자궁내막증 여성에서 증가된 자궁내막용종의 빈도; 질환의 중증도와의 관련성

장혜진,황경주,김미란,안상태,변재광,이은희,박진영,Chang, Hye Jin,Hwang, Kyung Joo,Kim, Mi Ran,Ahn, Sang Tae,Byun, Jae Guang,Lee, Eun Hee,Park, Jin Young 대한생식의학회 2006 Clinical and Experimental Reproductive Medicine Vol.33 No.3

목 적: 자궁내막증에서 발견되는 자궁내막용종의 발생빈도와 자궁내막증 질환의 중증도와의 연관성에 대해 알아보고자 한다. 연구방법: 불임, 심한 월경통, 난소종양 등을 주소로 복강경 수술이 필요했던 여성 631명을 대상으로 하였다. 복강경 수술로 확인된 자궁내막증을 가진 434명과 자궁내막증이 없었던 197명의 여성에서 자궁내시경을 이용한 조직학적인 검사를 통해 자궁내막용종의 발생 빈도를 비교하였다. 또한 자궁내막증 질환의 중증도는 American Fertility Society classification 에 따라 나누었고, 그에 따른 자궁내막용종의 빈도를 비교하였다. 결 과: 자궁내막증을 가진 군 (434명)과 정상 대조군 (197명) 간에 나이, 불임기간, 호르몬 수치 등의 임상적인 차이는 보이지 않았고, 자궁내막용종은 자궁내막증을 가진 여성에서는 274명 (63%)에서 관찰되었고, 자궁내막증이 없는 대조군에서는 58명 (29.8%)에서 관찰되었다(p=0.001). 자궁내막증 1기와 2기에서는 자궁내막용종이 동반된 경우가 각각 54.2%와 64.4% 이었으나, 자궁내막증 3기와 4기에서는 67.6%와 70.2%로 통계적으로 유의하게 정상 대조군에 비해 자궁내막용종의 동반 확률이 높았고, 자궁내막증 중증도에 따라 자궁내막용종의 빈도가 유의하게 증가하는 양상을 보였다(p=0.008). 결 론: 자궁내막증을 가진 여성에서 자궁내막용종을 동반할 확률이 정상인에 비해 높았고, 중증 자궁내막증일수록 동반되는 자궁내막용종의 빈도가 증가하였다. Objective: The aim of this study was to evaluate the correlation between severity of endometriosis and the incidence of endometrial polyp. Methods: The study population consisted of six hundred thirty-one women who had undergone laparoscopic operation due to infertility, severe dysmenorrhea or ovarian tumors. We divided two groups: 434 women with endometriosis (study group) and 197 women without the disease (control group). The presence of endometriosis was documented by diagnostic or therapeutic laparoscopic operation and the disease severity was scored according to revised The American Fertility Society classification. We confirmed the endometrial polyps by pathologic examination after hysteroscopic polypectomy, and compared endometrial polyp incidence according to severity of endometriosis. Results: There was no significant difference between groups with regard to age, mean duration of infertility. Endometrial polyps were found in 274 women (63.0%) with endometriosis and in 58 controls (29.8%, p=0.0000). The incidence of endometrial polyps differed significantly according to stage of endometriosis. The incidence of endometrial polyps were 77/142 (54.2%), 58/90 (64.4%), 73/108 (67.6%, p<0.05), 66/94 (70.2%, p<0.05) in endometriosis stage I, II, III, and IV. There was a linear correlation between stage of endometriosis and endometrial polyps incidence (p=0.008). Conclusion: Endometriosis is accompanied by endometrial polyps. This results showed positive correlation between severity of the endometriosis and incidence of endometrial polyps. It is the possible mechanism for low pregnancy rate in the severe endometriosis.

TGF-β1에 의하여 유도된 인간자궁내막의 탈락막화(Decidualization)에 있어서 ERK (Extracellular Signal Regulated Kinas)와 PPARγ (Peroxisome Proliferator-Activated Receptor Gamma)의 역할

장혜진,이재훈,김미란,황경주,박동욱,민철기,Chang, Hye Jin,Lee, Jae Hoon,Kim, Mi Ran,Hwang, Kyung Joo,Park, Dong Wook,Min, Churl K. 대한생식의학회 2006 Clinical and Experimental Reproductive Medicine Vol.33 No.2

목 적: 본 연구를 통해 $TGF-{\beta}1$에 의해 유도된 인간자궁내막의 탈락막화 과정에서 ERK와 $PPAR{\gamma}$의 역할을 규명하고자 하였다. 연구방법: 자궁내막 기질세포는 DMEM/F12 (10% FBS, 1 nM E2 and 100 nM P4) 조건에서 배양하였다. 연구 목적에 따라 $TGF-{\beta}1$ (5 ng/ml), Rosiglitazone (50 nM)와 PD98059 ($20{\mu}M$)를 배양액에 첨가하였다. Trypan-Blue와 hematocytometer를 이용하여 현미경하에서 세포의 개수를 측정하였다. Enzyme-linked immunosorbent assay (ELISA)와 western blotting 방법을 사용하여 단백질의 발현 정도를 관찰하였다. 결과 및 결론: 배양액에 $TGF-{\beta}1$을 첨가하여 세포의 증식 정도를 측정한 결과 $TGF-{\beta}1$이 세포의 증식을 억제하는 것을 알 수 있었다. 또한 배양된 세포로부터 PGE2 및 prolactin의 발현을 유도하는 것을 알 수 있었다. 이러한 $TGF-{\beta}1$의 작용은 Smad 및 ERK의 활성화를 통하여 일어남을 알 수 있었다. $PPAR{\gamma}$의 기질인 rosiglitazone을 배양액에 첨가한 결과 $TGF-{\beta}1$에 의한 세포 증식의 억제가 역전되는 것을 알 수 있었다. 뿐만 아니라, 세포 내 ERK의 활성 역시 억제 시켰으며 이 결과 PGE2와 prolactin의 발현이 억제 되는 것을 관찰할 수 있었다. 따라서 본 연구를 통해 $TGF-{\beta}1$에 의한 자궁내막 기질세포의 탈락막화는 Smad와 ERK의 활성화를 통하여 이루어지며 이러한 과정은 $PPAR{\gamma}$에 의해 억제됨을 알 수 있었다. Objective: To investigate the role of ERK and $PPAR{\gamma}$ on the $TGF-{\beta}1$ induced human endometrial stromal cell decidualization in vitro. Method: Endometrial stromal cells are cultured under the following condition: DMEM/F12 (10% FBS, 1 nM E2 and 100 nM P4). $TGF-{\beta}1$ (5 ng/ml), Rosiglitazone (50 nM), and PD98059 ($20{\mu}M$) were added according to experimental purposes. Trypan-Blue and hematocytometer were utilized to count cell number. Enzyme-linked immunosorbent assay (ELISA) and western blotting were utilized to detect proteins. Result: $TGF-{\beta}1$ inhibited proliferation of cultured human endometrial stromal cells and induced expression of PGE2 and prolactin. This effect was mediated by Smad and ERK activation. Administration of rosiglitazone, $PPAR{\gamma}$ agonist, prevented $TGF-{\beta}1$ effect on cell proliferation. Furthermore, Rosiglitazone inhibited $TGF-{\beta}1$ induced activation of ERK, consequently reduced PGE2 and prolactin production. Conclusion: $TGF-{\beta}1$ induced decidualization of endometrial stromal cell through Smad and ERK phosphorylation. $PPAR{\gamma}$ acts as a negative regulator of human ndometrial cell decidualization in vitro.

컨벤션 종사자의 조직신뢰가 직무만족과 조직몰입에 미치는 영향연구

장혜진(Hye Jin Chang) 한국관광연구학회 2014 관광연구저널 Vol.28 No.3

This study deals with empirical analysis of the effect of convention employees` organizational trust on jobsatisfaction and organizational commitment. For an empirical study, it has conducted a survey, targeted at PCO(Professional Convention Organizer) located nation-widely and employees of convention centers, through directvisits, e-mails and telephone calls, from January to February, 2013, where total 350 questionnaires were distributed,223 returned and 219 chosen as valid samples. In addition, the questionnaires have been analyzed by using SPSS21.0 statistics package for frequency analysis, reliability analysis, exploratory factor analysis, correlation analysis,multicollinearity analysis, and regression analysis. The results of the analysis verifying the hypothesis of the studywere as follows: First, convention employees` organizational trust affected all factors of job satisfaction positively;Second, convention employees` organizational trust affected all factors of organizational commitment positively;Third, factors relating to the job and factors relating to wages and welfares affected affective commitment andnormative commitment, and factors relating to bosses and colleagues affected affective commitment positively atstatistical significance level, respectively. The study suggests that it is necessary to enhance job satisfaction andorganizational commitment through organizational trust of convention employees.

초기 자궁경부암 수술 후 재발 고위험 군에서 보조적 동시 항암화학 방사선치료의 적정성 및 효용성 평가

장혜진 ( Hye Jin Chang ),유희석 ( Hee Sug Ryu ),전미선 ( Mi Sun Chun ),박재선 ( Jae Sun Park ),권종희 ( Jong Hee Kwon ),장기홍 ( Ki Hong Chang ),이정필 ( Jung Pil Lee ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.6

목적 : 초기 자궁경부암 (병기 IA, IB, IIA) 환자에서 근치적자궁적출술과 골반림프절절제술 후에 치료실패율이 높은 고위험군에게 보조적 동시 항암화학방사선치료 (GOG #109 protocol)에 따른 치료의 효용성 및 적정성을 알아보고자 하였다. 연구 방법 : 1994년 7월부터 2001년 6월까지 아주대학교 병원에서 초기 자궁경부암 (병기 IA2, IB, IIA)으로 진단 받고, 근치적 자궁적출술과 부대동맥 및 골반림프절절제술을 시행한 환자 151명 중에서 부대동맥림프절 전이가 있거나 선행화학요법 혹은 방사선치료를 시행한 환자들을 제외한 144명을 대상으로 연구를 시행하였다. 이들 중에서 암세포의 골반림프절 전이, 절단면 침윤 혹은 자궁방 침윤을 보인 30명을 치료군으로 하여 보조적 동시 항암화학방사선요법 (adjuvant concurrent chemoradiotherapy)을 시행하고 치료 효과와 부작용을 후향적으로 임상 분석하였다. 보조적 치료는 수술 후 2-3주 이내에 항암화학치료를 시작하였고, 매 4주마다 총 4주기를 시행하였고, 제 1일에 cisplatin 70 mg/m^2, 2일에서 5일까지 5-FU (1000 mg/m^2)를 주사하였다. 2주기에서 3주기에 방사선치료는 5주간 병용되었다. 결과 : 수술적 치료를 받은 144명의 환자 중에서 9명 (6.3%)이 재발하였고, 치료군에서 3명 (10%), 대조군에서 6명 (5.3%) 이었다. 5년 생존율은 치료군이 100%, 대조군이 96.8%로 통계적인 차이는 없었고, 5년 재발률 (9.5% vs 6.3%)과 5년 무병생존율 (90.5% vs 93.7%)에서도 치료군과 대조군의 유의한 차이는 보이지 않았다. (p>0.05) 결론 : 본 연구로 근치적자궁적출술 및 림프절절제술 후 치료 실패 고위험 인자를 가진 초기 자궁경부암환자에서 보조적 동시 항암화학방사선치료를 함으로써 5년 재발률 및 5년 무병생존율을 위험인자가 없는 대조군 수준으로 향상 시킬 수 있음을 확인하였다. Objective : This study was undertaken to evaluate the efficacy of postoperative concurrent chemoradiotherapy (CCRT) and to investigate the recurrence and survival rates after adjuvant CCRT in high risk early cervical cancer (stage IA2, IB, IIA) patients who were treated by radical hysterectomy and pelvic lymphadenectomy. Methods : From July 1994 to June 2003, we reviewed the chart of 146 patients who underwent radical abdominal hysterectomy and pelvic lymphadenectomy at Ajou University Hospital for early cervical cancer (stage IA2, IB, IIA). CCRT was performed in 30 patients with high risk factors such as positive pelvic lymph node, positive parametrial involvement, or positive surgical margins. Chemotherapy consisted of cisplatin ( 70 mg/m^2 on day 1) and 5-FU (1000 mg/m^2 on day 2-5) for 4 cycles every 4 weeks beginning 2-3 weeks after operation. Pelvic radiotherapy were started with 2nd and 3rd cycle of chemotherapy concurrently. We compared the recurrence rate and survival rate with 114 patients who received no adjuvant therapy after operation. The mean follow up period was 49 months (24-94 months). Results : Disease recurred in 9 of 144 patients treated with surgery (6.3%). There were recurrences in 3 patients after CCRT (10.0%), and in 6 patients in the control group (5.3%) respectively. The actuarial 5- year overall survival rates for patients with adjuvant CCRT, and with no adjuvant treatment were 100%vs. 96.8% (p>0.05). The recurrence and progression-free survival rates were 9.5% vs 6.3%, 90.5% vs. 93.7% (p>0.05). Conclusion : This study shows good local control and 5 years overall and progreesion free survival rates in the high-risk cervical cancer patients after CCRT which is similar results seen in control group. Our results indicate that adjuvant concurrent chemoradiotherapy seems to be effective in stage IA2-IIA cervical concer patients with high risk.

폐경 후 여성에서의 호르몬 치료와 유방암

장혜진 ( Hye Jin Chang ),지병철 ( Byung Chul Jee ) 대한폐경학회 2008 대한폐경학회지 Vol.14 No.2

The Womens Health Initiative (WHI) was initiated in 1992 as a major disease-prevention research program among postmenopausal women. The program includes a randomized controlled intervention trial involving 68,132 postmenopausal women in the age range 50∼79 at randomization and four distinct interventions including hormonal therapy (HT) for coronary heart disease prevention with breast cancer as an anticipated adverse effect. The overall profile of HT effects is not consistent with recommendations for primary prevention because of the high sensitivity to safety concerns when intervening on otherwise healthy women. WHI did not study HT in the way that it is be administered in practice-the women were older than would normally be considered for initiating HT and the study did not tailor the study hormones to the individual women. And there was a discrepancy of hazard ratio estimates for estrogen-progesterone therapy (EPT) and estrogen (ET) alone between the clinical trials (CT) and observational studies (OS). Factors complicating interpretation of the results include differences in breast cancer risk profiles between women in CT and those in OS as well as heterogeneity in the definitions of menopause and prior use of HRT as applied by the WHI investigators to the two populations. In the WHI data, recent evidences suggest that ET reduces the overall risk of breast cancer. The risks of these outcomes are higher for EPT than for ET. The benefit-risk ratio for HT is favorable close to menopause but decreases with aging and with time since menopause in previously untreated women. WHI clinical trial contributions, challenges, and guidelines of various societies are reviewed and discussed.

수도권 지역 컨벤션 센터의 브랜드 자산에 대한 IPA 연구

장혜진(Hye Jin Chang) 한국관광연구학회 2010 관광연구저널 Vol.24 No.4

These days companies are thinking brand equity as a invisible worthy equity and a core strategy of the companies. These trends are also influenced in convetion center`s fierce competition. This study reviewed Korean capital area`s Convention Center`s brand equity via IPA. The research findings suggest the following: first, the most important things in brand equity are the brand itself of convention centers, positive feeling and service quality. And the most satisfied factors are satisfaction and familiarity. And differentiation, satisfaction, consideration, symbol and logo, familiarity are higher in satisfaction than the importance. Second, in the satisfactions of convention center, COEX is higher than KINTEX in average in all parts. Third, in the IPA matrix of COEX, hit one first and remembrance of name etc. are ``keep up good work``, investment value and unchangeable quality etc. are ``concentrate here``, renovation and ad massage etc. are ``low priority`` and familiarity and consideration etc. are ``possible overkill``. Forth, in the IPA matrix of KINTEX, remembrance of name and positiveness etc. are ``keep up good work``, peculiar image and leadership etc. are ``concentrate here``, symbol & logo and hit one first etc. are ``low priority`` and recycle and high quality etc. are ``possible overkill``. The results of this study elicited some implications. First, convention centers should raise brand equity value through service quality improvement. Second, renovation, leadership and improvement of investment value should be concentrated for better service quality. Third, COEX should keep leader of Korea convention market and supplement investment value, quality improvement and positive feeling. Forth, KINTEX should keep good quality and concentrate on establishment of peculiar image and leadership.

전시 개최지 선택 속성이 전시자의 만족 및 충성도에 미치는 영향에 관한 연구

장혜진 ( Hye Jin Chang ) (사)한국마이스관광학회(구 한국컨벤션학회) 2012 MICE관광연구 Vol.12 No.2

This study reviewed the effect of exhibition destination selection attributes on the exhibitors` satisfaction and loyalty. It`s the point of the need of marketing strategy about host facilities and host destination, relating to exhibitor`s destination selection. First, this study investigated the effect of five exhibition destination selection attributes on exhibitors` satisfaction. As a result of first, host destination`s traffic and sleeping accommodations/exhibition cost pay regard to exhibitor`s satisfaction. Second, this study examined the effect of five exhibition destination selection attributes on the exhibitors` loyalty. As a result of second, host destination`s overnight accommodations/exhibition cost and facilities` operation pay attention to exhibitor`s loyalty. Third, this study inquired the effect of exhibitors` satisfaction on the exhibitors` loyalty. As a result of third, exhibitors` satisfaction is mindful of exhibitors` loyalty. Finally, with these results, this study presented the marketing application plans of exhibition destination.

자간전증 임산부의 분만전 및 분만후 혈장 Matrix Metalloproteinase (MMP)-2, -9의 변화

장혜진 ( Hye Jin Chang ),양정인 ( Jeong In Yang ),김호빈 ( Ho Bin Kim ),김행수 ( Hang Soo Kim ),유희석 ( Hee Sug Ryu ),오기석 ( Ki Suk Oh ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.8

목적: 자간전증 임산부의 혈장에서 MMP-2 및 MMP-9 값을 측정하여 정상 임신과 비교하고, 분만 전후 MMP-2 및 MMP-9 값의 변화를 알아보고자 하였다. 연구 방법: 아주대병원 산부인과에서 분만한 자간전증 임산부 20명을 연구군으로, 연구군과 임산부의 나이, 분만시 재태연령, 산과력이 비슷한 정상 혈압의 임산부 20명을 대조군으로 분만전 및 분만 24시간 후에 임산부 혈장 MMP-2, -9 값을 enzyme-linked immunoassay Objective: To evaluate the changes of plasma MMP-2, -9 levels in preeclampsia between antepartum and postpartum periods, and compare with normotensive pregnant. Methods: Plasma MMP-2, -9 levels were determined with enzyme-linked immunoassay in pregnant wo

Sex ratio in infants born after blastocyst transfer: A meta-analysis

장혜진 ( Hye Jin Chang ),( Jung Ryeol Lee ),( Byung Chul Jee ),( Seung Yup Ku ),( Chang Suk Suh ),( Seek Hyun Kim ),( Young Min Choi ),( Jung Gu Kim ),( Shin Yong Moon ) 대한산부인과학회 2007 대한산부인과학회 학술대회 Vol.93 No.-

회원논단 : 식중독 세균 신속검출 기술 동향

장혜진 ( Hye Jin Jang ),채창훈 ( Chang Hoon Chai ),오세욱 ( Se Wook Oh ) 한국식품위생안전성학회 2013 Safe Food Vol.8 No.4