거대 자궁점막하평활근종 분만의 1예

오세기(SK OH),이인철(IC Lee),박신근(SK Park),배병위(BC Bai) 대한산부인과학회 1976 Obstetrics & Gynecology Science Vol.19 No.5

거대 자궁점막하평활근종 분만의 1예를 보고하는 바이다. The submucous leiomyoma of uterus is observed occasionally but the case of a large submucous leiomyoma protruding through cervix and vagina is not seen so frequency. Authors presented a cases of delivery of a large submucous leiomyoma of uterus with it`s review of literature briefly.

산전 초음파로 진단된 태아 선천성 골형성부전증 1 례

황미정(MJ Hwang),박신근(SK Park),이동진(DJ Lee),조상래(SL Cho),김완영(WY Kim),이종학(JH Lee),김종화(JH Kim),백원영(WY Paik) 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.5

Osteogenesis imperfecta is a heterogeneous group of inherited disoders characterized by bone fragility that is accompanied by other evidence of malfunction of connective tissue including abnormalities in teech (dentinigenesis imperfecta), hearing loss, alterations in scleral hue, and evidence of soft tissue dysplasia. One of these, the perinatal from on osteogenesis imperfecta type II is rare disorder characterized by small thoracic cavity, beaded rib, and hort, bowed limbs. We recently experienced a case of osteogenesis imperfecta type II diagnosed in utero by ultrasonogram and confirmed by postnatal radiograph and autopsy. We present the case with a brief review of the literatures.

자궁파열 42예

배병주(BJ Bai),박신근(SK Park),김성연(SY Kim),박종배(JB Park),김순자(SJ Kim) 대한산부인과학회 1981 Obstetrics & Gynecology Science Vol.24 No.6

1. The incidence of uterine rupture was 1:167 delivery 2. The age distribution was rupture from 20 to 46 years of age and about 60% in 4th decade. According to parity, 20 of these 42 cases were over 4. 3. The other obstetric past histories except previous cesarean section were marked with numerous spontaneous abortion, difficult delivery, deep cervical laceration and placenta perfecta. 4. On the classfication of uterine rupture according to cause there were 15 spontaneous rupture with no previous surgery, 11 spontaneous rupture with previous uterine surgery and 16 traumatic uterine rupture. 5. On the anatomical classfication complete uterine rupture were 11 of 17 uterine ruptures and incomplete were 6 of 17 cases. 6. On the gestational duration at uterine rupture, 28 of all 42 cases were ruptured at the pregnancyat 38-42 weeks. 7. On the duration of labor at uterine rupture 34 of all cases were less than 18 hours. 8. The places of uterine rupture were home (14 cases) local clinic (7cases) S.R.C.H (7 cases) and midwife(5 cases). 9. Laparotomy (19 of 32 cases ) was performed within 6 hours after uterine rupture. 10. The most important symptoms were severe abdominal pain, shock, vaginal bleeding and abdominal distention. Hematuria were checked in 12 of 42 cases. Hb. was over 8.0 gm% in 16 of 17 cases (3rd period). 11. Amount of the tranfused blood were less than 7 pints in 14 of 17 cases (3rd peirod)

Nitric Oxide가 사람 자궁평활근의 수축-이완에 미치는 영향 및 그 작용기전에 관한 연구

이종학(JH Lee),박신근(SK Park),이순애(SA Lee),김종화(JH Kim),백원영(WY Paik),정원석(WS Chung),장기철(GC Jang) 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.8

The purpose of this study was to establish whether endogenous L-arginine/nitric oxide(L-ARG/NO) pathway system exists in human uterine smooth muscle and this muscle is responsive to exogenous nitric oxide(NO). The differences of the effect of NO on myometrial contractility between pregnant and non-pregnant uterus were also observed. Isometric tension of human myometrial strips from pregnant(n=10) and non-pregnant(n=20) women were measured in vitro in response to L-arginine(L-ARG), N-nitro-L-arginine methyl ester(L-NAME), or Nw-nitro-L-arginene(L-NNA) that modulate endogenous L-ARG/NO action as well as to exogenous NO that is generated by photolysis of NO-carrying compound such as streptozotocin(STZ). Changes of amplitude and cycle length of phasic contraction by photolysis of STZ with various concentration were measured and compared between pregnant and non-pregnant uterus. Cyclic guanosine monophosphate(cGMP) levels were measured by radioimmunoassay in various testing conditions of myometrial tissues. Spontaneously contracting non-pregnant myometrial strips were relaxed by application of L-ARG(10-3mol/L). This L-ARG-induced relaxation was obliterated by application of L-NAME(10-3mol/L). These L-ARG- or -L-NAME-induced effects were exagerated in the lipopolysaccharide(10 micro g/ml)-pretreated or pregnant myometrium. The non-pregnant myometrial contractile activity was decteased by exogenous NO dose-dependently, that is, by photolysis of the STZ with the concentration of 10-6, 10-5, 10-4, and 10-3 mol/L, the mean percent decrease of amplitude were 8.3%, 15.8%, 26.4%, and 45.7%, respectively and the mean percent delay of cycle length were 14.3%, 24.5$, 48.8%, and 120.6%, respectively. These mean percent changes of amplitude and cycle length under the same dose of STZ(10-4 mol/L) were greater in pregnant myometriums compared with non-pregnant ones(26.4% vs 50.5%, 48.8% vs 73.3%, mean +- SD, p

임신중독증에 관한 임상적 고찰

이우용(WY Lee),원창용(CY Won),박신근(SK Park),배병주(BJ Bai) 대한산부인과학회 1977 Obstetrics & Gynecology Science Vol.20 No.6

1972년 4월 1일부터 1975년 12월 31일까지 만3년 9개월간 서울 적십자병원 산부인과에서 입원, 분만, 치료한 총 2077예중 임신중독증환자 479예에 대한 임상적 관찰을 한 결과는 다음과 같다. 1) 임신중독증의 빈도는 23.1%로서 이중 자간전증이 19.2%, 자간증이 3.9%이었다. 2) 환자의 연령은 20세 이하가 63.6%이었다. 3) 임신지속기간이 38주에서 42주에 속하는 예가 40.7%이었다. 4) 초산임신 대 경산임부의 비는 59.3% 대 40.7%이었다. 5) 쌍태임신에 있어서 임신중독증의 빈도는 70.2%로서 단태임신의 약 3배에 해당되었다. 6) 임신중독증환자에 있어서 부종은 (-)가11.5%, (±)가 8.8%, (+)가26.6%, (++ )가2 3.5%, (+++ )가 21.7%, (++++ )가 17.6%,이었다. 7) 임신중독증환자에 있어서 단백뇨(-)가 5.3%, (±)가 18.4%, (+)가 24.6%, (++ ) 가15.6%, (+++ )가 19.9%, (++++ )가 16.0%였다. 8) 분만전 및 분만중의 수축기혈압은 139㎜Hg 이하인 경우가 6.4%나 되었고, 140∼ 159mmHg가 25.6% 160∼199㎜Hg가 47.4%, 200㎜Hg이하인 경우가 20.4%엿다. 9) 분만전 및 분만중 확장기혈압은 89㎜Hg 이하인 경우가 5.9%, 90㎜Hg이상인 경우가 94.1%였다. 10) 분만 제2월에 있어서의 수축기혈압은 139㎜Hg 이하가 48.4%였다. 11) 분만 제2일에 있어서의 확장기혈압은 89㎜Hg 이하가 29.9%로 되었다. 12) 임신중독증환자의 1.0%에서는 부종만, 6.9%에서는 고혈압만 1.4%에서는, 단백뇨만 나타냈다. 13.5%에서는 부종과 고혈압이 합병해서 나타났고 2.1%에서는 부종과 단백뇨 11.2%에서는 고혈압과 단백뇨가 나타났다. 삼대징후군이 다 나타나는 경우가 63.5%였다. 두통이 35.1%, 시력장해가 11.4%에서 나타났다. 13) 입원당시의 임신중빈혈(혈색소가 10.0gm%이하)이 31.1%나 되었고 분만제2일에서는 빈혈이 61.7%나 되었다. 총혈청단백이 정상최저하한치인 5.5g% 이하인 경우가 36.4%였고, 혈청 creatinine 이 1.6mg% 이상인 경우가 6.2%, 혈청뇨산이 3.0mg% 이상인 경우가 전중독증환자의 95%였다. 14) 안저소견을 보면 정상소견이 50.4% Ⅰ도가29.7%, Ⅱ도가 14.1%, Ⅲ도가 4.2%, Ⅳ도가 1.4%였다. 15) 분만양상을 보면 경질분만이 86.1%, 복식제왕절개술이 13.8%였다. 16) 태아의 평균체중은 2941g이었다. 17) 입원중 태아치사율은 8.6%이었다. 18) 입원후 모체사망은 0.7%였고 임신중독증에 의한 모체사망이 전모체사망의 27.2 %였다. 19) 임신중독증환자에게 올지도 모르는 여러가지 후유증을 예방하고 태아 및 모체사망율은 감소시키기 위해서는 철저한 산전간호와 적절한 치료가 필요하다. In spite of the widespread advances in the treatment of toxemia in recent years, it remains the major cause of maternal and preinatal morbidity and mortality. But good prenatal supervision, with the early detection of signs and symtoms of on-coming toxemia, and approprite treatment will arrest their mortalities and morbidities, and outcome for baby and mother will be usually satisfactory, The data tabulated are based on 479 cases with the diagnosis of toxemia among 2077 cases of total deliveries between Apr. 1, 1972 and Dec. 31, 1975 at the Seoul Cross Hospital. the results are follows: 1. The incidence of toxemia is 23.1%, preeclampsia 19.2%, eclampsia 3.9% mild preeclampsia 8.4%, severe preeclampsia 10.8% antepartum eclampsia 2.9%, intrapartum eclampsia 0.2%, postpartum eclampsia 0.8%. 2. Patient`s age is under 29 year old in 63.6%. 3. About three fourth (73.4%) is concentrated between 38 weeks and 42 weeks of pregnancy. 4. The incidence of primipara in toxemia is 59.3%. para 2;16.9%. para 3;11.7%. para 4;6.8%. para over 5;5.0%. 5. The incidence of toxemia in twin pregnancy is 70.2%. 6. The edema(-) in toxemia is 11.5%, edema(trace); 8.8%, edema (+); 26.6%, edema(#): 23.5%, edema(*) : 21.7%, edema(*) ; 7.6%. 7. The proteinuria (-) in toxemia is 5.3%, proteinuria (trace); 18.4%, proteinuria (+); 24.6%, proteinuria (*); 15.6%, proteinuria (*); 19.9%, proteinuria (*); 16.0%, 8. regarding the systolic blood pressure in antepartum, 6.4% in toxemic patient is 139 mmHg or less in blood pressure, 25.6% between 140 mmHg and 159 mmHg. 47.4% between 160 to 199 mmHg. 20.4% over 200mmHg 9. Regarding the diastolic B.P. in antepartum or intrapartum, 5.9% is 89 mmHg or less, 94.1% over 90 mmHg. 10. Regarding the systolic B.P. in postpartum 2nd day, 48.4% is 139 mmHg or less, 51.6% is over 140 mmHg. 11. Regarding diastolic B.P. in postpartum 2nd day, 29.9% is 89 mmHg or less, 70.1% is over 90 mmHg. 12. The case that showed edema only is 1.0%, proteinuria only 1.4%. hypertension only 6.9%, edema plus hypertension 13.5%, edema plus proteinuria; 2.1%, hypertension plus proteinuria 63.5%, headache; 35.1% in all toxemia; visual disturbances; 11.4% in all toxemia. 13. Regarding the laboratory findings, anemia(Hgb; less than 10.0% gm%) is 31.1% in admission day and 61.7% in postpartum 2nd day. 36.4%of the studied cases(55 cases) revealed low total serum protein(less than 5.5 gm%), and only 6.2%(55 cases) showed elevated serum creatinine (more than 1.6 mg%), and majority (95%) showed the elevated uric acid (more than 3.0 mg%). 14. The fundoscopic findings are as follows; normal; 50.4%. grade I;29.7%. grade II; 14.1%, Grade III 4.2%, Grade Ⅳ; 1.5%. 15. the method of delivery is as follows; vaginal delivery; 86.1%. cesarean section; 13.8%. 16. The average weight of newborn babies in 2941g. 17. The sum of stillbirth and newborn death rates during admission is 8.6% 18. Over one fourth(27.2%) of all maternal death is due to toxemia.

만기분만시 태반과 함께 만출된 Lippes Loop의 1례

배병주(BJ Bai),송석조(SJ Song),박신근(SK Park) 대한산부인과학회 1971 Obstetrics & Gynecology Science Vol.14 No.5

만기분만시 태반과 함께 만출된 Lippes Loop의 1례를 보고하는 바이다. A case of Lippes-loop which deliveried with placenta at third stage of labor, is presented. And the current literature are reviewed briefly here.

선미골 기형종의 1례

이상은(SE Lee),이채영(CY Lee),박신근(SK Park),배병주(BJ Bai),박희옥(HO Park) 대한산부인과학회 1982 Obstetrics & Gynecology Science Vol.25 No.6

기형종은 전신 어디에나 발생할 수 있으나, 난소를 제외하고는 발생학적으로 선미골에 다발하며 선천성이 대부분이고 여아에 많다. 낭종성인 경우는 종양이 커도 분만시 파열되어 분만이 가능한 경우가 대부분이나, 충실성이고 종양의 크기가 큰 경우는 분만 장애를 일으키나 매우 드물다. 충실성 선천성 선미골 기형종으로 인하여 제왕절개술과 종양 절제후 질식 분만한 1예를 경험하였기에 문헌 고찰과 함께 보고하였다. Sacrococcygeal teratoma of the fetus is rare. That that requires cesarean section because of dystosia is very rare. We have met a case of large solid sacrococcygeal teratoma of fetus recently. A case of sacrococcygeal large teratoma with brief review is reported.

분리중복자궁 및 중복질 2예

배병주(BJ Bai),송석조(SJ Song),박신근(SK Park),김희석(HS Kim) 대한산부인과학회 1971 Obstetrics & Gynecology Science Vol.14 No.2

저자들은 23세 및 26세 초산부로서 임신중독증을 주소로 입원하여 제왕절개술로 생아를 분만하고 치료된 예이다. The uterus didelphys is one of the rare congenital anomalies, and it was even judged incompatible with life bofore. Complete duplication occurs from faulty fusion of the two Mullerian ducts and during the first two early months of fetal life. We experienced two cases of uterus didelphys complicated with toxemia and are now presenting them in a brief review.

흔적부각 자궁에 합병한 화석태아의 1예

원창용(CY Won),이우용(WY Lee),박신근(SK Park),배병추(BC Bai) 대한산부인과학회 1978 Obstetrics & Gynecology Science Vol.21 No.3

Congenital anomalies of female genital tract are comparatively rare. Pregnancy in association with anomalies is rarer still. We have experienced a case of lithopedion in rudimentary uterine horn. This paper reports a case of lithopedion in rudimentary uterine horn, Gartners duct cyst in vagina and agenesis of left kidney, and presents with a brief review of the literature concerning the reproductive problem in uterine anomalies.

질방광루의 치험례

이인철(IC Lee),김성희(SH Kim),이순표(SP Lee),박신근(SK Park) 대한산부인과학회 1978 Obstetrics & Gynecology Science Vol.21 No.4

Vesicovaginal fistula is the most common type of urinary fistula. We experienced vesicovaginal fistula after total hysterectomy due to dysfunctional uterine bleeding. The most common cause of urinary fistula is operative accidents, especially total abdominal hysterectomy. General princiles for management of vesicovaginal fistula is described. 1. Full urologic study and diagnosis. 2. Elimination of infection and contamination, and so having the tissues in as good condition as possible. 3. Optimal time of operation about 6 months after fistula developed. 4. Preoperative cystoscopic examination. 5. For good outcome, sufficient exposure of operative field, wide area of demarcation, sufficient immobilization of the bladder and separate closure of vaginal incision without tension. 6. Postoperative drainage of the bladder.