Bochdalek공을 통한 선천성 횡경막 탈장증 1 예

김탁(T Kim),김진홍(CH Kim),나중열(JW Rha),홍성봉(SB Hong) 대한산부인과학회 1988 Obstetrics & Gynecology Science Vol.31 No.6

저자등은 21세의 건강한 임신부에서 36주에 부분 전치태반으로 제왕절개만출술을 시행하여 태어난 2900g의 남아에서 선천성 횡경막 탈장을 발견하여 수술을 권유하던 중 사망한 1례 를 경험하였기에 문헌적 고찰과 함께 보고하는 바이다. Congenital disphragmatic hernia occures about one in every 2200 new born infant and is a condition in which the abdominal contents protured into the thoracic cavity through a congenital defects in the diaphragm. congenital diaphragmatic hernia is divided into two types; one is herniation through the foramen of morgagni and the other is gerniation through the foramen of Bochdalek. Herniation trough the foramen of Bochdalek is the most common type of congenital diaphragmatic hernia nd requires emergency operation in the affected new born infants. Congenital disphragmatic hernia is frequency associated with congenital heart disease Down`s syndrome, hydrocephalus, undersceded testis, ureteral reflux meckel`s diverticulum, malformation of mid gut. We experienced one case of herniation through foramen of Bochdalek and presented this case

임신과 동반된 후복막 신경섬유초종 1 례

김영찬(YC Kim),김진홍(CH Kim),강재성(JS Kang),홍성봉(SB Hong) 대한산부인과학회 1988 Obstetrics & Gynecology Science Vol.31 No.12

저자들은 임신중에 난소종양과 요추간판탈출증 과 감별진단이 어려웠던 임신과 동반된 후복 막 신경섬유초종 1예를 경험하였기에 문헌적 고찰과 함께 보고하는 바이다. retroperitoneal neurilemmoma is relatively rare and benign tumor. during the pregnancy, its symptoms and signs are similar to ovarian cyst and HNP. And its relationship to pregnancy is not well identified. We present 1 case of retroperitoneal neurilemmoma assocated with pregnancy and brief review of the literatures.

초기임신부 및 융모상피종 환자에 있어서의 세포 매개면역

김장흡 ( JH Kim ),조봉춘 ( BC Cho ),김진홍 ( CH Kim ),한구택 ( GT Han ),석준호 ( JH Suk ),강홍일 ( HI Kang ),안웅식 ( WS An ) 대한산부인과학회 1983 Obstetrics & Gynecology Science Vol.26 No.1

결론 저자들은 초기 임신부와 치료전 상태의 융모상피종 0기 및 I~IV기 환자에 대하여 말초혈액내 임파구 절대수, DNCB 감작에 의한 피부반응 및 임파구 배양에 의한 PHA 반응도 그리고 rosette 형성시험을 통한 T-임파구 절대수를 측정하였으며, 이를 비임신 건강대조군과 비교하였고, 융모상피종의 임상경과 등과 연관지 어 다음과 같은 결론을 얻었다. 1. 초기 임산부에 있어서의 임파구 백분율, DNCB 피부반응 및 PHA 자극반응은 대조군에 비하여 유의한 감소가 있었으나 임파구 절대수와 T-임파구수는 차이가 없었다. 2. 융모상피종 0기 (포상기태)환자에서는 DNCB 피부반응과 PHA 자극반응이 임산부에서와 비슷하게 감소되었으며, 역시 임파구 절대수와 T-임파구수는 변화가 없었다. 포상기태 배출후 15~72시간에 일시적인 PHA 자극반응의 저하가 관찰되었으며, 1년간의 임상 추적증에 면역기능이 낮은 7예에서 악성변화가 발견되 었다. 3. 융모상피종 I∼IV기 환자중, 특히 전이가 진행된 III~IV기 환자에서 임파구 절대수, DNCB피부반응과 PHA 자극에 대한 임파구 분화도 그리고 T-임파구수가 유의하게 감소하였으며, 면역기능이 낮을수록 항암 화학요법에 대한 반응이 불량하였다. 4. 말초혈액내 임파구수, DNCB 피부반웅 및 PHA 자극반응 등의 검사방법 사이에는 유의한 비례관계가 있었다. 5. 임산부와 융모상피종 0기 환자에서 임파구배양액에 자가혈청을 가하였을 때 ,H-thymidine uptake치의 감소 현상이 있었으며, 이를 당시의 요중hCG호르몬 농도와 비교하였을때 유의한 역상관관계가 관찰되었다. 이상의 결과로 보아 임신부 및 융모상피종 환자에서 세포매개 면역이 유의하게 감소되었으며, 그 원인은 혈청인자, 특히 hCG흐르몬의 영향일 것으로 생각된다. 또한 융모상피종 환자의 세포매개 면역은 임상경과 및 화학요법의 치료효과와 밀접한 관계가 있음을 알 수 있었다. The role of the immune system in pregnancy and neoplastic diseases has long been a subject of controversy. lmmunoregulatory process tolerating the fetus and the trophobl-astic neoplasia, as natural allografts, is not fully understood but usually explained by the suppressed host immunocompetence. Several authors recommended somne humoral factors (serum proteins, immune complex or hormones etc.) as the key depressants affecting the maternal immunologic system. Patients with advanced cancer have a depressed immunological function and in view of the accumulating evidence for a relationship between immunologic reactivity and prognosis, information of indⅳidual patient on immunocompetence may be of great importance in the clinical evaluation of the cancer patients. In an effort to study the cell-mediated immunity of pregnant women and patients with gestational trophoblastic neoplasia (GTN), authors employed a battery of lymphocytem- onitoring techniques: absolute lymphocyte counts, DNCB skin testings, PHA-induced ly-mphocyte transformation and T_lymphocyte rosettes. The results were as follows: 1. In healthy nonpregant women, the peripheral lymphocyte count and the T-cell subpopulation were 2,146±813/ui and 83.9±6.2% (1,796 810/ul) respectively. The positⅳe rate of DNCB skin response was 90.0%, and H-thymidine uptake of PHA-stimulated lymphocytes was 126,248±38,038 cpm/2x1,000,000 cells. 2. Women with early gestation revealed the significant decrease in DNCB skin react- ion,H-thymidine uptake of PHA-stimulated lymphocytes and proportion of peripheral lymphocytes, but there were no differences of absolute lymphocyte count and T-cell rosettes as compared with the healthy nonpregnant control. 3. In patients with GTN stage 0(hydatidiform mole) : (1) DNCB skin reactⅳity and PHA-induced lymphocyte transformation were, although not statistically in DNCB test (0.083)

융모성질환에서 초회화학요법후 b-hCG변화에 따른 예후 관찰

황인수(IS Hwang),김진홍(CH Kim),강병철(BC Kang),이진우(JW Lee),김창이(CY Kim),김수평(SP Kim) 대한산부인과학회 1984 Obstetrics & Gynecology Science Vol.27 No.14

저자들은 1973년 1월부터 1983년 10월까지 가톨릭중앙의료원의 융모성질환연구소에 융모성질환으로 등록되어 화학요법을 받은 484에의 환자들 중 본 연구소의 예를 대상으로 시행한 역행성조사를 통해, 치료전 b-hCG의 기초수준값이 초회화학요법치료후 1 log.이하로 감소한 경우를 "양호" b-hCG의 기초수준값이 초회화학요법후 뚜렷한 감소는 있으나 1 log. 이하로 감소가 되지 않은 경우를 "보통" b-hCG의 기초수준값이 초회화학요법후 변화가 없거나 증가한 경우를 "불량"한 반응군으로 분류하여 이러한 종양의 반응이 화학요법의 횟수와 기간에 어떠한 영향을 미치는가를 관찰하여 다음과 같은 결론을 얻었다. 1. 융모성질환의 기별 분류에 따른 초회화학요법후 종양의 반응은 융모성질환 제 I기군의 "양호"와 "보통 반응군의 백분율이 각각 38.8%와 37.1%, 융모성질환 제 II기군. "보통"과 "불량"한 반응군의 백분율이 각각 50.0%와 30.2%를 보여 융모성질환 제 I기군의 반응이 가장 좋았다. 2. 융모성질환의 각기별 위험군의 분류에 따른 초회화학요법후의 반응은 융모성질환 제 I기군의 저위험군과 중등도 위험군에서 "양호"와 "보통"반응군의 백분율이 가장 높았고 제 III기군에서는 각 위험군에서 모두 "보통"과 "불량"한 반응군의 백분율이 높았음을 보였다. 3. 융모성질환의 각 기별 초회화학요법후 종양의 반응에 따른 경쾌수준까지의 화학요법의 평균 회수는 융모성질환 제 I기군의 "양호"한 반응군이 3.58+-1.34회였으며, 융모성질환 제 III기군의 "불량"한 반응군은 7,75+-2.27회였다. 4. 융모성질환의 각 기별 최회화학요법후 종양의 반응에 따른 경쾌수준까지의 화학요법의 평균기간은 융모성질환 제 I기군의 "양호"한 반응군이 8.58+-3.74주였고, 융모성질환 제 III기군의 "불량"한 반응군은 23.06+-7.80주를 보였다. 5. 융모성질환의 위험군의 분류에 의한 초회화학요법후 종양의 반응에 따른 화학요법의 평균횟수는 융모성질환 제 I기에서는 위험군에 따라 변화가 없었으나, 융모성질환 제 II기와 제 III기에서는 저위험군에서 고위험군으로 될수록 화학요법의 평균횟수가 증가하였다. 6. 융모성질환의 위험군의 분류에 의한 초회화학요법후 종양의 반응에 따른 화학요법의 평균기간은 융모성질환 제 I기군과 제 II기군은 중등도의 위험군까지는 위험군에 따라 치료기간이 길어지지 않았으나, 융모성 질환 제 II기군의 고위험군에서부터 융모성질환 제 III기군에서는 고위험군으로 될수록 화학요법에 평균기간이 증가하였다. 이상의 성적으로 보아 융모성질환의 치료와 예후는 초회화학요법후 b-hCG의 측정값의 변화에 크게 좌우되며, 융모성질환의 치료전에 본 질환의 기별분류와 예후접수에 따른 위험군의 분류를 철저히 시행하여 적절한 화학요법제를 선택하여야 할 것으로 생각된다. In attempt to evaluate the effect of tumor response on the outcome of trophoblastic disease after initial chemotherapy, we studied on the subjects of 336 patients registered at the Korea Research Institute of Trophoblastic Disease in Catholic Medical College from January, 1973 to October, 1983. We measured tumor markder, hCG b-subunit values, by using RIA and observed changes of hCg b-subunit values after initial chemotherapy according to the stage and risk group of each stage. We also observed the effects of the changing grade on outcome until remission and obtained the following results. 1. The tumor response after initial chemotherapy was good in stage I compared to stage III. However, there was no such relationship among other stages and risk groups of each stage. 2. In all stages of the cases of good tumor response after initial chemotherapy, the number of courses until remission was and period of treatment was also short. 3. In all risk groups of the cases of good tumor response after initial chemotherapy, the number of courses until remission was less than the bad cases and period of treatment was shorter.

Secnidazole ( Flagentyl ) 1 회 요법에 의한 트리코모나스 질염의 치유 효과

유기성(KS You),김병인(BI Kim),김진홍(CH Kim),한구택(GT Han),이준모(JM Lee),이종건(CK Lee),이헌영(HY Lee) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.1

Trichomonas vaginalis infection is still a prevailing, sexually transmitted disease though metronidazole has been utilized as a choice of treatment of this disease. Several recent investigations of safer, more effective, newer drugs and of its mode of administration has been made. In an attempt to assess the effectiveness of the treatment with secnidazole, we orally administered secnidazole 2.0gm once a day and made follow-up examinations of the treated women. The following results were obtained: 1) The main subjective symptoms disappeared within 2 or 3 days of treatment. 95.2% cure rate was obtained 1 week after treatment and 93.9% cure rate 4 weeks after treatment. 2) We obtained 96.8% cure rate 1 week after treatment and 97.9% cure rate including 3 women unresponsive to the initial therapy but cured with repeated administration. The above results were confirmed by the microbiological examinations including wet smear, and papanicoleau smear. 3) 8.2% of the administered women exhibited side effects but its side effects were mild. 4) The hypersensitivity and toxicity to the high dosage used in this study were not seen.

임신에 합병된 Nephrotic Syndrome 1예

임창서(CS Lee),김영일(YI Kim),함재홍(JH Ham),김진홍(CH Kim) 대한산부인과학회 1981 Obstetrics & Gynecology Science Vol.24 No.3

저자들은 임신에 합병된 Nephrotic Syndrome 1예를 경험하였기에 간략한 문헌고찰과 아울려 증례를 보고하였다. Nephrotic Syndrome during pregnancy is a rare condition . Characterized by generalized edema, massive proteinuria and hypoproteinemia the Nephrotic Syndrome may be of unknown etiology or may accompany a number of systemic disease such as diabetes mellitus amyloidosis or lupus erythematosus. A case that will reported was not performed renal biopsy due to pregnancy. Steroid therapy was not effect to this case. At Catholic University Medical College , a case of Nephrotic Syndrome during pregnancy was presented and recent literature are briefly reviewed.

절박유산 및 자간전증 환자의 혈청내 순환면역 복합체의 관한 연구

오경추(KC Oh),이상대(SD Lee),심도진(DJ Shim),김영일(YI Kim),김진홍(CH Kim),김수평(SP Kim),나종구(JG Na) 대한산부인과학회 1986 Obstetrics & Gynecology Science Vol.29 No.12

1985년 1월부터 1985년 12월까지 가톨릭의대 부속 강남성모병원 산부인과에 내원하였던 정상임부 60명, 절박유산 환자 10명, 자간전증환자 10명을 대상으로 혈청면혁 복합체치를 C1q binding assay로 측정하여 다음과 같은 결론을 얻었다 1 정상임부의 혈청 C1q binding %는 임신 제 1기 11 77±4 65, 제2기 11 93±6 26, 제3기 16 69±12 02로써 임신후반기에는 증가하는 경향을 보였으나 의의있는 차이는 보이지 않았다 2 절박유산 환자의 C1q binding %는 임신 제1기와 비교할 때 약간 높게 나타났으나 유의한 차이는 없었다 3 자간전증 환자의 C1q binding %와 임신 제3기의 C1q binding %간에는 유의한 차이가 없었다 4 절박유산 환자의 예후에 따른 C1q binding %는 유산이 일어난군과 임신이 계속된군 사이에 유의한 차이가 없었다 Under the hypothesis that immune mechanism is related to incidence of threatened abortion and preeclampsia, in order to comfirm the role of immune complex as a causing factor of its clinical symptoms, we measued circulating immune complexexs in patients of threatened abortion and preeclampsia by PEG (polyethylene glycol) precipitation method by using complement C1q and obtained the following results 1 Serum C1q binding % of normal pregnancy was 11 77±4 65 in 1st trimester, 11 93±6 26 in 2nd trimester and 16 69±12 02 in 3rd trimester, and tended to increase in 3rd trimester But significant difference was not shown 2 Serum C1q binding % of threatened abotion showed slight increase when compared with 1st trimester of normal pregnancy 3 No significant difference of C1q binding % was found between preeclampsia and 3rd trimester of normal pregnancy 4 No significant difference of C1q binding % according to prognosis in patients of threatened abortion was found between abortion group and term pregnancy group

분만유도 목적으로 사용한 PGE2질정의 효과

한구택(GT Han),최승도(SD Choi),이진우(JW Lee),나종구(JG Na),김진홍(CH Kim),김수평(SP Kim),이헌영(HY Lee) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.3

The mechanism of the initiation of labor is not yet fully understood, but it is generally believed that some factors such as the changes of the endogenous steroid hormones and the prostaglandin may be responsible for the cervical ripening and myometrial contraction. Nowadays the prostaglandin has been used through various routes to induce labor. In order to clarify the effects of prostaglandin of the labor induction and the mechanism of labor, the PGE2 was administered intravaginally to the 42 pregnant women between 38 and 42 weeks gestation and the levels of estradiol, progesterone and cortisol were measured by RIA from the serum collected before and during labor and after the placental expulsion. The results were as follows; 1. The failure rate of the induced labor by intravaginal PGE2 was 9.5%. 2. The mean durations of labor of the control and the experimental group were 4.27±2.38 hours and 4.10±2.67 hours respectively. 3. There were no significant differences between the Apgar scores of the newborn infants delivered from the control and experimental those from the group. 4. The level of the estradiol of the control and experimental group with successful results measured before labor were 32.1±6.2ng/ml and 38.8±12.1ng/ml respectively, and those measured after placental expulsion were 27.3±4.3ng/ml and 20.6±12.5ng/ml respectively. There was significant decreases in the estradiol levels after labor compared with those before labor. 5. The levels of progesterone of the control and the experimental group with successful results measured before labor were 221.2±58.7ng/ml and 245.8±62.9ng/ml respectively, and those measured after placental expulsion were 170.0±49.6ng/ml and 161.0±76.4ng/ml respectively. There were significant decreases in the progesterone levels after labor compared with those before labor. 6. The levels of cortisol of the control and the experimental group with successful results measured before labor were 33.9±7.0㎍/dl and 40.9±9.8㎍/dl, and those measured after placental expulsion were 63.4±10.2㎍/dl and 69.9±15.4㎍/dl respectively. There were significant increases in the cortisol level before labor compared with those before labor. We conclude that the changes of the endogenous steroid hormones in the women intravaginally administered PGE2 were similar to those in control group and the intravaginal admistration of PGE2 may be the effective method for induction of labor.

긴장성 요실금의 비수술적 치료

김진홍 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.5

자궁내막의 Mullerian Adenosarcoma 1 예

김진홍,나종구,윤중한,정민화 대한산부인과학회 1991 Obstetrics & Gynecology Science Vol.34 No.2

저자들은 비교적 드문 자궁내막에 발생된 Mullerian adenosarcoma 예를 경험하였기에 간단한 문헌고찰과 함께 보고하는 바이다. Mullerian adenosarcoma is a distinctive type of mullerian mixed tumor. We report a rare case of mullerian adenosarcoma of endometrium with a brief review of the literature.