임신 및 산욕시 혈청 Amylase 활성도에 관한 연구

이효표(HP Lee) 대한산부인과학회 1977 Obstetrics & Gynecology Science Vol.20 No.12

1977년 7월1일부터 10월 31일까지 서울대학교 의과대학 부속병원 산부인과에 내원한 임신 6주부터 40주까지의 정상임신 135예와 입원한 정상만삭임신 및 합병증없이 정상만삭 질식분만한 후 제4일까지의 산모 98예를 대상으로 주정맥혈액을 채혈하여 SmithRoe변법을 사용하여 혈청 amylase치를 측정하였다. 그리고 대조군으로서는 질환이 없고 임신중이 아닌 부인 25예를 대상으로 하였다. 한편 21예에서 질식분만시 모체혈액과 제대혈액을 함께 채취하여 혈청 amylase치를 측정하였다. 이상의 성적을 분석검토하여 다음과 같은 결과를 얻었다. 1. 비임신 대조군의 평균 혈청amylase치는 108.0±23.5U.이었다. 2. 임신중의 혈청 amylase치를 살펴보면 임신 6∼10주군에는 107.1±25.4U이었으나 차 츰 상승하여 임신 21∼25주군에는 175.9±44.8U.로서 최고로 높았으며 그 후 차츰 저하 되어 임신 36∼40주군에는 127.0±38.9U.로 저하되었으나 비임신 대조군에 비하여 아직 도 유의하게 높았다. 3. 임신중에는 임부의 혈청amylase치가 25주까지는 계속 상승하였고 그 후에는 임신종 말까지 점차적으로 그러나 현저하지는 않게 저하하였다. 4. 제2 및 제3 trimester의 정상임부의 상당수에서 혈청 amylase치는 비임신 대조군의 정상상한치(평균치+2표준편차) 155.0U.를 훨씬 초과 하였다. 5. 산후 1∼4일의 산모 혈청 amylase치는 대체로 정상만삭임부에 비하여 아직 높기는 하나 통계적 유의성은 없었다. 6. 제대혈액의 혈청 amylase치는 모체혈액에서 보다 훨씬 낮았으며 이 효소의 모체/태 아의 비는 3.14:1이었다. Total serum amylase activity was measured by means of Smith-Roe`s modified method in the randomly selected 135 normal pregnant women between 6 to 40 weeks and 98 normal term graved and normal postpartum subjects through the fourth day afeter vaginal delivery at the Department of Obstetrics and Gynecology, seoul National University Hospital during the period from July 1 to October 31, 1977. In addition, 25 normal nonpregnant women without systemic disease were strdied. From 21 patients paired maternal venous and cord blood samples were obtained at vaginal delivery and carried through the same analytical procedure, and the maternal/fetal ratio of enzyme levels clculated. The results are as follows; 1) the mean serum amylase value recorded in our nonpregnant control subjects was 108.0±23.5 unit. 2) By contrast with this value, the mean serum amylase value, computed for each of the 5 week periods between weeks 6 to 40 of pregnancy, rose from107.1 ±25.4 unit in the 6 to 10 week to 175.9±44.8 unit in the 21 to 25 week, and then diminished to 127.0±38.9 unit in the 36 to 40 week. 3) there was a progressive rise in serum amylase from weeks 6 to 25 during pregnancy, followed by a gradual but less pronounced fall to the end of pregnancy. 4) In a considerable number of these normal pregnant women in the second and the presumptive upper limit of normal(mean+2S.D.) in this study. 5) the level of serum amylase activity in the early puerperal women was slightly, but insignificantly increased as compared with normal nonpregnant women. 6) Serum amylase activity was consistently demonstrated in cord serum although it was much lower than in maternal blood. The mean ratio of maternal to fetal enzyme levels was 3.14:1.

부인과 악성종양의 화학요법 감수성검사를 위한 in Vitro Clonlgenic Assay

이효표(HP Lee),차상헌(SH Cha),주권량(KR Joo),강순범(SB Kang),장윤석(YS Chang),김노경(NK Kim) 대한산부인과학회 1987 Obstetrics & Gynecology Science Vol.30 No.5

저자들은 1985년 3월부터 1985년 8월까지 서울대학병원 산부인과에 입원한 부인과 악성종양환자 19명을 대상으로 in vitro clonogenic assay 즉 HTSCA를 시행하여 다음과 같은 결과를 얻었다 1 자궁경암은 11례중 3예에서 성장을 보여 27 3%, 난소암은 4례중 3례에서 성장을 보여 75%, 자궁내막암은 3례중 2례에서 성장을 보여 66 7%의 성적을 보였고 원발소 불명의 선암은 1례중 1례에서 성장을 보였다 즉 전체 부인과악성종양 19례중 9례에서 성증을 보여 47 4%의 성적을 나타내었다 2 암세포집낙형성율은 자궁경암은 0 005∼0 01%, 난소암은 0 008∼1 2%, 자궁내막암은 0 008∼0 1%였고 원발소불명암은 0 005∼0 5%였다 3 자궁경암에서의 최대혈장농도의 1/10에서의 집낙생존수의 약제관련도는 vincristine 32%, cis-platinum 40%, vinblastine 42%, bleomycin 45%, mitomycin-C 45%, methotraxate 55%, cyclophosphamide 64%, 5-fluorouracil 76%, actinomycin-D 78%순이었다 4 난소암에서의 cis-platinum의 최대 혈장농도와 최대혈장농도의 1/10에서의 집낙생존수의 약제관련도는 44%와 56%로서 중등도의 감수성을 보였다 5 자궁내막암에서의 최대혈장농도의 1/10에서 집낙생존수의 약제관련도는 cis-platinum 34%, cyclophosphamide 38%, 5-fluorouracil 42%, mitomycin-C 44%, actinomycin-D 48%, vincristine 48%, vinblastine 52%, methotraxate 60%, bleomycin 64%순이었다 In vitro clonogenic assay provides a way of testing the effectiveness of chemotherapeutic agents in treatment of cancer as well as a study of tumor biologh Tumor specimens from 19 patients having cervical, ovarian, or endometrial carcinomas were studied with the in vitro clonogenic assay, 9 of which grew in vitro since May, 1985 Various chemotherapeutic agents by the culture surface drug application technique were tested against these tumors on soft agarose The results were as follows: 1 The percentage of tumor specimen which grew in the soft agarose plate was 47 4% Of the 11 cervical cancer studied, 3 grew(27 3% growth rate) Of the 4 ovarian tumors tested in the labortory, 3 grew(75%), 2 of 3 endometrial cancers grew(66 7%) and 1 of 1 adenocarcinoma of unknown primary site grew(100%) 2 Plating efficiencies of cervical cancer were 0 005-0 01%, that of ovarian cancer were 0 008-1 2%, that of endometrial cancer were 0 008-0 1% and that of adenocarcinoma of unknown origin was 0 005-0 05% 3 Of the 3 patients whose cervical cancer specimens grew in culture, the dose-related degree of colony survival at 1/10 peak plasma level was demonstrated in the order of the following: vincristine 32%, cis-platinum 40%, vinblastine 42%, bleomycin 45%, mitomycin-C 50%, methotraxate 55%, cyclophosphamide 64%, 5-fluorouracil 76% and actinomycin-D 78% 4 Of the 3 patients whose ovarian cancer specimens grew in the laboratory, the dose-related degree of colony survival of cis-platinum at peak plasma concentration was 44% 5 Of the 2 patients whose endometrial carcinoma specimens grew in the plate, the dose-related degree of colony survival at 1/10 peak plasma level was as follows: cis-platinum 34%, cyclophosphamide 38%, 5-fluorouracil 42%, mitomycin-C 44%, actinomycin-D 48%, vincristine 48%, methotraxate 60% and bleomycin 64%

난소암의 화학요법

이효표(HP Lee) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.10

자궁경부암 제IB기 및 IIA기환자의 치료성적에 영향을 미치는 예후인자에 관한 분석적 연구

이효표(HP Lee),김현우(HW Kim) 대한산부인과학회 1987 Obstetrics & Gynecology Science Vol.30 No.7

저자들은 1975년 2월부터 1984년 2월까지 서울대학병원 산부인과에 입원하여 한시적 전자궁적출술 및 골반내 임파절적출술 또는 이와 병행하여 보조적 방사선치료를 받았던 자궁경부암 IB기 216례 및 IIA기 141례를 대상으로 하여 다음과 같은 결론을 얻었다 1 자궁경부암 IIA기가 IB기에 비하여 종양직경 4cm이상, 자궁경부 외 1/3 침윤, 임파절 전이 등이 많았으며(P<0 01), 혈관내 침윤 및 암세포의 조직학적 분화정도 등은 유의한 차이가 없었다(P>0 05) 2 종양직경 4cm이상, 자궁경부 외 1/3침윤, 임파절 전이 등은 상호연관관계가 있었다(P<0 01) 3 혈관내 침윤은 자궁경부 외 1/3침윤, 임파절 전이 등과 상호연관관계가 있었다(P<0 01) 4 암세포의 조직학적 분화정도와 종양의 크기, 자궁경부 침윤정도, 임파절 전이, 혈관내 침윤 등과는 유의한 관계가 없었다(P>0 05) 5 질단단에 침윤이 있는 경우에 재발율이 높았다(33 3% VS 13 2%, P<0 05) 6 종양직경 4cm이상, 자궁경부 외 1/3침윤, 임파절 전이 등이 있는 군에서 2년간 무병생존율이 낮았다(P<0 01) 그러나 혈관내 침윤유무, 암세포의 조직학적 분화정도에 따른 2년간 무병생존율의 차이는 유의하지 않았다(P>0 05) 7 자궁경부암 기에 따른 재발율은 유의한 차이가 없었다(P>0 05) 8 고위험군에서의 재발율이 비고위험군보다 높았으나(P<0 01), 기에 따른 차이는 유의하지 않았다(P>0 05) 9 고위험군에서 수술만 시행한 군과 수술후 보조적 방사선치료를 병행하여 시행한 군에서 재발율은 유의한 차이가 없었다(P>0 05) 10 1개의 임파절에 전이가 있었던 군에 비하여 2개이상의 임파절에 전이가 있었던 군에서 재발율이 높았다(P<0 05) Clinico-pathological analysis was performed to 216 cases of cervical carcinoma stage IB and 141 cases of cervical carcinoma stage IIA treated by means of total hysterectomy and bilateral lymphadenectomy with or without postoperative radiotherapy in the Department of Obstetrics and Gynecology, Seoul National University Hospital, from Feburary 1975 to Feburary 1984 The results were as follows: 1 There was significant difference in tumor size, depth of invasion and lymph node metastasis between cervical carcinoma stage IB and IIA(P<0 01), but no significant difference in vascular invasion and degree of differentiation(P>0 05) 2 There was significant correlation among tumor size, depth of invasion and lymph node metastasis(P<0 01) 3 There was significant difference in depth of invasion and lymph node metastasis between vascular invasion and noninvasion(P<0 01) 4 There was no significant difference in tumor size, depth of invasion, lymph node metastasis and vascular invasion among degrees of differentiation(P>0 05) 5 The recurrence rate was higher in the patients with positive resection margin(P>0 05) 6 The patients who had bulky primary tumor, deep invasion of cervix or lymph node metastasis had a lower 2-year NED(no evidence of diseases) rates(P<0 01), but the patients who had vascular invasion or degree of differentiation revealed no significant difference in 2-year NED rates(P>0 05) 7 There was no significant difference in recurrence rate between cervical carcinoma stage IB and IIA(P>0 05) 8 Recurrence rate was higher in high risk group such as the patients who had bulky primary tumor, deep invasion of cervix, lymph node metastasis, and/or vascular invasion(P<0 01) 9 There was no significant difference in recurrence rate between operation alone and operation plus postoperative radiotherapy in high risk group(P>0 05) 10 There was significant difference in fecurrence rate between patients with one and two or more lymph node metastasis(P<0 05)

Methotraxate 투여로 인한 말초 백혈구 염색체 변이에 관한 연구

이효표(HP Lee) 대한산부인과학회 1972 Obstetrics & Gynecology Science Vol.15 No.8

저자는 MTX투여가 백혈구염색체에 미치는 영향을 조사하기 위해 Moorhead등의 방법을 사용하여 변이에 대한 조사를 시행한 바 MTX투여종료 2주후의 염색체소견은 거의 정상과 비슷한 경향을 보였다. Attempt has been made to study the type, frequency, and distribution pattern of the chromosome aberration induced by MTX, and the relationship of MTX dosage to the incidence of chromosome aberrations in human leucocytes. The peripheral blood leucocytes were cultured by the method of Moorhead et al. with a slight modification. In a preliminary study, the human blood leucocytes were cultured in vitro for 72 hours obtained from a healthy woman and a patient of gydatidiform mole without previous admin- istration of cytostatic agent or irradiation. Twenty-four hours before fixation, MTX(0.1-100 ㎍/ml) was added to the culture media. The data obtained in this study indicated that MTX added directly to the culture media in vitro did not cause any significant chromosomal damage. In an in vivo study, 25 sets of leucocyte culture from 5 patients of hydatidiform mole and 3 patients of choriocarcinoma were observed before and after the administration of MTX of varying doses. Upon chromosome analysis, 5 sets of leucocyte culture before administration of MTX and 20 sets after administration showed cells of good quality containing a sufficient number of chromosomes in metaphase. The following results were obtained; 1. The frequency of appearance of aneuploid cells was slightly higher in the treated series than the untreated control. 2. Chromatid and chromosome gaps and breaks appeared in 7.63% of cells in the treated series whereas it was 3.75% in the controls, indicating the significant difference between the treated and untreated series. 3. If all abnormalities are counted, including chromatid and chromosome gaps or breaks, fragments, and other abnormal chromosomes, 9.64% of the cells were involved in the treated series, and 3.75% in the controls. 4. The majority of chromosome defects was found among A and C groups of chromosomes in the MTX series. 5. Abnormal chromosomes such as dicentric chromosomes, ring chromosomes, fragments and deletions were found in the treated series, but not in the controls. 6. It was noticed that the incidence of chromosome aberrations in MTX therapy was highest at a certain range of dose(15mg-65mg), but it appeared to decrease as the dose increased. 7. Most of the chromosomal aberrations induced by MTX have disappeared 2 weeks after the termination of its administration.

포상기태 후 혈청내 b-hCG치 회귀의 예후적 특성에 관한 연구

이효표(HP Lee),김규현(KH Kim) 대한산부인과학회 1984 Obstetrics & Gynecology Science Vol.27 No.10

The importance of human chorionic gonadotropin(hCG) determinations folowing evacuations of a hydatidiform mole to detect trophoblastic disease has been universally recognized. However, indications for diagnosis and treatment of post-molar trophoblastic disease based on serial hCG measurements are frequently too general to resolve the individual chlinical problems. The postevacuation serum human chorionic gonadotropin regression curves of 29 cases with hydatidiform mole admitted at Seoul National University Hospital was analyzed to fefine the criteria for diagnosis and treatment of post-molar trophoblastic disease. The results were as follows: 1. Eighteen cases (62%) demonstrated a progressive fall in serum Beta-hCG titers to levels undetectable by radioimmunoassay within 14 weeks. 2. In remaining 11 cases (38%), the regression curve exhibited a plateau or rise in titer, during the first 6 weeks after evacuation. The significance of these curves was discussed with a brief review of literature.

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.

난소갑상선종의 1예

이효표(HP Lee),양충열(CY Yang),김홍택(HT Kim),최락성(RS Choi),이교웅(KW Lee) 대한산부인과학회 1968 Obstetrics & Gynecology Science Vol.11 No.9

A case of struma ovarii(1.3Kg, 17x15x14cm) originated from the left ovary of a Korean house-wife(34 years of age, Para:4-0-1-4) was reported. The tissue fragments of the tumor were taken for histological study. Eight out of ten tissue Fragments were made up of thyroid tissue in predominant amounts, two had dermoid cyst elements(hair follicles, sebaceous glands and epidermis of the skin) The patient sischarged from the hospital on the 12th hospital day. Postoperative BMR 3 weeks after discharge was +5%.

복강경의 진단적 이용에 관한 임상적 연구

이효표(HP Lee) 대한산부인과학회 1978 Obstetrics & Gynecology Science Vol.21 No.12

One hundred seventy-three diagnostic laparoscopies have been performed to assess the clinical impression from April, 1975 to November, 1978 in Seoul National University Hospital. Infertility, possible ectopic pregnancy and obsure pelvic mass are the leading indications for laparoscopy. The results obtained are summerized as follows: 1. The accuracy of the clinical diagnosis confirmed by laparoscopy was 60.0%. 2. The accuracy of the laparoscopic diagnosis confirmed by laparotomy was 97.0%. 3. Laparoscopy revealed 5 cases(55.6%) of associated pelvic pathology in 9 cases of unexplained infertility. 4. The correlation of laparoscopic findings in 63 patients with abnormal hysterosalpingograpy was investgated. In only 36 cases(57.1%) there was complete agreement between hysterosalpingography and laparoscopy. 5. In the 38 cases with possible ectopic pregnancy, only 14 cases(36.8%) have been proved to be ectopic pregnancy. 6. In the 22 patients with suspicious ovarian cyst, 17(77.3%) were found to have ovarian cyst, and 5 were interpreted as not ovarian cyst. 7. In the 24 primary amenorrhea patients many useful findings for treatment have been found by laparoscopy. 8. Varying degree of therapeutic procedures were performed in 9 of the total 173 cases.

생물리학적 감시를 이용한 산전 태아상태의 평가

이효표(HP Lee),신면우(MW Shin) 대한산부인과학회 1982 Obstetrics & Gynecology Science Vol.25 No.10

Five fetal biophysical variables, fetal breathing movements, fetal movements, fetal tone, qualitative amniotic fluid volume, and the nonstress test were measured in the same observation period in 61 high risk and 30 normal patients hospitalized at S.N.U.H. All delivered within one week of the last observation. The relationship between individual biophysical variables and combinations of variables to the outcome of pregnancy as judged by five-minute Apgar Score, fetal distress in labor, and perinatal mortality rate was determined. For single test, the false negative rate was significantly low except qualitative amniotic fluid volume and was similar volume. Combining tests resulted in a significant change in both the false negative and false positive rates as compared to any single test. The most accurate differentiation of the normal from the compromised fetus was obtained when all five variables were studied. The perinatal mortality ranged from 0 when all variables were normal to 500 per 1,000 when 3 variables were abnormal. These data suggest that combined fetal biophysical testing is a more accurate method of antepartum fetal evaluation than any single method relatively.