산모 및 제대 혈중 납농도에 관련된 행태학적 및 사회경제적 요인에 관한 조사

김주자,우극현,이임순 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.1

생활환경에 따라 산모 및 제대 혈중 납농도가 차이가 있을 것이며 그러한 납농도에 영향을 미칠수 있는 행태학적 및 사회경제적 수준의 영향이 어느정도일가 하는 문제를 알아보기 위하여, 연구대상 지역을 도시, 농촌, 공단 지역으로 구분하여 이들 각 지역에 거주하는 분만중의 산모를 대상으로 혈중 납농도 및 신생아의 제대 혈중 납농도를 조사하였으며 그에 관련된 여러 위험요인들에 대하여도 조사하였다. 도시지역으로는 서울에서 순천향 서울병원, 농촌지역으로는 음성에서 순천향 음성병원, 공단지역으로는 구미에서 순천향 구미병원을 선정하였다. 1993년 1월 부터 3월 사이의 기간동안 분만을 위하여 각 병원에 입원한 산모 306명에게서 일반 기초검사 및 혈중납 측정을 하였으며 분만시 신생아의 제대혈을 채취하였고 같은 기간동안 분만보조 간호사에 의하여 면접에 의한 설문작성을 하였으며 또한 의무기록도 조사하였다. 결과는 다음과 같다. 1. 조사대상자인 산모의 평균 연령은 27.5±5.3세, 임신기간은 39.4±3.1주로 모든 지역별 유의한 차이는 보이지 않았다. 산모 혈중 납농도는 4.73±1.49 ㎍/dl, 제대 혈중 납농도는 4.35±1.29 ㎍/dl이었으며 모두 지역별 유의한 차이는 보이지 않았다. 2. 산모의 생물학적 및 사회경제적 요인을 4분위로 나누어 각 등급정도에 따른 산모 및 제대 혈중 납농도의 변화경향을 조사한 결과 산모연령, 아기의 출생시 체중, 임신기간, 가정의 총 연수입등의 정도에 따라 일정한 변화경향을 보이지 않았다. 3. 산모 및 제대 혈중 납농도의 변화경향을 조사하기 위하여 산모 및 남편의 건강행태를 질문하여 전혀, 가끔, 자주, 매일의 4가지로 구분하여 그 정도에 따라 산모및 제대 혈중 납농도를 조사한 결과 임신중 산모의 철분복용, 비타민 복용, 화장품사용, 흡연, 음주, 커피음용에 있어서 일정한 경향을 보이지 않았으며 남편의 흡연, 음주, 커피음용의 정도에 있어서도 일정한 경향을 보이지 않았다. 4. 모든 조사대항 요인들과 산모 및 제대혈중 납농도와의 상관관계를 조사한 결과 산모 혈중 납농도와 제대 혈중 납농도와의 통계적으로 유의한 양의 상관관계를 보였으며 남편의 교육정도와는 산모 및 제대 혈중 납농도 모두에서 유의한 상관관계를 보였다. This study was performed to examine the effect of demographic and behavioral and socioeconomic factors on the maternal and cord blood lead level. Three Soon Chun Hyang University Hospitals (Seoul, Eumsung, Kumi) participated as of urban, rural, industrial areas, respectively. Blood sampling for lead and other routine tests and questionnaire were done on 306 pregnant women who were admitted to these hospitals to deliver the baby. Women who have history of disease, such as diabetes, hepatitis etc. were excluded from the analysis. The results were as follows; 1. Mean maternal age was 27.5±5.3, and mean gestational period was 39.4±3.1 weeks. Mean concentration was 4.73±1.49 ㎍/dl in maternal blood lead and 4.35±1.29 ㎍/dl in cord blood lead. there were no statistically significant differences between community areas. 2. Tendency of maternal and cord blood lead level by the degree of quartile of each demogrphic and socioeconomic variables showed no statistical significance in maternal age, baby birth weight, gestational period, family income. 3. Tendency of maternal and cord blood lead level by the degree (never, often, very often, everyday) of maternal and paternal health behavior showed no statistical significance in maternal iron supplement, vitamine intake, use of cosmetics, smoking, alcohol drinking, coffee drinking during pregnancy and paternal smoking, alcohol drinking, coffee drinking. 4. Correlation between demographic, health behavioral, socioeconomic variables and maternal and cord blood lead showed significant positive correlation between maternal and cord blood lead, and also correlation of paternal education to both maternal and cord blood lead.

만성적인 관절통을 유발한 유리체 혹은 비골하 부골에 대한 치료경험

김연일,지정우 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

요추 디스크 수술 후 심내막염을 동반한 장골 동정맥루의 혈관내 치료 경험

허균 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Iliac artery and vein fistula is rare after lumbar disk surgery and usually, open repair through the arterial lumen was performed. We report a case of 41-year-old man whose diagnosis was infective endocarditis with arteriovenous fistula connecting the left common iliac artery and vein. He was performed lumbar diskectomy before 19 years. After aortic valve replacement and mitral valve replacement, this arteriovenous fistula was repaired with insertion of endovascular stent in the left common iliac artery and external iliac artery, and coil embolization of the left internal iliac artery. We follow up him for 1 year after the procedure and he have no complications.

개흉수술 후에 재발된 월경성 기흉

이철세 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

A 21 years old female was admitted our hospital due to repeated pneumothorax. Pneumothrax episode was related to the menstruaction. We diagnosed her case as catamenial pneumothorax. Bullectomy and pleurodesis were done without hormonal therapy. But 2 years later, pneumothorax recurred on same side of the chest. Open thoracotomy was done. And careful searching for endometriotic lesion on pleura and diaphragm was performed but no evidence was obtained. Machanical and chemical pleurodesis were applied, The patient was discharged uneventfully. The patient was taking oral contraceptive medication. OPD follow-up was done without recurrence up to now.

혈흉환자에서 흉강 내에 잘못 거치된 쇄골하정맥 도관 : 증례보고 A case report

진희철 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

During the central venous catheterization, intravascular placement of the catheter is often confirmed by aspiration of blood through the catheter. We experienced a malpositioning of subclavian cathter into intrapleural cavity although blood has been aspirated successfully through the catheter in the patient with hemothorax. In the patient with hemothorax, we strongly recommend that chest X-ray film must be checked after a central venous catheterization.

노인에게서 대퇴골 고관절 치환술시 마취관리 : 증례보고 A case report

채원석 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

An Ninety-year old female patient was transferred to the operating room for hip arthroplasty under regional anesthesia. Pulmonary (unction studies revealed severe restrictive pattern, and cardiomegaly noted in her chest X-ray examination. For the prevention of hypothermia, we first prepared blanketrol and IV line warmer and attempted epidural anesthesia, but we failed. We then did spinal anesthesia which was successfully administered. After performing regional anesthesia and injection of methylmethacrylate bone cement into the intramedullary canal, blood pressure and pulse was stable and no other evidence of instability. In the recovery room, she did not show any other symtoms, and three weeks later, she was discharged hospital without any sequelaes.

The radiologic findings of numb-chin syndrome as the presenting symptom of benign degenerative calcified mass on the mandibular bone

박형국 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

The numb chin syndrome reflects an abnormality in mental nerve or inferior alveolar nerve. It manifests as objective and/or subjective sensory disorders in the distribution of the mental nerve or inferior alveolar nerve, represented primarily by half of the lower lip and chin, also known as mental neuropathy It is an uncommon occurrence with cancer (breast, lung, lymphoma and hematological malignancies) and consists of numbness in the lower lip and chin. Facial numbness was associated with malignancy was first referred to as the num chin syndrome by Calverley and Mohnac in 1963. The mechanism of such a manifestation can be direct compression of the mental or inferior alveolar nerve by metastases to mandible, base of the skull, or leptomeningeal seeding.

일측성 질폐쇄 및 동측 신장 무발생을 동반한 중복자궁 2예

윤일영,여소진,김형문,김정식,김태희,이해혁,남계현,이권해,김준모,김민의 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Uterus didelphys with unilateral obstructed hemivagina and ipsilateral renal agenesis usually presents after menarch with progressive abdominal pain during menses secondary to hematocolpos, and indeed a very rare congenital anomaly due to Mullerian duct malformation. An accurate and prompt diagnosis is of importance to permit treatment and to assure the future fertility of the patient. Pelvic ultrasound, physical examination and pelvic MRI established a diagnosis of hematometracolpos secondary to uterus didelphys with unilateral imperforate hemivagina. An incision in the vaginal septum allowed drainage of the hematocolpos, providing relief of the patients symptoms. We report two case of uterus didelphys with obstructed hemivagina with brief review of the literature.

조기위암 천공 1예

이문수,김태윤,김성용,백무준,김창호,조무식 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

An exceedingly rare case of perforated early gastric cancer is reported. A 68-year-old man developed a peritonitis due to perforation of early gastric cancer. Emergency radical operation was performed and followed by uneventful recovery. The histologic examination of the surgical specimen showed early gastric cancer of typeⅢ, composed signet ring cell carcinoma. 5 years of surgery, the patients survived with no evidence of tumor recurrence. The rarity of this complication in early gastric cancer is discussed and the literature reviewed.

악성흉수를 동반한 폐의 유상피 혈관내피종 1예

나주옥 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Epithelioid hemangioendothelioma (EH) is a rare boderline malignant tumor originating from vascular endothelial cells and occurs in many organs such as soft tissues, lung, liver and bone. But, pulmonary EH which simultaneously involves pleura and liver is very rare. In the present report, we described an uncommon case of EH involving the lung, pleura and liver in a 26-year-old woman. Chest CT showed single nodule in right upper lobe with large amount of pleural effusion at same side and abdominal CT multiple round low densities in liver. The EH was confirmed by microscopic analysis and immunohistochemical staining of CD34+ from open lung biopsy specimen.