자궁내구 기능부전증

문영기(YK Moon),노경병(KB No),황태식(TS Hwang) 대한산부인과학회 1962 Obstetrics & Gynecology Science Vol.5 No.1

Because of the rarity of reports on the subject of the "Internal os of the cervix" in Korea and the controversy about it`s management, six patients with incompetent internal os have been reported. These were seen at Yonsei University Hospital between February, 1956 and September, 1961. A modified Shirodkar operation was performed on 2 cases during the second trimester of pregnancy and resulted in a viable term fetus for both. A Lash operation was carried out on 1 case during the non pregnant siate. In the remaining cases, the patients delivered before it was possible to perform surgical correction. After reviewing the literrature on this subject, and in accord with the cases reported, the tentative policy for the management of this condition in our department has been presented. This plan is basically that those cases which are found during the non pregnancy are to be corrected by a Shirodkar operation and those who are diagnosed during the non pregnant state are to be corrected by either a Lash operation or a Shirodkar operation during next pregnancy depending upon desirability of children, age, and possibility of cooperation of the patients. A significant history of previous criminal adortion was found in those patients and probably represents on etiological factor.

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%.

Estrogen 투여에 의한 백서 뇌하수체 전엽유선 자극 홀몬분비세포 ( L.T.H.Cell ) 형태학적 변화

문영기(YK Moon),박찬규(CK Park) 대한산부인과학회 1974 Obstetrics & Gynecology Science Vol.17 No.10

Estrogen을 자성백서에 투여하여 뇌하수체전엽의 유선자극홀몬 분비세포(LTH Cell)에 미치 는 형태학적 변화를 전자현미경으로 관찰하여 다음과 같은 결론을 얻었다. 1) 체중변동은 정상대조군에 비하여 estrogen을 투여한 군에서 다같이 체중의 감소를 보였 다. 2) 뇌하수체 중량변동은 estrogen을 투여한 Ⅰ, Ⅱ 및 Ⅲ군에서 증가되었다. 3) 뇌하수체전엽의 유선자극홀몬분비 세포의 미세 구조 변화로는 핵의 증대, mitobhondria 의 증가, Rough Endoplasmic Reticulum의 증가, Golgi membrance의 확장 및 분비과립의 감소 등이 매일 estrogen 0.5mg/kg 및 0.2mg/kg 투여 후 전자에서는 4주, 후자에서는 1주 후부터 관찰되었다. The recent great increase in the use of female sex hormones particularly for contraception and for the treatment of gynecological proglems makes it necessary to further study the side reactions and complications of the female sex hormones. Estrogen is one of the most important hormones used clicically. It has a significant effect on the pituitary gland function, particularly on the feed-back mechanism of the Neure- hypothalamo-pituitary-ovarian-endometrial axis. Using electron microscopy, this study investigated the morphological changes in the LTH cells of the anterior potuitary of rats following the administration of estrogen. Estrogen morphological effect was observed in three groups of rats. Groups Ⅰ was the control group which received 0.5cc saline intramuscularly daily. Groups Ⅱ received 0.05mg/kg of estrogen, IM daily. Groups Ⅲ were given 0.2mg/kg of estrogen, IM daily. Results : 1) As the dose of estrogen was increased there was a parallel decrease in the body weight. 2) As the dose of estrogen was increased there was a parallel increase in the weight of the pituitary gland. 3) After 4 weeks for Groups Ⅱ and weeks for Groups Ⅲ the following morphological changes were noted following estrogen administration. (1) Nuclear enlargement. (2) Increased mitochrondris. (3) Expansion of the Golgi mimbrane. (4) Decreased secretion granules.

임신부사망및 페리네탈사망에 관한 임상적 고찰

문영기(YK Moon),오성규(SK Oh),이재억(JA Lee),양인환(IW Yang) 대한산부인과학회 1965 Obstetrics & Gynecology Science Vol.8 No.9

14 cases of maternal deaths were encountered among 2864 deliveries and 151 prenatal cases. Average maternal mortality was 50.5. There were 80 cases of stillbirths and 92 cases of neonatal deaths among the 2914 births. Average perinatal mortality was 62.1. These were seen at Yonsei University Hospital between February, 1959 and August 1964. Rate of maternal mortality decreased rapidly in comparison to perinatal mortality. The majority of preinatal deaths were in the premature group. Prenatal care controlled the maternal mortality and perinatal mortality. All of the maternal deaths had not been under prenatal care. Maternal mortality committee and perinatal mortality committee are needed for control maternal mortality and perinatal mortality.

자궁내구기능부전증 - 임신중 외과적 치료에 대하여

문영기(YK Moon),오성규(SK Oh),이준환(JH Lee),홍성선(SS Hong) 대한산부인과학회 1965 Obstetrics & Gynecology Science Vol.8 No.9

The Shirodkar operation were performed on 19 cases with incompetent internal os of the cervix in pregnancy. These cases were seen at Yonsei University Hospital between February, 1959 and August, 1964. However the following 2 cases showed abnormal tissue reactions around the cervix which disturbed the normal courses of labor. Vaginal deliveries following Shirodkar operation were 80% successful. Corrected data showed 93.3% Shirodkar operation and trachelorrhaphy are needed in cases of incompetent internal os with deep cervical laceration.

형광항체법을 이용한 질강내 Candida albicans의 검색에 관한 연구

문영기(YK Moon),황동훈(DH Hwang) 대한산부인과학회 1975 Obstetrics & Gynecology Science Vol.18 No.8

candida albicans의 빠르고 정확한 고정을 목적으로 형광항체법을 이용하여 다음과 같은 결 론을 얻었다. 1. 배양방법에 의한 candida albicans의 고정예는 총 218예중 48예(22.0%)이었으며 형광항체 법에 의한 방법과의 일치율은 97.9%이었다. 2. 임산부 147예를 대상으로 형광항체법으로 candida albicans라고 고정된 예는 28예로서 9.0%이었다. 3. 유흥업소 종업원 71례를 대상으로 한 실험에서 양성인 예는 21예로서 29.5%이었다. 4. 형광항체법은 사용이 가능한 방법 중의 하나이다. One hundred forty seven vaginal swab specimens from out-patients who had come to severance Hospital for antenatal care and 71 from general entertainer in the pulbic resorts at Kangwha-d area, were colletec for the diagnosis of candida albicans infection by employing direct fluorescent antibody technique. The results are summarized as follows; 1. Forty eight cases our of 218 sample (22.0%) cultivated on Sabouraud`s glucose slant media were identified as candida albicans and agreement rate between positive cases detected by cultivation method and DFAT was 97.9%. 2. Out of 147 specimens obtained from the out-patients 28 cases (19.0%) were revealed as positive reaction by DFAT. 3. 21 positive cases out of 71 general entertainers (29.5%) were detected by DFAT. 4. As in above results it is considered that DFAT is an available tool for the diagnosis of candida albicans infection especially in mass survey.

산욕기 난관불임수술에 있어서의 임상병리 조직학적 연구

문영기(YK Moon),유병일(BI Yoo),송찬호(CH Song),곽현모(HM Kwak) 대한산부인과학회 1976 Obstetrics & Gynecology Science Vol.19 No.2

1) 질식분만후 난관결찰술을 시행할 경우가 356예 제왕절개술과 동시에 시행한 경우가 210예 였다. 2) 97.5%에서 Pomeroy씨 법에 의해 시술되였다. 3) 적응증은 다산부가 96.1%, 내과적적응증이 3.4%였다. 4) 이환율은 6.7%였다 5) 산전, 분만중 또는 난관결찰수술전에 감염의 증후가 없었던 537예의 난관을 병리조직학 적으로 검색하였다. 이 중 7예(1.3%)에서 급성난관염이 검색 되었는데 이 소견은 분만후 시간이 경과함에 따라 그 빈도가 증가되였으나 수술후 이환율과는 관계가 없었다. 아급성난관염 및 만성난관염도 각각 1예(0.2%) 및 5예(0.9%)가 검색되었다. 566 cases of tubal sterilization, 356 cases after vaginal delivery, and 210 cases at the time of cesarean section, were performed at the Department of Obstetrics and Gynecology, Yonsei Medical Center from January 1, 1965 to December 31, 1972.

조기파막 ( S.P.R.M. )

황태식(TS Hwang),문영기(YK Moon),이동희(DH Lee) 대한산부인과학회 1963 Obstetrics & Gynecology Science Vol.6 No.5

Because of the importance of the subject of "Spontaneons premature rupture of membrane and the controversy about it`s frequency in total deliveries, dry labor and infection, a clinical study of spontaneous premature rupture of amembrane has been carried out. 198 cases of "Spontaneous premature rupture of membrane" was seen at Yonsei University Hospital between February, 1959 and July 1962. In these clinical observations, the author`s attention was especially directed to the incidence, lengths of labor, delivery method, and the effect on the mother and fetus. The result obtained are as follows. 1) Incidence in total delivering mature babies the rate among primipara(15.%) was relatively higher than multipara (10.8%). 2) Among those delivering mature babies the rate among primipara and multipara was 14.4% and 8.4% respectively. The higher incidence of "Spontaneous premature rupture of membrane" among term primipara may be related to an associated higher incidence of breech presentation in this group. 3) Among the mature group there was 2 hours reduction in the total lengths of labor compared with the control group. This reduction was noted mainly in the lst stage. 4) 80% of the total group began spontaneous labor within 48 hours of rupture of membranes. 5) There was no differenec between "Spontaneous premature rupture of membrane" and control group with reference to the mothod of delivery 6) Majority of perinatal death in "Spontaneous premature rupture of membrane" occured among the premature cases. 7) No effect of prophylactic antibiotics therapy was noted. 8) The routin method of management of "Spontaneous premature rupture of membrane" patients as practiced in Severance Hospital, is briefly summerized. .... SPRM...., PROM...

임신과 합병된 자궁경암에 관한 임상적 고찰

유능화(NH Yoo),문영기(YK Moon),곽현모(HM Kwak) 대한산부인과학회 1978 Obstetrics & Gynecology Science Vol.21 No.9

1) 임신과 합병된 자궁경암환자 26예에 대하여 임상적 고찰을 하였으며 26예중 비침윤성암이 6예, 침윤성암이 20예였다. 2) 자궁경암의 임신에 대한 발생빈도는 1:1110(0.09%)이었으며, 자궁경암환자에 있어서의 임신합병빈도는 1:69(1.43%)였다. 3) 연령의 범위는 31~45세까지였으며 36~40세군이 10예(38.4%)로 가장 많았으며 평균연령은 37.7세였다. 4) 분만회수의 경우, 5회 이상의 경산부가 26예중 11예(42.4%)로 가장 많았고 다음이 4회 경산부로 7예(26.9%)로서 다산부에서 자궁경암이 호발함을 알 수 있었다. 5) 임상증상으로는 접촉출혈이 17예로(비침윤성암-2예, 침윤성암-15예) 가장 많았으며, 임신중 자궁출혈의 경우 접촉출혈의 유무가 자궁경암을 감별진단하는데 큰 도움을 주었다. 6) 세포학적 진단을 26예중 24예에서 시행한 결과, Class Ⅲ 이상이 22예나 되어 진단적 정확성은 91.4%였다. 7) 진단의 동기는, 타병원에서 자궁경암이 의심스럽거나 확진되어 전원된 경우가 12예, 임상증상 및 진찰소견상 자궁경암이 의심되어 진단을 하게 된 경우가 12예였고 2예는 다른 질환으로 수술후 병리조직검사를 통하여 확인된 경우였다. 8) 진단시기를 임신기간으로 분류하여 보면, 임신초기가 11예로 가장 많았으며, 임신중기가 9예, 임신말기 및 산욕기가 각각 2예였다. 9) 자궁경암의 진행도를 보면 stage Ⅱ가 9예로 가장 많았으며, 다음이 stage Ⅰ으로 7예였고 stage 0가 6예, stage Ⅲ 및 Ⅳ가 각각 2예였다. 10) 침윤성암 20예의 조직학적 분류를 보면, poorly differentiated type이 13예(65.0%)로 가장 많았으며, moderately well differentiated type이 6예(30.0%), well differentiated type이 1예(5.0%)였다. 11) 치료성적을 보면, 비침윤성암의 경우, 임신중기 전에 진단된 전예(6예)에서 전자궁적출술을 시행하였고, 침윤성암시는 방사선치료만을 시행한 경우가 15예(75.0%)로 가장 많았으며, Radical abdominal hysterectomy는 4예(20.0%)에서 시행하였으며, 4예중 1예는 재발로 인하여 External Irradiation도 시행하였다. 12) 침윤성암의 경우, 분만방법으로는 Classical cesarean section을 원칙으로 하였으며, Classical cesarean section에 의해 분만된 태아는 전예(4예)에서 생존하였다. 13) 침윤성암환자 20예에 대한 예후관찰은 15예만이 가능하였고, 최장 예후관찰기간은 4년 6개월이었고, 최단 예후관찰기간은 3개월이었다. 재발은 2예에서 확인되었다. Carcinoma of the cervix is the most common malignant tumor in women in Korea, but it is infrequently associated with pregnancy. Carcinoma of the cervix during pregnancy has been the subject of considerable discussion and contradiction as to behavior, incidence, treatment and the diagnosis. Certainly early diagnosis followed by immediate and adequate therapy is most important. For this object, routine cervical smear should be examined in all pregnant women. There are few reports in cervical cancre during pregnancy in Korea. We observed cervical cancer during pregnancy 12 years ago(1959.2~1964.8) for further evaluation of cervical cancer during pregnancy, we studied 26 cases of cervical cancer associated with pregnancy in the Depratment of Obstetrics and Gynecology, Severance Hospital and Wonju Christian Hospital during the period from Sep., 1, 1967 to Jul., 31, 1977. The results obtained were as follows; 1) The incidence of cervical cancer among pregnant women was 1:1110(0.09%) and the incidence of pregnancy among cerical cancer patients was 1:69(1.43%). 2) Age distribution of cervical cancer during pregnancy was from 31 to 45 years and the average age was 37.7 years. 3) Average parity was 4.28. 4) Contact bleeding was encountered in 17 cases and 2 cases were entirely asymptomatic cases. 5) Cytologic smear as a screening procedure was performed in 24 cases, and 22 cases(91.4%) were more than Class Ⅲ. 6) Acoording to motivation of diagnosis, were eferred to our department from other clinic 12 cases. 7) At the time of diagnosis, 1st trimester-11 cases, 2nd trimester-9 cases, 3rd trimester-2 cases and postpartum-4 cases were found. 8) According to the clinical stage, the results showed stage 0-6 cases, stage Ⅰ-7 cases, stage Ⅱ-9 cases, stage Ⅲ-2 cases and stage Ⅳ-2 cases. 9) External irradiation and intracavitary irradiation were done in 15 caes(75.0%) and radical abdominal hysterectomy with pelvic lymphadenectomy was done in 4 cases of invasive carcinoma of the cervix. 10) The result of follow up was poor bec

Behcet 증후

박기현(KH Park),문영기(YK Moon) 대한산부인과학회 1974 Obstetrics & Gynecology Science Vol.17 No.9

최근 Behcet씨병에 완전한 이해와 관심을 갖고 외음부궤양을 주소로 한 환자를 조사하여 우리 나라에도 많은 환자가 있음을 발견하였고 이를 위하여 피부과, 안과 및 신경과의 협력 이 요망된다. 앞으로 더욱 임상적 연구를 하여 원인을 찾고 진단치료면에서 더욱 발전하여 야 할 것으로 사료된다. Frequent finding of Behcet´s syndrome among Korean women has received increasing attention. With the recognition of Behcet`s syndrome and interdepartmental cooperation of gynecologist, dermatologist, ophthalmologist and neurologist, more Behcet`s syndrome can be found. The pathogenesis and principal method of treatment, however, have not been carified. General review and 2 cases of Behcet`s syndrome were briefly summarized.