양수과다증 85 례의 임상적고찰

김현주(HJ Kim),홍경화(KW Hong),홍희선(HS Hong),전정희(JH Jeun) 대한산부인과학회 1988 Obstetrics & Gynecology Science Vol.31 No.11

1981년 1월부터 1986년 12월까지 일신기독병원에서 진단된 양수과다임신 85예, 97태아의 임 상적 고찰의 결과는 다음과 같다. 1. 발생빈도는 1000분만당 2례(0.2%)였다. 2. 초임부에서 적게 발생하며 20-24세에 많고 25-29세에 적게 발생했다. 3. 85례중 93.8%에서 질식 분만ㅇ르 하였고, 6.2%에서 제왕절개수술을 했다. 둔위 분만이 병 원 비에 비해 10배이상 높았다. 4. 모체 및 분만에 따른 합병증으로 조기 진통이 가장 흔한 합병증이었고, 다태 임신, 임신 성 고혈압 동반이 현저히 높았으며, 태반 조기 박리와 산후 출혈의 빈도도 높았다. 5. 태아 합병증으로는 27.8%의 사산률과 54.6%의 신생아 사망률을 보였으며, 75.2%의 조산 아와 51.5%에서의 태아 기형을 보였다. 주산기 사망율이 1000분만당 824.7명이엇고, 교정 주산기 사망률도 1000분만당 505명이었다. A review of 85 cases of hydramnios which occured among 42280 delivery, an incindence 0.2% at Il sin Christian hospital between January 1st. 1981 and December 31st 1986 is presented. Hydramnios was defined as those cases in which the volume of liquor was measured as 2000 mls or more. Associated maternal and fetal conditions were evaluated and compared to the clinical course and outcome of each pregnancy. Among the 85 cases of hydramnios the associated factors was multiple gestation 12 cases (14.1%) pre-eclampsia 10 cases (11.8%) and 50 caese with congenital malformation but in 25 cases (29.1%) no cases could be found . 32 (38.9%) cases were associated with spontaneous onset of premature labour and 19 (22.4%) were associated with abnormal presentation. There were 97 infants delivery and these 73 (75.2%) were premature. The total perinatal morthality rate was 824.7 per 1000 delivery and even when it was corrected to exclude to babies with malformations incompatible with life and those under 1000gm the perinatal mortality rate was still 505 per 1000 delivery. Appropriate mangagement is essential in order to reduce maternal complications and where possible perinatal mortality and early diagnosis of fetal abnormalities by ultrasonogram is an essential part of the management.

Serrated Edged Macro Morcellated[SEMM] 방식의 자궁적출술에 대한 임상 고찰

김현주(HJ Kim),김상향(SH Kim),황연희(YH Hwang),김은규(EG Kim),전정희(JH Jeun) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.5

Objective: The purpose of this study was to evaluate the advantage and safety of subtotal hysterectomy in women with benign gynecologic diseases. Methods: A retrospective study of 37 cases of CASH and 20 cases of CISH, 55 cases of TAH at Il Sin Christian Hospital from October, 1996 to December, 1998. Statistical analysis was performed using the Scheffe test. Results: The operation time was 110±31.9min in CASH, 230.5±65.7min in CISH, 145.3± 30.8min in TAH and there was statistical significance between 3 groups, mean blood loss in TAH[466.4±320.7cc] was much more than CASH[277.6±162.2cc], CISH[220±212.4cc], so there was statistical significance[p<0.05]. The complication rate was 10.8% in CASH, 10% in CISH, 30% in TAH. The complication rate was higher in TAH, so there was statistical significance. The hospitalization day was 6.5±0.95days in CASH, 6.4±1.09days in CISH, 7.5±1.19days in TAH, hospitalization day of TAH was significantly longer than CASH, CISH[p<0.05]. Conclusion: Subtotal hysterectomy is efficient and safe operation substitutes for total hysterectomy in women with benign gynecologic disease. We noticed that cervix is not a useless organ, so it should not be removed without a proper indication.

Change of Nitric Oxide Synthasesfrom Epicardium to Endocardium in Rat Cardiac Ventricular During Ischemic Preconditioning

Chong DV,Kim NR(김나리),Youm JB(염재범),Joo H(주현),Park WS(박원선),Kang SH(강성현),Kim TH(김태호),Kim HK(김형규),Kim HJ(김현주),Moon HJ(문혜진),Lee HS(이현숙),Khoa TM,Thu VT,Kim EY(김의용),Han J(한진) 한국생물공학회 2005 한국생물공학회 학술대회 Vol.2005 No.10

양측성 다낭종신을 동반한 반복된 태아 낭상임파관종 1 례

김성희(SH Kim),신지원(JW Shin),김현주(HJ Kim),서성숙(SS Seo),하현미(HM Ha) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.8

This is a case report of a cystic hygroma with polycystic kidney in a fetus which was suspected by ultrasonography and was confirmed by autopsy. Recently, we have experienced this case in 25-year old woman repeatedly and we report that with a brief review of relevant literature.

거대아에 대한 임상적 고찰

홍경화(KW Hong),김현주(HJ Kim),오주엽(JY Oh),전정희(JH Jeun),민보은(BE Min) 대한산부인과학회 1988 Obstetrics & Gynecology Science Vol.31 No.7

1981년 1월1일부터 1985년 12월 31일까지 5년간 일신기독병원에서 출생한 36692예의 신생아 중 출생시 체중 4000gm이상이 신생아 및 그들 산모를 대상으로 임상기록을 중심으로 통계 학적으로 조사분석하여 다음과 같은 결론은 얻었다. 1. 거댕빈도는 4000gm이상 4.1% 그중 4.5kg미만 3.7% 4.5kg이상 0.4%였다. 2. 출산경력에 따른 빈도는 초산부 42.1%, 경산부 57.9%였다. 3. 산모연령분포는 25-29세군 54.3% 30-34세군이 17.1%, 35세이상군이 4.2%여다. 4. 산모의 임신초기 체중과 신장과의 관계에서 과체중 26.9%, 비만 21.9%였다 5. 산모의 임신중 체중증가에서 16kg이상 증가군은 23.3%였다. 6. 재태기간은 42주이상이 19.7%였다. 7. 거대아를 낳은 과거력을 4.5kg이상 군에서 50.7%가 가지고 잇었다. 8. 분만방법은 제왕절개수술이 29.7%였고, 적응증으로는 아두골반불균형이 높은 빈도를 보 였다. 9. 모성 합병증은 분만 2기지연이 10.3% 견갑난산 0.8%, 산후출혈이 13.6%, 경구당부하시험 이상이 12.5%였다. 10. 거대아의 성비는 192.0:100으로 남아의 비가 높앗다. 11. 신생아 합병증으로 태아 저산소증이 17.6%였다. 12. 태아 기형율은 1.0%였다. 13. 주산기 사망은 1,000명당 12로 자궁내 태아사망 5예, 분만중 사망 3예, 신생아 사망 4예 가 있었다. A study was done on 1491 cases of macrosomia infants weighting 4000gm or more, delivered Il sin Christian hospital January .1st 1981 and December. 31st 1985. The results were as follows; 1. The Total number of delivery during the study period was 36692 and the incindence of infants weighting 4000gm or more was 4.1% and that of infants weighting 4500mg or more was 0.4%. 2. The incindence of multiparity was 57.9% compared to 41.9% overall hospital distribution. 3. Compared to the overall hospital distribution there was a lower incindence of mothers aged less than 25 and an increased incindence of mothers age over 30 4. These was increased incindence of post maturity 19.7% being 42 weeks and over compared to hospital incindence 6.5%. 5. Male to female ratio was 192.0:100.0 compared to overall hospital ratio of 106.0:100.0 6. Cesarean section delivery rate was 29.7% compared to 16.8% hospital rate and main indication for section were cephalo-pelvic disproportion previous cesarean and abnormal presentation. 7. Postpatum glucose tolerance test was done in 497 cases and of the 12.5% had an abnormal G.T.T 8. Maternal complications were hypertenstion in pregnancy(11.7%) delayed second stage of labor (10.3%) shoulder dystocia(0.8%) and postpartum hemorrhage (13.6%). 9. Neonatal complications were birth hypoxia (17.6%) cephalhematoma(9cases), clavicle fracture (2cases) and Erb`s palsy(1case). 10. There were only 15 infants (1.0%) with congenital anomalies compared to 2.2% overall hospital incindence . 11. There were 5 cases of fetal death in utero, 3 cases of intrapartum death giving a perinatal mortality rate of only 8.1 compared to overall hospital perinatal morthality rate of 30.7

무정자증과 관련된 45 , X/46 , XY 혼합 생식선 이상발생 1 예

남윤성(YS Nam),김현주(HJ Kim),이숙환(SH Lee),곽인평(IP Kwak),윤태기(TK Yoon),차광열(KY Cha) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.8

Gonadal dysgenesis traditionally has been based upon phenotypically classified syndromes in which one or both gonads become atretic or streaks. In chromosomally competent ovarian (or gonadal) failure (CCOF) the karyotypes are 46,XX or 46,XY with no cytogenetically demonstrable abnormalities. In chromosomally incompetent ovarian (or gonadal) failure (CIOF) cytogenetic abnormalities are present and include 45,X and mosaicisms (45,X/46,XX), partial deletionsof X (46,X, del[Xq], and ring X), structural abnormalities of X (46,X, i[Xq]) or Y with their mosaicisms, and mixed gonadal dysgenesis (45,X/46,XY). The gonadal phenotypes include bilateral streaks, a unilateral streak and a contralateral ovary or testis, and bilateral abdominal or scrotal testes. Somatic phenotypes range from patients with the classic Turner phenotype with short stature and sexual infantilism, though those with limited gonadal function resulting in partial or complete isosexual or heterosexual pubertal changes, to those with normal stature and sexual infantilism. We have experienced a case of mixed gonadal dysgenesis in male infertile patient with azoospermia. So we report this case with a brief review of literatures.

R32/R152a 혼합작동유체를 적용한 해양온도차발전사이클 성능 특성

이호생(H. S. Lee),김현주(HJ. Kim),차상원(S. W. Cha),이승원(S. W. Lee) 한국해양환경·에너지학회 2013 한국해양환경·에너지학회 학술대회논문집 Vol.2013 No.11

우수한 열역학적 성질들로 인해 1930년대부터 사용하던 염화불화탄소(CFC) 및 수소화염화불화탄소(HCFC)가 오존층 붕괴의 주원으로 밝혀짐에 따라, 몬트리올의정서에 따라 기존에 사용하던 CFC, HCFC계열의 냉매들은 사용이 규제되고 이를 해결하기위한 대체냉매의 개발이 시급한 상황이다. 이를 해결하기 위한 방법으로는 신 냉매제작 또는 기존의 냉매를 혼합하여 사용하는 방법이 있다. 본 논문에서는 기존의 냉매를 혼합하여 해양온도차발전에 적용하였을 때에 그에 따른 사이클의 성능특성에 대해 연구를 하였다. 다양한 혼합작동유체 중 산업용 히트펌프에 연구 중인 R32/R152a를 해양온도차발전에 적용하였다. 사이클로는 기존의 밀폐형사이클, 암모니아/물 혼합물에 적용하고 있는 칼리나 사이클에 대해 시뮬레이션 해석을 수행하였다. 온열원의 온도는 26℃, 냉열원의 온도는 5℃를 적용하였다. R32를 적용한 밀폐사이클의 출력은 22kW, 사이클의 효율은 2.02%를 보였다. 혼합작동유체를 적용하였을 때에 R32/R152a(67%:33%)의 출력은 23.24kW, 사이클 효율은 2.26%로 기존의 단일 냉매보다 5.6%, 사이클효율은 11%상승함을 확인 하였다. 칼리나 사이클 또한 위와 같은 방법으로 연구를 수행하였다. It has been discovered that chlorofluorocarbon(CFC) and hydrochlorofluorocarbon(HCFC) which had been used since 1930 caused ozone layer depletion due to high thermodynamics characteristics. Series of CFC and HCFC refrigerants were regulated according to the Montreal Protocol. Therefore, development of an alternative refrigerant urgently needs to resolve ozone layer depletion. There are two ways to resolve the problem; Development of a new refrigerant and mixed refrigerants. In this paper, performance characteristics of cycles was studied when mixed existing refrigerants were used for ocean thermal energy conversion (OTEC). Among the various mixed refrigerants for industrial heat-pump, R32/R152a used in ocean thermal energy conversion system. For simulations, R32/R152a were used in existing closed cycle and Kalina cycle which is used only ammonia and water as mixed refrigerant. Temperature of the warm heat source was 26 celcius degree, temperature of the cold heat source was 5 celcius degree. In results of simulation, Gross power of the closed cycle on R32 was 22kW, and efficiency of the cycle was 2.02%. When the mixed refrigerant of R32/R152a, in the ratio of 67 to 33, gross power of the closed cycle was 23.24kW, and efficiency of the cycle was 2.26%. Gross power and cycle efficiency of R32/R152a increased by 5.6% and 11% than those of existing single refrigerant. Additionally, the same simulations were conducted in Kalina cycle with the same various composition ratio of mixed refrigerant.

성반전 남성 1 예

남윤성(YS Nam),김현주(HJ Kim),이숙환(SH Lee),곽인평(IP Kwak),윤태기(TK Yoon),차광열(KY Cha) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.8

The incidence of XX male reversal is approximately 1 in 20,000 to 1 in 24,000 male births, a rare disorder. The affected individuals are non-ambiguous at birth with normal male phenotype. They have a 46,XX karyotype, are chromatin positive, and may also be H-Y antigen positive. This group of patients have been key in isolating the gene controling the formation of the testis. By restriction enzyme fragmentation of the X chromosomes and the use of DNA probes, it has been shown that the majority of the XX sex-reversed males contain fragment of DNA from the short arm of the Y chromosome in the distal end of the short arm of the X chromosome. These patients have exclusively testicular tissue and develop the wolffian system while the mullerian duct regress. The external genitalia are of nonambiguous male phenotype, very similar to Klinefelter`s syndrome, but there is a more frequent association with hypospadias and an average height below normal. The testes are small and firm but bilaterally descended. The penile length is normal or slightly shorter than normal, and these patients also develop gynecomastia and hyalinization of the seminiferous tubules at puberty with incomplete pubarche. Infertility occurs secondary to hypogonadism. We have experienced a case of sex-reversed male in azoospermic patient. So we report this case with a brief review of literatures.

무통분만의 임상 경과

조지영(JY Cho),김경미(KM Kim),이지연(JY Lee),김현주(HJ Kim),황혜란(HR Hwang) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.8

The aim of this study was to evaluate the effect of epidural analgesia on labor progress. We studied 340 women at term, with singleton fetus in vertex presentation and with spontaneous onset of labor at the Department of Obstetrics and Gynecology, Il Shin Christian Hospital during 6 months from June 1, 1997 to November 30, 1997. Comparison of 170 women (100 cases of primiparous women, 70 cases of multiparous women) who received epidural analgesia in labor with 170 women (100 cases of primiparous women, 70 cases of multiparous women) who did not receive epidural analgesia was performed. The results were as follows: 1. The frequency of oxytocin augmentation was significantly greater in the primiparous and multiparous epidural group than in the primiparous and multiparous control group (p<0.05). 2. The duration of the first stage and second stage of labor was significantly delayed in the primiparous and multiparous epidural group than in the primiparous and multiparous control group (p<0.05). 3. The mode of delivery showed no significant difference between epidural group and control group. 4. The meconium-stained amnionic fluid, Apgar score and birth weight were similar in both groups. 5. The maternal blood loss was similar in both groups.

ASCUS 및 AGUS의 임상적 평가

황연희(YH Hwang),양정미(JM Yang),김현주(HJ Kim),김미란(MR Kim),김정혜(JH Kim),이은희(EH Lee) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.7

Objective: To evaluate the incidence and clinical significance of ASCUS and AGUS in cervical smear by The Bethesta System. Method: Study was carried by review of medical record of ASCUS and AGUS retrospectively from January 1997 to December 1998 at ILSIN Christian Hospital. Results: From the 21,388 cases of cervical smears, ASCUS was diagnosed in 593 cases[2.77%] and AGUS in 187 cases[0.87%]. Pathologic results of ASCUS were revealed in 15 cases[4.56%] as HPV, 24 cases[7.29%] as dysplasia, 9 cases[2.74%] as CIS and 1 case[0.31%] as SCC. So 14.89% was abnormal lesion. Pathologic results of AGUS were revealed 5 cases[5.21%] as HPV, 15 cases[15.63%] as dysplasia, 7 cases[7.29%] as CIS and 1 case[1.04%] as adenocarcinoma. So 29.17% was abnormal lesion. Conclusion: The relatively high incidence of abnormal lesion of ASCUS and AGUS necessitates aggressive follow up and treatment are needed especially in Korea where colposcopic cost are low.