성선 자극 호르몬에 의해 유도된 인간 난소내 세포사멸된 난자에서의 StAR 단백질의 발현

김세광 ( Sei Kwang Kim ),박철홍 ( Cheol Hong Park ),양현원 ( Hyun Won Yang ),김명신 ( Myoung Shin Kim ),정경아 ( Kyung Ah Chung ),배상욱 ( Sang Wook Bai ),박기현 ( Ki Hyun Park ),조동제 ( Dong Jae Cho ),윤용달 ( Yong Dal Yoon ) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.12

목적 : 인간 난자 및 배아의 퇴화에 따른 미토콘드리아 내 StAR 단백질의 존재 여부 및 변화 양상을 알아보고자 하였다. 연구 방법 : 여성 불임 환자에서 보조생식술을 통해 채취된 난자 가운데 정상 난자와 분절화를 보이는 난자를 구분하여 TUNEL 염색 방법으로 세포사멸 여부를 확인하고, immuno-labelling 방법을 적용하여 StAR 단백질 발현 정도를 측정함으로써 난자의 분절화에 따른 StAR protein의 관련 여부를 확인하였다. 결과 Objective : To determine the distribution and expression of steroid acute regulatory (StAR) protein in human oocyte and embryo in relation to apoptosis. Methods : Immuno-labelling and confocal microscopy were applied to examine the localization of StAR pr

자간전증 산모의 제대동맥에서 혈관내피세포의 기능의 변화

김세광(Sei Kwang Kim),최형민(Hyung Min Choi),박용원(Yong Won Park),김재욱(Jae Wook Kim),안덕선(Duck Sun Ahn),강복순(Bok Soon Kang) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.6

목적 : 자간전증 산모의 제대동맥을 이용하여 혈관 내피세포의 이완 기능의 이상 유무를 알아보고, 내피세포의 손상 기전과 혈관 평활근의 이상 여부를 연구하고자 하였다. 방법 : 1998년 6월부터 1999년 11월까지 연세대학교 의과대학 신촌 세브란스병원에서 분만한 중증 자간전증 산모의 제대동맥과 같은 기간 동안 얻은 정상 산모의 제대동맥을 이용하여 여러 가지 혈관 활성물질(vasoactive substances)의 효과를 장력 실험 및 bioassay 실험을 통해 비교, 관찰함으로써 자간전증 산모에서 관찰되는 혈관긴장도 증가 현상이 혈관 내피세포의 기능저하로 유발되는 지, 혹은 혈관 평활근세포의 기능 변화에 의해 유발되는 지의 여부를 확인하였다. 결과 : 1. 내피 의존성 이완제에 의한 제대동맥의 이완의 효과는 정상 산모에 비하여 중증 자간전증 산모에서 현저하게 감소하였다. 2. 내피 비의존성 이완제에 의한 제대동맥의 이완 효과 역시 정상 산모에 비하여 중증 자간전증 산모에서 현저히 감소하였다. 3. 중증 자간전증 산모의 경우 혈관 내피세포에서 endothelial derived relaxing factor (EDRF)의 유리가 억제됨을 bioassay 실험을 통하여 직접 확인 할 수 있었다. 4. 8-bromo-cGMP(cyclic Guanosine Monophosphate)에 의한 제대동맥의 이완 효과가 정상 산모에 비하여 중증 자간전증 산모에서 현저히 감소하였다. 결론 : 중증 자간전증 산모의 경우 혈관 내피세포로부터 혈관 이완물질인 EDRF의 유리가 감소되어 있을 뿐 아니라 유리된 EDRF에 대한 혈관 평활근세포의 반응성 역시 현저히 저하되어 있음을 알 수 있었다. Objectives & Methods : To directly examine the function of the endothelial cell(EC) and smooth muscle cell in umbilical arteries acquired from preeclampsia patients between June 1998 to November 1999, using a conventional tension measurement and bioassay experiment.Results : Relaxation responses to EC-dependent relaxing agents including bradykinin and A23187 in human umbilical artery rings were significantly decreased in preeclampsia(p<0.01). Relaxation responses to EC-independent agents(SNP and SNAP) were also inhibited in umbilical artery rings acquired from preeclampsia patients(p<0.01). To test the change of endothelial cell function in preeclampsia without involvement of smooth muscle dysfunction, we used human umbilical artery and rabbit femoral artery as a donor and detector, respectively, in bioassay experiment. Relaxation responses to EC-dependent agents(A23187 and bradykinin) showed similar results to conventional tension measurement (p<0.01). Relaxation responses to 8-bromo-cGMP in human umbilical artery rings were also significantly decreased in preeclampsia(p<0.01).Conclusion : It can be concluded that increased vascular resistance in preeclampsia is not only due to the disturbance of endothelial function, but also to smooth muscle dysfunction.

45,X / 47,XYY 모자이크 터너증후군

김세광(Sei Kwang Kim),김재욱(Jae Wook Kim),양영호(Young Ho Yang),김현주(Hyun Joo Kim),모형진(Hyoung Jin Mo),배상욱(Sang Wook Bai),김인규(In Kyu Kim) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.1

45,X/47,XYY mosaicism is a rare sex chromosomal disorder with clinical information limited to 25 cases in the literature. We report an unusual mosaic Turner syndrome case in a 35-year old Korean woman with a phenotypic female, primary amenorrhea, short stature, immature secondary sexual characteristics. Cytogenetic analysis including G- and Q-banding revealed 45,X/47,XYY mosaicism, and SRY gene was demonstrated by polymerase chain reaction(PCR). Prophylactic bilateral gonadectomy was performed because the presence of Y-chromosomal sequences in Turner stigmata may predispose this patient to gonadoblastoma formation.

자궁내막암 환자에서 혈청 CA 125 의 예후인자로서의 가치

김세광(Sei Kwang Kim),정재은(Jae Eun Chung),김재욱(Jae Wook Kim),김영태(Young Tae Kim),김동규(Dong Kyu Kim),노성일(Sung Il Roh),조정현(Jung Hyun Cho) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.10

N/A Objective : The prognostic value of serum CA 125 sampled before the staging operation and the right CA 125 cut-off level in endometrial cancer was evaluated. Methods : Medical charts of 119 endometrial cancer patients diagnosed and surgically treated at the Department of Obstetrics and Gynecology, Yonsei University College of Medicine from March 1995 to March 2001 were reviewed. The prognostic value of CA 125 was evaluated by comparing it to other established prognostic factors of endometrial cancer such as myometrial invasion, cervix extension, tumor size, and grossly invasive disease. Enzyme immunoassay (Elecsys 2010; Roche Ltd., Basel, Switzerland) was used for the measurement of serum CA 125. Results : The level of presurgically taken serum CA 125 level correlated well with the established prognostic factors of endometrial cancer. CA 125 was one of the information that could be obtained prior to the surgical staging for predicting extensive endometrial cancer, and it could be correlated with the 5 year survival. CA 125≥20 U/ml had a higher sensitivity and lower false negative rate in predicting extensive endometrial cancer compared to the conventionally used level of CA 125≥35 U/ml. Conclusion : CA 125 has a prognostic value in predicting the extensive endometrial cancer needing lymphadenectomy, therefore it might be included in the baseline study of endometrial cancer for predicting the prognosis and individualizing the treatment modality. CA 125≥20 U/ml might be considered as the cut-off level in endometrial cancer for a better sensitivity and false negative rate.

자궁경부암에서 Cdc25A, Cdc25B 및 Cdc25C의 발현

김혜연 ( Hye Yeon Kim ),김재욱 ( Jae Wook Kim ),김세광 ( Sei Kwang Kim ),김영태 ( Young Tae Kim ),김재훈 ( Jae Hoon Kim ),김성훈 ( Sung Hoon Kim ),김상운 ( Sang Wun Kim ),윤보성 ( Bo Sung Yoon ),남은지 ( Eun Ji Nam ),조혜진 ( Hye 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.10

목적: 본 연구는 자궁경부암에서 세포주기 조절인자인 cell division cycle (Cdc) 25A, Cdc25B 및 Cdc25C 발현 양상을 정량적으로 측정하여 이들이 자궁경부암의 발암과정에서 어떠한 역할을 하는지를 규명하며 아울러, 자궁경부암의 여러 다른 임상적 및 병리학적 예후 인자와 상관관계가 있는지를 연구하고자 하였다. 연구 방법: 본원 산부인과에서 2000년 2월부터 2005년 3월까지 수술적 치료를 받은 환자를 대상으로 하여 신선 자궁경부 조직을 얻었다. 역전사 중합요소 연쇄 반응과 Western blot analysis를 이용하여 각각 Cdc25A, Cdc25B 및 Cdc25C의 mRNA와 단백질 발현 양상을 확인하였다. 결과: 자궁경부암 조직에서의 Cdc25A, Cdc25B 및 Cdc25C의 mRNA 발현은 정상 자궁경부 조직보다 모두 통계학적으로 유의하게 높았으며 (p=0.02, 0.01, 0.02), Cdc25A, Cdc25B 및 Cdc25C의 단백질 발현 양상도 자궁경부암 조직에서 정상 자궁경부 조직에 비해 모두 통계학적으로 유의하게 높은 결과를 보였다 (p=0.01, 0.02, 0.01). 또한 자궁경부암에서의 Cdc25A, Cdc25B 및 Cdc25C의 mRNA 발현과 단백질 발현을 임상적 및 병리학적 예후 인자들에 따라 비교한 결과 환자의 연령과 Cdc25B mRNA 발현 (p=0.03), 세포 형태와 Cdc25C mRNA 발현 (p=0.04) 사이에서는 통계학적으로 유의한 상관관계를 보였으나 그 외의 인자들인 세포아형태, 혈청내 squamous cell carcinoma antigen (SCC Ag) 수치, 유세포 분석법을 통한 DNA flow cytometry 결과, 림프절 전이, 림프혈관 침범, 인유두종 바이러스 감염 등과는 통계학적으로 유의한 상관 관계를 보이지 않았다. 결론: 본 연구 결과에 따르면 Cdc25A, Cdc25B 및 Cdc25C가 대조군인 정상 자궁경부 조직에 비해 자궁경부암 조직에서 통계학적으로 유의하게 높게 발현됨을 확인할 수 있었다. 따라서, 자궁경부암의 발생기전에 Cdc25A, Cdc25B 및 Cdc25C가 중요한 역할을 할 가능성을 제시하였다. 또한 Cdc25A, Cdc25B 및 Cdc25C의 mRNA와 단백질 발현은 환자의 연령이 50세 이상인 경우에 Cdc25B mRNA 발현이 유의하게 높았으며 (p=0.03), 세포형태에 따라 분류하였을 때 편평상피세포암에서 Cdc25C mRNA 발현이 통계학적으로 유의하게 높았다 (p=0.04). 그러나, 다른 예후 인자들과는 통계학적으로 유의한 상관관계를 보이지 않았다. 향후 Cdc25A, Cdc25B 및 Cdc25C가 자궁경부암의 유용한 예후 인자로 사용되기 위해서는 향후 생존율과 연관된 연구가 추가로 뒷받침되어야 할 것으로 생각된다. Objective: This study was undertaken to quantitatively detect Cdc25A, Cdc25B and Cdc25C in cervical carcinoma and determine the relationship between the expression of mRNA and protein of cell division cycle (Cdc)25 phosphatase and various clinicopathologic prognostic factors of cervical carcinoma. Methods: 39 patients diagnosed with cervical carcinoma between February 2000 to March 2005 and 10 patients with benign gynecologic disease were enrolled in this study. A reverse transcriptase-polymerase chain reaction (RT-PCR) and Western blot analysis were used to analyze the expression of Cdc25 phosphatase mRNA and protein in fresh invasive cervical cancer tissue and normal cervix tissue. Results: The mRNA expressions of Cdc25A, Cdc25B and Cdc25C in the cancer tissues were significantly greater than in the control (p=0.02, 0.01, 0.02), respectively. A Western blot analysis yielded same results (p=0.01, 0.02, 0.01). There were also significant relationships between the age and the Cdc25B mRNA expression (p=0.03), between the cell type and the Cdc25C mRNA expression (p=0.04). However, other clinicopathologic prognostic factors including stage, subtype, SCC Ag level, DNA flow cytometry, lymph node metastasis, lymphovascular space invasion and HPV positivity were not statistically significant. Conclusion: Our results show that Cdc25A, Cdc25B and Cdc25C expression levels were significantly greater in cervical cancer patient group than in those of control group. Thus Cdc25 phosphatase might play an important role in carcinogenesis of cervical carcinoma. Further studies based on the correlation between Cdc25 phosphatase and survival rate would be need to support Cdc25 phosphatase as a prognostic factor of cervical carcinoma.

인간 난소의 과립 세포 배양 중 Leptin이 스테로이드 생성에 미치는 영향

김세광,김명신,황경주,권혁찬,조동제,Kim, Sei-Kwang,Kim, Myong-Shin,Hwang, Kyung-Joo,Kwon, Hyuck-Chan,Cho, Dong-Jae 대한생식의학회 2000 Clinical and Experimental Reproductive Medicine Vol.27 No.1

Objective: To elucidate the location of leptin and receptors of ovary specimens obtained from patients undergoing hysterectomy by immunohistochemical staining and to determine the effect of leptin on the steroidogenesis of cultured granulosa cells. Method: In the culturing process of the granulosa cells, FSH (1 IU/ml)and leptin (50 ng/ml), IGF-I (50 ng/ml) was administered to each study group (Group I: FSH; Group II: FSH, leptin; Group III: FSH, IGF-I; Group IV: FSH, IGF-I, leptin), and the levels of estradiol, progesterone, androstenedione in the culture media was measured by radioimmunoassay. Statistical analysis was conducted by one-way ANOVA with Scheffe test. Results: The results showed that leptin and leptin receptors were both found to be strongly stained in granulosa and theca cells, and also in some interstitial cells. Leptin receptors were also observed in cultured granulosa cells. While there was no statistically significant difference in the androstnedione concentrations between the groups, estradiol concentrations was significantly decreased in Group IV ($2202.0{\pm}151.14$ pg/ml) compared to Group III ($2859.0{\pm}122.6$ pg/ml), and progesterone concentrations were also significantly decreased in Group II($4696.3{\pm}190.6$ ng/ml) and Group IV ($4517{\pm}206.78$ ng/ml) compared to Group III($5546.0{\pm}179.5$ ng/ml). Conclustion: The study result of this study suggest that leptin is directly involved in the regulation of ovarian functions, in particular steroidogenesis.

GnRH-agonist에 의한 인간 과립-황체화 세포의 세포사멸과 PBR 단백질의 발현

김세광,염윤희,윤정미,배상욱,양현원,조동제,윤용달,송찬호,Kim, Sei-Kwang,Youm, Yun-Hee,Yoon, Jeong-Mi,Bai, Sang-Wook,Yang, Hyun-Won,Cho, Dong-Jae,Yoon, Yong-Dal,Song, Chan-Ho 대한생식의학회 2004 Clinical and Experimental Reproductive Medicine Vol.31 No.2

Objective: To investigate whether GnRH-agonist (GnRH-Ag) using in IVF-ET affects apoptosis of human granulosa-luteal cells and expression of peripheral benzodiazepine receptor (PBR) protein involved in the apoptosis of the cells. Methods: Granulosa-luteal cells obtained during oocyte retrieval were cultured and treated with $10^{-5}M$ GnRH-Ag. Apoptosis of the cells by the treatment was confirmed using DNA fragmentation analysis 24 h after culture. The presence of PBR protein within the cells was examined by immunofluorescence staining and the expression of the protein was analyzed by Western blotting. In addition, it was measured for progesterone and nitric oxide (NO) produced by granulosa-luteal cells after GnRH-Ag treatment. To evaluate the relationship between NO production and PBR expression, sodium nitroprusside (SNP) as a NO donor was added in media and investigated the expression of PBR protein by Western blotting. Results: Apoptosis increased in the granulosa-luteal cells 24 h after GnRH-Ag treatment, whereas the expression of PBR protein significantly decreased. Furthermore, the production of progesterone and nitric oxide (NO) by the cells significantly fell from 12 h after the treatment. In the results of Western blotting after SNP treatment, the expression of PBR protein increased in the treatment with SNP alone to the granulosa-luteal cells, but was suppressed in the treatment with GnRH-Ag and SNP. Additionally, the staining result of PBR protein in the cells showed the even distribution of it through the cell. Conclusion: These results demonstrate that GnRH-Ag treatment induces apoptosis, decreasing expression of PBR protein and NO production in human granulosa-luteal cells. The present study suggests that one of the apoptosis mechanism of human granulosa-luteal cells by GnRH-Ag might be a signal transduction pathway via NO and PBR.

태아발육지연 임신에서 산소농도가 영양배엽세포의 telomerase 활성도에 미치는 영향

정영내(Young Nae Jung),김세광(Sei Kwang Kim),정현철(Hyun Cheol Chung),박규현(Kyu Hyun Park),김창한(Chang Han Kim),장영건(Young Kwon Chang),권자영(Ja Young Kwon),김성훈(Sung Hun Kim),노성일(Sung Il Roh),조동제(Dong Jae Cho) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.8

N/A Objective : To observe the difference in telomerase activity (TA) expression in the placenta between fetal growth restriction (FGR) with preeclampsia and those without and to evaluate the effect of oxygen concentration on the TA expression in the trophoblastic cells. Methods : Telomerase activity was measured in 48 (normal pregnancies, 16; preeclampsia with FGR, 15; normotensive FGR, 17) placentas which were obtained between 32 and 41 weeks' gestations. Trophoblastic cells were extracted from 8 chorionic villi samples obtained from 8-10 weeks' placenta and were cultured in either 2%, 8%, and 20% oxygen atmosphere. Then TA was examined by using telomeric repeat amplification protocol (TRAP) assay. Results : During 3rd trimester of pregnancy, exhibited TA expression in normal pregnancy, FGR complicated by preeclampsia, and normotensive FGR groups were 11 of 16 (68.8%), 4 of 15 (26.7%), and 4 of 17 (23.5%), respectively. Significantly lower level of TA was detected in the FGR group compared to the normal pregnancies (p=0.009), whereas within FGR pregnancies, presence of preeclampsia did not seem to have statistically significant effect on TA expression. TA expression levels were measured by optical density in trophoblasts cultured under various oxygen concentration which revealed that significantly higher TA was exhibited in the cells cultured in 2% oxygen compared to 8% and 20% (p<0.001). However no significant difference was noted in TA between cells cultured in 8% and 20% oxygen. Conclusion : Decreased TA in the placenta from pregnancies with FGR was noted regardless of presence of preeclampsia indicating a probable correlation between FGR and placental senescence. Since increased TA was noted in trophoblastic cells that were cultured in hypoxic condition, we could speculate that the intervillous oxygen tension during early-stage placental development plays a certain role in the placental degeneration in pregnancies complicated by FGR and preeclampsia.

수질증을 동반한 잔존 총배설강

이진우 ( Jin Woo Lee ),김세광 ( Sei Kwang Kim ),조재성 ( Jae Sung Cho ),전명재 ( Myung Jae Jeon ),노진래 ( Jin Lae Roh ),이현정 ( Hyun Jung Lee ),박기현 ( Ki Hyun Park ),구자승 ( Ja Seung Koo ),조상호 ( Sang Ho Cho ),한석주 ( Seok 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.9

Persistent cloaca is a very rare congenital anomaly with a single common perineal opening for the genital, urinary and gastrointestinal tracts, which arises from defects in the embryonal process of descent of urorectal septum or fusion to cloacal membrane. Anomalies associated with persistent cloaca are found in the upper urinary tract, gastrointestinal tract, cardiovascular system, central nervous system and respiratory system, which are not easily detected through ultrasound during pregnancy. It has been reported that if those anomalies are diagnosed early, they can be corrected surgically. We present a case of persistent cloaca with hydrocolpos confirmed by autopsy after emergency cesarean section which was initially presented as a huge abdominal cystic mass and bilateral hydronephrosis by ultrasound at 34 weeks of gestation.

골반 장기 탈출증 환자에서 각 연령별에 따른 수술 후 합병증 비교

김혜연 ( Hye Yeon Kim ),전명재 ( Myung Jae Jeon ),정다정 ( Da Jung Chung ),김세광 ( Sei Kwang Kim ),김재욱 ( Jae Wook Kim ),배상욱 ( Sang Wook Bai ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.11

목적: 본 연구는 골반 장기 탈출증 환자에서 연령이 증가함에 따라 수술 후 퇴원까지의 합병증이 증가하는지에 대해 알아보고자 하였다. 연구 대상 및 방법: 1999년 3월부터 2006년 2월까지 본원 산부인과에서 골반 장기 탈출증으로 수술을 시행 받은 환자 중 기록 분석이 가능한 322명의 환자를 대상으로 하였다. 40대부터 80대까지 각 연령에 따른 환자들의 특성과 재원일수, 신체질량지수, 기왕 수술력, 수술 시간, 수술 방법, 마취 방법, 기저 질환, 수술 전 후의 혈색소 차이와 수술 후 합병증에 대해 후향적으로 조사하여 비교 분석하였다. 결과: 연령별로는 40-49세가 35명 (10.9%), 50-59세 97명 (30.1%)이었고, 60-69세가 123명 (38.2%)으로 가장 많았으며, 70-79세가 64명 (19.9%), 80세 이상은 3명 (0.9%)으로 가장 적었다. 각 연령군 간에는 분만력에서만 유의한 상관관계를 보였으며, 병기, 신체질량지수, 기왕 수술력, 수술 시간, 수술 종류, 마취 종류, 기저 질환, 수술 전후의 혈색소 차이는 통계학적으로 유의한 상관 관계가 없었다. 또한 발열, 빈혈, 수혈 여부, 혈종, 장마비, 장폐색, 상처 감염, 상처 열개, 하부 요료계 감염, 폐렴, 골반 감염, 심부전, 심근 경색, 폐부종, 폐색전 등의 수술 후 합병증 발생에서 각 연령군 간에 유의한 차이를 보이지 않았다. 결론: 골반 장기 탈출증 환자에서 수술 후 합병증의 발생은 환자의 연령과 연관성이 없는 것으로 사료된다. Objective: The purpose of this study was to estimate the effect of age on the risk of in-hospital surgical morbidity in patients with pelvic organ prolapse (POP). Methods: Of the women aged 40 years and older who underwent surgical correction of POP at this institution from March 1999 to February 2006, 322 had medical records that could be analyzed. These patients were grouped according to decade of age and assessed according to a set of characteristics and postsurgical complications. Results: There were 35 patients between 40 to 49 years of age, 97 between 50 to 59 years, 123 between 60 and 69 years, 64 between 70 to 79 years and 3 patients were 80 years or older. There were no differences between age groups regarding the following variables: stage, delivery history, BMI, previous surgical history, underlying medical disease, duration of hospital stay, operation time, type of operation and anesthesia, difference of preoperative and postoperative hemoglobin level. There were differences only for parity. Also, between each age group, no statistical differences were noted in postoperative complications. Conclusion: The risk of in-hospital surgical morbidity in patients with POP was not related to the age of the patients.