자궁경관점액의 생물리학적 성질의 평가

신용철(YC Shin) 대한산부인과학회 1973 Obstetrics & Gynecology Science Vol.16 No.5

The mechanisms involved by which the cyclic changes of nomal cervical mucus either block or enhance sperm migration in the female genital tract are largely due to the biophysical changes which take place during menstrual cycle. If these mechanisms are well understood, it may be possible to develop ways by which normal mid-cycle cervical mucus can be safely altered to be aneffective barrier of sperm migration. On other hand, steroidal contraceptives containing progestogen induce characteristic physicochemical changes in the cervical mucus, which are considered to be significant for the contraceptive effect, in view of the definite inhibition of sperm migration in cervical mucus. Therefore, comparison of the biophysical properties of cervical mucus obtained from the normal menstrual cycle and oral contraceptive group may be an interesting study. The author applied a new microscopic technique described by Davajanx et al, that is, the stretching of cervical mucus prior to slow drying (under cover slip) in order to demonstrate its biophysical characteristics, the observed denditic crystal patterns are compared each other and measured their sizes. Studies were performed on each ten cases from the proliferative, ovulatory, and secretory phases of the normal menstrual cycle and twenty cases of oral contraceptive group, and seven cases of early pregnancy. The results are as follows; 1. The predominant feature of the stretched mucus obtained from a normal proliferative phase and mid-cycle is the parallel linear alignment of the dendritic crystals, but that of secretory phases reavealed the dendritic crystals to be in a network pattern. 2. The parallel orientation of dendritic crystals with the formation of clear channels may be essential for successful migration of sperm. 3. The stretched mucus of the oral contraceptive group revealed the dendritic crystals to be in a network pattern without regard to menstrual days. Network pattern of oral contraceptive group did not differ from that of secretory phase. 4. Network pattern of the dendritic crystals may inhibit the way of sperm migration. 5. The stretched mucus of the early pregnant women showed the parallel arrangement of the columns, which are consists of two phase contrasted components in cervical mucus.

유루무월경증후군의 평가

신용철(YC Shin) 대한산부인과학회 1981 Obstetrics & Gynecology Science Vol.24 No.5

유루무월경증후군(galactorrhea amenorrhea syndrome)은 Chiari씨의 보고이후 학계에 많은 관심을일으켰으나 Prolactin(이하PRL로 약함)이 분리정제된 것은 비교적 최근의 일이다. 뇌하수체 전엽에서 분비되어 유집의 분비를 촉진시키는 이 호르몬을 방사면역측정 할 수 있게 되면서 고PRL혈증(hyperprolactinemia)에 대한 연구가 활발해졌고 시상하부-뇌하수체의 정신내분비기전이 밝혀졌으며, 유루무월경증후군의 병적생리를 더 잘 이해하게 되었다. 진보한 방사선진단기술과 PRL의 정밀한 측정 및 신경내비기능검사에 의하여 병인적 진단능력이 향상되었으며 transsphenoidal microscopic pituitary surgery 의 도입과 새로운 치료의학의 발달로 유루무월경증후군의 치료법이 특수해지고 세분되었다. 최선의 치료를 제공하기 위해서는 PRL분비선종과 다른 기능성 원인들의 감별은 물론 미세하수체선종(pituitary microadenoma)의 조기발견과 중구신경계의 기능이상을 국지화(localization)해야 한다. 유루증을 일으키는 원인을 보며는 시상하부에서 PRL 억제인자의 성합을 방해하는 질환 및 약품 PIF의 운송을 방해하는 질환, PRL을 분비하는 하수체선종, 갑상선이나 성선의 기능이상을 포함하는 뇌하수체질환, 흉벽의 말초신경 손상이나 자궁적출술, 상상임신과 같은 신경성 자극 등이 있는데 이상은 모두 PRL의 과도한 분비를 일으키거나 PRL에 대한 반응을 위치하고 갑상선과 부신질환에 의하는 수도있다. 유루증환자가 발견되면 먼저 PRL의 혈중농도를 측정할 것이며 PRL값이 상승되어 있으면 병력과 이학적 소견을 참고로 고 PRL혈증에 적절한 해석을 내린다. 조사가 필요하다고 판단되면 일차적으로 뇌하수체 호르몬의 기초수준과 시야를 측정하고 터키안의 다원단층촬영술과 기뇌촬영술과 경동맥촬영술등이 있고 내분비평가에는 성장호르몬과 성선자극호르몬의 여량(reserve)에 대한 시험과 시상하부-하수체-부신 축의 시험 그리고 PRL의 자극 및 억제시험이 포함된다. 저자는 유루무월경증후군의 진단 및 기능적 평가방법을 중신으로 기술하고자 한다.

만기임신양수의 산염기균형에 관한 연구

신용철(YC Shin) 대한산부인과학회 1978 Obstetrics & Gynecology Science Vol.21 No.11

In recente year a number of components of the amniotic fluid have been noted to change progressively during pregnancy and accordingly have been intensively investigated as indicators of fetal maturity and well-beings for better management of mothers and babies. Amniotic fluid has also become of practical interest with the advent of dragnostic amniocentesis: water and solute exchange directly between amniotic fluid and various parts of pregnant uterus across extracellular membrane as extracellular compartment of human tissues. It is the object of the present study to show that a proper interpretation of the acid-base value of the amniotic fluid may offer important information about general conditions of the fetus and neonate. Experiments were designed with each group of twenty vigorous and depressed babies delivered by cesarean section under spinal anesthesia in healthy Korean women without O2 inhalation.l Acid-base values were measured in arterial blood of mothers radial artery and fetal umbilical vein, and amniotic fluid which aspirated just before taking out babies from amniotic sac. Following result were obtained: 1. Average values of partial pressure of oxygen and carbon dioxide and hydrogenion concentration(pH) in the amniotic fluid of twenty vigorous babies(above Apgar score 8) were 45 0.28 mmHg, 51 0.30 mmHg, and 62 0.34 nEq/L(pH=7.21) respectively. 2. Average values of partial pressure of oxygen and carbon dioxide and hydrogenion concentration(pH) in the amniotic fluid of twenty depressed babies(under Apgar score 4) were 20 0.21 mmHg. 80 0.20 mmHg, and 123 0.84 nEq/L(pH=6.91) respectively. 3. Correlation of hydrogenion concentration with PO2 and PCO2 was not observed. 4. There was a good correlation in the acid-base status of the amniotic fluid of vigorous and depressed babies with those of neonate. 5. It is suggestive that the values of acid-base status in amniotic fluid near term reflect the general condition of neonate and may serve the estimation of fetal status.

신장이 분만에 미치는 경향

김난희(RH Kim),박진배(JB Park),신용철(YC Shin),이위창(WC Lee) 대한산부인과학회 1975 Obstetrics & Gynecology Science Vol.18 No.10

1. The incidence of C/S showed a gradual significant decrease from the shorter to the longer stature group. 2. Although the incidence of C/S showed a gradual increase from the younger to the older age group in longer women, the most prominent result showed in shorter and older nullipara 3. Ture conjugate diameter was lower in shorter women. 4. The incidence of antepartum complications was higher in the shorter stature, but no difference was noted in postpartum complications 5. Duration of labor was significantly prolonged in short primiparas. 6. There was no sighnificant relationship between the maternal height and infant weight. 7. The premature delivery was more prevalent in short stature than other group.

양성난소점액낭종의 파열에 의한 복막점액종의 2예

김난희(RH Kim),박진배(JB Park),신용철(YC Shin),이위창(WC Lee) 대한산부인과학회 1975 Obstetrics & Gynecology Science Vol.18 No.8

저자등은 49세와 50세의 여자에서 우측난소의 점액 낭종으로 부터 생긴 복막점액종 2예를 경험하엿기에 보고하며 문헌고찰을 하였다. myxoma peritonei is a relatively rare condition in which massive gelationous accumulation in the peritioneal cavity and gelatinous infiltration of the serous tissue resulting from perforation of mucinous cystoma or mucocele. Two cases of myxoma peritonei originated from benign mucinous cystadenoma of the ovary were reported with a brief review of the literature.

흉추강내로 전이된 신경아세포종 1예

신용철,박동빈,신규만 梨花女子大學校 醫科大學 醫科學硏究所 1989 EMJ (Ewha medical journal) Vol.12 No.2

The authors report a case of neuroblastoma with metastasis into the throacic spinal canal. It manifested as an extradural mass with spinal cord compression. The clinicopathologic features, radiologic findings & surgical treatment are discussed with brief review of the literatures.