Orciprenaline ( Alupent ) 이 조기자궁 수축에 미치는 영향에 대한 임상적 고찰

조성진(SJ Cho),김용철(YC Kim),박형무(HM Park),송인철(IC Song) 대한산부인과학회 1979 Obstetrics & Gynecology Science Vol.22 No.6

1975년 1월초부터, 1977년 12월 말까지 국립의료원 산부인과에서 조기진통이라는 진단하에 Orciprenaline(Alupent)를 정주한 환자 30명을 대상으로 다음과 같은 결론을 얻었다. 1) 산모의 연령은 평균 24.3세이었고, 가장 빈도가 많은 연령군은 21∼25세군이며, 초산부가 경산부보다 많았다. 2) 성공한 예(재태기간 36주 이상 지연분만한 경우)는 30예중 18예로 성공률은 60%이었다. 또한 24시간 이상 분만을 지연시킨 경우는 21예로 70%이었고, 7일 이상, 분만을 지연시켰던 예는 12예로 40%이었다. 3) 입원당시 자궁개대가 3cm이하이었던 산모 23예중 17예예가 36주 이후에 분만하여 성공률은 73.4%이었으나 4cm이상인 경우는 7예중 1예로 14.3%이었다. 4) 자궁수축억제 효과는 10분에서 20분 사이에 가장 현저하였으며, 이 효과는 자궁수축의 빈도 및 강도와 밀접한 관계가 있었다. 총 30예중 orciprenaline 정주에 전혀 효과가 없었던 예는 2예이었다. 5) Orciprcnaline의 정주전 및 정주시의 맥박의 변화는 전자가 75±5회/분이었으나 후자는 124±6회/분으로 유의한 차이가 있었으나 혈압은 유의한 차이를 발견하지 못하였다. 6) 태아의 심음은 30예중 15예(50%)에서 증가하였으며, 주산기 사망률 과 특별한 관계는 없었다. 7) 전분만아의 주산기 사망률은 18.8%이었고, 36주 이전에 분만한 분만아의 주산기 사망률은 35.7%이었고, 36주 이후에 분만한 분만아의 주산기 사망률은 5.6%이었다.

산과영역에 있어서 지속성 경막외마취에 관한 임상적 고찰

조성진(SJ Cho),주경란(KR Joo),박찬용(CY Park),김경태(KT Kim),송인철(IC Song),주영철(YC Joo),박인서(IS Park) 대한산부인과학회 1979 Obstetrics & Gynecology Science Vol.22 No.5

국립의료원 산부인과에서 1978년 1월 초부터 1978년 8월 말까지 산과적 합병증이 없었던 산모 100명을 정상 산모군 50예와 경막외마취 시행군 50예로 나누어 비교 관찰하여 다음과 같은 결론을 얻었다. 1. 산모의 분만회수별 분포는 대조군에서 초산부 26예, 경산부 24예이었고, 경막외마취 시행군에서는 초산부 30예, 경산부 20예였다. 연령별 분포는 각각 공히 26∼30세군이 제일 많은 분포이었다. 2. 분만 제1기의 기간은 초산부에서는 자궁개대가 5cm 이하인 경우 및 5∼10cm인 경우 대조군은 각각 460.5±36.18분, 165.9±19.67분이었고, 경막외마취 시행군에서는 각각 480.3±32.43분, 158.5±18.39분이었다. 경산부에서는 대조군의 경우 각각 228.8±23.46분, 77.5±13.24분, 경막외마취 시행군의 경우 각 216.3±24.17분, 104.0±14.31분을 보여 초산부에서는 경막의 마취 사용할 때 분만기간이 짧아지는 경향을 보였다. 3. 분만 제2기의 기간은 초산부에서 대조군이 48.0±6.62분, 경막외마취 시행군이 96.2±13.15분이었고 경산부에서는 각각 20.1±1.79분, 54.8±3.73분을 보여 분만 제2기의 기간은 경막외마취 시행시 지연되는 경향이었다. 4. 객관적 및 주관적 점수를 합하여 측정한 경막외마취의 효과는 0∼4(Good)군이 42예(84.0%), 5∼8(Fair)군이 7예(14.0%), 9∼12(Poor)군이 1예(2.0%)로 경막외마취 사용할 때 무통분만의 큰 효과를 볼 수 있었다. 5. 태아절박증은 대조군에서 50예 중 2예(4.0%), 경막외마취 시행군에서 50예 중 1예(2.0%)로 유의한 차이가 없었고, 1분 Apgar 평점은 7-10점군이 대조군 50예 중 47예, 경막외마취 시행군 50예 중 48예이었고 5분 Apgar평점은 7-10점군이 대조군 50예 중 49예, 경막외마취 시행군 50예 전례로서 경막외마취가 태아에 나쁜 영향을 미치지 않았다. 6. 분만형태는 대조군에서는 정상분만 42예(84.0%), 흡인분만 5예(10.0%), 제왕절개술 3예(6.0%)이었고, 경막외마취 시행군에서는 각각 25예(50.0%), 23예(46.0%), 2예(4.0%)를 보여 경막외마취 시행시 흡인분만의 빈도가 4.6배 증가하였다. 7. 경막외마취 시행 후 진통효과는 평균 12.3±5.4분에 나타났으며, 약 반수(48.0%)에서 11∼15분 사이에 진통효과가 나타났다. 8. 총 lidocaine사용량은 분만 제1기에 144.3±21.7mg, 분만 제2기에 120±8.3mg이었고, 일회 투여량에 의한 진통효과의 지속기간은 각각 52.4±9.4분, 66.2±3.5분이었다. 9. 분만소요기간은 태아의 체중 Clinical research was made to clarify the effect of the continuous epidural analgesia on labor in 50 cases of uncomplicated pregnancies in comparison with 50 cases of control group who did not undergo analgesia during labor at the Department of Obstetrics and Gynecology from January to August, 1978. The results were as follows: 1. In the control group, 26 women were primipara and 24 women were multipara, while 30 women were primipara and 20 women were multipara who underwent labor and delivery under epidural analgesia. The most common maternal age ranged from 26 to 30 in both groups. 2. Duration of the first stage of labor was measured subdividely according to the extent of cervical dilatation, which revealed shortening of labor in primipara under epidural anesthesia. It took 460±36.18 minutes until cervix dilated to 5cm and 165±19.67 minutes over 5cm to full dilatation in the control primipara. It was 480±32.43 and 158±18.39 minutes in primipara under epidural anesthesia, respectively. In the multipara, it took 228.8±23.46 minutes and 77.5±13.24 minutes in the control group and 216.3±24.17 and 104±14.31 minutes in the anesthesized group. 3. Duration of the second stage of labor was lengthened in anesthetic group. While it took 48.0±4.62 minutes in the control primipara and 96.2±13.15 minutes in the women under anesthesia, it was 20.1±1.79 minutes in the control multipara and 54.8±3.73 minutes in the multipara under the epidural anesthesia. 4. Subjective and objective scoring were applied to evaluate the extent of pain relief in anesthetic group: 42 women(84.0%) had good score(0-4), 7(14.0%) fair score(5-8) and only one(2.0%) poor score(9-12). 5. Fetal distress occured in 2 cases in control group and 1 case in the anesthetic group. 47 and 48 cases had good 1 minutes Apgar score(7-10) in control group and anesthetic group, respectively. 49 cases of the control group and all cases of anesthetic group had 5 minutes Apgar score over 7, which showed no significant adverse effects of epidural

Retinoblastoma 종양억제 유전자의 유방암 계대세포에서 Steroid 수용체 활성억제에 관한 연구

송준(J Song),조성진(SJ Cho),이경일(KI Lee),김선행(SH Kim),강재성(JS Kang),이규완(KW Lee),이진용(JY Lee),구병삼(BS Koo) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.10

Cancer results from mutations that disrupt the harmonious checks and balances that regulate normal cellular growth and development. These mutations arise in two classes of interacting genes:those that facilitate cell growth and tumor formation(oncogenes), in which mutation or overexpression is oncogenic, and those that inhibit these processes(tumor supp-ressor genes) whose loss is oncogenic. The human retinoblastoma(Rb) protein, a tumor suppressor, acts as transcription factor or/and cell cycle regulator. Heterogenous expression of the Rb gene product contributes to the genesis of a diverse group of human neoplasma such as breast, prostate, small cell lu- ng, bladder carcinoma and leukemia. Its structural aberrations were observed in 25% of br- east tumor cell lines studied and 7% of the primary tumors, such as homozygous internal deletions and total deletion. These observations suggest that Rb protein is involved in bre- ast cancer development. Here we report that Rb protein represses steroid receptor function and its involvement of cell cycle process in human breast cancer cell line, MCF7 cells. 1. The overexpression of Rb protein repressed the steroid receptor function in breast cancer cell line, MCF 7. 2. When we introduced the mutant type Rb expression vector(deletion of exon 22), such repression was not observed. 3. By introducing E2F expression vector, the action of Rb protein was repressed. 4. Rb protein modulated the binding patterns of proteins to Kil-GRE site. 5. Flow cytometry analysis showed that Rb protein acts on G0/G1 stage of cell cycle process. These findings provide the molecular basis of breast cancer therapy using Rb protein.

악성 난소종양 환자의 혈청내 LDH황성도에 관한 연구 ( 제1보 )

김용철(YC Kim),조성진(SJ Cho),박찬용(CY Park),이우홍(WH Lee) 대한산부인과학회 1980 Obstetrics & Gynecology Science Vol.23 No.4

혈청내 LDH치와 난소암과의 관계를 조사하였던 바 다음과 같은 결론을 얻었다. 1.71예의 양성 난소종양의 혈청내 LDH는 평균 187.2 18.2 units로 정상군(241.4 21.0 unit)보다 높지 않았다. 2.13예의 양성골반 내 질환에서도 176.8 48.7unit로 특이한 사항은 없었다. 3.악성 난소암 13예의 수술 전 혈청내 LDH치는 정상보다 평균 2.6배(624.1 51.5 unit)ㄹ 증가를 보였으며 적절한 처치를 시행 치 않고 단지 시험개복만을 행하였던 2예에서는 수술 후 혈청내 LDH치는 (625/476,620/528 unit) 수술 전 보다 상승되는 경향을 보였다. 4.침윤성 자궁경부암 11예의 경우 LDH는 209.5 21.1 unit로 정상과 차이를 발견 할 수 없었으나 융모성 상피암 5예의 편균 LDH 치는 442.8 69.6 unit로 정상 보다 증가되어 있다. The incidence and prognosis of ovarian cancer were variable. Recently the diagnostic methods of other gynecologic malignancy such as cervical cancer and choriocarcinoma were significantly improved, but unfortunately there was no effective secreening techinques available to detect the ovarian cancer in the early siage. In addition to variable familial methods for evaluation of ovarian cancer, biochemical investigations as carcinoembryonic antigen (CEA), alpha-fetoprotein and lactic gehydrogenase were attempted. These studies were designed to gind correlation between serum-LDH activity and ovarian cancer. 97 patients who were impressed as ovarian tumor were checked by means of routine studies and serum-LDH at National Medical Center during the period of January 1977 to December 1979. The results were as follews: 13cases with ovarian cancer gad a signigicant elevated level of serum-LDH(mean; 642.1 51.5 unit) and which dropped agter proper management. There was no relationship between serum-LDH level and voth cases of benign ovarian tumors (mean; 187.2 18.2 unit) and other benihn pelvic masses (mean; 176.8 48.7 unit), but other gynecologic malignancier had a normal or rather elevated value of serum-LDH in contrast to normal group (cervical cancer; 209.5 21.1 unit, choriocarcinoma; 422.8 69.6 unit).

765㎸ 송전계통 보호계전기의 오차분석을 통한 정정지침에 관한 연구

崔勉松(MS Choi),李承宰(SJ Lee),姜相熙(SH Kang),趙誠振(SJ Cho),裵玲浚(YJ Bae),趙範燮(BS Cho),柳永植(YS Yoo) 대한전기학회 2003 전기학회논문지A Vol.52 No.1

자궁외임신에 대한 임상 통계학적 고찰

박성구(SK Park),이명근(MK Lee),조성진(SJ Cho),박형무(HM Park) 대한산부인과학회 1978 Obstetrics & Gynecology Science Vol.21 No.2

국립의료원 개원이후 즉 1960년초부터 1976년 말까지 만 17년간 본원 산부인과에 입원 가료후 병리조직학적 검사를 시행한 자궁외임신 환자 778예에 대하여 임상통계적 고찰을 하였으며 그 결과는 다음과 같다. 1. 자궁외임신의 분만수에 대한 빈도는 1:26.0(3.9%)였다. 년도별 발생빈도를 관찰할 때 현저한 증감의 추세는 볼 수 없었다. 2. 빈발연령은 25-34세로 64.1%를 점유했으며 평균 연령은 30.8세였다. 3. 불임자는 8.2%, 미산부는 14.4%이며, 1-4회 임신이 68.2%를 점유하였고 경산회수는 3회 이후에서 외임 발생빈도와 반비례 하였다. 4. 불임기간은 평균 4년 7개월이었다. 5. 기왕력은 인공유산이 56.3%로 가장 많았고 개복수술이 14.8%이며 이중 반복 외임이 11.2%, 충수절제수술이 2.2%, 골반내 결핵 2.0%이었다. 또 자궁내 장치를 삽입한 상태에서 외임이 된 2예가 있었다. 6. 주요증상은 동통이 99.9% 성기출혈이 91.3% 무월경이 62.1%였으며 오심구토가 37.3%, 현훈이 16.1%, 임신자각증상이 2.1%였다. 복부 진찰에서 압통이 87.7%, 팽창 67.7%, 종류촉지 68.0%였으며, 골반내진시 하복부 및 부속기 압통이 85.2%, 부속기 종류촉지 78.3%, 자궁경부 압통이 43.9%, 자궁증대, 더글라스와 팽만이 35.0%였다. 7. 쇽크의 증상을 보였던 예는 54.9%였고 혈색소 10gm% 이하의 빈혈을 보였던 예가 80.5%였다. 8. 임신 반응검사는 54.8%에서 양성이었다. 9. 증상발현후 입원까지의 기간은 6일 이상이 67.2%였다. 10. 진단의 정확도는 95.4%였으며 더굴러스와 천자의 적중율은 97.4%였다. 11. 이환은 우측이 다소 많았고 착상부위는 난관이 98.2%, 난소가 0.5%, 자궁경부가 0.4%, 난관절제후 자궁각임신이 0.1%였다. 난관임신에서는 팽대부 91.8%, 협부 4.1%, 체부 2.7%, 간질부 1.3%였다. 12. 복강내로 실혈된 혈액양은 60.5%에서 1,000-2,000cc로 측정되었다. 13. 중절양식은 파열이 87.5%, 유산의 11.8%, 무상이 1.4%였다. 14. 수술방법은 환측난관절제가 67.3%, 환측부속기절제가 33.4%였으며, 동시에 병행한 수술은 대측난관결찰이 9.3%, 충수절제수술이 1.8%, 대측난관성형술이 0.9%였다. 15. 외임에 동반된 타질환은 난관수종 2.1%, 골반내염증 1.4%, 난소낭종 0.9%, 자궁근종 0.4%, 골반결핵 0.3%였다. 16. 전 외임 예중 사망은 1예이었다. A clinico-statistical survey was made on a series of 778 ectopic pregnancies operated and confirmed with histopathological study at the Department of Obstetrics and Gynecology, National Medical Center during the period from January 1, 1960 to the end of December 1976. The results obtained were as follows. 1) During the same period, there were 20,209 deliveries, thus giving a rate of 1 ectopic per 26.0 deriveries, a rate of 3.9%. There has been no appreciable increase or decrease in the incidence of ectopic pregnancy. 2) The highest frequency of ectopic pregnancies was in 25-34 years of age, comprising of 64.1% and the mean age was 30.8 years. 3) The frequency of nulligravida was 8.2%, and nullipara, 14.4%, 68.2% of ectopic pregnancies was between gravida 1 to 4. 4) The mean duration of infertile period was 4 years and 7 months. 5) A history of previous curettage was noted in 56.3% of total. 14.8% of total cases had previous laparotomy. Among them, repeat ectopic pregnancies were 11.2% and appendectomy, 2.2%. A history of venereal diseases was detected in 4.0%, pelvic inflammatory disease, 2.2% and pelvic tuberculosis, 2.0% respectively. The intrauterine device in utero was noted in 2 cases of ectopic pregnancies. 6) The 3 most common symptoms in order of frequency were pain (99.9%), vaginal bleeding (91.3%) and amenorrhea (62.1%). Nausea and vomiting was found in 57.3%, dizziness and vertigo in 16.1% and subjective symptoms of pregnancy in 2.1%. Of the abdominal findings, tenderness was noted in 87.7%, distension in 67.7% and palpable mass in 68.0%. On pelvic examination, lower abdominal or adnexal tenderness was detected in 85.2%, adnexal mass in 78.3%, tenderness on the motion of cervix in 43.9%, the enlarged uterus in 36.0% and fullness in Cul-de-sac in 35.0%. 7) 54.9% of ectopic pregnancies was in shock state and hemoglobin level less than 10 gm% was found in 80.5% of cases. 8) The pregnancy test was positive in 54.8% of the total. 9) The period to admission after initial symptoms was more than 6 days in 67

기능성 난소종양 ( 특히 여성난소종양 ) 의 임상적 관찰

박인서(IS Park),강옥희(OK Kang),조성진(SJ Cho),박춘식(CS Park) 대한산부인과학회 1977 Obstetrics & Gynecology Science Vol.20 No.5

1. 여성화난소종양의 발생빈도는 전 난소종양의 1.7%, 전 악성난소종양의 15.7%이었다. 2. 여성화난소종양중 과립막세포종이 62.5%, 세포막세포종 25.0%, 과립막 세포막 세포종 12.5%이 었다. 3. 여성화난소종양 환자의 최소연령은 23세, 최고연령은 72세이었고 평균연령은 42.6세 이었다. 4. 여성화난소종양 16예 중 7예(43.8%)는 5회 이상의 경산부이었고 6예(37.5%)는 미산부이었다. 5. 생식 연령층이 10례(62.5%)로 가장 많았고, 폐경기후가 5예(31.3%), 생식기전 연령충이 1예(6.3%)이었다. 6. 임상증세로 하복부 종양촉지가 13예(81.3%), 복수 9예(56.3%), 월경과다 6예(37.5%) 의 순위이었다. 7. 자궁내막선암이 공존하였던 경우가 8예(50.5%), 자궁내막중식증이 있었던 경우가 6 예(37.5%)이었다. 8. 치료는 외과적 절제술을 원칙으로 하였으며 방사선 치료를 선택적으로 시행하였다. 9. 수술 후 경과 및 예후는 16예 중 10예(62.5%)에서 재발없이 생존하고 있었다. Clinical observation was made on sixteen cases of granulosa-theca cell tumors collected at the Department of Obstetrics and Gynecology from January 1,1960 to December 31,1975. The results were as follows: 1. The incidence of feminizing ovarian tumors for all ovarian neoplasm and for all ovarian malignancy were 1.7% and 15.7%, respectively. 2. Granulosa cell tumor occupied 62.5%, theca cell tumor 25.0% and granulosa-theca cell tumor 12.5% of all feminizing ovarian tumors. 3. The youngest age and oldest age for feminizing ovarian tumors were 23 and 72 year old, respectively. The mean age was 42.6 year old. 4. Out of 16 feminizing ovarian tumors, 7 cases (43.8%) belonged to more than 5 parity group and 6 cases (37.5%) to nulliparous group. 5. Out of 16 feminizing ovarian tumors, 10 cases (62.5%) occured in menstruating period, 5 cases (31.3%) in postmenopausal period and 1 case(6.3%) in premenstrating period. 6. Clinical manifestations revealed palpable mass in 13 cases(81.3%), ascites in 9 cases (56.3%) and hypermenorrhea in 6 cases(37.5%) 7. Endometrial adenocarcinoma concomitantly existed in 8 cases (50.0%) and endometrial hyperplasis in 6 cases (37.5%) 8. Treatment primarily resorted to surgical intervention and followed by irradiation therapy in the selective cases. 9. Ten cases out of 16 (62.5%) were survival without sign of recurrence so far.

자궁내 피임장치와 동반된 골반 방선균증 1 예

허택(T Hur),양남훈(NH Yang),김동석(DS Kim),이명아(MA Lee),조성진(SJ Cho) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.9

Actinomycosis is a slowly progressive infection due to an anaerobic gram-positive bacterium. Actinomycotic infection of the female genital tract are rare. The presence of a long-standing intrauterine contraceptive device (IUD) is a well-known risk factor in young women. The diagnosis is frequently missed preoperatively. Actinomyces infection should be born in mind in the differential diagnosis of a young female with an IUD, fever, and abdominal mass. All patients with IUDs should undergo annual cytologic smears. We have experenced a case of pelvic actinomycosis associated with IUD and report this case with a brief review of literatures.

폐경기 여성에서 호르몬대치요법이 혈청지질에 미치는 영향

이소영(SY Lee),천관영(KY Cheon),남미현(MH Nam),양희생(HS Yang),조성진(SJ Cho) 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.7

53 healthy women who had been amenorrhea for at least 1 year were randomly assigned to cyclic, sequential hormone regimen for 6 months. They received 0.625 mg conjugated equine estrogen(CEE; Premarin^R), respectively, from days 1-25 and 5 mg medroxy progesterone acetate(MPA; provera^R) from days 16-25. Hormonal replacement therapy had favorable effects on lipid metabolism. After 6 months treatment high density lipoprotein (HDL) cholesterol level and triglyceride increased 16% and 28% compared with pretreatment values, respectively. The findings of this study on the relative effects of hormonal replacement therapy administered wequentially, on lipid metabolism provide guidelines for the treatment of postmenopausal women.

항 Cardiolipin 항체와 임신에 대한 연구

한기정(KJ Han),주관영(KY Joo),배덕호(DH Bae),이명아(MA Lee),조성진(SJ Cho),박인서(IS Park) 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.6

Currently, there are some reports concerning adverse pregnancy outcome complicated by anticardiolipin antibody. This study sought to determine the correlation with pregnancy outcome in 62 complicated pregnancies of third trimester of gestation. Result were compared with 60 normal pregnancies of third trimester. Sixty-two complicated pregnancy were classified by 52 present complicated pregnancies, 5 previous and 5 previous with present complicated pregnancies. Complicated pregnancies were combined with spontaneous abortion, more than two, fetal death in uterus after 20 weeks of gestation (FDIU), fetal growth retardation in uterus(IUGR), preterm labor, pregnancy induced hypertension, abruptio placenta and placenta previa. Anticardiolipin antibody was detected by enzyme-linked immunosorbent assay (ELISA). Mean level of anticardiolipin antibody was 0.177 in normal pregnancies, 0.127 in previous complicated pregnancies and 0.186 in previous with present complicated pregnancies. Level of anticardiolipin antibody was not statistically correlated with previous and previous with present compliated pregnancies. In present complicated pregnancies, mean level of anticardiolipin antibody was 0.146, which was statistically significant association with present complication, especially preterm labor and fetal growth retardation in uterus. On the basis of the above data, we concluded that there is a statistically significant association between level of anticardiolipin antibody and the present complication, especially preterm labor and IUGR. But it is controversal that anticardiolipin antibody seems to be predictive value of complicated pregnancy.