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안영준,신향미,전권희,문인근,서홍식,송호영,안혜선 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.1
본 저자들은 31세 임산부에서 진행된 부분포상기태가 있으면서 쌍태아 임신을 경험하였기에 간단한 문헌고찰과 함께 보고하는 바이다. Ultrasonography has become the preferred noninvasive diagnostic imaging modality that enables early confirmation of gestational trophoblastic disease. Twin pregnancy with partial hydatidiform mole and coexisting fetuses was lived at a later gestational age, and had higher preevacuation beta-hCG levels. When disease is not metastatic, chemotherapy is started for a rising or persistantly elevated beta-hCG level. Teh common complications of hydatidiform mole, hemorrhage and infection, decreased in incidence recently due to early diagnosis and evacuation of hydatidiform molar tissue. We recently experienced one case of advanced twin pregnancy with partial hydatidiform mole and coexisting fetuses.
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이용준 ( Lee Yj ),배공명 ( Bae Gb ),허영무 ( Heo Ym ),서재현 ( Seo Jh ),김상부 ( Kim Sb ),최재경 ( Choi Jk ),박우재 ( Park Wj ) 한국품질경영학회 2017 품질경영학회지 Vol.45 No.4
Purpose: In this study, the reliability growth management procedures for armed vehicle is suggested and an illustrative case study of launcher system is given. Methods: Crow-AMSAA model is adopted to manage reliability growth of armed vehicle using failure data acquired from development test phase to field operation phase. Between the development test phase and the production phase, the suggested reliability growth procedures for armed vehicle entails accelerated life test of the selected module whose design is changed to improve its reliability for assuring the target system reliability. And it can be verified through estimating the system reliability based on the failure data of field operation phase. Results: It is shown that the proposed reliability growth management procedures are effective for armed vehicle based on the case study of launcher system. After estimating the reliability of launcher system at every development test, some items are selected to change their designs for improving reliability. Accelerated life test is performed to prove the reliability improvement and finally it is verified through the field operation. Conclusion: The reliability growth management procedures for armed vehicle is suggested and the case study of launcher system shows it can be effective for managing the reliability growth of the armed vehicle.
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만삭임신 시 조기파수 환자에서 진통유발을 위한 Prostaglandin E2의 평가
조성남,서성진,이종진,조유진,문현창 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.7
목적: 만삭임신에서 진통발현 전 자연파수 시 그 처치는 산과의에게 가장 어려운 문제점 중의 하나입니다. 이에 저자들은 만삭임신에서 조기파수 된 환자들에 대한 세가지 처치방법들을 후향적 비교 분석하고자 하였습니다. 연구방법: 본 연구에서는 1996년 1월 1일부터 1997년 12월 31일까지 전북대학교병원 산부인과를 방문한 임신 38주에서 41주사이의 두위의 단태임신으로 파막후 3시간까지 진통이 없는 건강한 140명의 산모를 대상으로 하여 무작위로 3군으로 분류하여 조사하였습니다. 결과: 분만경과시간은 프로스타글란딘E2를 사용한 군과 옥시토신을 사용한 군에서 대조군에 비해 짧았고[P$lt;0.05], 모성감염은 프로스타글란딘E2를 사용한 군에서 옥시토신을 사용한 군과 기대요법을 이용한 대조군에 비해 적었으며[P$lt;0.05], 제왕절개율은 3군에서 차이가 없었고, 또한 프로스타글란딘E2를 사용한 군에서 심한 부작용은 없었다. 결론: 프로스타글란딘E2를 이용한 만삭임신에서 조기파수 된 환자의 분만유도는 옥시토신을 사용하는 것보다 안전하고 간편하다고 볼 수 있다. Objective: The management of premature rupture of the membranes in healthy pregnancy women at term without uterine activity is a matter of debate. A retrospective study comparing three management methods for patients at term with premature rupture of membranes was performed. Methods: This study was undertaken to compare the effectiveness of intravaginal prostaglandin E2 [PGE2] of term labor with oxytocin induction and expectant management in healthy 140 pregnant women with spontaneous rupture of membranes before the onset of labor from Jan. 1, 1996 to Dec. 31, 1997 at the Department of Obstetrics and Gynecology, Chonbuk National University, Medical School. Results: The time interval to delivery was shorter in prostaglandin and oxytocin groups versus control group with statistical significance[P$lt;0.05]. The incidence of maternal infection was lowest in prostaglandin group versus oxytocin and control groups with statistical significance[P$lt;0.05]. Overall cesarean section rate was low in prostaglandin group versus oxytocin and control groups without statistical significance. No adverse effects were observed in prostaglandin group. Conclusion: Vaginal PGE2 suppository can be used successfully to induce labor after premature rupture of membranes at term with greater ease of adminstration when compared with oxytocin.
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정상 만삭임부와 신생아 혈청 Lipoprotein (a) 농도에 관한 연구
허민,박형무,서정호,이재우,강용기,차영주 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.10
본 연구는 중앙대학교 의과대학 부속 용산병원 산부인과에서 1993년 11월부터 1994년 9월까 지 만삭정상 질식분만 혹은 제왕절개 수술로서 분만한 산모 400명과 신생아 233명에 대하여 측정한 Lipoprotein(a) 와 7일후에 추적관찰이 가능했던 산모 67명에서 측정한 Lipoprotein(a) 을 정상군, 경계부위군, 비정상군으로 나누어 비교분석하고 분만 전후의 수치와 변화를 봄으로써 우리나라 정상산모와 신생아의 정상 혈중 Lipoprotein(a) 의 농도를 구하고, 내인성 호르몬이 혈중 Lipoprotein(a) 의 농도에 미치는 영향을 보고자 하여 다음과 같은 결과를 얻었다. 1. 정상 만삭 산모의 혈중 Lipoprotein(a) 의 평균농도는 21.07+-23.56mg/dl이었다. 2. 산모의 혈중 Lipoprotein(a) 의 농도에 따른 분포는 다음과 같다. 혈중 농도가 9mg/dl이하 군에서 42%로 제일 많은 분포를 보이고 있고 정상치인 25mg/dl이하군이 70%의 분포를 보이고 있었다. 3. 분만 후 7일째 다시 외래에서 측정한 산모의 혈중 Lipoprotein(a) 농도를 분만 전에 측정 한 수치와 비교하여 보면 각각 44.22+-22.53mg/dl, 60.93+-35.52 mg/dl로 분만후 혈중 Lipoprotein(a) 의 유의한 상승이 관찰되었다. 4. 신생아의 제대 혈중Lipoprotein(a) 의 평균 농도는 1.78+-2.88mg/dl으로 모체의 혈중 농도의 9.4%에 지나지 않는 농도였고 분포는 1mg/dl에서 5mg/dl까지의 군이 224명으로 전체의 96% 를 차지하고 있는 비대칭적 분포를 보이고 있었다. 5. 신생안 233명에 대한 모체의 혈중 Lipoprotein(a) 농도의 정상군, 경계군, 비정상군의 분류 에 따른 신생아 제대 혈중 Lipoprotein(a) 농도의 유의한 차이는 보이지 않았으며 신생아 성 별이나 체중에 따른 농도의 변화에서는 성별에 다른 유의한 차이는 보이지 않았으나 체중 4000gm이상의 신생아 군에서의 다른 체중군에 비하여 유의한 상승이 관찰되었다. 분만 후의 임부의 혈중 Lipoprotein(a) 의 농도의 유의한 상승이 관찰된 결과로써 혈중 에스트로젠과 프로제스테론의 급격한 변화에 의하여 Lipoprotein(a) 의 농도가 영향을 받음을 밝힘 으로써 폐경기 여성에서의 혈중 Lipoprotein(a) 의 측정이 동맥경화성 질환의 위험성의 상승 을 억제하는데 있어서의 호르몬 대체요법의 유용성에 대하여 기초적인 자료로서 이용할 수 있으리라 사료된다. The Lipoprotein(a) represents a cholestery-ester, low-density-lipoprotein like particle with apolipoprotein B-100 linked to apoprotein, has recently attracted the attention of several research because of its apparent atherogenic and thrombogenic role. Lipoprotein(a) is independent risk factor for atherosclerosis in human when its plasma concentration is greater than 30 mg/dl. There is a strong genetic predisposition to Lp(a) therefore high concentrations of Lipoprotein(a) is confirmed to be one of the most prevalent hereditable risk in cardiovascular disease. Serum Lipoprotein(a) levels seem to be insensitive to dietary modification and other lipid-lowering agents but its concentration is decreased by postmenopausal HRT. Pregnancy induces hyperlipidemia and hyperlipoproteinmia and high concentration of estrongen and progesterone. This study was conducted in other to evalute 1) the normal levels and distribution of serum Lipoprotein(a) of full term pregnant mothers and Newborns. 2) role of endogenous estrogen and full term pregnant mother and postpartum period. 3) role of genetic factors in Lipoprotein(a) concentration during fetal period. 4) to know whether other factors such as fetal sex and weight could be causative factors to control the serum Lipoprotein(a) of newborns. We investigated the changed in serum Lipoprotein(a) concentratioan on normal full term pregnancy and postpartum state. Blood sampling were carried out from mothers just before delivery and the newborn infants cords for the measurement of serum Lipoprotein(a) . The mothers were divided into 3 groups such as normal borderline, abnormal according to serum Lipoprotein(a) level. The result were as follows. The mean value for Lp(a) of all 400 individuals entering the study was 21.07+-23.56 mg/dl. 70.25% were normal range groups, 11.25% wee bordering groups and 18.50% were abnormal high level groups. The mean value for Lp(a) of 233 newborn infants was 1.78+-2.88 mg/dl, and 233 their mothers was 18.92+-21.65 mg/dl. Lp(a) concentrations at fulterm pregnancy mother were significantly lower than at postpartum period. Theses findings suggest that endogenous estrogen and progesterone may have active role in decreasing the levels of serum Lp(a). There were no difference in Lp(a) concetrations of new born infants between male and female infants, but Lp(a) concentraion according to infants' weignt have showed differences. The new born infants above 4,000g weight have significantly more increased Lp(a) level than other newborn infants below 4,000g weight. The Lp(a) levels of newborn infants delivered from mothers of 3 groups according to serum Lp(a) levels show similar. Therefore there seems to be no role of genetic factors on Lp(a) concentration during fetal period.
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김재욱,김세광,서경,임영구,김완기,주수길,임종철,이용제 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.4
The varicella during pregnancy is rare. The incidence of varicella among pregnant women is about 5 in 10,000 pregnancies. In 1947, Laforet and Lynch were the first to describe an association between maternal varicella infection in early pregnancy and congenital anomalies in the offspring. the existence of a syndrome was first postulated by Srabstein et al(1974), Brunell(1983), Kotchmar(1984), and recently Higa et al.(1987) described most of the malfomations associated with maternal varicella infection. Varicella-Zoster viurs(VZV) infections acquired during pregnancy may result in serio us disease for both the mother and the fetus. The effects on maternal health can range from a mild chikenpox exanthem to servere life-theatenig illness often complicated by viral pneumonitis. The fetus may remain unaffected, but VZV infection during early pregnancy has been associated with a congeital syndrome including muliplie defects of the skin, limb, eyes, and brain. We reports our experience with a varicella during pregnancy with a brief literature review.
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