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이영(Young Lee),백은정(Eun Jeong Baik),신종철(Jong Chul Shin),정대영(Dae Young Chung),김수평(Soo Pyung Kim),김창이(Chang Yee Kim),문희봉(Hee Bong Moon),이종승(Chong Seung Yi) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.1
목적: 태아 심박동(fetal heart rate; FHR)은 자율신경계의 조절로 나타나는 현상으로 정상 심박동은 자체의 주기성, 교감 신경 또는 미주 신경 및 부교감 신경으로부터 영향을 받는다. 자율신경 하에 조절되는 심장박동은 성인의 경우 나이 성별에 따른 차이가 있으며, 성별에 따른 자율신경의 생리 작용이 다르다는 것을 알 수 있다. 이에 저자들은 태아 성별에 따른 임상적 여러 변수들 그리고 태아 심박동과 차이를 연구하였다. 연구 방법: 가톨릭 의과대학 산부인과학 교실에 산전 진찰 및 분만을 위해 내원한 산모 중 전자식 태아감시 장치를 시행하였고, 본원에서 분만하여 신생아 임상 소견을 알 수 있었던 317명의 667개의 태아 심박동 자료를 대상으로 하여, 기초 태아 심박동수, 태아 심박동 증가, 태아 심박동 감소, Percent acceleration time(PAT) 및 Percent deceleration time(PDT)를 계산하였고, 변이도로 표준 편차, Mean minute range(MMR)의 장기변이도(LTV) 및 단기변이도(STV)를 계산하였다. 결과: 분석 결과 남아 분만군과 여아분만군의 비교에서 기초 태아 심박동수 137.64±13.68 bpm, 140.51±12.43bpm(P=0.007), PAT는 6.10±4.00bpm, 4.90±3.34bpm(P=0.001), 그리고 PDT는 7.50±8.70bpm, 6.18±7.70bpm(P=0.039)으로 유의한 차이가 있었으나, 표준 편차는 8.84±10.11bpm, 8.11±3.56bpm, LTV는 80.38±62.79msec과73.65±54.60msec, STV는 14.06±9.79msec과 13.33±12.32msec로 차이가 없었다. 결론: 위의 결과로 남아와 여아의 태아 심박동은 차이가 있으며, 이는 발생 시기부터의 부교감 신경과 교감 신경의 발달 차이로 인한 심장 및 체강의 연결계의 차이가 임신 기간 중에 발생한는 것이 원인으로 사료 된다. Objectives: The purpose of this study is to analyze the previously unreported effect of fetal sex on the fetal heart rate and to measure its magnitude in relation to the effects of other independent clinical variables. Methods: Three hundred and seventeen pregnant women who were able to provide electronic fetal heart rate monitoring were evaluated. On the basis of fetal sex after birth, 167 pregnant women who delivered male neonate were for males group and 146 examples who delivered female neonate were for female group. We analyzed fetal heart rate data using the Catholic Computer Assisted Obstetric Diagnosis System(CCAOD). Results: Female fetuses had significantly faster basal heart rate(140.51±12.43bpm) than male fetuses(137.64±13.68 bpm).(P=0.007) Percent acceleration time(PAT) increased significantly for males(6.10±4.00bpm), comparing to females(4.90±3.34bpm).(P=0.001) Also percent deceleration time(PDT) was significantly higher in male fetuses(7.50±8.70bpm) than female fetuses(6.18±7.70bpm).(P=0.039) But there was no differences in standard deviation(SD)(8.84±10.11bpm, 8.11±3.56bpm), long term variation(LTV)(80.38±62.79msec, 73.65±54.60msec), and short term variation(STV)(14.06±9.79msec, 13.33±12.32msec) between male and female fetuses. Conclusion: The fetal heart rate of female fetuses differ from that of male fetuses. Computerized linear analysis and nonlinear analysis of antepartum fetal heart rate will need to take into account the multiple factors that influence the fetal heart rate to identify precisely which pattern predict clinical outcome.
박두호(Doo Ho Park),최상욱(Sang wook Choi),강숙영(Sook Young Kang),김재성(Jae Sung Kim),박성환(Sung Hwan Park),이성(Seong Lee),임근우(Keun woo Lem),홍승덕(Seoung Dug Hong),김창이(Chang Yee Kim) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.4
Each primary or metastatic jejunal choriocarcinoma is extremely rare occurrence. We experienced a case of choriocarcinoma of the jejunum with a metastasis to the liver of a 37-year-old woman. The patient had suffered from massive intestinal hemorrhage. The report illustrates that cularly in a young woman, choriocarcinoma of the small bowel should be considered a possible cause of intestinal bleeding.
Copper T 자궁내장치의 방광 내 전이 후 발생한 방광결석
송록 ( Rok Song ),위지선 ( Ji Sun We ),황성진 ( Seong Jin Hwang ),박인양 ( In Yang Park ),김찬주 ( Chan Joo Kim ),김창이 ( Chang Yee Kim ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.2
An intrauterine device (IUD) is one of the most commonly used contraceptive method in the world. One of the major complications of intrauterine contraception is the perforation through the uterine wall into the pelvic or abdominal cavity. The incidence is 0.9 people per 1000. However, bladder perforation is even more rare. It happens mostly at the time when it was inserted. The symptom varies from no symptom at all to low abdominal pain, massive bleeding, et cetera. We report a case with displaced intrauterine device in bladder, producing the bladder stone which was managed with cystoscopic lithotripsy and intrauterine device removal, followed by a review of the literature.
이정기(Jeong Ki Lee),이은주(Eun Ju Lee),홍승표(Seung Pyo Hong),김지훈(Ji Hoon Kim),최운민(Woon Min Choi),민기옥(Ki Oak Min),문희봉(Hee Bong Moon),김흥기(Heung Ki Kim),김창이(Chang Yee Kim),고영미(Young Me Koh) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.11
We report a case that a neuroblastoma in a fetus was recognized before birth and its growth could be observed. The diagnosis was made by ultrasonography. The suprarenal mass initially showed pure cystic features on ultrasound. Surgical exploration revealed an adrenal cystic tumor and histology showed a neuroblastoma in situ. Forty-five infants with prenatally detected neuroblastoma were found in the English literature; about one-half of them were cystic neuroblastomas and most had a favorable outcome.
이은주(Eun Ju Lee),이정기(Jeong Ki Lee),홍승표(Seung Pyo Hong),민기옥(Ki Oak Min),문희봉(Hee Bong Moon),고영미(Young Me Koh),김창이(Chang Yee Kim),김흥기(Heung Ki Kim) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.1
Primary choriocarcinoma of the fallopian tube has been known for 4% of choriocarcinoma also 1.7% of gestational trophoblastic disease. Its symptom and sign in presentation are similar to the ectopic pregnancy or adnexal mass, thus it is confirmed through histopathological descriptions after explolaparotomy or laparoscopy. Mostly it is common in younger women who are reproductive, we have done conservative surgery followed by chemotherapy. After that, the prognosis was good. We have experienced a case of primary choriocarcinoma of the fallopian tube and reported with a brief review.
박기영(Ki Young Park),이영(Young Lee),송지민(Ji Min Song),류진희(Jin Hee Yoo),박철훈(Cheol Hoon Park),고영미(Young Me Koh),김홍기(Heung Ki Kim),김창이(Chang Yee Kim) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.8
The simultaneous existence of intrauterine and extrauterine pregnancies is known as a heterotopic pregnancy. Spontaneous heterotopic pregnancy is a rare event although its incidence has increased since the recent development of treatment of infertile women with ovulation induction or in-vitro fertilization and embryo transfer(IVF-ET).The theoretical rate of this condition was estimated to be approximately 1 in 30,000 pregnancies. The early diagnosis of heterotopic pregnancy is very difficult . So there is a high maternal morbidity and fetal loss. We reported a IVP - ET patient resulting in the successful delivery of live infant at 35weeks of gestational age from intrauterine pregnancy following surgical removal of ruptured concurrent extrauterine pregnancy.
이정기,유영옥,이은주,문희봉,김창이,박철훈,고영미,박기영,김흥기 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.1
목적 : 복강경 수술과 기존의 질식 자궁 적출술이 어떤 차이점이 있으며 두 수술의 적응증을 정하는데 구별이 가능한가에 주안점을 두고 두 수술법을 비교하게 되었다. 방법 : 1997년 5월부터 2000년 3월까지 가톨릭 대학교 의과 대학 성바오로 병원에서 자궁탈이 없는 자궁 질환을 가진 100명의 질식 자궁 적출술을 시행받은 환자와 100명의 복강경하 질식 자궁 적출술을 시행받은 환자를 비교하여 다음과 같은 결과를 얻었다. 결과 : 환자의 평균나이는 복강경하 질식 자궁 적출술을 받은 군이 46.2세로서 질식 자궁 적출술을 받은 군인 50.2세보다 적었다. 이전의 개복 수술의 기왕력은 복강경하 질식 자궁 적출술을 받은 군이 39%로서 질식 자궁 적출술을 받은 군의 16%보다 높았다. 수술의 적응증은 두군 모두 자궁 근종이 58 %, 51 %로 많이 차지하고 있었다. 총 수술 시간은 복강경하 질식 자궁 적출술을 받은 군이 142.96분으로 질식 자궁 적출술을 받은 군의 77.06분보다 오래 걸렸다. 수술중 평균 헤모글로빈의 변화는 복강경하 질식 자궁 적출술을 받은 군이 2.15로 질식 자궁 적출술을 받은 군의 2.17과 차이가 없었다. 적출된 자궁 평균 무게는 복강경하 질식 자궁 적출술을 받은 군이 221.6g으로 질식 자궁 적출술을 받은 군의 182.3g보다 컸다. 수술중 발생된 비뇨기계 손상은 복강경하 질식 자궁 적출술을 받은 군이 3 %로 질식 자궁 적출술을 받은 군의 2 %보다 높았다. 결론 : 질식 자궁 적출술을 시행할 수 있을 경우 질식 자궁 적출술이 복강경하 질식 자궁 적출술보다 비용면, 미용면, 합병증의 감소에 좋으며 수술 경험의 부족, 개복 수술의 기왕력으로 유착이 의심되는 경우나 질식 자궁 적출술의 비 적응증에는 복강경하 질식 자궁 적출술이 기존의 개복 수술을 대신할 수 있을 것으로 사료된다. Objective : To compare the outcomes of a method of assigning patients to a vaginal or laparoscopically assisted vaginal approach to hysterectomy. Method : Hysterectomy is the most common gynecologic operation. A clinical evaluation was attempted to analyze 100 cases of LAVH which was performed at St. Paul hospital from May 1997 to March 2000, and to compare them with 100 cases of vaginal hysterectomy at the same hospital. we used simple electrosurgical technique without using the disposable staples and other instruments. Results : The mean age of the patients for LAVH was 46.18 years and that of VTH was 50.23 years. The most common indication for LAVH and VTH was Myoma uteri. The mean Hb change in LAVH was 2.15 and the Hb change of VTH was 2.17. The mean operative time of LAVH was 142.96 minutes and that of VTH was 77.06 minutes. The mean weight of uterus for LAVH was 221g and the mean weight of VTH was 182 g. The total percentage of urinary tract injury for LAVH was 3 % and that for VTH was 2 %. Conclusion : VTH, if possible, must be considered as a primary choice since it is were efficient than LAVH in cost, cosmetic aspects and complications. Further LAVH may be replaced with a laparotomy for hysterectomy in case of an insufficient operational experience, a previous abdominal operation hystory and the incapability of being indicated for VTH.