Meperidine 점적주입의 진통완화 효과

전정일(CI Chun),최명학(MH Choi),문재민(JM Moon),진성대(SD Jin) 대한산부인과학회 1971 Obstetrics & Gynecology Science Vol.14 No.10

진통완화의 목적으로 초산부와 경산부 각각 20예에서 meperidine을 점적주사하여 다음과 같은 결론을 얻었다. 1) 진통완화를 지속시킬 수 있는 이상적인 평균용량 1.29mg/kg/hr를 산출할 수 있었다. 2) 진통완화 효과는 90%에서 양호 7.5%에서 중등도였으며 2.5%에서 불량으로 나타났다. 3) Meperidine 점적주사는 전체분만소요시간에는 영향을 주지 않았다. 4) 자궁진통기록계상 수축빈도는 다소 감소하는 양상을 보였으나 진폭과 지속시간에는 영향이 없 었고 이상파의 출현도 없었다. 5) 태아의 상태는 양호하였으며 1분 Apgar score는 95%에서 7-10이었고 5분 Apgar score는 전 예에서 7-10이었다. 6) 산후실혈량, 자궁수축 그리고 자궁복귀에는 영향을 주지 않았다. Obstetric analgesia and anesthesia have much been developed since 1847 when Dr. Simpson had first started obstetric anesthesia in his practice. However, there are still many problems to bo solved. Meperidine, one of the well known analgesic has long been used as a single dose of intramuscular or intravenous route with being accompained by some difficulties for controlling dosage. Intravenous infusion of meperidine was used and it was accompained by an excellent analgesic affect with constant level in the blood. Intravenous infusion of meperidine was used to 20 primigravidas and 20 multiparas and it`s results were as follow; 1. The mean dosage of meperidine for maintaining ideal analgesic effect was 1.29 mg/kg/hr. 2. The incidence of good, moderate and poor analgesic effects were 90%, 7.5% and 2.5% respectively. 3. Intravenous infusion of meperidine did not affect the duration of labor. 4. The frequency of uterine contraction seems to be decreased but it did not affect the intensity and duration of uterine contraction. 5. The condition of newborns were excellent and 95% of newborns had an apgar score of 7-10 at one minute and all newborns had 7-10 at 5 minutes. 6. Intravenous infusion of meperidine did not affect uterine contraction, involution and bleeding in postpartum.

임신 혈장 CBG를 이용한 황체 홀몬의 Competitive Protein Binding Assay에 관한 연구

김승조(SJ Kim),전정일(CI Chun),홍창수(CS Hong) 대한산부인과학회 1973 Obstetrics & Gynecology Science Vol.16 No.3

In order to get available corticosteroid binding globuline (CBG or Transcortin) for the measurement of plasma progesterone, competitive binging analysis with standard progesterone after making tritiated corticosterone-CBG complex was done for the binding specificity and affinity. Preparation and isolation of CBG from the blood plasma of human pregnant women in the third trimester was accomplished with filtration by Whatman 50 and precipitation by neutral salt followed ultracentrifuge. The results was as follows. (1) The presence of CBG with high affinity and specificity for binding progesterone has established in human pregnant women. (2) Competitive binding reaction of progesterone with tritiated corticosterone-CBG complex was satisfactory for the standard curve in which obtained over the useful range of bound percent from 90%(0.5ng) to 30%(16.0ng). (3) Eventhough disc electrophoresis have suggested the presence of albumin and other protein in the stripped and precipitated plasma with neutral salt, the CBG was highly specific and strong affinity to bind with steroids.

Placental Percreta로 인한 자연 자궁천공의 1예

김경태(KT Kim),전정일(CI Chun),김수평(SP Kim) 대한산부인과학회 1974 Obstetrics & Gynecology Science Vol.17 No.11

1회의 임신중절을 받은 바 있는 경산부에서 임신 32주에 placenta percreta로 인한 자궁천공 의 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Placenta percreta is a very rare disease which develops serious obstetric complications during the pregnancy and postpartum. It is not easily diagnosed and differentiated other obstetric emergency. We present the spontaneous uterine perforation due to placenta percreta during the pregnancy 32 weeks, and review the literature.

소음순유합의 2예

문재민(JM Moon),전정일(CI Chun),박원상(WS Park),정성수(SS Chung) 대한산부인과학회 1971 Obstetrics & Gynecology Science Vol.14 No.10

소음순유합의 2예를 경험하였기에 보고하는 바이다. The authors recently experienced two cases of agglutination of the labia minora. Of the two cases, one patient was 5 years old and the other was 6 months old. These patients were brought to our department by the parents who found morphological abnormalities in the patients. The abnormalities were easily detected by means of inspection and manual examination. A simple incision was conducted and the disorders were completely crued after about a week treatment as outpatients.

Sarcoma Botryoides의 1례

오원섭(WS O),전정일(CI Chun),나종구(Rha CG),강재화(JH Kang),조진희(CH Cho) 대한산부인과학회 1971 Obstetrics & Gynecology Science Vol.14 No.8

Sarcoma Botryoides의 1례를 경험하였기에 보고하는 바이다. A very rare case of sarcoma botryoides was reported with its clinical course which we are going to report is uncommon. We reviewed literatures on the sarcoma botryoides, and findings.

고령초산부에 대한 임상통계학적 고찰

황순경(SK Whang),김창이(CY Kim),전정일(CI Chun),오원섭(WS O),최광영(KY Choi) 대한산부인과학회 1976 Obstetrics & Gynecology Science Vol.19 No.12

가톨릭의대 산하 8개 병원에서 만 5년간에 분만한 35세이상의 고령초산부 204예를 임상적으 로 중요한 항목을 같은 수의 대조군과 비교 관찰하여 다음과 같은 결론을 얻었다. 1. 발생빈도는 0.49%(204예)였으며 지역별 차이는 없엇다. 2. 이상태위가 26%(53예)로 대조군의 약 2배이며 이상두위 18.1%(37예) 와 둔위 6.4%(13예) 였다. 3. 분만방법은 술식분만이 62.7%(128예)로서 30.4%(62예)가 제왕절개분만이었고 27.5%(56예) 가 흡입 분만이었다. 4. 제왕절개분만의 적응증은 아두골반불균형과 협소골반의 33.8%(21예)와 선택적 수술의 33.8%(21예)가 가장 많았고 태아가사상태가 19.5%였으며 임신중독증이 8.1%(5예)이었다. 5. 신생아 체중은 평균 3061gm으로 대조군보다 125gm정도 적으며 조산아는 8.7%(18예)를 보였다. 6. 주산기 사망률은 4.9%(10예)로 대조군의 2.9%(6예)보다 높았으며 원인으로는 조산아가 가 장 많았다. 7. 선천성 기형은 1.9%(4예)로 대조군의 0.9%(2예)보다 높앗다. 8. 산전 모성합병증은 대조군에 비하여 약 3배가 많았고 임신중독증, 자궁기증부전, 아두골 반불균형의 순이며, 산후 모성 합병증은 약 2배가 많앗고 경관열상, 산욕열, 산후출혈 및 요 도감염의 순이었다. In this study 204 cases of elderly primiparae among 41272 parturient seen at the Dept. of Obsterics and Gyunecology eight Hospital including. st Mary`s Hospital affiliated catholic medical college from January 1. 1970 to December 31. 1974 were clinically observed and statistically reveiwed. The results were summarized as follows; 1. The number of elderly primiparae was consisted of 204 cases among 41272 parturient. Its incidence was 0.49%. 2. Malpresentation was showed in 26.0% among them the most common type was abnormal vertex and breech presentation. 3. In mode of delivery, operative delivery rate was 62.7% including cesarean section (30.4%) 4. In the view of the indication for cesarean section elective cesarean section was the most common (33.8%) other indications were CPD (29.0%) fetal distress (19.5%) and toxemia (8.1%) in order 5. The average birth weight of infant was 3061 gm and 8.7% of prematurity was encountered. 6. The perinatal mortality rate was 4.9% 7. congenital fetal anomalies were seen in 1.9% 8. Antepartum complications were 3 times and postpartum complications were twice more than the control group. the former was the pre-eclampsia uterine dystocia and CPD etc., and the latter was the laceration puerperal fever and urinary infection etc.

범발성 홍반성 낭창과 임신

김경태(KT Kim),박병호(BH Park),전정일(CI Chun) 대한산부인과학회 1975 Obstetrics & Gynecology Science Vol.18 No.3

저자들은 가톨릭의과대학 산부인과학교실에서 임상적, 이학적 소견이 전신성 홍반성 낭창과 일치하고 전형적인 L.E 세포가 발견된 34세의 다산부에서 2회의 임신을 관찰할 수 있었다. Although disseminated lupus erythematosus is a relatively uncommon disease , it has a predilection for young women during the childbearing age, and the association of lupu pregnancy should not be overlooked. The following case is noe in which pregnancy was complicated by S.L.E this 35 year old multiparous women (2-0-1-2), in amenorrhea 36 weeks, was admitted to our Hospital with complications of occipital headache, severe generalized edema and butterfly rash for 5 year she delivered her first baby at home without specific complications 7 years ago, second baby at our hospital with mild S.L.E manifestations 3 years ago, and third baby with pronounced S.L.E manifestations. Typical L.E cells were found in peripheral blood smear of mother, but not of fetus. During admission she was treated with diuretics, antihypertensive drugs and prednisolone, but no improvement was found until puerperal period. NOw she revealed good condition but sustained hypertension and microscopic hematuria.

초음파진단장치를 이용한 자궁내 태아발육 측정

라종구(JG Rha),임정애(JA Im),전정일(CI Chun),김승조(SJ Kim) 대한산부인과학회 1976 Obstetrics & Gynecology Science Vol.19 No.1

저자는 자궁내 태아성숙도 및 체중을 예측하기 위한 방법으로 정상한국인 태아 312명에 대 해 초음파로 아두대횡경치를 측정하여 임신월령에 따른 아두 및 체중의 성장방정식을 산출 하고 초음파아두대횡경치에 의한 예측체중과 실측체중과의 차를 비교 관찰하여 다음과 같은 결론을 얻었다. 1. 임신월령이 37주 이상인 정상한국인 임산부에서 태아 250명에 대한 아두대횡경치와 체중 과의 방정식은 Y=0.86X -4.62kg이었다. 2. 임신주수 20주에서 28주 사이의 임부 88명에서 임신주수에 따른 아두대횡경의 관계는 Y=0.27X-0.75cm 로 2.7mm/week의 증가비율을 나타낸다. 3. 임신주수 29주에서 43주사이의 임신부 350명에서의 임신주수와 아두대횡경의 관계는 Y=0.18X+1.95cm 으로 1.8mm/week의 증가비율를 나타낸다. 4. 정상임신 29주에서 43주 사이의 임산부 312명을 대상으로 실험한 결과 아두대횡경의 초 음파측정치와 실측치의 회기직선을 Y=0.55X +4.04로 표시하고 아두사상의 유의적인 차를 발 견할 수 없으며 실계측치와의 오차한계는 +-1mm이내가 85.2%, +-1.5mm이내가 94.3%이었 다. 5. 정상임신 37주이상의 임산부 176명에서 태아체중 예측공식에 초음파로 계측한 아두대횡 경치를 대이바여 얻은 예측체중과 분만후 24시간내에 실측한 체중을 비교한 결과 그 평균치 간의 차는 133gm이고 오차한계는 2.95-3.36kg군에서 가장 적었다. 1. The relationship between the biparietal diameter of 312 normal korean newborn infant and their weights were quite obvious and calculated by means of the equation, Y=0.86X -4.62kg 2. The growth rates of biparietal diameter according to each gestational week were Y=0.27X-0.75cm in 20-28 gestational week, and Y=0.18X+1.95cm in 29-43 gestational week, respectively 3. The correlative differences of ultrasonic biparietal diameter and postnatal actual measurement were within +-1mm in 85.2% and +-1.5mm in 94.3%. 4. The regression line of the ultrasonic biparietal diameter and actual biparietal diameter, is Y=0.55X + 4.04 and the sighnificant differences were not showed. 5. The mean error between estimated body weight by using above growth equation and the postnatal actual weight was 133 gm. The data is most confident in 36-43 gestational week.

사지기형증의 2례

강희운(HW Kang),유한선(HS Yoo),전정일(CI Chun) 대한산부인과학회 1977 Obstetrics & Gynecology Science Vol.20 No.12

저자들은 신체 여러 부위에 기형을 동반한 선천성 사지결손증 2예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Congenital skeletal limb deficiencies are rare cases in congenital anomalies of newborn infants. Authors experienced two cases of peromelia, who had multiple anomalies such as absence of external genitalia, anal atresia, hemivertebrae, anencephaly and cephalocele. In case 1, autopsy findimgs revealed the complete duodenal obstruction between second and third portion, and anal atresia. X-ray findings showed multiple bone anomalies such as hemivertebrae, dislocation of femoral head due to incomplete formation of the pelvis. In this case, we could not recognize sex of the baby grossly so we confirmed that is male by chromosomal study and pathologic findings. In the second case, we could observed that the baby was anencephalic monster with cephslocele, but other organs were normal in autopsy findings except multiple skeletal limb deficiencies.

골반위 445예에 대한 임상통계학적 고찰

김기진(KJ Kim),길송학(SH Kil),전정일(CI Chun),류명열(MY Yoo) 대한산부인과학회 1970 Obstetrics & Gynecology Science Vol.13 No.4

The Breech presentation is the most common mal-presentation. From Jan. 1963 to Dec. 1968, 455 cases of Breech presentation were delivered at Dept. of OB&Gyne. St. mary`s Hosp. Catholic Medical College. 1. The incidence of Breech presentation was 3.98% of all deliveries. 2. The most frequent age group was 25~29 years of age. 3. The most frequent incidence of gestation week was between 37 and 40. 4. Among them (breech presentation) only 39.6% of breech presentation was recieved antenatal care. 5. The most common type of breech presentation was incomplete breech. 6. In case of infant body weight, weighing more than 2,500gr fetal death was 5.7% and most frequently occured weighing 3,500~3,999gr in body weight. 7. Cord prolapse was 6.4% of all cases and most frequently occured in multigravida, premature, and complete breech. 8. Partial breech extraction was most common type of delivery and 50.6% of all cases. 9. C/S` was performed in 29 cases and 6.4% of all cases. 10. Post-partum hemorrhage was one of the most common maternal complicution, but among them no one lost blood more tham 1000cc in amount. 11. Three cases of clavicle fracture, one case of humerus fracture and one case of Erb`s palsy were occured as a fetal complication. 12. The causes of fetal death was immature and premature, 74% of all cases, and in cases of full term baby, asphyxia was 6.4%, brain damage was 3.3% and 16.3% of unknown causes. 13. According to the breech score index which was studied in Temple University Medical Center in 1967 for our 276 cases weighing more than 2,500grams of infant, breech score index was below 4 in almost all cases of poor progression of labor and prognosis. 14.There was a trend to the high score in lower body weight, lower score in high body weight as a consequence of index scoring by infant body weight. 15. Duration of labor was shorter in high score group than low score group.