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Simplified protocol of nuchal translucency measurement: Is it still effective?
전종관 ( Jong Kwan Jun ),( Sun Min Kim ) 대한산부인과학회 2014 대한산부인과학회 학술대회 Vol.100 No.-
Objective: Nuchal translucency (NT) is the most powerful screening tool for Down syndrome and congenital cardiac anomaly, therefore strict guidelines were established to get accurate NT values. However, to stick to the guideline in all pregnant women is time-consuming and superfluous in majority of low risk population. We undertook this study to investigate whether the simplified protocol enables to select low risk group and is effective in them even if we skip the suggested NT measurement. Methods: NT and crown-rump length (CRL) were measured prospectively. First, CRL was measured in the ordinary view that was mid-sagittal section of fetus in neutral position, and NT was measured at the same frozen screen (first measured value, 1MV). Then, NT was measured again according to the Fetal Medicine Foundation (FMF) guideline (second measured value, 2MV). Results: There was good correlation between 1MV and 2MV in each case (r = 0.83, P < 0.001). All of the NT values over the 95th percentile in 2MV also belonged to over the 95th percentile in 1MV. NT value of 2 mm in 1MV could be used as a cut-off to obtain over the 95th percentile 2MV by receiver operating characteristic curve (sensitivity 100%, specificity 80.5%). The proportion of 1MV ≥ 2 mm was only 23.8% of all cases, namely we had only to measure 2MV in 23.8% patients. Every 95th percentile or more 2MV could be detected with this simplified protocol. Conclusion: If NT is less than 2 mm at ordinary CRL view, we may skip suggested NT measurement according to FMF guideline.
유산물, 융모막 조직, 양수 세포 및 태아 혈액에서 나타나는 염색체 이상 핵형에 대한 다기관 연구
전종관(Jong Kwan Jun),최진(Jin Choe),최영민(Young Min Choi),황도영(Do Yeong Hwang),오선경(Sun Kyung Oh),문신용(Shin Yong Moon),이진용(Jin Yong Lee) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.7
목적 : 염색체 이상 질환은 유전질환 중에서는 상당히 흔한 질병이다. 그러나 한국인에서의 염색체 이상에 대한 포괄적이고 다기관 연구는 전무한 상태이다. 일부 연구기관에서 각 연구기관에 해당하는 염색체 이상에 대한 자료들만 보고하고 있는 실정이다. 질병의 관리에 있어서나 질병의 연구에 있어서 포괄적인 통계자료의 필요성은 매우 중요하다. 이에 본 연구진은 유산물, 융모막 조직, 양수세포, 태아의 혈액을 대상으로 시행한 염색체 검사 결과중 핵형 이상을 보인 증례를 분석하였다. 방법 : 전국의 23개의 유수한 세포유전학 검사 센터로부터 1977년부터 1999년까지 염색체 검사를 시행한 예중 유산물 394 예, 융모막 조직 198 예, 양수세포 1,060 예, 태아 혈액 141 예에서 핵형 이상을 보인 증례 1,793 예를 수집, 분석하였다. 결과 : 유산물에서는 수적 이상이 85%를 차지하였으며 구조적인 이상은 13%를 차지하였다. 수적 이상에 가장 흔한 염색체 핵형 이상은 16번 염색체의 삼염색체 질환이었다. 융모막 조직에서는 수적이상은 60%, 구조적 이상은 31.3% 이었으며 가장 흔한 염색체 핵형이상은 다운 증후군이었다. 양수세포의 경우는 구조적 이상이 50.5%를 차지하여 수적 이상을 능가하였다. 양수세포의 경우도 가장 흔한 질환은 다운 증후군이었다. 태아의 혈액의 경우는 수적 이상이 63.8%를 차지하였으며 가장 흔한 염색체 핵형 이상은 에드워드 증후군이었다. 결론 : 본 연구가 염색체 이상에 대한 포괄적인 다기관 연구로는 국내에서 최초일 것으로 사료된다. 각 시료마다 염색체 이상 핵형의 종류가 다르지만, 가장 흔한 염색체 핵형의 이상은 삼염색체로 외국의 경우와 유사하였다. 본 연구를 바탕으로 한국인 전체에 대한 염색체 핵형 이상에 대한 분석이 시행되어야 할 것이다. Objectives : Chromosomal anomalies are common disease entity among genetic diseases. But there are scanty reports about the status of chromosomal abnormalities in Korean. In addition, the comprehensive multi-center study of chromosomal abnormalities in Korean has never been performed. Methods : We have collected 1,793 cases (394 abortuses; 198 chorionic villi; 1,060 amniotic fluid cells; 141 fetal blood), which showed abnormal karyotype results from twenty three cytogenetic centers in Korea from the year of 1977 to 1999. Results : In abortuses, numerical chromosomal abnormalities was 85%, and structural abnormalities was 13% and the most frequent anomaly was trisomy 16. In chorionic villi, numerical anomaly was 60.0% and structural anomaly was 31.3% and the most frequent karyotype was Down syndrome. In amniotic fluid cells, structural anomaly exceeded the number of numerical anomaly and the most frequent anomaly was Down syndrome. In fetal blood, numerical anomaly was 63.8% and the most frequent karyotype was trisomy 18 (23.4%) Conclusion : This may be the first comprehensive and multi-center study in Korea. The proportion of the abnormal karyotypes in each specimens was different from each other. Based on this study, the more comprehensive study should be performed to all the Korean population.
Pregnancy-induced arthralgia and arthritis in small joints of hands
전종관 ( Jong Kwan Jun ),( Hyo Jin Choi ),( Jung Chan Lee ),( Chan Wook Park ),( Yoo Kyung Sohn ),( Soo Young Oh ),( Soon Sup Shim ),( Eun Bong Lee ),( Joong Shin Park ),( Yeong Wook Song ),( Bo Hyun Yoo 대한산부인과학회 2004 대한산부인과학회 학술대회 Vol.90 No.-
임신 토끼에서 항생제 투여시 지속된 자궁내 감염이 주산기 예후에 미치는 영향
전종관(Jong Kwan Jun),윤보현(Bo Hyun Yoon),신희철(Hee Chul Syn),이홍균(Hong Kyoon Lee),박교훈(Kyo Hoon Park) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.2
N/A Objective: In a rabbit model using hysteroscopy-guided inoculation of E.coli with antibiotic administration, we determine the effects of persistent intrauterine infection on perinatal outcome including fetal death, congenital sepsis, and abnormal fetal-placental growth and amniotic fluid volume in live fetuses. Methods: Rabbits with timed pregnancies underwent hysteroscopy at 20 to 21 days of gestation(70%). Animals were inoculated with E. coli (0.2 ml containing 10 cfu/ml) and administered ampicillin-sulbactam(100 mg/kg/day; Unasyn; Pfizer) every 8 hours beginning 30 minutes after microbial inoculation until they were killed 5 days after hysteroscopy. In the first study, the following outcome parameters were evaluated between fetuses with and without pe#rsistent intrauterine infection: fetal survival, congenital sepsis, maternal morbidity, and placental pathology. In second study was performed in 16 rabbits having only both live fetuses with and without persistent intrauterine infection in a rabbit simultaneously. We evaluate the effects of persistent intrauterine infection on fetal-placental weight and amniotic fluid volume in live fetuses. Results: 1) Fetuses with persistent intrauterine infection had significantly fewer live fetuses, more positive cord blood cultures than those without (live fetuses: 44% vs 82%, p<0.000001; positive cord blood cultures: 44% vs 3%, p<0.000001, respectively; Fishers exact test). However the rates of maternal morbidity and placental inflammatory lesions were similar between the two groups. 2) The placental weight and amniotic fluid volume were significantly less in live fetuses with than in those without persistent intrauterine infection. Moreover the fetal weight was decreased in live fetuses with persistent intrauterine infection, but it was not statistically significant(placental weight: p<0.05; amniotic fluid volume: p<0.05; fetal weight: p 0.051, respectively; Wilcoxon matched-pairs signed ranks test). Conclusion: Fetal complications including fetal death, congenital sepsis, and decreased fetal-placental weight and amniotic fluid volume wae produced in utero when pasistent intrauterine infection was present with antibiotics administration after inoculstion of E. coli. Therefore, when treating with antibiotics in intrauterine infection, it is needed to observe and monitar the presence of persistent intrauterine infection, and if it is peristent, delivery may be considered for the improvement of pregnancy outcome.
생식세포 난관내이식시 잉여난자의 체외수정 결과에 따른 임신 예측도
김석현,전종관,신창재,김정구,문신용,이진용,장윤석,Kim, Seok-Hyun,Jun, Jong-Kwan,Shin, Chang-Jae,Kim, Jung-Gu,Moon, Shin-Yong,Lee, Jin-Yong,Chang, Yoon-Seok 대한생식의학회 1992 Clinical and Experimental Reproductive Medicine Vol.19 No.1
By means of the results of In vitro fertilization(IVF) of supernumerary oocytes, the possibility of predicting a pregnancy outcome following gamete intrafallopian transfer(GIFT) and the prognostic implications for future pregnancy were evaluated in 46 GIFT cycles excluding simultaneous program of GIFT and IVF from February, 1989 to July, 1991. IVF of supernumerary oocytes were identified in 21 cycles, but not in remaining 25 cycles. There was no significant difference in age, duration and etiologic factors of infertility, and serum levels of FSH, LH and $E_2$ on MCD #3 and $E_2$ on the day of hCG injection between fertilized(N=21) and unfertilized group(N=25). The number of oocytes retrieved was similar in both groups. The number of supernumerary oocytes available for IVF after transfer was $5.43{pm}2.95$ ranging from 2 to 12. The prenancy rate in fertilized group, 33.3%(7/21), was higher without statistical significance, compared with 8.0%(2/25) in unfertilized group. Using IVF of supernumerary oocytes as a test of pregnancy following GIFT, sensitivity was 77.8 %; specificity, 61.2%; positive predictive value(PPV), 33.3%; negative predictive value(NPV), 92%. The fertilization rate of supernumerary oocytes in pregnant group, $86.4{\pm}22.8%$ was significantly higher compared with $56.1{\pm}20.2%$ in nonpregnant group. In cases with fertilization rate ${\geq}80%$, pregnancy was expected with PPV of 85.7%. In conclusion, IVF of supernumerary oocytes in GIFT program can be a profitable method as a prognostic indicator of pregnancy following GIFT. More aggressive diagnostic and therapeutic measures should be performed in cases with failure in IVF of supernumerary oocytes.
신재준 ( Jae Jun Shin ),최지영 ( Ji Young Choe ),김선민 ( Sun Min Kim ),이승미 ( Seung Mi Lee ),오경준 ( Kyung Joon Oh ),박찬욱 ( Chan Wook Park ),박중신 ( Joong Shin Park ),전종관 ( Jong Kwan Jun ),박성혜 ( Sung Hye Park ),신희철 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.3
Listeriosis is an infectious disease caused by Listeria monocytogenes, a gram positive, facultatively anaerobic bacterium. Listeriosis occurs primarily in newborn infants, elderly patients, immunocompromised patients and pregnant women. One third of the patients are pregnant women, and complications of this disease include miscarriage, stillbirth and preterm labor. We experienced a case of listeriosis in a singleton pregnancy at 23rd week of gestation that presented with fever, chill, lower abdominal pain, backache, and eventually resulted in fetal death in utero. Autopsy results of the stillborn baby, as well as blood and amniotic fluid culture of the mother confirmed Listeria monocytogenes infection. Proper antibiotics therapy thereafter led to clear recovery of the infected mother. We report this case with a brief review of literature.
이희준 ( Hee Jun Lee ),김선영 ( Sun Young Kim ),박정우 ( Jeong Woo Park ),김우오 ( Woo Oh Kim ),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
Unilateral pulmonary agenesis is a very rare developmental malformation that is often associated with other anomalies. The prognosis of pulmonary agenesis varies from stillbirth, to neonatal death, to survival without any symptoms depending on the presence of associated congenital malformations. Therefore, it is very important to perform a prenatal diagnosis of unilateral pulmonary agenesis. We describe a case of unilateral pulmonary agenesis diagnosed in the second trimester by transabdominal ultrasound.