고 사구체전 저항의 신장에서 수출소동맥 이완에 대한 신혈역학적 반응 : 수학적 접근

양훈모,주명찬 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.1

To progressive increases in efferent arteriolar resistance (RE), GFR responds with an initial increase followed by a decrease. The biphasic response implies that the response of GFR to RE varies depending on the renal hemodynamic conditions. We studied, with a glomerular model, the mechanism of deterioration of renal function during angiotensin I converting enzyme inhibitor (ACEI) in the kidney with renal artery stenosis. The glomerular model was based on a simulation of flow along a glomerular capillary with negligible resistance and uniform ultrafiltration coefficient (kf, 0.09 nl·sec-1·mmHg-1). The control preglomerular resistance (RPRE) and RE were 0.071 and 0.081 mmHg·min·ml-1, respectively. The effect of renal artery stenosis is to increase RPRE by inserting a fixed stenotic resistance in series with the afferent arteriolar resistance, and RPRE which is the sum of the resistances of stenosed renal artery and afferent arteriole is increased in the kidney with stenosed renal artery. Since the higher RPRE is associated with greater reduction in GFR in response to reduction in RE, the kidney with stenosed renal artery will respond with severer decrease in GFR to postglomerular vasodilation. In addition, the preglomerular vasodilation which accounts for the major compensatory response to renal hypotension in the normal kidney becomes less and less effective in recovering PG and GFR during a decrease in renal artery pressure as the resistance caused by the stenosis becomes greater. The model has shown that these two factors contributed to the greater reduction in GFR (34ml·min-1 during renal artery stenosis vs. 46.5ml·min-1 during control) despite an increase in kf (40%) during ACEI in the kidney with renal artery stenosis (resistance; 0.082 mmHg·min·ml-1). In conclusion, severer deterioration of renal function in response to ACEI administration in the kidney with renal artery stenosis results from the reduced ability of RPRE to decrease in response to hypotension and the increased sensitivity of GFR to a decrease in RE when RPRE is increased.

단각 자궁의 과잉 난소 1예

이금원,주명찬,신현철,조태승,신영우,배동한 순천향대학교 1993 논문집 Vol.16 No.2

A case of supernumerary ovary is reported. The patient had two right sided ovaries, combined with contralateral hemiuterus, A supernumerary ovary is ectopic ovarian tissue that may arise from the urogenital ridge as independent primordia, an extremely rare condition. To our knowledge, since Wharton reported the first case in 1939, 14 cases have been reported in the literature.

전이성 복막성 평활근증 1예

신현철,유백근,주명찬,이금원,조태승,신영우,배동한 대한부인종양 콜포스코피학회 1993 Journal of Gynecologic Oncology Vol.4 No.1

Leiomyomatosis peritonealis disseminat,a is a rare non-neoplastic proliferation of histologically benign smooth muscle that occurs in the alxlominal cavity of women during the reproductive years of life, often giving rise to false choical impression of d.isseminated carcinomatosis grossly. In 1952 Wilson & Peale described a condition which they called $quot;multiple peritoneal leiomyomas$quot;. Taubert et al(1965) clearly delinated the features of the lesion and named it leiomyomatosis peritonealis disseminata(LPD). We report a case of leiomyomatosis peritonealis disseminata with a brief review of literatures.

비면역성 태아수종에 대한 임상적 고찰

이권해,남계현,주명찬,김희범,조태호 순천향대학교 1992 논문집 Vol.15 No.4

The retrospective study was performed including 13 cases of nonimmunologic hydrops fetalis who were delivered at the Department of Obstetrics and Gynecology, Soonchunhyang University, College of Medicine from Jan. 1990 to June 1992 during the period of 3years. The results were as follows 1. The incidence of NIH was 0.24%. 2. Average maternal age was 28years. Average gravida and parity were 2.2 and 0.7. Average gestational weeks was 26.8weeks. 3. The sex ratio of male to female was 1:1.25/ 4. Frequency of maternal condition associated with NIH were hypoalbuminemia (37.5%), anemia(30.8%), poly or oligohydramnios(30.8%), maternal disease(15.4%), syphilis(7.7%) and drug medication in early pregnancy(7.7%). 5. Associated fetal anomaly were gastroschisis(7.7%), omphalocele(7.7%), hydrocephalus(7.7%), cord anomaly(7.7%) and anatrophic dwarfism(7.7%). 6. The result of chromosomal study in the 3 cases of NIH were normal; 2 cases (46, XX), 1 case (46,XY). 7. Complications in 13 involved pregnancies were poly or oligohydramnios(30.8%), preterm labor(7.7%), placenta previa(7.7%), breech presentation(23.1%), transverse lie(7.7%). 8. Maternal serum α-fetoprotein was checked in ten of total cases. Maternal serum α-fetoprotein were increased in 5 cases (50.0%). 9. Amniotic fluid α-fetoprotein was checked in 4 of total cases. Amniotic fluid α-fetoprotein were increased in 2 cases (50.0%) 10. Gestational age at ultrasonographic diagnosis of NIH was 20-25weeks (53.8%), 26-30weeks(23.1%), 31-35 weeks (15.4%) and 36-40weeks(7.7%). 11. Ultrasonographic findings of NIH were fetal ascites (100%), edema on scalp or abdomen(76.9%), fetal hydrothorax(61.5%), poly or oligohydramnios (30.8%), intrauterine growth retardation (23.1%), large placenta(15.4%). 12. Management associated gestational weeks were bougination (76.9%), normal spontaneous vaginal delivery (15.4%), cesarean section(7.7%). 13. Autopsy finding were generalized edema (100%), marked extramedullary hematopoiesis in liver, spleen(75.0%), fetal ascites (100%), hydrothorax(75.0%), severe anasarca(50.0%), lung hypoplasia (85%), congestion of liver and spleen (50.0%), infarction of adrenal gland (12.5%). 14. Neonatal death rate was 100%.

제 71 차 춘계학술대회 : 초록보고 ; 부인과 다발성 원발 악성종양의 임상적 고찰

이철호,유백근,주명찬,이금원,이정재,남계현,이권해 대한산부인과학회 1993 춘계학술대회 Vol.- No.-

부인과 다발성 원발 악성종양의 임상적 고찰

이철호,유백근,주명찬,이금원,이정재,남계현,이권해 대한산부인과학회 1993 대한산부인과학회 학술대회 Vol.71 No.-

부인과 다발성 원발 악성종양의 임상적 고찰

이철호,이정재,남계현,이권해,유백근,주명찬,이금원 대한부인종양 콜포스코피학회 1993 Journal of Gynecologic Oncology Vol.4 No.1

Sixteen multiple primary carcmomas were found in 674 patients with gynecologic malignancies who were treated in our departiment from l980 to 1992. Cases with possible metastasis or recurrence were not included in this study, The incidence of rnultiple primary carcinomas in gynecologic rnalignancies was 2.1%, Multiple primary carcinomas were encountered in 2.4% of 674 cervical cancers, 1.4% of 73 ovarian cancers respectively. The most frequent sites of uther cancers were seen in the stomach(5/16) and lung(3/l6).

자궁경부암 환자의 근치수술에 대한 임상적 고찰

이권해,김성호,이중구,이금원,이철호,주명찬,이정재,남계현 순천향대학교 1993 논문집 Vol.16 No.2

From 1986 through 1990, 71 patients with carcinoma of the uterine cervix were treated primarily with surgery at Soonchunhyang Hospital, Seoul, Korea. The purpose of this report was to analyze the clinical data and survival rate of these patients. 1. The clinical stages of 71 patients who had operation were as followed : Stage ?? 9 cases(12.6%) ; Stage ?? 48 cases(67.8%); Stage ?? 9 cases(12.6%) ; and ?? 3 cases(7.0%). 2. The survival rates by stages in confirmed patients by followed up were Stage ??100%; Stage ?? 83.6%; Stage ?? 88.9%; Stage ?? 100%. 3. The survival rates by histopathologic subtype were Squamous cell carcinoma, 87.2%; Adenocarcinoma, 100%. 4. The survival rate of positive lymph nodal metastasis was 84.6% and one of negative lymph nodal metastasis was 91.3%. 5. The survival rate of operation only group was 91.6%, and one of operation plus adjuvant radiation therapy group was 90.0%.