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인간 난소에서 생리 주기에 따른 Mullerian Inhibiting Substance와 그 수용체의 발현
김장흡 ( Jang Heub Kim ),정서호 ( Seo Ho Chung ),최은주 ( Eun Joo Choi ),황성진 ( Hwang Seong Jin ),조현희 ( Hyun Hee Jo ),김미란 ( Mee Ran Kim ),김은중 ( Eun Jung Kim ),김진홍 ( Jin Hong Kim ),류기성 ( Ki Sung Ryu ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.9
목적 : Mullerian inhibiting substance (MIS)의 주 생산 장기인 가임기 여성 난소에서 MIS와 MIS가 결합하는 MIS type II 수용체 (MISR II)의 정확한 발현위치와 월경에 따른 변화를 알아보고 생식생리에 미치는 역할을 밝히고자 연구를 시행하였다. 연구 방법 : 월경주기와 난소기능이 정상이면서 난소종양이 없는 부인과 환자의 난소조직을 월경주기별 (난포기, 배란기, 황체기)로 구분하여 각각 7예씩 총 21예를 대상 In this study, in order to further understanding of function of Mullerian inhibiting substance (MIS) and the ontogeny of the production profile of biologically active MIS and MIS type II receptor (MISR II), the patterns of their localization according to
( Jang Heub Kim ),( David T Maclaughlin ),( Patricia K Donahoe ) 대한산부인과학회 2014 Obstetrics & Gynecology Science Vol.57 No.5
Mullerian inhibiting substance (MIS), also called anti-Mullerian hormone (AMH), is a member of the transforming growth factor-β super-family of growth and differentiation response modifiers. It is produced in immature Sertoli cells in male embryos and binds to MIS/AMH receptors in primordial Mullerian ducts to cause regression of female reproductive structures that are the precursors to the fallopian tubes, the surface epithelium of the ovaries, the uterus, the cervix, and the upper third of the vagina. Because most gynecologic tumors originate from Mullerian ductderived tissues, and since MIS/AMH causes regression of the Mullerian duct in male embryos, it is expected to inhibit the growth of gynecologic tumors. Purified recombinant human MIS/AMH causes growth inhibition of epithelial ovarian cancer cells and cell lines in vitro and in vitro via MIS receptor-mediated mechanism. Furthermore, several lines of evidence suggest that MIS/AMH inhibits proliferation in tissues and cell lines of other MIS/AMH receptor-expressing gynecologic tumors such as cervical, endometrial, breast, and in endometriosis as well. These findings indicate that bioactive MIS/AMH recombinant protein should be tested in patients against tumors expressing the MIS/AMH receptor complex, perhaps beginning with ovarian cancer because it has the worst prognosis. The molecular tools to identify MIS/AMH receptor expressing ovarian and other cancers are in place, thus, it is possible to select patients for treatment. An MIS/AMH ELISA exists to follow administered doses of MIS/AMH, as well. Clinical trials await the production of sufficient supplies of qualified recombinant human MIS/AMH for this purpose.
Kim, Jang Heub,Kim, Eun Jung,Kim, Jin Hong,Lee, Jin Woo,Lee, Hun Young CATHOLIC MEDICAL CENTER 1992 Bulletin of the Clinical Research Institute Vol.20 No.1
Forty-four polycystic ovary patients were treated for a total of 57 cycles with intermediate dose FSH. Patient selection was based on hyperandrogenism, oligoovulation, and physical signs. Patients with multiple factor infertility were excluded from the study. Seventeen conception cycles occurred in 17 patients (Pregnancy cycles). The spontaneous abortion rate was 29.4%. Forty cycles did not result in conception (Nonpregnancy cycles, 23 patients). Sixteen pregnancies (94%) occurred within the first 2 treatment cycles. Pregnancy and Nonpregnancy cycles were compared for characteristics associated with a successful outcome. There was no difference in the average cycle lengths, number of baseline follicles, serum estradiol, or number of large follicles on day of hCG. Compared with the Nonpregnancy cycles, the cycles resulting in pregnancy required a significantly higher number of FSH ampules according to body weight. The duration of FSH administration also increased with increasing body weight in the Pregnancy cycles. In the Pregnancy cycles, body weight (X) was correlated to the number of ampules FSH (Y) used (r=0.728) and the following formula was identified: Y=0.33622X-9.3635. Using this formula, the number of treatment days (Z) could be predicted from the number of ampules (Y): Z=(Y-12)÷3+9. Serum testosterone was greater (91.8±41.6 vs 57.1±30.4 ng/ml, p<0.03) and the average BSA was significantly higher in patients who conceived (1.88±0.2 vs. 1.73±0.2 ㎡, p<0.04). Serum LH/FSH ratio on day 5 was higher in the Pregnancy cycles, but not significantly different. Ovarian hyperstimulation occurred in 1 cycle (6%) in the Pregnancy cycles and 14 (35%) in Nonpregnancy cycles. These data suggest 1) the intermediate dose pure FSH protocol is most likely to be successful among more “classic” PCOD patients as evidenced by obesity, high BSA, elevated LH/FSH ratio, and higher testosterone, 2) if pregnancy is to occur, it is most likely to occur within two treatment cycles, 3) patients who do not conceive with intermediate dose FSH are more likely to experience ovarian hyperstimulation, and 4) formulas are provided which help anticipate the number of FSH ampules which will be used and the number of treatment days FSH will be required.
Comparative Evaluation of Hysterosalpingography and Laparoscopy in Diagnosis of Infertile Women
Kim, Jang Heub,Kim, Seung Jo CATHOLIC MEDICAL CENTER 1980 Bulletin of the Clinical Research Institute Vol.8 No.1
From 1974 to 1979, inclusively, 91 patients from the Infertility Clinic of St. Mary's Hospital, Catholic Medical College, were evaluated with both HSG and laparoscopy. In 46.6% of the cases there were complete aggrement between HSG and laparoscopy. HSG showed 9.1% false posive and 8% false negative findings. The results showed that premedication with Buscopan Compositum^� in HSG was of benefit in decreasing the incidence of false positive tubal occlusion. Peritubal adhesion was the pathologic process most commonly missed by HSG and diagnosed subsequently by laparoscopy. As for the factors other than tubal occlusion and/or peritubal adhesion, other pelvic diseases were the most common abnormalities discovered by laparoscopy, whereas all intrauterine factors were easily detectable by HSG.
양성 부인과질환 환자에서 다양한 자궁적출술 방법에 따른 임상경과의 비교
김현영,조현희,이윤진,권지영,김석원,팽기영,김장흡,김진홍 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.4
목적 : 소복부절개를 통한 자궁적출술의 방법이 기존에 사용되어왔던 각종 자궁적출술의 방법에 비해 어떠한 장점이 있는지를 알아보고자 한다. 연구 방법 : 양성의 부인과 질환으로 자궁적출술을 받은 환자 300명중 40명은 소복부반월형횡절개로 자궁적출술을 시행하고, 186명은 복부반월형횡절개를 통한 고전적 자궁적출술을, 28명은 복강경하 질식자궁적출술을, 46명은 질식자궁적출술을 시행한 후 각군의 특징과 수술후 회복정도를 비교하였다. 결과 : 소복부절개를 이용한 수술군은 수술군의 선택에 있어서는 기존의 고전적방법과 마찬가지로 질환군이나 과거수술력 등에 따른 한계가 없었으며, 수술후 임상경과는 복강경하 질식자궁적출술과 같은 빠른 회복의 장점을 가졌다. 결론 : 소복부절개를 통한 자궁적출술은 기존의 여러 자궁적출술의 방법에 따른 장점을 갖는 수술방법이다. Objective : To evaluate the clinical effectiveness of minilaparotomy total hysterectomy compared with other methods of hysterectomy ever used. Methods : Data of 300 women who had been done hysterectomy due to benign gynecologic disease were used for this thesis. Minilaparotomy hysterectomy was done for 40 women, classical transabdominal hysterectomy for 186 women, laparoscopic assisted vaginal total hysterectomy for 28 women and vaginal total hysterectomy for 46 women. Women's clinical data and clinical outcome were compared using Excel and SPSS. Results : Minilaparotomy hysterectomy has no limitation in choosing patient and adnexal surgery like classical transabdominal hysterectomy, and postoperative clinical course is so rapid similar with laparosocopic assisted vaginal total hysterectomy. Conclusion : Minilaparotomy hysterecomy is good choice for treatment of benign gynecologic disease.