모성 건강관리 평가에 관한 임상적 연구 ( 제1보 )

이재현(JH Lee),오보훈(BH Oh),최동수(DS Choi) 대한산부인과학회 1981 Obstetrics & Gynecology Science Vol.24 No.9

1980년 2월1일부터 12월31일까지 11개월동안 경희대학교 의과대학 부속병원 산부인과에 분 만을 목적으로 입원한 산모 1547명을 대상으로 국제 출산력연구소(IFRP)에서 개발한 모성 기록표에 의거하여 작성된 내용을 조사분석하여 다음과 같은 결론을 얻었다. 1. 산모의 평균연령은 28.05±3.92세이며 25-29세군이 853례(55.72%)로 가장 많았고, 임신 및 분만의 위험이 높은 35세이상 군과 19세이하군이 100예(6.53%)이었으며 기혼이 경우가 96.34%로 대부분을 차지하였고 미혼인 경우가 0.20%이었으며 평균교육기간은 11.69±1.43년 이었다. 2. 산모의 평균생아출산횟수는 0.68±0.95회이었고, 생아출산력이 없는 경우는 802명(54.2%) 으로 가장 많았으며 1회 생아 출산한 산모가 31.6%, 2회 출산 9.5%, 3회 출산 2.9%, 4회 출 산 1.0% 순이었으며, 5회 이상 생아출산한 산모도 0.7%로 나타냈다. 최종전 임신결과를 보면 만삭분만 32.4% 인공유산 19.3%, 자연유산 7.3%, 조산 1.7%, 사산 1.0%의 순이엇다. 3. 대상산모 591례의 평균혈색소치는 9.24±2.01gm%이었고, 임신빈혈이 있는 경우가 319례 (54.0%), 빈혈이 없는 경우가 272예(46.0%)이었으며, 임신기간 37주이전에 분만한 산모군과 출산아 체중이 2500gm미만인 산모군에서 빈혈의 발생빈도가 현저히 증가하였다. 4. 평균임신기간은 39.87+-2.65주이었으며 조산아의 출산빈도는 20대 산모군 (8.63%)에 비해 10대 산모군 (16.67%)과 40대 산모군에서 각각 2배이상의 높은 빈도를 나타내었으며, 분만횟 수별 조사안의 출산빈도는 다경산부 (19.24%)에서 초산부(8.85%)나 경산부 (8.73%)에 비해 현저히 증가하였다. 5. 분만방법의 유형별 분포를 보면, 자연질식분만 53.08%, 흡입분만 29.89% 겸자분만 1.35% 제왕절개 14.87%이었으며 이중 흡입분만비율은 초산부 (42.27%)에서 경산부 (15.05%)에 비해 현저히 높앗다. 1. The mean age of 1531 cases was 28.5±3.92. the age group 25-29 was most common with 55.7% (853 cases ) and the age group of over 35 and under 19 in high risk pregnancy was 6.53% (100cases). The group of currently married status occupied the majority of cases (96.3%) and never married : 0.2%. the mean education years was 11.68±1.43 2. The mean live births in obstetric history was 0.68+-0.95. No history of live births was most common with 54.2%(802 cases) one live birth represented 31.6% two births : 9.5% 3 births : 2.9% 4 births : 1.0% and 5 or more births : 0.7%. 3. Mean hemoglobin level of 591 caes was 9.24±2.01gm% : 319 cases (54.0%) were in anemic condition and 272 cases (36.0%) were not in anemic condition. The incidence of anemia increased remarkably in the delivery groups of gestational age under 37 wks, and in infants weighting less than 2500gm. 4. Mean gestational age was 39.87±2.65wks. According to the incidence of premature delivery by matenal age, the delivered groups of ages under 19 (16.67%) and over 40(23.07%) were twice as high than groups of ages 20-29 (8.63%) and by parity the delivered group of the grand multipara (19.24%) was markedly increased from the primipara (8.8%) or multipara(8.73%). 5. The methods of delivery of 1479 cases were as follows ; spontaneous vaginal delivery : 53.08% , vacuum delivery :29.89%, forceps delivery : 1.35% , C-section : 14.87% , and among them , vacuum delivery was used more commonly in the primipara (42.27%) than the multipara (15.05).

부인과 악성종양 세포주에 대한 항암제의 감수성 검사에 있어서 집락형성법과 [^3H]Thymidine Incorporation을 이용한 Rapid Assay의 비교연구

이재현(JH Lee),김승보(SB Kim),이선경(SK Lee),남상윤(SY Nam),조해성(HS Cho),정재돈(JD Jung) 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.5

Assays that measure [^3H] thymidine incorporation by cells plated in soft agar were investigated to identify a rapid method for assessing chemosensitivity of tumor cells. Two established cell lines (HeLa and JAR) were tested for the effectiveness of chemotherapeutic agents using colony forming assay on plastic and assay that measure [^3H] thymidine incorporation by scintillation, and the result was compared. 1. Colony forming efficiency of HeLa on plastic was 17.5%, and that of JAR was 18.9%. 2. By colony forming assay, drug-related inhibition(%) of colony formation of HeLa on Cisplatin, Vinblastine, Mitomycin, and Adriamycin was 71%, over 99%, over 99%, and 62%, and that of JAR was 83%, over 99%, 68%, and over 99%, respectively. 3. Drug-related inhibition(%) of [^3] thymidine incorporation by scintillation of HeLa on Cisplatin, Vinblastine, Metomycin, and Adriamycin was 75%, over 99%, 96%, and 69%, and that of JAR was 34%, over 99%, 78%, and 88%, respectively. 4. There was nosignificant difference between two methods comparing chemosensitivity except JAR, which has significant difference between two methods on Cisplatin (P<0.005). (Inhibition of coloby formation on plastic was 83%, where as inhibition of [^3H] thymidine incorporation by scintillation was 34%). So we can predict the effectiveness of anticancer chemotherapeutic agents by rapid assay using [^3H] thymidine incorporation, which the result can be obtainable within 5 days, and early chemotherapy can be accomplished.

배란유도주기로부터 결과된 임신들에 있어서 혈청 β-HCG 의 초기배경에 대한 비교 연구

이재현(JH Lee),서병희(BH Suh),홍진기(JK Hong),고영호(YH Koh) 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.7

To evaluate the early background of serum HCG β-subunit in pregnancy, 12 pregnancies achived by ovulation induction were studied, which included 8 siglton pregnancies, 1 twin pregnancy, 2 clinical abortions, 1 ectopic pregnancy. We measured the serial serum concentrations of HCG β-subunit on -1,0,7,12,16,18th days after ovulation. The results were as follows; 1. No significant increasement of β-HCG in all cases was found on preovulatory and ovulatory day when 5000 IU HCG was injected on preovulatory and ovulatory day, serum β-HCG decreased to less than 5mIU/ml within 7days in 83% of the cases. 3. β-HCG values on the 12th day after ovulation were 49mIU/ml highest in twin pregnancy, 19.63±9.73mIU/ml and 18.00±8.00mIU/ml simularly in normal signleton pregnancy and spontaneous abortion respectively and 4mIU/ml lowest in ectopic pregnancy. 4. β-HCG values on the 14th day after ovulation were 169mIU/ml highest in twin pregnancy, 69.25±37.12 mIU/ml and 67.00±17.00mIU/ml similary in normal sigleton pregnancy and spontaneous abortion respecively and 11mIU/ml lowest in ectopic pregnancy. 5. β-HCG values on 16th day after ovulation were 652 mIU/ml highest in twin pregnancy, 380 mIU/ml next in ectopic pregnancy and 244.50±168.77 mIU/ml and 95.00 mIU/ml in normal singleton pregnancy and spontaneous abortion repectively. 6. Initial diagnosis of pregnancy could be obtained on the 8th to 12th day after ovulation in 83% of the cases and on the 14th day in 100% of the cases. 7. Exponential rates on β-HCG in normal singleton pregnancy were 0.271±0.051 on the 12th to 14th day after ovulation, 0.248±0.088 on the 14th to 16th day and 0.303±0.201 on the 16th to 18th day. 8. Doubling times of β-HCG in normal singleton pregnancy were 1.154±0.227 days on 12th to 14th day after ovulation, 1.511±0.853 days on 14th to 16th day and 1.092±0.280 days on 16th to 18th day.

한국정상인 혈청효소 ( Aldolase, Amylase 및 Cholinesterase ) 의 활성도에 대하여

이재현(JH Lee) 대한산부인과학회 1963 Obstetrics & Gynecology Science Vol.6 No.3

The serum aldolase, amylase and cholinesterase activities of the normal Koreans were determined. The resuelts are obtained as follows: (1) The serum aldolase activities of male and female Koreans are 0.16±0.08 units/1, 0.14±0.07 units/1, respectively. (2) The serum amylase activities of male and female Koreans are 157.51±75.86 units/dl, 169.19±61.21 units/dl, respectively. (3) The serum cholinesterase activities of male and female Koreans are 30.5±1.8, 29.1±1.7 respectively.

특집 임신중독증의 치료

이재현(JH Lee) 대한산부인과학회 1976 Obstetrics & Gynecology Science Vol.19 No.5

임신중독증의 병태가 대단히 복작하고 그 증상이 다양하므로서 이에 따른 치료 또한 여러 가지 주의점을 포함하고 있어 매우 힘든다. 여기에 대체적인 치료의 의의와 대요를 기술하 여 보았다.

여과지 전기영동법에 의한 모체 및 태아혈색소의 차이에 대하여

이재현(JH Lee) 대한산부인과학회 1960 Obstetrics & Gynecology Science Vol.3 No.1

모체 및 태아혈색소를 여과지전기영동법(Ph8.6의 veronal buffer 사용)에 의하여 분리한 결과 모체측이 태아측보다 빠른 이동상(higher anodic mobility)을 보여 주었다. The observation on the maternal and fetal hemoglobin by means of paper electrophoresis revealed that the anodic mobility of the maternal hemoglobin was higher than that of the fetal hemoglobin.

여지전기영동법에 의한 모체 및 태아혈청단백분획상의 차이에 대하여

이재현(JH Lee) 대한산부인과학회 1958 Obstetrics & Gynecology Science Vol.1 No.1

Ⅰ) 모체 및 태아 각각 100예에 대하여 여지전기영동법에 의한 혈청단백분획상을 조사함에 있어서 각 단백분획부를 용출시켜 그 양을 측정 비교하는 한편 Densitometry에 의한 Density curve를 그려 그 차이를 관찰한 바 다음과 같은 결과를 얻었다. Ⅱ) Albumin 분획에 있어서 모체측은 태아측보다 거의 예외없이 적고 γ-globumin분획을 제외한 α1-globumin, α2-globumin, β-globumin 분획은 일반적으로 모체측이 높다. (1) 모체혈청 Albumin은 태아백청 Albumin보다 10.88% 낮다. (2) 모체혈청 α1-globumin은 태아혈청 α1-globumin보다 1.92% 높다. (3) 모체혈청 α2-globumin은 태아혈청 α2-globumin보다 3.23% 높다. (4) 모체혈청 β-globumin은 태아혈청 β-globumin보다 7.15% 높다. (5) 모체혈청 γ-globumin은 태아혈청 γ-globumin보다 1.42% 낮다. Ⅲ) A/G 비율은 모체측이 태아측에 비해서 낮다. Observing the serum protein fractions of the maternal and fetal serum by paper-electrophoresis in 100 normal delivery cases, the following results were obtained; 1) The maternal serum albumin was 10.88% lower than that of the fetal serum. 2) The maternal serum α1-globulin was 1.92% higher than that of the fetal serum. 3) The maternal serum α2-globulin was 3.23% higher than that of the fetal serum. 4) The maternal serum β-globulin was 7.15% higher than that of the fetal serum. 5) The maternal serum γ-globulin was 1.42% lower than that of the fetal serum. 6) In A/G ratio, the maternal side was 0.47 lower than the fetal side. The maternal serum albumin was almost always lower than that of the fetal serum, while the maternal serum α1-globulin, α2-globulin, and β-globulin were generally higher than the same fractions of the fetal side except for γ-globulin

자궁외 임신의 임상병리학적 고찰

이재현(JH Lee),김대훈(DH Kim),박태수(TS Park) 대한산부인과학회 1973 Obstetrics & Gynecology Science Vol.16 No.2

저자들은 1968년 1월 1일부터 1972년 8월 31일 까지 4년 8개월 동안 카톨릭의과대학 부속 성 바오로병원 산부인과에 입원하였던 정상분만 환자 5017예와 자궁외 임신환자 303예에 대하여 임상병리학적 검색을 하고 문헌 고찰 결과 다음과 같은 결론을 얻었다. 1) 자궁외 임신의 정상임신에 대한 빈도는 6.0%였다. 2) 정상분만과 초 및 재 재궁외 임신의 연령은 대체로 정규분포곡선을 보이며 재 자궁외 임신은 전체 자궁외 임신 환자의 15.6%였다. 3) 자궁외 임신의 빈도는 연령과 분만횟수 증가에 따라 증가하며 중절횟수와의 관계는 분명하지 않으나 추출변동의 개념을 고려한다면 증가하는 추세를 보였다. 4) 자구외 임신에서 Arias-Stella`s reaction과 탈락막 변화는 50%에서 나타났다. 5) 난소임신 3예와 경관임신 3예를 보고한다. The clinicopathological study on the 5017 normal deliveries, 303 ectopic pregnancies including 3 ovarian pregnancies and 3 cervical pregnancies experienced in St. Paul´s hospital was made during 4 years and 8 months period from Jan. 1968 through Aug. 1972. The results were as follows: 1) The ratio of ectopic pregnancy to normal pregnancy was 16.5:1 (about 6%). 2) Repeated ectopic pregnancy was found in 15.6% of all ectopic pregnancy. 3) Frequency of ectopic pregnancy was increasing tendency parallel to the increase of the age and parities of patients. It was also suspected that the increase of ectopic pregnancy had a correlation with the increase of number of abortion. 4) Arias-Stella´s reaction and decidual change was detected in 50% of all ectopic pregnancy.

HumanChorionic Gonadotropin

이재현(JH Lee),서병희(BH Suh) 대한산부인과학회 1983 Obstetrics & Gynecology Science Vol.26 No.10

hCG는 면역학적 혹은 생물학적 방법에 의하여 임신의 진단등에 신속하고 편리하게 이용될수 있는 glycoprotein이지만 다른hormone과의 교차반응이 있으므로 감도가 낮은 방법을 이용하는 경우에는 위양성, 또는 위음성등이 문제시된다. 한편 높은 감도 및 특이성이 있는 β-subunit hCG RIA의 이용으로 절박유산의 예후, 포기상태의 유형진단과 악성잠재력 및 치료지침결정, 난소암의 보조적진단과 예후판정, 자궁외임신의 조기 진단과 파열여부등을 파악하는데 보조적인 방법이기는 하지만 경우에 따라 결정적인 역할을 할 수 있기 때문에 hCG의 양성반응시 각기 감별사항을 면밀히 추적하고 연속검사의 실시가 요구된다.

모체 및 태아의 혈액 단백량, 혈청유리 아미노산량 및 혈액핵인산량의 차이에 관하여

이재현(JH Lee) 대한산부인과학회 1963 Obstetrics & Gynecology Science Vol.6 No.3

The maternal and fetal serum proteins (total protein, albumin, globulin and A/Gratio) (30 mother-fetus pairs) and tree amino acid (54 mother-fetus pairs) and blood nucleic acid phosphorus(RNAP &. DNAP) (30-32mother-fetus pairs) were determined and compared. The following results are obtained. 1. Serum Proteins 1) The maternal and fetal serum total protein levels are 7.00±0.40 gm%, and 6.34±0.45 gm%, respectively (p<0.01) 2) The maternal and fetal serum albumin levels are 3.37±0.26 gm%, and 3.72±0.36 gm%, respectively (p<0.01) 3) The maternal and fetal serum globulin levels are 3.63±0.27 gm%, and 2.63±0.25 gm%, respectively (p<0.01) 4) The maternal and fetal serum A/G ratio are 0.92±0.09 and 1.42±0.18, respectively (p<0.01) Thus, maternal serum total protein and globulin levels are higher than fetal one, but maternal serum albumin and A/G tatio are lower than fetal one, 2. Serum Free Amino Acid. The maternal & fetal serum tree amino acid levels are 5.57±1.01 N mg% and 6.63±0.93 N mg% (p<0.01). Thcn, maternal serum free amino acid level is lower than fetal one. 3. Blood Nucleic Acid Phosphorus 1) The maternal and fetal blood RNAP are 1.79±0.47 mg/dl, and 2.34±0.53 mg/dl, respectively (0.5>p>0.1) 2) The maternal and fetal blood DNAP are 0.36±0.11 mg/dl, and 0.58±0.15 mg/dl, respectively (p<0.01) The difference between materanl and fetal blood RNAP is not so significant and maternal blood DNAP level is lower than fetal one. (the difference is highly significant)