구강 편평세포암종에서 Taxol과 Cyclosporin A의 세포사멸 상승 작용 효과

서민정,한세진,이재훈,Suh, Min-Jung,Han, Se-Jin,Lee, Jae-Hoon 대한악안면성형재건외과학회 2007 Maxillofacial Plastic Reconstructive Surgery Vol.29 No.5

Oral squamous cell carcinoma is the most prevalent oral cancer, which is characterized by its high metastasis and recurrent rates and poor prognosis. Taxol is an anticancer agent which is microbial products extracted from jew tree. It combines with the tubulin and induces apoptosis by inhibiting mitosis of cell with microtubule stabilization. Recently, it was reported to be effective in various solid tumors, but only very slight effect has been seen in oral squamous cell carcinomas due to its cell-specific potencies. Cyclosporin A is used as immune suppressant and is being applied in anticancer therapy as its mechanism of induction of change of apoptotic process in various cells have been known. In this study, oral squamous cell carcinoma HN22 cell line was used for in vitro experiment and as for the experimental group taxol and cyclosporin A were applied alone and to observe the synergistic effect of apoptosis, Taxol and cyclosporin A were coadministered with different concentration of taxol for comparison. The results were obtained as follow: 1. There was no difference in Bcl-2, Bax, caspase 3, 8, 9 mRNA expression when cyclosprin A or taxol was applied alone to HN 22 cell line. 2. Caspase 3, 9 mRNA expression was prominently increased when cyclosprin A and taxol were applied together to cancer cell. 3. No significant difference was observed when cyclosporin A and taxol($1{\mu}g/ml$ and $3{\mu}g/ml$) were applied together to cancer cell line. 4. No significant difference was seen in Bcl-2, Bax, and caspase 8 mRNA expression in all the groups of in vitro experiments. 5. When cyclosporin A was applied alone in vivo study on the nude mice, histopathologi cal findings was similar to those of the control group. Oral squamous cell carcinoma induced by inoculation of HN 22 cell line was not reduced after treatment of cyclosporin A. 6. When taxol was applied alone, the islands of squamous cell carcinoma still remained, which meant insignificant healing effect. There was a lesser volume increase compared with the cyclosporin A alone. 7. When taxol and cyclosporin A were applied together, the connective tissue and calcification were seen in the histopathologic findings. Oral squamous cell carcinoma was decreased and cancer cell was disappeared. In observing the tumor mass change with time, there was a gradual decreased size and healing features. As the results of the in vitro experiment, it could conclud that only when the two agents are applied together, mitochondria-mediated apoptosis occurred by considerable increase of caspase 3, 9 mRNA expression, irrespectable of the concentration of taxol. In vivo experiment, there was a discrete synergistic effect when the two agents were applied together. But single use of cyclosporin A was not effective in this study. Based on the results of this experiment, if further clinical studies are done, taxol and cyclosporin A could be effectively used in treatment of oral squamous cell carcinomas.

복강경을 통해 진단된 원발성 난관암

서민정 ( Min Jung Suh ),이성하 ( Sung Ha Lee ),김두만 ( Du Man Kim ),국일영 ( Ill Young Kook ),박세현 ( Sae Hyun Park ),박동춘 ( Dong Choon Park ),김대훈 ( Dae Hoon Kim ),윤주희 ( Joo Hee Yoon ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.6

Malignant neoplasm of the fallopian tube is the rarest of the gynecologic cancers. Vaginal bleeding, vaginal discharge, and pelvic pain are the most common symptoms. Because of these non-specific symptoms, the diagnosis of this Least common neoplasm is rarely made before Laparotomy. The tumor is typically unilateral and has histologic subtypes, endometrioid and serous adenocarcinoma being the most common subtypes. Surgery, clearly the mainstay of treatment, is also the first approach to diagnosis. The procedure of choice is total abdominal hysterectomy with bilateral salpingo-oopho-rectomy. We had experienced one patient with primary tubal cancer, successfully evaluated with Laparoscopy. And then we intend to report the case of the above patient and have a brief discussion about that.

A huge smooth muscle tumor in vagina

서민정 ( Min Jung Suh ),( In Cheal Jeung ),( Dong Choon Park ) 대한산부인과학회 2007 대한산부인과학회 학술대회 Vol.93 No.-

태반조기박리의 임상적 고찰

서민정 ( Min Jung Suh ),김옥경 ( Ok Kyoung Kim ),김두만 ( Du Man Kim ),유희정 ( Hee Jeong Yu ),박철훈 ( Cheol Hoon Park ),노덕영 ( Duck Yeong Ro ),김태응 ( Tae Eung Kim ) 대한주산의학회 2006 Perinatology Vol.17 No.1

목적 : 태반조기박리는 응급처치를 요하는 산과적 질환이나 현재로써는 이 질환을 임신 중 예견할 수 있는 진단적 방법이 없으므로, 본 연구는 환자의 기록을 임상적으로 고찰하고 기존 연구 문헌과 비교하여 산모와 태아의 합병증을 감소시키기 위하여 실시하였다. 방법 : 1991년 1월 1일부터 2003년 12월 31일까지 시행된 20,483예의 분만 중 태반조기박리로 진단된 80예의 임상 자료들을 분석하였다. 결과 : 13년 동안 태반조기박리의 발생 빈도는 0.4%였고, 97.5%가 임신 28주 이후에 발생하였다. 원인적 요소를 알 수 없는 경우가 67.5%로 나타났고, 임신성 고혈압이 동반된 경우가 22.5%의 빈도를 보였다. 임상 증상은 자궁내 태아 사망 10예를 포함한 질출혈이 46.3%, 하복부 통증 33.75 %, 태아 긴박증 10%, 조기 진통 5%를 보였다. 과반수의 산모에서 분만 전에 태반조기박리의 진단이 가능하였고, 제왕절개율은 93.8%였다. 태반 박리 정도에 따른 태아 생존율은 경도는 94.1%, 중등도는 84.6%였으나, 중증의 경우는 14.3%로 낮았다. 아울러 태반 박리 정도에 따른 태아의 1분/5분 Apgar score는 경도, 중등도, 중증에서 각각 5.9±2.5점/7.5±2.2점, 5.5±2.7점/7±2.8점 및 1.3±2.4점/1.3±3.0점으로 경도와 중등도의 태반조기박리 때보다 중증의 태반조기박리 때 1분/5분 Apgar score가 각각 유의하게 낮았다(p<0.01). 본 연구에서 산모가 사망한 예는 없었다. 결론 : 본 연구에서 태반조기박리의 원인적 요소를 알 수 없는 경우가 2/3로 임신성 고혈압의 원인적 요소나 임상증상의 파악이 치료의 중요한 지침을 제공한다고 생각된다. 또한 태반조기박리로 인한 태반기능부전은 태아에게 중대한 위험요소로 나타났으며, 이에 태반조기박리로 의심이 되는 경우는 박리가 더 이상 진행되지 않도록 즉각적인 분만을 시도함과 아울러 필요한 경우 미숙아 분만에 대한 관리를 준비는 것이 태아의 합병증을 줄이기 위하여 중요하다고 할 수 있겠다. Objective : Placental abruption is one of the obstetric hemorrhage diseases that needs emergent treatment. But there is no predictable tool for placental abruption at present, we clinically analyzed its incidence, etiological factors, signs and symptom and neonatal outcome for reducing complications of this disease. Methods : The data presented here were based on 80 cases of placental abruption among 20,483 deliveries during 13 years of period from January, 1991 to December, 2003. Results : The incidence of placental abruption was 0.4%. Most of cases (97.5%) occurred over 28 weeks of gestational age. The incidence of unknown etiological factor was 67.5% and pregnancy-induced hypertension was related in 22.5% of cases. The most common signs and symptom was vaginal bleeding (46.3%). Lower abdominal pain (33.8%), fetal distress (10%), premature labor (5%) were also noted. The half of the patients was diagnosed before delivery and the mode of delivery was cesarean section in 93.8%. The survival rate of newborns in severe degree group (14.3%) of placental abruption was lower than that of mild degree group (94.1%) or moderate degree group (84.6%). Additionally, Apgar scores at 1min and 5min of newborns in severe degree group (1.3±2.4/1.3±3.0) were significantly lower than that of mild degree group (5.9±2.5/7.5±2.2) or moderate degree group (5.5±2.7/7±2.8) (p<0.01). There was no maternal death in our study. Conclusion : Because the etiological factor of this disease was uncertain in two thirds of cases, comprehension of etiological factor such as pregnancy-induced hypertension and signs and symptom is emphasized. Bleeding and uteroplacental insufficiency caused by placental abruption affect fetal jeopardy in severe cases. Accurate diagnosis and adequate treatment including management of premature baby should be conducted in suspicious case of placental abruption for prevention of progression of this disease.

복강경하 병기설정 수술을 시행한 난소의 Sertoli-Leydig Cell Tumor, 1예

서민정 ( Min Jung Suh ),유시현 ( Sie Hyun You ),최주혁 ( Joo Hyuk Choi ),오은경 ( Eun Kyeong Oh ),남궁정 ( Jeong NamKung ),박미선 ( Mi Sun Park ),지은영 ( Eun Young Ji ),강영화 ( Young Hwa Kang ),윤주희 ( Joo Hee Yoon ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.7

Sertoli-Leydig cell tumor는 난소 종양 중 0.5% 이하를 차지하는 드문 성색간질 종양이으로, 대부분 젊은 여성 (30-40세)이고, 1% 이하에서 양측성을 보이기 때문에 종양의 보존적 절제와 환측 난관의 절제가 치료이다. 최근 개인 산부인과 병원에서 Sertoli-Leydig cell tumor, pooly differentiated, Stage Ia, grade III로 진단되었으나, 불충분한 수술 후 본원에 전원되어 복강경하에 성공적으로 병기설정수술을 시행한 1예를 경험하여 문헌고찰과 함께 보고하는 바이다. Sertoli-Leydig cell tumors are rare sex cord-stromal tumors. These tumors account for less than 0.5% of all ovarian tumors. Because these tumors appear predominantly in young women (between the age of 30 and 40) and are bilateral in less than 1% of cases, conservative removal of the tumor and adjacent fallopian tube is justifiable. Recently, we experienced a case of successful laparoscopic surgical staging in patient of Sertoli-Leydig cell tumor which was previously incompletely evaluated in local OBGY clinic. There are no solid data to suggest that usefulness and risk of laparoscopic surgical staging and adjuvant therapy with stage I disease of these tumors until now. So we present it with a brief review of literature.

자궁체부의 원발성 악성 림프종

서민정 ( Min Jung Suh ),박동춘 ( Dong Choon Park ) 대한산부인과학회 2011 Obstetrics & Gynecology Science Vol.54 No.1

Primary uterine non-Hodgkin`s lymphoma is a rare malignancy and the most common histological subtype is the diffuse large B-cell lymphoma. This case is a patient underwent surgery for early gastric cancer in November 2007, and determined to be completely cured, and subsequently, during the follow up observation, in pelvic computed tomography, a uterine mass suspicious to be either uterine cervical cancer or uterine sarcoma was observed. She was transferred to department of gynecologic oncology, modified radical hysterectomy and pelvic lymph node dissection were performed. Histologically the uterine mass was diagnosed as diffuse large B-cell lymphoma. Currently she is received the rituximab, cyclophosphamide, adriamycin, vincristine, and prednisone chemotherapy. Thus we report the case with a brief review of the literature. Primary malignant lymphoma in the uterus is very rare, and its diagnosis as well as treatments has not been established. Therefore, in the future, through continuous clinical discussion on this disease, a guideline for the diagnosis and treatment for primary uterine lymphoma should be established.

전자간증 및 자궁내성장제한에서 사람 백혈구 항원-G 발현의 분석

서민정 ( Min Jung Suh ),문정민 ( Jeong Min Moon ),허수영 ( Soo Young Hur ),김사진 ( Sa Jin Kim ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.3

목적: 전자간증 및 자궁내성장제한 임신부와 전자간증과 자궁내성장제한이 동반된 임신부를 대상으로 태반의 발현과 혈액내의 수용성 형태 (soluble form)의 HLA-G 발현을 조사하고 그 결과를 정상 임신부와 비교 분석하였다. 연구방법: HLA-G 발현은 전자간증이 합병된 임신 11예, 자궁내성장제한이 합병된 임신 18예, 전자간증과 자궁내성장제한이 동반된 임신 8예 및 다른 합병증이 없는 정상 임신 10예를 대상으로 하여 sandwich enzyme-linked immHLA-G unosorbent assay (ELISA)를 시행하고 정량적으로 분석하였다. 결과: 전자간증, 자궁내성장제한 및 전자간증과 자궁내성장제한이 동반된 임신부의 혈장 내 HLA-G 단백질 농도의 중앙값은 각각 0.072 μg/ml, 0.081 μg/ml, 0.086 μg/ml로 측정되어 정상 임신부 (중앙값, 0.360 μg/mL)와 비교하였을 때 통계적으로 유의하게 감소된 것으로 나타났다 (P=0.002, P=0.003, P=0.049). 전자간증, 자궁내성장제한 및 전자간증과 자궁내성장제한이 동반된 임신부의 태반 HLA-G 단백질 수치의 중앙값도 각각 0.016 μg/mg, 0.021 μg/mg, 0.015 μg/mg로 측정되어 정상 임신부 (중앙값, 0.091 μg/mL)와 비교하였을 때 역시 통계적으로 유의하게 감소된 것으로 나타났다 (P<0.001, P=0.001, P=0.002). 한편, 대상 임신부 모두의 혈장 내 HLA-G 단백질 농도와 태반 HLA-G 단백질 수치는 통계적으로 유의한 상관관계를 보였다 (r=0.807, P<0.001). 결론: 전자간증과 자궁내성장제한과 같은 비정상적인 임신에서 태반 내 HLA-G 발현의 감소와 이에 따른 모체내로 HLA-G 순환의 감소가 태아와 모체사이의 면역체계 조절에 변화를 유발하고, 이러한 질환 발생의 병태 생리에 중요한 요인으로 작용할 것이라는 가능성을 제시한다. 또한 전자간증과 자궁내성장제한의 발생을 예견하는 데에 HLA-G 단백질 수치 측정이 유용하게 이용될 것으로 생각된다. Objective: To determine whether soluble HLA-G protein levels in plasma and/or HLA-G protein in placental tissues differ between women with gestational complications (preeclampsia and/or intrauterine growth restriction, IUGR) and women with normal pregnancies. Methods: A sandwich enzyme-linked immunosorbent assay was used to investigate the HLA-G expression level in 11 cases of preeclampsia, 8 cases of preeclampsia with IUGR, 18 cases of IUGR, and 10 normal control subjects. Results: Plasma HLA-G levels were decreased significantly in the preeclampsia group (median, 0.072 μg/mL), the preeclampsia with IUGR group (median, 0.086 μg/mL), and the IUGR group (median, 0.081 μg/mL), in comparison with normal pregnant women (median, 0.360 μg/mL) (P=0.002, P=0.049, and P=0.003, respectively). Also, Placental HLA-G levels were decreased significantly in the preeclampsia group (median, 0.016 μg/mg), the preeclampsia with IUGR group (median, 0.015 μg/mg), and the IUGR group (median, 0.021 μg/mg), in comparison with normal pregnant women (median, 0.091 μg/mg) (P<0.001, P=0.002, and P=0.001, respectively). There was a significant correlation between plasma and placental HLA-G levels (r=0.807, P<0.001). Conclusion: Our results indicate that the attenuated expression of placental HLA-G and reduced release of this protein into the maternal circulation in gestational complications, such as preeclampsia and IUGR may alter the maternal-fetal immune relationship, and thus could be at play in the pathophysiology of these diseases. This suggests that assessment of levels of HLA-G proteins may be useful in predicting development of preeclampsia and IUGR.

복부 피부 절개부위에 재발한 자궁경부암 환자에서 종양의 광범위 절제 후 Gore-Tex(R) 패치를 이용한 복원

서민정 ( Min Jung Suh ),최주혁 ( Joo Hyuk Choi ),박동춘 ( Dong Choon Park ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.10

Recurrence of cervical cancer at a skin incision site is uncommon. We met a patient who received an incomplete operation for cervical cancer and she was transferred to our hospital. When she underwent the first operation she was misdiagnosed as having a benign uterine mass and she received an abdominal total hysterectomy. But the postoperative pathologic finding was cervical cancer. Therefore she was then referred for postoperative cisplatin-5FU concurrent chemo-radiotherapy. Five months after the concurrent chemo-radiotherapy, one solitary metastatic mass was found in the abdominal scar. We performed wide excision. The fascia defect at the excision site was so wide we could not perform the primary closure. Therefore, we used a polytetrafluoroethylene (Gore-Tex(R)) patch as a fascia substitute and we reconstructed the abdominal wall with a fasciocutaneous flap. Then she received cisplatin concurrent chemo-radiation therapy.

우울 경향과 복모혈(腹募穴), 배유혈(背兪穴) 압통과의 관계 비교 연구

서민정 ( Min Jung Suh ),김송이 ( Song Yi Kim ),박영재 ( Young Jae Park ),정원모 ( Won Mo Jung ),차수진 ( Su Jin Cha ),이향숙 ( Hyang Sook Lee ),이혜정 ( Hye Jung Lee ),박히준 ( Hi Joon Park ) 경락경혈학회 2010 Korean Journal of Acupuncture Vol.27 No.4

Objective: To examine whether any correlation between tendency towards depression and tenderness at special acupuncture points exists, thus to explore the potential diagnostic property of acupuncture points. Methods: A total 31 subjects were included in this study. They filled out questionnaires about their mental [Beck Depression Inventory (BDI), Stress Response Inventory (SRI), Profile of Mood States (POMS)] and physical (fatigue due to overexertion, and food accumulation) symptoms. Identical weight around Alarm points (CV17, CV12, ST25, CV5, CV4, and LR13) and transport points (BL14, BL20, BL21, BL22, BL25, and BL27) was given using an algometer and the subjects rated their pain on an 11-point numerical rating scale. Heart rate variability (HRV) was also measured. Results: The subjects were divided into two groups, normal and depressive tendency groups with a cut-off point of nine on BDI. The depressive tendency group reported significantly higher values in SRI, POMS, and questionnaire for fatigue due to overexertion. In the pressure pain measurement, depressive tendency group had more pressure pain at CV12, left side of BL20, BL14, BL22 and both sides of BL21, BL25, BL27, significantly (each p<0.05). The data of HRV did not show significant differences between groups. Conclusions: People with a tendency towards depression may be prone to stress, negative mood, and fatigue due to overexertion. In addition, they may be more likely to develop tenderness at alarm points and transport points compared with healthy people. Further research is needed to confirm this finding.

각 (脚)이 있는 거대 점막하 자궁근종의 질외 탈출에 의한 자궁내반 (內反)의

송민종 ( Min Jong Song ),유시현 ( Sie Hyun You ),서민정 ( Min Jung Suh ),국일영 ( Ill Young Kook ),윤주희 ( Joo Hee Yoon ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.2

Uterine leiomyomas are the most common uterine tumors. They are estimated to be present in approximately 20% of all women of reproductive age. They may be present in subserosal, intramural, or submucosal in location within the uterus, or located in the cervix, in the broad ligaments, or on a pedicle. Many studies report that the malignant potential of a preexisting uterine leiomyoma is extremely rare, occuring in less than 0.5%. Uterine leiomyomas may cause a range of syptoms, for example, severe anemia from abnormal uterine bleeding, dysmenorrhea, constipation from rectosigmoid compression, dysuria, frequency, residual sensation due to bladder compression. Patients with those symptoms or cancer phobia should be treated. Rare but severe symptoms associated with uterine leiomyomas are rectosigmoid compression, with intestinal obstruction, thrombophlebitis of lower extremities from venous stasis, polycythemia, ascites, severe pain from torsion and infection of prolapsed pedunculated submucosal myoma and uterine inversion from prolase of pedunculated submucosal leiomyoma. Now we report a rare case of uterine inversion resulted from prolapse of huge pedunculated uterine submucosal leiomyoma, which caused hypovolemic shock due to massive uterine bleeding.