장기 복막투석 동물 모델에서 물수송체의 역할

박민선(MS Park),차정호(JH Cha),김진(J Kim),(Soren Nielsen) 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.2

N/A Sufficient fluid removal is vital to renal replace-ment therapy in end-stage renal failure patients. Aquaporins are integral membrane proteins and the primary water channels that allow water transport only. Type 1, 3 and 4 aquaporins were found in peritoneal capillary walls and peritoneal mesothelial cells. Approximately 5096 of total amount of free water transported during peritoneal dialysis is through aquaporins. Ultrafiltration failure and fluid overload are found in some of long-term continous ambulatory peritoneal dialysis(CAPI3) patients and are major causes of withdrawl from CAPD. Long- term use of high glucose containing dialysis solutions, and functional and morphological changes of aquaporins were suggested as possible mechanisms of ultrafiltration failure. However, a direct relation between alterations of aquaporins in the peritoneum and ultrafiltration failure in long-term CAPD has not been reported yet. In this study peritoneal aquaporins and ultrafiltration were evaluated after long-term peritoneal exposure to high glucose containing dialy- sis solutions in rats. Sprague-Dawley rats with normal kidney func- tions were used. Twenty five milliliter of 4.25% glucose containing dialysis solutions were injected into the peritoneal cavity twice a day for 12 weeks in 13 rats(dialysis-group). The other 13 rats were used without intraperitoneal injection as controls (control-group). One rat from each group died during the study was excluded. After 12 weeks of intraperitoneal injection, a 2 hour peritoneal transport study was done in 9 rats from each group. To calculate intraperitoneal fluid absorption rate, (131)I labelled human serum albumin(RISA) was used as a volume marker. Mesenteries were taken from the remaining three rats from each group for immuno-histochemistry for aquaporin type l. Intraperitoneal volume after 2 hour dialysis was significantly lower in dialysis-group than in control-group(33.7±3.6 vs 39.4±6.1mL, p<0,05). The peri- toneal fluid absorption rate was significamtly higher in dialysis-group than in contml-group(0,070±0.051 vs 0.049±0.016 mL/min, p<0.05). Dg'P> srxlium was signifieantly higher in dialysis-group than in con- trol-group(0.890±0.014 vs 0.856±0.038, p<0.05).D₂P₂urea and D2/D0 glucose did not differ between the two groups. Immunohistochemistry revealed that aquaporin type 1 was strongly stained in the me-sentery capillary walls in control-group, while it was almost disappeared in dialysis-group. In conclusion, long-term use of high glucose containing dialysis solutions decreased aquaporin type 1 population in the peritoneum and ultrafil-tration volume. Increased peritoneal fluid absorption rate is also in part responsible for decreased ultra- filtration volume after long-term use of dialysie solutions.

원발성난관암 1예 보고

박기복(KB Park),이제호(JH Lee),이의돈(ED Rhee),이경희(KH Lee),임흥배(HB Im),송계용(KY Song) 대한산부인과학회 1983 Obstetrics & Gynecology Science Vol.26 No.2

결론 43세된 여자에서 발생된 원발성난관암 1예를 체험하였기에 간단한 문헌고찰과 보고하는 바이다. Primary carcinoma of the follopian tube is one of the least common gynecologic malignancies. This paper reports our experience with a case of primary fallopian tube carcinoma incidentally encountered.

Laparoscopic Burn 의 2예

박원종(WC Park),이원기(WK Lee),이재현(JH Lee) 대한산부인과학회 1977 Obstetrics & Gynecology Science Vol.20 No.5

저자는 경희의료원 산부인과에서 복강경난관불임술로 인한 합병증으로 화상의 2예를 경험하였기에 문헌적 고찰과 함께 보고하는 바이다. Female sterilization by laparoscopic technics has many advantages over traditional methods. However, it still has come some problems to be improved, especially in electric coagulation method. It has danger of heat injury such as gastro intestinal, bladder& abdominal burn. We have presented the recent our own experience of 2 series complication reguiring Laparotomy occured in electric coagulation, one case was complicated from intestinal burn with omental adhesion and the other was ovarian burn due to electric coagulation. The presentation, management, and hospital course of these injuries are presented.

제왕절개 수술후의 뇨관손상

문제호(JH Moon),김화은(HW Kim),장병기(BK Chang),박영상(YS Park),강영호(YH Kang) 대한산부인과학회 1980 Obstetrics & Gynecology Science Vol.23 No.1

결론 저자들은 제왕절개 수술후 발생한 죠관질누의 예를 체험하였기에 간단한 문헌적 고찰과 함께 보고하는 바이다. Althogh trauma to the urster is encountersd less frequently then trauma to other levelss of urinary tract, ureteral injury is likely to kesult in serious complications. Ureteral injury after cesarean section are, however, very rare. We present a case ureteral injury following cesarean section with a burief review of literatures.

Yoon`s Falope Ring에 의한 난관 불임수술시 Lidocaine Jelly의 효과

하정환(JH Ha),박영동(YD Park),김재욱(JU Kim),곽현모(HM Kwak) 대한산부인과학회 1976 Obstetrics & Gynecology Science Vol.19 No.4

1975년 2월19일부터 동년 4월23일까지 연세대학교 의과대학 산부인과교실에서 Yoon`s falope ring에 의한 복강경난관 결찰술을 한 162예를 선택하여 Lidocaine jelly를 좌측난관에 도말하여 다음과 같은 결론을 얻었다. 1. 대상자의 연령별 분포는 35-39세가 43.2%였고 생존자녀수는 3명이 41.4%로 수위를 차지 하였다. 2. 교육정도는 대부분이 중,고등학교 정도였다. 3. 수술소요시간은 98%에서 15분이내였다. 4. 대상자 162예중 147예 90.7%에서는 양측공히 동통이 없었으며 9.3%에서만이 동통을 호소 하였다. 동통을 호소한 9.3%(15예)중 lidocaine jelly를 도말한 좌측난관에 동통을 호소하지 않 앗던 경우가 6예, 반대로 동통을 호소한 예가 6예엿다. 본 연구에서 국소마취제 도말이 완전히 동통을 제거할 수는 없었으나 다소나마 동통을 감소 시킬수는 잇었으며 이것이 난관결찰술후의 동통에 대한 문제를 해소하는 충분한 방법은 못 되었다. A clinical study was carried out for the evaluation of the pain control effect of lidocaine topical anesthetic application on the tube by means of Yoon`s ring laparoscopic female sterilization at Yonsei University medical Center Total 162 cases of laparoscopic tubal sterilization by Yoon`s ring were performed by unilateral application of Lidocaine as out patient bases from February 19, 1975 to April 30, 1975. We were not able to evaluate the true effect of the local anesthetics, lidocaine, in the presence of preoperative sedation with Demerol and valium, but as a result some analgesic effect was noted in several cases. for more detailed effect of lidocaine ointment on laparoscopic sterilization further study was needed.

뇨실금을 동반하거나 하지않은 자궁탈에 대한 질식자궁적출술과 전질벽협축술의 임상적 및 요로 역학적 효과

유지헌(JH Yoo),오세창(SC Oh),이명아(MA Lee),박찬용(CY Park),조성진(SJ Cho),박인서(IS Park) 대한산부인과학회 1987 Obstetrics & Gynecology Science Vol.30 No.4

1983년 3월부터 1985년 2월까지 만 2년간 국립의료원 산부인과에 입원하여 질식자궁적출술 및 질벽협축술을 시행한 27명의 자궁질탈출증 환자에서 다음과 같은 결론을 얻었다 1 환자의 평균연령은 55 1세로 모두 경산부이었다 긴장성 뇨실금을 동반한 예는 21례로 77 8%이었으며, 분만횟수가 증가함에 따라 자궁질탈출증 및 뇨실금의 빈도는 증가하였다 2 수술후 뇨실금, 빈뇨, 배란곤란, 급뇨 등의 요로증상은 현저히 호전되었으며, 수술후 뇨실금이 1예 발생하였는데 이는 배뇨근 부전증에 의한 것이었다 3 수술후 합병증은 질개구탈출술, 배뇨근 부전중, 질방광루, 신우신염 각 1예씩 있었으며, 그 빈도는 14 8%이었다 4 방광내압검사상 뇨실금군 및 뇨실금을 동반하지 않은 군 모두에서 유의한 차이는 없었다 5 복압을 가하였을 경우 방광기저부 및 PUV junction의 하강도는 수술후 양군 모두에서 감소하였으나, 유의한 차이는 없었고, 증상소실군과 지속군 사이에도 하강도의 유의한 차이는 없었다 6 수술후 복압을 가하였을 경우 angle of inclination의 변화는 뇨실금군에서 현저히 감소 하였으며, 증상소실군과 지속군 사이에는 유의한 차이가 없었다 7 수술후 PUV angle의 변화는 뇨실금 유 무에 관계없이 공히 감소하였으며, 증상소실군과 지속군 사이에 유의한 차이를 보였다 위와 같은 결론으로 첫째, 방광내압검사는 뇨속도검사(uroflowmetry)와 함께 시행하지 않았기 때문에 의의있는 정보는 얻을 수 없었으나, 배뇨근 부전증 및 신경성 방광을 감별하는데 도움이 되었고, 둘째, Chain을 이용한 방광뇨도촬영술은 비디오 방광뇨도 촬영술과 같은 특수검사시설이 없는 경우에 PUV angle의 변화정도를 관찰하기 위하여 시행하여 볼 만한 가치가 있었다 Clinical and urodynamic studies were made on 27 cases of uterine prolapse with or without incontinence after vaginal hysterectomy and anterior colporrhapy at the Department of Obstetrics and Gynecology, National Medical Center from March 1, 1983 to February 28, 1985 The results obtained were as follows; 1 All patient were multiparous women whose mean age was 55 1 year The incidence of urinary incontinence associated with uterine prolapse was 77 8%, which tended to be increasing according to the number of parity and age 2 Urinary symptoms such as stress incontinence, frequency, voiding difficulty and urgency were markedly improved after operation Urinary incontinence newly developed in one case due to detrusor instability 3 The overall incidence of postoperative complication was 14 8% Complications induced each one case oe vaginal vault prolapse, detrusor instability, vesicovaginal fistula and pyelonephritis respectively 4 Preoperative and postoperative cystometry showed no significant difference in either with or without urinary incontinence 5 On straining, symptom improved group showed more decrease in the descended length of the bladder base and posterior urethrovesical junction than the symptom continued group, but there was no statistical significance between each group 6 On straining, the postoperative change in the inclination angle was prominently noted in incontinent group than in continent one But no significant difference was found between symptom improved and continued group 7 Significant difference in the decrease in posterior urethrovesical angle between incontinent and continent group, which also significantly decreased in both symptom improved group and continued group

브로이스 혈종기태의 1예

박원길(WK Park),안종호(JH Ahn),박상빈(SB Park) 대한산부인과학회 1978 Obstetrics & Gynecology Science Vol.21 No.8

A case of Breus hematoma mole that is known to primitive case in Korea, was repated with the brief review of some literatures.

Turner 씨 증후군 1예

강대웅(DW Kang),김종현(JH Kim),박형무(HM Park),박인서(IS Park) 대한산부인과학회 1983 Obstetrics & Gynecology Science Vol.26 No.6

저자들은 최근 성적 소아증, 단신, 성선 발육부전을 지닌 45XO형의 Turner 씨 증후군 1예을 경험하였기에 문헌적 고찰과 함께 보고하는 바이다. The Turner`s syndrome refers to the instance of gonadal dysgenesis associated with somatic anomalies such as sexual infantilism, primary amenorrhea webbing of the neck, cubitus valgus and so on. The authors have recently experienced such a patient as gonadal dysgenesis with primary amenorrhea, sexual infantilism and short stature than her chronological age, and we report this case with a brief review of the literatures.

복강불임술후에 발생한 자궁외 임신의 4예

김화은(HW Kim),문제호(JH Moon),장병기(BK Chang),박영상(YS Park),강영호(YH Kang) 대한산부인과학회 1981 Obstetrics & Gynecology Science Vol.24 No.4

저자들은 1977년 5월부터 1978년 12월사이에 복강경 불임수술 후에 속발된 자궁외 임신 4예 를 경험하였기에 간략한 문헌고찰과 아울러 증례를 보고하였다. Four cases of Ectopic pregnancy following Laparoscopic Tubal Sterilization are presented with the review of literature available.

자궁경암 15,092예 및 수술 561예에 대한 임상적 고찰 - 1963년부터 1983년까지의 임상적 분석 -

이의돈(ED Rhee),이제호(JH Lee),이경희(KH Lee),박기복(KB Park) 대한산부인과학회 1984 Obstetrics & Gynecology Science Vol.27 No.9

원자력병원이 개원한 1963년 11월부터 1983년 12월 31일까지 20년간 산부인과에 등록된 부인암중 자궁경암의 년도별 임상기 분포율의 변화와 1965년 1월 1일부터 1978년 12월 31일까지 14년간 수술한 자궁경암 561례의 치료성적을 조사하여 다음의 결과를 얻었다. 1. 1963년 11월부터 1983년 12월 31일까지 산부인과를 방문한 신 환자 140,906례중 부인암환자는 15,805례(11.2%)이었다. 2. 15,805례의 부임암중 자궁경암은 15,092례(95.5%)이었다. 자궁경암중에서는 제 0기부터 제 IV기까지가 11,952례(79%)이었고 타병원에서 수술이나 방사선치료를 받고 내원한 환자는 3,140례(20.8%)이었다. 3. 제 0기, I기 및 II기의 년도별 분포율의 변화는 1963-68년에 각각 0.1%, 8.0% 및 28.8%에서 1979-83년에는 각각 5.4%, 14.6% 및 48.1%로 증가하였고 제 III기와 IV기는 각각 57.4%와 5.6%에서 각각 3.02%와 1.7%로 감소하였다. 4. 수술환자 561례의 기별 분포는 제 0기가 54례(9.6%), IA 99례(17.7%), IB 314례(56.0%), IIA 73례(13.0%), 그리고 IIB 21례(3.7%)이었다. 5. 수술환자의 연령분포는 제 0기, I기 및 II기 모두 41-45세군(28.7%)이 가장 많았다. 6. 수술환자의 분만회수는 제 0기, I기 및 II기 모두 3-4회군(43.6%)이 가장 많았으며 임신동반율은 3.0%이었다. 7. 수술환자의 병리조직학적소견은 편평상피암이 95.8%, 선암은 4.0%, 그리고 선편평상피암세포암은 0.2%이었다. 8. 임파선전이율은 IA가 0%, IB 10.5%, IIA 13.9%, 그리고 IIB는 21.1%이었다. 9. 수술후 추적확인된 환자의 5년생존율은 제 0기와 IA는 100.0%, IB 91.3%, IIA 80.7%, 그리고 IIB는 75.0%이었다. 10. 수술후 추적확인된 환자의 10년생존율은 IB가 69.4%, IIA 61.5%, 그리고 IIB는 58.3%이었다. 11. 수술후 5년추적율은 제 0기가 70.4%, IA 80.4%, IB 71.8%, IIA는 70.4%, 그리고 IIB는 71.4%이었으며 전체의 73.6%가 추적되었다. 12. 수술후 10년추적율은 IB가 32.6%, IIA는 58.3%, 그리고 IIB는 57.9%이었다. 13. 수술후 재발 확인된 시기는 1년이내가 41.9%로 가장 많았고 다음은 1-2년(23.3%)이었다. From 1965 through 1978, 561 patients with carcinoma of the uterine cervix were treated primarily with surgery at Cancer Research Hospital, Seoul, Korea. The purpose of this report was to analyze the clinical data and survival rate of these patients. Also we compared the changing trends for the 15,092 cases of carcinoma of the uterine cervix registered simultaneously, according to clinical stage during the 20-year period from Nov.1963, the opening day of our hospital to 1983. The results were as follows: 1. The number of gynecologic malignancies registered from Nov.1963 to 1983 was 15,805 cases and the proportion of gynecologic malignancies to the new patients, 140,906 cases, was 11.2%. 2. The proportion of carcinoma of the uterine cervix to the gynecologic malignancies was 95.5%(15,092 cases). 3. The proportion of stage 1, I, & II increased from 0.1%, 8.0% & 28.8% in 1963-1968 to 5.4%, 14.6% and 48.1% in 1979-1983 respectively. But stage III & IV decreased from 57.4% and 5.6% to 30.2% and 1.7% in the same period respectively. 4. The clinical stage of 561 patients who had operation were as follows: Stage 0, 54 cases(9.6%); Stage IA, 99 cases(17.7%); Stage IB, 314 cases(56.0%); Stage IIA, 73 cases(13.0%; and Stage IIB, 21 cases (3.7%). 5. The results of histopathologic subtype were distributed as follows; Squamous cell carcinoma was 95.8%, adenocarcinoma was 4.0% and adenosquamous cell carcinoma was 0.2%. 6. The frequency of lymph node metastasis was 0% in Stage IA, 10.5% in Stage IB, 13.9% in Stage IIA, and 21.1% in Stage IIB. 7. The 5-year survival results by stages in confirmed patients by follow up were Stage 0, 100.0%; Stage IA, 100.0%; Stage IB, 91.3% Stage IIA, 80.7%; and Stage IIB, 75.0%. 8. The 10-year survival results in confirmed patients by follow up were Stage IB, 69.4%; Stage IIA, 61.5%; and Stage IIB, 58.3%.