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조기분만진통 임산부에서 양수 tumor necrosis factor-α 와 조직학적 융모양막염 및 선천성 패혈증과의 관련성에 관한 연구
박교훈(Kyo Hoon Park),윤보현(Bo Hyun Yoon),전중관(Jong Kwan Jun),박중신(Joong Shin Park),김길자(Gil Ja Kim),이홍균(Hong Kyoon Lee),신희철(Hee Chul Syn) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.5
N/A Objective : Our purposes were (1) to determine whether amniotic fluid concentrations of tumor necrosis factor-α are of value in the diagnosis of histologic chorioamnionitis of preterm placenta and in the prediction of congenital sepsis in patients with preterm labor and intact membranes and (2) to compare the diagnostic performance of placental histologic finding and amniotic fluid culture with that of amniotic fluid tumor necrosis factor-α for this outcome variable. Methods : The relations among placental histologic finding, perinatal outcome, amniotic fluid culture, and amniotic fluid tumor necrosis factor-α concentrations were examined in 61 consecutive patients with preterm labor and intact membranes who delivered preterm neonates within 72 hours after transabdominal amniocentesis. Tumor necrosis factor-α was determined by enzyme-linked immunosorbent assays. Mann-Whitney U test, Fisher's exact test, receiver-operator characteristic curve, and multiple logistic regression were used for analysis. Results : 1) Women with acute histologic chorioamnionitis had significantly higher median amniotic fluid tumor necrosis factor-α concentrations than those without histologic chorioamnionitis (median 83.2 pg/ml, range 1.4 to 7241 pg/ml vs median 1.6 pg/ml, range 0 to 59.9 pg/ml, p <0.0001). Amniotic fluid tumor necrosis factor-α concentrations ≥4.6 pg/ml had a sensitivity of 88% (28/32) and specificity of 80% (23/29) in the diagnosis of acute histologic chorioamnionitis. 2) Amniotic fluid concentrations of tumor necrosis factor-α were significantly higher in neonates with congenital sepsis than in those without congenital sepsis (median 227.5 pg/ml, range 1.2 to 7241 pg/ml vs median 3.8 pg/ml, range 0 to 735 pg/ml, p <0.0005). Amniotic fluid tumor necrosis factor-α concentrations ≥41 pg/ml had a sensitivity of 82% (23/29) and specificity of 79% (38/48) in the prediction of congenital sepsis. 3) Multiple logistic regression indicated that elevated amniotic fluid tumor necrosis factor-α (≥41 pg/ml) was the only independent predictor of congenital sepsis (odd ratio 12.9, 95% confidence interval 1.3 to 125.3, p <0.05) after correction for known confounding variables [i.e., low gestational age at birth (≤32 weeks), positive amniotic fluid culture, histologic or clinical chorioamnionitis, low Apgar score (<7)]. Conclusion : Test of amniotic fluid tumor necrosis factor-α is of value in the antenatal diagnosis of histologic chorioamnionitis and congenital sepsis in patients with preterm labor and intact membranes. Amniotic fluid tumor necrosis factor-α is a better independent predictor of congenital sepsis than placental histologic finding or amniotic fluid culture.
이중엽(Joong Yeup Lee),심순섭(Soon Sup Shim),한수연(Soo Yeon Han),고은미(Eun Mi Ko),박중신(Joong Shin Park),전종관(Jong Kwan Jun),윤보현(Bo Hyun Yoon),신희철(Hee Chul Syn) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.8
Acardiac twin is a rare complication of multifetal pregnancy. The literatures report an incidence of 1% among monochorionic twin pregnancies, I. E. 1 of 35,000 pregnancies. The absence of identifiable fetal heart structures in one twin and reduction anomalies in many organ systems suggest the diagnosis. It has been hypothesized that in the presence of artery-to-artery and vein-to-vein anastomoses in a monozygotic placenta, blood is perfused by hemodynamically advantaged pump-twin to the recipient twin by retrograde flow. The principal perinatal problems associated with acardiac twinning are congestive heart failure of pump-twin, maternal polyhydramnios, preterm delivery and intrauterine death. The outcome is invariably fatal for the acardiac twin and 50-75% of the normal twin. Management options include observation, medical therapy, and selective termination of acardiac twin. The most appropriate intervention for the various clinical presentations of this disorder is undetermined, and conservative nonintervention is often appropriate. Long-term follow-up data on surviving pump twins are lacking. We experienced a case of acardiac twin gestation which showed satisfactory outcome with conservative management, so we present the case with a brief review of the literature.
비면역성 태아수종: 임상양상과 신생아의 생존과 관련된 예후인자
이중엽 ( Joong Yeup Lee ),손유경 ( Yoo Kyung Sohn ),심순섭 ( Soon Sup Shim ),임준희 ( June Hee Im ),심재윤 ( Jae Yoon Shim ),박중신 ( Joong Shin Park ),전종관 ( Jong Kwan Jun ),윤보현 ( Bo Hyun Yoon ),신희철 ( Hee Chul Syn ) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.12
목적 : 비면역성 태아수종의 발생빈도, 관련조건 (혹은 원인), 주산기 결과를 확인하고, 신생아 생존과 관련있는 예후인자를 밝혀내고자 하였다. 연구 방법 : 1988년 10월부터 2001년 2월까지 서울대학교병원 산부인과에서 진단된 54예의 비면역성 태아수종의 후향적 고찰을 통하여 발생빈도, 관련조건, 주산기 결과를 확인하였다. 아울러 생존하여 출산된 20예의 신생아를 28일 초과 생존한 군과 28일 이하에 사망한 군으로 구분하여 신생아 생존과 관련된 Objective : We undertook this study to find out clinical characteristics and prognostic factors of neonatal survival in nonimmune hydrops fetalis (NIHF). Methods : From Oct. 1988 to Feb. 2001, 54 cases of nonimmune hydrops fetalis diagnosed at Seoul Natio
박영수 ( Young Soo Park ),안소정 ( So Jung An ),이경희 ( Kyung Hee Lee ),전성욱 ( Sung Wook Chun ),박찬욱 ( Chan Wook Park ),박중신 ( Joong Shin Park ),박규주 ( Kyu Joo Park ),전종관 ( Jong Kwan Jun ),신희철 ( Hee Chul Syn ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.12
Small bowel obstruction in pregnancy is a rare critical condition with high morbidity and mortality. The diagnosis of small bowel obstruction in pregnancy is often delayed because the symptoms such as nausea, vomiting, and abdominal pain mimic typical pregnancy-associated complaints. So, a high level of suspicion especially in patients with a history of previous abdominal surgery is essential for early diagnosis. Once the diagnosis is made, surgery should be performed immediately. We present the first case of small bowel obstruction during pregnancy in Korea with a brief review of the literature.
박지윤 ( Jee Yoon Park ),박정우 ( Jeong Woo Park ),이동옥 ( Dong Ock Lee ),박찬욱 ( Chan Wook Park ),박중신 ( Joong Shin Park ),전종관 ( Jong Kwan Jun ),신희철 ( Hee Chul Syn ) 대한산부인과학회 2011 Obstetrics & Gynecology Science Vol.54 No.12
Most chemotherapeutic drugs are known to possess significant teratogenic effects. Although several agents have been proven to be safe for the fetus after organogenesis period, there is limited information on their use during pregnancy and it is very difficult to establish researches on the effect to human. We report a very unique case of unrecognized pregnancy in lung cancer patient who had been treated with variable agents of chemotherapy. A 25-year-old woman (gravida 0) who had been diagnosed as non-small cell lung cancer 6 years ago and received multiple regimens of chemotherapy presented at full term pregnancy with unknown gestational period. Without knowledge of pregnancy, she received a palliative chemotherapy with Docetaxel during first and second trimesters. Vaginal delivery with induction of labor due to postterm pregnancy was performed after evaluation of her medical condition and fetal surveillance. A 2,450 g female newborn was delivered with no evidence of congenital malformations.