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      • KCI등재

        제왕절개술에 관한 임상적 고찰

        문영기(YK Moon),이동식(DS Lee),오기석(KS Oh),김광숙(KS Kim) 대한산부인과학회 1974 Obstetrics & Gynecology Science Vol.17 No.5

        1961년 1월 1일부터 1971년 12월 31일까지 만 10년간 연세대학교 의과대학 산부인과에 입원 하여 1000gm 이상의 태아를 분만한 13,738예의 산모 가운데 1,121예의 제절예와 8쌍의 쌍태 아를 포함한 981예의 사산아 및 신생아를 대상으로 다음과 같은 결론을 얻었다. 1) 제절의 빈도는 8.1%였다. 2) 적응증은 반복제왕절개술이 32.8%로써 가장 많았고 아두골반 불균형이31.7%, 태위이상이 10.7% 등의 순위였다. 3) 제왕절개술식으로는 자궁협부 횡절개술이 92.7%였고 자궁체부 종절개술이 6.5%였다. 4) 제왕절개술과 동시에 시행된 수술은 난관결찰술이 20.3%로써 가장 많았다. 5) 마취방법으로는 전신마취가 76.9% 요추마취가 21.9%였다. 6) 모성사망율은 0.5%였고 모성이환율은 30.7%였다. 7) 파막된 시간별 모성이환율은 파막된 시간이 길수록 높았으며 파막 후 12시간 이상군이 이하군보다 현저히 높았다. 8) 주산기 사망의 백분율은 8.15%였다. The study was carried out retrospectively based on the clinical charts of 973 patients who had cesarean sections performed, and 981 newborns including 8 pairs of twins delivered at Dept. of Obst. & Gyn., College of Medicine, Yonsei University from January 1, 1961 to December 31, 1971. The result obtained were as follows : 1) Cesarean section rate was 8.1% for the period. 2) Among the indications for cesarean section, the previous cesarean section was the most prevalent (32.8%), and the others were cephalopelvic disproportion (31.7%), malpresentation (10.7%) in order. 3) In the types of operation, lower cervical transverse type was most common (92.7%) and classical type was only 6.5%. 4) Of 221 combined operations with cesarean section, tubal ligations were perfomed in 197 cases. 5) The general anesthesia was major type and its rate was 76.1%, and spinal anesthesia was 21.9% and so on. 6) It was found that meternal mortality was 0.5% and the morbidity was 30.7%. 7) Maternal morbidity rate was increased as the duration of rupture of membranes was extended. Particulary the group of more than 12 hours after rupture of membrane were higher greatly than the group of less than 12 hours. 8) Perinatal morbidity was 8.15%.

      • KCI등재

        임신중 감작된 Rh음성 임부의 치험 1 예

        문형,박문일,정성노,정창영,임기은,오명석,김기성 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.12

        본원 산부인과에서는 최근 Rh 음성 임부가 간접 Coombs검사상 항체역가가 증가하여 양수천자에 의한 분광비색검사후 임신 제 33주에 조기분만을 유도한 1예를 경험하였기에 간단한 문헌고찰과 함께 보고하였다. When the Rh negative mother is sensitized, the risk of erythroblastosis fetalis is increased. If the indirect Coombs test titer is at or above the level of 1: 16 and an amniotic fluid ^450 falls into the 80%-90% level of zone 2 or into zone 3, prompt delivery should be undertaken or intrauterine transfusion is considered. We experienced a case of successful delivery in a sensitized Rh negative mother who was monitored using indirect Coombs test and amnoitic fluid spectrophotometry. We present this case with a brief review of literatures.

      • KCI등재

        한국여성에서 자궁경부암을 조기진단하는데 있어 자궁경부의 세포학적 검사와 중합효소 연쇄반응을 이용한 인유두종 바이러스 16번, 18번 검색의 효능성에 관한 연구

        주갑순,김영태,서호석,문준,오민정 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.1

        자궁경부암 발생에 가장 밀접한 관련이 있는 HPV 16과 18의 존재유무를 정상 Pap smear를 보이는 경우에도 검색하여 자궁경부암 검진에 사용되는 위음성율이 높은 Pap smear의 보완, 추후 자궁경부암 발생의 위험이 높은 고위험군을 조사하기 위하여 정상 Pap smear를 보인 85명과 비정상 Pap smear를 보인 17명의 환자에서 HPV type 16 및 18의 검색을 통하여 다음과 같은 결과를 얻었다. 1. 정상 pap smear 소견을 보인 군(85명)에서 HPV type 16 및 18의 감염율은 각각 11.8% 및 1.2%였다. 2. 비정상 Pap smear 소견을 보인 군(17명)에서 HPV 16 및 18의 감염율은 각각 41.2% 및 23.5%였다. 이상의 결과로 볼 때, 자궁경부세포에서 PCR을 이용한 HPV의 검색을 Pap smear와 동시에 시행하는 것은 기존의 Pap smear를 보완하여 정상 Pap smear를 보이는 경우 예측하기 힘든 자궁경부암 발생의 고위험군의 발견과 이 경우 정기적인 Pap smear 및 질확대경 검사를 통하여 자궁경부암 전단게인 자궁경부 상피내종양 단계에서 조기진단함으로 자궁경부암의 예방에 기여할 것으로 사료된다. Cervical cancer is the most common gynecologic malignancy and leading cause of death in Korean women. Although the precise etiologh of cervical cancer is unknown, epidemiologic studies suggest that venereally transmitted infectious agents could play an important role in the etiology of cervical cancer. Recently, human papillomavirus(HPV) has been reported to be associated with neoplastic change. A very sensitive polymerase chain reaction(PCR) capable of amplifying specific DNA sequence by up to a millionfold was developed for detection of HPV DNA. The purpose of this study is to investigate the efficacy of cervical cytoloty and PCR for detection of HPV type 16, 18 and to study the possible role pf PCR as complementary test for identification of high-risk group which can not be detected by cervical cytology alone. This study included 102 cases, 85 cases showing normal cytology and 17 cases showing abnormal cytology. The results were as follows; 1. Positive rates of HPV type 16 and 18 were 11.8% and 1.2%, respectively, among 85 cases showing normal cytology. 2. Positive rates of HPV type 16 and 18 were 41.2% and 23.5%, respectively, among 17 cases showing abnormal cytolog. Especially, overall positive rate of HPV type 16 and/or type 18 was 83.3% among 6 cases diagnosed as invasive cervical cancer. According to these results, concurrent use of HPV detection by PCR from cervical scrapes with cytologic examinatio seems to be a complementary method for prevention of cervical cancer.

      • KCI등재

        초기임신에서 태아 심박동수의 변화양상과 그 의의에 관한 연구

        주갑순,박용균,조수용,서호석,허준용,문준,박지영,김동오 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.7

        1992년 2월부터 1993년 6월까지 본원 산부인과 외래를 방문한 임신 제 6주부터 12주사이의 산모중 초음파상으로 태아의 심박을 확인할 수 있었던 150명에서 각 주수에서의 태아 심박동수를 측정한 결과 임신 제 6주부터 10주까지 태아 심박수는 통계학적 의의가 있는 증가를 보였고(p$lt;0.05), 이때 각 주수와 태아 심박수와의 상관계수 r=0.81로 높은 상관관계를 보였다. 그러나, 정상 임신군과 절박 유산군과의 사이에서 태아 심박수의 차이는 통계학적 의의가 없었다(p$gt;0.05). The resolution power of transvaginal sonography has recently been rapidly improved so that it is now an essential method in evaluating the normal fetal growth in an early intrauterine pregnancy. Even though there were many studies on the values and structures which used in estimating the gestational age and wellbeing of the fetus, such as gestational-sac, crown rump length, fetal heart beat and b-hCg, there was still no significant correlations definitely clarified between the changes of the fetal heart beat and the consequent outcome of the pregnancy. Therefore, we studied on the changes of the fetal heart beat in normal early pregnancy and the impact of the abnormal factors on the fetal heart rate. The results are summrized as following. 1. The fetal heart rate was 123.9+-11.9, 140.1+-14.6, 162.2+-10.9, 173.1+-12.7, 174.5+-7.2, 169.3+-10.8 and 164.9+-10.9/min in the 6th, 7th, 8th, 9th, 10th, and 12th weeks of pregnancy respectively in the normal pregnancy groups while, in the threatened groups the fetal heart rate showed 123.2+-12.2, 140.1+-16.1, 160.7+-11.7, 167.4+-11.5, 171.3+-13.8, 165.8+-14.5 and 166.0+-8.5/min in the same corresponding weeks of pregnancy. 2. The fetal heart rate showed a tendency to increased during sixth to tenth weeks of pregnancy but ot slightly decrease during tenth to twelfth weeks of pregnancy. This results showed statically significantl increase of fetal heart rate during the sixth to ninth week of pregnancy(p$lt;0.05). But there was no statiscal significance in the rest of the weeks(p$gt;0.05). 3. The correlation analysis between fetal heart rate and gestational age resulted r(correlation coefficient) equals 0.81 which means there is high correlations between them. 4. There was no significant difference of fetal heart rate between the groups of pregnancy and threatened abortion(p$lt;0.05).

      • KCI등재

        임신부에서 실시한 Anti-HEV 측정에 대한 연구

        주갑순(KS Ju),박용균(YK Park),조수용(SY hough),서호석(HS Suh),허준용(JY Hur),이갑노(KN Lee),신재철(JC Shin),문준(J Moon) 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.3

        임신부를 대상으로 실시한 본 연구에서 E형간염에 대한 항체양성율이 9.9%로 나타난 것은 우리나라에도 E형 간염이 상당히 존재하는 것을 보여주고 있으나, 임신부들의 연령별, 임신횟수 및 분만횟수별 분포에서는 각군간 유의한 차이를 볼 수 없었고, 또한 대부분에서 임상증상이 발현하지 않는 즉 무증상 감염(subclinical infection)으로 지나가는 것으로 나타났다. 그러나 간염환자에서 A형, B형 및 C형 간염이 배제된다면 반드시 E형 간염에 대한 검사는 실시해야 할 것이며, 또한 임신중 E형 간염이 발생한 경우에 그 치사율이 매우 높은 것으로 알려져 있으므로 향후 임신과 E형 간염의 관게에 대한 지속적인 연구가 필요할 것으로 사료된다. Hepatitis E was formerly called enterically-transmitted, enteric, epimemic, waterborne, or fecal-oral non-A, non-B hepatitis. Another non-A, non-B hepatitis, namely hepatitis C poses serious problems of livers to cirrhosis ans gepatocellular carcinoma in the industrialized countries. On the other hand, hepatitis E may not be endemic in these countries but is prevalent in developing countries. Hepatitis E has its highest attack rate in young to middle aged adults, with highest case-fatality rates in pregnant women. But it is not clear whether the pregnncy itself caused more severe disease, whether pregnant women were more symptomatic because of other manifestations of pregnancy, or whether pregnant women(in developing countries) were nutritionally and medically disadvantaged, thus allowing more severe impact of the infection. This study was undertaken with the objective of searching the prevalence of hepatitis E in Korea and evaluate the effect of hepatitis E on pregnancy. A total of 313 pregnant women who visited the antenatal clinic were selected during the period from May, 1994 to July, 1994 at the department of Obstetrics and Gynecology, Guro hospital, Korea University and taken the test for IgG and IgM anti-HEV with the use of ELISA kit. The positive rate of anti-HEV was 9.9%(IgG ; 5.9%, IgM ; 3.0%, IgG and IgM ; 1.0%). The discrepancy among age or parity groups was not shown, and almost all of infected women have no clinical manefestations. So we concluded that hepatitis E exists in Korea but most infected cases are probaby subclinical infections. But it is considered the patient must take the test for anti-HEV in case hepatitis A, B and C are excluded, and further study in the effect of HEV on pregnancy should be performed.

      • KCI등재

        임신과 동반된 난관기형종 1 례

        정기성,문용호,김안택,엄상탁,정자영 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.4

        저자들은 30세 여자 환자에서 임신과 동반된 왼쪽 난관 양성기형종 1례를 경험하였기에 문헌적 고찰과 함께 보고하는 바이다. Teratoma of the Fallopian Tube is very rare. A case of the mature cystic teratoma was noted incidentally in a patient who was undergoing cesarean section for placenta previa. Diagnosis was made on the basis of the post-partial salpingectomy biopsy findings. Here we present the case with a brief history and review of the literatures.

      • KCI등재

        대음순에 발생한 점액종의 1예

        윤강섭(KS Youn),박주현(JH Park),임현정(HJ Im),문상배(SB Moon),윤강혁(KH Yoon) 대한산부인과학회 1982 Obstetrics & Gynecology Science Vol.25 No.7

        저자 등은 47세의 부인의 대음순에서 발생한 850 gm의 점액종 1예를 치험하였기에 문헌 고찰과 함께 보고한다. Myxoma is a rejatively rare benign neoplasm,which usually develops in the superficial subcutaneous tissue and occasionally in other parts of the body,such as heart,skin,fascia,muscle and bone,etc. We had a case of myxoma in the labia major of a 47 year old woman, which measured 13*16*4cm in size and weighed 850 gm. Histologically, these tumors are characterized by a proliferation of loosely scattered stellate and spindle shaped cells set in a myxomatous stroma which is composed of acid mucopolysaccharide.

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