조산의 예측 지표로서의 fetal fibronectin의 유용성

정집광,이해혁,이정재,이석민,이순곤,남계현,이임순,이권해 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Objective: The purpose of this study was to evaluate clinical efficacy of fetal fibronectin as a marker to predictor of preterm labor. Materials & Methods: The study group consisted of sixty-eight healthy pregnant women, at gestational age between 24 and 36 weeks, who visited our department with vaginal discharge from April, 1995 to December, 1997. For comparison, we divided all of the pregnant women into two groups by the result of ROM-Check^®, positive groups(N=21) and negative groups(N=47). When preterm labor appeared, 50mg of ritodrine hydrochloride(Yutopar^®) mixed I liter of 5% dextrose solution was administered slowly intravenously. Results: 1) The gestational age at delivery and the interval time from admission to delivery in the positive groups were significantly shorter than those of the negative groups(p<0.05). 2) The positive groups had significantly lower birth weight and Apgar scores than the negative groups(p<0.05). 3) Among the negative groups, in case of tocolytics administration, the interval time from admission to delivery significantly delayed more than that time in case of no tocolytics administration(p<0.05). Conclusions: The detection of the fetal fibronectin in vaginal discharge had a useful method as a predictor of preterm labor. Tocolytics was more effective in the negative groups than in the positive groups.

자궁경부 종양에서 EGFR, TGF-alpha 및 Ki-67 발현에 대한 면역조직학적 연구

정집광(Jib Kwang Chung),이슬기(Seul Kee Lee),김민관(Min Kwan Kim),배동한(Dong Han Bae),김창진(Chang Jin Kim) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.4

N/A Objective : Cervical carcinoma of the uterus, the most common maliganacy among women in Korea, which its etiology and pathogenesis are not yet determined. Recently, since it has been found about the function of the growth factor and its receptor, involved in the regulation of cellular growth and differentiation, many studies have been undertaken about the role of growth factors and its receptors in the growth and differentiation of the tumor cell. Methods : In this study, we examined the expression of EGFR, TGF-alpha and Ki-67 in 50 CINs and 20 invasive cervical cancers using immunohistochemical stain. Results : Positive rate of EGFR was 92% in CIN, 80% in invasive cancer, negative rate of TGF-alpha was 74% in CIN, 80% in invasive cancer and Ki-67 labelling index(LI) in normal basal cell, CIN I-II, CIN III were 5±0.7, 13±2.5, 65±5.4 repectively and in invasive cancer, LI was over 90. from this result as cervical carcinoma progresses, the expression of EGFR and Ki-67 increase while that of TGF-alpha decreases. Conclusion : As cervical carcinoma progress, the expression of EGFR and Ki-67 increase while that of TGF-alpha decreases. Further studies on the expression of EGFR and TGF-alpha and its growth-stimulation mechanism in cervical carcinoma are warranted to establish the pathogenesis of the cervical carcinoma.

Toremifene 사용과 관련된 자궁내막 폴립 1 예

정집광(Jib Kwang Chung),이석민(Seok Min Lee),박은희(Eun Hee Park),방성윤(Sung Yun Bahng),김태성(Tae Sung Kim),문성택(Seong Taek Mun),진소영(So Young Jin) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.7

Antiestrogens have been widely used in the treatment of breast cancer patients. Although tamoxifen is one of the most prevalent antiestrogens, some reported its hepatocarcinogenic effects and the long-term treatment may increase the risk of endometrial and gastrointestinal cancer. Toremifene is an interesting new antiestrogen and have a similar antitumor efficacy as tamoxifen, with less side-effect including less uterotrophic effect compared to tamoxifen, in mice. we report a case of endometrial polyp which were associated with toremifene use, in postmenopausal woman with breast cancer, with a brief review of literature.

자연임신에서 분만 및 주산기 예후에 대한 임상적 고찰

이윤희,안준모,김태성,박은희,정집광,이석민,이해혁 순천향의학연구소 2002 Journal of Soonchunhyang Medical Science Vol.8 No.1

Object: To compare pregnancy outcome between term pregnancy and postterm pregnancy. Method: A clinical observation has been made on 60 cases of postterm pregnancies out of 64 cases delivered at the Dept. of Obstetrics & Gynecology, Soonchunhyang University from January 1, 1997 to May 31, 2002. 100 cases of full term deliveries of 37 to 42 gestational weeks conducted in same period were used as the control group for this study. We analyzed their cesarean section rate, fetal weight, placental weight, meconium stain, perinatal morbidity. The statistical significance was defined as P<0.05. Result: The following results were obtained 1. The incidence of postterm pregnancy was 1.34%. 2. The cesarean delivery rate in postterm group(51.7%) was significantly higher than control group(26%). 3. The incidence of large fetus (weight over 4,000gm) in the postterm group(21.7%) was higher than control group(2%). 4. The weight of placenta was 757g and 706g in the postterm group and control group respectively. 5. 1, 5 minute Apgar score lower in the postterm group than control group. Conclusion : To decrease perinatal morbidity and cesarean rate at 42 or more weeks gestation, appropriate labor induction and twice weekly biophysical profile and USF(AI, Doppler) may be indicated.

폐경기 여성에서 호르몬 대치 요법시 병행 투여된 프로제스토젠 투여 방법에 따른 혈청 지질 및 지단백에 미치는 영향

이임순,전섭,이순곤,이해혁,이권해,정집광,이석민 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.1

Objective : The purpose of our study is to evaluate the effect of different administration method of progestogen on lipid profiles including total cholesterol, LDL(low density lipoprotein)-cholesterol, HDL(high density lipoprotein)-cholesterol, triglycerides during hormone replacement therapy in postmenopausal women. Methods and Materials : Seventy-one postmenopausal women who were assigned to following groups (Group I : conjugated equine estrogen(CEE), 0.625 mg/day plus continuous medroxyprogesterone acetate (MPA), 2.5mg/day, Group II : CEE, 0.625 mg/day plus cyclic MPA, 5mg/day for 12days/month. And we measured serum total cholesterol, high density lipoprotein (HDL)-cholesterol, low density lipoprotein (LDL)-cholesterol, and triglycerides before hormone replacement therapy(HRT) and 12 months later after hormone replacement therapy. Results: 1. Total cholesterol decreased in group I,III. 2. HDL-cholesterol increased in group I,II,III. 3. LDL-cholesterol decrease in group I,II. 4. Triglycerides increased in group I,II,III. There was significance in serum total cholesterol and LDL-cholestrerol among three groups. Conclusions : Estrogen alone or in combination with progestogen both in cyclic and continuous use improves lipid profiles, so medroxyprogesterone acetate(MPA) does not seem to blunt estrogenic effect on lipid profiles.

임신 말기 유도 분만에서 미소프로스톨 경질 투여와 옥시토신 정맥 투여의 효과와 안정성 비교

한효상 ( Hyo Sang Han ),이정재 ( Jeong Jae Lee ),안준모 ( Ahn Joon Mo ),정집광 ( Jib Kwang Chung ),이임순 ( Im Soon Lee ),이권해 ( Kwon Hae Lee ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.1

목적 : 임신말기의 유도분만에서 prostaglandin E1의 유도체인 미소프로스톨 경질 투여와 옥시토신 정맥 투여의 유도분만 효과 및 안정성을 비교하고자 본 연구를 시행하였다. 연구 방법 : 2000년 12월 1일부터 2002년 3월 31일까지 순천향 대학병원 분만실에 입원한 37주 이상의 임신부 중 유도분만의 금기증이 없는 63명의 임신부에게 25 킽의 미소프로스톨을 42명에게 3시간 간격으로 경질 투여하였고, 21명에게는 정맥으로 옥시토신을 분당 Objective : To compare the safety and efficacy of intravaginally administered misoprostol (PGE1 analogue) versus intravenously administered oxytocin for labor induction at term. Methods : Among 63 patients over 37 weeks, randomly selected 42 patients were

유방암 환자에서 타목시펜 사용 후 자궁내막에 발생한 암육종 1 예

이임순(Im Soon Lee),이윤희(Yun Hee Lee),정집광(Jib Kwang Chung),이석민(Seok Min Lee),안준모(Jun Mo Ahn),김신아(Shin Ah Kim),김대원(Dae Won Kim),김성욱(Seong Uk Kim),조환성(Hwan Sung Joe),김동원(Dong Won Kim) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.7

Tamoxifen, which is often used in breast cancer therapy, has also been used in the treatment of patients with advanced and recurrent endometrial carcinoma. Tamoxifen has been shown to have significant benificial effects in the treatment of breast cancer patients as hormonal therapy. However, there is evidence that tamoxifen may affect other hormone sensitive organs, including the uterus and ovaries. An increased risk of endometrial polyps, endometrial hyperplasia and endometrial cancer has been reported in tamoxifen treated women. We are able to make this report because we have experienced uterine endometrial carcinosarcoma which is developed in a patient treated with tamoxifen for five years following a modified radical mastectomy due to breast cancer in our hospital.

조기 복강임신 1례

전준기 ( Jun Gi Jeon ),이지연 ( Ji Yeon Lee ),정집광 ( Jib Kwang Chung ),심일구 ( Ill Goo Shim ),김희범 ( Hee Beom Kim ),고은석 ( Eun Suk Koh ) 대한주산의학회 1999 Perinatology Vol.10 No.3

한국 여성 1 , 131 명의 피임실천 및 실태에 대한 조사

이임순(Im Soon Lee),이윤희(Yun Hee Lee),정집광(Jib Kwang Chung),이석민(Seok Min Lee),이해혁(Hae Hyeog Lee),이정재(Jeong Jae Lee) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.6

목적 : 1,131명을 대상으로 한 설문지 조사로 한국여성의 피임에 대해서 조사하여 최근 가장 많이 사용하는 피임방법, 문제점과 만족도를 알아보고 앞으로의 방향을 제시하고자 하였다. 연구 대상 및 방법 : 2000년 1월부터 2001년 10월까지 순천향대학병원 산부인과를 방문한 성경험이 있는 가임기 여성 1,131명을 대상으로 설문지 조사를 실시하였다. 설문지 내용은 크게 대상자의 일반적 특성, 피임방법, 부작용, 만족도를 포함하여 조사하였다. 결과 : 조사 대상자 1,131명의 평균 연령은 35.1±5.9세였으며 직업은 주부 (68%)가 가장 많았고 교육정도는 고등학교졸업 (49.2%)이 가장 많았다. 대부분이 결혼한 여성 (92.6%)이었으며 평균자녀수는 1.7±1.1명이었고 평균 유산수는 0.8±1.5회였다. 피임에 대한 조사에서 평균 피임기간은 4.6±4.9년이였으며 가장 많이 사용하는 피임 방법은 콘돔 (29.0%), 자궁내장치 (21.1%), 난관수술 (13.5%), 경구피임약 (12.2%), 날짜피임법 (9.3%), 정관수술 (7.9%), 질외사정법 (6.4%), 기타 (1.2%) 순이였다. 41세 이상과 중학교 졸업 이하에서는 난관수술이 많았고 40세 이전에서는 콘돔과 경구 피임약을 많이 사용하였다. 자궁내장치가 부작용이 가장 많다고 하였으며 분비물 증가와 월경량 증가를 꼽았다. 만족도 조사에서는 대체적으로 피임에 만족하였으며 난관수술과 정관 수술의 만족도가 높았다. 결론 : 가장 많이 이용하는 피임방법은 콘돔이였고, 과거의 영구적 불임 방법에서 일시적인 피임 방법으로 변화하는 추세이었으며, 일시적 피임 방법은 부작용이나 피임실패율로 인하여 만족도가 떨어지는 있는 것으로 조사되어 콘돔, 자궁내 장치, 경구피임약 등의 사용방법에 대한 교육이 시급한 실정이다. Objective : We conducted a research into the current method of contraception used by Korean women (1,130 were surveyed) in order to understand about any problems they may be experiencing and their levels of satisfaction. Our objective is to be able to suggest appropriate methods of contraception which are desired by Korean women. Method : We gave questionnaire to reproductive age women who visited Soonchunhyang University Hospital in Seoul from January 2000 to October 2001. Items of the survey contained general characteristics such as, the method of contraception, side effect (if any), and level of satisfaction. Results : The mean age was 35.1±5.9 years and the most common occupation was that of housewife (68%), the mean parity was 1.7±1.1, and the mean abortion was 0.8±1.5. The mean contraception period was 4.6±4.9 years, of the methods used, condoms were the most common (29.0%), followed by intrauterine device (21.1%), tubal sterilization (13.5%), oral contraceptive (12.2%), periodic abstinence (9.3%), vasectomy (7.9%), coitus interruptus (6.4%) and others (12.4%). Among women above 41 years of age, sterilization was the most common method. Condom and oral contraceptives were the most common methods among women under the 40 years of age. The side effects, menorrhagia and leukorrhea were the most common among the women who had used the method of contraception with inrauterine divice. Tubal sterilization and vasectomy gave the most satisfaction. Conclusion : The most common used contraceptive method among Korean reproductive age women was the condom. We found that the form of contraception has been changing from permanent method to a temporary one. Therefore the education for women in the use of condom, oral contraceptives, and intrauterine device should be completed as soon as possible.

한국인 임신부에서 Factor V 유전자 돌연변이와 중증 전자간증의 관계

이주롱 ( Joo Long Lee ),이순곤 ( Soon Gone Lee ),이정재 ( Jeong Jae Lee ),이해혁 ( Hae Hyeog Lee ),정집광 ( Jib Kwang Chung ),최규연 ( Kyu Yeon Choi ),이임순 ( Im Soon Lee ),이권해 ( Kwon Hae Lee ) 대한주산의학회 2002 大韓周産醫學會雜誌 Vol.13 No.4

연구목적:단백 C는 활성화 단백 C(Activated protein C, APC)로 활성화되어 응고인자중 factor Va와 factor Ⅷa를 불활성화시키는 항응고 물질이다. 활성화 단백 C 내성이 유전성 혈전증의 중요한 원인이라는 사실이 밝혀졌으며, 이 대부분이 factor V 유전자의 돌연변이(factor V Leiden mutation)에 의한 것임이 알려졌다. 본 연구에서는 factor V 유전자 돌연변이로 야기되는 활성화 단백 C에 대한 내성이 중증 임신 전자간증의 임신부에서 관찰된 보고가 있고 병태 생리에 역할을 한다는 가설을 접하고 중증 전자간증 임신부에서의 factor V Leiden mutation의 빈도를 조사해 정상 임신부와 비교해 보고자 하였다. 방법:정상 혈압을 가진 403명의 임신부와 중증 전자간증으로 진단된 158명의 임신부의 혈청을 대상으로 factor V 유전자의 506번 아르기닌(arginin) 구간에 대한 중합 효소 연쇄 반응을 시행한 후 Mnl 1 제한 효소로 절단하여 절단 여부를 관찰하여 factor V Leiden mutation여부를 관찰하였다. 결과:정상 임신부 403명과 중증 전자간증 임신부 158명중 factor V Leiden mutation은 한 예에서도 관찰되지 않았다. 결론:본 연구결과 백인에서와는 달리 한국인에서는 활성화 단백 C 내성 및 factor V Leiden mutation이 발견되지 않았으며, 한국인에서의 중증 전자간증에 대한 위험요소중 유전자에 대한 다른 연구가 필요할 것으로 생각된다. Objective: A study showed that resistance to activated protein C may develope some cases of severe preeclampsia. A common missense mutation in the factor V gene, the Leiden mutation, is the most frequent genetic cause of resistance to activated protein C. Our objective was to determine whether this mutation is more prevalent in patients with severe preeclampsia than in normotensive controls. Method: Deoxyribonucleic acid was extracted from whole blood of 158 gravid women of severe preeclampsia and 403 normotensive gravid women. The polymerase chain reaction was used to amplify exon 10 of the factor V gene, followed by allele-specific restriction with Mnl 1 for mutation detection. Results: No patients were homozygous for the Leiden mutation. We could not find any positive case with FV: Q506 in the normal or patient group. Conclusion: We could not find that carriers of the factor V Leiden mutation are increased risk for severe preeclampsia. In contrast to the reports in Caucasian, the prevalence of APC resistance and FV: Q506 might be very low or absent in the Korean population. But, carriers of this common thrombophilic mutation may be identified so that other causes and risk factors for inherited thrombophilia should be investigated in the Korean population.