보존혈액에 관한 혈액학적 및 생화학적 연구

강치명(CM Kang) 대한산부인과학회 1962 Obstetrics & Gynecology Science Vol.5 No.2

Since the Korean War, mary blccd banks have been established in Korea. Although they have made a great contribution to the medical practice, unexpected untoward side effects following transfuion of the preserved whole blood were not infrequently experienced. The Author studied the hematological and biochemical changes, as well as the change of coagulability of the preserved whole blood in an attempt to clarify the cause of thoes adverse side effects. The hematological and biochemical changes were observed in the preserved blood in ACD. For the change of coagulability, the blood preserved in ACD and EDTA solution (25 ml. respectiveiy for 100 ml. of blood) and heparinized blood (5 ml. of heoarin for 100 ml. of blood) were used. Prothrombin time, recalcification time and heparin tolerance test were employed for coagulability test. 1) The erythrocyte count of the preserved blood decreases gradually, but its decrease is not so remarkable until after three weeks of preservation. 2) Erythrocyte sedimentation rate retards gradually and after two weeks of preservation almost no change in sedimentation is observed. 3) Hematocrit of the blood increases as the time goes on, but not remarkably. 4) Leucocytes and blood platelets decrease markedly within a week after storage of the blood. 5) Potassium, cholesterol and inorganic phosphorus in the plasma increase. 6) On the contrary, glucose, fibrinogen and sodium in the plasma decrease. 7) Protein in the plasma are almost invariably unchanged. 8) Coagulability of the preserved blood in various solutions decreases in general. The preserved blood in ACD and EDTA solutions show gradual decrease in the coagulability tests. On the other hand, the coagulability of the heparinized blood is so rapidly decreased that it becomes inert to any coagulability tests in five days.

한국 정상인, 산모, 신생아 및 우계의 혈액상

강치명(CM Kang) 대한산부인과학회 1962 Obstetrics & Gynecology Science Vol.5 No.5

The author carried out the study on the blood pictures of cattle and fowls which live in the same environment with human being and also on the blood pictures of paturient mothers and newborn infants who are quite different from those of the normal adults. The author obtained the following conclusions: 1) The platelet count, the erythrocyte count, the homoglobin, and hematocrit are decreased in paturient mothers. But leucocyte count is increasd in paturient mothers. 2) Leucocyte count is considerably increased in newborn infants. 3) The platelet count of cattle blood is lower than that of human blood. 4) The erythrocyte count, hemoglobin and plarelets of fowls blood are markedly lower than those of human blood. But normoblasts are seen in the peripheral blood of fowls and leucocyte count of fowls blood is higher than that of human blood.

해녀를 중심으로한 제주도 부인의 초조년령 ( 초경 )

강치명(CM Kang) 대한산부인과학회 1962 Obstetrics & Gynecology Science Vol.5 No.5

The author has obtained the results about the age of menarche of women, espectially a group of Sea-women in Cheju Island, which is located on the south end of Korea, the climate, custom and culture as well as the environment of which, are quite diffrent from those of main land. The results are following: the average age of menarche of Sea-woman in Cheju Island is 17.5years of age, while the women in main land, 16.9years of age. As the conclusion, the average age of menarche of Sea-women in Cheju Island is more or less later than that of main land.

외음부에 발생한 파제트병 4 예

강순범,이효표,송용상,김재원,박노현,김용범,이철민,박인애,임경실 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.5

외음부에 생기는 파제트병은 매우 드문 외음부 종양으로써 높은 재발율을 보이는 것으로 알려져 있다. 파제트병은 apocrine선을 포함하고 있는 신체 어느 부위에나 생길 수 있으며 비교적 느리게 진행하는 상피내 종양이다. 전세계적으로 수백례가 보고되고 있으나 정확한 발생 빈도는 알려져 있지 않으며 유방외에서 생기는 파제트병의 대부분은 외음부에서 생기는 것으로 보고되고 있다. 외음부 파제트병은 대개는 상피내에만 국한되어 있으나 약 20%에서는 선암을 동반하고 있으며, 약 30%에서는 다른 장기의 악성 종양을 동반하는데 주로 유방이나 비뇨생식기계 또는 위장관계에서 생기는 것으로 알려져 있다. 외음부 파제트병의 치료는 광범위 병변의 절제술[wide local excision]로 충분하며, 만일 동반된 선암이 있는 경우에는 광범위 외음부 절제술[radical vulvectomy]과 동측 서혜부 림프절 절제술[ipsilateral inguinal lymphadenectomy]을 시행하여야 한다. 외음부 파제트병은 그 빈도가 매우 적으며 외음부의 다른 종양들과는 다른 임상병리학적 특성을 가졌기에 저자들은 1988년부터 1998년까지 본 병원에서 경험한 외음부 파제트병 4예를 문헌고찰과 함께 보고하는 바이다. Extramammary Paget`s disease of the vulva is an uncommon vulvar neoplasm that is a slowly progressive intraepithelial carcinoma and develops in an apocrine gland-bearing areas of the body. Several hundred cases have been described worldwide, however the precise incidence remains unclear. Paget`s disease of the vulva most often presents as an intraepithelial lesion, but underlying adenocarcinoma with this process in up to 20% of cases. A second synchronous or metachronous primary neoplasia is associated with extramammary Paget`s disease in about 30% of patients. The most common presenting symptom is vulvar pruritus, and typical finding is erythematous, eczematous lesions of the vulva. Vulvar Paget`s disease is often multifocal, and histologic evidence of disease is frequently greater than is clinically apparent. So, frozen-section surgical margin evaluation is utilized as a guide to extent of excision. Treatment of Paget`s disease requires wide local excision and if there is an underlying adenocarcinoma, radical vulvectomy is required, which should be combined with at least an ipsilateral inguinal-femoral lymphadenectomy. Due to its rarity and different disease patterns, we present a clinicopathologic study of four cases seen at our hospital from 1988 to 1998.

신장과 요관에서 다발성으로 발견된 Lymphoepithelioma-Like Carcinoma

강두경,정한수,박창면,김한권,박종연,강길현,노재윤 大韓泌尿器科學會 2003 Korean Journal of Urology Vol.44 No.3

VAC와 BEP 복합화학요법후 완전관해를 보인 내배엽동종양 1 례

강영호,김용철,이종민,박종규,왕영미,조경훈,강창성,박연이 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.11

본 저자들은 최근 30세 여성에게서 발생한 내배엽 동종양 1례를 경험하여 수술후 VAC와 BEP복합화학요법을 시행한 후 지금까지 11개월째 완전관해를 관찰하고 있어, 이에 문헌고찰과 함께 보고하는 바이다. The endodermal sinus tumor is a rare, malignant germ cell tumor that primarily affects children an young women. The important advances in the treatment of endodemal sinus tumor are the use of postoperative combination chemotherapy and the monitoring of the disase process bu serum AFP. We report a case of 30-year-old woman with endodermal sinus tumor of the ovary. This tumor was stage Ic. Postoperatively, she received one cycle of VAC and three cycles of BEP combination chemotherapy. She has been still alive and free of disease for 11 months after operation.

혈액투석 환자의 산-염기 불평형에 관한 연구

강종명,박한철,안정경,이창화,강경원,김상목,박찬현 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.2

To study the effect of metabolic acidosis, which is generally present on chronic hemodialysis patients, blood gas analysis of A-V fistula blood, chemical chemistry data, nutritional parameters, and illness outcome were correlated on 146 patients. The results : 1) 28 paired samples of A-V fistula blood pH(7.318 ±0.052) were different from femoral artery blood pH(7.332±0.048), but the two were closely correlated (p=0.000). The correlation on PO₂and PCO₂tests were also strong. 2) The average of A-V fistula blood gas studies were pH 7.282±0.061. 3) The values of A-V fistula blood pH were most closely related with serum CO₂content, followed by PCO₂BUN, PO₂and phosphate and not with nutri-tional status, frequencies of hospital admission and Karnofsky score. 4) During the 18 months observation, 8 of 146 patients died of medical causes. The expired cases were low in serum albumin, old in age, long in dialysis interval. The mortality rate was not related with blood gas parameters. 5) The nutritional parameterslthough loose, worse in the group of serum CC4 content more than 20mEq/L. 6) After sodium bicarbonate 1.5-3.0gm/day by mouth, there were insignificant rise in pH and in nutritional parameters. The incidence of gastrointestinal symptoms, however, increased significantly. In conclusion, nutritionally better patients were scattered in the serum CO₂content below 20mEq/L, and therefore, near normal acid-base stuatus may suggest poor nutritional status. However, in acidotic patients, treatment with alkali may improve nutritional state further.

재태기간 진단기준에 따른 지연임신의 빈도 및 분만결과

강영호,김용철,이종민,박종규,왕영미,조경훈,강창성,박연이 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.7

1993년 9월부터 1994년 2월까지 한일병원 산부인과에서 임신 28완전주수 이후에 분만한 총 4,823례를 제 1군은 산모의 월경력이 불규칙하거나, 최종월경일을 모르거나, 출산 또는 소파수술 시행후 무월경 상태에서 임신이 된후 초음파 소견상 임신 26완전주수 이상에서 산전진찰을 시행한 산모군으로 하였고 제 2군은 산모의 월경력이 규칙적이고 최종월경일을 정확히 기억하고 있는 산모중 임신 26완전주수 이후에 산전진찰을 시행한 산모군으로 제 3군은 월경력에 관계없이 초음파상 임신 26완전주수 이전에 주기적인 초음파를 통하여 재태기간을 신뢰할 수 있는 산모군으로 분류하였다. 그 결과로 제 3군의 임신기간, 지연임신의 빈도, 유도분만율 및 유도분만 실패율이 제 2군에 비하여 유의하게 감소하였으며 저자들은 이번 연구를 통하여 임신초기 주기적인 초음파에 근거한 임신기간(gestational age)의 산출이 최종 월경일에 근거한 경우보다 중요하다는 결론을 내릴 수 있었다. A total of 4,823 births which occurred after 28 completed weeks of gestation at Han-Il hospital from September, 1993 to February, 1994 were studied and divided to 3 groups. The group I consisted of 419 women who had irregular menstruation, unknown last menstrual period pregnancy during amenorrhea after delivery or D/E and whose USG findings at first antenatal check were more than 26 completed weeks of gestation. The group II consisted of 2,848 women who had regular menstruation, accurate last menstrual period and whose USG findings at first antenatal check were more than 26 completed weeks of gestation. The group III consisted of 1,556 women who had serial USG before 26 completed weeks of gestation irrespective of menstrual history. The results obtained in this study were that gestational age, incidence of postterm pregnancy, induction rate and induction-failure rate of group III were significanly lower than those of group II. It can be concluded that the gestational age from the early USG is clinically more important than that from last menstrual peroid.

Cisplatin을 포함한 항암화학요법 치료시 환자에서 발생하는 오심 및 구토에서의 정맥주사용 및 경구용 Tropisetron과 Ondansetron의 비교연구

강순범,이효표,송용상,김재원,박노현,김용범,이철민,서동기 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.10

Tropisetron의 항암화학요법 후에 발생하는 급성 및 연성 오심의 조절 효과는 ondansetron과 비교하여 유의한 차이가 없었고 구토의 조절 효과에서도 두 군 사이에 유 의한 차이가 없었다. 부작용의 발생 빈도와 정도에서도 두 군 사이에 유의한 차이를 보이지 않았다. 그러나 하루에 두 번 이상 투여해야 하는 ondansetron과는 달리 tropi setron은 하루에 한 번 투여하여 ondansetron과 비슷한 효과를 얻을 수 있어서 투여 방법의 간편함을 고려할 때 tropisetron이 ondansetron과 함께 항암화학요법을 시행받는 환자의 오심과 구토의 조절에 유용하게 사용될 수 있을 것으로 사료된다. Background & Aim: Nausea and vomiting are, from the patient`s viewpoint, by far the most distressing adverse effects related to the treatment with anticancer chemotherapy, especially with cisplatin-based chemotherapy. The purpose of this study was to evaluate the antiemetic effectiveness and tolerability of tropisetron (Navoban ) and ondansetron (Zofran ) in gynecologic cancer patients receiving cisplatin-based combination chemotherapy. Materials & Methods: Sixty seven patients receiving cisplatin-based combination chemotherapy were enrolled after randomization into two groups (group A and group B) and received either the tropisetron or the ondansetron respectively. The efficacy of controlling acute/delayed emesis and adverse effects were compared. Statistical analysis was performed using the Mantel-Haenszel test. Results: The efficacy of controlling nausea with tropisetron and ondansetron was 80.6% and 80.0% in day 1; 64.5% and 70.0% in day 2; 61.3% and 76.7% in day 3; 74.2% and 66.7% in day 4; 67.7% and 76.7% in day 5; 80.6% and 80.0% in day 6 respectively. The efficacy of controlling vomiting with tropisetron and ondansetron was 83.9% and 93.3% in day 1; 71.0% and 80.0% in day 2; 74.2% and 76.7% in day 3; 77.4% and 73.3% in day 4; 87.1% and 70.0% in day 5; 90.3% and 80.0% in day 6 respectively. Statistically all of these results were not significantly different. Headache, constipation and diarrhea were common adverse effects in both groups and these were not statistically significantly different in incidence and severity. Conclusions: Although the efficacy of tropisetron in controlling nausea/vomiting induced by cisplatin-based chemotherapy is not more excellent than that of ondansetron, it seems to be a clinically useful drug due to its simplicity of administration.

자궁경부암에서 복합선행화학요법의 예측인자로서 bcl-2 , p53 유전자 발현 및 Apoptosis의 유용성에 대한 연구

강재성,이종민,조현이 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.5

목적; 자궁경부의 편평상피세포암종 환자에서 bcl-2와 p53 유전자의 과발현과 apoptosis의 정도가 항암치료의 효과를 예측하는데 유용한지 여부를 알아보고자 하였다. 연구 방법; 질 확대경하 조준 생검으로 자궁경부의 편평상피세포암종으로 진단받은 36명을 연구 대상으로 H-E 염색하여 apoptosis를 일으키고 있는 세포를 관찰하였고 bcl-2와 p53 유전자에 대한 면역조직화학적 염색을 실시하였다. 결과; bcl-2 유전자의 과발현은 선행화학요법의 비반응군에서 반응군에 비하여 유의하게 많이 관찰되었으며[p=0.031], p53 유전자의 과발현은 선행화학요법의 비반응군에서 반응군에 비하여 많이 관찰되었으나 통계적으로 유의한 차이는 없었고[p=0.407 / 0.309] apoptosis는 선행화학요법의 반응군에서 비반응군에 비하여 많이 관찰되었다[p=0.011]. 결론; bcl-2의 과발현과 apoptosis의 정도는 선행항암요법의 반응성과 관련이 있으며 예측인자로서 사용될 수 있을 것으로 사료되며 p53의 과발현이 갖는 생물학적 의미는 보다 많은 연구가 필요하리라 생각한다. Objective; We studied the relationship between bcl-2, p53 gene expression, apoptosis and clinical response to neoadjuvant chemotherapy in patients with cervical squamous cell carcinoma to evaluate the possibility of using them as useful markers for sensitivity in selecting patients to cisplatin-based neoadjuvant chemotherapy. Methods; This study included 36 patients with locally advanced cervical squamous cell carcinoma. The specimens were obtained from cervical squamous cell carcinoma before chemotherapy by colposcopy directed biopsy and processed for immunohistochemical staining with a monoclonal antibody against bcl-2 and p53 after hematoxylin-eosin staining to review the pathologic diagnosis and to count apoptotic cell. Results; bcl-2 gene was significantly more expressed in non-responders than responders to chemotherapy. p53 gene was more expressed in non-responders than responders to chemotherapy, but the difference was not statistically significant. Apoptosis was significantly more encountered in responders than non-responders to chemotherapy. Conclusion; Overexpression of bcl-2 and increased apoptosis are correlated with the clinical response to chemotherapy and would be considered as useful markers for sensitivity in selecting patients to neoadjuvant chemotherapy.