한국형 자궁경부 촬영진 ( New Cervicography ) , 세포검사 그리고 HPV-DNA 검사를 이용한 새로운 자궁경부암 검진 모델 ( Model ) 개발

김승조(SJ Kim),박찬규(CK Park),이효표(HP Lee),남궁성은(SE Namkoong),강순범(SB Kang),서호석(HS Saw),이재관(JK Lee),김수녕(SN Kim),김재원(JW Kim),배석년(SN Bae),김찬주(CJ Kim),이근호(KH Lee),이선영(SY Lee),김인호(IH Kim),이찬(C Lee),이정노(JN Lee) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.5

N/A Objective : The false negative rate of conventional cytology is reported to range from 18 to 45%. It is necessary to develop more effective screening strategies that would ideally be more accurate than conventional cytology. This study is designed to investigate the potential of conventional cytology, cervicography, HPV-DNA testing and their combinations as primary screening techniques for cervical neoplasia. The purpose of this project is to develop the models and guidelines for screening tools of cervical cancer of the uterus by evaluating sensitivity, specificity and cost-effectiveness of all the screening methods. Study design : We conducted a screening of random sample of women who visited the department of OB-Gyn. of five different major university hospitals such as Catholic University Hospital, Korea University Hospital, Seoul National University Hospital, Yeonsei University Hospital and Pochon CHA University Bundang CHA Hospital, from May 1, 1996 to April 30, 1999. In a cohort women with an age range of 20 to 70 who underwent routine cytologic screening at Catholic University, Hospital Bundang CHA General Hospital and local clinics from April 1, 1996 to Decomber 31, 2000. cervicography (n=417,125) and testing for HPV-DNA (n=1,347) by the hybrid capture assay were studied for the ability of the cervical cancer screeuing. A new cervicography system with Kim's classification which was developed by Prof. Kim Seung Jo as an adjunctive method for the cervical cancer screening was applied in this cohort study. And then, accuracy, effectivencess, cost-effectiveness of the single or combined screening method were analysed. Result : Sensitivity and specificity of Pap smear were ranged from 55.6% to 83.1% and 72.8% to 88.3% respectively. The combination of Pap smear and cervicography had sensitivity from 89.7% to 98.6%, specificity from 68.2% to 93.2%. With combination of Pap smear, HPV DNA test and cervicography, sensitivity became also highest accuracy among all screening methods from 92.8% to 98.8%. Considering medical charges for diagnosis and social cost occurred by false positive and false negative results, the most cost-effective diagnostic modality was thought to be the combination of Pap smear and cervicography(91,433 won). In patients who were diagnosed as LSIL, colposcopic examination confirmed progression to high grade intraepithelial lesion(HSIL) in 10.7% patients, persistence of LSIL in 55% patients during the 3 year follow-up period. Accuracy of the screening for cervical cancer and CIN can significantly be improved by cytology with new cervicography rather than cytology alone. We concluded that cervicography can be important adjunctive tests for cervical cytology, improving the effectiveness of cervical screening by allowing a more sensitive detection of cervical neoplasia.

CAPD in Korea 1990-1991

( Lee HB ),( Han DC ),( Bang BK ),( Chae DW ),( Cheon SJ ),( Cho DK ),( Cho JK ),( Choi CP ),( Choi EJ ),( Ha SK ),( Han DS ),( Lee HY ),( Jee YS ),( Jeon GU ),( Hong CD ),( Hong SY ),( Kang CM ),( Ka 대한신장학회 1993 Kidney Research and Clinical Practice Vol.12 No.3

임신성 당뇨 진단 기준값 차이의 임상적 의의

이영,송승규,김수평,이종건,김은중,김사진,이귀세라,허수영,강규섭,남정,김용옥 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.10

1996년 1월 1일부터 1997년 12월 31일까지 가톨릭대학교 성가병원에서 분만한 산모 4388명 중에서 임신 24∼28주에 50 gm 경구당 부하검사를 시행한 1384명에서 140 mg/dl 이상의 양성 반응을 보여 100 gm 경구당 부하검사를 시행하였던 223명을 대상으로 정상군이 158명(17명 누락), 치료받지 않은 Coustan군이 26명(2명 누락) 그리고 치료받은 NDDG 기준의 임신성 당뇨군이 39명(3명 누락)으로 후향적으로 조사하여 다음과 같은 결과를 얻었다. 1. NDDG기준에 의한 임신상 당뇨의 빈도는 2.8%였 으며 Coustan기준을 사용한다면 4.9%로 50% 이상의 임신성 당뇨 빈도의 증가를 보였다. 2. NDDG군은 정상군에 비하여 처음 제왕절개술 및 총 제왕절개술, 조산 등에서 높은 빈도를 질식 분만에서는 낮은 의의 있는 차이를 보였으나 Coustan군에서는 조 산의 빈도만 높았다. 3. Coustan군에서 NDDG군에 비하여 과체중아, 거대아, 질식 분만, 제왕절개술, 조산 및 산과적 합병증에 대한 유의적인 차이는 없었다. 이상의 결과로 100 gm 경구당 부하검사에서 Caustan 기준으로 역치 값을 낮추는 것은 거대아 및 산과적 이환율을 낮추는 것 없이 임신성 당뇨 진단에 있어 과다 진단을 초래할 것으로 생각된다. Objective: To determine the incidence of gestational diabetes mellitus and relationship between birth weight and mode of delivery by two sets of 3-hour glucose tolerance test criteria, those recommended by the National Diabetes Data Group (NDDG) and Carpenter and Coustan criteria (Coustan). Methods: Between January 1996 and December 1997 from Holy Family hospital of Catholic Medical College , a total of 1384 pregnant women were screened for a plasma glucose of 140mg/dl or greater.223 positive subjects received a 3-hour glucose tolerance test interpreted by the two criteria.Data are presented for 158 (17 were lost of F-U) positive screen, negative glucose tolerance test subjects; 26 (2 were lost of F-U) subjects with untreated Coustan criteria; and 39 (3 were lost of F-U) subjects with treated GDM by NDDG. Results: 1. Gestational diabetes mellitus incidence was 4.9% overall based on the Coustan criteria and 2.8% by the NDDG criteria. 2. Primary & total cesarean delivery, and preterm delivery in NDDG were increased significantly, Episiotomy was decreased when compared with normal group, but preterm delivery in Coustan was increased significantly. 3. There were no significant differences in episiotomy, macrosomia, large baby, cesarean deliveries, and pregnancy outcomes between the women with not-treated Caustan group and treated NDDG. Conclusions: Our results indicate that the criteria of Carpenter and Caustan would overdiagnose Gestational Diabetes Mellitus without improving perinatal and pregnancy outcomes.

만성 신부전 산모의 만삭 제왕절개 분만 1 예

이종학,김종화,백원영,이성재,이순애,정영택,신정규 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.10

저자 등은 만성 신부전증으로 정기적인 혈액투석을 시행하고 임신기간중 양수과다증으로 인해 반복적 양수천자를 시행하였던 37세 산모에서 임신 37주 만에 2640 gm의 건강한 남아를 반복제왕절개술로 성공적인 분만을 한 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Pregnancy is an unusual event in patient with chronic renal failure under going hemodialysis. When it occurs, spontaneous abortion, still birth, and neonatal death end 75% to 80% of the pregnancies. The mother is at risk for hypertension and abruptio placenta. The fetus is at risk for prematurity and growth retardation. Successful term pregnancy and cesarean delivery of a patient with chronic renal failure is presented.

자궁동정맥기형의 임상경험

이국,이윤호,이병석,신숙진,민혜원,이장호,김동익 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.9

자궁동정맥기형의 진단에 있어 Doppler초음판 1차적 진단방법으로 매우 유용하며 치료방법으로 자궁을 보존하고자 하는 경우에는 1차적 치료방법으로 TAE를 시행하는 것이 유용하다고 사료된다. We experienced 4 clinical cases which had been diagnosed of uterine arteriovenous malformation by Doppler ultrasonogram and pelvic angiogram. In all patients, trasarterial emolization was performed as first choice of treatment modality. Among them, two cases have failed. However, another two patients conceived after the successful transarterial embolization. Therefore, we concluded Doppler ultrasonogram si a useful diagnostic method in patients with arteriovenous malformation. And trasarterial embolization is effective as a first choice of treatment in patients who desire to preserve fertility.

RhD 음성 산모의 자궁경부세포와 말초혈액을 이용한 태아 RhD 상태의 산전검색

이영,김수평,이종건,신종철,김사진,백은정,이귀세라,정대영,노승혜 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.6

목적 : RhD 음성 여성의 임신에 따른 태아 RhD 상태의 산전 검색에 있어서 자궁 경부 세포와 모체 말초 혈액간의 진단 도구로써의 유용성을 상호 비교해 보고자 한다. 방법 : 임신 7-34주 간의 RhD음성인 15명의 임산부로부터 자궁 경부 세포와 모체 말초 혈액을 채취하였다. 각채검물 들은 RhD and RhCc/Ee 특히 유전자의 primer를 이용하여 heminested PCR을 시행하였다. RD-A3/Rd-A2 [291bp in size] primer를 이용 해 30 회의 일차 증폭 후, RD-A5/RD-A2 [262 bp in size] primer를 이용하여 여러 횟수의 이차 증폭을 시행하였다. 부계 및 태아의 RhD 상태는 혈청학적 검사 또는 PCR을 이용하여 확인하였다. 결과 : 모든 부계 및 태아의 혈액형을 RhD 음성이었다. 일차 증폭 후, 15명의 자궁 경부 세포에서 5 명, 15 명의 모체 말초 혈액에서 2 명이 PCr 양성으로 검출되었다. 10, 15, 20 및 25 회의 이차 증폭에서는 자궁 경부 세포에서 각각 12,13,15 및 15, 모체 말초 혈액에서 각각 2, 13, 14, 및 15 명이 RhD 양성 소견을 보였다. 결론 : 일차 증폭과 10회의 이차증폭에서는 자궁 경부 세포의 경우가 RhD 상태의 검출에 용이했으나, 위의 연구에서 우리는 두 가지 방법 모두 RhD 음성 산모에서 태아의 RhD 상태 평가에 유용하다고 보았다. 또한 이러한 방법들은 DNA 검색을 통한 기타 다른 유전 질환의 산전 진단에 적용될 수 있으리라고 본다. Objective : We studied to compare usefulness of transcervical cells[TCCs] and peripheral blood of RhD-negative mother for prenatal determination of fetal RhD status. Methods : Peripheral blood and TCC samples obtained from fifteen RhD-negative women at 7-34 weeks in gestation. They were tested for fetal RhD status using heminested PCR with primers specific for the genes coding for RhD and RhCc/Ee. After the first amplification of 30 cycles using primers RD-A3/RD-A2[291bp in size], the second amplification of various cycles was performed using primers RD-A5/RD-A2[262bp in size]. Parental and fetal RhD status was confirmed by serologic and/or PCR methods. Results : All paternal and fetal blood type were RhD positive. After the first amplification, fetal RhD status could be determined in five of 15 TCC samples and in two of 15 peripheral blood samples, After the second amplification of 10, 15, 20 and 25 cyles, fetal RhD status could be determined in 12, 13, 15 and 15 of 15 TCC samples and in 2, 13, 14 and 15 of 15 peripheral blood samples, respectively. Conclusion : Although TCC samples could be determined more fetal RhD status than peripheral blood samples in the first amplification and the second amplification of 10 cycles, this study suggested that both methods are useful for prenatal determination of fetal RhD status from RhD-negative pregnant women. Furthermore, both of these methods are expectied to becom the preferred prenatal diagnosis at the DNA level while also having applications for other genetic disorders.

CAPD in Korea , 1981 ~ 1989

( Lee HB ),( Han DC ),( Park MS ),( Hwang SD ),( Lee SK ),( Bang BK ),( Cho DK ),( Choi CP ),( Choi EJ ),( Choi Y ),( Ko KW ),( Cheon SJ ),( Ha SK ),( Han DS ),( Hong SY ),( Jae YS ),( Kang CM ),( Par 대한신장학회 1991 Kidney Research and Clinical Practice Vol.10 No.3

급성 하벽 심근경색에서 측부 유도의 ST분절의 특성과 병변 동맥의 관계

이숙진,임헌길,조한표,신대희,최성일,이 상,이재웅,김경수,김순길,김정현,이방헌,이정균 대한순환기학회 2001 Korean Circulation Journal Vol.31 No.10

Pelagic oxycline and damage potential of hypoxia to the Pacific oyster Crassostrea gigas suspended in longline aquaculture systems

Lee, SJ,Jo, Q,Han, JC,Park, YC,Park, TG Inter-Research Science Center 2017 Aquaculture environment interactions Vol.9 No.-

Cellular mechanisms for trazodone-induced cardiotoxicity

Lee, S,Lee, H-A,Kim, SJ,Kim, K-S SAGE Publications 2016 Human & experimental toxicology Vol.35 No.5

<P>The second-generation selective 5-HT2 receptor antagonists and reuptake inhibitors (SARIs) class antidepressants are known to have fewer cardiovascular side effects than the older ones. However, several case reports showed that trazodone, one of the second-generation SARIs, induces QT prolongation, cardiac arrhythmia, and ventricular tachycardia. Although these clinical cases suggested trazodone-induced cardiotoxicity, the toxicological actions of trazodone on cardiac action potentials (APs) beyond the human ether-a-go-go related gene (hERG) remain unclear. To elucidate the cellular mechanism for the adverse cardiac effects of trazodone, we investigated its effects on cardiac APs and ion channels using whole-cell patch clamp techniques in human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) and transiently transfected human embryonic kidney cells (HEK293) with cardiac ion channel complementary DNA. Trazodone dose-dependently decreased the maximum upstroke velocity (V-max) and prolonged the AP duration, inducing early after depolarizations at 3 and 10 M that triggered ventricular arrhythmias in hiPSC-CMs. Trazodone also inhibited all of the major ion channels (I-Kr, I-Ks, I-Na, and I-Ca), with an especially high inhibitory potency on hERG. These data indicate that the prolonged AP duration and decreased V-max due to trazodone are mainly the result of hERG and sodium ion inhibition, and its inhibitory effects on cardiac ion channels can be exhibited in hiPSC-CMs.</P>