vol.31 No.6

저자등은 21세의 건강한 임신부에서 36주에 부분 전치태반으로 제왕절개만출술을 시행하여 태어난 2900g의 남아에서 선천성 횡경막 탈장을 발견하여 수술을 권유하던 중 사망한 1례 를 경험하였기에 문헌적 고찰과 함께 보고하는 바이다. Congenital disphragmatic hernia occures about one in every 2200 new born infant and is a condition in which the abdominal contents protured into the thoracic cavity through a congenital defects in the diaphragm. congenital diaphragmatic hernia is divided into two types; one is herniation through the foramen of morgagni and the other is gerniation through the foramen of Bochdalek. Herniation trough the foramen of Bochdalek is the most common type of congenital diaphragmatic hernia nd requires emergency operation in the affected new born infants. Congenital disphragmatic hernia is frequency associated with congenital heart disease Down`s syndrome, hydrocephalus, undersceded testis, ureteral reflux meckel`s diverticulum, malformation of mid gut. We experienced one case of herniation through foramen of Bochdalek and presented this case

양성 난소기형종과 합병된 갑상선성유암종 1 예

김종오(JO Kim),김현수(HS Kim),장기훈(KH Chang),김탁(T Kim),이규완(KW Lee) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.3

Ovarian strumal carcinoid associated with mature cystic teratoma is rarer entity. Strumal carcinoid of the ovary is a type of germ cell tumor characterized by an intimate mixture of thyroid tissue and carcinoid. They are usually seen in postmenopausal women, and always bilateral. It is always benign, and treatment with a simple oophorectomy or salphingoophorectomy is effective. A case of strumal carcinoid with teratoma of the ovary in a 36 year old woman was presenter and reviewed briefly.

제왕절개술에 있어서 기존의 방법과 새롭게 개발된 FAST ( Finger Assisted Stretching Technique ) 법의 비교에 관한 연구

박용균(YK Park),정경우(GW Jeong),김탁(T Kim),허준용(JY Hur),김선행(SH Kim),서호석(HS Suh),강재성(JS Kang),조수용(SY hough),주갑순(KS Ju) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.1

The cesarean section has been considered as one of the most prime and most commonly performed operations in the obstetrics and gynecology field. In fact, all cesarean sections have depended upon the operator`s experience. However, there have been several cases reported on new technique of cesarean section in many developed countries, but not in Korea until we started the recent research. We have developed a new type of cesarean section named FAST(Finger Assisted Stretching Technique) through study on strength/weakness of other operation techniques as well as many other researches we conducted in the past plus our own experiences. To find the differences on the following subjects; operating time, postoperative complication, and recovery period. We compared and analyzed data from using new and traditional techniques. We selected 120 patients(group A using FAST: 45 patients, group B using traditional technique: 75 patients) as samples for this study. Together, they were all conducted cesarean section at Korea University, Guro Hospital between May 1993 and December 1995. Student-t-test and chi-square test were used for statistical analysis. We consider that below 0.05 for P value is statistically significant. The results of comparative study between two groups are; 1. There was no comparative difference on average age: group A: 29.6(range 23~39, S/D 7.1) group B: 31.1(range 24~38, S/D 5.4) 2. There was a significant difference on average operation times: group A: 15.4 min.(range 11~19, S/D 3.6) group B: 41.3 min.(range 23~50, S/D 19) 3. There was a significant difference on average amount of bleeding: group A: 580 ml(range 450~750, S/D 101) group B: 916 ml(range 800~1000, S/D 99) 4. There was a significant difference on the value of hemoglobin before & after operation group A: 0.8 g/dl(range 0.4~1.6, S/D 0.25) group B: 1.9 g/dl(range 0.9~2.6, S/D 0.21) 5. There was a significant difference on average period of hospitalization: group A: 3.7 days(range 3~4, S/D 0.7) group B: 6.4 days(range 5~8, S/D 0.6) 6. No one from group A experienced any infection, but 3 cases of wound infection and 2 cases of voiding difficulty were reported from group B. 7. 11 cases from group A and 16 cases from group B had laparotomy for some other reasons, later. There was no adhesion found in group A, but adhesions found in 2 cases from group B.

자궁경부에 발생한 원발성 암육종

강재성(JS Kang),김탁(T Kim),이희경(HK Lee),임내인(NI Lim),박문향(MH Park) 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.9

Primary carcinosarcoma of the uterine cervix is very rare neoplasms. Carcinosarcoma and mixed mesodermal tumor are different only in histologic appearance and they have a similar clinical course and prognosis. Carcinosarcoma consists only of intermingled carcinomatous and homologous sarcomatous component, and mixed mesodermal tumors demonstrate heterologous elements that take the form of striated muscles, cartilage or bone. The present report describes a 36-year-old woman diagnosed with primary carcinosarcoma of the uterine cervix. She was treated with radical hysterectomy and paraaortic cin-cyclophosphamide. We reviewed this patient with a brief literatures.

항공기 개발을 위한 소음해석 및 시험

박남은(N.E. Park),김탁(T. Kim),박좌근(J.G. Park),우철훈(W.H. Woo),최건묵(G.M. Choi) 한국소음진동공학회 2010 한국소음진동공학회 학술대회논문집 Vol.2010 No.4

자궁내막증 환자에 있어서 GnRH agonist ( Nafarelin Acetate ) 의 치료 효과

구병삼(BS Koo),김탁(T Kim),김영태(YT Kim) 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.12

The aim of this study is to evaluate the safety and efficacy of nafarelin acetate as a primary treatment for endometriosis. The patients were treated with [6-D-3-(2-naphtyl) alanine] GnRH, administered into the nostrilby means of a metered spray pump which delivers 100 mcl resulting in al dose of 200mcg per day for 6 months. After the completion of treatment, the laparoscopic scores, severity of symptoms, and adverse effects were assessed. The following results were obtained: 1. There was a statistically significant decrease in endometriosis scores in 28 (93%) of 30 patients treated. 2 Symptoms of endometriosis disappeared or decreased. 3. There was none of patients interrupted during treatment due to adverse effects. The data suggest that gonodotropin releasing hormone agonist nafarelin is a welcome and convenient addition to the available medical treatment regimens for women suffering from endometriosis.

자궁경부에 발생한 Adenoma Malignum ( Minimal Deviation Adnocarcinoma ) 의 1 예

이상희(SH Lee),오민정(MJ Oh),김탁(T Kim),이규완(KW Lee),나중열(JW Rha) 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.10

The Adenoma Malignum (Minimal deviation adenocarcinoma) of the uterine cervix is very rare and has been used for a cervical adenocarcinoma characterized by glands with a deceptively benign histological appearance. But the prognosis of this tumor is poor We experienced one case of Adenoma malignum forund in 33-year-old house wife performing hysterectomy and report this case with a brief veveiw of literature.

난포호르몬 및 황체호르몬치와 GnRH agonist 사용 체외수정시술의 예후

이낙우(NW Lee),송준(J Song),김탁(T Kim),김선행(SH Kim),구병삼(BS Koo) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.2

Although significant progress has been realized in the induction of follicular develpment,oocyte recovery,and the laboratory aspects of human in vitro fertilization(IVF),implantation rate and pregnancy rate after embryo transfer(ET) remain low. Among many variable factors related with implantation and early pregnancy maintenance, hormonal factor is thought to be important. Empirical hormonal therapy during periimplantation period was performed, but there is little information about the optimal hormonal environment during periimplantation period. To assess the prognostic importance of estradiol(E2) and progesterone(P4) levels on the day of hCG administration in IVF cycles treated with adjunctive GnRH agonist, we reviewed the 79 cycles underwent oocyte retieval for IVF after controlled ovarian hyperstimulation(COH) with GnRH-agonist and hMG/FSH exclusive of male factor and over 38 years old, from january 1995 to december 1995. Serum E2 and P4 levels were determined using radioimmunoassay(RIA) on the day of hCG administration(day 0). We analized IVF-ET outcome(number of oocytes,number of embryos transferable,fertilization rate,implantation rate and pregnancy rate/cycle) related to the serum E2 and P4 levels. The serum E2,P4 levels on the day 12 were measured to compare the luteal phase pattern of serum E2,P4 in conception and nonconception cycles. The followings are summarized results. 1. Absolute P4 level on the day 0 was related to the size of recruited follicular mass(FM) and number of embryos transferable(P < 0.0001, < 0.05) but not related to the fertilization rate(FR) and pregnancy rate(PR). 2. In lower corrected P4 level(day 0 P4/oocyte), FM was increased(P < 0.01). 3. Absolute E2 level on the day 0 was related to the size of FM and number of embryos transferable(P < 0.05, P < 0.01)and not related to the FR and PR, but implantation rate(IR) was increased in lower E2 group(P < 0.05). 4. Corrected E2 level(day 0 E2/oocyte) was not related to the FM and FR but IR and PR were increased in lower corrected E2 group(P < 0.05). 5. There was no significant differences in the absolute levels of P4 and E2 during the late luteal phase between the pregnant and nonpregnant cycles, but E2/P4 ratio in pregnant group was higher than that of nonpregnant group(P < 0.05). In conclusion, it is suggested that absolute level of steroids during late follicular phase has no impact on the PR in IVF cycles and high E2 level per oocyte may have adverse effects on the embyronic development as well as endometrial receptivity.