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조기양막 파열로 인한 양수과소증에서 경복부 양수주입술의 임상적 유용성
김미경(Mi Kyung Kim),원혜성(Hye Sung Won),신명신(Myung Shin Shin),김소라(So Ra Kim),정지윤(Ji Yoon Chung),이필량(Pil Ryang Lee),이인식(In Sik Lee),김 암(Ahm Kim) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.2
목적 : 조기 양막 파수로 인한 양수과소증에서 복식 양수 주입술의 임상적 유용성을 알아보고자 하였다. 연구방법 : 1997년 3월부터 1998 12월까지 서울중앙병원에서 경복부 양수주입술을 시행한 조기양막 파수로 인한 양수 과소증환자 19명을 대상으로 환자-대조군 연구를 하였다. 임상비교는 의무기록을 통해 조사하였으며, 조기 양막 파수로 인한 양수과소증군(n=19)과 그 대조군(n=40)을 비교하였다. 결과 : 양수주입군에서 의미있는 재태기간 연장효과를 관찰할 수 있었다. 양수주입군에서 분만시 다양성 심박동 감소가 줄었으며, 조기양막파수로 양수주입을 시행한 군에서 5분 아프가 점수가 개선되었다. 분만방법이나 신생아 체중, 감염은 각각의 대조군에 비해 차이가 없었다. 신생아의 RDS 이환율이 양수 주입군에서 의미있게 감소하였으나 dexamethasone을 투여하지 않은 신생아에서는 양 군에 차이가 없었다. 결론 : 조기 양막 파수로 인한 양수 과소증에서 복식 양수 주입술은 비교적 안전하게 시행될 수 있으며, 보존적인 치료에 비해 재태기간 연장의 효과가 있다. 향후 좀 더 많은 대상군으로 전향적 무작위적 연구가 필요할 것으로 사료된다. Objective : This study was performed to evaluate the clinical utility of transabdominal prophylactic amnioinfusion on oligohydroamnios caused by preterm premature rupture of membrane(PPROM). Methods : There were 59 singleton pregnant women with oligohydroamnios caused by PPROM who were treated by transabdominal amnioinfusion at the department of from March 1997 to December 1998. Nineteen pregnant women who underwent prophylactic amnioinfusion were designated as study group and 40 pregnant women who did not undergo prophylactic amnioinfusion were designated as control group. Clinical data were drawn from medical records, such as time interval from amnioinfusion to deliver, birth weight, incidence of variable deceleration, Apgar score at 1 minute, Apgar score at 5 minutes, and so on. Statistical analyses were performed by means of Student t test, Mann Whitney U-test, Fisher's exact test where appropriate. P value below 0.05 was considered significant. Results : The median interval from amnioinfusion to delivery w as longer in study group than in control group (13.0 29.3 days vs. 5.0 13.0 days, p<0.05). The incidence of variable deceleration during labor in study group was 16% and that in control group was 43%(p<0.05). The incidence of Apgar score at 5 minutes below 7 was lower in study group than that in control group(39% vs. 43%, p<0.05). The incidence of respiratory distress syndrome was lower in study group than that in control group(16% vs. 83%, p=0.05) However, there were no significant difference in the incidence of respiratory distress syndrome between them who did not undergo dexamethasone treatment, in mode of delivery, birth weight, and incidence of chorioamnionitis between two groups. Conclusion : Transabdominal prophylactic amnioinfusion may have a positive role in the management of PPROM.
김선율(Seon Yul KIM),서태호(Tae Ho SEO),신종암(Jong Ahm SHIN) 전남대학교 수산과학연구소 2002 수산과학연구소논문집 Vol.11 No.-
The random amplified polymorphic DNA analysis of four sea cucumbers, Holothuria pardalis, H. monacaria, Stichopus japonicus and Cucumaria chronhjelmi from Geomun-do was performed. Ten primers of 10-mer arbitrary primer kit were used for PCR. Similarity was calculated by Jaccard’s equation. The band pattern was different in three of ten primers. The similarity between S. japonicus and C. chronhjelmi, H.pardalis and C. chronhjelmi, S. japonicus and H. monacaria, S. japonicus and H. pardalis, H. monacaria and C. chronhjelmi, and H. pardalis and H. monacaria was 0.42, 0.55, 0.63, 0.68 and 0.85, respectively.
선천성 후부 요도 판막 증후군의 자궁 내 치료 : 바구니 모양의 도관을 이용한 태아의 방광-양막강 문합술 1예
차지만(Ji Man Cha),원혜성(Hye Sung Won),김미경(Mi Kyung Kim),김소라(So Ra Kim),정지윤(Ji Yoon Chung),이필량(Pil Ryang Lee),이인식(In Sik Lee),김 암(Ahm Kim) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.2
We present a case of in-utero treatment of posterior urethral valve syndrome(PUVS) by vesicoamniotic shunting. The shunt was established by basket-shaped catheter at the 22 weeks' gestation. Enlarged bladder and hydronephrosis were improved after the shunt procedure. The baby was delivered at the 39 weeks' gestation and had normal serum range of BUN and creatinine. Because the outer opening of catheter was burried under abdominal skin on the day before delivery, posterior urethral valve excision and basket removal through urethra were operated by endoscopy on the 2nd day of birth. The baby has been followed up for 5 months and in good health. We report this case with a brief review of literature. Shunt operation in-utero is considered as a safe and effective therapy for lower urinary tract obstruction caused by PUVS.
강정훈,고경석,유시준,원혜성,이인식,김 암 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.5
Cleft lip & palate are the most frequent manifestation of facial malformations. Fetuses with cleft lip & palate have a much higher incidence of multiple malformations and chromosomal aberrations than neonates with cleft lip & palate. Thus, ultrasonography of the fetal face has become important for the detections of major syndromal malformations or chromosomal disorders. Especially in cases with a family history of cleft lip & palate, we should confirm or exclude the diagnosis and associated anomalies have to be ruled out when cleft lip & palate are present Positive findings have different clinical outcomes and obstetrical implications. We detected five fetuses with cleft lip & palate, using ultrasonography. We taught to their parents about disease entities, operative schedules with complications and sequelaes, and feeding, etc.. Also, we performed genetic counseling for other malformations and chromosomal disorders in case with a history of stillbirth of fetus with cleft lip & palate. Our teaching and genetic counseling provided early cognitive, emotional and behavioral supports to mother. Also, a recent development of the fetal endoscopic surgery in life threatening conditions has raised the possibility of fetal cleft lip & plate repairs. This sophisticated prenatal diagnostic imaging will play the basic and important roll in the progression of endoscopic fetal surgery in plastic surgery.