진행난관 임신 1 예

김종인,서영우,김강현 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.3

저자들은 임신 21 주까지 진행된 난관임신 1 예를 경험하였기에 문헌고찰과 함께 증례 보고하는 바이다. Advanced tubal pregnancy is very rare condition, being the least common type of advanced ectopic pregnancy. A case of a 21 week`s ruptured tubal pregnancy is presented with brief review of literatrure.

Electrical Polarization Characteristics and BSA Binding Capability of Hydrothermally Treated CaTiO₃ Powder

Hong SB,Seo YW,Jeong SH,Kim JW,Park YJ,Song HJ 대한치과재료학회 2011 대한치과기재학회 학술대회 Vol.2011 No.5

Molecular Characterization of a cDNA encoding putative integral membrane protein, HvSec61, expressed during early kernel development in barely

Jang CS,Lee TG,Seo YW 한국작물학회 2003 한국작물학회 학술발표대회 논문집 Vol.2003 No.-

국소적 유로키나아제 투여로 치료한 급성 혈전성 신동맥 폐색증 1예

성한동,이상재,서찬희,장병일,심재광,이동일,김영우,김종현 대한순환기학회 2003 Korean Circulation Journal Vol.33 No.3

생물리학적 푸로필을 이용한 태아안녕의 평가

박종영(JY Park),박용원(YW Park),서경(K Seo),박찬규(CK Park) 대한산부인과학회 1989 Obstetrics & Gynecology Science Vol.32 No.7

1988년 3월1일부터 1988년 10월31일까지 만 8개월간 연세대학교 의과대학부속 세브란스병원 산부인과에서 진료받은 고위험임신군 114명을 대상으로 BPS를 시행하여 다음과 같은 결론 은 얻었다. 1. 대상으로한 고위험임신 114예중 40예에서 비수축성 자궁검사 결과가 무반응였으며 반응 성을 보인예는 74예이었다. NST에서 무반응성을 보인 40예에서 5분 Apgar치 <7, 태아곤란 증, 호흡곤란증후군발생 통계학적으로 의의있게 증가하였다. 2. NST와 BPS의 상관관계를 보면, 초음파를 이용한 4가지 변수의 결과가 정상인 69예중 20 예에서 NST가 무반응성이었으며 3가지 변수만 정상이었던 36예중에서는 14예서 2가지 변수 만 정상이었던 6예엇는 3예에서 1가지 변수만 정상이었던 경우는 무반응성 NST를 보여 BPS의 높은 신뢰도를 보여주고 있다. 3. BPS결과를 보면 6예에서 비정상 17예에서 equivocal (BPS=6), 91예에서 정상이었다. 비정 상 BPS결과를 보인 6예에서 정상 BPS를 보인 91예에서보다 신생아 이환율을 나타내는 지 표중, 태아곤란증, 5분 Apgar 치 <7, 호흡곤란증후군 발생빈도가 의의있는 증가를 보였는데 이중 5예(83%)에서 5분 Apgar치가 7미만으로 가장 높은 빈도수를 나타내었다. 4. 주산기이환율을 나타내는 지표중 태아곤란증, 5분 Apgar치, 호흡곤란증후군을 기준으로한 진단정확도를 조사하면, 1) NST의 특이도는 81%로 BPS의 특이도 98%보다 낮았으며, 민감도는 76%로서 BPS의 민 감도55%보다 높앗다. 2) BPS의 위양성율은 16%로서 NST위양성율 46%보다 통계학적으로 의의잇는 낮은 결과를 얻었다. 3) BPS의 양성에측율은 83%로서 NST의 53%보다 높았으며 음성예측율은 95%로서 NST의 음성예측율 92%보다 높은 결과를 얻었다. 1. In 40 cases of NST non-reactive high risk pregnancy, statistically significantly increase in the incindence of fetal distress 5 minute Apgar score <7 and the respiratory distress syndrome compared to the NST reactive group was observed. 2. Of 69 instances with four normal variables of BPS, 20(29%) instances had non-reactive NST. and there were 14(39%) instances of non-reactive NST among 36 instances associated with normal variables of three. Of 6 cases of two normal variables 3(50%) cases had non-reactive NST and in 3cases with one normal variable all showed non-reactive NST 3. All six cases with abnormal BPS group showed statistically significantly increase in the incindence of fetal distress, low 5-minute Apgar score, respiatory distress syndrome 4. Diagnostic accuracy of BPS in the prediction of perinatal morbidity based on fetal distress , 5minute Apgar score <7, respiratory distress syndrome were as following. Specificity = 98%, Sensitivity=55% False positive rate = 16%, False negateive rate =4.3%. positive predictive value = 83% negateive predictive value = 95% From this study , BPS test is currently useful in the prediction of perinatal morbidity in high risk pregnancy

Parity and Survival in Pregnancy Associated Breast Cancer Patients

H. Gwak,ST. Lim,YW. Jeon,SY. Kim,YJ. Seo 대한외과학회 2018 대한외과학회 학술대회 초록집 Vol.2018 No.11

자궁내 태아발육지연 : 위험요인, 원인 및 비교위험도 Risk Factors and Their Relative Risk

박찬규,박용원,서경 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.12

1961년 1월부터 1985년 12월까지 연세의료원 산부인과에 내원하여 분만한 한국인의 단태 출생아 중 임신 28주이후에 출생한 임신부 및 출생아를 대상으로 태아발육지연아의 발생율을 조사하여 임신부 및 출생아의 특성별 태아발육지연아의 발생율의 차이를 조사하였으며, 태아발육지연을 초래할 수 있는 가능한 원인적 위험요인으로서 임신부의 요인, 태반 및 제대의 요인 및 태아의 요인별로 각각 태아발육지연아의 발생율 및 비교위험도를 산출하였더니 그 결과는 다음과 같았다. 1. 태아발육지연아의 발생율은 10.4%였다. 2. 태아발육지연아는 최근에 올수록 그 발생율이 감소하고 있으며, 임신부의 연령별 및 과거분만력의 경우는 낮은 연령 및 초산부에서 가장 높았고, 고연령 및 다산부에서 다시 증가하는 경향을 보였다. 3. 태아발육지연과 관계있는 임신부의 요인들로는 임신중 고혈압성 질환, 심장질환, 갑상선 기능항진증 등이 있으며, 이중 임신중 고혈압성질환의 경우는 특히 만성고혈압에 그 비교위험도가 3.6으로 가장 높았다. 4. 태아 및 태반의 요인으로는 선천성기형아의 경우 3.8∼4.2의 높은 비교위험도를 보였으며, 태반의 이상으로는 전치태반 및 태반조기박리의 경우에서 태아발육지연과 관계가 있었다. 5. 태아발육지연아의 주된 원인별 분류에서 원인을 찾을 수 있었던 경우가 26%였으며, 단일 원인으로서 임신중 고혈압성질환이 전체의 15.8%로서 가장 높았다. This study was undertaken at the department of Obstetrics and Gynecology, Yonsei University College of Medicine, to investigate the association between some of the risk factors and the incidence of fetal growth retardation and their relative risk. The studied population were selected from patient`s who admitted at Y.U.M.C. during period of 1961 through 1986 with following criterias; Korean. singletone pregnancy with live birth and known gestational weeks with 28 or more. And then, the risk factors were analyzed in terms of maternal factors,placenta and umbilical cord factors and the fetal factors. And then incidence rates were compared according to the risk factors and the relative risks were evaluated. The following results were obtained. 1. The incidence rates for fetal growth retardation for the studied group during period of 1961 through 1986 were 10.4%. 2. The incidence rates for fetal growth retardation curve showed $quot;U$quot; shaped apperance. The FGR incidence rates were higher at young aged mother and primigravida and also observed at old aged mother and multiparous women. This result suggested that, the FGR incidence rates were continuously decreased up to certain point and again it increase with increase in age and parities. 3. According to the risk factors for the fetalgrowth retardation, hypertensive disorder during pregnancy, cardiac diseases and hyperthyroidism were associated with the increase incidence of FGR. The relative risk for FGR in hypertensive disorder during pregnancy were much higher than other risk factors, especially the relative risk of chronic hypertension was significantly high as 3.6. 4. According to the placental and fetal causes, the relative risks were much higher in neonates born with congenital anomalies as 3.8-4.2. For the placental causes, placental previa and placental abruptio showed some association with fetal growth retardation. 5. Only 26% of etiologic factors for the FGR were found to have known causes. Of this, hypertensive disorder during pregnancy took majority of these as 15.8%.

조기임신에 있어서 비수축검사의 효용성

박찬규,박용원,서경,강성호,란세관 대한산부인과학회 1991 Obstetrics & Gynecology Science Vol.34 No.1

임신 29주부터 34주사이의 고위험 임부 181명에 대해 총 230회의 NST와 이중에서 NST시행후 1주내에 분만한 70명의 NST를 분석하여 다음과 같은 결과를 얻었다. 1. 대상임부의 적응중에서 임신성고혈압이 29예(41%)로 가장 많았고, 양수조기파막 19예(27%), 자궁내태아발육 지연이 10예(14%) 등의 순이었다. 2. 총 230예의 NST의 reactivty를 임신 주수별로 보면 29~30주가 26예(68%), 31~32주가 49예(72%), 33~34주가 96예(77%)의 reactive pattern을 보였고 nonreactive pattern은 29~30주가 9예(24%), 31~32주가 14예(21%), 33~34주가 17예(14%), nonreactive with deceleration은 29~30주가 3예(8%), 31~32주가 5예(7%), 33~34주가 11예(9%)였다. 3. 저 Apgar점수를 나타낸 경우가 reactive가 9예(20.5%), nonreactive가 9예(60%), nonreactive with deceleration이 9예(81.8%)였다. 4. 양수내 태변착색된 경우가 reactive는 3예(6.8%), nonreactive는 5예(33.3%), nonreactive with decederation은 4예(36.4%). 5. 태아곤란증으로 인한 제왕절개술은 reactive는 3예(6.8%), nonreactive는 4예(26.6%), nonreactive with deceleration은 3예(27.2%)였다. 6. 신생아호흡곤란증은 reactive는 9예(20.5%), nonreactive 6예(40.0%), nonreactive with deceleration이 3예(27.2%)였다. 7. 자궁내 태아발육지연은 reactive가 6예(13.6%), nonreactive가 5예(33.3%), nonreactive with deceleration이 2예(18.2%)였다. 8. 주산기 태아사망율은 reactive는 2예(4.5%), nonreactive는 4예(26%), nonreactive with deceleration이 4예(36%)였다. During the 12 months, from January, 1988 to December, 1988, a total of 230 NST`s were performed on 181 high-risk preterm pregnant women from 29 to 34 weeks. 70 of 181 high risk preterm pregnant women were delivered singleton infants within 1 week after last NST. They were grouped according to reactivity of the last NST. The results were as follows, 1. The common indications for NST were PIH(41%) and SPRM(27%). 2. Among 230 nonstress tests, reactive pattern was noted in 26 cases(68%) in 29~30 weeks interval, 49 cases(72%) in 31~32 weeks interval, and 96 cases(77%) in 33~34 weeks interval. Nonreactive pattern was noted in 9 cases(24%) in 29~30 weeks interval, 14 cases(21%) in 31~32 weeks interval, 17 cases(14%) in 33~34 weeks interval. Nonreactive with deceleration pattern was noted in 3 cases(8%) in 29~30 weeks interval, 5 cases(7%) in 31~32 weeks interval, 11 cases(9%) in 33~34 weeks interval. 3. Among 70 patients, who delivered singleton infants within 1 week after last NST, low Apgar Score was found in 9 cases(20.5%) in reactive group, and 9 cases(60%) in nonreactive group, 9 cases(81.8%) in nonreactive with deceleration group. 4. C-section due to fetal distress was done in 3 cases(6.8%) in reactive group, 4 cases(26.6%) in nonreactive group, 3 cases(27.2%) in nonreactive with deceleration group. 5. Perinatal death was noted in 2 cases(4.5%) in reactive group, 4 cases(26%) in nonreactive group, 4 cases(26%) in nonreactive with deceleration group. The results suggest that NST should be used as a primary screening test for the evaluation of antepartum fetal wellbeing in preterm high risk pregnancy after 29 weeks.

만삭 전 조기 양막파수가 신생아에 미치는 영향

최순미,이국,이윤호,박용원,서경,남궁란,유용균 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.1

Management of preterm premature rupture of the membranes(PPROM) represents a clinical dilemma for the obstetrician. Several randomized controlled trials showed that if the membranes had been ruptured, they recommanded immediate delivery for reducing infectious complications, however others recommanded expectant and conservative management for reducing complications related to prematurity. In this study, we compared the neonatal mortality and morbidity between neonates with and without ruptured membranes. 1. The incidence of PPROM was 3.1 percents of total birth. 2. Neonatal death, respiratory distress syndrome, asphyxia, ventilator care, pneumonia, intraventricular hemorrage and urinary tract infection were not different between two groups, however there were significantly statistical differences of hyperbilirubinemia and NICU care. 3. Hperbilirubinemia and NICU care showed significantly statistical differences between two groups, especially after 35 gestational weeks. 4. There were significant increases in ventilator care and NICU care, however no increases were found in other infectious morbidity and respiratory distress syndrome. In conclusion, there was no difference between two groups on infectious morbidity and neonatal death and we may suggest that such findings were resulted from the prophylactic antibiotic therapy.

Abnormal Pregnancy Sonogram and Chromosome Anomalies : 4 Years Experience

송찬호,양영호,박용원,조재성,윤달영,서동호 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.8

산전 초음파 진단시 태아기형이 의심되는 경우 많은 예에서 염색체이상을 동반하므로 반드시 산전태아 염색체 검사를 실시하여야 하며, 또한 그 결과는 치료적 임신중절 및 자궁내 태아수술과 같은 intrauterine intervention 여부의 결정에 중요한 지표가 될 것으로 사료된다. Over a four-year period, 88 pregnancies with different malformations detected by ultrasound were examined cytogenetically. Gestational age ranged from 13 to 37 weeks. Chromosomal analysis was performed on amniocentesis, cordocentesis, placental biopsy and fetal body fluid aspiration. Fourteen fetuses(15.9 percent) had abnormal karyotypes, including 5 cases of Trisomy 21, 2 cases of Trisomy 13 and 7 cases of monosomy X. Those all were delivered vaginally. In remained 74 chromosomally normla fetuses, 1 fetus and pleuroamniotic shunt on intrauterine pregnancy at 34 weeks and 7 cases had corrective or palliative surgery neonatally. Another 6 cases took conservative management after delivery. Combined cytogenetic and ultrasonographic techniques allow the distinction between minor isolated, correctable anomalies and severe developmental defects. Knowledge of the fetal chromosome constitution in the setting of an abnormal ultrasound has important obstetric management implications such as in utero surgery, termination of pregnancy, and avoid unnecessary cesarean section or neonatal surgery.