제왕절개술에 관한 임상적 고찰

황용우(YW Hwang),이철진(CJ Lee),김현중(HJ Kim),최영희(YH Choi),서국재(KJ Suh) 대한산부인과학회 1981 Obstetrics & Gynecology Science Vol.24 No.10

1. Cesarean section rate was 7.67%. 2. The age distribution of Cesarean section showed 57.5% between 25 and 30 year, 20.0% between 30 and 35 years, 14.7% between 20 and 25 years and 5.0% between 35 and 40 years respectively. 3. Indication for Cesarean section were C.P.D (40.9%) malposition (17.5%) placenta previa (8.4%) toxemia (3.1%) twin (2.5%) placental abruption (2.2%), and fetal distress (2.7%). 4. Among the indication of primary Cesarean section in multiparous dystocia was the most prevalent (44.2%) and the others were hemorrhage (18.4%) malposition (18.4%) and miscellaneous. 5. In the type of operation Lower cervical transverse type was most common(84.7%) and classical type was 10.6%. 6. The general anesthesia was performed at the rate of 90.94% and spinal was 9.06%. 7. Tubal ligation (15.3%) and appendectomy (5.6%) were performed coincidentally. 8. Among the Cesarean section cases, 266 cases (83.1%) were performed on emergency and the others electively. 9. The gestational ages at the time of operation were 40 weeks (30.0%) 41 weeks (16.6%) and 42 weeks (10.9%) 10. Apgar scores of the newborn in 2500 gram or more of baby weight was over 7 points at 286 cases (87.2%). 11. Maternal complications rate due to Cesarean section was 18.1% and mortality rate was 0.94%. 12. perinatal death rate of fetuses and newborn was 8.23%.

Dehydroepiandrosterone-Sulfate 투여가 산요기부인의 혈청 Prolactin치 및 Estradiol치에 미치는 영향

황용우(YW Hwang) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.11

1. 모체혈청 prolactin치(Table 1) DHEA-S를 투여한지 12시간 이상 경과한 후에 분만한 group 1에서는 분만직후의 혈청 PRL치는 259.0±39.7ng/㎖이고, DHEA-S를 투여한지 12시간 이내에 분만한 group 2의 분만직후의 혈청 PRL 치는 246.4±41.5ng/㎖이였고, 대조군에서는 239.1±76.2ng/㎖로서 거의 같았으며, 분만 24시간 후에 서도 상기순서대로 270.2±39.2ng/㎖, 282.9±61.3ng/㎖, 279.7±73.4ng/㎖로서, 각 군간에 유의한 차 이가 없었다. 2. 모체혈청 estradiol-17 치(Tab야 2) 분만직후의 혈청 E2-17 치는 를 투여한지 12시간 이상 경과한 후에 분만한 경우에서는 6677.8± 1316.3ng/㎖였고, DHEA-S를 투여한지 12시간 이내에 분만한 경우에서는 9576.7±1196.4ng/㎖로서, 대조군의 2958.8±726.6ng/㎖에 비하여 현저히 높았다(각각 p<0.01 및 p<0.05). 그러나, 분만 24시간 후에서는 각각 246.3±62.5pg/㎖, 546.5±95.8pg/㎖ 및 226.6±32.4pg/㎖ 로서 DHEA-S 투여후 36시 간이 경과하면 거의 정상치로 감소하였다. 따라서, 전반적으로 DHEA-S 투여로서 일시 혈중 E2-17 치는 현저한 증가를 보이나, 36시간이 지나 면 거의 감소하여 정상치로 되고, 한편, 혈중 PRL치는 하증의 감소가 없음으로, DHEA-S 투여가 유 즙분비에 거의 영향을 미치지 않은 것으로 사료된다. In order to evaluate the effect of dehydroepiandrosterone sulfate (DHEA-S) on maternal serum levels of estradiol-17 (E2-17) and prolactin we administered DHEA-S to 30 women shortly before their deliveries and measured the serum levels of E2-17 and prolactin by means of radilommunoassay The samples were taken immediately and 24hrs after delivery We devided the 30 wemen in 2 group namely one consists of women who had delivery after more than 12hrs of administrating DHEA-S(group 1. 14 persons) and the other who had delivery within 12hrs (group 2, 16 persons) of giving DHEA-S As controls we also tooks samples in the same way from 10 women who had delivery without DHEA-S(group 3) The serum prolactin levels (ng/ml) immediatly after delivery were 259.0±39.7(group 1) 246.3±41.5(group2) and 239.1±76.2 (group3) and became significantly higher 24hours after delivery showing 270.2±39.2 (group 1) 282.9±61.3(group 2) and 279.7±73.4 (group 3) respectively But there were no significant differences between each group The E2-17 levels (pg/ml) were 6677.6±1316.3(group 1), 9576.7±1196.4 (group 2) and 2958.8± 726.6(group 3) immediatly after and 246.5±62.5 (group 1) 546.5±95.8(group 2) and 226.6±32.4 (group 3) 24 hours after delivery In group 1, and 2., the levels of estradiol-17 are understandably higher than that of group 3., but they decrease rapidly reaching the group 1. almost to the normal (control`s) value Above results show the administration of DHEA-S does very little effect if any on prolactin level and elevate estradiol-17 level temporaly but the E2-17 decrease rapidly after delivery to normal value

임신중절을 목적으로 고농도식염수 주입에 의한 자궁괴사 및 복막염의 1예

김영환(YW Kim),박의호(EH Park),임광호(KH Lim),한영석(YS Han),황용우(YW Hwang) 대한산부인과학회 1980 Obstetrics & Gynecology Science Vol.23 No.2

결론 저자들은 30세의 경산부에서 양막내 고농도식염수를 사용하여 임신중절 시킨 후 자궁괴사와 복막염을 일으킨 1예를 경험 하였기 에 문헌적 고찰과 함께 보고하는 바이다. Extensive uterine necrosis and peritonitis occured after the injection of hypertonic saline to terminae pregnancy is a rare and grave condition. Recently, authers exprienced a case of termination of pregnancy by this technic at our Dept. of Obetrtric & Gynecology. A case of uterine necrosis and perironitis after the kypertonic saline abortion is presented with brief literature.

임신중에 Endodermal Sinus Tumor와 Dysgerminoma 가 합병한 1예

임광호(KH Lim),김영환(YW Kim),한영석(YS Han),황용우(YW Hwang) 대한산부인과학회 1980 Obstetrics & Gynecology Science Vol.23 No.11

난소에서 발생하는 endodermal sinus tumor는 주로 20세 전,후에서 발생하며, 악성도가 심하여 치명율이 높다. 광범위 수술이나 방사선치료보다는 단순히 일측병소부위제거술 및 여러가지 화학요법을 실시하는 것이 어느정도 효과가 있다고 한다. 저자들은 25세된 초임부에서 endodermal sinus tumor와 dysgerminoma가 혼재되어 발생한 난소배세포종을 1977년 7월 12일 광범위 수술후 방사선 치료하였으나 4개월만인 1977년 11월 16일에 사망한 1예를 경험하였기에 문헌고찰과 아울러 보고하는 바이다. Endodermal sinus tumor is one of the most malignant neoplasms arising in the ovary. We are experienced one case of endodermal sinus tumor mixed with dysgerminoma in pregnancy and report it with brief review of the literatures.

폐전이 없이 신장, 비장전이 및 자연 파열을 동반한 융모상피암 1 예

강영식(YS Kang),조정식(JS CHO),황용우(YW Hwang),임광호(KH Lim),김성용(SY Kim) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.3

Choriocarcinoma is a highly malignant, frequently metastatic form of gestational trophoblastic disease. The most common sites of metastatic involvement with trophoblastic tumors are the pulmonary parenchyma and the vagina. But the renal and splenic involvements are rare. Therefore these involvement are rarely detected in asymptomatic patients by clinical examination. We report a case of choriecarcinoma metastasized to the Lt kidney and spleen which was diagnosed 8 months later of loss of follow-up after molar evacuation.

거대자궁근종의 1례

정종호(JH Chung),최영희(YH Choi),정승우(SW Chung),강영식(YS Kang),황용우(YW Hwang) 대한산부인과학회 1983 Obstetrics & Gynecology Science Vol.26 No.7

A case of giant myoma in 22 years old nulliparous unmarried women has been experienced. We present this case with a brief review of the concerned literature.

개복수술의 임상적 고찰

문호길(HG Moon),김현중(HJ Kim),정혁(H Jung),황용우(YW Hwang) 대한산부인과학회 1982 Obstetrics & Gynecology Science Vol.25 No.8

1975년 1월부터 1979년 12월까지의 5년간 조선대학교 의과대학 부속병원 산부인과에서 입원하여 개복수술을 받은 제왕절개술, 자궁외임신, 난소종양, 자궁근종, 자궁경부암, 골반강내 염증성질환 및 융모성질환의 연령적 분포, 병명별 분포, 수술명, 증상등을 분석하여 다음과 같은 결론을 얻었다. 1.전 질병의 연령적분포는 20세 이하로부터 55세 이상에 이르기까지 광범위하게 분포되어 있었고 25세 내지 35세에서 349예인 49.9%를 차지하고 있었다. 2.700예중 제왕절개가 320예로 45.7%였고 자궁적출술은 254예로 36.2%였고 난관절제 및 난소절제술은 91예로 13%였다. 3.제왕절개술은 25세내지 30세층에서 184예로 전체 320예의 57.5%였다. 제왕절개술의 중요 원인은 C.P.D.,태위이상, 전치태반,previous C-section등이었다. 제왕절개술의 방식은 Lower Segmental transverse method가 271예로서 84.7%였다. 4.자궁외임신은 20세부터 40세까지에서 전체 72예중 70예가 이 연령층에 속하여 97.2%였고, 25세 내지 30세층에서 가장 많아 26예 (36.1%)였다. 5.난소종양중 가장 많은 예는 버종양성난소낭종이였으며 이는 29예로 반수에 이르렀다. 수술방법으로는 난소종양절제술이 33예로서 56.9%였고 자궁적출술을 겸하였던 예는 23예로 39.7%였다. 6.자궁근종의 호발연령은 40세 내지 50세층으로 29예(50.9%)였고 주증상은 출혈과 복통이었다. 7.자궁경부암의 연령적 분포로는 40세 이상층에서 38예로 70.4%였고 가장 많은 발생율을 보인 군은 45세 내지 50세군이었다. 자궁경부암의 수술방법은 Radical hysterectomy가 22예로 40.8%였다. 8.골반강내 염증성질환의 발생분포는 25세부터 50세에 이르기까지 거의 비슷하게 발생하였으며 전체 40예중 34예(85.0%)에서 자궁적출을 겸하였다. 9.융모서질환은 역시 25세이상 50세에 이르기까지 거의 같은 비율로 발생하였으며 전체 23예에서 자궁적출술이 시행되었다. The studies on 700 cases such as age distribution, diagnosis, operative methods and symptoms were performed with cesarean section,ectopic gestation, ovarian tumor, myoma uteri,cervical carcinoma, pelvic inflammatory disease and trophoblastic disease during the period of 5 years from Jan.1971 to Dec. 1979. 1.The age distribution of all cases (700) ranged from less than the age of 20 year to 55 year. In the group from the age of 25 to 35 year, 349 cases(49.9%) were treated by abdominal laparotomy most frequentry. 2.In the same period, cesarean section was performed in 320 cases( 45.7%) and hysterectomy in 254 cases (36.2) and salpingectomy and oophorectomy iin 91 cases(13.0%). 3.Cesarean section was the most frequentry operative method that was from the age of 25 to 30 year, 184 cases (57.5%) were performed. The main indications of cesarean section were cephalo pelvic disproportion,malpresentation, previous cesarean section and placenta previa. 4.The common operative method of cesarean section was lower segmental transverse incision(84.7%). 5.Seventy cases of all ectopic gestation ranged from the age of 20 year to 40 year. 6.The most common cases of ovarian tumors were nonneoplastic cyst (50.0%0 and ovarian tumors also occupied at the age of 20 to 35 year in 29 cases( 50.0%). 7.Myoma uteri occurred mainly at the age of 40 to 50 year in 29 cases (50.9%) and the main symptoms were bleeding and abdominal pain. 8.The age distribution of cervical carcinoma showed over the age of 40 year in 38 cases (70.4%). 9.The age distribution of pelvic inflammatory disease showed evently from the age of 25 to 50 year and 34 cases among 40 cases(85.6%) were treated by hysterectomy. 10.Trophoblastic disease ranged from the age of 25 to 50 year and 23 cases were treated surgically.