선천성 일측 다낭종신과 반대측 신결여 1 예

변지수,송태복,위점숙,손세호 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.1

본 교실에서 최근 임신중 초음파검사에 의해 진단된 왼쪽 다낭종신, 오른쪽 신결여 및 그외 동반기형을 가진 태아 1예를 경험하였기에 부검소견 및 문헌고찰과 함께 보고하는 바이다. Unilateral multicystic kidney and unilateral renal agenesis are both relatively rare congenital anomalies and usually associated with urinary tract and other anomalies. We present a case of antenatally diagnosed unilateral multicystic kidney with contralateral renal agenesis based on clinical and autosy findings with a brief review of literature.

성교통

변지수 대한산부인과학회 1991 Obstetrics & Gynecology Science Vol.34 No.10

심포지움 : 자궁경암 ; 자궁경암에 대한 화학요법

변지수 대한산부인과학회 1984 대한산부인과학회 학술대회 Vol.53 No.-

Rb3Sb2Br9 페로브스카이트 양자점의 제작과 특성분석

변지수 한국물리학회 2019 새물리 Vol.69 No.2

Although lead (Pb)-containing perovskite quantum dots have shown great potential in various elds of applications such as light-emitting diodes, solar cells and displays, due to the toxicity of Pb and its chemical instability, commercialization of Pb-perovskite-based products has not yet been realized. Hence, it is necessary to look for other metals, environmentally much safer than Pb, to replace Pb. Because tin (Sn) and germanium (Ge), which are in the same group as Pb, show some instability due to oxidation of +2 states to +4 states, bismuth (Bi) and antimony (Sb) are more viable choices to replace Pb as Bi and Sb form +3 ions with electronic congurations similar to that of Pb2+. We report the synthesis of environmentally safe, lead-free Rb3Sb2Br9 perovskite quantum dots (PQDs) by using a modied ligand-assisted reprecipitation (m-LARP) technique and their properties to demonstrate the possibility of using them in diverse elds of applications. Our lead-free PQDs are tens of nanometers wide and less than 2 nm in height, showing a fairly uniform size distribution. Optical characterization of these PQDs shows a considerable absorption in the UV region and some photoluminescence around 400 nm. 납(Pb)이 주로 섞인 페로브스카이트 (perovskite) 양자점은 LED, 태양전지, 디스플레이 등의 응용분야에서 기대되는 신물질이지만, 화학적 불안정성과 납의 독성은 응용제품 개발 및 산업화의 장애요소가 되고 있다. 따라서 페로브스카이트 양자점 물질에서 환경적으로 안전하여 납을 대체할 수 있는 물질에 관한 연구가 필요하다. 납과 같은 그룹인 주석(Sn)과 게르마늄(Ge)이 비슷한 특성이 기대되는 자연스러운 선택일수 있으나, +2가 상태가 +4가로 산화되는 불안정성으로 인해 Pb$^{2+}$와 비슷한 전자배열을 가지는 +3가의 비스무트(Bi)나 안티모니(Sb)가 더 나은 선택으로 여겨진다. 본 연구에서는 변형된 리간드 보조 재침전 (modified ligand-assisted reprecipitation, m-LARP) 방법을 이용하여, 납이 포함되지 않고 환경적으로 안전한 무납 Rb$_3$Sb$_2$Br$_9$ 페로브스카이트 양자점(PQDs)을 제작하였고, 기본적인 특성 분석을 통해 그 응용 가능성을 알아보았다. 제작된 양자점은 수십 나노미터(10$^{-9}$ m) 너비와 2 nm 이하 높이의 균일한 크기 분포를 보였으며, 자외선 (UV) 영역 대의 흡수를 통해 400 nm 파장대역에서 발광특성을 보였다.

인공수정

변지수 대한산부인과학회 1989 연수강좌 Vol.15 No.-

자궁경부 상피내암과 미세침윤암의 질확대경소견에 대한 연구

변지수,최호선,박진순,오영현 대한부인종양 콜포스코피학회 1990 Journal of Gynecologic Oncology Vol.1 No.1

This study was performed ta evaluate difference of colposcopic findings between carcinoma in situ and microinvasive carcinoma. From August l, 1988 through November 30,1989, the conixation was undertaken in 138 patients. We compeied colposcpic findings with hiatologic diagnoiis on 1656 seetions. Comparison between the microinvasive carcinorna and the carcinoma in situ groups showed a significant higher incidence of large exoeervtcal lesion size($gt;3/2 33.9% vs. 1.2%), circumscribved location around external cervical os.(75.0% vs, 51.2%), combined abnormal colposcopic findings(19.6/a vs. 3. 7%) and deep endocervical involvement( $gt;lcm : 23,2% vs. 7. 3% ). (P$lt;0.01) Granular area was showed 11% incidence of the worst histologic diagnosis.

제왕절개분만 환자에서 조기 경구 영양공급의 평가

변지수,송태복,김윤하,이지영,김은미 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.7

제왕절개 수술이 비교적 젊고 건강한 여성에서 시행되어지고 개복수술이지만 장관의 조작은 거의 하지 않는다는 점에 착안하여 제왕절개 수술한 여성에서 수술 후 조기에 경구 영양공급을 하는 것이 고식적인 방법으로 채택되어져 온 장음이 들리고 가스가 배출된 후에 식사를 공급하는 것과 비교하여 위장관 기능에 이상 증상을 초래하는 빈도를 조사함으로써, 조기 경구 영양공급의 임상적인 유용성에 대해 알아보고자 1997년 5월 1일부터 동년 8월 31일까지 전남대학교병원 산부인과에서 제왕절개분만한 80명의 환자를 대상으로 다음과 같은 결과를 얻었다. 1. 주사 수액제제의 투여 기간은 조기 경구 영양공급 군(연구군)에서 21.6±7.8시간으로 대조군의 32.2±9.0시 간보다 더 짧았고(p<0.01), 따라서 주사 수액제제의 투여량도 연구군에서 3.4±1.3 L로 대조군의 4.6±1.0 L보 다 의의있게 적은 양이었다(p<0.01). 2. 수술 종료 후 일상적인 식사가 가능하게 되는데 걸 리는 시간은 연구군에서 17.4±4.1시간으로 대조군의 37.6±11.4시간보다 더 짧았다(p<0.01). 3. 수술 후 처음으로 가스가 배출되는데 걸리는 시간 은 연구군에서 29.6±8.0시간으로 대조군의 33.6±8.6시 간보다 더 짧았다(p<0.05). 4. 위장관의 이상 증상으로 환자가 호소하는 복부팽만 이나, 오심, 구토 증상이 나타나는 빈도는 연구군에서 17.5 %이고 대조군에서 15.0%로 의의있는 차이가 아니었다. 이상의 결과로 제왕절개 수술 후 조기에 경구 영양 공급을 하는 것이 고식적인 방법과 비교하였을 때 위장 관계 이상 증상의 빈도를 증가시키지 않으면서, 더 빨리 일상식사가 가능하게 됨을 보았으며 이런 결과로 보아 조기에 경구 영양을 하는 것이 빠른 퇴원도 용이하게 할 수 있을 것으로 사료되었다. This study was performed to assess the gastrointestinal function and patient acceptability of early oral feeding after cesarean delivery. From May 1997 to August 1997, eighty healthy women delivered by cesarean section were assigned alternately to either early initiation of oral feeding or conservative dietary management. In the early feeding group, the first postoperative oral feeding of regular hospital diet was provided within 8 hours after completetion of operation. In the conservative management group, the regular hospital diet was given only if the abdomen was not distended, bowel sounds were auscultated, and flatus had passed. The patient information and data on 1) the duration and amount of intravenous fluid administration, 2) the time of return to regular diet and first gas passage and 3) the rate of gastrointestinal complaints such as nausea, vomiting, or abdominal distension were recorded prospectively. The results were as follows; 1. The duration of intravenous fluid administration in the early feeding group (study group) was significantly shorter than those in the control group, 21.6±7.8 versus 32.2±9.0 hours (p<0.01). Therefore, the amount of iv fluid in the study group was significantly smaller than those in the control group, 3.4±1.3 versus 4.6±1.0 L (p<0.01). 2. Compared with the control group, the study group had a rapider return time to regular oral diet, 17.4±4.1 versus 37.6±11.4 hours (p<0.01). 3. Compared with the control group, the study group had a significantly shorter mean interval to first gas passage, 29.6±8.0 versus 33.6±8.6 hours (p<0.05). 4. The frequency gastrointestinal complaints such as nausea, vomiting, or abdominal distension did not show significant difference in both groups; 17.5% in the study group versus 15.0% in the control group.

자궁경부암에서 인형 유두종바이러스 16/18형 감염과 p53 유전자 변형과의 상관성

변지수,이여일,류무현,정상우,남종희,박형기 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.2

Recent studies of molecular biology have suggested that infection with human papillomavirus(HPV) is implicated in the pathogenesis of cervical carinoma. HPV infection alone, however, does not appear to be sufficient for the process of maliganant transformation, suggesting the requirement of additional cellular events. The mutation of p53, which is involved in negative control of cell proliferation, may play a role in the carcinogenesis of cervical carcinoma. The present study was designed to clarify the association between infection with HPV and p53 alteration in primary carcinoma of human uterine cervix. We investigated 46 prim-ary cervical carcinomas for the presence of HPV DNA by in situ hybridization(ISH) with probe specific for HPV 16/18, and examined the accumulation of p53 protein by immunohis-tochemistry(IHC) and the p53 alteration by polymerase chain reaction-single strand confor-mation polymorphism(PCR-SSCP) using formalin fixed, paraffin -embedded tissue. HPV DNA 16/18 was detected in 18 cases(39.1%) of 46 cervical carcinomas. The accumulation of p53 was identified in tumor cells: low level 43.5%(20/46) and high level 32.6% difference of positive reaction by IHC method. But there was no statistical significant between the infection of HPV and the accumulation of p53(p=0.847). Mutations in exons 4 through 9, where the vast majority of point mutations were reported in human neoplasms, were screened by PCR-SSCP analysis. Altered mobilities of the PCR product of p53 were also found in 9 cases(26.5%) of 34 cervical carcinoma: one in exon 4, four in exon 5/6, two in exon 7, and two in exon 8/9. The mutation of p53 was observed in 41.1%(19/46) respective of the result of IHC and PCR-SSCP, and there was slightly higher p53 alteration in HPV negative cases(23.8%, 11/46) than in HPV positive cases(17.4%, 8/46) without statistical significance(p=0.729). The conclusion of these observations suggests that HPV infection and alteration of p53 may play a critical role in tumorigenesis of carcinoma of the human uterine cervix independently, ant there is important difference in the tumorigenic pathway between two factors.

산전 초음파로 진단된 회장폐쇄증 신생아 치유 1 예

변지수,송태복,윤영돈,박진순,김은경 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.6

저자들은 임신 37주에 초음파검사에 의해 태아의 장폐쇄증을 진단하여 임신 39주에 제왕절개 분만후 분만당일 수술로 교정하여 성공했던 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Congenital intestinal atresia is a relatively rare lesion, occurring in 1 of 330 to 20,000 births and results in high mortality during the neonatal period. It is the one amenable to successful surgical correction and has good prognosis by early teratment. The following factors have significant influence on prognosis in neonatal congenital atresia ; gestational age, birth weight, age at the time of operation, the level of obstruction along the intestinal tract, the natrue of the operative procedure, and associated congenital problems. We report a case of ileal atresia diagnosed by ultrasongrapy at 37 weeks gestational age and operated on the day of cesarean section with a brief review of literatures.

만기임신에서 Misoprostol에 의한 자궁경부숙화 및 분만유도에 있어서 Prostaglandin E₂ 질정과의 비교연구

변지수,송태복,김윤하,이경민 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.4

목적: 본 연구의 목적은 만기임신에서 자궁경부숙화와 분만유도에 있어서 misoprostol 질식투여의 효용성과 안전성을 prostaglandin E2(PGE₂) 질정과 비교하는 것이다. 연구방법: 내과적, 산과적 이유로 유도분만을 시행하는 59명의 만기임산부를 무작위 추출하여 misoprostol 50㎍과 PGE₂ 3mg을 질식투여하였다. 59명중 30명에서 misoprostol을, 29명에서 PGE₂를 사용하였고, 첫번째 투여 6시간후 규칙적인 자궁수축이 시작되지 않거나 경관숙화에 실패한 경우[Bishop score 7점미만]에는 동량을 한번 더 투여하여 6시간후 재평가하였다. 결과: 성공률은 misoprostol군에서 83.3%, PGE₂군에서 58.6%로 misoprostol군에서 의의있게 높았고, 1회 투여후의 성공률도 유의한 차이를 보였다[60% vs 31%]. 성공군에서 분만까지의 평균소요시간, oxytocin 사용, 24시간내 분만 등에 있어서 양군간의 통계학적 유의한 차이는 없었다. 분만방법, 제왕절개의 적응증, tachysystole이나 hyperstimulation syndrome의 빈도, 신생아에 대한 영향력 등에도 양군간 차이가 없었다. 결론: Misoprostol의 질식투여가 만기임신에서 자궁경관숙화와 분만유도에 저렴하고 효과적인 약제이며, 양군간의 부작용이나 합병증에 있어서도 유의한 차이가 없었다. Objective: The goal of this study is to compare the safety and efficacy of intravaginal misoprostol with that of intravaginal PGE₂ for labor induction and cervical ripening in term pregnancy. Methods: Fifty nine patients with indications for induction of labor with unfavorable cervices were randomized to received either 50㎍ misoprostol or 3mg PGE₂ intravaginally. Among 59 patients recuited, 30 received misoprostol and 29 received PGE₂. The second dose was repeated 6 hours after first dose, if the cervices were unfavorable. At 6 hours after applying second dose, the cervices were reevaluated. Results: Regular uterine contraction and/or successful cervical ripening[Bishop score ≥7] after administration of one dose was statistically more often in the misoprostol group than that in the PGE₂ group[60% vs 31%, p$lt;0.05]. No difference was noted in successful induction rate after two doses administration between misoprostol group and PGE₂ group[23.3% vs 27.6%]. Total 25[83.3%] in misoprostol group & 17[58.6%] in PGE₂ group were achieved successful cervical ripening or labor induction by each drug[p$lt;0.05]. There were no significant differences in the mean time to delivery, the need for oxytocin, delivery within 24hours. No significant differences were noted in cesarean section rate, frequency of tachysystole[20% vs 10.4%] and hyperstimulation[3.3% vs 6.9%], and neonatal outcomes between two groups. Conclusion: Intravaginal administration of misoprostol is an effective and inexpensive agent for cervical ripening and induction of labor. Misoprostol 50 ㎍ was acceptable as initial dosage for unfavorable cervices in term pregnancy compared with PGE₂ 3mg. Complications were not statistically different between two groups.