정상임신 중 , 후반기 태아 대퇴골 성장의 초음파적 계측에 의한 임신연령 측정

곽미영(MY Kwak),오수영(SY Oh),육순오(SO Yook),이경림(KR Lee),전종영(JY Jun) 대한산부인과학회 1987 Obstetrics & Gynecology Science Vol.30 No.4

임신 중 1/3기부터 만삭까지의 정상임부 574례를 대상으로 하여 그 각 주별 태아의 대퇴골길(femurlenght)를 측정 분석한 결과 다음과 같은 결론을 얻었다 1 임신 중 1/3기(19주에서 27주간)에 있어서 각주별 태아 대퇴골길이의 주당 평균성장치는 2 52mm로서 그 평균 성장치의 분산범위는 비교적 좁은 폭의 변이를 보였으며 임신주수와 대퇴골길이의 성장치와의 사이에 현저한 상관관계가 있었다(r=0 9320, t=34 200, p<0 0001) 2 임신 후 1/3기(28주에서 41주)에 있어서도 각 주별 대퇴골 평균성장치는 1 618mm로서 임신 중 1/3기에 비하여 성장률 이 비교적 완만한 경항을 보였고 임신주수와 대퇴골길이의 평균성장치와의 관계는 역시 분산범위의 폭이 좁았으며 그 양자간에 현저한 상관관계를 보였다(r=0 9092, t=43 304, p<0 0001) 3 결론적으로 태아의 대퇴골길이의 측정은(임신중기 및 후기)태아의 임신연령을 예측하는데 간편하고도 대단히 유용한 방법의 하나라고 분석되었다 그러나 그 기술에 있어서 상당한 숙련이 필요할 것으로 생각된다 The growth of the ultrasound fetal femur length during normal pregnancy is presented A total of 574 measurements of the fetal femur length from 19 week gestation through term were taken The data was analyzed by means of the method of least squares linear regression The results of this analysis were as follows: 1 Calculated growth rate of femur length in this study group was 2 52mm/week from 19 to 27 week gestation and the regression line of the femur lengths in the above same period of pregnancy was as follow Y= -25 487280+2 81919164X(r=0 9320, t=34 200, p<0 0001) 2 The growth rate of the femur length decreased to 1 618mm/week after 28 week up to 41 week gestation and the regression line of the femur lengths in the same period of pregnancy was as follow Y= 5 901830+1 675048X(r=0 9092, t=43 304, p<0 0001) 3 In conclusion, the measurement of fetal femur length by ultrasound was a very simple and useful noninvasive method in prdiction of gestational age of fetuses in the 2nd and 3rd trimester

초기임신에서 16 주 사이의 자궁동맥 혈류속도파형의 양상

김수평,이진영,신종철,백은정,최명희,곽은정,신재인 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.8

가톨릭대학교 의과대학부속 강남성모병원 산부인과 외래를 내원한 초기임신에서부터 16주사 이의 정상임산부 90명에서 시행된 90회를 대상으로 경질도플러 초음파를 이용하여 좌, 우 자궁동맥의 혈류속도 파형을 임신주수에 따라 분석하여 다음과 같은 결과를 얻었다. 1. 임산부의 평균연령은 27.8+-3.4세였고, 평균분만력은 1.4+-0.5회였다. 2. 임신이 진행됨에 따라 자궁동맥의 이완기말 혈류속도가 증가하는 파형과 특징적인 diastolic notch가 발견되었다. 3. 좌, 우 자궁동맥의 도플러 지수는 임신주수에서 유의한 차이가 없었다. 4. 좌, 우 자궁동맥의 평균 도플러지수는 임신주수가 진행되면서 전반적으로 계속적인 감소 경향을 보였다. 이상의 결과로 보아 자궁동맥의 혈류는 초기임신부터 시작하여 임신 16주이전에 이미 상당 한 변화가 있음을 알 수 있었으며, 태아의 건강상태 및 예후를 진단하는데 있어서 경질 도 플러 초음파의 조기 이용의 유용성에 대해서는 향후 더 많은 연구가 이루어져야 될 것으로 생각된다. Doppler studies of ueterine artery in normal pregnancy showed a progressive increase in diastolic blood flow starting early in the second trimester. The aims of this study were to evaluate whether uterine artery flow velocity waveforms decrease as advancing in gestational age and to compare whether there is a difference in S/D ratio between both uterine arteries from early pregnancy to 16 weeks in gestation. We conducted a study using a transvaginal pulsed wave and color Doppler in 90 normal singleton pregnant women, with a total of 90 instances. There was a progressive increase in end-diastolic velocity wave form with gestation. Diastolic notches were noted in all of cases. There was prograssive fall in S/D ratio with advancing in gestation. between right and left uterine arterises, S/D ratio in all gestational age were not a significant differences in all gestational age. These results suggest that the resistance to uterine blood flow is already getting a reduction in early pregnancy.

만성 허혈 후 통증모델에서 발생한 건측의 이질통과 척수의 중추감작

곽경화 ( Kyung Hwa Kwak ),정경영 ( Kyung Young Jung ),최지영 ( Jy Young Choi ),류태하 ( Tae Ha Ryu ),여진석 ( Jin Seok Yeo ),박성식 ( Sung Sik Park ),임동건 ( Dong Gun Lim ),김시오 ( Si Oh Kim ),백운이 ( Woon Yi Baek ),홍정길 ( Ju 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.4

Background: Mirror-image allodynia is a mysterious phenomenon that occurs in association with many clinical pain syndromes including complex regional pain syndromes (CRPS). Underlying mechanisms for the development of such pain are still a matter of investigation. Several studies suggest that activation of the N-methyl-D-aspartate (NMDA) receptor is essential for central sensitization as a base for persistent pain. The aim is to assess whether alteration of NMDA receptor expression correlates with the contralateral allodynia in the chronic post-ischemia pain (CPIP) model rats representing CRPS-Type I. Methods: Application of a tight-fitting tourniquet for a period of 3 hours before reperfusion produced CPIP in male Sprague-Dawley rats. The mechanical paw withdrawal thresholds to von Frey stimuli (using a dynamic plantar aesthesiometer) were measured as pain indicators in ipsilateral and contralateral hindpaws. Phosphorylation of the NMDA receptor 1 subunit (pNR1), assessed with Western blot, was measured in the contralateral L4-6 spinal cord. Results: Ipsilateral and contralateral mechanical allodynia is present at 4 hours after reperfusion, peaked at 3 days, and continued for 7 days after reperfusion. The relative density of pNR1 of CPIP rats significantly decreased in the contralateral L4-6 spinal cord compared to baseline value (P<0.05). There was significant correlation between paw withdrawal threshold and the relative density of pNR1 (ipsilateral; R2=0.75, P<0.01, contralateral; R2=0.60, P<0.01). Conclusions: These data suggest that pNR1 is correlated to the contralateral mechanical allodynia in CPIP rats. (Korean J Anesthesiol 2009;56:419~24)

유산과 동시에 시행한 복강경 불임술의 안전도에 관한 임상적 비교연구

김원규(WK Kim),전종영(JY Jun),박찬규(CK Park),곽현모(HM Kwak) 대한산부인과학회 1979 Obstetrics & Gynecology Science Vol.22 No.7

1977년 1월부터 12월까지 만 1년간 연세대학교 의과대학 산부인과 수태조절실에서 유산과 동시에 복강경 불임술을 시행한 158예(제1군), 유산만 시행한 666예(제2군), 복강경불임술만을 시행한 1361예(제3군)에 대해 임상통계학적으로 비교분석하여 다음과 같은 결과를 얻었다. 1. 수술당시 및 직후의 제1,2,3군의 합병증의 발생율을 보면 각각 0.63%, 0.00%, 0.15%였다. 2. 조기 수술후의 제1,2,3군의 합병증의 발생율은 각각 0.00%, 0.30%, 0.007%였다. 4. 제3군에서 1예의 임신이 있었다. 유산과 동시에 복강경불임술을 받은 제1군은 158예로서 비교적 적은 예의 경험이지만 통계학적 분석결과에 의하면 유산 혹은 복강경불임술을 단독으로 시행한 다른 두군에 비하여 의의있는 합병증 및 실패율의 차이는 없다고 사료되므로 이는 그 안전도에 있어서 별 차이가 없다는 것을 추정할 수 있었다. 고로 임신 10주 이내의 유산과 복강불임술을 동시에 시행할 경우 본 연구에서는 단독으로 시행한 군보다 합병증 및 실패율의 차이는 없으므로 불임수술의 수락도가 가장 높은 시기인 유산직후에 권장함이 좋다고 사료된다. To evaluate the safety of laparoscopic sterilization performed at the time of vaccum aspiration, records of 158 patients undergoing combined vaccum aspiration and laparoscopic sterilization(group 1) were reviewed and compared with those of 666 patients who had abortion only(group 2) and with those of 1361 patients who underwent laparoscopic sterilization only(group 3) with the same outpatient procedure. Mean operating time for the combined procedure was 8 minutes 52 seconds. Immediate complication rates for group 1, group 2, and group 3 were 0.63%, 0.00%, and 0.15%, respectively(P>0.05). Early postoperative complication rates for group 1, group 2, and group 3 were 0.00%, 0.3% and 0.07%, respectively(P>0.05). Late postoperative complication rates for group 1 and group 3 were 5% and 16% respectively(P>0.05). Our findings indicate that patients who underwent outpatient laparoscopic sterilization with abortion did not encounter higher rates of complications that the other two groups.

A Case of Paracentric Inversion of Chromosome 18 (q21.1q22.1)

( Gh An ),( Kh Choi ),( My Kim ),( Jy Han ),( Hk Ahn ),( Jh Chung ),( Mh Kim ),( Sw Lee ),( Yj Han ),( Dw Kwak ),( Yh Chae ),( Sy Park ),( Hm Ryu ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.98 No.-

We report on a case with a paracentric inversion of the long arm of chromosome 18: 46,XX,inv(18)(q21.1q22.1). A karyotype 46.XX.add(18) was found during antenatal diagnosis (amniocentesis) performed at local clinic because of advanced maternal age (38 years). And the pregnant woman visited our hospital at 18.4 weeks to confirm the result. We performed the amniocentesis and found the karyotype 46,XX,inv(18)(q21.1q22.1). The inversion was also found in the mother and the maternal grandmother of the fetus by chromosome studies from peripheral blood . The high resolution ultrasonography performed at 20.5 weeks showed normal findings. The diagnosis of paracentric inversion can be difficult and might be incorrect because of the variety of unpredictable unbalanced chromosome products that can result from a paracentric inversion. The vast majority of paracentric inversions are likely to be harmless. The risk of having an abnormal child for carriers of paracentric inversions is expected to be low. but sometimes by the variation of breakpoint or recombination process, various clinical phenotype can be seen : 18q- syndrome including: microcephaly, epicanthal folds, midface hypoplasia, and abnormally modeled ears, dermatoglyphic whorls on fingertips, clubfeet, hearing loss, and developmental delay. The mother is now ongoing pregnant state and the baby needs long term follow up after birth. This report underlines the importance of careful antenatal diagnosis and genetic counseling for parental and fetal paracentric inversion.

Genome-wide gene expression analysis in the fetal trisomy 21 placenta

( Yj Han ),( Ej Choi ),( Jm Lee ),( Dw Kwak ),( Sw Lee ),( Mh Kim ),( Jh Chung ),( Hk Ahn ),( Js Choi ),( Jy Han ),( My Kim ),( Jh Lim ),( Hyun Mee Ryu ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-

목적: To gain new insight of gene expression into the pathogenesis of trisomy 21 (T21) placenta, we performed whole human genome expression analysis in placenta tissue (normal and T21) samples. 방법: We profiled whole human genome expression of placenta samples from normal and T21 fetuses using GeneChip Human Genome U133 plus 2.0 array and predicted the functions of differentially expressed genes using bioinformatics tools. 결과: One hundred-ten genes were significantly differentially expressed in the T21 placenta compared with the normal placenta (33 down-regulated and 77 up-regulated). Among them, some genes were significantly associated with focal adhesion, Alzheimer's disease, and Parkinson's disease pathway. The down-regulated genes in the T21 placenta were distributed on various chromosomes. The down-regulated genes were significantly associated with cystitis, metaplasia, pathologic neovascularization, airway obstruction, and diabetes mellitus type 2. None of down-regulated genes were on chromosome 21 causing T21, whereas over half (59.7%) of up-regulated genes were located on chromosome 21. The up-regulated genes were significantly associated with T21 and T21-related disorders, such as mental retardation, neurobehavioral manifestations, and congenital abnormalities. 결론: Our findings provide a broad overview of whole human genome expression in the placentas of fetuses with T21 and could contribute to future research efforts concerning genes involvement in disease pathogenesis.

자궁경부종양의 맥관 형성과 선행항암화학요법과의 관계

조영래,전상식,이일창,곽정식,이택후,원재연,김대한,김삼식 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.7

자궁경부에 염증성 반응이나 종양성 병변이 없는 정상 자궁경부 조직 8예와 28예의 자궁경부 편평상피내종양조직과 항암화학약물요법 후 광범위 자궁절제술을 실시하여 최종 조직 소견을 얻을 수 있었는 46예의 자궁경부 편평상피 침윤암 환자의 생검 조직을 내피세포에서 분리한 CD34 항원에 대한 단일클론항체인 QBEnd/10 (BioGenex, CA, USA)을 이용한 면역화학염색을 하여 다음과 같은 성적을 얻었다. 1. 자궁경부 상피내종양군에서 정상 자궁경부 조직군에 비해서 신생혈관의 수가 의미있게 증가하였으며(p< 0.05) 상피내종양의 병변이 심할수록 신생혈관수의 증가도 비례하여 증가되었는데 이러한 결과는 경도의 자궁경 부 상피내종양에서부터 침윤암까지의 점진적인 진행 과 정에 맥관 형성이 관여함을 시사해 주었다. 2. 선행항암화학약물 치료를 실시한 침윤성 자궁경부 암군에서 치료의 반응이 우수한 군에서 평균 신생혈관의 수는 145.53±47.72(Mean±SD)개로 그렇지 못한 군의 101.40±30.70(Mean±SD)개에 비해서 의미있게 증가하였는데(p<0.01) 이러한 결과는 자궁경부암에서 선행항 암화학요법을 실시하는 경우에 그 반응도를 예측케 함으로써 환자에 따른 적절한 치료 방법의 선택 등 임상적 가치를 제공할 수 있겠다. 3. 침윤성 자궁경부암의 기존의 임상 및 병리조직학 적 예후인자들인 종양의 크기, 임파절 전이, 침윤의 깊이, 임파혈관의 종양세포 침범, 그리고 자궁방 조직침윤 등과 신생혈관수와는 통계학적인 상관관계가 없었으며 치료 후의 무병 생존율과 치료 전 종양의 생검 조직에서 의 맥관 형성 정도와도 통계학적인 상관관계는 없었다. 4. 선행항암화학요법을 실시한 23예에서 항암화학요 법이 자궁경부 편평상피암 조직의 맥관 형성에 미치는 영향은 항암치료 후 맥관 형성이 감소되는 경향을 보여 주었으나 통계학적으로는 의미가 없었다. 결론적으로 자궁경부 상피내종양에서 침윤성 암으로 의 진행에 맥관 형성이 관여되지만 자궁경부 침윤암에서 맥관 형성 정도를 독립적인 예후인자로 결정하는 것 은 아직까지 문제가 있다고 생각하며 다만 선행항암화학요법의 종양 반응도와 치료 전 생검 조직에서의 맥관 형성 정도 사이의 밀접한 관계는 앞으로 자궁경부암에 서 치료적 응용의 가치가 있다고 할 수 있겠다. Various clinical and histopathologic characteristics are currently used to obtain prognostic information about cervical carcinoma, but they do not predict accurately the outcome for individual patients. Thus, there is need to identify additional tumor characteristics that are able to predict more accurately the outcome for an individual patient with cervical cancer. Tumor microvessel density has recently been demonstrated to correlate strongly with disease aggressiveness in several types of malignancies. However, little is known of the significance of neovascularization in cervical cancer. In this study, we explored the relationship between microvessel count and progression of the cervical neoplasia, the correlation between response to neoadjuvant chemotherapy and tumor angiogenesis, and we investigated if tumor angiogenesis could serve as a prognostic factor in cervical carcinoma. Tumor tissues were obtained from 28 patients with cervical intraepithelial neoplasia and 46 patients with squamous cell carcinoma of the cervix. Microvessel were identified by immunohistochemical methods using monoclonal antibody QBEnd/10 to the CD34. In each case, three microscopic fields (×200) with the highest number of microvessels were counted and averaged. The results were as follows. Comparison of microvessel counts underlyng low grade lesion with microvessel counts of high grade lesion showed a statistically significant increase in the more advanced lesions (p<0.05). Patients whose tumor response to neoadjuvant chemotherapy were good had significantly higher microvessel counts than those showing poor response (145.53 47.72 vs 101.40 30.70, p<0.01). There was no correlation between microvessel count and tumor size, node status, lymphvascular invasion, depth of invasion, or parametrial invasion. In univariate analysis by log-rank test, vascular count was not significantly associated with disease free survival. Microvessel counts from postchemotherapy specimen showed lower tumor vascularity than prechemotherapy specimen but there was no significance. These results suggest that angiogenesis is an early, critical step in cervical neoplasm. Microvessel countingmay be a prognostic factor linked to tumor chemoresistance and may not be suitable for clinical use as a prognostic factor in cervical carcinoma.

HVDC Planning 절차 및 기술개발

이재걸(Lee JG),송지영(Song JY),배영재(Bae YJ),김용학(Kim YH),김태균(Kim TK),김구한(Kim GH),장길수(Jang GS),곽노홍(Kwak NH) 대한전기학회 2016 대한전기학회 학술대회 논문집 Vol.2016 No.11

AtBAG6, a novel calmodulin-binding protein, induces programmed cell death in yeast and plants

Kang, CH,Jung, WY,Kang, YH,Kim, JY,Kim, DG,Jeong, JC,Back, DW,Jin, JB,Lee, JY,Kim, MO,Chung, WS,Mengiste, T,Kolwa, H,Kwak, SS,Bahk, JD,Lee, SY,Nam, JS,Yun, DJ,Cho, MJ Plant molecular biology and biotechnology research 2005 Plant molecular biology and biotechnology research Vol.2005 No.

Calmodulin (CaM) influences many cellular processes by interacting with various proteins. Here, we isolated AtBAG6, an Arabidopsis CaM-binding protein that contains a central BCL-2-associated ethnogeny (BAG) domain. In yeast and plants, overexpression of AtBAG6 induced cell death phenotypes consistent with programmed cell death (PCD). Recombinant AtBAG6 had higher affinity for CaM in the absence of free Ca^2+ than in its presence. An IQ motif(IQXXXRGXXXR, where X denotes any amino-acid) was required for Ca^2+ -independent CaM complex formation and single amino-acid changes within this motif abrogated both AtBAG6-activated CaM-binding and cell death in yeast and plants. A 134-amino-acid stretch, encompassing both the IQ motif and BAG domain, was sufficient to induce cell death. Agents generating oxygen radicals, which are known to be involved in plant PCD, specifically induced the AtBAG6 transcript. Collectively, these results suggest that AtBAG6 is a stress-upregulated CaM-binding protein involved in plant PCD.

Direct Activation Of Capsaicin Receptors By Products Of Lipoxygenases : Endogenous Capsaicin-Like Substances

SW Hwang,H Cho,JS Shin,SH Cho,SY Lee,CJ Kang,JY Kwak,MH Wang,Y-G Suh,U Oh 대한약학회 1999 大韓藥學會 總會 및 學術大會 Vol.48 No.-