산전초음파진단에 의한 골형성부전증 1 예

박용원(YW Park),정인배(IB Chung),김재욱(JU Kim),양영호(YH Yang),한은경(EK Han),박찬일(CI Park) 대한산부인과학회 1989 Obstetrics & Gynecology Science Vol.32 No.10

최근저자들은 제태기간 36주에 초음파진단에 의해 선천성 골형성부전증을 경험하였기에 문 헌적 고찰과 함께 보고하는 바이며, 이를 경험으로 많은 저자들이 보고한 바와 같이 임신 14주이후부터 숙련된 초음파 술자에 의한 의례적인 시행이 산전관리의 필수적 검사임을 강 조하지 않을 수 없다. osteogenesis imperfecta is a clinical , genetically biochemically radiologically heterogenous group of inherited connective tissue disorder characterized by bone fragility and other evidence of connective tissue involvement. One of these , the perinatal form on OI tyep II is rare disorder characterized by poorly ossified calvaria, beaded rib and short, bowed limbs. we recentrly exeprinced a case of OI type II diagnosed in utero by ultrasonography and confirmed by postnatal radiograph and autopsy. We present the case with the review of the literatures

Assisted Reproductive Technology에 의하여 임신된 59예의 임상적 결과

정인배,한상원,한혁동,차동수,이영진,신승철 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.8

1988년 10월부터 1992년 12월까지 본병원 불임클리닉에서 219명을 대상으로 180예의 IVF-ET, 19예의 GIFT, 20예의 ZIFT를 시행하여 다음과 같은 결론을 얻었다. 1. 임신은 총 219예의 배아이식중 59예에서 성공하여 26.9%의 임신율을 보였다. 2. IVF-ET는 총 180예에서 40예 성공하여 22.2%, GIFT는 총 19예에서 8예 성공하여 42.1%, ZIFT는 총 20예에서 11예 성공하여 55.0%의 성공율을 보였다. 3. 다태아임신은 ART에 의한 임신 59예중 16예(27.6%)이고 이중 쌍태아 14예(23.7%), 3태아 2예(3.4%)였으며, 이중 쌍태아 11예(84.5%), 3태아 2예(100%)는 37주이전에 분만되었다. 4. 유산율은 9예(15.3%)였으며 IVF-ET 7예(17.5%), GIFT 1예(12.5%), ZIFT 1예(9.1%)였다. 5. 자궁외임신은 모두 3예(5.1%)였다. 즉 IVF-ET 2예(5.0%), ZIFT 1예(9.1%)였다. 6. ART에 의하여 분만된 47예에서 태어난 65명 중 신생아 중환자실에 입원한 신생아는 8명이었으며 주된 이유는 저체중아 6예(9.2%)가 원인이었다. 7. ART를 시행하여 분만된 신생아에서 선천성기형은 없었다. 이상의 결과로 ART 시행하여 분만된 신생아에서 별 다른 해로운 영향이 없었고, 산과적 합병증 또한 질출혈 및 다태아 임신으로 인한 조기분만을 제외하면 정상임신과 별 차이 없었다. 다태임신의 경우 조기분만으로 인한 미숙아, 저체중아의 출산빈도가 높기 때문에 배아이식의 수를 제한하거나, 선택적 유산술에 의해 산과적 합병증을 줄일 수 있다고 생각된다. Fifty-nine pregnancies conceived by assisted reproductive techniques (ART) from October 1989 to December 1992 in the Department of Obstetrics of Gynecology, Yonsei University, Wonju College of Medicine, resulted in 47 deliveries and 65 babies. There were 9(15.3%) clinical miscarriages and 3(5.1%) ectopic pregnancies when total pregnancies were considered. The most common complications of ART assisted pregnancies were vaginal bleeding (57.6%) and hypertension(6.4%). Cesarean section was the method of the delivery in 36(76.6%) of patients. Eight (12.3%) babies required admission to the neonatal intensive care unit. All babies except one of twins at 29 weeks of gestation survived. The congenital abnormality was not noted.

결절성 경화증 및 심장 횡문근종과 동반된 태아수종 1 예

정인배,한상원,차동수,김명철,이준원,김윤미 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.10

저자들은 임신 35주의 산모에서 태아수종 및 양수과다증을 동반한 태아의 결절성 경화증과 심장내 횡문근종 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Cardiac rhabdomyoma is the most common primary tumor of the heart in young children; however, it accounts for only 0.04% of all pediatric neoplasm. About 30∼60% of all cardiac rhabdomyoma occur along with tuberous sclerosis. Cardiac rhabdomyoma is one of reasons for non-imune fetal hydrops. We report a case of fetal hydrops combined with intracardiac rhabdomyoma and tuberous sclerosis diagnosed prenatally from ultrasound. The tumor was diagnosed at 35weeks of gestation.

조기양수파열로 사산한 Ectrodactyly 1 례

정인배,차동수,이영진,김명철,박찬호,박형진,김남식 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.10

Split hand split foot(SHSF) is a rare human developmental defect characterized by mi-ssing digits, fusion of remaining digits, and a deep median cleft in the hands and feet. Cy-togenetic studies of deletions and translocations associated with this disorder have indicated that an autosomal dominant split hand/split foot locus maps to 7q21-q22. We have experienced a case of ectrodactyly in a 25-year-old primigravida woman and her baby and reported out our experience with a review of related literature.

투명대 (Zone Pellucida) 두께에 영향을 미치는 요인에 관한 연구

정인배,한상원,한혁동,이영진,홍민,박형진 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.10

The purpose of present study was to assess which parameters influence human oocyte zona pellucida(ZP). Zone pellucida thickness was evaluated in 124 oocytes of 16 cycles IVF-ET with intracytoplasmic sperm injection(ICSI) between July 1995 and October 1995 at the department of obstetrics and Gynecology, Yonsei university, Wonju Christian Hospital. The zone pullucida thickness was 17.7±2.0μm(mean±SD) for 107 metaphase Ⅱ oocy- tes. The zona pullucida thickness was singinficantly different according to maximum estr- adiol(E2) value;The mean thickness of Zona pellucida was thinner below 2000 pg/ml of E2 value than that above 2001 pg/ml of E2 value(p<0.05). And when the metaphase Ⅱ oocytes was cultured for 3 days, the mean thickness of Zona pellucida was thinner than that of metaphase Ⅱ oocytes whether fertilization or not(p<0.01, p<0.03). But the Zona pellucida thickness was not significantly different from the age of women and the oocyte maturation status(p>0.05).

체외수정 및 배아 이식후 제 16 일이내 임신군과 비임신군사이의 임상증상의 비교

정인배,한혁동,차동수,이영진,박찬호,홍민 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.9

Following IVF & ET it is common to develop clinical symptoms according to pregnancy outcome until day of pregnancy test(post ET day 16). But surprisingly, the squalae of day-case IVF and ET have not been reported . This study was analyzed on clinical symptoms after ET between pregnancy group and non-pregnancy group in 157 IVF and ET cycles from september, 1995 to June, 1996 at the department of Obstetrics and Gynecology, Yonsei University, Wonju Christian Hospital. The results obtained were as follows : 1. The breast engorgement was reported by 36 of 46(78.3 %) of our patients in pregnancy group and 65 of 111(58.6 %) of our patients in non pregnancy group. The results of both group showed significant difference(p$lt;0.05). In pregnancy group, highest incidence was noted at post ET day 4, which was continued until post ET day 16. In non-pregnancy group, highest incidence was noted from post ET day 4 to day 7, which diminished gradually over following 5 days and then nearly disappeared. 2. The vaginal bleeding was reported by 8 of 46(17.4 %) of our patients in pregnancy group and 35 of 111(31.5 %) of our patients in non-pregnancy group. The results of both group did not show significant difference(p$gt;0.05). However in pregnancy group, vaginal bleeding was noted from post ET day 8, which its incidence was peaked at post ET day 10 and its pattern was vaginal spotting. In non-pregnancy group, vaginal bleeding was mens like pattern and its incidence was peaked at post ET day 15. 3. The itching sensation on vagina was reported only in pregnancy group(4.3 %) and the urticaria and itching sensation on skin was reported only in non-pregnancy group(5.4 %). The results of both group did not show significant difference(p$gt;0.05). As other symptioms, abdominal pain, back pain and gastrontestinal sympotoms(nausca vomiting, diarrhea, constipation) were reported by 27,4 and 4 of 46 pregnant patients(58.7%, 8.7% and 8.7%) and 56,8 and 9 fo 111 non-pregnant patients(50.5%, 7.2% and 8.1%). The results of both group did not show significant difference(p$gt;0.05). In conclusion, these clinical symptoms occuring until day of pregnancy test after ET(post ET day 16) were helpful in prediction of sucessful implantation and useful reference data following IVF & ET cycle.

단안증 및 낭포성 수활액 낭종을 겸한 기형아의 1 예

정인배,조윤상,홍민,이준원,최성진,고시선 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.10

저자들은 연세대학교 원주의과대학 원주기독병원 산부인과학교실에서 단안증 및 낭포성 수활액낭종을 겸한 기형아의 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Cyclopia is a rare congenital fetal occular anomaly in which the eyes are fuse together and located in a single orbit. A proboscis-like structure is situated above the orbit. It is commonly associated with hydrocephalus, anencephalus, polydactyly, hermaphroditism, hernia, and etc. We have experienced a case of the chromosome mosaicism in a fetus with cyclopia and cystic hygroma observed in a 26-year-old primiparous woman, and report it with a brief review of related literatures.

태아 단안증 1 예

정인배,한혁동,차동수,이영진,박수희,김경철 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.6

본 연세대학교 원주의과대학 산부인과에서는 무월경 34주에 자연질식 분만된 균형적 상반(3p : 10q)전좌(balanced reciprocal(3p : 10q) translocation)을 갖은 아버지에서 태어난 비균형적 핵형(unbalanced karyotype)을 보이는 태아 단안증 1예를 경험하여 이에 간단한 문헌고찰과 함께 보고하는 바이다. Cyclopia is rare congenital craniofacial anomaly, in which the two orbits have merged to form a single, centrally located cavity with one eye. A proboscis-like structure is situated above the orbit. This report presents a case of cyclopia attributable to an unbalanced karyotype in a family with balanced reciprocal (3p:10q) translocation.

임신중독증에 있어서 혈소판용적의 변화

정인배,한상원,이영진,최현일 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.12

혈액응고계의 중심적 역할을 하는 혈소판의 형태벼놔에 대한 관찰을 하므로써 임신중독증의 조기 지표로써 평균 혈소판용적의 변화의 가치에 대하여 알아보고자 다른 합병증을 동반하지 않은 임신중독증 환자를 대상으로 정상 임신부의 그것과 비교검토하고 다음과 같은 결과를 얻었다. 1. 임신중독증군의 혈소판수는 21.8 +or- 7.82 (*10^4/mm^3)으로 정상 임신군의 29.8 +or- 5.02(*10^4/mm^3)에 비하여 유의하게 낮았다. 2. 평균 혈소판용적은 정상군 8.08 +or- 1.72 fl에 비하여 임신중독증 9.17 +or- 1.22 fl로 유의하게 임신중독증군이 높았다. The etiological factors leading to pregnancy induced hypertesion are still obscure. Since the concept of Disseminate intravascular coagulation was established, it has been assumed that platelets may play an important role in the pathogenesis of pregnancy induced hypertension. Therefore, in order to elucidate the role of platelet volume changes, platelet volume was studied in groups of women suffered from pregnancy induced hypertension and compared with normal pregnant groups. As the morphology of platelet, the number of platelet (PLT), mean platelet volume (MPV) was measured. The results were as follows: 1. The number of platelet was low significantly in th pregnancy induced hypertension group compared with normal pregnant control. 2. On the other hand, mean platelet volume was high significantly n the pregnancy induced hypertesion group compared with normal pregnant control. These findings suggests that, in pregnancy induced hypertension, platelets are in a hyperactive state and there is a rapid turnover caused by consumption.

대량수혈로 인해 조절되지 않는 거대 후복막강출혈을 복강내 Radiotapes 폐색으로 조절한 1 예

정인배,한혁동,차동수,김대현,이영진,김영국,박천식 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.4

저자들은 대량수혈후 생긴 범발성 혈관내 혈액응고나 응고기전의 장애로 인해 지혈되지 않는 복강내 출혈이 복강내 radiotapes 폐색으로 조절될 수 있다는 것을 경험하였기에 문헌과 함께 보고하는 바이다. In traabdominal packing with radiotapes for surgically uncontrolled hemorrhage from retroperitoneal injuries exacerbated by the hypothermia, acidosis and caogulopathy regained popularity over the past decase. In this case, intraabdominal radiotapes packing was done for uncontrollable hemorrhage from retroperitoneal injury after cesarean section. As a result intraabdominal packing helped achieve hemostasis of coagulopathy due to massive transfusion in the face of surgically uncontrolled bleeding.