자궁외임신으로 오진된 복강내 출혈

이승호(SH Lee),권영진(YJ Kwan),정형근(HK Chung),김용호(YH Kim) 대한산부인과학회 1971 Obstetrics & Gynecology Science Vol.14 No.7

자궁외임신으로 오진된 복강내 출혈을 보인 증례를 보고하는 바이다. Physicians are so freguently encountered with diagnostic problems of ectopic pregnancy that the percentage of error given by all authors is quite large, varying from 15 to as much as 35 percent. There were 319 laparotomies performed under the diagnosis of ectopic pregnancy at cheil Hospital, Seoul, Korea from December 1963 to August 1969. Among these, 5 case revealed no other intraabdominal pathology that hemoperitoneum. Preoperative diagnosis were based on the history of slight spotting beginning a few days after an expected period, relatively sudden noset of colicky lower abdominal pain, tenderness over the lower abdomen and internal pelvic organs and were decisive with positive culdocentesis in all of these cases. Intrauterine exploration was performed on one of them, who returned with exactly the same symptoms one month after having laparotomy, and presence of intrauterine adhesion was found. This condition has been classically described by Asherman but no literature was found that describing such development of the pathology occurring secondary to the intrauterine adhesion. criteria of differential diagnosis between reflux hemoperitoneum and ectopic pregnancy are made out with the retrospective study of there cases as following. In case of reflux hemoperitoneum; 1. General conditons and vital signs are within normal limits. 2. Hemoglobin and hematocrit are within normal ranges. 3. No history of sterility. 4. History of artificial abortion or intrauterine instrumentation one to three months prior to the present illness. 5. In some cases history of the same or similar experience one to three months prior to the present illness. 6. No palpable adnexal mass. 7. Negative pregnancy test. 8. Intrauterine probing prior to laparotomy.

Pitocin 적응증의 완화

이승호(SH Lee),김득순(DS Kim),이현우(HU Lee) 대한산부인과학회 1969 Obstetrics & Gynecology Science Vol.12 No.5

Use of pitoin in obstertrical practice is known to have various advantages among those being induction and augmantation of delivery as a primary indication. However, use of pitocin can be extended to the mothers who are apparently in normal labor with the aim of reduction of the number of painful hours and conversion of night time delivery to day time which is more convernient to the physician and to the safty for the mothers and babies. It will be a great achievement in modern obstetries practice if this management brings no significant harm to the baby or mother. There have been a total of 1780 deliveries gestation over 37 weeks encounted at Cheil Hospital, through December 1963 to july 1967. Among those 1598 cases(89.8%) were delivered vaginaly and 182 cases(10.2%) were managed by Cesarean section. Following this policy the percentage of day deliveries in 714 cases of the augmentation group was increased to 73% (pri,ipara, 277 (77%): Multipara, 243 (68.6%). The duration of labor in the augmentation group also greatly shortened to a figure of hours and 54 minutes in the primipara, and 4 hours and 10 minutes in the multipara which is in contrast to the Korea average duration of labor of 14 hours in the primipara and 7 hours and 30 minutes in the multipara. The number of complications in this series was decreased in comparison to the control group. In this group the corrected fetal mortality was 2 cases (0.21%). 6 cases (0.63%) of fetal distress, 1 case (0.1%) of rupture of the uterus due to use of midforceps and 12 cases (1.2%) of postpartum hemorrhage and there were no cases of maternal mortlity.

산부인과 진료전 주의요강 - 내막소파 , 원추절제 , 천자검사 ( 복강 , 흉강 )

이승호(SH Lee) 대한산부인과학회 1980 Obstetrics & Gynecology Science Vol.23 No.8

지금까지의 문헌고찰과 여러 학자들의 연구를 바탕으로 볼 때 소파술은 어느 정도의 위험을 내포하므로 가임연령의 여성에게 적절한 피임법에 대한 충분한 교육을 시켜 되도록이면 피임을 목적으로 한 소파술은 감소시켜야겠으며, 피임 실패 또는 다른 이유로 중절을 필요로 할 경우는 비교적 위험부담이 적은 조기중절을 권장함이 바람직한 일이다. 또한 우리나라 실정에서는 일반의원에서 예비검사와 다른 검사실 검사를 충분하게 실행하기 어려우므로 상세한 병력과 의학적 소견을 바탕으로 하여 환자선택에 주의를 기울이는 것이 무엇보다 중요하며, 사고시에 대비하여 적절한 약제와 장비를 준비해야 한다. 원추절제는 질확대경하 생검법으로 사용빈도가 많이 감소되었으나 질확대경을 이용하는 경우에도 원추절제를 필요로 하며, 상피내암의 경우 자궁적출술이 원칙적인 치료방법이나, 추후검사를 충분히 할 수 있는 젊은 부인에서는 원추절제로서 대신하기도 한다. 원추절제는 외래에서 시행할 수도 있으나 2~3일 정도 입원하는 것이 안전하다. 복강내 병변을 진단하기 위한 보조방법으로 복강천자를 시행하며 부인과에서는 더글라스와 천자도 동일목적으로 사용된다. 복강천자의 정확성을 높이기 위해 복강세정이 사용되나 의식상태가 나쁘거나 장 유착이 있는 경우는 위양성이 많으며 시간소모가 많은 단점이 있다. 흉강천자시 늑간 혈관과 신경을 손상시키지 않기 위해 녹간 하단부에 천자해야 하며 한번에 대량 천자를 하지 않도록 한다.

성교손상의 2예

이승호(SH Lee) 대한산부인과학회 1978 Obstetrics & Gynecology Science Vol.21 No.7

Two cases of vaginal injury by coitus are presented and brief review of pertinent literature is added.

Parlodel ( Ergocriptine, CB 154 ) 의 유즙분비 억제효과

이승호(SH Lee),남용강(YG Nam) 대한산부인과학회 1978 Obstetrics & Gynecology Science Vol.21 No.4

Therapeutic efficacy of parlodel, CB 154, in prevention and suppression of lactation has been evaluated in 50 puerperal women. The total number of women comprised 32 cases of prevention of postpartum lactation and 18 cases of suppression of established lactation. Medication was started 4 to 6 hours after delivery in the prevention group and as soon as the decision was made in the suppression group, lasting for 14 days in both. Methods of medication were designed in two different wasys to evaluate whether or no differences in the efficacy and rebound reaction between them, the one is simple method taking 2.5mg parlodel tablet twice daily and the other is tapering method having 2.5mg three times a day for the first 5 days and 2.5mg twice a day for the next 4 days and once a day for the last 5 days. The radioimmunoassay of serum prolactin (hPRL) values in 6 parlodel treated women were so impressive as to fall rapidly down to the normal levels. Fig. 1 demonstrates the postpartum changes of hPRL values in parlodel treated cases and nursing women. Criteria of clinical evaluation were the degree of breast engorgement, pain, milk secreation and rebound engorgement. The drug effectiveness were excellent and were thought to be superior to any other conventional methods of treatment revealing about 90% scored Good and about 10% were Fair regardless of preventation and suppression, method of medication, parity, type of delivery and history of previous suppression. 14 out of 50 cases (28%) showed rebound reaction but they passed through spontaneously without additional medication. The frequency of rebound milk secretion was found to be more common among the patients treated for prevention of postpartum lactation than among those treated for suppression of established engorgement of the breast. Hemodynamic studies and laboratory tests of blood and urine carried out during and after the treatment remained within normal limits and uterine involution of parlodel treated cases showed no difference from normal nonmedicated puerpe

한국인 임부의 정상 정규 검사 결과에 대한 연구 ( 예보1 )

이승호(SH Lee),노경병(KB No) 대한산부인과학회 1961 Obstetrics & Gynecology Science Vol.4 No.1

1. 한국인임부 320예에 산전규검사(Antenatal routine laboratory test)를 시행하고 각종검사결과를 고찰하였다. 2. 한국인임부의 혈색소 평균치는 11.02gm% Hematocrit 평균치는 34.59%이었다. 3. 한국인임부의 창내기생충검사에서 Ascaris Lumbricoides 77.7%, Anchylostoma duodenale 24.7%, Trichocephalus trichiurus 85.7%, Trichostrongylus Orientalis 29.1% 그리고 Clonorchis Sinensis 2.8%가 양성이었다. 4. 임부에 있어서의 뇨단백검사는 임신중독증 경중의 척도가 되며 그의 조기진단 및 치료방침 결정에 큰 도움이 되었다. 5. 임부 뇨당의 양성율은 약 8%였다. 6. 임부매독혈청반응양성율은 약 1.4%였다. 7. 임부의 활동성 폐결핵은 약 2.75%에서 양성이었다. 8. 임신중 소정의 진찰 및 검사를 받은 임부군은 안받은 임부군보다 산과적합병증의 발생 빈도가 현저히 낮았으며 특히 자궁내태아사망율은 전군에서는 1예도 없었음에 비하여 후군에는 12예나 되어 좋은 대조가 되었다..

지연분만에 관한 임상적 고찰

이승호(SH Lee),손위익(WY Sohn),안종호(JH Ahn),박상빈(SB Park) 대한산부인과학회 1974 Obstetrics & Gynecology Science Vol.17 No.3

1) 1964년 1월부터 1972년 12월까지 본병원 산부인과에 입원하여 만기분만한 산모 중 지연 분만의 발생빈도는 10.7%였다. 2) 연령분포는 25∼29세에서 가장 많았으나 빈도는 연소층과 고령층에서 높았다. 3) 산력별로는 초산부 67%, 경산부 33%이며 평균연령은 초산부 25.3세, 경산부 29.1세였다. 4) 분만시간은 초산, 경산부 공히 24∼36시간에 분만이 가장 많았고 다음은 초산에서 48∼ 60시간, 경산에서 60∼72시간이었다. 5) 원인분석에서 태위별로는 두위 82.0%, 둔위 13.6%, 횡위 3.9%이며 여기에 수반된 원인으 로는 자궁수축부전 22.4%, C. P. D. 14.0%, 자궁과다팽만 11.8%였다. 6) 자연분만이 45.2%이고 나머지는 vacuum, 유도겸자분만 등에 의해 분만되었고 이 중 제 왕절개술에 의한 분만이 9.2%였다. 7) 산후감염률은 11.3%였다. 8) Apgar score는 score 1∼6이 31.5%, score 0가 8.3%로서 인공소생술을 요한 경우가 많았다. The purpose of this study was to evaluate the prolonged labor among the full term deliveries admitted to the Kyungpook National University Hospital between Jan. 1, 1964 and Dec. 31, 1972. By evaluating 288 cases of prolonged labor in its same period, the following results were obtained. 1) The incidence of prolonged labor was 10.7%. 2) Although the peak of their occurences was seen in 25 to 29 years age group, its relative incidence was rather high in the aged and in the young women. 3) The incidence in the primipara was 67% with average age 25.3 years and that of multipara was 33% with 29.1 years in average. 4) The duration of labor was mostly from 24 to 36 hours in primi and multipara inclusively. From 48 to 60 hours in primipara and from 60 to 72 hours in multipara were the duration of labor in the next frequency. 5) The possible cause of prolonged labor was uterine dysfunction (22.4%), C. P. D. (14.0%), overdistention of uterus (11.8%) etc, and the fetal presentation are as follows ; cephalic ; 82.0%, breech ; 13.6%, transverse ; 3.9%. 6) The method of delevery was as follows ; spontaneous delivery ; 45%, forcep delivery ; 11.4%, vacuum extraction ; 42.6%, cesarean section ; 9.2%. 7) The maternal morbidity was seen in 11.3% of all cases. 8) The Apgar score of newborn baby was as follows ; 7-10 ; 60.2%, 1-6 ; 31.5%, 0 ; 8.2% and in many cases, artificial resuscitation was needed.

거대 자궁근종 분만의 1예

이승호(SH Lee) 대한산부인과학회 1978 Obstetrics & Gynecology Science Vol.21 No.6

A case of huge delivered myoma with 45 years old parar 7 women is presented and brief review of pertinent literature is added.

부인과영역의 종양 및 종류와 난관자궁조영술

이승호(SH Lee),이태호(TH Lee) 대한산부인과학회 1981 Obstetrics & Gynecology Science Vol.24 No.4

Hysterosalpingographic studies were carried out on the 29 cases of female genital neoplasms with 16 cases of leiomyoma and 13 cases of ovarian tumors, including a case of corpus luteum cyst, through March 1 1980 to Dec 31 1980 at our Ob. and Gyn. Department. The result summarized were as follows On the hysterogyaphic studies of the uterine leiomyoma cases with irregular and regular edge of cavum uteri were 7 cases or 43.8% and 9 cases or 56.2% respectively. Cases which revealed filling defect were 10 cases or 62.5% and among these, 8 cases were local in origin, showed most part. The pictures of filling defects were variable, polyp like, spherical, semispherical, irregulary lobulate, semilunar and sickel form etc. cases revealed enlarged uterine cavum were 6 cases or 37.5% and cases with deformed 7 cases or 43.8%. Tubal elongation on the affected side was observed 11 cases out of 13 cases revealed 84.6% and tumor surface coating was seen only 4 cases or 36.4%. Calcification was recongnized on 2 cases of mucinous cystadenoca.

배란성 월경주기의 세포학적 검토

이승호(SH Lee),박원길(WK Park),이태호(TH Lee) 대한산부인과학회 1977 Obstetrics & Gynecology Science Vol.20 No.2

배란성월경주기를 가진 110명의 성숙부인의 각 월경주기를 8등분,동일군에 속아는 각예를 8군으로 만들어 각군마다의 성홀몬 분비변동에 따른 핵농축지수의 변화를 연구한 바 아래와 같이 요약할 수 있었다. 제1군에서 제8군까지의 각군의 핵농축지수의 평균치는 각각 22.9%, 39.9%, 48.6%, 56.2%, 17.4%, 26.7%, 27.6%, 15.0%이었다. 제 1,2,3,4각군의 핵농축지수의 변동은 제1군부터 제4군까지 점차적인 상승경향을, 그리고 제5군에서는 급격한 감소를 보인 후 다시 약간증가하여 제8군에서 최저치로 이행하였다. 배란직전과 직후에 해당한다고 추정되는 제4군과 제5군의 양군 핵농축지수를 비교한 바 유의차를 인정할 수 있었다. Each cycle of 110 women with ovulatory menstrual cycle equally devided into eight categories, and devided each cycles, which belong to same category were made in 8 groups. The studies were undertaken about changes in karyo-pyknotic indices of each group and results obtained were summarized as follows. Mean values of each group of karyo-pyknotic indices from group 1 to group 8 were 22.9%, 39.9%, 48.6%, 56.2%, 17.4%, 26.7%, 27.6% 15.0% respectively. Karyo-pyknotic indices observed among the group 1 to the group 4, progrssively increasing tendency and marked decrease at group 5, slight increasing tendency thereafter, the lowest value at group8. Difference of karyo-pyknotic index noted between group 4 and group 5 was significant.