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손성빈(Sung Bin Son),최훈(Hoon Choi),한성식(Sung Shik Han),강영숙(Young Suk Kang),박영준(Young Jun Park),이제훈(Je Hoon Lee),김복린(Bok Lin Kim),조용균(Yong Kyoon Jo),박교훈(Kyo Hoon Park),이철민(Chul Min Lee),이홍균(Hong Kyoon Lee) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.2
Fetal intussusception is not common and the underlying mechanism triggering the event is not known at present. There are few reports of successful diagnosis in fetus with prenatal ultrasongraphy. It may be detected by meconium peritonitis. Meconium peritonitis is a nonbacterial foreign body reaction or chemical inflammation by intestinal perforation result from intestianl atresia, intussusception and fetal bowel obstruction. Recently we experienced a 33+1 weeks of gestational fetus with fetal intussusception who had prenatal ultrasonographic detection with meconium peritonitis, and the infant was underwent postnatal laparotomy. We present this case with a brief review of literature.
이성기(Sung Ki Lee),김세광(Sei Kwang Kim),김석영(Suk Young Kim),한성식(Sung Shik Han),김인규(In Kyu Kim),양영호(Young Ho Yang),김재욱(Jae Wook Kim) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.1
N/A Objective: The aims of this study was to examine whether epileptic women with antiepileptic drugs(AEDs) treatment during pregnancy were associated with an increased risk of adversed pregnancy outcome. Methods: The study design was a retrospective analysis of 91 epileptic pregnant women attending the Severance Hospital Yonsei Medical Center between January 1980 and June 1998. Of the 91 women, data from 84 were available for analysis. Adverse pregnancy outcome in 66 women who were exposed to AEDs during pregnancy were compared with those of 18 controls who were not. The main adverse pregnancy outcome included spontaneous abortions, perinatal deaths, preterm deliveries, fetal growth restriction and congenital anomalies. Results: Epileptic women with AEDs treatment during pregnancy were not significantly different from their controls in the incidence of spontaneous abortions(1.5% vs, 5.5%), perinatal deaths(1.5% vs. 0%), preterm deliveries(3% vs. 5.5%), fetal growth restriction(3% vs. 0%), and congenital anomalies(3% vs 5.5%). An adverse outcome occurred in 8 of 66 women(l2%) in the study group and 3 of 18 control group(16.5%). This difference was not statisitically significant. Conclusion: Our study shows that epileptic women who were exposed to AEDs during pregnancy do not have an increased risk of adversed pregnancy outcome than the women who were not.
가역적 후백질 뇌병증 증후군(Reversible Posterior Leukoencephalopathy)이 동반된 자간증 1례
최준원 ( Joon Won Choi ),한성식 ( Sung Shik Han ),손성빈 ( Sung Bin Son ),최영숙 ( Young Sook Choi ),민현주 ( Hyun Ju Min ),이철민 ( Chul Min Lee ),박교훈 ( Kyo Hoon Park ),조용균 ( Yong Kyoon Jo ),최훈 ( Hoon Choi ),김복린 ( Bok 대한주산의학회 2001 Perinatology Vol.12 No.3
내과적 치료 실패가 예상되는 자궁외 임신에서 다회 methotrexate 화학요법
민현주(Hyun Ju Min),한성식(Sung Shik Han),최준원(Jun Won Choi),손성빈(Sung Bin Son),최영숙(Young Suk Choi),이철민(Chul Min Lee),김복린(Bok Lin Kim),최훈(Hoon Choi),조용균(Yong Kyoon Cho),박교훈(Kyo Hoon Park),이홍균(Hong Kyoon Lee) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.11
N/A Objective : The purpose of this study was to determine the efficacy of multiple dose methotrexate (MTX) chemotherapy approved as a primary treatment of ectopic pregnancy in suspected medical treatment failure of ectopic pregnancy. Methods : This study included 77 hemodynamically stable high risk ectopic pregnants diagnosed from January 1995 to June 2000 at department of Obstetrics & Gynecology, Sanggye Paik hospital, Inje university. High risk criteria of our study were adnexal ectopic mass 3.5 cm or serum β-hCG 4,000 mIU/ml or presence of fetal heart beat(FHB) or presence of peritoneal fluid and fresh blood on culdocentesis. Statistics were analyzed with 2-test, Student χ2-test and odds ratio of each risk factors. Results : The response rate of multiple dose MTX chemotherapy was 85.7%(66/70). There was no statistically difference of risk factors between success and failure group except fetal heart beat. Among 11 failure patients, there were 3 patients with adnexal ectopic mass 3.5 cm (odds ratio=1.4, 0.3∼5.7), 3 patients with presence of FHB, 7 patients with presence of peritoneal fluid(odds ratio=1.0, 0.3∼3.8), 8 patients with serum β-hCG 4,000 mIU/ml (odds ratio=2.8, 0.7∼11.6). Conclusion : There results suggest that multiple dose MTX chemotherapy can be treated regardless of ectopic mass size, presence of pretoneal fluid, serum β-hCG level. But we must pay attention to treat ectopic pregnancy with presence of fetal heart beat.
유용균(Yong Gyun Yoo),조재성(Jae Sung Cho),박용원(Yong Won Park),한성식(Sung Shik Han),이연혜(Yeon Hye Lee),윤혜정(Hye Jeong Yoon) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.3
N/A Purpose: The diagnostic usefulness of fetal echocardiography in congenital heart disease is well known. One of the indications for fetal echocardiography is presence of extracardiac anomalies and such coexistent congenital heart disease may have important implications for obstetric and neonatal management. Materials and methods: 496 women with singleton pegnancies with amgenital anomalies that underwent penatal care and follow-up in Severance Hospital for 5 years from 1991 to 1995 were evaluated for the incidence of congenital heart disease. Results: The incidence of congenital heart disease in fetuses with the associated extracardiac anomalies were as follows; central nervous system 6.9%(11/160), gastro-intestinal system 10.7%(8/75), genito-urinary sysem 4.7%(4/85), others 5.6%(4/72). Thirty-one of eighty-ane fetuses with congenital heart disease were found to have the associated extracardidac anomalies and ten of them chenoscenal abnormalities. Conclusion: We recommend that fetuses with congenital extracardiac anomalies sbould be checked for the presence of congenital heart disease and chmmosomal abnormalities, if needed.
자간전증이 prostaglandin E2 및 oxytocin을 사용한 분만유도에 미치는 영향
박교훈(Kyo Hoon Park),조용균(Yong Kyoon Cho),최훈(Hoon Choi),김복린(Bok Rin Kim),한성식(Sung Shik Han),이철민(Chul Min Lee),이홍균(Hong Kyoon Lee) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.3
N/A Objective : The purposes of this study were 1) to determine whether preeclampsia itself affects failure of labor induction with prostaglandin E2 and oxytocin and 2) to investigate risk factors for failed induction in women with preeclampsia. Method : Fifty preeclamptic women and 175 nonpreeclamptic women requiring labor induction were studied prospectively. Intravaginal prostaglandin (PG) E2 tablet (Dinoprostone, The Upjohn company, 3 mg) followed by a second dose if the cervix assessed 6 hours later was 5 or less of Bishop score, and oxytocin were used for labor induction. Women with rupture of membrane, spontaneous contraction resulting in cervical change or an initial cervical examination showing more than 2 cm dilatation and 50% effacement were excluded. Statistics were analyzed with 2 test, Student t test, and multiple logistic regression. Results : 1) The women with preeclampsia had a significantly higher rate of failed induction than did those without preeclampsia [24% (2/50) versus 9% (16/175); p <0.05]. However, the women with preeclampsia had a higher rate of the use of magnesium sulfate, and were more likely to decrease gestational age at induction and increase maternal weight than those without preeclampsia (p <0.0001, respectively). There were no significant differences in prevalence of nulliparity and low initial Bishop score (≤3) between the women with and without preeclampsia. 2) Multiple logistic regression showed that preeclampsia itself was not associated with failed induction after correction of known confounding variables (odds ratio 0.22, 95% confidence interval 0.03-2). 3) In women with preeclampsia, the use of magnesium sulfate only was associated with increased risk of failed induction analyzed by multiple logistic regression(odds ratio 38.5, 95% confidence interval 1.6-897). Maternal weight with 70 kg or more was associated with increased risk of failed induction, but it is not statistically significant (p=0.055). Conclusion : 1) The risk of failed induction is increased in women with preeclampsia, but not by preeclampsia itself but by the use of magnesium sulfate, prematurity, and increased maternal weight secondary to preeclampsia. 2) The use of magnesium sulfate is independent risk factor for failed induction in women with preeclampsia.
한국인 심부전증 환자 심근에서의 인형 거대 세포 바이러스 감염
이명용,이무용,김영권,한성식,최성준,김효수,이영우,서정돈 단국대학교 1998 論文集 Vol.33 No.-
Objectives: In order to evaluated the prevalence and the site of infection of cytomegalovirus in terminally failing heart, cytomegaloviral DNA was detected in the explanted hearts of transplantation recipients. Methods: DNA extractions were performed from explanted failing hearts(N=22) and normal hearts(N=5) and polymerase cain reactions(PCRs) were done for detection of late gene sequence coding pp150 glycoprotein. The products were confirmed by electrophoresis on the 1% agarose gel. n order to improve the detectability of cytomegaloviral genome, nested PCRs were executed with the primers designed for the original 607 bp products. In situ PCRs also were done with the samples which were confirmed as positive for CMV viral genome by nested PCRs. Results: All patients had IgG anti-cytomegalovirus antibody and did not have IgM anti-cytomegalovirus antibody. Cytomegaloviral genomes in myocardium were detected by polymerase chain reaction. The 607bp products by PCRs were found in both explanted failing heart(3 cases/22. 13.5%) and normal hearts( 1 case/5, 20.0%). In nested PCRs, 186bp products were found in both failing hearts(LV 4/22, LA 3/2, RV 4/22, RA 0/17) and normal hearts(LV 2/5, LA 1/4, RV 2/5, RA 2/5). These was no significant change in positivity of cytomegaloviral DNA genome between failing and normal hearts. Total positivity of cytomegaloviral genome in explanted hearts was 44.4% according to the nested PCR results. The positivity of cytomegaloviral DNA by n situ PCR was 33.3%(4/12), and the site of positive reaction was the nuclei of the myocardial cells. Conclusion: Cytomegalovirus was rarely observed in explanted hearts of terminal heart failure and nested PCR could enhance the sensitivity of cytomegaloviral genome detection. The result of the in situ PCR showed the site of the cytomegaloviral infection was nuclei of the myocardial cells. Cytomegalovirus, however, might have no direct causal relationship in the development of terminal heart failure.
박태진,윤성철,이연희,한성식,조종태,탁우택,최유식 대한내과학회 2001 대한내과학회지 Vol.61 No.6
Subcapsular renal hematoma without a history of trauma is uncommon, which has been reported with the association of underlying renal tumor, vascular or inflammatory disease. Recently, subcapsular renal hematoma has been reported to be a rare complication of acute pyelonephritis. If abdominal pain is acutely aggravated or hematocrit is rapidly decreased in the patient of acute pyelonephritis, subcapsular renal hematoma as a complication of acute pyelonephritis should be considered and confirmed by subsequent imaging studies. We report two cases of subcapsular renal hematoma as a complication of acute pyelonephritis.(Korean J Med 61:669-673, 2001)