The Outcome and β-hCG Value After First Three Course Chemotherapy in Trophoblastic Disease

나종구 ( Jong Gu Rha ),강병철 ( Byung Chul Kang ),정재근 ( Jae Keun Jung ),김승조 ( Seung Jo Kim ) 대한산부인과학회 1988 대한산부인과학회 학술대회 Vol.61 No.-

다운 증후군과 임신 합병증에서 임신 제 2삼분기 양수내 Activin A, Inhibin A 와 B 의 농도와 이들 비율의 의의

류상우 ( Sang Woo Rhu ),이종건 ( Jong Gun Lee ),김용욱 ( Yong Wook Kim ),이영 ( Young Lee ),신종철 ( Jong Chul Shin ),류영옥 ( Young Oak Lew ),나종구 ( Jong Gu Rha ),김수평 ( Soo Pynug Kim ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.6

목적 : 모성 연령, 임신 주수, 성별에 따른 activin A, inhibin A와 B의 변화와 다운 증후곤과 임신 합병증이 동반된 임신에서 이들 단백질의 농도와 비율의 변화를 조사하고자 하였다. 연구 방법 : 임신 제 2삼분기에 양수천자술을 시행한 71예를 대상으로 하였으며, 임신 예후는 의무기록을 통하여 후향적으로 조사하였다. 다운 증후군 10예를 연구군으로, 정상 염색체 소견을 보인 61예를 비교군으로 하였다. 임신 합병증군은 정상 염색체 소견을 보인 61예 중 15예였으며, 자간전중 (preeclamsia), 임신성 당뇨, 조산, 자궁내 발육지연, 사산 등이 포함되어 있다. 양수내 activin A, inhibin A와 B의 농도는 효소결합면역흡착검사(ELISA)를 통해 측정하였으며, 통계분석을 Mann-Whitney U test와 regression analysis를 시행하였다. 결과 : activin A/inhibin B 비율과 산모 연령사이에 유의한 상관관계 (r=0.277, p=0.011)가 있었으며, inhibin A/inhibin B와 산모 연령사이에도 유의한 상관관계 9r=0.261, p=0.015)가 있었다. inhibin A 농도와 임신주수 사이에 유의한 상관관계 (r=0.474, p<0.001)가 있었다. 양수내 inhibin A와 inhibin B 농도는 다운증후군 군에서 유의하게 낮았으나 (p<0.05), activin A/inhibin B 비율과 inhibin A/inhibin B 비율에서는 유의한 차이를 보이지 않았다. 임신 합병증이 동반된 정상 염색체 군에서 양수내 inhibin A와 B, activin A의 농도와 이들 사이의 비율은 합병증이 동반되지 않은 군과 비교하여 유의한 차이가 없었다. 결론 : 본 연구에서는 다운 증후군 임신시 제 2삼분기 양수내 inhibin a와 B는 유의하게 감소하였으나, activin A와 이들 사이의 비율은 변화하지 않았다. 이러한 사실은 다운 증후군 임신시 양수내 inhibin의 감소와 함계 activin A의 상대적 감소가 동반될 수 있음을 의미한다. Objective : To evaluate the amniotic fluid levels and each ratio of activin A, inhin A and B in Down`s syndrome and other complicated pregnancies. Methods : This study was performed in 71 women who had undergone a midtrimester amniocentesis with the clinical indications and whose pregnancy outcome was retropsectively determined. Ten Down`s syndrome, 15 complicated pregnancies including, preeclamsia, gestational diabetesis mellitus, preterm labor, intrauterine growth restriction (IUGR), and 46 noncomplicated pregnancies with normal chromosome were included in this study. Amniotic fluid activin A, inhibin A and B were measure using enzyme linked immunosorbent assays (ELISA). Statistical analysis was performed with Mann-Whitney U test and regression analysis. Results : There were significant positive correlation (r=0.277, p=0.011) between the ratio activin A/inhibin B level and maternal age and significant positive correlation (r=0.261, p=0.015) between maternal age and the ratio inhibin A/inhibin B level. There were also significant positive correlation (r=0.202, p=0.045) between gestational weeks and inhibin A levels and significant positive correlation (r=0.474, p<0.001_ between gestational weeks and inhibin B levels. Amniotic fluid inhibin A and inhibin B levels were significantly (p<0.05) decreased in Down`s syndrome compared with the normal chromosomal groups but there was no difference in the ratio activin A/inhibin A and in the ratio activin A/inhibin B between these groups. The amniotic fluid levels of activin A, inhibins (A and B), each ratio of complicated pregnancies groups with normal chromosome was not significantly different from those of uncomplicated pregnancies with normal chromosome. Conclusion : This study revealed that amniotic inhibin levels were significantly decreased in Down`s sundrome. But, activin A and each ratio were unchanged. The results suggest that activin A may by relatively decreased in each case of Down`s syndrome.

중증 전자간증 태반에서의 Vascular Endothelial Growth Factor, Platelet-Derived Growth Factor 및 Intercellular Adhesion Molecule의 발현 양상

이귀세라 ( Gui Se Ra Lee ),이종건 ( Jong Kun Lee ),한운섭 ( Woon Sup Han ),이영 ( Young Lee ),김사진 ( Sa Jin Kim ),나종구 ( Jong Gu Rha ),김수평 ( Soo Pyung Kim ),남궁성은 ( Seong Eun Namkoong ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.3

목적 : 자간전증의 병인으로 생각되어지는 태반의 성장과 발달에 관여하는 혈관생성인자와 흡착물질의 태반에서의 발현에 대해서 알아보고자 하였다. 연구 방법 : 정상 혈압을 보이는 임신 여성 10명 (정상대조군)의 태반과 중증 자간전증 환자 20명 (자간전증군)의 태반에서 VEGF, PDGF 및 ICAM-1의 발현을 영양모세포, 융모내기질세포 및 융모내 태아혈관내피세포를 면역조직화학적 염색을 통하여 비교하였다. 결과 : 자간전증군 태반의 합포영양막에서 정상대 Objective : To determine the expression of vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF) and intercellular adhesion molecule (ICAM-1) in placenta from pregnancies complicated by severe preeclampsia and normal pregnancies

유도 분만시 미소프로스톨 투여용법의 임상적 고찰

김사진 ( Sa Jin Kim ),신종철 ( Jong Chul Shin ),윤철구 ( Chul Gu Yoon ),양용재 ( Yong Jae Yang ),이근호 ( Keun Hoo Lee ),박태철 ( Tae Chul Park ),나종구 ( Jong Gu Rha ),김수평 ( Soo Pyung Kim ),이희중 ( Hee Joong Lee ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.12

목적 : 임신 말기에 필요에 따라 프로스타그란딘 E1 유도체인 미소프로스토롤을 질 경내에 투여해서 자궁경관을 숙화시킨 후 정상 질식 분만한 산모 중에서 두 군으로 나누어 이의 결과를 비교하였다. 연구 방법 : 유도 분만을 위한 자궁 숙화가 필요한 37주 이상의 정상 만삭 임신산모에서 무작위로 35명에서는 미소프로스톨 50㎍, 32명에게는 미소프로스톨 100㎍을 질 경내에 4시간마다 최고 6회까지 투여하였고 규칙적인 진통이 없거나 진통이 있더라도 자궁경관 Objective : The purpose of this study was to compare the efficacy and the safety of two different dose regimens of intravaginal misoprostol for labor induction. Methods : Sixty-seven consenting women with maternal or fetal indication for labor and no prio

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.

산전 진찰 중 진단된 방광 요막 낭종

김연희 ( Yeun Hee Kim ),신종철 ( Jong Chul Shin ),이영 ( Young Lee ),박철훈 ( Cheol Hoon Park ),박인양 ( In Yang Park ),안현영 ( Hyun Young Ahn ),고현선 ( Hyun Sun Ko ),이연수 ( Youn Soo Lee ),나종구 ( Jong Gu Rha ) 대한주산의학회 2004 Perinatology Vol.15 No.4

Fetal vesicoallantoic cyst is extremely rare anomaly of umbilical cord. This disorder is thought to be a remnant of the extraembryonic portion of the allantois and incomplete obliteration of the vesico-allantoic lumen results in a wide spectrum of urachal anomalies. A 23-years-old primigravida was referred to our hospital at 18 weeks of gestation age because of fetal abdominal cystic mass in basal part of umbilicus. On the ultrasonographic examination, the cystic mass appeared to be in direct communication with the urinary bladder markedly distended. The cytogenetic study by amniocentesis showed normal 46, XY. The fetus was dead at 21 weeks of gestation age. The results of autopsy showed multiple anomalies. We report this rare case with review on similar anomalies of the allantois.

OVCAR-3와 SKOV-3 난소암 세포주에서 Flow Cytometry를 이용한 Apoptosis와 p53 단백의 측정

윤주희 ( Yoon Joo Hee ),최운만 ( Choi Woon Min ),조윤성 ( Jo Yun Seong ),나종구 ( Rha Jong Gu ),한구택 ( Han Gu Taeg ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.7

OVCAR-3와 SKOV-3 난소암 세포주에서 taxol 투여에 의해 유발된 고사 (apoptosis)의 연구를 통하여 두가지 세포주들 사이의 p53의 발현과 세포사의 생물학적 기전을 알아보고자 본 연구를 수행하였다. RPMI 1640 배양액으로 배양한 OVCAR-3와 SKOV-3 난소암 세포주를 taxol (paclitaxel)을 투여하지 않은 대조군과 taxol을 24시간 및 48시간 동안 투여한 투여군으로 나누어 실험을 진행하였다. 수확한 세포들을 먼저 annexin V-FITC (fluorescein isothiocyanate)와 anti-cytokeratin 항체인 clone CAM5.2와 clone MNF116과 반응시킨 다음 세포들을 세척하고 p53 항체를 가하여 반응시켰다. 세포들을 세척한 후 FITC와 공유 결합된 goat anti-mouse (GAM) immunoglobulin G (IgG)-FITC (이하 GAM IgG-FITC) 및 GAM IgG-phycoerythrin (PE) 이차 항체와 반응시켜 염색하였으며, 이어서 propidium iodide (이하 PI)를 이용하여 DNA를 염색하였다. 세포들의 분석에는 488 ㎚의 레이저가 장착된 표준 FACScan flow cytometer로 측정하였다. Taxol을 투여한 후 SKOV-3와 OVCAR-3 세포주 모두에서 G_2M에 세포들이 정지된 것으로 보아 정지된 세포들이 궁극적으로는 세포사 과정으로 진입할 것으로 생각되었다. Cytokeratin과 annexin V 및 G_0G_1 전분기 분획으로 표현된 고사 분획의 출현이 OVCAR-3 세포주에 비해 SKOV-3 세포주에서 낮은 것은 SKOV-3 세포주의 taxol에 대한 낮은 감수성을 나타내는 결과로 생각되었다. SKOV-3 세포주에서 p53 발현은 관찰되지 않았고, G_0G_1 전분기 분획의 미미한 증가 및 cytokeratin과 annexin V으로 측정된 고사 분획의 변화가 관찰되지 않았다. OVCAR-3 세포주에서 p53이 taxol의 투여 여부와 관계없이 발현되었지만 투여 시간에 따른 증가는 관찰되지 않았던 점과 G_0G_1 전분기 분획과 cytokeratin과 annexin V으로 측정된 고사 분획의 완만한 증가로 미루어 볼 때 p53의 발현이 세포주기 변화와 G_2M 분기의 정지와 무관하였으나 고사의 출혈과 관련되어 있을 것으로 생각되었다. 이러한 관찰은 향후 종양으로부터 채취한 종양 세포 부유액에 항암 화학요법제를 투여한 후 유발되는 고사의 정도를 신속하고 정확한 flow cytometry로 측정함으로써 항암 화학요법제의 투여 전 감수성을 알아보는 검사법의 개발 가능성을 암시하는 것으로 생각되었다. Objective : Taxol (paclitaxel)-induced apoptosis was studied to understand their biological mechanism correlated with the expression of p53 in the SKOV-3 and OVCAR-3 ovarian cancer cell lines. Materials and Methods : The SKOV-3 and OVCAR-3 cell lines were cultured in RPMI 1640 medium without taxol (control group) and with taxol for 24 h and 48 h (experimental group). After harvest, the cells were stained with annexin V-FITC (fluorescein isothiocyanate) and anti-cytokeratin antibodies (clone CAM5.2 and clone MNF116). They were washed and stained with p53 antibody. After then the secondary antibodies, i.e., FITC- or phycoerythrin (PE)-conjugated goal anti-mouse (GAM) immunoglobulin G (GAM IgG-FITC or GAM IgG-PE) were added in the cells and they were incubated in the dark. DNA of these cells were stained sequentially with propidium iodide (PI). Standard FASCcan equipped with a 499 ㎚ single laser was used for the analysis of these cells. Results : Both of SKOV-3 and OVCAR-3 cell lines were arrested in the G_2M phase after treatment of taxol, suggesting that these cells would eventually enter into the stage of cell death. Fractions of negative cytokeratin and positive annexin V and amount of sub-G_0G_1 fraction indicative of apototic fractions were lower in the SKOV-3 cell line compared with that in OVCAR-3 cell line, probably as a result of lower sensitivity of SKOV-3 cell line to the taxol. p53 expression were not detected in SKOV-3 cell line. On the basis of observed findings in SKOV-3 cell line and findings of high expressions of p53 regardless of taxol treatment, no increase in their expressions according to culturing time, and gradual increases in sub-G_0G_1 fractions and in fractions of negative cytokeratin and positive annexin V indicative of apoptosis in OVCAR-3 cell line, we concluded that the expression of p53 would not be associated with cell cycle changes and the arrest in the G_2M pahse but associated with the appearance of apotosis. Conclusion : Our results suggest that flow cytometric detection of the apoptotic fractions would be an effective, fast, and accurate method for the chemosensitivity test in tumor cells before the administration of anti-cancer drugs in gynecologic cancer patients.

제왕절개술 후 합병된 폐색전증

길기철(Ki Cheol Kil),강대호(Dae Ho Kang),이종건(Jong Kun Lee),백은정(Eun Jeong Baik),이영(Young Lee),나종구(Jong Gu Rha),김수평(Soo Pyung Kim) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.1

Pulmonary Embolism, one of the causes of maternal death, is a life threatening disease that needs early and accurate diagnosis. We have exprerienced a case of a fatal pulmonary embolism which was diagnosed by lung perfusion scan on the postoperative 1 day after cesarean delivery and was managed with heparin therapy. We present this case with a brief review of literatures.

배양된 제대정맥내피세포에서 중증자간전증환자 혈청이 내피세포 생육 및 Endothelin-1합성에 미치는 영향

김용욱(Yong Yook Kim),나욱렬(Wook Yull Na),이종건(Jong Kun Lee),이영(Young Lee),백은정(Eun Jeong Baik),나종구(Jong Gu Rha),김사진(Sa Jin Kim),이형근(Hyung Gun Lee),신종철(Jong Chul Shin),김수평(Soo Pyung Kim) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.7

목적 : 중증자간전증 환자의 혈청이 배양된 제대정맥 내피세포의 생육과 endothelin-1의 합성에 미치는 영향을 알아보고자 하였다. 연구방법 : 합병증이 없이 분만한 정상 임산부로 부터 제대정맥 혈관 내피세포를 얻어 정상임신부의 혈청 또는 중증 자간전증 환자의 혈청과 함께 생체외 배양을 하여, 비색 MTT법으로 제대정맥 혈관내피 세포의 생육에 대한검사, endothelin-1의 합성에 미치는 영향을 조사하였고, 동시에 정상임신부 및 자간전증 환자 혈장내의 endothelin-1의 농도를 측정하였다. 결과 : 1. 비색 MTT 측정에서 환자 또는 정상 산모의 혈청과 24시간 동안 배양시킨 배양액의 흡광도는 각각 0.0837±0.0129와 0.0718±0.0078로 두군간에 유의한 차이가 없었으며, 48시간 동안 배양시킨 실험에서 흡광도는 0.1268±0.0186과 0.1133±0.0103으로 두군간에 유의한 차이가 없었다. 2. 정상임신부의 혈청내 endothelin-1의 농도는 22.66±8.6 fmol/ml, 중증자간전증 환자의 혈청내 endothelin-1의 농도는 49.98±25.27 fmol/ml로 중증자간전증 환자에서 유의하게 높았다.(P<0.05) 3. 정상임신부의 형청을 가한 경우 endothelin-1의 함성량은 37.52±18.41 fmol/ml이며 중증자간전증 환자 혈청을 가한 경우는 97.58±53.64 fmol/ml 로 중증자간전증 환자의 혈청은 endothelin-1의 함성을 유의하게 증가시켰다.(P<0.05) 결론 : 자간전증 환자의 혈청은 혈관내피세포의 생육에는 별로 영향을 미치지 않았으며 선택적으로, 특이하게 내피세포기능중 Endothelin-1의 합성을 현저히 증가시켰다. Objectives: In order to assess the effects of sera from severe preeclamptic patients on endothelial cell viability in vitro and endothelin-1 synthesis in cultured human umbilical vein endothelial cells.Methods: The cultured human umbilical vein endothelial cells were incubated with media containing 10% sera from women with either preeclamptic patients or normal pregnancies for 24 hours or 48 hours. After then, their viability was measured by colorimetric MTT{3-(4,5-dimethylthiazol-2yl)2,5-diphenyl tetrazolium bromide} assay and their production of endothelin-1 was measured. We also measured the serum levels of endothelin-1 level in sera obtained from the normal and severe preeclamptic pregnancies. Results: The calorimetric MTT assay revealed that after 24 hours, the absorbances in the media treated with normal pregnancies and severe preeclampsia sera were 0.0718±0.0078 and 0.0837±0.0129, respectively and after 48 hours, they were 0.1133±0.0103 and 0.1268±0.0186, respectively. Serum obtained from severe preeclampsia did not affect endothelial cell viability. 2. The serum mean levels of endothelin-1 in normal and severe preeclamptic pregnancies were 22.66±8.6 fmol/ml and 48.98±25.27 fmol/ml. The mean level in preeclamptic sera was significantly higher than that of normal pregnant women. (P<0.05) 3. After 24 hours, the mean amount of endothelin-1 stimulated by normal pregnant and severe preeclamptic sera were 37.52±18.41 fmol/ml and 97.58±53.64 fmol/ml, respectively. The mean amount of endothelin-1 in preeclamptic sera-treated cells was significantly higher than that of normal pregnant sera-treated cells. (P<0.05). Conclusion: The sera from severe preeclamptic women do not affect cell viability but act selectively on specific activation of their function such as endothelin-1 production. And it is necessary that the identification and isolation of the putative serum factor(s) will be performed to resolve the pathogenesis in future.

姙産婦 및 骨盤臟器 腫瘍患者에서의 Toxoplasma Latex 凝集抗體價의 意義

崔源永(Won-Young Choi),崔亨洛(Hung-Rak Choi),羅琮球(Jong-Gu Rha) 대한기생충학열대의학회 1985 The Korean Journal of Parasitology Vol.23 No.2