과배란 유도된 인간 난자의 성숙도 및 체외수정 난할율에 관한 연구

노형일(HI Noh),장윤석(YS Chang) 대한산부인과학회 1988 Obstetrics & Gynecology Science Vol.31 No.9

과배란 유도된 인간 난자의 성숙도 및 체외수정 난할율 To compare the stimulation effect of clomiphene citrate, clomiphene citrate/hMG and hMG, the serum E2 level, the diameter and number of aspirated follicles and clevage rate or preovulatory oocytes were evaluated. Twenty five patients with irrepairable tubal disease were stimulated by clomiphene citrate (n=7), clomiphene citrate/hMG (n=6) and hMG (n=12) for the purpose of in vitro fertilization and embryo transfer and the following results were obtained. 1. Serum estradiol (E2) levels on the day of hCG administration were 746.3+-225.6 Pg/ml in clomiphene citrate group , 1105+-348.4 Pg/ml in clomiphene citrate/hMG group and 968.4+-247.0 Pg/ml in HMG group . The serum E2 value of clomiphene citrate group was significantly lower than those of clomiphene citrate/hMG group and hMG group . There was no significantly difference in E2 value between clomiphene citrate/hMG group and gMG group. 2. The diagmeter of leading follicles by ultrasonogram on the day hCG administraion were 19.9+-1.8 mm in clomiphene citrate/hMG group and 15.5+-1.2mm in hMG group , the follicle diameter of clomiphene citrate group being greater than those of clomiphene citrate/hMG group and hMG group significantly . But no significantly difference of follicle diameter between clomiphene citrate/hMG group and hMG group was demonstrated. 3. The number of folicles with diameter above 10mm by sonogram on the day of hCG injection were 2.1 in clomiphene citrate group , 3.0 in clomiphene citrate/hMG group and 3.7 in hMG group . 4. The number of oocytes found per patients at aspiration were 1.3 in clomiphene citrate group , 1.5 in clomiphene citrate /hMG group and 1.5 in hMG group . 5. The detection rate of pre-ovulatory oocytes at aspiration were 75.0% in clomiphene citrate group 88.9% in clomiphene citrate / hMG group and 66.7% in hMG group . 6. The cleave rate of pre-ovulatory oocyte at 44 hours after insemination was 83.3% in clomiphene citrate group , 75% in clomiphene citrate / hMG group and 80% in hMG group.

인삼이 산욕기 부인의 혈중 Prolactin치에 미치는 영향에 관한 연구

장윤석(YS Chang),이진용(JY Lee),노형일(HI Noh),배효원(HW Bae) 대한산부인과학회 1979 Obstetrics & Gynecology Science Vol.22 No.5

A double blind study was performed in 41 women to establish the effectiveness of ginsenoside triol(a chemical component of Ginseng saponins) in suppressing puerperal lactation and to compare it with that of bromocriptine. Forty one women who were delivered normally and who did not wish to breast feed were randomly allocated to one of three groups. Ginsenoside triol was given orally in a daily dose of 0.23gm to 22 cases, bromocriptine in a daily dose of 5mg to 7 cases, and placebo in apparently identical capsules to 12 cases respectively for 14 days starting from delivery. The clinical effectiveness of treatments was assessed by recording milk secretion, engorgement of the breast and breast pain. Serum prolactin levels were assayed radioimmunologically using Diichi human prolactin kit. The inhibitory effect on milk secretion was greatest in cases receiving bromocriptine. On the 3rd day postpartum, the inhibitions by placebo, ginsenoside triol andbromocriptine were 16.7%, 27.3% and 100% respectively. On the 7th day postpartum, placebo suppressed milk secretion in 50.0%, ginsenoside triol in 68.2%, whereas, bromocriptine in 100%. The prevention of breast engorgement and pain was also greatest in bromocriptine group. On the 3rd day postpartum, the preventions by placebo, ginsenoside triol and bromocriptine were 16.7%, 22.7% and 100% and on the 7th day postpartum 58.3%, 72.7% and 100% respectively. Initial serum prolactin levels before delivery were similar in all groups, ranging their mean values around 300ng/ml. Under ginsenoside triol treatment, the mean prolactin value declined gradually with fluctuation to 181.5ng/ml on the 7th day and 66.3ng/ml on the 14th day, and there was no difference in the profiles of serum prolactin between ginsenoside triol and control groups. On the other hand, serum prolactin levels in bromocriptine group fell rapidly to 34.0ng/ml on the 3rd day and 37.0ng/ml on the 14th day. In terms of milk secretion, breast engorgement and pain, ginsenoside triol seemed to have some e

한국 부인암 환자의 치료후 추적조사에 관한 연구

라건영(KY Rha),신면우(MW Shin),박재일(JI Park),장윤석(YS Chang),노형일(HI Noh) 대한산부인과학회 1980 Obstetrics & Gynecology Science Vol.23 No.1

1) 부인암등록환자수는 본대학 산부인과에서 입원치료를 받고 퇴원할 때 등록하는데 그 총 환자수는 1959년부터 1978년까지 만 20년간 1643예였고 그 중 자궁경암은 1305예(79.4%), 불모암은 228예(13.9%), 난소암은 73예(4.6%), 자궁체암은 22예(1.3%)였다. 2) 년평균치료환자수는 자궁경암이 65.3예, 불모암이 11.4예, 난소암이 3.8예, 자궁체암이 1.1예였으며 자궁두암은 연도에 따라 치료수가 뚜렷이 증가하였으나 다른 종류의 암에서는 특별한 증가나 감소의 현상을 볼 수 없었다. 3) 지역별분포는 모든 종류의 등록환자수는 서울시내가 지방보다 높은 분포를 보여 64.0%∼68.3%를 차지하고 있다. 4) 발병년령은 자궁경암과 난소암에서는 40세대에서 가장 높은 발생수를 보이고 있으나 불모암에서는 20세대, 자궁체암에서는 50세대에 가장 높은 발생빈도를 보여 주었다. 5) 분*과의 관계는 자궁경암과 자궁체암은 분*회수가 3∼4회인 경우에, 불모암에서는 분*회수가 1∼2회인 경우에, 또 난소암에 서는 분*회수가 미산부 또는 1∼2회 경산인 경우에 가장 높은 빈도를 보여 주었다. 6) 암의 치료시기로는 자궁경암에서 0기암이 10.7%, 제1기암이 43.2%로서 비교적 초기암이 반수이상이었으며, 자궁체암의 경우 도 제1기암이 77.3%였으나 난소암에서는 제3기암 및 제4기암이 각각 22.7%, 29.3%로서 말기암이 반수이상 차지하고 있다. 7) 병리조직학적분류로서는 자궁경암에서 편평상피세포암이 94.9%였고, 선암이 4.2%, adenoacanthoma가 0.9%였는데 자궁체암에 서는 전례가 자궁막선암이었으며 난소암에서는 장액성선암이 34.7%로서 가장 많은 높은 빈도를 나타냈다. 8) 타장기에의 전이는 자궁경암에서 제1기 및 제2기암의 경우 골반내 임파선전이는 각각 13.7%, 32,5%를 나타냈고, 불모암에서 는 폐장전이가 61.8%로 가장 높고, 질전이, 골반내전이, 뇌전이, 외음전이의 순으로 되어있다. 난소암에서는 인접부위로의 전 이가 5.3%, 복강내장기나 복강외부까지 침윤된 경우가 52.0%나 되었다. 9) 치료방법으로서는 자궁경암의 경우, 0기암은 수술요법, 제1기와 제2기암은 원칙적으로 병행요법, 제3기와 제4기암은 방사선 요법을 1978년까지는 시행하였다. 난소암과 자궁체암은 수술요법, 불모암은 화학요법을 시행했으나 환자의 년령, 건강상태 및 암의 진행상태에 따라 병행요법을 사용하기도 하였다. 10) 추적대상환자수는 전체등록환자수에서 외래로 5년이상 방문하므로써 추적된 환자와 치료후 5년이 경과하지 않은 환자 그리 고 주소가 불분명한 환자를 제외하고 조사대상으로 하였는데 질병별로는 자궁경암이 558예, 불모암이 106예, 난소암이 34예, 자 궁체암이 8예였으며 지역별로는 서울거주자가 414예, 지방거주자가 292예로 총 706를 추적대상으로 하였다. 11) 추적성적은 추적대상암등록자중 서울시내에서는 414예중 64예가 확인되어 15.5%의 확인율을 보였고, 지방의 경우에는 292예 중 123예가 확인되어 42.1%의 확인율을 보임으로서 지방의 경우가 추적성적이 훨씬 우수하였는데 이는 주소이동이 적고 인간관 계가 더 밀접한 것이 원인으로 생각된다. 12) 5년생존율은 외래 및 거주지 추적으로 확인된 각 질병별 5년생존율은 자궁경암에서 0기암은 100.0%, 제1기암은 92.4%, 제2 기암은 59.7%, 제3기암은 26.7%, 제4기암은 0%였고 불모암은 65.7%, 난소암은 33.3%, 자궁체암은 62.5로 나타났다. 조사원을 거주지파견시켜 생존 및 건강여부, 타질환으로 인한 사망여부를 추적확인한 자궁경암환 The main purpose of this study was to evaluate the five year survival rate and epidemiologic analysis of 1,643 gynecologic cancer patients treated at S.N.U.H from January, 1959 to December; 1978. The five tear survival rate was based on the confirmed patients by home visit. The rusult were as follow : 1.The total number of registered patients from 1959 to 1978 was 1,643 cases [cervical ca.:1,305(79.4%), chorio ca.:228(13.9%), ovarian ca.:75(4.6%), corpus ca.:22(1.3%)]. 2.The mean annual incidence of patients were 65.3 cases in cervical ca., 11.4 case in chorica., 3.7 casesin ovarianca., and 1.1 cases in corpus ca.. 3.The distribution of patients by residency showed thaat over sixty percent of patients located in Seoul city. 4.Age distribution of patients was concentrated on the age of 40-49 in the cerv- ical ca, and ovarian ca, 20-29 in the chorioca., 50-59 in the corpus ca.. 5.parity distribution of patients was concentrated on the parity 3-4 in the cer- vical ca, and corpus ca., 1-2 in the chorioca., 0 in the ovarian ca. 6.Histopathologic type of patients showed that 94.9% of cervical cancer patients belonged to the squamous cell ca., 4.2% to the adenoca., 0.9% to the adeno- acanthoma and all cases of corpus ca., and 32.5% in stage cerveal ca.. 7.The frequency of metastases was 13.7% in stage I cervcal ca., and 32.5% in stage cervcal ca., On the cheriocarcinoma, 61.8% of the cases was found to be metastasized and the most frequent site was the lung. 8.Seven hundred and six patients were the subject of the follow-up study by home visit, among whom 414 cases located in Seoul and 292 cases in local area. The percentile result of confirmation by home visit was 15.5% in Seoul and 42.1% in local area. 9.The five year survival rate of confirmed patients by home visit was 100% in stage 0, 89.5% in stage I, 52.0% in stage , 20.0% in stage III, 0% in stage IV of the cervical ca, of the uterus; 66.7% in corpus ca., 28.6% in ov- arian ca., and 55.0% in cgorioca.