전신마취하 수술이 신기능에 미치는 영향

윤능수,김익수,이종현,이희동 충남대학교 의과대학 지역사회의학연구소 1980 충남의대잡지 Vol.7 No.1

As an attempt to elucidate the functional change of human kidney by surgery under general anesthesia(halothane), various renal functions were compared before, during and after surgery under anesthesia among 18 adult patients admitted at Chungnam National University Hospital. They were confirmed to have normal functions before surgery (control group). Most of renal functional changes recovered 3 days after surgery. The results of renal function changes during surgery under anesthesia were summarized as follows; 1) decreased renal plasma flow(C_PAH) as 70.8% with P<0.01 decreased glomerular filtration rate(C_IN) as 78.6% with P<0.05 decreased urine flow as 36.0% with P<0.01 slight elevation of filtration fraction without significance 2) decreased osmolar clearance(Cosm) with P<0.01 Most cases(15/18) of negative fluid balance by free water clearance 3) decreased urinary filtration and excretion of Na^+ with P<0.05 slight elevation of renal tubular reabsorption rate without significance extraordinally increased filtration of K^+ with P<0.01 From the above results, it is suggested that the effect of surgery under halothane anesthesia on renal function is due to renal hemodynamic change by increased compensatory renal vascular resistance during anesthesia and surgery.

회장을 이용한 요로전환술에 대한 임상적 관찰 : A Clinical Review on 9 Cases

윤능수 충남대학교 의과대학 지역사회의학연구소 1978 충남의대잡지 Vol.5 No.2

Ureterocutaneostormy, Bricker operation, was applied to 9 patients admitted at the department of urology, Chungnam National University Hospital during the period from January 1976 to September 1978. Bricker operation has been generally accepted as the favorable method of permanent supravesical urinary diversion. Some authors reported the cases with this surgery recently in Korea but the numbers of case were still a little. Herein, the author added 9 cases with clinical review including surgical experiences, postoperative course, early complication, etc. and recommend that this procedure had better apply widely to the surgical field of urology in Korea with good case selection, improved skill, early detection and prevention of of complication.

Cyclosporin의 신이식 면역억제에 관한 연구

윤능수 충남대학교 의과대학 지역사회의학연구소 1985 충남의대잡지 Vol.12 No.2

In vitro test was performed to detect the effects of cyclosporin on human lymphocytes for renal allograft. The results were as below : 1. Cyclosporin inhibited cellular proliferation, generation of cytotoxic cells in MLC and MLC-CML. 2. The inhibition related with dose-dependant. 3. The immunosuppressive effect in primary response could be continued in secondary response by restimulation using multiple specific or third party stimulators.

지역사회(충남일부지역)의 의료실태, 가족계획 및 모자보건에 관한 조사보고

윤능수,노흥태 충남대학교 의과대학 지역사회의학연구소 1976 충남의대잡지 Vol.3 No.2

The survey on medical care, birth control and MCH in rural area was investigated for 294 households and 212 women from the same households at Sungjuri, Misanmyun, Boryunggun, Chungnam during the period from July 26 to July 30, 1976. The results are summerized as follow: 1) Annual prevalence rate observed as 60.2% by household and 146.7 by 1,000 population. The most frequent problem were disease of digestive and respiratory system as 23.4%, 21.8% respectively. 2) Utilization of medical facilities were drugstore(14.3%), hospital or clinic(13.3%), health center (6.1%), in order of frequency. And 59.5% of household took medical care at home by means of folk medicine. 3) The chief reason of not use of medical facilities were economic poverty as 77.8%. 4) In birth control 58.2% of household agreed to reform and 29.5% of them adopted actually by means of contraceptic oral pills in 47.1%. Their chief source of knowledge about birth control was taken from counseler of health center in 62.2%. 5) Ideal number of child was 3 in 40.1%, 2 in 39.5%. 6) 72.1% of women had no consultation with a physician during the prenatal period, only 3.7% of women could take to rest during the puerperal period. 7) 86.4% of women delivered their babies at home and delivery attendance by a professional person occurred only 7.7% of the time. 8) Artificial abortion was experienced by 30.3% of women, surveyed. 9) Most of women gave breast feeding in 90.1%, continued till the period of 6 months to 1 year in 43.9%.

만성전립선염의 임상적 연구

윤능수 충남대학교 의과대학 지역사회의학연구소 1980 충남의대잡지 Vol.7 No.2

A clinical study was made on 59 cases of chronic prostatitis diagnosed at Chungnam National University Hospital during the period from January to December in 1980. The following results were obtained : 1. Age distribution showed the highest incidence in 3rd and 4th decades(78.0%) with slightly more predominant urban residents. 2. The most of them had experienced previously acute or chronic urethritis(79.7%) and visited this hospital with duration of onset within 1 month(33.9%), over 3 months (57.6%). 3. Major subjective symptoms were urethral discomfort(44.1%), pollakisuria(18.6%), perineal discomfort(16.9%) in order of frequency. 4. On rectal palpation of prostate, 48 cases(81.4%) and abnormal findings in consistency or size but 11 cases(18.6%) were within normal limited. 5. Microscopic findings of wet smear of expressed prostatic secretion revealed more than 10 W. B. C. /H. P. F. in 52cases(88.1%) and the remanined were within normal limited. 6. On evaluation of diagnostic criteria, they had been diagnosed by the combination of components with abnormal findings of prostatic palparion, abnormal microscopic findings of prostatic secretion and symptoms. 40 cases(67.8%) had 3 components, 15 cases (25.4%) 2 components and 4 cases(6.8%) had only 1 component. To make the more correct diagnosis quantitative cultures of 3 voided urine and expressed prostatic secretion are recommended. 7. Among 28 cases known course, they had 54.8% of cure rate during the period of 11.6 weeks.

기업체 종업원의 성태도와 성질환의 탐색에 의한 노동능력의 효과적 관리

윤능수,예민해,장명웅 충남대학교 의과대학 지역사회의학연구소 1977 충남의대잡지 Vol.4 No.2

A survey was conducted on 1546 workers in Daejeon area (male:116, female: 1430) for 1 year, from August 1, 1976 to July 31, 1977, for the purpose of understanding their current status of sexual attitude and sexual disease (V.D.) and of improvement their labor efficiency in works. Among 1546, workers, 868 were examined by stained smear of urine, urine culture, stained smear & culture of vaginal discharge for gonococcal infection, V.D.R.L. for syphilis. The results were summerized as follows: 1. The age distribution was revealed the peak in the age group of 20 to 22 years with 45.1%. They were all unmarried. 2. By the educational background, the greatest proportion with 51.2% was primary shcool, 36.4% was middle school. 3. Regarding the working duration, 53. 7 % worked less than 2 years. 4. Regarding the status of general sexual knowledge, middle lower class was 59.4% and lower class, 22.0 %. 5. Main sources of sexual knowledge got from books 39.7%, talking with friends 27.6% and popular weekly journal 14.5%. 6. 79.9% of workers wanted to receive the early regular sexual education. 7. Female workers had knowledge about menstruation in 48.0% before menarche. They got this knowledge from friends 20.7%, school 19.6%, and mother 17.6% in order. 8. The age distribution of menarche revealed the peak with 70.6% from 15 year to 17 year of age. 9. Regarding the masturbation, male workers experienced in 96.6% and the first experience was average 17.9 year of age with range from 13 year to 21 year. Female worker experienced in 40.0%. 10. They recognized the sex as love sex in 50.3%, reproduction sex 23.8%, and recreation sex 4.7%. Especially female worker recognized that the sex is dirty in 9.9%, male worker had the tendency that the sex was more recreative. 11. Regarding sexual contact before marriage, if they loved each other, it might be innocent in 15.5% of male, 10.0% of female, and permitted in 62.0% of male, 47.7% of female, and forbidden in the 8.6% of male, 16.0% of female. 12. Female worker might be free their limitation of body till hands in 42.2% of cases, lips 4.6%, breast 2.9%, sexual intercourse 10.6% to the lover. 13. After sexual intercourse they believed that they should get married in 27.6% of male and 22.2% of female workers. 14. Regarding the sexual experiences before marriage, 79.3% of male and 25.3% of female reported had such experiences. Among experienced female group, 9.9% of them had many times. The first sexual experience was the peak in 18 year of age in male, 17 year of age in female. The majority of sexual partner of first experience was prostitute in male, boy friend in female. 15. Induced abortions were found to have been experienced 9.8% of. female workers. 16. In male cases after sexual contacts, 27.6% was neglect or left, 3.4% visited hospital, 36.2% visited pharmacy. 15.5% of them reported to have experienced venereal disease. 12.0% was uncertain, 56.9% had no diseases. In female case, 33.4% agonized, 5.2% visited obstetrics-gynecology clinic, 14. 3% visited pharmacy. 17. Homosexual tendency was found in 22.5% of female cases and 3.4% of male cases. 18. In the incidence of antibiotic administration, the frequent group was 5.4%, the moderate was 18.9%, the rare was 33.0%, no administration was 35.8%. Recent experiences of administration of antibiotics within 1 week revealed that yes 14.1%, yes but uncertain drugs 16.2%, no 54.9%. 19. As the utilization of medical care, the majority of them, 42.3%, consulted the pharmacy and 22.9% of them visited the dispensary in works. 20. Utilization of the rest time by the case of male workers revealed watch TV & radio (29.3%), game (22.4%), sleeping (10.3%) in order and by the case of female worker watch TV & radio (28.1%), reading (26.0), talking (15.9%). 21. As the utilization of recreation facility within works, group of unsatisfied opinion was 40.2%, moderate 29.4%, satisfied 7.4%. 22. When they were in status of agonizing sexual problem they should be absent at works in 5.2% of male, 14.4% of female, they could seldom work in 31.0% of male, 11.7% of female. 23. Female felt satisfied in 40.8% of cases to have occupation in these works. 24. Of response about the rape in female they will reject desperately 41.8%, accept, if threatened, 22.5%, make secrete 13.0%, go to court 14.7%. 25. Of response requiring virgin as premarriage condition, female worker revealed no interest in 34.7%, agree 26.2%, rejection to get marry 8.1%, dislike 7.7%. Male worker wanted physical virgin in 27.6%, psychological virgin in 39.7%, no interest in 17.2%. 26. Of response to female drinking, female could be accepted in 34.5% by themselves, 46.6% by male, and might be free in 9.7% by themselves, 10.3% by male and should be rejected 38.5% by themselves, 27.6% by male. To female smoking female should be rejected in 56.1% by themselves, 70.7% by male, could be permitted sometimes in 15.4% by themselves, 12.1% by male, might be free 9.7% by themselves, 5.1% by male. Female smoking was much rejected than female drinking by both sexes. 27. Among 868 laboratory examining cases of workers Neisseria group were observed in 11.1%, and VDRL was positive in 3.5%.

白血病을 同伴한 陰莖 特續勃起症 治驗 1例 : Treated by Caverno-saphenous Shunt Procedure

尹能秀 충남대학교 의과대학 지역사회의학연구소 1975 충남의대잡지 Vol.2 No.1

A case of priapism admitted to departement of urology in this hospital, Chungnam national university. Blood examination revealed marked increase of leukocytes (115,000), blood smear showed 43% of immature cells chiefly consisted of myelogenous series including myeloblasts, promyelocytes, myelocytes and metamyelocytes. We could easily diagnose of chronic myelocytic leukemia referred from internal medicine department. Conservative treatment for priapism such as sedation, ice water enema, local cold application and irrigation of corpora cavernosa with heparin-saline solution tried but all failed. Eventually cured it by caverno-saphenous shunt operation. Here we report a new case of priapism in leukemia with related references.

방광암에 대한 임상적 침윤도와 병리조직적 침윤도의 비교연구

윤능수 충남대학교 의과대학 지역사회의학연구소 1983 충남의대잡지 Vol.10 No.2

Staging of bladder cancer is based on an assessment of the depth of involvement of the bladder wall by the neoplasm. It is important to make clinical staging as accurate as possible because it has proved to be the best guide to the appropriate treatment and the best predictor of the ultimate prognosis. In this study, comparision of clinical stage to post-surgical pathologic stage was made. The following results were obtained. 1. The mean age of 59 cases was 55.5 years old. The ratio of male to female was 3.5 : 1. 2. Clinical stage A and B_1 was 40 cases(67.8%). Pathologic stage A and B_1 was 36 cases(61%). Metastatic carcinoma(stage D) was 7 cases(11.9%). 3. The rate of accuracy was 70% in superficial carcinoma. Understaging rate was 10% and overstaging rate was 20%. 4. 98.2% of lower grade tumor(grade Ⅰ and Ⅱ) was superficial cancer. 56.2% of high grade tumor was invasive cancer and 43.8% was metastatic cancer.

前立腺肥大症의 臨床的 考察

尹能秀 충남대학교 의과대학 지역사회의학연구소 1975 충남의대잡지 Vol.2 No.2

A clinical study was made on 19 cases of Benign Prostatic Hyperplasia admitted during 1.5 year-period from Apr. 1974 to Sept. 1975 in the Department of Urology, Chungnam National University Hospital. The results are summerized as follows: 1) During this period, 123 patients hospitalized, 19 cases were B.P.H. giving a rate of 15.4% revealed the increasing tendency in incidence than other previous retorts in Korea. 2) Age distribution was between 60 and 85, mean age being 69.4. Peak incidence of age range was 60 to 69, giving a rate of 52.6%. 3) Interval elapsed from initial symptoms to admit was 52.6% within 1 year and 21.1% over 5 years. 4) Most frequent initial disturbance was dysuria(13 cases), while the other common manifestations were pollakisuria urinary retention, gross hematuria in order. Mean amount of residual urine was 440 ml. 5) The degree of prostatic enlargement was mostly Grade 2 on rectal palpation. So-called "prostate glans" 68.4% in all cases. 6) In urinalysis, microscopic hematuria was 15 cases (78.9%) and pyuria 12 cases (63.2%). Positive urine culture was 11 cases (57.9%). In blood, leukocytosis was 6 cases (31.6%), secondary anemia 1 case (5.3%), elevated blood urea nitrogen/crentinine 2 cases (10.5%). 7) Pre-existing disease before operation was discovered in 11 cases (57.9%) related to senility consisting of hypertension 5 cases, emphysema 3 cases, diabetes millitus 1 case. E.K.G. revealed abnormal findings in 7 cases (36.9%) with various degree of left ventricular hypertrophy, myocardial ischemia, right atrial enlargement and hypokalemia. 8) By cystoscopy, there revealed trabeculation 13 cases (86.6%), inflammation 9 cases (59.9%), diverticulum 1 case (6.7%) and stone 1 case (6.7%). 9) There revealed findings of hydroureter 5 cases (26.3%), hydronephrosis 3 cases (15.8%) and non-visualization 1 case (5.3%) on I.V.P. and findings of urethral change such as narrowing, spreading and elongation in all cases (100%), tilting 7 cases (36.8%) reflux 1 case (5.3% ) on cystourethrogram. 10) Prostatectomy underwent on 15 cases, of which 3 cases suprapubically, 12 cases retropubically. During opeartion blood was transfused in 13 cases with mean amount of 1.4 pint. It took average 2 hour 40 minutes to perform each operation. Mean weigh of removed prostatic tissue was 30.4 gm. 11) Histopathology of prostate tissue disclosed nodular hrperplasia in 14 cases (100%). associated prostate carcinoma 1 case (7.1%) and assotiated inflammation 5 cases (35.7%) 12) Druing average 12.7 days postoperative hostipalization, gross hematuria disappeared on average 9.5 days and indwelling catheter removed on average 10.6 days. 13) No serious complication other than epididymitis developed in a few case was observed postoperatively.

요로결석증에 대한 임상적 관찰

윤능수 충남대학교 의과대학 지역사회의학연구소 1978 충남의대잡지 Vol.5 No.2

We observed statistically the basic clincal status of urolithiasis, 51 cases, admitted during the initial 4 years period from Jan. 1974 to Dac. 1977 to make the more ideal management in future period in the department of urology, Chungnam National University Hospital. The results were summerized as follows: 1. During this period, among 398 hospitalized patients, 51 cases were urolithiasis giving a rate of 12. 8% revealed lower percentage of incidence than other previous reports in Korea. 2. Among those patients male to female ratio was 2. 9 : 1, 3rd and 4th decades had the highest age distribution with a rate of 56. 9%. 3. Provincial distribution showed the prevalency in Daejon City with a rate of 54. 9%. There were no cases from other areas than Chung Chung Nam Buk Do. 4. Stones were located in ureter 58. 8%, kidney 23.6%, bladder 13.7% and urethra 3. 9% in order. The ratio of stone of upper urinary tract to lower urinary tract was 82. 4 : 17.6. Among those with ureteral stone 80. 0% were located on lower 1/3 ureter. In the aspects of number of calculi and laterality of calculi, single stone was 88. 2%, unilateral stone of upper urinary tract was 97. 6%. 5. Among clinical symptoms, patiants complained of flank pain in 82.3% of cases, colic 52. 9%, gross hematuria 27. 5%, dysuria 25. 5%, pollakisuria 21. 6% and nausea-vomiting 17.6%. 6. Pyuria was present in 47. 1 % of cases, blood leukocytosis in 27. 5%. Positive urine cultures with more than 10s/ml. colonies were obtained in 30. 3% of 33 cases. The most common microrganism was E. coli. 7. Among 51 cases of urolithiasis 43 cases(84. 3%) were treated surgically, 8 cases(15.7%) were expectant to spontaneous expelling. Among surgical methods ureterolithotomy was the most common with 24 cases. 8. Advantages of management of urolithiasis by references recommended to much more use of cystoscopic instrumental manipulation and medical treatment for prophylaxis of urolithiasis in medically or metabolically active cases since the knowledge about etiology of stone was more investigated recently.