뇌혈관질환 환자의 후유증의 개선에 대한 Propentofylline(HWA 285)의 임상 연구

최영빈,박정욱,한시령,양동원,나정호,김범생 최신의학사 1994 最新醫學 Vol.37 No.6

뇌수막종에 대한 임상적 고찰

한종우,김정훈,이선호,김현집,한대희,심보성,최길수 대한신경외과학회 1989 Journal of Korean neurosurgical society Vol.18 No.5

The authors analyzed the surgical treated meningioma patients admitted to department of neurosurgery of Seoul National University Hospital between January, 1978 and December, 1987. The following results were obtained: 1) Meningioma was the most common in the 5th decade (46 cases, 37.7%) and the male to female ratio was 1:2.1 2) The pathologic types were meningothelial type (94 case, 77.0%), transitional type, fibroblastic type and angioblastic type in order of frequency. 3) Convexity represented the single most common site of tumor (36 cases, 29.5%), followed by the parasagittal-falx, sphenoid wing, and cerebellopontine angle (CPA) in order of frequency. 4) The most common initial presentation was ⅡCP sings and the mean duration of symptom was 22.5 months. 5) The most common CT finding was high density in PCT and strong homogeneous enhancement in ECT. Hypervascularity was seen in 83 cases (70.3%) on the angiography. 6) The total removal was done in 73.8% of patients and the postoperative mortality rate was 4.1%. 7) At the time of the analysis, 15 cases(12.3%) had shown evidence of recurrence, and the mean duration of recurrence was 3.18 months. 8) The follow up result was excellent in 75 cases(61.5%), good in 28 cases(23.0%), fair in 8 cases(6.6%), and poor in 6 cases(4.9%) and dead in 5 cases(4.1%).

자발성 두개강내 출혈에 대한 임상적 분석 : from Jan. - '80 to Sep. - '87

한대희,오창완,이선호,최길수,심보성 대한신경외과학회 1989 Journal of Korean neurosurgical society Vol.18 No.7-12

The authors analyzed 619 patients with spontaneous intracranial hemorrhage which had been diagnosed by brain CT scan. The following results were obtained; 1) The causes, in descending order of frequency, were aneurysm, hypertension, arteriovenous malformation, tumor, Moyamoya disease, blood dyscrasia and infarction. 2) The peak incidence age was in the 5th and 6th decades, but arteriovenous malformation cases showed peak incidence in the 3rd decade. 3) The peak incidence season was spring, but arteriovenous malformation cases showed even distribution around the year. 4) Of the 619 cases, 445 cases(71.9%) were treated operatively. Of them, 321 cases(51.9%) were treated radically, removing the cause of hemorrhage. 5) Regarding the frequent site of hemorrhage, SAH was present in 94% of aneurysm cases, ICH in 99% of hypertension cases and 85% of arteriovenous malformation cases, and SDH in 80% of blood dyscraesia cases. 6) Aneurysm cases showed best prognosis and hypertension cases showed most serious prognosis. 7) Cases with intraventricular hemorrhage showed poor prognosis.

주상변압기 열적 특성 향상을 위한 복합절연 시스템 적용

이병성(BS Lee),송일근(IK Song),이재봉(JB Lee),김동명(DM Kim),한상옥(SO Han) 대한전기학회 2002 대한전기학회 학술대회 논문집 Vol.2002 No.7

자간전증 산모에서 증가된 혈장 호모시스테인의 위험인자로서의 임상적 유용성 연구

김성도,한종설,송혜섭,이교원,김범영,최익준,신봉식,장우섭,조현구 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.10

목적: 자간전증이 있는 미산부에서 혈중 호모시스테인 농도가 증가하는지를 조사하여 혈중 호모시스테인이 자간전증에서 위험인자로서의 임상적 유용성이 있는가에 대하여 연구하였다. 연구 방법: 1997년 10월부터 1998년 4월까지 강북 삼성병원 산부인과에 분만을 위해 입원한 미산부중 자간전증이 있었던 미산부 20명(중증: 9명, 경증: 11명; 20명 중 13명: 조기발병 자간전증미산부)을 환자군으로 정하고 자간전증이 없었던 미산부 20명을 대조군으로 선정하여 이들 40명 모두의 혈액을 채취한 다음 high performance liquid chromatography로 혈장 총호모시스테인 농도를 측정하였고, 방사선면역측정법으로 엽산과 비타민 B12 농도를 측정하였다. 결과: 자간전증이 있었던 미산부에서 호모시스테인 농도는 12.61±3.06 μmol/L로서 자간전증이 없었던 정상 미산부에서의 6.63±1.72 μmol/L보다 통계적으로 유의하게 높았고(p<0.05), 조기에 자간전증이 발병했던 13명의 미산부에서 호모시스테인 농도는 12.71±3.41 μmol/L로서 자간전증이 없었던 정상 미산부에서의 6.63±1.72 μmol/L보다 통계적으로 유의하게 높았다(p<0.05). 엽산의 경우 환자군에서 6.86±2.96 nmol/L로서 대조군에서의 8.17±3.26 nmol/L와 통계적으로 유의한 차이가 없었으며, 비타민 B12 경우에도 환자군에서 237.8±73.1 pmol/L로서 대조군의 277.4±68.9 pmol/L와 통계적으로 유의한 차이가 없었다. 환자군에서 혈중 호모시스테인 농도가 중증군에서 13.79±3.23 μmol/L, 경증군에서 11.65±2.68 μmol/L로 두 군간에 통계적으로 유의한 차이가 없었다. 결론: 자간전증이 있는 미산부에서 분만당시에 측정한 혈중 호모시스테인은 증가하며, 자간전증을 예측할 수 있는 위험인자로 유용될 수 있을 것으로 사료된다. 호모시스테인이 자간전증 발병에 어떤 역할을 하는지, 그리고 자간전증을 어떻게 예방할 수 있는지에 대한 더 많은 연구가 필요할 것으로 사료된다. Objective: This study was designed to determine whether homocyst(e)ine is elevated in nulliparous pregnant women with preeclampsia, and to evaluate a clinical usefulness of elevated plasma homocyst(e)ine with preeclampsia as a risk factor. Methods: Of 40 nulliparous pregnant women studied from October, 1997 to March, 1998, 20 had preeclampsia (severe: 9, mild: 11; 13 early onset preeclampsia of 20) and 20 were normal pregnant controls. We measured plasma homocyst(e)ine levels by high performance liquid chromatography , and folic acid and vitamin B12 concentrations by radioimmunoassay at the time of their delivery. Results: Mean (standard deviation) plasma homocyst(e)ine levels in the two groups, 20 nulliparous women with preeclampsia and 13 nulliparous women with early onset preeclampsia, were significantly higher than in the 20 nulliparous women without preeclampsia, respectively (12.61±3.06 versus 6.63±1.72 μmol/L, P<0.05; 12.71±3.41 versus 6.63±1.72 μmol/L, P<0.05). Folic acid and vitamin B12 concentrations were not significantly different between two groups, respectively (folic acid, 6.86±2.96 versus 8.17±3.26 nmol/L; vitamin B12, 237.8±73.1 versus 277.4±68.9 pmol/L). Mean (standard deviation) plasma homocyst(e)ine levels were not significantly different between severe and mild preeclampsia(13.79±3.23 versus 11.65±2.68 μmol/L). Conclusion: Homocyst(e)ine levels are elevated in nulliparous pregnant women with preeclamsia at the time of their delivery and might be useful to predict the preeclampsia as a risk factor. Further studies are required to determine what role homocyst(e)ine may play in the etiology of preeclampsia, and to investigate how to prevent preeclampsia.

자궁내막암의 임상병리학적 고찰

박찬용,한병수,송준,이학희 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.4

저자 등은 1975년 7월부터 1989년 6월까지 만 13년간 국립의료원 산부인과에서 진단 및 치료를 시행받은 자궁내막암 환자 20명을 대상으로 임상병리학적 조사를 시행하여 다음과 같은 결과를 얻었다. 1. 환자의 평균 연령은 52세이고, 평균 분만력은 2.3이었다. 2. 월경력과의 관계에서 폐경기 이후가 75%로써 가장 많았고, 폐경기가 20%, 폐경기 전이 5% 순이었다. 3. 조직학적 진단으로는 선암이 60%로 가장 많았고, 선극세포종이 20%였다. 4. 주된 임상증상으로는 비정상적 자궁출혈이 90%이었으며, 이중 75%가 폐경기 이후 출혈로 가장 많았고 하복통 15%, 비정상적 질분비 10% 순이었다. 5. 유발인자는 고혈압, 불임, 비만, 에스토로겐의 사용 예, 당뇨 등을 들 수 있었으나 직접적인 관계로 보기는 어려웠다. 6. 동반된 골반내 질환으로는 자궁근종 25%, 자궁선근종 20%, 자궁내막증식증 15%, 난소낭종 10% 등이었다. 7. 임상기별 분석결과 제 1기 18예(90%), 제 2기 1예(5%), 제 3기 1예(5%)였으며, 세포분화가 양호할수록 자궁 침습도가 낮았으며 임상기도 낮았다. 8. 임상기와 수술후 일치율은 80%였다. 9. 수술을 시행했던 20예 중 전자궁적출 및 양측 부속기절제를 시행한 예가 13예(65%)였으며, 선택적 임파절제를 첨가한 예가 4예(20%), 방사선 조사를 첨가한 예가 3예(15%)였다. Significant advance in our knowledge of endometrial cancer have occured in the past decade. The incidence of the disease has risen in most western, industrial countries, and better understanding of the pathologic subtypes has evolved the relationship between exogenous estrogen use and endometrial cancer has been well documented. We have studied clinico-pathological correlation of endometrial carcinoma in 20 patients from July, 1975 to June, 1989 at Department of Obstetrics and Gynecology in National Medical Center. The mean age of endometrial cancer was 52 and mean parity was 2.3 Fifteen cases (75%) were postmenopausal, 4 cases (20%) were menopausal and 1 case (5%) was premenopausal. Pathologic subtypes were adenocarcinoma (60%), adenoacanthoma (20%), papillary adenocarcinoma (10%) and adenosquamous cell carcinoma (10%) in order of frequency. Abnormal vaginal bleeding was encountered in 90%, commonly postmenopausal, 75% lower abdominal pain in 15% and vaginal discharge in 10%, respectively. Risk factors were hypertension (20%), infertility (20%), obesity (15%), estrogen use (10%), diabetes millitus (5%) and hyperlipidemia (5%). Associated pelvic pathologies were myoma uteri (25%), adenomyosis (20%), endometrial hyperplasia (15%) and ovarian cyst(10%), respectively. A great number of patient (90%) was stage Ib. Concordance rate between clinical and surgical stage was 80%. Thirteen cases (65%) were treated by TAH and BSO, 4 cases (20%) by TAH, BSO with selective lymphadenectomy, 3 cases (15%) by TAH, BSO with radiation.

만삭분만의 예측지표로서의 태아 Fibronectin과 유도분만시 Misoprostol의 효용성 연구

김성도,한종설,송혜섭,최재호,이교원,김범영,신봉식,고염규 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.9

결론적으로 태아 fibronectin 정성 검사와 Bishop 점수를 병행하여 유도분만의 시기를 결정하는데 사용한다면 제왕절개 수술률을 감소시키면서 유도분만을 성공적으로 수행할 수 있을 것으로 사료된다. Objective: To evaluate the efficacy of misoprostol induced induction of term labor according to the presence fo fetal fibronectin in cervicovaginal secretion. Methods: 90 women scheduled for induction of labor were examined for Bishop score and were undergone for intravaginal application of 50 ㎍ of misoprostol at 6 hours interval. Misoprostols were administered continuously unless any of regular labor, spontaneous rupture of membrane or fetal distress occurred. In our study, 49 cases showed fibronectin positive cervicovaginal secretion, 41 cases showed fibronectin negative cervicovaginal secretion, 15 cases undergone for cesarean section. Results: 1. No significant difference were observed in Bishop`s score between the two groups. (4.72±0.98 versus 4.47±1.05). 2. Mean numbers of misoprostol administration were 1.33±0.57 and 2.03±1.03 in positive group and negative group respectively. Mean times required from labor induction to vaginal delivery were 470±388 min and 861±513 min respectively. Vaginal delivery in 12 hours were 79% and 50% in positive group and negative group respectively. 3. Dividing the cases according to the high and low Bishop score with cutoff level Bishop score of 5, mean numbers of misoprostol administration were 1.11±0.32 and 2.86±0.86 in high score group and low score group respectively. Mean times required from labor induction to vaginal delivery were 380±227 min and 1266±443 min in high score group and low score group respectively. Vaginal delivery in 12 hours were 89.9% and 14.3% in high score group and low score group respectively. Conclusion: Above study results suggest that fetal fibronectin qualitative immunoassay along with the evaluation of Bishop score might play important role in determining the appropriate timing of labor induction.

조산 및 만삭임신에서의 Shake Test

조성진,한병수,이학희,박홍식 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.11

1988년 1월 1일부터 1988년 6월 30일까지 국립의료원 산부인과에 입원한 조산아 25례와 만삭아 25례를 대상으로 포말안정시험을 실시하여 다음과 같은 결론을 얻었다. 1. 포말안정시험의 결과에서 조산아는 음성 3례, intermediate 2례, 양성 2례였고 만삭아에서는 25례 모두 양성이었다. 2. 음성 3례, intermediate 2례는 위음성이었고 양성 45례 모두 호흡곤란증후군이 나타나지 않았다. 3. 위음성과 1분 Apgar치와 특별한 관련성은 보이지 않았다. Foam test is a rapid, simple, econological test which has been devised to determine whether surfactant is present in amniotic fluid. the test depends on the ability of the pulmonary surfactant to generate stable foam in the presence of ethanol. We analysed each 23 and 25 sample of amniotic fluid in preterm and term by foam test. The results were as follows; 1. The result were 3 negative, 2 intermediate and 28 positive in preterm and all positive in term. 2. Infants of 43 pregnant women with positive test were free of respiratory distress. 3. 3 negative and 2 intermediate test were false negative. 4. There was no correlation between false negative and Apgar score of 1 minute.

Gardnerella Vaginalis의 성장조건과 Biotypes

이정규,한세준,장하종,김병수,이길형,양남웅,신성희 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.6

Gardnerella vaginalis의 성장에 관한 일반적인 조건들과 임상검체에서 분리된 야생균주들의 생 물형, 보관조건에 따른 생존율을 시험한 결과 다음과 같은 결과를 얻었다. 1. 각 종 동물혈에 대한 G. vaginalis의 용혈능을 시험한 결과 인혈, 마혈, 양혈에 대하여 용혈 능력이 있었으며, 양혈에 대한 용혈능이 가장 높았다. 2. G. vaginalis의 증식에 적당한 고체배지는 Casmans agar에 5% Filedes enrichment와 5% horse serum을 넣은 배지였다. 3. Casmans agar에 X와 V인자만을 넣은 배지에서 균의 성장이 없었기 때문에 X와 V인자외 의 다른 성장인자를 필요로 한다. 4. 액체배지에서 가장 높은 성장율을 나타낸 배지는 Csamas agar에 용혈인혈을 10% 넣은 CTH10배지였다. 5. 각 액체배지에서 성장곡선을 그린 결과 지연기는 대략 6시간이었으며 정상기는 약 20시간 정도였다. 6. 임상검체에서 분리된 야생균주의 생물형은 1, 2, 3, 4, 5, 7이었으며 6과 8은 형별되지 않았다. 15균주중 가장 많은 생물형은 7이었다. 7. 균주의 단기보관시 가장 오래동안 생존하는 보관법은 혐기성 냉장 보관 상태로써 28일이상 생존하였다. We have studied general growth conditions of Gardnerella vaginalis, which is the predominant vaginal microorganism in women with bacterial vaginosis, and carried out biotyping of 15 wild strains isolated from bacterial vaginosis patients. Standard strain (ACTT 14018) of G. vaginalis had hemolytic activity to human blood, horse blood and sheep blood, but there were no hemolysis on geese, duck, beef and rabbit blood agar. We have confirmed that transparent solid media adequate for good growth of G. vaginalis was Casmans agar supplemented with 5% Fildes enrichment and 5% horse serum. There was no visible colonial growth on Casmans agar patched with X(Haemin) and V(nicotinamide adenine dinucleotide) factor strips. It means that G. vaginalis needs another unknown growth factor besides X and V factors G. vaginalis have exhibited best growth in Casmans broth supplemented with 10% freezing- thawing lysed human blood after 48 hours incubation, when growth was measured by optical density. In growth curve checked by the hour (Fig. 1), lag phase was about 6 hours after inoculation and growth was attained to stationary phase about 20 hours after inoculation. In biotyping, we have identified biotype 1,2,3,4,5,7 among eight kinds of biotypes, biotype 6, 8 were not typed, and type 7 was most common biotype(5/15 strains). Finally we have observed that this bacteriae had survived for 28 days more at 4。C anaerobic storage condition. It that this short period storage condition is more suitable for short survival of bacteriae than another three conditions (Table 5).

뇌혈관조영술 소견상 잠재성인 뇌혈관기형

왕규창,조병규,한대희,이선호,김현집,지제근,심보성,최길수 대한신경외과학회 1989 Journal of Korean neurosurgical society Vol.18 No.7-12

본 교실에서는 뇌혈관조영술 소견상 나타나지 않은 잠재성 뇌혈관기형 17예를 경험하여 이들에서 특징적인 임상 소견을 관찰할 수 있었으며 특히 MRI가 본 질환의 진단과 관리에 있어 큰 도움이 되었기에 문헌고찰과 함께 이를 보고하는 바이다. Authors report 17 cases of angiographically occult vascular malformation of the brain experienced from July 1978 to February 1989. In 11 cases the diagnosis was confirmed by the operative and pathological findings and in the other 6 cases the clinical course and the radiological findings suggested the diagnosis. All the cases had the evidences of hemorrhage. Five of those had episodes of repeated hemorrhage. The characteristic findings of magnetic resonance imaging improved the sensitivity and specificity of diagnosis. Case summary and illustrative cases were presented with the review of literature.