전이된 고위험임신성 융모상피종양에서 항암화학요법에 따른 합병증 및 치료성적

이혜승(HS Lee),박찬규(CK Park),최동희(DH Choi),김재욱(JU Kim),이창훈(CH Lee) 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.3

The choice of initaial treatment modality in the high risk group of metastatic gestational trophoblastic neoplasia in which resistance to single agent chemotherapy is predicted, is very important. To investigate the significance of initial treatment modality, results of chemotherapy and subsequent toxicities were compared between primary and secondary combination chemotherapy after failure of initial single agent chemotherapy. 48 subjects with high risk metastatic gestational trophoblastic neoplasia were admitted to Severance Hospital and received anticancer chemotherapy from January, 1970 to December, 1988. The results of chemotherapy according to modality and subsequest toxicities were retrospectively analyzed. The results were as follows : 1. In the primary combination chemtoherapy group, the remission rate was 69.6%, mean remissiin duration was 18.3 months, 5 year cumulative survival rate was 66.1%, all of which were significantly better than either the single agent chemotherapy group or the secondary combination chemotherapy group. 2. The incidence of hepatotoxicity and granulocytopenia, 80% and 83.3% respectively, were more frequent in the secondary combination chemotherapy group than the other groups. 3. After the use of primary combination chemotherapy became popular since 1983, remission rate was improved up to 81.8%, from 48.7%. The mean remission duration and the 5 year cumulative survival rate were also significantly increased when compared to the period from 1970 to 1982. In conclusion, primary combination chemotherapy in high risk group of metastatic gestational trophoblastic neoplasia is recommended not only to improve remission rate and survival, but also to reduce toxicities of chemotherapy.

융모막 융모샘플링(C.V.S)이 임산부 혈청 alpha-Fetoptrotein치에 미치는 영향에 관한 연구

양영호(YH Yang),김도형(DH Kim),김창규(CK Kim),이명선(MS Lee),이창훈(CH Lee) 대한산부인과학회 1989 Obstetrics & Gynecology Science Vol.32 No.12

연세대학교 의과대학 산부인과학교실에 산전유전질환 진단 및 치료적 임신중절을 목적으로 내원한 56명의 환자중 27명을 대상으로 융모막 융모셈플링을 실시하엿으며 융모채취전후 MSAFP치를 측정하여 이를 임신주수, 융모채취량, 카테터 삽입회수와 비교분석하여 다음과 같은 결론은 얻었다. 1. 임신 6-12주의 주수별 MSAFP치의 중앙값은 각각 3.0, 3.0, 3.0 , 3.0, 3.7 , 5.9, 10.0 IU/ml 이었다. 2. CVS를 시행한 27예중 18예에서 (59.3%) 20%이상의 MSAFP증가를 보였고, 이중 50%이상 100%미만은 15예로 55.5%, 100%이상은 13예로 48.1%의 빈도를 보였다. 3. CVS 후의 MSAFP로부터 태아모체성 출혈량을 계산하여 60ul이상 3예, 100ul 1예의 결과 를 보였다. 4. 채취된 융모양이 많을수록 MSAFP가 증가하였다. 5. 같은 양의 융모채취에 대해 카테터 삽입회수 3-4회인 군에서 1-2회인군에비해 MSAFP의 증가폭인 컸다. 본연구결과 CVS 후의 태아모체성 출혈을 주소하기 위하여는 CVS에 충분한 경험을 가진 산 부인과 의사와 초음파 및 유전학실험실 요원간에 긴밀한 협조하에 가능한한 최소한의 카테 터 삽입회수와 검사에 필요한 최소량의 융모채취가 필요하다고 사료된다. FMH during CVS may contribute in subsequently raising the chance of abortion and even cause maternal Rh isoimmunization . Detection and quatitation of FMH could be made by determining the changes in MSAFP level by enzyme immunoassay before and 15 minutes after CVS. CVS was perfomred in 27 patients for prenatal genetic diagnosis using a flexible plastic catheter introduced transcervically under real-time ultrasonography guidance . MSAFP levels were analyzed comparatively according to their gestational weeks, amounts of villi sampled and the frequency of catheter-pass. Fifty-nine percent of these patients had an increaed MSAFP levels by 20 per cent or more. Such a rise was thought to reflect crossing of fetal blood through intervillous space upon performing CVS, A prospective correlation was obtained. The group given three to four catheter-passes had more elevated levels of MSAFP than the group given only one or two passes . In three of these patients more than 60 ul of fetal blood was transferred with only one of them presumed with more than 0.1ml of expected volume of FMH. To minimize the chance of FMH during CVS, a least amount of villi should be obtained for diagnosis with as few catheter-pass as possible.

감속기용 유량제어 솔레노이드 밸브 최적 설계

김병찬(BC Kim),안성해(SH An),정영진(YJ Jeong),하정완(JW Ha),박강우(GW Park),노의동(ED Roh),이창훈(CH Lee) 한국자동차공학회 2022 한국자동차공학회 부문종합 학술대회 Vol.2022 No.6

산전유전질환진단에 있어서 임신주수와 그 검사방법에 따른 염색체검사의 유용성에 관한 연구

양영호(YH Yang),최인철(IC Choi),김세광(SK Kim),박용원(YW Park),장기홍(KH Jang),이창훈(CH Lee),송찬호(CH Song) 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.11

The increasing incidence of congenital malformations and anomalies today is giving rise to heightened awareness and interest. The diagnostic modalities currently available include chorionic villi sampling (1st trimester), amniocentesis (2nd trimester), cordocentesis, placenta biopsy (2nd, 3rd trimester) and etc. This study aims to demonstrate the effectiveness of chorionic villi sampling, amniocentesis, cordocentesis and placenta biopsy in the prenatal detection of chromosomal anomalies according to the gestational ages of the fetuses, and was conducted from January 1985 to July 1990 at Yonsei University, College of Medicine. Three hundred and sixty-four cases (175 cases of chorionic villi sampling, 170 cases of amniocentesis, 19 cases of cordocentesis and placenta biopsy0 who had underwent prenatal cytogenetic studies according to their gestational ages were selected for subjects. Analysis of indications, fetal karyotypes and fetal outcomes were performed. The indications for chorionic villi sampling and amniocentesis wer 39.7% and 32.3 for advanced maternal age, 22.8% and 28.8 for previous chromosomal abnormality, 20.1 % and 21.2% for previous congenital anomaly of the fetus respectively. The indications of cordocentesis and placenta iopsy were 94.7% for suspicious ultrasound findings and 5.3% for late booking or unsuccessful amniotic fluid cell culture respectively. Abnormal fetal karyotypes were obtained in 12 cases (3.3%). The cytogenetic results of 5 cases with parental balanced translocation were same as the parental karyotypes in 2 cases, 1 case of partial tirsomy and 2 cases of Down Syndrome. Fetal loss rates were 5/175(2.9%) in chorionic villi sampling and 1/171 (0.6%) in amniocentesis. Therefore, we hope to make it possible to apply these modalities to high-risk pregnancies regardless of the gestational ages and thus reduce the incidence of congenital anomalies.

급성 신우요관이행부폐색을 유발한 성체 흰쥐에서 환측 신장의 혈역동학적 변화와 Hypoxic Inducible Factor-1α 및 Inducible Nitric Oxide Syntase 발현

이상돈,이창훈,최은호 大韓泌尿器科學會 2003 Korean Journal of Urology Vol.44 No.5

산전 진단된 연골무형성증

양영호,박용원,이창훈 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.3

연골 무형성증은 사지 및 관골의 단축을 그 특징으로 하는 질환으로써 약 10,000-25,000명당 한명꼴로 나타난다. 이 질환은 상염색체 우성으로 유전되지만 새로운 돌연변이에 의한 경우가 원인의 80%를 차지하기 때문에 정상 표현형의 부모에서라도 충분한 태아골격에 대한 평가없이는 산전진단이 힘들다. 과거에는 방사선검사에 수반되는 태아에 대한 영향 때문에 충분한 검사가 불가능 했으나 최근에는 산전 초음파의 발달로 진단이 가능하게 되었다. 저자들은 26세 초산부로 임신 37주 처음 내원하여 산전 초음파진단상 양수과다증 및 사지단증과 선천성기형으로 진단된 경우로, 가족력상 양쪽 모두 유전학적 질환은 없었고, 방사선 및 약물 복용에 대한 과거력도 없었으며, 임신 40주에 3,440gm의 남아를 질식 분만한 예로, 분만후 태아관찰소견상 상지 및 하지가 짧았으며, 전두골돌기 및 Nasal bridge가 함몰되어 있고, 상완골이나 경골 등이 짧고 넓어져 있으며, 천장골 절흔이 작아져 있는 전형적인 연골 무형성증 1예를 경험하였기에 문헌적 고찰과 함께 초록보고하는 바이다. In utero detection of achonaroplasia was possible in a late pregnancy in 1 26 year old woman. Both gravida and spouse were phenotypically normal with no evidence of any skeletal dysplasia in either of their family pedigree. The baby subsequently born was typically achondroplastic.

반복자연유산의 세포유전학적 연구

양영호,김세광,이창훈,김미순 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.4

본 연구는 1981년 7월부터 1987년 6월까지 6년간 연세대학교부속 유전학검사실에 의뢰된 3회이상의 반복자연유산을 주소로 하는 52쌍의 부부를 대상으로 하여 말초혈액의 임파구에 대한 염색체 분석을 시행하여 염색체 이상의 유형 및 빈도를 조사산출한 결과 다음과 같은 결과를 얻었다. 1. 염색체 이상 빈도는 총 52쌍 중 8예(부자 4예, 모친 4예)로서 15.4%를 나타내었다. 2. 8예 중 2예(3.8%)에서 tandem translocation이 모두 여성에서 발견되었다. 3. 부염색체이상은 1예의 inversion을 포함하여 14ps^+, 15ps^+, long Y 등의 6예가 발견되어 11.1%의 빈도를 나타냈다. 4. 발견된 염색체 이상 8예 중 6예가 3회유산경험쌍에서 나타났다. 이상의 결과로 보아 습관성반복유산을 호소하는 환자에게서 부부의 염색체 분석을 시행하는 것이 바람직하며, 또한 이들 부부의 경우 태아 손실의 6~16%가 부친 염색체의 이상으로 오기 때문에 장차의 임신에 대하여 산전 세포 유전학적 검사를 하는 것이 좋다고 하겠다. Karyotyping of peripheral blood lymphocytes was made of 52 couples with apparently normal phenotypes having a history of habitual abortion who had visited Yonsei University Medical Center from July 1982 to June 1987 in order to evaluate, if any, the frequency and types of chromosome abnormality. The overall incidence of chromosome abnormality was 15.4 percent (8 in 52). Tandem translocation was detected in the two, who were all females. There were six other abnormalities (11.1 percent) including one case each of inversion, 14ps^+, 15ps^+, and long Y. Sixty-two percent of the detected chromosomal abnormalities were from the couples with a history of habitual abortion, suggesting a positive correlation between chromosomal abnormality and the number of spontaneous abortion. Our findings support than karyotyping is worthwhile in couples presenting with a history of recurrent abortion.

영아의 악성 횡문양 신종양

신동길,이상돈,임영탁,이창훈 大韓泌尿器科學會 2003 Korean Journal of Urology Vol.44 No.4

윌름종양으로 오인한 신장 내 신경모세포종

박현준,이상돈,이창훈 大韓泌尿器科學會 2003 Korean Journal of Urology Vol.44 No.4

악성종양의 발현이 척추증상으로 나타난 전이성 척추종양 환자의 원발 병소에 대한 분석

허종희,곽호신,장웅규,이창훈 대한신경외과학회 2003 Journal of Korean neurosurgical society Vol.33 No.1