자궁내 태아사망의 임상적 고찰

이권해,이정재,조현철,이석민,이임순,이해혁,김권대,이순곤,남계현 순천향의학연구소 1999 Journal of Soonchunhyang Medical Science Vol.5 No.2

Objective: This study was designed to evaluate diagnosis and complication, prognosis during clinical study of cases of intrauterine fetal death. Methods and materials: This is a clinical study of 56 cases of the intrauterine fetal death among 8064 deliveries at Seoul Sunchunhyang university hospital during 5 years from January, 1994 to December, 1998. Results: The incidence was 0.7%. The age distribution of mothers was 18 - 44 years and was highest in the 25 - 29 years range(46.4%). The parity was the most highest in the nulliparous group(51.8%). The most common gestational weeks was 20 - 28 weeks gestational period(46.4%), and most common presentation was cephalic(73.5%). The most common weights of the intrauterine fetal death was from 5,00gm to 1,000g(48.2%). The mode of the most common delivery was the induction of delivery(57.2%). The etiologic factors were: unknown(42.9%), preeclampsia(17.9%), chorioamnionitis(14.3%), congenital anomaly(12.5%), abruptio placenta(7.1%), cord complication(3.6%), placenta previa, death of one for twin. There were 2 cases of maternal complication(DIC, Uterine atony). Conclusion : Intrauterine fetal death should be diagnosised early and treated properly to reduce risk of the maternal complication.

조산의 예측 지표로서의 fetal fibronectin의 유용성

정집광,이해혁,이정재,이석민,이순곤,남계현,이임순,이권해 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Objective: The purpose of this study was to evaluate clinical efficacy of fetal fibronectin as a marker to predictor of preterm labor. Materials & Methods: The study group consisted of sixty-eight healthy pregnant women, at gestational age between 24 and 36 weeks, who visited our department with vaginal discharge from April, 1995 to December, 1997. For comparison, we divided all of the pregnant women into two groups by the result of ROM-Check^®, positive groups(N=21) and negative groups(N=47). When preterm labor appeared, 50mg of ritodrine hydrochloride(Yutopar^®) mixed I liter of 5% dextrose solution was administered slowly intravenously. Results: 1) The gestational age at delivery and the interval time from admission to delivery in the positive groups were significantly shorter than those of the negative groups(p<0.05). 2) The positive groups had significantly lower birth weight and Apgar scores than the negative groups(p<0.05). 3) Among the negative groups, in case of tocolytics administration, the interval time from admission to delivery significantly delayed more than that time in case of no tocolytics administration(p<0.05). Conclusions: The detection of the fetal fibronectin in vaginal discharge had a useful method as a predictor of preterm labor. Tocolytics was more effective in the negative groups than in the positive groups.

폐경기 여성에서 호르몬 대치 요법시 병행 투여된 프로제스토젠 투여 방법에 따른 혈청 지질 및 지단백에 미치는 영향

이임순,전섭,이순곤,이해혁,이권해,정집광,이석민 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.1

Objective : The purpose of our study is to evaluate the effect of different administration method of progestogen on lipid profiles including total cholesterol, LDL(low density lipoprotein)-cholesterol, HDL(high density lipoprotein)-cholesterol, triglycerides during hormone replacement therapy in postmenopausal women. Methods and Materials : Seventy-one postmenopausal women who were assigned to following groups (Group I : conjugated equine estrogen(CEE), 0.625 mg/day plus continuous medroxyprogesterone acetate (MPA), 2.5mg/day, Group II : CEE, 0.625 mg/day plus cyclic MPA, 5mg/day for 12days/month. And we measured serum total cholesterol, high density lipoprotein (HDL)-cholesterol, low density lipoprotein (LDL)-cholesterol, and triglycerides before hormone replacement therapy(HRT) and 12 months later after hormone replacement therapy. Results: 1. Total cholesterol decreased in group I,III. 2. HDL-cholesterol increased in group I,II,III. 3. LDL-cholesterol decrease in group I,II. 4. Triglycerides increased in group I,II,III. There was significance in serum total cholesterol and LDL-cholestrerol among three groups. Conclusions : Estrogen alone or in combination with progestogen both in cyclic and continuous use improves lipid profiles, so medroxyprogesterone acetate(MPA) does not seem to blunt estrogenic effect on lipid profiles.

다산부에서 자간전증의 임상적 고찰

이주롱,이석민,한효상,이해혁,이임순,이권해 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

목적 : 전자간증 산모에서 초임신부와 다산부 각각의 임상적 특징을 조사하여 비교 분석하고자 하였다. 연구방법 : 1998년 1월부터 1999년 12월까지 2년간 순천향대학 서울병원에서 입원 분만한 임신성 고혈압성 질환 환자중 초임신부 106명과 다산부 50명, 총 150명을 대상으로 임상통계학적으로 조사 분석하였다. 결과 : 분만까지 임신기간의 비교시 초임신부에서는 33-36주에서 17.9%였고 다산부에서는 34.0%로, 다산부에서 조기분만의 예가 의의있게 많았다. 신생아 체중이 2500g 미만인 군이 초임신부군에서는 36.8%였고 다산부군에서는 62.0%로 다산부군에서 더 많았다. 임신성 고혈압성 질환의 중등도를 보면 중증자간전증의 초임신부에서 35.8%와 다산부에서는 44.0%로, 초임신부에 비해 다산부군의 중증 자간전증의 비율이 많았다. 결론 : 중증 임신성 고혈압성 질환이 다산부군에서 더 많았으며 적은 주수에서 제왕절개술을 시행해 출생아의 체중이 초임신부군에 비해 더 작았고 Apgar 점수도 더 낮았다. Objective : To study the clinical differences of primiparous and multiparous preeclamptic patients. Methods : We statistically analyzed 106 primiparous and 50 multiparous preeclamptic patients who were admitted to the Soonchunhyang University Hospital from January 1998 to December 1999. Results : It was statistically found that multiparae were more likely to give premature birth than primiparae: Thirty four percents of multiparae gave birth in the period between the 33rd and the 36th gestational weeks while 17.9% of primiparae did in the same period. Sixty two percents of the newborn babies of multiparae weighed less than 2500g. Among primiparae, the ratio was 36.8%. In addition, more multiparae(44.0% vs. 35.8%) suffered from severe preeclampsia. Conclusion : severe preeclampsia was found more frequently among multiparae. Since they gave birth earlier by cesarian section than primiparae, their babies weighed less and had lower apgar scores.

폐경기 여성에서 호르몬 대치 요법시 병행 투여된 프로제스토젠 투여 방법에 따른 골대사의 생화학적 지표에 미치는 영향

이권해,강선영,임경빈,이해혁,구도형,이석민 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.1

Purpose : To evaluate the impact of added progestogen on biochemical markers of the bone turnover undergoing hormone replacement therapy in the postmenopausal women. Materials and Methods : There are 71 postmentopausal women who are divided into three groups (Group I, Group II, Group III). Group I(continuous combined)is given conjugated equine estrogen (CEE, 0.625mg, day 1-30) plus medroxyprogesterone acetate (MPA, 2.5mg, day 1-30), Group II(unopposed estrogen) is given conjugated equine estrogen (CEE, 0.625mg, day 1-30) plus medroxyprogesterone acetate (MPA, 5mg, day 1-12). And there were measured serum osteocalcin, serum total alkaline phosphatase and urinary deoxypyridinoline excretion before starting hormone replacement therapy and 12 months later. Results : The serum osteocalcin, serum total alkaline phosphatase and urinary deoxypyridinoline excretion significantly decreased after hormone replacement therapy (Group, I, II, III). And there was no significance in decreases in biochemical markers of the bone turnover among three groups. Conclusions : It was concluded that the impact of added progestogen on the biochemical markers of the bone turnover undergoing hormone replaced therapy in postmenopausal women was not significant than nothing added group. Thus we concluded that progestogen was not impact on decreasing on the biochemical markers of the bone turnover in postmenopausal women undergoing hormone replacement therapy.

심혈관계 질환으로 관상질환 집중치료실에 입원한 환자들의 혜후 측정을 위한 APACHEⅢ점수 체계의 임상적 유용성

이공섭,이창선,최현주,홍종서,강지향,김도형,이민영,오인균,김병엽,김상억,김학찬,한승혜,이재용,지영우,안경주 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8

저산소성 허혈성 뇌손상을 유발시킨 어린 백서에서 Myeloperoxidase 측정 검사

양혜정(Hae Joung Yang),피대훈(Dae Hun Pee),임지혜(Ji Hye Lim),최병민(Byung Min Choi),이기형(Kee Hyoung Lee),은백린(Baik-Lin Eun) 대한소아신경학회 2002 대한소아신경학회지 Vol.10 No.2

목 적 : 예전에는 뇌경색 부위에서 발견되는 백혈구를 단지 뇌손상에 뒤따르는 생리적인 반응으로만 생각하였으나 최근 10년 사이 재관류 손상에서도 백혈구에 의한 염증 작용이 중요한 역할을 한다고 알려지면서 이들의 역할에 대한 연구가 새롭게 이루어지고 있다. PML의 존재는 세포질내 과립에서 분비되는 MPO를 생화학적으로 측정함으로서 증명할 수 있는데 저자들은 미성숙 뇌에서 저산소성 허혈증에 의한 뇌손상이 발생할 때 백혈구가 침윤되는 과정을 MPO 측정 검사를 통하여 관찰하였고, P와 L-selectin 억제제인 Fucoidin을 투여한 후 MPO의 변화를 확인하였다. 방 법 : 생후 7일된 어린 흰쥐를 사용하여 우측총 경동맥을 전기 응고시켜 자르고 8% 산소에 노출시켰다. 저산소 노출 후 회복 시간에 따라 동물을 희생시키고 뇌를 추출하여 뇌조직 1 g당 10mL의 20 mM potassium Phosphate buffer(pH 7.4)를 첨가하여 50초간 분쇄하였다. 각각의 균질회된 조직 샘플들은 4℃에서 20분 동안 원심 분리하여 상층액을 제거한 후, 침전물은 처음 조직량에 따라 조직 1 g당 10 mL의 0.5% cetylditrimethylethyl ammonium bromide(wt/vol)가 첨가된 50 mM potassium phosphate buffer(pH 6.0)를 첨가하였다. Vortex를 이용하여 buffer와 침전물을 잘 섞고 60℃수조에서 120분 동안 방치하였다. 그 후 각 조직 샘플들을 4 watts에서 음파처리하고 4℃에서 15분 동안 원심 분리를 시행하여 상층액을 새로운 tube에 옮겼다. MPO 측정검사를 위한 MPO reaction buffer는 50 mM potassium phosphate buffer(pH 6.0) 100 mL에 0.53 mM odianisidine edihydrochlorde와 0.0005% HO를 섞어 만들었다. MPO reaction solution 2.9 mL에 각각의 MPO sample 0.1 mL을 첨가하여 460 nm의 파장에서 5분 동안 MPO에 다른 흡광도 차이를 관찰하였다. 결 과 : 조직내 백혈구 침윤의 지표로 측정한 MPO 활성도는 대조군에서는 미미하였으나 총 경동백을 절단한 우측 대뇌군에서는 허혈 및 저산소증 유발 후 8시간째부터 현저히 증가되기 시작하여 24시간 경과 후 발현이 가장 높았으며, Fucoidin 50 mg/kg으로 전처치한 약물 실험군에서는 MPO 활성도가 현저히 감소하였다. 결 론 : 백혈구는 미성숙 뇌의 저산소성 허혈증에 의한 뇌손상에서 중요한 매개체 역할을 하며, 백혈구의 생화학적 활성도를 나타내는 MPO 활성도는 저산소성 허혈성 뇌손상의 정도를 측정하는 지표로 이용될 수 있다고 생각된다. Purpose : Neutrophils found around an infarcted area in the brain was once considered as only the physiologic response following the brain injury, but recent studies have shown that inflammatory responses by neutrophils play an important role in the reperfusion injury. The presence of ploymorphonuclear leukocytes(PML) is proven by biochemical assay of myeloperoxidase(MPO) Secreted in the cytoplasmic granules. We observed the process of PML infiltration on hypoxic-ischemic brain injury of immature rats by the assay of MPO activity and changes of the MPO activity after the administration of fucoidin, inhibitor of P- and L-selectin. Methods : We used a well characterized model of the brains of 7 day-old-rats, which had unilateral hypoxic and ischemic injuries(HI). Those injuries were induced by unilateral carotid artery ligation followed by timed exposure to hypoxic inspiratory gas mixture(8% O). MPO activity was measured in the brain tissue homogenates of HI rats(n=18) at 0, 2, 8, 24 and 48 hrs and in rats that received fucoidin immediately before and again after hypoxia(50 mg/kg, n=6) at 8 and 24 hrs. Controls(n=2) were rats with neither hypoxia nor ischemia. The brain samples were homogenized in 20 mM potassium phosphate buffer(pH 7.4) for 50 secs. The homogenate was centrifuged at 14,000 g at 4℃ for 15 mins and the supernatant was discarded. The tissue was pulverized, weighed, and suspended in 1 mL of 50 mM potassium phosphate buffer solution(pH 6.0) contatining 0.5% cetylditrimethylammonium bromide(wt/vol). The tissue was sonicated and centrifuged at 10,000 g for 15 mins. 200 µL of the supernatant was mixed with 1 mL of 50 mM potassium phosphate buffer solution(pH 6.0) containing 10 μL of 1.325 mM o-dianisidine hydrochloride and 170 µL of 3% hydrogen peroxide(vol/vol). Changes in absorbance at 460 nm were measured for 5 mins by using microplate reader. One unit of MPO activity was defined as that degrading 1 µmol peroxide/min at 25℃, and the result was expressed as units of MPO/100 gm tissue. Results : In HI rats, MPO activity increased at 2 hrs after HI and peaked at 24 hrs in the right hemisphere. In rats with fucoidin treatment immediately before and again after hypoxia, the MPO activity significantly decreased in both hemispheres compared with HI rats(P<0.05). MPO activity in the tissue of control rats was insignificant. Conclusion : The dynamic changes of the MPO activity suggest the important role of PMN on hypoxic-ischemic brain injuries in immature rats. MPO activity could be used as an index of the severity of injuries of hypoxic-ischemic brains.

임신 종결 후 발생한 자궁 동정맥 누공에서 자궁동맥색전술로 치료한 1예

김종민,이해혁,김태희,남계현,심일구,이권해,김형문,이임순,장종호 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Arteriovenous fistula of uterus is rarely reported disease. This vascular malformation is very dangerous condition because Dilatation & curettage can cause massive uterine bleeding without accurate diagnosis. The diagnosis is made by angiography, gray scale ultrasonography, color and duplex doppler ultrasonography, computed tomography, and magnetic resonance imaging is helpful. Especially color and duplex doppler ultrasonography is allows convincing detection and diagnosis of arteriovenous fistula. Recently transcatheter uterine artery embolization is treatment of choice. We have experienced a case of arteriovenous fistula of uterus. Which is presented with a brief review of literature.

Effect of 840 nm light-emitting diode(LED) Irradiation on Monosodium Iodoacetate-Induced Osteoarthritis in Rats

( Hyun-ji Lee ),( Ha-nul Soe ),( Woo-bin Soel ),( Kyung-sun Soe ),( Jong-won Ju ),( Hae-sung Lee ),( Ung-bae Park ),( Min-suk Yu ),( Ji-hyun Lee ) 대한임상병리사협회 2013 조직세포검사학회 발표자료집 Vol.2013 No.-

Background The objective of this study was to evaluate whether 840 nm light-emitting diode (LED) could be effective in a noninvasive, therapeutic device for the treatment of monosodium iodoacetate-induced osteoarthritis in rats. Method Twenty male Sprague-Dawley rats weighing approximately 200 g each were divided into four groups: control group (C); monosodium iodoacetate-treated(MIA) group; monosodium iodoacetate-treated(MIA) group with LED phototherapy(MIA-LED); indomethacin-treated group(IMT). Osteoarthritis(OA) was induced by intra-articular injection of 50 μl of 3 mg MIA through the patellar ligament of the right knee. Control rats were injected with an equivalent volume of saline. In the MIA-LED group, the animal knees were exposed to LED stimulation at intervals of 15 min/day, for 1 weeks after MIA treatment. Animals were sacrificed at 2 weeks postoperatively. Knee joints were removed and fixed overnight in 10% neutral buffered formalin and subsequently decalcified by EDTA for 2 wk before being embedded in paraffin. Frontal sections (4 μm thick) of the medial aspect of the rat knee joints were prepared every 250 μm. The OA clinical score was monitored by knee movement and by radiographic analyses. Histologic analyses were performed following staining with hematoxylin and eosin, Safranin O-fast green, or toluidine blue, and histologic changes were scored according to a modified Mankin system. Results Radiographic examination showed no differences between the MIA-treated and the MIA-LED-treated rats. Sclerotic regions adjacent to the tibioepiphyseal margin, thinning of the epiphysis, and a small exophite were evident in the MIA-treated and the MIA-LED-treated rats, whereas tibioepiphyseal margin was well preserved in the IMT-treated rats compared with the two groups. Histologically, the lesion severity of knee joint by Mankin``s scoring showed not a significant difference between the MIA-treated and the MIA-LED-treated rats, however the lesion score was significantly decreased in the IMT rats compared with the two groups. Discussion The irradiation of LED at 840 nm after monosodium idoacetate treatment was no significant difference between the respective arthritis parameters in LED-treated group compared with indomethacin-treated group. However, the total Mankin score was significantly decreased in MIA-LED-treated group compared with monosodium iodoacetate-treated group. These results indicate that LED phototherapy was some beneficial influence on the repair of chondral lesion in osteoarthritis rats.

난치성 백반증에 대한 흡입물집을 이용한 비배양 표피세포이식술 20례

배정민 ( Jung Min Bae ),정한미 ( Han Mi Jung ),이한나 ( Han Na Lee ),이로우 ( Ro Woo Lee ),은성혜 ( Sung Hye Eun ),권혁선 ( Hyuck Sun Kwon ),이지혜 ( Ji Hae Lee ),김경문 ( Gyong Moon Kim ) 대한피부과학회 2018 대한피부과학회지 Vol.56 No.7

Background: As nonsurgical interventions for vitiligo are not always successful, various surgical modalities have been used in patients with refractory vitiligo. Of these, non-cultured epidermal suspension transplantation (NCES) was recently introduced to treat large recipient sites using cells from small donor tissue. Objective: We assessed the effectiveness and safety of NCES as a surgical treatment for patients with refractory vitiligo. Methods: We retrospectively reviewed 20 cases in 17 patients (11 females; median age 25 years) who underwent NCES from July 2015 through March 2018. Suction blisters (20 mm in diameter) were collected from the patient’s inner thigh at a donor-to-recipient area ratio of 1:5. After the addition of 5 mL recombinant trypsin solution to the suction blisters, followed by incubation at 37°C for 60 min, epidermal cells were manually scraped off the blister surface, and epidermal cell suspension was obtained by centrifugation at 1,500 RPM for 5 min. The suspension was applied to the vitiligo regions after epidermal ablation of those regions. Phototherapy resumed 1 month later. Treatment success was defined as ≥75% repigmentation of the surgical site, and all adverse events were noted. Results: Overall, 85.0% of cases (17/20) exhibited treatment success. Adverse events included hyperpigmentation (20%) and surgical site infection (5%), but the treatment was tolerable in all cases. Conclusion: NCES is a reliable surgical option for patients with vitiligo refractory to nonsurgical treatment. Large areas of vitiligo can be treated by NCES, and use of this technique should be encouraged in Korea. (Korean J Dermatol 2018;56(7):426∼432)