고 Prolactin혈증에 대한 임상적고찰

최욱환,김창훈,장미경,차문석 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.3

1984년 1월 초부터 1988년 6월까지 부산대학교 산부인과 외래에 월경이상, 유루증, 불임증 등으로 내원한 환자중 고 PRL혈중을 보인 127례의 환자에서 고PRL혈중의 임상적인 특성과 bromocriptine으로 치료한 환자에서 월경재개, 유루증소실, 배란유도, 임신유발 및 임신의 산과작 결과에 대해 연구 검토하여 다음과 같은 결과를 얻었다. 1. 환자의 연령분포는 평균연령이 29.4%±5.26세였고, 2630세군이 48.8%로 가장 호발 연령군이었다. 2. 환자의 주소로는 일차성불임증이 69례(54.3%), 유루증 64례(50.4%), 무월경이 47례(34.6%), 이차성불임이 37례(29.2%), 희발월경이 16례(12.6%)이었다. 3. 유루증을 보인 환자군에서의 혈중 PRL평균치는 유루증을 보이지않은 환자군과 통계학적으로 유의한 차이를 보이었으며(P$lt;0.05), 또한 유루증과 월경이상이 동반된 환자군에서의 혈중PRL평균치는 유루증단독증상을 보인 환자군과는 통계학적인 유의한 차이를 보이었다(P$lt;0.01). 4. 무월경 환자군에서의 혈중PRL평균치는 정상월경을 보인 환자군과 통계학적으로 유의한 차이를 보이었으나(P$lt;0.05), 정상월경과 희발월경군 상호간에는 통계학적인 유의한 차이를 보이지 않았다(P$gt;0.05). 5. Bromocriptine치료로 유루증 53례중 45례(84.9%)에서 평균 10.0 ± 1.93주의 치료로 유루증소실을 관찰하였다. 혈청PRL치는 평균 9.1 ± 0.99주의 치료로 85례중 65례(76.5%)에서 정상치로 감소하였다. 무월경을 보인 39례에서 평균 8.1 ±0.92주의 치료로 30례(76.9%)에서 월경의 재개를 관찰하였다. 무배란성주기를 보인 19례에서 평균 11.4 ± 1.98주의 치료로 배란을 확인하였다. 6. 임신된 22례의 평균치료기간은 38.8 ± 16.39주며, 3개월내에 45%, 1년내에 72.7%가 임신이 되었고, 자연임신된 4례도 관찰할 수 있었다. 7. Bromocriptine치료로 임신된 22례의 산과적 결과는 만삭분만이 18례(81.8%), 조기분만이 2례(9%), 자궁외임신이 1례(4.5%), 자연유산이 1례(4.5%)이었다. One hundred and twenty seven hyperprolactinemic patients who visited out-patient department at Pusan National University Hospital from Jan. 1, 1984 to June 30, 1988, with chief complaints of galactorrhea, amenorrhea, oligomenorrhea, and infertility were studied to evaluate the clinical characteristics and resolution of amenorrhea, galactorrhea, and anovulation, induction of pregnancy and pregnancy outcome after bromocriptine treatment. The results of this study were as follow; 1. Average age of all hyperprolactinemic cases was 29.4 years, and the most prevalent age group was 26 ~ 30 years (48.8 %). 2. Primary infertility was the most common chief complaints, giving 54.3 % of all cases, galactorrhea in 50.4 %, amenorrhea in 34.6 %, secondary infertility in 29.1 %, oligomenorrhea in 12.6 %, headache in 9.4 % and visual disturbance in 2.4 % respectively. 3. The serum prolactin levels were significantly increased in the patient group with galactorrhea compared to the patient group without galactorrhea (P $lt; 0.05) and also increased in the patient group with menstrual abnormalities and galatorrhea compared to the patient group with galactorrhea only (P $lt; 0.01). 4. The serum prolactin levels were significantly increased in the patient group with amonorrhea comapred to the patient group with regular menstruation (P $lt; 0.05). 5. By bromocriptine treatment, the average time tot he restoration of menstruation was 8.1 ± 0.92 weeks and complete cessation of galactorrhea occurred in averaged time of 10.0 ± 1.90 weeks. Ovulation was restored in 11.4 ± 1.98 weeks after treatment. 6. By bromocriptine treatment, 22 cases (29.7 %) among all studied cases were concepted and the average time to the conception was 38.8 ± 1.79 weeks, and ten cases (45 %) among all concepted cases occurred in first 3 months, 16 cases (72.2 % among all concepted cases occurred within one year. 7. The outcomes of 22 pregnancies induced by bromocriptine treatment were term delivery in 18 cases, preterm delivery in 2 cases, ectopic pregnancy in 1 cases, and spontaneous abortion in 2 cases.

卷頭言

崔旭煥 대한치과재료학회 1991 대한치과재료학회지 Vol.18 No.2

근관충전 재료사 요약

최욱환 의치학사 1988 치과임상 Vol.8 No.10

姙娠性 高血壓 疾患의 治療

崔旭煥 한국의학사 1983 診斷과治療 Vol.3 No.1

자간전증 및 자간증의 고뇨산혈증에 관한 임상적 연구

최욱환 부산의대 1983 부산의대잡지 - 부산대학교 의과대학 Vol.23 No.2

Expression of Nitric Oxide Synthase and Endothelin-1 in Human Uterine Artery from Full-Term Pregnancies

최욱환,이선희,김은진,김관회,임병용 대한약리학회 2005 The Korean Journal of Physiology & Pharmacology Vol.9 No.3

The aim of this study was to determine the roles of ET-1 and NO on uterine blood flow in pregnancy. Uterine arteries were isolated from 17 nonpregnant and 12 pregnant women. Nonpregnant group included patients with median age of 48.6±2.3 years who underwent hysterectomy, because of myoma. Pregnant group included patients with median age of 31.3±1.4 years undergoing cesarean delivery. ET-1 and ET-2 induced concentration-dependent contraction in isolated nonpregnant and pregnant uterine arteries. The contractile response and maximal contraction were increased in pregnant uterine arteries. In nonpregnant uterine arteries, there was no contraction in response to ET-3, whereas pregnancy induced concentration-dependent contraction by ET-3. Tissue nitrite/nitrate level and immunohistochemical staining of eNOS and iNOS were increased in pregnant uterine arteries, compared with nonpregnant uterine arteries. In addition, the expressions of eNOS and iNOS mRNA were significantly increased in pregnancy. Moreover, contractions by ET isopeptides, including ET-1, were enhanced, and immunohistochemical staining of ET-1 and ET-1 mRNA expression was increased in pregnant uterine arteries. These results suggest that NO production by increased NOS activity, especially eNOS activity, is related to placental and uterine blood flow. Furthermore, ET-1 appears to play a pathophysiological role in pregnant complications such as hypertension.

산후출혈의 처치

최욱환 中央醫學社 1996 中央醫學 Vol.61 No.5

성염색체이상에 관한 임상적 연구

최욱환 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.6

To provide current information on sex chromosome abnormalities to obstetricians and gynecologists who encounter such diagnoses and who counsel prospective parents faced with the prenatal diagnosis of a sex chromosome abnormalities. I reviewed 116 patients` clinical data and results of karyotype which proven sex chromosome abnormalities in cytogenetic unit of Department of Ob. & Gyn., PNUH during the period of 1993. Aug.~1996. Dec. The results of the analysis of karyotyping in sex chromosome abnormalities in these 116 cases are like following. 1. Peak age group when diagnosed abnormal sex chromosome is 26~35 years old in men(46 among 56 cases) and 16~30 years old in women(40 among 60 cases). 2. The most common primary reason of abnormal sex chromosome is sterility in men(48 among 56 cases) and amenorrhea in women(36 among 60 cases). 3. The most common referred primary reason in Klinefelters syndrome is sterility(44 among 49 cases) and in Turners syndrome is primary amenorrhea(27 among 55 cases). 4. The most common type of abnormal sex chromosome is Klinefelters syndrome in men(49 among 56 cases) and Turners syndrome in women(55 among 60 cases). 5. In my 116 cases of abnormal sex chromosome, numerical abnormalities are 67 cases, mosaicisms 28 cases, structural abnormalities 13 cases, XY female 6 cases, and XX male 2 cases. So the most common abnormal sex chromosome is numerical abnormality. 6. In my 55 cases of Turners syndrome, XO karyotypes are 26 cases, X, abnormal X are 11 cases, and mosaic pattern are 18 cases. So the most common karyotype in Turners syndrome is standard pattern(45,X). In conclusion, abnormal sex chromosome were very important causes of infertility, amenorrhea, abnormal pubertal development, ambiguous genitalia, and stature. Therefore, these patients must taken cytogenetic study, and obstetrics and gynecologists provide accurate and comprehensive genetic counseling.

Abortion in Teenagers

최욱환 대한산부인과학회 1983 Obstetrics & Gynecology Science Vol.26 No.1

심장질환이 합병된 임신

최욱환 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.2