산욕기에 있어서 Bromocriptin 투여로 인한 혈중 Prolctin치의 감소가 FSH, LH 및 Estradiol 치에 미치는 영향

라건영(KY Rha),이진용(JY Lee) 대한산부인과학회 1979 Obstetrics & Gynecology Science Vol.22 No.1

To elucidate the role of prolactin on the function of hypothalamic pituitaryovarian axis during the puerperium, concentrations of FSH, LH, prolactin and estradiol were measured in the sera of 8 lactating women and 7 women treated with bromocriptine. In the bromocriptine treated group serum mean prolactin level fell rapidly to 34ng/ml by the postpartum 3rd dary in association with the effective suppression of lactation, whereas the sustained high mean prolactin level of 247ng/ml on the postpartum 14th day in the lactating group. Serum FSH was barely detectable until the postpartum 5th day with increase back to 3-4mIU/ml on the postpartum 7th day in the lactating and bromocriptine treated groups. There was no significant difference in the concentration of FSH between both groups until the postpartum 14th day. Serum LH levels were higher than those of the normal menstrual cycle in both groups until the postpartum 14 days, probably due to contamination with remaining chorionic gonadotropin. Following clearance of placental estradiol during the post postpartum 7 days serum estradiol levels in the bromocription treated group rose again to 253 pg/ml at postpartum day 14, whereas those in the lactating group were remained low until the postpartum 14th day. In conclusion, it is suggested that the ovaries are the more refractory part of the hypothalamic-pituitary-ovarian axis during the postpartum period, due probably to the inhibiting role of prolactin on the ovarian steroidogenesis.

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.

한국인의 Friedman Curve와 Buscopan Compositum이 이에 미치는 영향

이효표(HP Lee),라건영(KY Rha) 대한산부인과학회 1968 Obstetrics & Gynecology Science Vol.11 No.2

For many years the traditional method of characterizing labor has been made by recording the length of the first, second and third stage. In 1954, Friedman developed a method which was more suitable for the statistical evaluation of the curve of labor. The Friedman curve was obtained by carefully recording the degree of dilation of the cervix in the coures of time. In this paper primigravidae and multigravidae were selected from the department of obstetrics and gynaecology, Seoul National University Hospital and the labor curves were recorded for each patient. In order to evaluate the normal labor curve in Korean women, 54 normal primigravidae and 51 multigravidae were selected out. Besides, 39 primigravidae and 34 multigravidae were selected in order to assess the effect of Buscopan Comp. This drug was administered in the frist stage of labour when the cervix was dilated to 2-4 cm, and regular and moderately strong contractions were present. The result of this study is that the labor curve in Korean women is very similar to the Friedman curve, and that Buscopan Comp. has the property shortening remarkably the first stage of labor. Consequently the over all duration of labor in the Buscopan Comp. group was much shorter than that in the control group.

양수 Creatinine농도에 대하여

김정구(JK Kim),라건영(KY Rha) 대한산부인과학회 1979 Obstetrics & Gynecology Science Vol.22 No.9

The purpose of the present study is to see whether the determination of amniotic fluid creatinine concentration has a clinical usefulness in prediction fetal lmaturity, and factors by which it is influenced. Creatinine concentration in the paired amniotic fluid and maternal serum was measured by Technicon autoanalyzer Ⅱ in the 73 normal pregnant women, 24 preeclamptic women, and 7 women delivered S.G.A.I.(Small for Gestational Age Infant) between 23 to 43 gestational weeks. The results were as follows : 1) The mean amniotic fluid and maternal serum creatinine concentration and the mean AF/MS ratio(amniotic fluid/maternal serum creatinine ratio) in preeclampsia were significantly higher than those in the normal pregnancy. 2) The mean amniotic fluid creatinine concentration in S.G.A.I. was lower tahn that in the normal pregnancy, and this has stastically borderline significance(0.05)

한국인 임산부에 있어서 임신특속 기간에 따른 양수내 포도당농도치에 관한 연구

신창재(CJ Shin),라건영(KY Rha) 대한산부인과학회 1981 Obstetrics & Gynecology Science Vol.24 No.3

Available biochemical parameters for the assessment of fetal maturity are still controversial . Since amniotic fluid glucose shows a progressive decrease with advancing gestational age, an investigation was done to see whether amniotic fluid glucose could be used as an index of fetal maturity. In 40 samples of amniotic fluid obtained from women at different gestational age, a relatively high degree of correlation was seen between gestational age and amniotic fluid glucose levels. Age, parity, and preclampsia did not have any effect on amniotic fluid glucose. While amniotic fluid glucose changes as the fetus matures , too much overlap in the values seen between the samples obtained before and after 37 weeks of gestation precluded its use as a clinically useful test of fetal maturity. It is suggested that the decrease observed in amniotic fluid glucose near term is related to the maturity of fetal kidney function.

Mayer-Rokitansky-Kuster-Hauser 증후군 3예의 치험

김정구(JK Kim),임선재(SJ Lim),이양우(YW Lee),오보훈(BH Oh),이효표(HP Lee),라건영(KY Rha) 대한산부인과학회 1979 Obstetrics & Gynecology Science Vol.22 No.6

저자들은 최근 서울대학교 의과대학 부속병원 산부인과학교실에서 M.R.K.H. 증후군 3례를 치험하였기에 문헌적 고찰과 함께 증례보고를 하는 바이다. The Mayer-Rokitansky-Kuster-Hauser syndrom refers to the clinical entity consisting of: normal female secondary sex characteristics, normal external genitalia, congenital absence of the vagina, a rudimentary uterus in the form of bilateral noncanaliculated muscular buds, and normal tubes and ovaries with normal cytogenetic and endocrine evaluation. Three cases of Mayer-Rokitansky-Kuster-Hauser syndrome were presented and the literature was reviewed briefly.