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- 저자 : 나연화(Yeon Hwa La) (검색결과 4 건)
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나연화(Yeon Hwa La),신병식(Byoung Shick Shin),박영하(Young Hwa Park),금형용(Hyung Yong Keum),김종철(Zong Chul Kim),이동욱(Dong Ook Lee),정우철(Woo Chuel Jung),이성원(Sung Won Lee),조용(Yong Cho),노의선(Eu Sun Ro) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.11
Trisomy 18, called Edward syndrome, occurs in about 3500-8000 births. It is much more common at conception, with about 95% of cases resulting in spontaneous abortion or stillbirth. Postnatal survival is poor, with the majority of patients dying in early infancy. Characteristic findings include cardiac malformations, mental retardation, growth retardation, a prominent occiput, micrognathia, clenched hands, and rocker-bottom feet, omphalocele. The prenatal sonographic findings of our case include delayed growth, omphalocele, wrist joint fixation, choroid plexus cyst, hydramnios and postnatal gross findings include growth retardation, omphalocele, wirst joint fixation, absence of radius, syndactyly, focal absence of phalanges and flexion deformities of fingers and toes. We report a case of prenatally diagnosed Edward syndrome, which is confirmed by chromosome analysis, with brief review of related literatures.
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자궁탈출증이외의 적응증에 대한 질식전자궁적출술의 임상적 고찰
이성원,정우철,정석희,나연화,조경철,한성태,서정래,조용,노의선 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.8
Objective : To analyse the clinical aspects of total vaginal hysterectomy, we evaluated age distribution, parity, previous abdominal operations, indications for hysterectomy, postoperative pathology, combined operations, operation time, bleeding amount, hemoglobin change, weight of uterus, and postoperative complications. Methods : We reviewed the medical records of the 50 patients who underwent total vaginal hysterectomy for the indications other than uterine prolapse from July 1998 to June 1999 at chunchon Sacral Heart Hospital, Hallym University. Results : 1. Age distribution was from 31 to 55 years old and 78% of patients were in 36 to 45 years old group. 2. The most common parity was para 2 (56%) and the next was para 3 (30%). 3. The most common previous abdominal operation was laparoscopic tubal sterilization and followed by appendectomy, cesarean section, and pelvic operation. 4. The most common indication for vaginal hysterectomy was uterine myoma (74%) and followed by cervical intraepithelial neoplasia, atypical endometrial hyperplasia, and dysfunctional uterine bleeding. 5. The most common postoperative pathologic finding was uterine myoma (56%) and followed by adenomyosis, cervical intraepithelial neoplasia, endometrial hyperplasia, endometrial polyp, endometriosis, microinvasive cervical cancer, and endometrial cancer. 6. The concurrent surgical procedures were ovarian cystectomy (6%), parovarian cystectomy (6%), salpingo-oophrectomy (6%), and anterior or posterior vaginal colporrhapy (10%). 7. The operative time was within 2 hour in almost all cases (98%). 8. The bleeding amount was within 500 cc in almost all cases (98%). 9. The hemoglobin change was within 3 g/dl in almost all cases (98%). 10. The weight of hysterectomized specimen was over 300gm in 32% of patients. 11. There were 5 cases (10%) of vaginal cuff hematoma with infection, 3 cases (6%) of upper respiratory infection, and 2 cases (4%) of bladder dysfunction as the postoperative complications. Conclusion : Total vaginal hysterectomy is a safe method for removing uterus even in the absence of prolapse. Recently it's indication is widening to the patient who has larger uterus and history of previous pelvic surgery. Because of it's advantage, total vaginal hysterectomy would be the preferred method of hysterectomy in the future.
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직장으로 투여한 Misoprostol 에 의해 조절된 산후 출혈 2 예
이성원,조용,한성태,정석희,나연화,서정래,정우철,노의선 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.4
산과적 출혈은 임신성 고혈압, 감염과 더불어 산모 사망의 3대사인 중 하나이다. 산후출혈은 산과적 출혈의 주된 원인이다. 자궁무력증이 산후출혈의 가장 많은 원인을 차지하고, 태아와 태반 분만 후 자궁 수축의 불량 때문이다. 산후 자궁이완에 의한 출혈 조절을 위해 먼저하는 치료방법은 자궁 수축제인 oxytocin과 ergot제제와 함께 자궁마사지를 기본으로 사용한다. 이 방법에 실패할 경우 보다 강력한 수축제인 sulprostone을 사용하였으며 실패할 경우 자궁적출술을 포함하는 수술적인 방법이 요구되었다. 최근 prostaglandin E1 유사체인 misoprostol은 경구, 질, 혹은 직장을 통해 투여시 즉각적인 자궁수축과 자궁경부 성숙 효과가 있다. 저자들은 산후 자궁무력증에 의한 출혈시 oxytocin, ergot제제, 혹은 prostaglandin E2 등에 반응하지 않는 경우 misoprostol의 직장 투여로 조절된 2례를 경험하였다. Obstetrical hemorrhage is one of the deadly triad, along with hypertensive disorder in pregnancy and infection. Postpartum hemorrhage is the major cause of obstetrical hemorrhage. Uterine atony is the most common cause of postpartum hemorrhage, and resulted from poor uterine contraction after delivery of the fetus and placenta. Initial management to control postpartum uterine atonic bleeding is based on the use of uterotonics such as well known oxytocin and ergot preparations together with uterine massage. Prostaglandin E2 analogue, sulprostone can be used next when these agents are failed to produce uterine contraction. The woman unresponsive to non-surgical managements requires surgical interventions including emergency hysterectomy. Recently prostaglandin E1 analogue, misoprostol, has been known to elicit potent uterine contraction and cervical ripening after oral, vaginal or rectal administration. We have experienced two cases of postpartum uterine atonic bleedings which were unresponsive to oxytocin, ergot, or prostaglandin E2, but were successfully controlled by rectal administration of misoprostols.
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