박영실 교수

The aim of this study was to survey multiple birth data and to analyze the recent trends of multiple births and its consequences on perinatal problems in Korea from 1991 to 2008. Data were obtained from the Korean Statistical Information Service. The total number of multiple births showed increasing trends. The multiple birth rate was maintained within less than 10.0 for the decade from 1981 to 1990. However, it increased gradually to reach 27.5in 2008. The maternal age for multiple births was h

Purpose: The recent trends of multiple births (MBs) conceived by assisted reproductive technology (ART) in Korea were analyzed as well as the relationship with maternal age, especially advanced maternal age. Methods: Data were obtained from the Korean Statistical Information Service and annual ART reports from the ART committee of the Korean Society of Obstetrics and Gynecology. Results: MBs increased from the early 1990s; there was a 275%increase by 2008. The number of total live births was 448

목적 : 임산부의 질 내 Ureaplasma urealyticum (Uu) 집락은 조기 양막파수 유무에 상관없이 자궁 내 수직감염을 일으켜 신생아의 15-89%에서 균이 동정되며, 염증반응과 연관하여 여러 기관에 영향을 미칠 수 있다. 저자들은 임산부의 질 내 Uu 집락이 신생아에게 미치는 임상적 영향을 재태기간 별로 나누어 비교분석 하였다. 방법 : 2006년 6월부터 2009년 6월까지 경희대 동서신의학병원에서 입원 또는 외래방문 하였던 임산부의 질분비물 Uu 배양 470건의 시행 결과에 따라 결과 추적이 가능하였던 신생아 219명을 대상으로 하였다. 35+0주미만의 미숙아군과 35+0주 이상의 준만삭아-만삭아군으로 나누어 임산부의 질 내 Uu 집락 유무[양성군, 음성군]에 따라 빈호흡의 발생, 산소치료 유무, 신생아 호흡곤란 증후군 및 기관지 폐 형성이상, 패혈증, 황달, 수유장애 등의 빈도를 비교하였다. 결과 : 양성군이 미숙아군 111명중 55명(49.5%), 준만삭-만삭아

BackgroundCurrently, the greatest challenge in hemophilia treatment is managing hemophilia pa-tients with inhibitors. The two main bypassing agents that are used to treat hemophilia patients with inhibitors are activated prothrombin complex concentrates (APCC) and re-combinant factor VIIa (rFVIIa). Hemophilia patients with inhibitors can develop bleeding episodes, that are refractory to monotherapy with either APCC or rFVIIa and thus are often difficult to manage. MethodsThis report describes a

Vascular cannulation is an invasive procedure that carries the risk of complications such as pseudoaneurysms. Hemophilia, the most common severe bleeding disorder of inheritance, increases the risk of such complications through underlying hypocoagulability. Although surgical ligation has been considered the gold standard treatment, less invasive options are currently available. Here we present 2 hemophiliac neonates for whom clotting factor replacement and ultrasound (US)-guided compression were

목 적 : 본 연구는 소아 동종 조혈모세포이식 후에 갑상선 기능의 단기간 변화와 갑상선기능이상의 빈도와 위험인자를 분석하고자 하였다. 방 법 : 2004년 1월부터 2006년 2월까지 가톨릭대학교 성모병원 소아과, 조혈모세포이식센터에서 동종 조혈모세포이식을 시행한 80명의 환자를 대상으로 연구를 하였다. 조혈모세포이식 전과 이식 후 1개월, 6개월, 12개월에 환자들의 혈청에서 TSH, T4, T3를 측정하였다. 결 과 : 조혈모세포이식을 하고 1개월 후의 갑상선 기능은 통계적으로 유의한 감소를 보이고 있었다(P<0.001). 1개월 후 갑상선 기능이상의 빈도는 80명중 43명(54%)에서 보였으며 이들 중 31명(39%)은 ETS를 보이고 있었다. 이식 후 일년 이내 갑상선 기능은 대부분 정상으로 회복되었다. 단변량 분석에 의하면 악성 질환인 경우(P=0.04)와 2도 이상의 급성 이식편대 숙주병(P=0.01)이 ETS의 위험인자였으나(P=0.04), 다변량 분석에 의하면 ETS

Among the patients with hemophilia, 10∼15% have hemophilia B, and 1∼3% of the hemophilia B patients develop inhibitor to factor IX clotting activity. Allergic reactions to concentrates containing factor IX (FIX) are serious complications during the treatment of hemophilia B patients with inhibitor. Although treatment with recombinant activated factor VII (FVIIa) is generally recommended in these patients, it is limited by the agent’s short half-life, a lack of experience with its use in this man

Inhibitor development is one of the major adverse events associated with increased morbidity and mortality in patients with congenital hemophilia. Recent treatment for them is immune tolerance induction (ITI), which involves the administration of high doses of factor concentrates over a prolonged period, sometimes combined with immunosuppressive agents. We report a case of inhibitor elimination with Rituximab, and high-dose factor VIII concentrates in a 5-year-old boy with hemophilia A. The pati

Hemophilia A (factor VIII deficiency) and Hemophilia B (factor IX deficiency) are the most common and serious congenital coagulation disorders. Accurate diagnosis is important and essential for effective management. A definitive diagnosis depends on factor assay to demonstrate the presence of factor VIII or factor IX. Bleeding should be treated with factor replacement therapy at the earliest moment possible, preferably within two hours from the onset of symptoms. In spite of improvements in hemo

The most effective treatment strategy for patients with hemophilia is replacement therapy with FVIII or FIX concentrates, which usually requires long-term, uncomplicated venous access. However, central venous access device (CVADs, ports) insertion requires inpatient admission and general anesthesia, and presents some problems regarding health insurance coverage. Peripherally inserted central catheters (PICCs) were inserted in two severe hemophilia patients aged 7 and 11 years with high titers of

BackgroundInhibitory antibodies to factor VIII (FVIII) are an important complication when managing patients with hemophilia A. Immune tolerance induction (ITI) has been regarded as a use-ful method for eradicating inhibitors. We report the results of a retrospective study in Korean patients with hemophilia A who underwent ITI.MethodsWe reviewed the records of patients with hemophilia A with inhibitors who underwent ITI from March 2004 to December 2014. ITI was started with FVIII concentrates at

배경: 중증 혈우병A, B 환자의 각각 11%, 5%에서 항체가 발생한다. 저자들은 혈우병 고항체 반응군 환자들을 대상으로 aPCC를 이용한 유지요법의 효과, 안전성, 인자 소모량 그리고 비용을 분석하였다. 방법: 고항체 반응군 혈우병 환자 11명을 대상으로 하였다. 동일한 환자들을 대상으로 순차적으로필요 시 보충요법과 유지요법을 시행하여 두 요법 동안의 출혈빈도, 항체가, 단순 방사선 소견, 이상증상 및 징후, 인자소모량 그리고 비용을 비교하였다. 유지요법에 필요한 제제로는 반감기가 긴 aPCC를 선택하였고, 용량은 30∼50 U/kg, 주 3회 정맥투여하였다. 결과: 평균 추적기간은 각각 필요 시 보충요법 6.8개월, 유지요법 10.6개월이었다. aPCC의 평균 용량은 45.2 U/kg 이었다. 유지요법 기간 중 혈관절증은 61.4% (P=0.003), 기타 출혈은 45.2% (P=0.109) 감소하였다. 항체가는 7명에서 감소하고, 4명에서 증가하였으나 기왕반응은 1명에

Background Congenital factor VII (FVII) deficiency is a rare hemorrhagic disorder that can cause excessive bleeding during and after surgery in affected patients. The recombinant form of activated factor VII (rFVIIa, NovoSevenⓇ from Novo Nordisk, Bagsvaerd, Denmark), which was developed as a second-generation bypassing agent, has recently been used in the management of bleeding for patients with congenital FVII deficiency. Methods We reviewed the results of 8 surgical procedures in 5 patients wi

BackgroundInhibitory antibodies to factor VIII (FVIII) or IX (FIX) are important issues when managing patients with hemophilia A or B. Advances in bypassing agents such as recombinant acti-vated FVII (rFVIIa) and activated prothrombin complex concentrates (APCC) have enabled the aggressive management of hemophilia with inhibitors during emergency or elective surgery. This study provides an updated evaluation of the safety and effectiveness of by-passing agents in treating perioperative bleeding.

Hemophilia, an inherited bleeding disorder, is caused by a deficiency of coagulation factor VIII or IX. Most of patients with hemophilia need vascular procedure, which can lead to complications. Even though these complications can also occur in normal people, hemophilia and coagulopathy are particular risk factors. We reviewed medical records of patients with hemophilia who underwent vascular procedures and investigated its complications. Vessel-related complications occurred in five patients. T