난소의 이소성 탈락막 변화에 대한 조직학적 연구

김두호(DH Kim),박흥원(HW Park) 대한산부인과학회 1977 Obstetrics & Gynecology Science Vol.20 No.6

저자는 난소의 이소성 탈락막변화의 발생원인을 규명코저 정상분비말기에 얻은 자궁내막조직(10예), 정상자궁임신시 얻은 내막조직과 난소조직(5예), 난관임신환자(20예)에서 얻은 난관과 난소조직 및 임신 없이 난소에 위탈락막증을 보인 2예의 난소조직에 대하여 조직화학적 검색을 하여 다음과 같은 결론을 얻었다. 1. 탈락막변화는 그 발생 장소나 임신여부와 관계없이 유사한 조직학적 소견과 조직 화학적 반응을 보였다. 2. 탈락막세포는 그 세포질의 주변부에 소량의 점액 물질을 갖고 있으며 그 염색성 으로 보아 중성과 산성이며 변색성을 나타내고 있었다. 3. 탈락막반응은 혈관주변에서 더욱 뚜렸하였으며 발생부위와 관계없이 서로가 유사 한 소견을 보였으므로 국소적인것 보다는 전신적인 인자가 관여하는 것 이라고 생각 된다. The etiology of ectopic decidual reaction in pregnancy has been supposed to be a variety of factors, such as chorionic gonadotrophic hormone, prolonged progesteronic stimulation or defence mechanism to the chorionic invasions(Nelson & Greene, 1958: Greenblatt & Krafka, 1941), mechanical trauma(Madjerek, 1969), adrenal cortical factor (Bassis, 1956), and effects of cyclic AMP (Leroy, 1974). In order to observe decidual reaction in variable sites, the author used endom etrial tissues obtained from women at late secretory phase, endometrial tissues and ovarian tissues from cases of normal uterine pregnacies and tubal pregnancies, and ovarian tissues from cases showing pseudodeciduosis without pregnancy, then applied several histochemical techniques to those specimens. The follows were ensued: 1. The decidual cells represented similar patterns to routine and special histological techniques in spite of varieties of sites of observation and presence or absence of pregnancy. 2. The decidual cells contained small amount of mucosubstances at the rim of their cytoplasm and they were neutral or acidic in nature. 3. On the ground of the fact that the decidual reactions were found around the blood vessels and they represented similar pattern each other in a variety of organ, the etiologic factor of the ectopic decidua may be ascribed to hormonic effects.

양수 태변 착색의 임상적 관찰

김두호(DH Kim) 대한산부인과학회 1970 Obstetrics & Gynecology Science Vol.13 No.3

This study was carried out retrospectively based on the clinical observation of the 83 cases of meconium staining amniotic fluid in 1,148 deliveries at the Department of Obstetrics and Gynecology, In-Chun Christian Hospital, from May, 1967 to May, 1968. The results were as follows; 1. The incidence was 7.2%, the meconium stained amniotic fluid was occured primigravida in 74.6%, multigravida in 25.4%. It occurs 3 times more in primigravida than in multigravida. 2. It occurs mostly at 40th weeks or more in pregnant period. 3. Fetal maturity: Mature group was in 73.1%, Premature proup was in 26.7%. Mature group was about 3 times more than premature group. 4. Fetal distress was occured in 9.4%of which was meconium staining amniotic fluid as well as irregularity of fetal heart tone or if tone below 100per minute or more than 160per minute. Still birth rate was in 38%, it was about from 6 to 8 times higher than normal rate. Etiology of fetal distress was investigated not only fetal anoxia but also vagal nerve tention. 5. Premature rupture of membrances occured 67cases. on 415 cases. It was revealed as higf in 80.7%. 6. In the over term group. control group was in 30%. spontaneous delivery group was 40.2% and pitocin induction group was in 43.3%. It was presumptive largely based on fetoplacental dysfunction. 7. Intrauterine bacterial infection was not significant to prophylactic antibiotics but S.P.R.M., prolonged labor and general conditions of mother were major cause and also sterilized vaginal examination was important. All of these were great influence to fetal morbidity, mortality and Maternal mortality. 8. In the prolonged labor meconium stained amniotic fluid was occured higher than 25% in over the 30 hours of total length of labor, especially it was occured higher than 25% in over the 30 hours of total length of labor, especially it was occured 28.4% in primigravida. 9. Maternal morbidity was 4.2%. 10. Perinatal morbidity was difficult to calculate because patient could not be followed up after discharge. Fetal death was 5 cases. 11. Meconium stained placental weight was average in 544.7gm. pathologic tissue study was not performed in all cases but amnionitis was found in 8 cases.

두흉복부 유합 중복기형 1예

김광철(KC Kim),박인재(IS Park),김두호(DH Kim) 대한산부인과학회 1976 Obstetrics & Gynecology Science Vol.19 No.11

A case report of a Cephalothoraco-Ventropagus with two sets of upper and lower extremities delivered through the vagina at the 32 weeks of gestation.

Testosterone Enanthate와 Estradiol Valerate를 사용한 한국부인에 있어서 산후 유즙분비억제게 관한 임상적 고찰

박양서(YS Park),김두호(DH Kim) 대한산부인과학회 1976 Obstetrics & Gynecology Science Vol.19 No.6

1974년 5월6일부터 1975년 9월30일까지 약 1년 5개월 동안 산후 유즙준비를 억제한 산모 115예를 대상으로 관찰하여 다음과 같은 결론을 얻었다. 1. 산후 수유를 하지않은 산모의 빈도는 18.7%였다. 2. 산후 비수유부의 적응증을 보면, 산모가 자기의 편리를 위하여 원한 예가 77예(67.0%) 로 서 대다수를 점했고 산모의 질병이 11예(9.6%) 조산아와 미숙아가 11예(9.6%) 자궁내 태아 사망이 6예(5.2%) 직장 관계가 5예(4.3%) 신생아 사망이 3예(2.6%) 선천적 기형이 2예(1.7%) 였다. 3. 유즙분비가 전혀 없었던 예가 92.1%였으며 유방증상은 전혀 없었거나 경했던 예가 89.1% 였다. 4. 초산부와 경산부, 임신 주수에 따른 유즙분비 억제와 유방증상에는 별 효과 차이가 없었 으며 모유수유 경험이있던 산모에서도 효과의 차이는 없었던 것 같았다. 5. 부작용은 전예에서 볼 수 없었다. A Clincal survey of the suppression effects of postpartum lactation and breast symptoms has been made on 115 nonurinsing mothers using 3ml of Testosterone Enanthate combined with Estradiol Valerate out of 614 deliveries from May 6, 1974 to September 30, 1975. The clinical data obtained were as follows. 1. The incidence of nonursing mothers was 18.7%. 2. In indication the cases desiring suppression of lactation for their convenience were most common. its rate was 67.0% and others were as follows, maternal disease 9.6% premature and imature births 9.6% intrauterine fetal death 2.5%, maternal occupational problems 4.3% neonatal death 2.6% and congenital malformation 1.7% 3. Lactation was inhibited completely in 92.1% and breast symptoms were absent or mild in 89.1% 4. There appeared to be no correlation between response and parity gestational period or previous nursing experience. 5. No nudesirable side effects were present in all cases

자궁경부 점액의 조직화학적 연구

이성재(SJ Lee),김두호(DH Kim) 대한산부인과학회 1977 Obstetrics & Gynecology Science Vol.20 No.3

저자는 자궁 경관부에 출현하는 점액의 성상을 밝히고 이점액이 주기적 변동을 하는지의 여부를 밝히고자 200예의 자궁 경관부에 대하여 몇가지 조직화학적 검색을 시행한 결과 다음과 같은 결론을 얻었다. 1) 일반조직 표본상에서 내경관부 선포와 선포상피는 뚜렷한 주기적 변동을 볼 수 없었 다. 2) 자궁내경관부 점액중에는 중성 약산성 및 황화점액이 포함되어 있었다. 3) 자궁내 경관부의 점액량은 주기적 변동을 하지만 이를 조직화학적 방법으로 검출하기 는 용이하지 않았다. 4) 자궁외 경관부 중층상피에는 중성점액만 있으며, 이는 주기적 변동 보다는 상피세포의 성숙도와 보다 밀접한 관련을 갖고 있었다. It has been suggested that the uterine cervix shows cyclic changes according to menstrual cycle. Since the uterus as well as fallopian tubes are originated from Mullerian duct, they show cyclic changes during menstruation. On histological viewpoint, Sjoval insisted that the length of the endocervical epithelium is grown up under the influence of estrogen during endometrial proliferative phase and reached the peak at the time of ovulation and thereafter regressed. Wollener observed that the maturity of the endocervical gland reached at the peak prior to menstruation then sloughed during menstruation. However, such hypotheses are controversial by various authors at present. Production of cervical mucus is increased at the time of ovulation, while viscosity of cervical mucus is decreased before ovulation and basal temperature is raised at the time of ovulation. Also arborization is noted at this time. Although the quantitative studies showed cyclic change of the cervical mucusa, histoc hemical studies are not yet been clarified Smith and Smith reported cyclic changes of pe riodic-acid-Schiff s positive materials in the cervical stromal tissue. Nogales and Botella observed decreased amounts of methylene blue, neutral mucin and glycophosphatase activity. To observe the nature and cyclic changes of the cervical mucus, cases of 200 totally hysterectomized uterus were examined and histochemical studies were carried out to the cervical tissue. Results are as follows; 1. No cyclic changes were observed on endocervical glands and epithelium by routine histologic studies. 2. Neutral, weakly acidic and sulfated mucus are seen in the cervical glandular lumen and epithelium in various states. 3. There was suspicious cyclic changes in amounts of endocervical mucus showed tendency of quantitative changes during menstruation. 4. The endocervical squamous epithelium contains only neutral mucin. It seems to be closely related with differentiation of the epithelium. No influence is seen with menstrual cycle.

융모종양에 관하여 ( 예보 )

황태식(TS Hwang),노경병(KB No),김두호(DH Kim) 대한산부인과학회 1962 Obstetrics & Gynecology Science Vol.5 No.2

This article is a preliminary report of the Yonsei University College of Medicine, from June 1, 1959 to July 30. 1961. A total of 20 cases were seen with the following distribution; Hydatiform mole 12, chorioadenoma destruent 1, choriocarcinoma 7. The following features were noted among the patients with hydatiform mole. One case was under age 25 and one case over 40 with all rest between the ages of 25-30. In the majority of patients tehre was a lapse of three months from the L>M>P> till the mole was passed but the shortest was 25 days and the longest was 155 days. 75% of the patients had a fever and at least 50% had a chilly sensation. Half the cases when first seen had uterine enlargement greater than expected by dates while 33% were consistent with their dates and the rest weresmaller than their dates. Toxemia was seen in 33% of the patients. One third of the patients who were less than 4 months pregnant or whose uterus was below the umbilicus had toxemia. Of the tow cases who were more than 4 months pregnant or whose uterus was enlarged above the umbilicus, one of them developed texemia. 25% of the patients devloped theca leutein cysts. The patients were managed by either pitocin induction or stimulation followed by a D&C. In one patient over 40 a hysterectomy was carried out after passage of the mole. the remaining paticnts were followed according to the chart seen in fig. 9 of the main article. The patients with choriocarcinoma ranged in age from 23 to 52 with three patients over 48 years old. The vast majority were multiparas. Four of the patients had a previous history of passing a mole and in the others there had been a normal delivery. None of the patients had had an abortion. Among the patients who passed a mole the diagnosis of carcinoma was made in one patient within 25 days and in the remainder before 10 months. Among the three patients who had had a normal pregnancy there was a time interval of 3 years in one case and 9 years in two cases. Theca lutein cysts were found in 3 cases. The Friedman test was positive in 100%. Metastatic lesions were found in the inngs in 57%, the vagina in 57% and in the broad ligament in 14%. A total abdominal hysterectomy and bilateral salpingoophorectomy was done in 4 patients. A combination of external rediotherapy and chemotherapy was tried in one case and no therapy was given in 2 cases. At present 2 patients have died, 3 are alive and well, and 2 have been lost to follow up.

난관 자궁내막증의 1 례

황병철(BC Whang),문원주(WJ Moon),김두호(DH Kim) 대한산부인과학회 1987 Obstetrics & Gynecology Science Vol.30 No.10

Endometriosis is the condition in which tissue like that of the uterine mucosa occurs outside the uterus. The disease of women, often affects the pelvis but may involve other area, including skin. The histogenesis of the endometriosis is not clearly established despite the various theories that has been presented. The prevailing theories include. 1. Transtubal regurgitation of menstrual blood. 2. The celomic metaplasia doctrine. 3. Lymphatic dissemination. 4. Hematogenous spread.

노인성 또는 위축성 질염 치료에 대한 Dienestrol 연구의 임상적효과

강천수(CS Kang),허민(M Hur),배도환(DH Pai),김두호(DH Kim) 대한산부인과학회 1978 Obstetrics & Gynecology Science Vol.21 No.10

1978년 2월 1일부터 8월 10일까지 노인성 또는 위축성 질염 환자 53예에서 Dienestrol연고를 사용하여 그 임상적 경과를 관찰하였으며 그 결과 다음과 같은 결론을 얻었다. 1. Dienestrol 연고는 노인성 또는 위축성 질염에 매우 우수한 효괄ㄹ 나타내었다. 2. Dienestrol 연고는 주사나 경구 투여에 의해서 나타나는 부작용이 전혀 없었다. 3. Dienestrol 연고는 암종 또는 암전구증을 제외하고는 금기 사항이 없어 다른 전신질환이 있을 때도 사용할 수 있었다. 4. Dienestrol 연고에 의한 치료는 장기간을 요하지 않았으며, 대부분 4주 이내에 치료되었다. The effectiveness of dienestrol cream in the treatment of atrophic or senile vaginitis has been evaluated in the 53 patients. In the 53 cases, 36 cases or 67.9%, were definitely improved both subjectively and objectively, or were cured; 11 cases of 20.8%, were not cured, but better improved either clinically or symoptomatically than when they were first seen. In one case or 1.9%, the condition was aggrevated and 5 cases or 9.4% could not be evaluated because of other complications such as trichomonal infestation or monilial infection which was developed after dienestrol therapy was begun. Topical application of the dienestrol cream was prescribed 2 times a day for a one week and once a day for the next one week, and once an every other day after 2 weeks during the last 4 weeks. Total of the cases were 53 cases and the age distribution was from 23 years to 74 years, the most frequent age group was from 51 years to 60 years. Relief of symptoms had to be accompanied by clinical response before the patient was considered improved. The healthy vagina maintained in many instance by using dienestrol cream over 3 weeks. No untoward affects were noted.

자연파열된 거대과립막세포종의 1 례

박지홍(JH Park),안성탁(ST Ahn),오혜숙(HS Oh),김두호(DH Kim) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.2

Although ovarian granulosa cell tumor is relatively rare neoplasm, it arises most frequently in the functioning ovarian tumors and occupies 10% of all solid malignant ovarian tumors. We present a case of spontaneously ruptured large granulosa cell tumor in 64- year-old postmenopausal women with a brief review of the literatures.

자궁내 태아사망의 임상적 고찰

이명희(MH Lee),오혜숙(HS Oh),김영선(YS Kim),김두호(DH Kim) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.2

Intrauterine fetal death is the death of a fetus after 20 weeks gestation or attainment of 500gm body weight prior to the complete expulsion from its mother. This is a clinical study of 159 cases of fetal death in uterus among 7650 deliveries at Incheon Gil Hospital during 4 years from January, 1980 to December, 1983. The results of this study are as follows: 1. The incidence of intrauterine fetal death was 2.07%. 2. Age distribution of mothers with intrauterine fetal death was between 18 to 41 years and was highest in the 26 to 30 years range(40.9%). 3. The parity of mother in intrauterine fetal death was most highest in nulliparous groups(54.7%) and next group is para-1. 4. There were 4 cases(2.5%) with previous history of intrauterine fetal death and 29 cases(18.2%) with previous history of spontaneous abortion. 5. The most common gestational weeks when intrauterine fetal death was detected was 37 to 40 weeks gestational period(21.4%) and the common presentation was cephlic(80.5%). The sex ratio of male vs female fetus was 1.01:1 and 69.2% of intrauterine fetal death weighing less than 2500gm. 6. The mode of delivery for intrauterine fetal death, spontaneous delivery was most common(40.8%), induction of labor was 33.5% and laparotomy was performed in 25.7% of intrauterine fetal death. 7. The etiologic factors of intrauterine fetal death, the unexplained cases were 37.8%, pre-eclampsia 19.5%, abruptio placenta 15.1%, congenital anomaly 6.3%, placenta previa 6.3%, syphilis 4.4%, chorioamnionitis 3.8%, cord prolapse 2.4%, maternal illness 1.8%, transverse lie 1.3%, trauma 1.3%. 8. There were 84 cases(53.8%) of maternal complication. The most common was hemorrhage(63.1%), and the others were intrapartum and postpartum fever (19%), cystitis(8.3%), wound infection(6%), uterine rupture(2.4%), sepsis(1.2%). 9. 77.9% of the cases had not received any prenatal care, 10.6% of cases had received care only 1 or 2 times and 3.3% had received 3 or 4 times, 8.2% had received more than 5 times.