황체기 결함이 있는 불임환자에서 클로미펜 투여 여부에 따른 자궁내막 내의 Prolactin의 발현 양상의 비교 연구

고승희,황정혜,심의섭,고재환,김용봉,장세진,Goh, Seung-Hee,Hwang, Jung-Hye,Sim, Ey-Sub,Koh, Jae-Whoan,Kim, Yong-Bong,Jang, Se-Jin 대한생식의학회 2003 Clinical and Experimental Reproductive Medicine Vol.30 No.1

Objective : Clomiphene citrate is one of the most commonly used drugs in the treatment of infertility, but the pregnancy rate achieved with clomiphene citrate is significantly lower than the ovulation rate due to its antiestrogenic effect on the endometrium. Endometrial prolactin is considered to be a marker and an inducer of predecidualization that is characteristic of secretory endometrium. The purpose of this study was to evaluate the association of clomiphene citrate and unsatisfactory endometrial differentiation to secretory endometrium by examining the endometrial expression of prolactin in clomiphene citratetreated infertile women with luteal phase defect. Methods : The endometrial samples from infertile women with luteal phase defect (n=27) were examined. Five cases during secretory phase and six cases during proliferative phase were obtained by biopsy. Sixteen cases were obtained by biopsy during secretory phase after clomiphene citrate treatment. By immunohistochemical staining for prolactin, all obtained endometrial tissues were examined. The differences in the endometrial expression of prolactin were evaluated between proliferative phase and secretory phase, and between clomiphene citrate treated group and no treatment group during secretory phase. Results: The staining of endometrial prolactin was significantly more intense in the glandular epithelial cells and stromal cells in the secretory endometrium than in the proliferative endometrium. The glandular expression of prolactin in the secretory endometrium was not significantly different between the clomiphene citrate-treated group and no treatment group (p=0.719), but the staining of prolactin in the stromal cells was significantly less intense in the clomiphene citrate-treated group than no treatment group (p=0.019). Conclusion: In this investigation, we demonstrated that the endometrial stromal expression of prolactin in the secretory phase was significantly lower in the clomiphene citrate-treated group campared with no treatment group in infertile women with luteal phase defect. And our finding suggests that clomiphene citrate may have an adverse effect on the endometrial predecidualization in infertile women.

원발성 난관암

고희은 ( Hee Eun Ko ),노지현 ( Ji Hyun Noh ),강윤경 ( Yun Kyung Kang ),고승희 ( Seung Hee Goh ),고재환 ( Jae Whoan Koh ),김용봉 ( Yong Bong Kim ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.1

Primary carcinoma of the fallopian tube is very rare and accounts for less than 1% of all gynecologic malignancies. Nonspecific symptoms are presented, so primary carcinoma of the fallopian tube was confirmed postoperatively on the basis of the pathologic

갑상선 기능 저하증과 동반된 거대 난소 종양

노지현 ( Ji Hyun Noh ),고승희 ( Seung Hee Goh ),심의섭 ( Ey Sup Shim ),고재환 ( Jae Whoan Koh ),김용봉 ( Yong Bong Kim ),최석구 ( Suk Koo Choi ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.4

In adult women, hypothyroidism has significant effect on reproduction. Hypothyroidism is associated with oligomenorrhea, amenorrhea, anovulation, hypermenorrhea, menorrhagia, infertility, spontaneous abortion, stillbirth or preterm delivery. It can cause

자궁경부암 진단에 있어 세포진 검사의 정확도에 관한 연구

김승룡,조삼현,이재억,황윤영,문형,김경태,고승희 대한부인종양 콜포스코피학회 1999 Journal of Gynecologic Oncology Vol.10 No.2

Background: Carcinoma of the uterine cervix is a theoretically preventable disease because its precursor lesions can be detected by cervical Papanicolau smears and appropriately treated, Although cervical cytology screening programmes have resulted in the redution of cervical cancer incidence and mortality, Pap smear have been subjected to intense scrutiny and criticism in recent years. The focus of criticism has been the false-negative Pap smear, and the false-negative Pap smear is the major quality issue currently facing the physicians. To reduce the false-negative rate of Pap smear, it is essential to improve the accuracy of Pap smear. But false-negative rate of Pap smear has been reported variously. Objective: This study was undertaken to evaluate accuracy of Pap smear by study false-negative and false-positive rate of Pap smear and to determine whether false-negative and false-positive rate had any correlations with clinical factors. Study design: The study population was comprised of 346 women, who were undertaken gynecologic operation at the Department of Obstetrics & Gynecology at Hanyang University hospital between March, 1997 and April, 1998. All patients were taken Pap smear before operation. In 93 women of these, preoperative diagnosis were cervical intraepithelial neoplasia and carcinoma in situ of uterine cervix, and in 253 women of these, preoperative diagnosis were benign disease as uterine myoma or adenomyosis, etc. All of their surgical specimen were examined. Pap smear, pathology, medical charts of all patients were reviewed retrospectively, and false-negative rate and false-positive rate were calculated. Clinical factors that associated with false-negative and false-positive rate were evaluated. Fishers exact test and Pearson chi-square test were used of statistical analysis, Results: False-negative rate of Pap smear was 7.2%, false-positive rate was 4.6%, corresponding rate with histology was 88.2%. Sensitivity and specificity of PAP smear were 87.0% and 97.0% respctively. According to gross finding of uterine cervix, erosion was 46.6% in cervical intraepithelial neoplasia, 67.8% in carcinoma in situ, 66.6% in microinvasive carcinoma of uterine cervix and 55.3% of 103 erosion findings was cervical intraepithelial neoplasia, carcinoma in situ or microinvasive carcinoma. 23.1% of cervical lesion were normal gross finding. Menopause was associated with false-negative rate and previous vaginal infection history, previous cervical minor operation, delivery mode, contraception method, pelvic inflammatory disease history, vaginal bleeding at Pap smear and gross finding of cervix were not associated. There were no clinical factors that were associated with false-positive rate Conclusion: Compared with other reports, false-negative rate(7.2%) and false-positive rate(4.6%) of Pap smear was lower and corresponding rate(88.2%) was higher in Hanyang university hospital. Because of higher false-negative rate in menopausal women, it need more careful to take and interpretate Pap smear in these group.

Vero 세포 공배양이 동결보존 후 해빙한 ICR계 생쥐 2-세포기 배아 발생율에 미치는 영향

장두영,고희은,이일한,정경남,고승희,고재환,김용봉 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.4

목적 : 동결보존 후 해빙할 경우 대부분의 포유류 배아에서 생존율이나 양질 배아의 회수율 및 임신율 등이 동결하지 않은 신선배아에 비해 현저하게 낮다. 본 실험에서는 Vero 세포 공배양이 동결보존후 해빙한 ICR계 생쥐 2-세포기 배아 발생에 유익한 영향을 미치는지 여부를 알아보고자 한다. 재료 및 방법 : 5-6 주령의 ICR 계 암컷 생쥐로부터 후기 2-세포기 배아를 얻어 1.5M 1,2-propanediol과 0.1M sucrose를 혼합한 동결보존액에서 동결시킨 다음 4단계 해빙방법을 거쳐 해빙한 후 2-세포기 배아만을 회수하여 실험재료로 사용하였다. 대조군으로서 Ham's F-10와 10% FBS을 섞은 배양액과 실험군으로서 Vero 세포가 단층으로 깔린 기본 배양액에 각각 배양하여 부화가 이루어질 때까지 배아 발달과정을 24시간 간격으로 5일 동안 관찰하였다. 결과 : 총 473개의 2-세포기 배아를 동결시켰으며 해빙 후 467개 (98.7%)의 2-세포기 배아를 회수하였다. 그중 2개의 할구 모두 건강한 배아가 299개 (64.0%), 1개의 할구가 변성된 것이 83개 (17.8%)였다. 2개의 할구 모두 건강한 299개 중 290개의 2-세포기 배아를 실험에 사용하였다. 배양 시작 24시간 후 4-세포기 이상의 배아 발생률은 대조군 (61.3%)과 실험군 (69.3%)간에 유의한 차이가 없었다 (p=0.161). 그러나 96시간, 120시간 이후 에는 대조군에 비해 Vero 세포 공배양군인 실험군에서 유의하게 높은 발생률을 보였다 (각각 14.4% 대 30.7%, (p=0.002); 9.0% 대 24.0%, (p=0.001)). 결론 : 동결보존된 2-세포기 생쥐 배아를 해빙 후 Vero 세포와 공배양할 경우 공배양이 동결과정이 해빙 후 미칠 수 있는 배아 발달의 저해효과를 제거하는 것으로 보이며, 이러한 효과는 배아 발달 과정 중 초기보다 후기에 더욱 현저한 것으로 보인다. 공배양의 이러한 이로운 효과는 동결보존된 배아를 체외배양시 임상의가 이식할 수 있는 적절한 시기에 양질의 배아를 얻을 수 있는 유용한 도구로 이용할 수 있다고 생각하며, 이로써 동결보존법의 단점인 낮은 임신율을 보다 향상시킬 수 있을 것으로 기대한다. Objective : The rate of developmental progression of frozen-thawed embryos is lower than that of nonfrozen embryos in mice, cows, humans and other mammalians. This study was designed and performed to evaluate the beneficial effects of coculture of Vero cells on the development of frozen-thawed two-cell stage embryos of ICR strain mice. Materials and Methods : The late two-cell stage mouse embryos were obtained from oviducts of 5∼6 week old mated ICR mice superovulated with pregnant mare's serum gonadotropin (PMSG) and human chorionic gonadotropin (hCG). Two-cell stage mouse embryos were frozen slowly with 1,2-propanediol and sucrose as cryoprotectants and thawed rapidly, followed by stepwise dilution. The frozen-thawed embryos were cultured in Ham's F-10+10% Fetal Bovine Serum (FBS) basal culture medium with and without Vero cells. The rates of development in both groups were compared every 24 hours for 5 days. Results : Vero cells did not significantly stimulate the rate of embryonal development compared to controls at 24 hours after culture, 124 (69.3%) and 68 (61.3%), respectively (p=0.161). On day 4, however, 55 (30.7%) cocultured embryos had developed to expanded-hatching blastocysts, which was the significantly higher number than that of the embryos in controls: 16 (14.4%) (p=0.002). In addition, more embryos in coculture developed to hatching-hatched blastocysts (43[24.0%]) compared to the controls (10[9.0%]) (p=0.001). Conclusion : Coculture of cryopreserved embryos after thawing with Vero cells seems to be an useful tool to remove the postthaw deleterious effects of freezing and to obtain better quality embryos appropriate for transfer. These beneficial effects of Vero cell coculture appear to become more prominent as the embryonic development progresses over time.

소음순에 발생한 Bowen씨 병 1예

안성호,안재형,황영수,고승희,고재환,김용봉,이혜경 인제대학교 백병원 2001 仁濟醫學 Vol.22 No.2

Bowen's disease is developed on skin or mucosal area. It is precancerous lesion and rarely progresses to invasive cancer. This disease can be developed in whole body, but rare in perineal and vulvar area. The authors experienced a case of Bowen's disease on labium minor and present it with brief review of the literature.