분만산모의 과거인공유산 경험에 대한 연구

조주연(JY Cho),성혜리(HR Sung) 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.8

A retrospective study was performed to analysis the causes and factors influrencing the past artificial abortion, of the 7025 mothers who were delivered at Cha General Hospital from Nov. 1992 to Dec 1993. The results were as follows. 1. 39% of the mothers had a past history of artificial abortion. The incidence of artificial abortion increased as the maternal age increased except for 20-24 years of age . 2. 40.0% of the mothers who had a history of artificial abortion were primipara. 3. The most common cause of artificial abortion, was due to premarital pregnancy(23.7%) followed by medication during early pregnancy(21.3%) the third was improper personal, social or financial circumastances to continue pregnancy and to take care of the baby.

창문수술 ( Window Operation ) 바토린낭종과 농양치료

조주연(JY Cho),차광열(KY Cha),차경섭(KS Cha) 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.1

The window Operation as a more effective way to treat Bartholin gland cysts and abscesses was developed. The window operation was attempted to treat all 79 cases of Bartholin cysts and all 55 cases of Bartholin abscesses during 7 years and 5 months from October 1986 to February 1994. Under local anesthesia, a small piece of skin including the cyst wall was excised in an oval shape, and suture was performed along the excised margin. Postoperative antibiotics were given in cases of acute inflammation before the window operation. A new mucocutaneous junction was observed in 4-week follow up period. No complications or recurrences have been observed during the study period. The window operation can be an effective alternative method in the treatment of Bartholin gland cysts or abscesses.

약 , 환경과 선천성기형 관계에 관한 연구

조주연(JY Cho),김인규(IK Kim),이규형(KH Lee) 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.10

A study was undertaken by questionaire to 7025 mothers who delivered at Cha General Hospital from NOV. 1992 to Dec. 1993 considering their exposure to drug, envionment or other potential teratogenic substances. Those who delivered their babies without amy malformations were classified as the control group . and those with the malfomations as the study group . The results were as follows. 1. 6706 cases delivered their babies without any malfomation and 319 cases (4.5%) with malfomations. 2. There were no significant age difference in both groups, but the incidence of delivering malformed childeren were higher in mothers above 34 years. 3. About 1/3 of the of paturients were working mothers. There were no significant differences according to occupational bases, but there was a tendency of more teachers in the control group . 4. About 50% of mothers in both group were exposed to drugs or other potentially hazadous substances. Those of about 30 % were exposed to radiation or drug. About 1/4 of mothers in both group who were exposed to radiation, drug, noxious gas, alchohol or tobacco in first trimester were not aware of their pregnancy. 5. 72% of total mother drank coffee 4.9% alchohol, 1.2 % tobacco and there is no significant difference between two groups. 39.4% of control group and 39.2% of study group drank coffee in the first trimester, 3.2 and 2.2% alchohol, 0.8 and 0.9% tobacco respectively but there was no significant difference. 6. a-feto protein value was measured to be 1.08+-0.38 MOM(multiple of the median for the population) for the control group and 1.21+-0.50 MOM for the study group which was not significantly different. The study group had more motheres with a-feto protein value below 0.5MOM, 2.0-2.4MOM and over 2.4MOM than control group . 7. The organs involved in congenital malformation were skin including car in 66 cases (0.9%), cardiovascular system 59 cases (0.8%), urogenital system was cases(0.7%), skeletal system 46 cases (0.7%) and degestive system was 24 cases(7.5%), considering the congenital malformation involving these organs and complex abnomalities, there was no significant difference between both groups, whether they were working mothers drug users, drinkers or tobacco smokers.

초음파 유산 진단에서 배아와 양막낭에 관한 연구

조주연(JY Cho),윤내영(NY Yoon),이유미(YM Lee) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.6

Objective: To minimize the side effects of intrauterine pregnancy at an early stage of intrauterine pregnancy in which an embryo can not be maintained, by early diagnosis and prompt operation. Methods: Pregnant patients, who had conditions that amniotic sac and embryo were observed with transvaginal sonography, and embryo was not in fetal cardiac activities in early pregnancy, as subject. Follow-up study was carried out prospectively on about 54 cases[GroupⅠ] that were difficult to get diagnosis of abortion objectively with G-sac size and other conditions although CRL was 5mm or below and no cardiac activities. The patients were explained that the possibility of abortion was almost 100% if CRL was 6-7mm or G-sac size corresponded to being 7 weeks pregnant, and suggested that they should choose between immediate D&E or waiting one more week. When CRL was 8mm or more and G-sac size corresponded to being 8 weeks or more pregnant, or when it is certain of diagnosis the condition as spontaneous abortion without further follow-up study due to the fact that in previous transvaginal sonography, an embryo was in cardiac activities but presently not, immediate D&E was suggested. Among the 70 cases[GroupⅡ] that got diagnosis of abortion with only one examination, D&E was done on 55 cases immediately and follow-up study was carried out with 15 cases because pregnant patients wanted to wait more. Results: Out of all 124 cases of pregnant patients, follow-up study was carried out GroupⅠ from 1 day to 3 weeks and 5 cases had profuse vaginal bleeding. Out of this 5, 4 had emergency D&E for incomplete abortion and 1 had complete abortion. The rest of the patients were confirmed of abortion through follow-up study. In GroupⅡ, among 15 cases that we did follow-up study because the pregnant patients wanted to wait some more, 2 cases had profuse vaginal bleeding and operated emergency D&E, and all the rest were diagnosed to have an abortion by re-examination. Conclusion: In case of intrauterine pregnancy, if amniotic sac is observed in G-sac and there is an embryo that does not have cardiac activities, it seems to be better to proceed with D&E immediately without waiting.

검사 전 식사가 임신성당뇨의 선별검사에 미치는 영향

조주연(JY Cho),백진영(JY Baek) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.7

Objective: This study was performed to investigate the impact of diet on the result of the screening test for gestational diabetes. Methods: As a screening test, a 50 gm glucose challenge test was done in 1,296 pregnant women between 24th and 28th weeks of gestation. Patients were divided into four groups depending on the diet before the test; 200 Kcal or more within three hours [Group Ia: n=737], less than 200 Kcal within three hours [Group Ib: n=209], fasted for between three hours and less than eight hours [Group II: n=224], fasted for eight hours or more [Group III: n=126]. When the plasma glucose was 130mg/dL or over a 3 hour oral glucose tolerance test [3h-OGTT] was adviced. Results: When the threshold value was 130 mg/dL, the positive rate of screening test was 19.8% of total [Group Ia: 17.6%, Group Ib: 21.1%, Group II: 21.9%, and Group III: 27.0%] and 19.1% of patients other than Group III. The positive rate of Group III was significantly higher than that of Grroup Ia and patients other than Group III [P < 0.05]. Among 257 patients with positive screening test results, 214 patients [83.3%] had 3 hour OGTT. However, the positive rate of 3 h-OGTT was not significantly different among groups; Group Ia [n=109]: 13.8%, Group b [n=34]: 8.8%, Group II [n=46]: 15.2%, Group III [n=25]: 4.0%. Conclusion: The screening test of GDM may be bette not to be done in a fasting state for 8 hours or more.

자궁경관무력증 치료에서 봉합수술 부위 및 안정과 수술 성공률

조주연(JY Cho),성혜리(HR Sung) 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.1

Mcdonald operation was done for 110 IIOC patients of which 78 cases were primary operation and 32 cases were repeat operation cases had undertaken cervical cerclage operation at other clinic but failed to achieve living baby. After present operation the patients were advised to have ralatively strict rest untill term or near term. The results were as follows 1. In primary operation the success rate was 95.5% when the cause of IIOC was known. The success rate was 91% in the total patients . 2. In repeat operation the success rate wa 90% when the cause of IIOC was unknown and 58.3% when possible cause of IIOC was known. The success rate was 78.1% in the total patients.

단속적 원형봉합 ( Interrupted Circular Suture ) 전치 유착태반 제왕절개 수술시 지혈방법

조주연(JY Cho),차광열(KY Cha),계정웅(CW Kay),김수연(SY Kim),차경섭(KS Cha) 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.12

Rapid accumulation of blood from the placental separation site during cesarean delivery for placenta previa sometimes obscures the surgical field and quickly leads to deterioration of the patient`s vital signs. We used the following technique in 20 cases of intractalbe bleeding among 120 cesareans for placenta previa. Following failure to control the bleeding by suture at the placental separation site via the lower segment cesarean incision, the vessels were ligated using interrupted 2-3 cm sutures at 1cm intervals in a circle around the bleeding area on the serosal surface of the uterus. The sutures were placed as deeply as possible in order to reach the endometrium. This led to marked decrease in bleeding and allowed the small vessels to be easily identified and ligated. The results were as follows. 1. The amount of blood transfused and the operation time were gradually reduced as we became adapt in the use of this ptocedure. 2. Our experience suggests that this technique could reduce the use of hysterectomy in cesarean section for placenta previa.

흡임소파술에 굽은 칼만 ( Karman ) 씨흡입관 사용

조주연(JY Cho),성혜리(HR Sung),차선희(SH Cha),김수연(SY Kim) 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.2

A curved Karman`s cannula that may give the benefit of reducing operating time and complications is introduced for suction crettage. The curved Karman`s cannula was made as follows : First, a 4-7cm portion of the straight Karman`s cannula is exposed to heat. When desired portion becomes soft, it is bent to a desired shape and angle (with 15 and 30), used in accordance with the shape of the uterus. Curved or straight cannulas were used alternatively every other year for 4 years from March 1990 to February 1994. Curved cannulas were used in 380 cases and straight cannuls were used in 423 cases in study period. A comparison study was carried out in 278 cases using the curved cannula and 321 cases using the straight cannula where follow up was possible until the subsequent menstrual period. The results were as follows. 1. The complications rate was 17% using the straignt cannula and 10% using the curved cannula. There was lower complication rate using the curved cannula than the straight one (p

한국인 선천성 이상질환이 의심되는 환자에 대한 세포유전학적 연구

김진경(JK Kim),양영호(YH Yang),황동훈(DH Hwang),노성일(SI Rho),조주연(JY Cho) 대한산부인과학회 1982 Obstetrics & Gynecology Science Vol.25 No.1

1974년 1월부터 1980년 5월까지 연세대학교 의과대학 부속병원 산부인과 유전학 연구실에서 선천성 이상이 의심되는 환자 428명에 대하여 세포유전학적 연구를 시행하여 다음과 같은 결과를 얻었다. 1. 다운증후군이 76예였으며 21번 염색체의 3배성이 69예, 모자이시즘이 7예였다. 2. 터너증후군이 13예였으며, 45,X가 7예, 모자이시즘이 6예였다. 3. 클라인펠터증훈군이 17예였으며, 47,XXY가 14예, 46,XY/47,XXY가 2예, 48,XXYY가 1예였다. 4. 원발성무월경이 62예였으며, 60세에서 46,XX,2예에서는 46,XY를 나타내었다. 5. 간성이 75세였으며 정상 염색체양상을 나타내었다. 6. 뇌성마비아동이 98예였으며, 정상 염색체 양상을 나타내었다. 7. 생식기관이외에 선천성 기형이 있었던 경우가 81예였으며 모두 정상 염색체 양상을 나타내었다. 8. 에드워드증후군이 1예 있었으며, 46,XY,+18염색체 양상을 나타내었다. 9. Cri du Chat증후군이 1예 있었으며, 46,XX,5P-의 염색체 양상을 나타내었다. 10. 기타 종질중격과 중복자궁이 각각 2에씩 있었으며, 정상 염색체양상을 나타내었다. As the cytogenetics developed, cytogenetic study in Korea has also developed progressively. However, cytogenetic studies in Korea were merely studies on normal chromosome pattern or simple studies of several genetic disorders or cases reports. This study is a systematical cytogenetic analysis of 428 cases where congenital disorders were suspected and referred to our cytogenetic laboratory in the Department of Obstetrics and Gynecology, Yonsei University Medical Center, from Jan. 1974 to May 1980. The results were as follows; 1) Downs syndrome was found in 76 cases, consisting of 69 cases(90.79%) of primary 21 trisomy and 7 cases of mosaicism. 2) Turners syndrome was found in 13 cases, consisting of 7 cases(53.85%) of 45,X and 6 cases of mosaicism. 3) Klinefelters syndrome was found in 17 cases, consisting of 14 cases(82.35%) of 47,XXY, 2 cases of 46,XY/47, XXY and 1 case of 48,XXYY. 4) Primary amenorrhea was found in 62 cases, consisting of 60 cases(96.78%) of 46,XX and 2 cases of 46,XY. 5) Intersex was found in 75 cases, consisting of 45 cases(60%) of 46,XY and 30 cases of 46,XX. 6) Cerebral palsy was found in 98 cases and all cases were normal karyotype. 7) Congenital anomalies excluding the reproductive organ was found in 81 cases were normal karyotype. 8) Edward syndrome was found in 1 case, karyotype was 46,XY, +18. 9) Cri-du Chat syndrome was found in 1 case, karyotype was 46,XX, 6P-. 10) Longitudinal vaginal septum and double uterus were found in 2 cases each and all cases were 46,XX.