Ritodrine 이 신생아 혈당값에 미치는 영향

노덕영(DY Ro),이충훈(CH Lee),이종건(CK Lee),나종구(JG Na),김수평(SP Kim),이헌영(HY Lee),성인경(IK Sung),이병철(BC Lee),조성훈(SH Cho) 대한산부인과학회 1988 Obstetrics & Gynecology Science Vol.31 No.11

저자들은 ritodrine이 신생아 탄수화물 대사에 미치는 영향을 알아보고져 ritodrine주입을 받은 모성에서 태어난 신생아 40예를 실험군으로 그리고 ritodrine주입이 없었던 모성에서 태어난 신생아 18예를 대조군으로하여 다음과 같은 결론은 얻었다. 1. 실험군과 대조군간에는 성비, 임신주수, 신생아체중, 1분, 5분 Apgar score, 분만통의 유 무, 제왕절개술 빈도에서 유의한 차이가 없었다. 2. 혈당값은 실험군에서 37.9±2.4 ml/dl 대조군에서 63.1±13.0 ml/dl 로 두군간에는 통계적으 로 유의한 차이가 없었다. 3. 저혈당증의 발생빈도는 실험군 40예중에서 9예 대조군 18예중 2예에서 발생하여 두 군간 에는 P value 0.06으로 통계적으로 유의성은 없었다. 그러나 저혈당의 임상증상을 보인 3예 는 모두 실험군에서 발생하였다. 4. 실험군 혈당값중에서 질식분만 예들은 43.3±4.8 mg/dl, 분만통을 갖고 제왕절개술한 예들 에서 36.3±15.0 mg/dl 분만통없이 제왕절개술한 예들에서 35.9±2.7 mg/dl엿으며 각군간에 혈당값은 유의한 차이가 없었다. In order to assess the effect of ritodrine on neonatal carbohydrate metabolism the sugar levels of the neonate delivery by ritodrine treated women were compared with those of the neonate delivery by non-treated women The results were as follows; 1. There was no significantly difference in sex ratio, gesational age, birth weight 1-minute and 5-minute Apgar score the presence of labor and the number of cesarean section delivery between these two groups. 2. The sugar levels were 37.9±2.4 mg/dl in experimental group and 63.1±13 mg/dl in control group . But there was no significantly difference 3. The hypoglycemia occured in 9 of 40 cases of experimental group and 2 of 18 cases of control group , respectively. But there was no significantly difference. All of the symptomatic hypoglycemic cases (3cases) occured in the experimental group . 4. In the experimental group , the blood sugar levels of vaginal delivery group , cesarean section with labor group and cesarean section without labor group were 43.3±4.8 mg/dl, 36.3±15.0 mg/dl and 35.9±2.7 mg/dl ,respectively. There was no significantly difference in each other.

과립-난포막 세포종의 임상병리학적 연구

박대순(DS Park),김인재(IJ Kim),윤희종(HC Yoon),노덕영(DY Ro),송기창(KC Song),김도강(DK Kim),남궁성은(SE Namkoong) 대한산부인과학회 1989 Obstetrics & Gynecology Science Vol.32 No.10

1980년 가톨릭의대 산부인과에 입원한 난소의 과립-난포막세포종 환자중 수술후 항암화학요 법을 시행하고 그 기간중 혈청 estradiol 농도를 추적검사한 6예를 대상으로 다음과 같은 결 론은 얻었다. 1. 연령분포는 6세부터 70세까지 다양하였으며 평균 43세이었다. 2. 임상기는 Ia에서 IIc까지 있었다. 3. 수술은 환측부속기 절제술 또는 전자궁적출술 및 양측부속기절제술과 함께 골반임파절생 검까지 하였으며 전예에서 수술후 항암화학요법을 시행하였다. 4. 기초 estradiol 치는 92 pg/ml에서 527pg/ml로 평균 261pg/ml이었고 수술후에는 25pg/ml에 서 217pg/ml 로 평균 81pg/ml이엇으며 1예에서는 부분반응후 재발이 의심되어 항암화학요법 의 전향으로 완전반응을 보였다. 이상으로 과립-난포막세포증 환자들의 치료효과 판정과 관리에 있어서 혈청 estradiol농도의 측정은 유용하다고 생각된다. The clinicopathological study with follow up of serum estradiol concentration were made on 6 patients with ovarian granulosa theca cell tumor. The patients were operated and all of them were perfomred of postoperative combinatin chemotherapy. The results were as follows; 1. The age distribution of those 6 patients was between 6 and 70 years. The mean age was 43 years. 2. The clinical stages were distributed between Ia and IIc. 3. The operation performed were unilateral salpingo-oophorectomy total hysterectomy with bilateral salpingo-oophorectomy or with pelvic lymph node biopsies. All patients were obtained postoperative combination chemotherapy with vincristine, actinomycin-D and cyclophosphamide or vinblastin bleomycin and cisplatin 4. The preoperative serum estradiol concnetration were distributed between 92 pg/ml and 527 pg/ml (the mean value was 261 pg/ml) the postopertive serum estradiol concetrtion were distributed between 25 pg/ml and 217 pg/ml 5. the combination chemotherapy with vincristine actinomycin-D and cyclophosphamide was effective in 5 patients and 1 patients was switched the chemotherapy from vincristine ,actionomycin-D and cyclophosphamide to vinblastin bleomycin and cis-platin because of elevated serum estradiol concnetration and satisfactory effect was showed.

질 입구에 발생한 평활근종 1 례

김도강,김수평,노덕영,신진웅,유병대,이형근 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.6

Leiomyomas of the vagina are rare benign solid tumors. A leiomyoma arises from muscle in the round ligament and appears as a firm movable tumor deep in the substance of the labium majus, but minority of these tumors occur in vaginal wall. A case of a 39 year old woman with leiomyoma of the vaginal orifice was reported with a brief review of literature.

제왕절개 자궁적출술의 임상적 고찰

김도강,김수평,노덕영,신진웅,장병우,변태섭,서천옥,이희중,강규섭 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.10

Objective: This report was undertaken to determine the present status of cesarean hysterectomy which was originally devised to prevent postcesarean infection and hemorrhage, and its conditions have gradually been widened to include many conditions in which removal of the uterus is necessary or desirable. Material & method: 53 cases of cesarean hysterectomy performed at Taejon St, Mary`s Hosp. from Jan. 1992 to Aug. 1997, was discussed and evaluated retrospectively. Results: There were 19, 823 deliveries during this period. Cesarean hysterectomy was performed in 53 cases of 8, 558 cesarean sections [0.56%] and 11, 265 normal spontaneous vaginal deliveries [0.04%], an total indication of 0.28%. In total subjects of 53 cases in this series, the subject were 31 cases of uterine atonic bleeding, 9 cases of adhesive placenta, 6 cases of placenta previa, 5 cases of uterine myoma with pregnancy and 2 cases of uterine rupture. All patients who had cesaren hysterectomy received transfusion from 1 pint to 40 pints. The post operative complications were atonic bladder, disseminated intrav ascular coagulopathy, febrile morbidity and wound infection. There was one maternal death due to acute, severe homorrhage and DIC. Conclusion: Postoperative complications still remain the main causes of maternal mortality. Therefore careful prenatal care, momentary judgement of right operation time, fresh blood transfusion and reduction of operation time are very important.

난소에 발생한 버키드임파종 1 예

김도강,김수평,노덕영,유병대,이희중,한상하 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.11

Malignant ovarian lymphoma is a very rare entity and has a poor prognosis. A 32-year-old woman visited Taejon St, Mary`s hospital due to abdominal discomfort and pelvic mass. Under the impression of ovarian malignancy, total abdominal hysterectomy with bilateral salpingpo-ophorectomy, lymph node biopsy was done. Histopathologic and immunohis tochemical study demonstrated the tumor to be Burkitt`s lymphoma of the ovary with involvem ent of the uterus, tubes, and bone marrow. Now she got one cycle of CHOP(cyclophosphamide, adriamycin, vincristine, prednisolone) chemotherapy and then follow up via OPD. We have reported a case of Burkitt`s lymphoma of the ovary with a brief review of literature.

완전 고환성 여성화증후군 1 례

김수평,김진홍,노덕영,최소영,류순원,윤수철 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.5

Androgen insensitivity(testicular feminization) syndrome is characterized by end organ androgen resistance associated with X-linked chromosomal disorder. Mutation of androgen receptor gene impairs normal sexual differentiation and development in karyotypic male, resulting in a spectrum of external genital phenotypes ranging from complete female to nearly complete male. A case of complete testicular feminization syndrome is presented with brief review.

조기양막파수에 의한 양수내감염증 및 신생아 이환율을 진단하는데 있어서 CRP 및 LDH의 역할

김수평,이종건,김진홍,노덕영,박대순,김인재,이선희,나욱열 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.5

조기양막파수의 원인과 결과로서 양수내감염증은 논란의 여지가 있으며, 양수내감염증에 이차적으로 태아는 자궁내감염기회가 생길 수 있다. 양수내감염과 신생아 이환율을 진단하는데 있어서 신뢰도를 평가하기 위하여 조기파수된 산모와 이들 산모로부터 태어난 태아로부터 혈중 CRP와 혈중 및 양수의 LDH를 측정하여 다음과 같은 결론을 얻었다. 1. 조기양막파수 산모에서 양수내감염증은 CRP양성인 경우를 근거로 했을때 CRP양성인 경우가 8예로서 양수감염율은 28.6%였다. 2. 조기양막파수 산모에서 혈청 LDH값은 CRP양성군과 음성군간에 유의한 차이가 없었으나 400IU/L를 기준으로 한 양수내 LDH값과 양수내 LDH와 혈청 LDH비 1.5를 기준으로 구분한 경우 양 군간에 유의한 차이가 있었다.(P$lt;0.05) 3. 양막조기파수 산모에서 태어난 신생아의 체중은 2500gm이상인 경우가 CRP음성군에서 83.3%, CRP양성군에서 16.7%로 유의한 차이를 보였다. 4. 파막후 24시간이 지난 산모 22명으로부터 태어난 신생아에서 CRT양성율은 27.2%였으며,CRP양서인 신생아에서 폐염, B형 간염, 급성위장관염, 신생아고빌리루빈혈증 및 미숙아의 이환율을 보였다. Amniotic fluid infection as the cause and the consequence of premature rupture of membrane is controvertible. Following the amniotic fluid infection, the fetus was susceptible to the intrauterine infection. In order to evaluate their reliability as a diagnostic tool of amniotic fluid infection and neonatal morbidity, LDH in serum, amniotic fluid and CRP of pregnant women with premature rupture of membrane and neonates delivered from them were measured. The results were as follows: 1. CRP, microbiologic findings and amniotic fluid infection rate: Considering positive CRP as amniotic fluid infection, amniotic fluid infection rate was 28.6 % (8/28) Microorganisms were isolated from all of the amniotic fluid specimens of CRP(+) eight cases by bacterial culture, but above 20-30 WBC/ml was revealed by Gram stain in seven cases of the CRP (+) eight cases. 2. CRP, LDH and histopathological findings of placentas: There was no significant difference in the level of serum LDH between CRP (+) and CRP (-) group. LDH greater than 400 IU/L and the ratio of amniotic fluid LDH/ serum LDH greater than 1.5, have a high correlation with amniotic fluid infection. There was no correlation between histologic reports of chorioamniotis and amniotic fluid infection. Based on more than 100 WBC/ml in amniotic fluid, there was no correlation between the number of WBC and amniotic fluid infection. 3. Neonatal morbidity and mortality. There was no difference in gestational age, Apgar score at 5 min, RDS, neonatal sepsis between maternal CRP (+) group and CRP (-) group, but significant difference was found in the neonatal birth weight. 4. Neonatal morbidity from prolonged rupture of membrane: The incidence of CRP (+) in the infants delivered from mother with prolonged rupture of membrane are 27.2 % (6/22). The CRP (+) infants have neonatal morbidity such as pneumonia, hepatitis B, acute gastroenteritis, neonatal hyperbilirubinemia and prematurity. In conclusion, these results suggest that not only the measurements of CRP from the pregnant women with PROM and their neonate but also the measurements of LDH in the amniotic fluid and the rate of amniotic fluid LDH/serum LDH might be useful for a screening test of amniotic fluid infection and neonatal morbidity.

폐경기여성에서 호르몬대치요법으로 인한 소변내 Deoxypyridinoline량의 변화에 관한 연구

김대훈,김수평,김진홍,유영옥,김은중,노덕영,권동진,정대영 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.2

Objective: Our purpose was to determine whether the bone resorption rate is evaluated by Deoxypyridinoline(Dpd) i urine, and to evaluate the clinical utility of Dpd to monitor the hormone replacement therapy effect in postmenopausal women. Study Design: We divided the patients into three groups, the control group was the women who were postmenopausal health state, and the experimental groups were the postmenopausal hormone replacement therapy group and the podtmenopausal nontherapy group. Urinary Dpd and serum FSH, Osteocalcin was measured in the both groups. Results: The urinary Dpd and serum osteocalcin were significantly increase in postmenopausal group(6.63±3.09 pmol/μmol creatinine; 10.54±3.77 ng/ml) compared to preme- nopausal group(4.15±1.32 pmol/μmol creatinine; 7.85±2.17 ng/ml). The urinary Dpd and Serum osteocalcin were significantly decreased in the postmenopausal HRT group(3.31±1.79 pmol/μmol creatinine; 8.31±3.13 ng/ml) compared to the postmenopausal nontherapy group (6.63±3.09 pmol/μmol creatinine; 10.54±3.77 ng/ml). In postmenopausal nontherapy group, there was no correlation between urinary Dpd and serum osteocalcin. But these makers were good correlated in postmenopausal HRT group. Conclusions: It is concluded that the assay of urinary Dpd is useful for the resorption marker of postmenopausal osteoporosis and it should be useful for the monitoring of hormone replacement therapy effect in postmenopausal women. Furthermore, urinary Dpd may be an important indicator to determine when to resume the therapy during cessation of HRT.

자궁경부 비정상세포진 (ASCUS-LSIL) 의 임상적 의의와 그 평가

김승조,배석년,남궁성은,박종섭,이준모,노덕영,신진웅,김찬주,최은아 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.2

The evaluation of women with low-grade cytologic abnormalities including atypical cells of undetermined significance(ASCUS) and low-grade squamous intraepithelial lesion (LSIL) is a topic of considerable controversy. Some women with low-grade cytologic abnormalities will have high-grade intraepithelial neoplasia(CIN II or III) or even invasive cancer. Now, it is almost universally accepted that the majority of invasive cervical cancer and high-grade intraepithelial neoplasia are associated with Human papillomavirus(HPV). Because of this, there has been increasing tendancy on using another triaging methods for evaluating women with a low grade abnormal Papanicolaou smear. Traditionally colposcopy was used and recently HPV DNA test and cervicography was widely used as a triaging methods. This study used the data gained from 151 evaluable women with ASCUS and LSIL in the Department of Obstetrics & Gynecology, Catholic University Medical College, Kangnam St. Mary`s Hospital from March 1995 to April 1996. 11,401 women had done cytology during this period and result was like this; 10,501 patients had normal cytology(92.1%), 244 patients had ASCUS(2.14%), 35 had AGCUS (atypical glandular cells of undetermined significance: 0.31%), 191 had LSIL(1.68%), 170 had HSIL(1.49%), and 160 had cervical cancers(1.41%). Patients with ASCUS were showed that CIN I WAS 5.6%(4/72), CIN II 4.2%(3/72) and CIN III 15.3%(11/72). Patients with LSIL were showed that CIN I was 5.1%(4/79), CIN II 7.6(6/79), CIN III 15.2%(12/79) and invasive cancer 7.6%(6/79). We adopted three management algorithms for evaluating women with ASCUS and LSIL. Three methods were like this; Colpscopy only or HPV DNA testing using hybrid capture which were used with DNAs extracted from the cerval swabs and tested with two pooled probes(probes containing HPV types of low oncogenic risk; 6, 11, 42, 43 and 44 or HPV types of high oncogenic risk; 16, 18, 31, 33, 35, 45, 51, 52 and 56) for HPV detection or both. We adopted only positive result with high risk HPV-probes in this article. At ASCUS group, sensitivity and specificity were 90.0% ad 32.5% in 62 women with colposcopy and 71.4%, 75% in 28 women with Hybrid Capture System. 27 women with colposcopy and Hybrid Capture System showed that sensitivity was 100%, and specificity was 26.3%. At LSIL group, sensitivity and specificity were 92.6% and 22.7% in 71 women with colposcopy and 69.2%, 65.4% in 39 women with Hybrid Capture System, 37 women with colposcopy and Hybrid Capture System showed that sensitivity was 91.7%, and specificity was 12%. Our result indicate that patients with smears showing some of ASCUS and LSIL are evaluated as CIN I, II, III and even invasive cancer. Therefore as a triage methods, the combination with colposcopy and HPV DNA test in women referred for low-grade abnormal cytology would be used as a sensitive methods for the detection of CINs. However, low -specificity of this combination approach was also considered as problem. This approach provides another information to differentiating ASCUS and LSIL into high- or low-risk group of progression.

Tamoxifen과 17 -estradiol이 시험관내 자궁경부암 및 난소암세포의 성장에 미치는 영향

김승조,김진우,남궁성은,김대훈,김도강,노덕영,박래옥 대한산부인과학회 1991 Obstetrics & Gynecology Science Vol.34 No.1

본 연구는 자궁경부암과 난소암으로부터 적출한 종양세포를 연성 한천세포배양법을 이용하여 배양시킨 후 10-8M, 10-9M 및 10-10M의 17 -estradiol과 10-6M, 10-7M 및 10-8M의 tamoxifen을 배양액에 투여하여 종양세포의 군락형성에 17 -estradiol과 tamoxifen이 미치는 영향을 관찰하여 다음과 같은 결론을 얻었다. 1. 자궁경부암과 난소암의 종양세포 군락형성에 있어서 17 -estradiol의 촉진작용은 없었다. 2. 자궁경부암에서 tamoxifen의 종양세포 군락형성 억제효과는 발견할 수 없었다. 3. 난소암에서 tamoxifen(10-7M&10-8M)은 종양세포 군락형성에 억제효과를 나타내었다. 4. 난소암에서 tamoxifen(10-7M & 10-8M)은 종양 세포 군락형성 억제효과는 17B-estradiol(10-8M)에 의하여 중화되지 않았다.(p$lt;0.03). To evaluate the effect of tamoxifen(TAM) and 17 -estradiol(estradiol) on the growth of cervical and ovarian cancer, the colony growth of cells disaggregated from 5 squamous cell carcinomas of cervix and 6 epithelial ovarian carcinomas in soft agar were studied. Mechanical and enzymatic dispersion was used to prepare a single cell suspension for plating. Tumor cells were cultured in the two-layer of soft agar system with enriched medium. The effect of tamoxifen and estradiol alone or simultaneously on cell growth were assessed. The results were obtained as follows. 1. Colony formation was much increased in serum containing media as compared to serum free media in cervical carcinoma(P$lt;0.015)and ovarian carcinoma(P$lt;0.03, one tailed test). 2. Tstradiol showed no difference on colony formation in cervical and ovarian carcinoma as compared to control value.But in serum free mediym, estradiol(10-8 M)moderately stimulated colony formation of 4 among 6 ovarian carcinomas, while tamoxifen(10-7 M)showed significant inhibition on colony formation of 4 among 6 ovarian carcnomas, while tamoxifen (10-7 M) showed significant inhibition on colony formation(P$lt;0.03). 3. Tamoxifen(10-7 M& 10-8 M) showed significant inhibitory effect on colony formation in ovarian carcinoma(p$lt;0.03), but no inhibition in cervical carcinoma. 4. The addition of estradiol(10-8 M) did not neutralize the inhibitory effect of tamoxifen(10-8 M)on colony formation in ovarian carcinomas(P$lt;0.03).