한국에 있어서의 임신성 고혈압증

변지수 ( JS Pyun ) 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.6

N/A

일측성 폐쇄질과 동측의 무신장을 동반한 완전중복자궁 1예

변지수(JS Pyun),강훈(H Kang),최영원(YW CHOI),진소자(SJ Jin) 대한산부인과학회 1981 Obstetrics & Gynecology Science Vol.24 No.6

A case of uterus didelphys associated with unilateral imperforate vagina is reported with a review of the literature. In all cases investigated, ipsilateral renal agenesis was found on the affected side. A summery of the embryologic development of the female reproductive tract is reviewed.

인간수난관절편의 전기자극효과에 관하여

노효섭(HS Ro),배남규(NK Bae),변지수(JS Pyun) 대한산부인과학회 1978 Obstetrics & Gynecology Science Vol.21 No.7

1) Phamacological analysis of the effects of field stimulation of the isolated human fallopian tube has been made. 2) The electrical stimulation produced contraction of the strips, which was inhibited in the presence of tetrodotoxin. 3) The contraction induced by the electrical stimulation was not affected by hexamethonium. 4) The contraction was inhibited by atropine and regitine, but potentiated by physostigmine and cocaine. 5) It is inferred that the adrenergic neurons as well as cholinergic fibers in the human fallopian tube play important role in production of the contraction by the field stimulation.

만기 분만아의 주산기 사망에 대한 고찰

김상우(SW Kim),오익렬(ER Oh),변지수(JS Pyun) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.6

The hospital records were reviewed of 135 infants born at or after 37 weeks of amenorrhea who suffered perinatal mortality during a 5-year period at Chonnam University Hospital. Overall perinatal mortality rate was 47.58 per 1,000 births, and the rate of subdevided groups was lowest in term infants. Half the deaths of term infants occurred intrapartum. 80.9% of intrapartal deaths was extramural cases (before the arrived at our hospital). The most frequent cause of death of term or post-term infants was extrinsic perinatal hypoxia. Further reduction in perinatal mortality for this group may require extension of perinatal care to all pregnancies. A goal for obstetrics care is that fetus alive in utero at 37 weeks of amenorrhea should not subsequently die in the perinatal period, provided no lethal malformation is present.

임신자궁의 염전 2예

박종덕(JD Park),조성남(SN Cho),김영인(YI Kim),변지수(JS Pyun) 대한산부인과학회 1982 Obstetrics & Gynecology Science Vol.25 No.9

전북대학교 의과대학 산부인과학교실에서 기형인 쌍각자궁과 동복자궁의 한쪽이 임신중에 염전을 일으켜 태아는 모두 이미 자궁내에서 사망했고, 응급개복술을 요하는 상태로 내원한 두 환자를 치험하였기에 문헌 고찰과 더불어 보고하는 바이다. The cases of the torsion of the pregnant uterus are reported with the review of literature. Uterine torsion during pregnancy is very rare. In the two cases investigated, uterine apoplexy (Couvelaire uterus) and congestive edematous swelling of the affected adnexa were noticed. A brief summary of the uterine torsion in pregnancy and the congenital anomalies of the uterus were reviewed.

제왕절개술의 임상적 고찰

김종덕(JD Kim),강훈(H Kang),박종덕(JD Park),변지수(JS Pyun) 대한산부인과학회 1979 Obstetrics & Gynecology Science Vol.22 No.5

1975년 2월 1일부터 1978년 7월 31일까지 3년 6개월동안 전북의대 부속병원 산부인과에 입원하여 1,000g 이상의 태아를 분만한 1,179예중 의무기록이 만족스러웠던 193예를 임상 통계학적으로 고찰하여 다음과 같은 결론을 얻었다. 1. 제절의 빈도는 16.4%였다. 2. 제절의 적응증은 아두골반불균형이 34.7%로 수위였으며 태위이상 14.5%, 전치태반 13.5%, 반복제절 9.8%, 태반조기박리 9.8%, 자간증 및 자간전증 8.3% 순위였으며 골반위의 제절율은 18.0%였다. 3. 연령분포는 26∼30세군이 43.0%, 21∼25세군 26.4%, 31∼35세군 16.6%의 순위이고 35세 이하가 87.1%이다. 4. 제절술식은 자궁협부의 횡절개술이 88.1%, 자궁체부종절개술이 10.3%, 제절자궁전적출술이 1.6%이었다. 5. 전예에서 전신마취를 시행하였다. 6. 선택적제절이 19.2%, 응급제절이 80.8%였고 수혈은 44.9%에서 시행하였으며 응급제절 43.6%, 선택제절 45.9%에서 수혈을 시행하였다. 7. 모성이병율은 13.0%이었고 산욕열 복부창상감염이 주 내용이었다. 8. 모성사망은 1예(0.52%)였다. 9. 미숙아 14.2%, 성숙아 85.8%, 3,000∼3,500g군이 37.6%였다. 10. 주산기 사망률은 19.2%였으며 사산 20예, 신생아사망 12예였고 그중 미숙아군이 18예로 과반수 이상을 차지하였다. Of 1,179 deliveries performed at Jeonbug National University Hospital From Feb. 1. 1975 to July 31. 1978, 193 cases of C-section was reviewed clinically. The results were as follows. 1. The rate of C-section was 16.4% for the period. 2. The age group of 26 to 30 years was 43.0% and 86.6% of all were below the age of 35 years. 3. In indications, C.P.D. was the most prevalent with 34.7% and malpresentation 14.5%, placenta previa 13.5%, repeated C-section 9.8%. There was some difference between the order of indication of primigravida and multipara. 4. In the type of operation, lower cervical transverse C-section was 88.1%, classical 10.3% and C-hysterectomy 17.6%. 5. Each of C-section were performed under the general anesthesia. 6. Of 193 cases of C-section, emergency C-section was 80.8%, elective 19.2%. Whole blood transfusion was carried out in the cases of 44.9% with emergency 43.6%, elective 45.9% respectively. 7. Apger score 6-10 was 74.1% and the mature newborn was 85.8%. 8. Perinatal mortality rate was 19.2%, stillbirth of which was 20 cases, the premature 18 cases. 9. The postoperative complications were noted in 13.0%, most of which were puerperal fever, wound infection of abdomen. 10. Maternal death occured in one case.

자궁경부암에서 인형 유두종바이러스 16/18형 감염과 p53 유전자 변형과의 상관성

변지수,이여일,류무현,정상우,남종희,박형기 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.2

Recent studies of molecular biology have suggested that infection with human papillomavirus(HPV) is implicated in the pathogenesis of cervical carinoma. HPV infection alone, however, does not appear to be sufficient for the process of maliganant transformation, suggesting the requirement of additional cellular events. The mutation of p53, which is involved in negative control of cell proliferation, may play a role in the carcinogenesis of cervical carcinoma. The present study was designed to clarify the association between infection with HPV and p53 alteration in primary carcinoma of human uterine cervix. We investigated 46 prim-ary cervical carcinomas for the presence of HPV DNA by in situ hybridization(ISH) with probe specific for HPV 16/18, and examined the accumulation of p53 protein by immunohis-tochemistry(IHC) and the p53 alteration by polymerase chain reaction-single strand confor-mation polymorphism(PCR-SSCP) using formalin fixed, paraffin -embedded tissue. HPV DNA 16/18 was detected in 18 cases(39.1%) of 46 cervical carcinomas. The accumulation of p53 was identified in tumor cells: low level 43.5%(20/46) and high level 32.6% difference of positive reaction by IHC method. But there was no statistical significant between the infection of HPV and the accumulation of p53(p=0.847). Mutations in exons 4 through 9, where the vast majority of point mutations were reported in human neoplasms, were screened by PCR-SSCP analysis. Altered mobilities of the PCR product of p53 were also found in 9 cases(26.5%) of 34 cervical carcinoma: one in exon 4, four in exon 5/6, two in exon 7, and two in exon 8/9. The mutation of p53 was observed in 41.1%(19/46) respective of the result of IHC and PCR-SSCP, and there was slightly higher p53 alteration in HPV negative cases(23.8%, 11/46) than in HPV positive cases(17.4%, 8/46) without statistical significance(p=0.729). The conclusion of these observations suggests that HPV infection and alteration of p53 may play a critical role in tumorigenesis of carcinoma of the human uterine cervix independently, ant there is important difference in the tumorigenic pathway between two factors.

선천성 일측 다낭종신과 반대측 신결여 1 예

변지수,송태복,위점숙,손세호 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.1

본 교실에서 최근 임신중 초음파검사에 의해 진단된 왼쪽 다낭종신, 오른쪽 신결여 및 그외 동반기형을 가진 태아 1예를 경험하였기에 부검소견 및 문헌고찰과 함께 보고하는 바이다. Unilateral multicystic kidney and unilateral renal agenesis are both relatively rare congenital anomalies and usually associated with urinary tract and other anomalies. We present a case of antenatally diagnosed unilateral multicystic kidney with contralateral renal agenesis based on clinical and autosy findings with a brief review of literature.

제왕절개분만 환자에서 조기 경구 영양공급의 평가

변지수,송태복,김윤하,이지영,김은미 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.7

제왕절개 수술이 비교적 젊고 건강한 여성에서 시행되어지고 개복수술이지만 장관의 조작은 거의 하지 않는다는 점에 착안하여 제왕절개 수술한 여성에서 수술 후 조기에 경구 영양공급을 하는 것이 고식적인 방법으로 채택되어져 온 장음이 들리고 가스가 배출된 후에 식사를 공급하는 것과 비교하여 위장관 기능에 이상 증상을 초래하는 빈도를 조사함으로써, 조기 경구 영양공급의 임상적인 유용성에 대해 알아보고자 1997년 5월 1일부터 동년 8월 31일까지 전남대학교병원 산부인과에서 제왕절개분만한 80명의 환자를 대상으로 다음과 같은 결과를 얻었다. 1. 주사 수액제제의 투여 기간은 조기 경구 영양공급 군(연구군)에서 21.6±7.8시간으로 대조군의 32.2±9.0시 간보다 더 짧았고(p<0.01), 따라서 주사 수액제제의 투여량도 연구군에서 3.4±1.3 L로 대조군의 4.6±1.0 L보 다 의의있게 적은 양이었다(p<0.01). 2. 수술 종료 후 일상적인 식사가 가능하게 되는데 걸 리는 시간은 연구군에서 17.4±4.1시간으로 대조군의 37.6±11.4시간보다 더 짧았다(p<0.01). 3. 수술 후 처음으로 가스가 배출되는데 걸리는 시간 은 연구군에서 29.6±8.0시간으로 대조군의 33.6±8.6시 간보다 더 짧았다(p<0.05). 4. 위장관의 이상 증상으로 환자가 호소하는 복부팽만 이나, 오심, 구토 증상이 나타나는 빈도는 연구군에서 17.5 %이고 대조군에서 15.0%로 의의있는 차이가 아니었다. 이상의 결과로 제왕절개 수술 후 조기에 경구 영양 공급을 하는 것이 고식적인 방법과 비교하였을 때 위장 관계 이상 증상의 빈도를 증가시키지 않으면서, 더 빨리 일상식사가 가능하게 됨을 보았으며 이런 결과로 보아 조기에 경구 영양을 하는 것이 빠른 퇴원도 용이하게 할 수 있을 것으로 사료되었다. This study was performed to assess the gastrointestinal function and patient acceptability of early oral feeding after cesarean delivery. From May 1997 to August 1997, eighty healthy women delivered by cesarean section were assigned alternately to either early initiation of oral feeding or conservative dietary management. In the early feeding group, the first postoperative oral feeding of regular hospital diet was provided within 8 hours after completetion of operation. In the conservative management group, the regular hospital diet was given only if the abdomen was not distended, bowel sounds were auscultated, and flatus had passed. The patient information and data on 1) the duration and amount of intravenous fluid administration, 2) the time of return to regular diet and first gas passage and 3) the rate of gastrointestinal complaints such as nausea, vomiting, or abdominal distension were recorded prospectively. The results were as follows; 1. The duration of intravenous fluid administration in the early feeding group (study group) was significantly shorter than those in the control group, 21.6±7.8 versus 32.2±9.0 hours (p<0.01). Therefore, the amount of iv fluid in the study group was significantly smaller than those in the control group, 3.4±1.3 versus 4.6±1.0 L (p<0.01). 2. Compared with the control group, the study group had a rapider return time to regular oral diet, 17.4±4.1 versus 37.6±11.4 hours (p<0.01). 3. Compared with the control group, the study group had a significantly shorter mean interval to first gas passage, 29.6±8.0 versus 33.6±8.6 hours (p<0.05). 4. The frequency gastrointestinal complaints such as nausea, vomiting, or abdominal distension did not show significant difference in both groups; 17.5% in the study group versus 15.0% in the control group.

선천성 두개안면 기형을 동반한 양막대증후군 1 예

변지수,김영일,송태복,최동석 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.8

양막대증후군은 임신초기에 양막이 파열되어 생긴 섬유성 끈이 태아의 여러부위에 붙거나 양막이 파열됨으로써 태아의 일부가 융모막에 붙어서 초래된다는 Torpin설로 임상적 양상을 가장 잘 설명할 수 있다. 아직 그 원인은 확실히 밝혀지지 않았으나 매우 드물게 발생하며 재발위험성이나 유전적인 소인은 없다. 최근 초음파기기의 발달로 이에 의한 진단이 향상되고는 있으나 다발성 선천성기형이 염색체이상으로 인한 경우가 있으므로 태아의 핵형검사가 필요하다. 이러한 선천성기형은 조기발견하여 이에 따른 적절한 유전상담이 시행되어야 하고 적절한 처치를 할 수 있어야 한다. In the amniotic band syndrome, congenital fetal anomalies are produced by strands of the membrane structure that attached to various aspects of the fetus after amniotic membrane rupture during early pregnancy. These strands may interfere with venous, arterial, and lymphatic flow to attached ateas of the fetus. A case of severe congenital craniofacial anomaly due to amniotic band diagnosed by ultrasonogram in the antenatal period is presented with a brief review of the literatures.