조기파수와 Cytochrome P450 1A1 및 1A2 유전자 다형성과의 연관성

김사진 ( Sa Jin Kim ),박철훈 ( Cheol Hoon Park ),신종철 ( Jong Cheol Shin ),양동은 ( Dong Eun Yang ),박인양 ( In Yang Park ),고현선 ( Hyun Sun Ko ),김연희 ( Yeun Hee Kim ),안현영 ( Hyun Young Ahn ),김수평 ( Soo Pyung Kim ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.12

목적 : 조기분만은 신생아 사망 및 이환의 가장 중요한 원인이지만 아직 원인이나 병태생리가 잘 밝혀져 있지 않다. 최근에 조기분만의 원인 및 발생기전을 유전학적 관점에서 접근하는 경향이 있다. 한국 여성에서 CYP1A1 및 CYP1A2 유전자 다형성이 조기파수에 의해 조기분만한 임신부와의 연관성을 알아보고자 이 연구를 시행하였다. 연구 방법 : 2002년 8월부터 2003년 10월까지 가톨릭의대 부속 병원들에서 37주 이후에 분만한 264명의 산모들과 Objective : Preterm delivery (PTD) is the leading cause of perinatal mortality and morbidity. However, its etiology and pathogenesis remain unknown in most cases. Recently, some research put forth the hypothesis that PTD results, at least in part, from a

토끼 태아에서 표피성장인자 투여가 코티졸 , 티록신 , 프로락틴의 생성에 미치는 영향

김수평(Soo Pyung Kim),신종철(Jong Chul Shin),이종건(Jong Kun Lee),김용욱(Yong Wook Kim),변태섭(Tae Sup Byun),신재인(Jae In Shin),이종승(Chong Seong Yi),나종구(Jong Gu Rha) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.12

N/A Respiratory distress syndrome (RDS) is a major cause of death in premature neonates, and it is caused by the failure of morphological and biochemical lung maturation (synthesis and secretion of lung surfactant). It is known that cortisol, thyroxine, prolactin, epidermal growth factor (EGF), and estrogen accelerate the lung maturation. Cortisol and thyroxine are currently used in the antenatal treatment for the prevention of RDS in premature neonates. In order to evaluate the effect of EGF on the levels of cortsol, thyroxine, and prolactin, this study was undertaken. Phosphate buffered saline (PBS) with and without EGF was directly injected into the 25 days gestational fetus in uterus. Blood was collected for the measurement of cortisol, thyroxine, and prolactin one day or two days after the injection. Body weights and lung weights were also measured. The results were as follows: 1. There was no significant difference in body weights and lung weights between PBS-treated group(control group) and EGF-treated poup(experimental group), 24 hours and 48 hours after the injection. 2. 24 hours after the injection, the levels of cortisol were significantly inaeased in the EGF-treated group compared with those in the PBS-treated group. However 48 hours after the injection, there was no significant difference in the levels of cortisol between the two groups. The levels of thyroxine and prolactin in the EGF-treated group did not significantly differ from those in the PBS-treated group 24 hours and 48 hours after the injection. In conclusion, in vivo, the synthesis of cortisol may be affected by EGF treatment, which suggests that the action of EGF for lung maturation may be partially mediated by the increased endogenous levels of cortisol.

수자궁질증의 산전 태아 초음파 소견 1 예

김사진(Sa Jin Kim),김수평(Soo Pyung Kim),김민정(Min Joung Kim),이상호(Sang Ho Lee),이희중(Hee Joong Lee),문희봉(Hee Bong Moon),이지현(Jee Hyun Lee),박철훈(Chul Hun Park),이귀세라(Gui Se Ra Lee),신종철(Joung Chul Shin) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.3

Cloacal anomalies are very rare congenital malformations with the incidence of 1/50,000-250,000 births. Hydrocolpos involves the dilatation of the vagina due to obstruction of the genital tract, leading to accumulation of secretions. Because of wide spectrum of abnormal anatomy involving urogenital and gastrointestinal systems, prenatal diagnosis is difficult. As ultrasound becomes more and more reliable, prenatal diagnosis is possible as early as in the second trimester. The presence of prenatally detected hydro (metro) colpos warrants a systematic evaluation of fetal and neonatal anatomy to rule out a large variety of possibly associated malformations or syndromes. We present a case of urogenital sinus maldevelopment which was initially presented as a fetal ascites.

전치 태반의 임상적 고찰

김수평(Soo Pyung Kim),이초희(Cho Hi Lee),김사진(Sa Jin Kim),허수영(Soo Young Hur),이귀세라(Gui Se Ra Lee),이지현(Jee Hyun Lee),권인(In Kweon),송승규(Seung Kyu Song) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.3

N/A Objective: A Clinical Study of Placenta P#revia done by cesarean section and the study of preterm delivery that is major cause of premature motality even thought expected managment of placente previa. Methods: This study was evaluated for the clinical analysis on the 641 patients with placenta previa among total deliveries of 56,120 cases at the St. Mary and Holy Family hospital of Catholic University from Jan. 1,1989 to Dec.31,1997. Results: The following results were obtained: 1. The total incidence of placenta previa was 1.14%. 2. The incidence of placenta previa increases with age. 3. Placenta previa has occurred more often in multipara(60.2%) than primipara(39.8%), and placenta previa has occurred more often in women who had experienced abortion(71.8%) than women who hadnt(28.2%). 4. The types of placenta previa distributed 326 cases of totalis(50.9%), 110 cases of partialis(17.2%), 99 cases of marginal(15.4%) and 106 cases of low lying placenta(16.4%). 5. The fetal presentation distributed 557 cases of vertex(86.9%), 49 cases of breech(7.6%), 28 cases of transverse lie(4.4%). 6. The types of uterine incision included 543 cases of low sepnent transverse incision(84.7%), 46 cases of classical incision(7.2%), 9 cases of inverted T incision and 43 cases of cesarean hysterectomy(6.7%). 7. Premature delivery of placenta previa prior to completion of 37 weeks was 186 cases(29.0%) and low birth infant less than 2,500gm was 128 cases(20.0%).and perinatal mortality rate was 28.0 per 1,000. 8. During delivery, 278 cases of placenta previa(43.4%) were transfused with mean 3.6 pints. Incidence of vaginal bleeding was 49.3% of placenta previa,mean admission day until delivery was about 5 day. Conclusion: there is a strong association between advancing age and incidence of placenta previa, and then. the risk increases with parity & the number of abortion. Considering the mean volume of blood loss more than 3 pints of blood should be prepared befor delivery.

복막의 악성혼합 뮬러리안종양 1 예

김수평(Soo Pyung Kim),김정자(Jeong Ja Kim),최은(Eun Choi),노승혜(Seung Hae Ro),김장흡(Jang Heub Kim),이안희(An Hee Lee) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.1

Malignant mixed miillerian tumor (MMMT) was one of the rare uterine sarcoma. This tumor is composed of sarcoma and carcinoma. Primary MMMT in the peritoneum is among the rarest sites for MMMT. MMMT is highly malignant and the prognosis is grave due to frequent recurrence and metastasis. In the world literature, only 22 cases with primary MMMT of the peritoneum have been reported and most of these were single report. We report one case of primary MMMT in the peritoneum with a brief review.

TDx - FLM 에 의한 태아 폐성숙도 측정에 혈액 및 태변이 미치는 영향

김수평(Soo Pyung Kim),신종철(Jong Chul Shin),이영(Young Lee),이종건(Jong Kun Lee),백은정(Eun Jeong Baik),김기홍(Ki Hong Kim),정대영(Dae Young Jung),김창이(Chang I Kim) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.3

N/A Objective: We studied to determine the effect of blood or meconium contamination on the TDx-FLM assay for the assessment of fetal lung maturity. We also studied to evaluate the degree of diluted contaminants that affect the results. Methods: Nineteen samples of amnotic fluid-14 cases < GA 37weeks and 5 cases > GA 37weeks-were collected and assayed for assessment of fetal lung maturity using tbe TDx-FLM assay. Among the above 19 samples, we used 12 samples-7 cases < GA 37weeks and 5 cases > GA37 weeks-to contaminate with blood or meconium. Maternal blood was added to the amniotic fluid at increasing concentrations fro 1:10 to 1:1280. Diluted meconium (0.5g meconium/10ml amniotic fluid) was added at increasing concentration fiom 1:1 to 1:128. Each samples were assessed by TDx assay. Results: TDx values in the cases of gestational age 37 weeks or more were matured level or borderline level(TDx value > 50mg/g), but below 37 weeks, TDx values wae immature level(TDx value < 50mg/g) except one case. In preterm cases, blood or meconium contamination did not affect the TDx values significantly, although the thick meamium contamination (diluted meconium: amniotic fluid 1:1 - 1:4) increased the TDx values. In term cases, they did not affect the TDx values. Conclusion: TDx test was suitable for the evaluation of fetal lung maturity regardless of blood or meconium contamination.

태아 긴박증에서 태아 심장박동의 비선형 동력학 및 카오스 분석

김사진(Sa Jin Kim),신종철(Jong Chul Shin),정대영(Dae Young Chung),심영보(Young Bo Sim),이상훈(Sang Hoon Yi),김창이(Chang Yi Kim),김수평(Soo Pyung Kim) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.6

목적 : 태아의 건강을 평가하기 위한 새로운 분석 방법을 개발하기 위함이다. 방법 : 전자식 태아 감시장치를 이용하여, 긴박증 태아에서 발생되는 심박동 신호를 컴퓨터로 받아들여 데이터 전처리 (low pass filtering; LPF)후에 비선형 분석으로 지연시간 (delay time), 매립차원 (embedding dimension), 상관차원 (correlation dimension), Isoangular return map을 통한 mean crossing, information entropy를 구하였고, 태아 긴박증 소견을 보인 신생아 22명의 출생후 제대 혈액 가스값을 산혈증군 5명과 비산혈증군 17명으로 나누어 비선형 카오스 분석 결과와 비교하였다. 결과 : 1. 데이터 전처리를 거친 지연 시간은 15.73±2.47 이었다. 2. FNN 법으로 계산한 매립 차원은 5.00±0.82 이었다. 3. 산혈증군의 상관차원은 1.41±0.20으로 비산혈증군의 상관차원 1.10±0.38 보다 높았으나 통계적 유의성은 없었다. 4. Isoangular return map 의한 mean crossing값은 산혈증군이 28.80±11.34이었고 비산혈증군은 16.65±7.00으로 통계적으로 유의성이 있었다 (P=0.008). 5. Information entropy에 의한 1-D ED 비교에서 산혈증군은 6.32±0.38, 비산혈증군은 6.20±0.28로 통계적인 의의가 없었다. 또한 2-D ED 값의 비교에서는 산혈증군은 10.20±0.34로 비산혈증군의 9.51±0.44보다 통계적으로 의의있게 높았다(P=0.004). 그러나 2-D EP 값 비교에서는 산혈증군은 8.70±0.90, 비산혈증군 9.22±0.74로 통계적으로 유의성이 없었다 (P=0.281). 또한 2-D ED(DI) 값도 산혈증군은 10.64±0.14, 비산혈증군은 10.51±0.18로 통계적으로 유의성이 없었다 (P=0.141). 결론 : 태아 심박동 자료로 컴퓨터를 이용한 비선형 및 카오스 동력학 분석이 실시간으로 태아의 건강상태를 평가할 수 있는 새로운 진단 방법으로 역할을 할 수 있다는 것을 알 수 있었으나, 임상에 적용하기까지는 향후 더 많은 연구를 통하여 이의 진단 기준 확립과 컴퓨터 프로그래밍화하여 실시간 진단 방법이 임상에 적용되어야 할 것으로 생각된다. Objectives: For estimating the antenatal fetal wellbeing to develop new analysis method of fetal heart rate(FHR) with electronic Fetal Heart Rate Monitoring(eFHRM) and computer.Methods: Heart rate signal is received from distressed fetus using eFHRM. It is necessary to carry out low pass filtering as a preprocess for the nonlinear method. Nonlinear parameters are calculated and classified to investigate the relations between these parameters and values of umbilical cord blood gas.Results: By dividing values of the umbilical cord blood gas into 5 fetuses of acidemic group and 17 fetuses of non-acidemic group after 22 neonates who presented fetal distress were born, the following results as compared with nonlinear chaotic analysis result were obtained. 1. Delay time through AMI for acidemic group was 16.80±3.11, and was higher than 15.41±2.27 for non-acidemic group, and is not significant in statistics.2. Embedding Dimension calculated with FNN method was 5.60±2.07 for acidemic group, and 4.71±1.26 for non-acidemic group, and it was not significant statistically.3. Correlation dimension for acidemic group was 1.41±0.20, and was higher than 1.10±0.38 for non-acidemic group, and is not significant in statistics.4. Mean crossing value by isoangular return map was 28.80±11.34 for acidemic group, and 16.65±7.00 for non-acidemic group, and it was significant statistically(P=0.008).5. In comparison of information entropy in 1-D ED, acidemic group was 6.32±0.38 and non-acidemic group was 6.20±0.28 and it was not significant statistically. Also, in comparison of value in 2-D ED, acidemic group was 10.20±0.34. It was higher than non-acidemic group of 9.51±0.43 significantly in statistics(P=0.004). But, in comparison of value in 2-D EP, acidemic group was 8.78±0.86 and non-acidemic group is of 9.22±0.74 and it wasn't significant statistically. And, 2-D ED(DI) value was 10.64±0.14 for acidemic group and 10.51±0.18 for non-acidemic group, and it wasn't significant statistically.Conclusions: By the above result, nonlinear dynamics and chaotic analysis of heart rate data with computer can serve as a new diagnosis method which may estimate the fetal wellbeing with real time. Through further studies for establishment of diagnosis standard and computer programming, real time diagnosis method shall be applied to clinical practice.

자궁경부암 세포에서 retinoid / interferon 에 의한 성장 억제 조절의 새로운 분자생물학적 기전

김수평(Soo Pyung Kim),남궁성은(Sung Eun Namkoong),김승조(Seung Jo Kim),김은주(Eun Joo Kim),엄수종(Soo Jong Um),박종섭(Jong Sup Park),이근호(Keun Ho Lee),김찬주(Chan Joo Kim) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.3

N/A Objective: Retinoic acids (RAs) and interferons (IFNs) have been implicated in the growth regulation of cervical cancer cells, which was suggested by clinical trials and in vitro experiments. However, the molecular mechanisms of growth regulation are not fully defined, The purpose of this study is to assess the effect of RA and/or IFN on human cervical carcinoma cells in vitro and to analyze their action mechanisms in HPV-positive cervical carcinoma cells by molecular biologic studies. Methods: HPV-positive (CaSki, HeLa), HPV-negative (C33A, HT-3), and non-cervical cancer Cos-1 cell lines were treated with RA and/ar IFN. Their effects on cell growth were evaluated by the cell pmliferation assay and the following BrdU DNA incorporation assay. The molecular mechanism was further investigated by a series of immunoblottings and transient cotransfection assays, which were conducted in HeLa cells and C33A cells using the CAT reporter gene assay. To observe the down regulation of HPV E6/E7 gene expression by RA/IFN, reverse transcription-polymerase chain reaction (RT-PCR) was perforned. Results: The powth of RA-treated cells was less suppressed than that of IFN-treated cells. Combined treatment of RA and IFN leads to additive effect on the growth suppression of HeLa and CaSki cells. The proliferation activity was most severely reduced in Hela cells by treatment of both all-trans-RA (AtRA) and IFN-r. Combined treatment of AtRA/IFN-r causes a great increase in the level of interferon regulatory factor-1 (IRF-1) protein in HeLa cells, whereas no induction of IRF-1 was observed in C33A cells. The CAT gene expression for IRF-1 was greatly induced by IFN-r in HeLa cells. Immunoblotting assays shows the concurrent induction of p21 CDK inhibitor and dephosphorylation of Rb protein in HeLa cells. In RT-PCR, an individual treatment of either RA or IFN reduced HPV E6/E7 mRNA levels and significantly cooperative when both RA and IFN were treated. By deaeasing E6 levels, the p53 level was increased in HeLs cells treated with RA and/or IFN. Transient cotransfection of IRF-1 and p53 as the transcription factors leads to the cooperative activation of a common p21 promoter to regulate the cell cycle. Conclusion: RA/IFN suppressed the growth of HPV-positive cervical cancer cells. When they were both #treated, additive suppressive effects were observed in cellular proliferation as well as DNA synthesis. The growth suppressive effect is likely to be related to the increased expression of IRF-1 and p21 (antitumoral effect; p53-independent). The down regulation of HPV E6 gene suppression may account for the resultant increase of p53 levels (antiviral effect; p53-dependent). Both induced IRF-1 and p53 cooperatively augument tbe suppession of p21 CDK inhibitor, which results in dephosphorylation of pRb. Although clinical effects are likely complex and may include interactions of in vitro growth inhibitory effects with immunomodulatory and antiangiogeaetic effect, tbese results suggest the optimal clinical role for the combination of RA/IFN in the treatment of cervical canccers.

임신오조증으로 발생한 Wernicke`s Encephalopathy 1 예

김수평(Soo Pyung Kim),유영옥(Young Oak Lew),김대훈(Dae Hoon Kim),양용재(Yong Jae Yang),이형근(Hyung Gun Lee),임채춘(Chae Chun Rhim),나순숙(Soon Sook Nah),박동춘(Dong Chun Park),정대영(Dae Young Jeong),김재훈(Jae Hoon Kim) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.1

Hyperemesis gravidarum is a complication defined as nausea and vomiting during early pregnancy. Wernickes encephalopathy is an illness of acute onset characterized by mental disturbance, paralysis of eye movements, and ataxia of gait cause by thiamine deficiency. We recently experienced a case of Wernickes encephalopalhy due to hyperemesis gravidarum, which is treated by administration of thiamine even though outcome of serious healthy problem to both mother and fetus, and reported it with a brief review of the literature.

임신성 당뇨에 대한 50-g, 1시간 Glucose Screening 검사

이종승 ( Chong Seong Yi ),김도강 ( Dou Kang Kim ),신종철 ( Jong Chul Shin ),김사진 ( Sa Jin Kim ),홍승덕 ( Seoung Dug Hong ),이종건 ( Jong Kun Lee ),나종구 ( Jong Gu Rha ),김창이 ( Chang Yee Kim ),김수평 ( Soo Pyung Kim ) 대한주산의학회 1994 大韓周産醫學會雜誌 Vol.5 No.4