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자간전증의 병인에 있어서 VEGF ( vascular endothelial growth factor ) 가 혈관 내피세포에 미치는 영향
조용균(Yong Kyoon Cho),이홍균(Hong Kyoon Lee) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.8
연구 목적 : 자간전증의 중요한 중간 원인은 혈관 내피세포의 기능 이상으로 알려져 있다. 따라서 자간전증 임신부의 혈액에서 높은 농도로 존재하는 것으로 알려진 VEGF가 혈관 내피세포의 기능 이상을 초래하여 자간전증을 유발하는 지를 알아보기 위해, 실험실에서 제대 정맥의 혈관 내피세포에 대한 VEGF의 영향을 알아보고자 하였다. 연구 방법 : 자간전증 임신부와 정상 임신부의 혈청에서 효소 면역 분석법을 이용하여 VEGF의 농도를 측정하였다. 제대정맥에서 혈관 내피세포를 분리하여 배양한 후, 제대정맥 혈관 내피세포를 VEGF, 자간전증 임신부 및 정상 임신부의 혈청으로 24시간 동안 자극시킨 후에 생성된 prostacyclin의 농도를 측정하였다. 연구 결과 : 자간전증 임신부가 정상 임신부에 비해 혈청 VEGF 농도가 유의하게 높게 나타났다. VEGF 농도가 증가함에 따라 prostacyclin 생성도 증가하였으며, 제대정맥 내피세포를 자간전증 임신부의 혈청으로 자극시켰을 때 postacyclin의 생성이 증가하였고 혈청 VEGF 농도와 prostatytlin 생성 사이에는 상당한 연관성이 있었다. 결론 : VEGF는 혈관 내피세포의 기능 이상을 초래할 수 있는 인자 중의 하나이며, 자간전증 임신부에서 나타나는 VEGF의 높은 혈청 농도가 자간전증의 병리학적 기전에 중요한 작용을 할 것으로 생각된다. Objective : Preeclampsia is primarily a disorder of the maternal endothelium. The objective of this study was to assess the effect of VEGF on human umbilical vein endothelial cells (HUVEC) in vitro. Methods : The serum concentrations of VEGF in women with preeclampsia and normotensive pregnant women were measured with a sensitive and specific enzyme immunoassays. After HUVEC were isolated and cultured in vitro, these HUVEC were stimulated with VEGF, sera from women with preeclampsia and normotensive pregnant women for 24 hours. And then prostacyclin levels were measured. Results : The serum concentrations of VEGF were significantly higher in women with preeclampsia than in normotensive pregnant women. Vascular endothelial growth factor induced a significant concentrationdependent increase in prostacyclin production. HUVEC stimulated with sera from women with preeclampsia showed an increase in production of prostacyclin. VEGF concentration in serum was correlated with prostacyclin production by the stimulated cells. Conclusion : VEGF may be one of the circulating factors that cause the alteration in endothelial function and the high serum concentration of VEGF is thought to be important in the pathogenesis of preeclampsia.
재발성 상피성 난소암 환자에서 Gemcitabine 단독 항암화학요법을 사용한 4예
박용주 ( Yong Joo Park ),이철민 ( Chul Min Lee ),서형주 ( Hyung Joo Seo ),이혜주 ( Hye Joo Lee ),김정선 ( Jaung Sun Kim ),고지경 ( Ji Kyung Ko ),조용균 ( Yong Kyoon Cho ),최훈 ( Hoon Choi ),김복린 ( Bok Rin Kim ),이홍균 ( Hong Ky 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.11
양용혁 ( Yong Hyuk Yang ),이가영 ( Ka Young Lee ),황희정 ( Hee Jung Hwang ),조용균 ( Yong Kyoon Cho ),김복린 ( Bok Rin Kim ),최훈 ( Hoon Choi ),이철민 ( Chul Min Lee ),고지경 ( Ji Kyung Ko ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.10
목적: 분만 전 후 심장근육병증 환자들의 임상적 특징 및 위험인자를 분석하여 예후를 평가하고자 하였다. 연구 방법: 1995년 1월부터 2005년 12월까지 본원에서 분만한 산모 중 분만 전 후 심장근육병증으로 진단된 10예를 대상으로 의무기록을 통해 임상자료 및 연속적인 심장 초음파검사 소견을 분석하였다. 결과: 진단시 평균 나이는 28.8±3.2세 였으며, 평균 임신주수는 37(+3)±4주 였다. 5예에서 분만 전 1주일 내에, 5예에서 분만 후 2주일 내에 발병하였다. 9예에서 초산부였으며, 3예에서 쌍태 임신이었고, 6예에서 자간전증을 보였다. 7예에서 제왕절개 수술을 받았고, 7예에서 혈색소 수치가 10 이하였으며, 4예에서 발병 전 수혈을 받았다. 평균 신체질량지수는 22.4±2.7 ㎏/㎡ 이었으며, 진단시 평균 좌심실 박출계수는 42.84±9.69%, 평균 구획단축률은 23.41±5.49%, 평균 좌심실 확장기말 내경은 5.58±0.55 ㎝/㎡이었다. 8예에서 좌심실 기능이 회복되었으며, 회복시 평균 좌심실 박출계수는 61.41±4.21%, 평균 구획단축률은 34.08±3.26%, 평균 좌심실 확장기말 내경은 4.68±0.76 ㎝/㎡이었다. 발생율은 2455명 중 1명이었고, 사망률은 평균 10개월 추적관찰동안 12.5%였다. 결론: 분만 전 후의 혈액역동학적인 변화가 급격하게 일어나는 산모에서 분만 전 후 심장근육병증의 발생 위험이 크며, 진단시 심장 초음파소견이 예후를 평가하는데 도움이 될 것이다. Objective: To examine clinical characteristics and risk factors and to assess prognosis of peripartum cardiomyopathy (PPCM). Methods: We retrospectively reviewed the medical records of 10 patients with confirmed PPCM by clinical symptoms and echocardiography, who delivered between January 1995 and December 2005 at our Hospital. Clinical and serial echocardiographic data of these patients were collected. Results: Mean maternal age at the time of diagnosis was 28.8±3.2 years and the mean gestational age was 37(+3)±4 weeks. Common associated conditions were nulliparity (90%), cesarean delivery (70%), anemia (70%), preeclampsia (60%), transfusion before diagnosis (40%), twin pregnancy (30%). At the time of diagnosis, the mean left ventricular ejection fraction (EF) was 42.84±9.69%, fractional shortening (FS) was 23.41±5.49%, and left ventricular end diastolic dimension (LVEDD) was 5.58±0.55 ㎝/㎡. Normalization of left ventricular function occurred in 8 patients (80%). After recovery of the left ventricular function, mean EF was 61.41±4.21%, FS was 34.08±3.26%, and LVEDD was 4.68±0.76 ㎝/㎡. Incidence of PPCM was 1 in 2455 pregnancies, and maternal mortality was 12.5% in 10 months follow-up. Conclusion: The risk of PPCM may increase in puerperal women with rapid dramatic hemodynamic change. Echocardiography may provide significant prognostic information.
태반조기박리가 동반된 임신성 고혈압 임산부와 정상혈압 임산부에서의 주산기 예후에 대한 비교 분석
박지용(Ji Yong Park),정진훈(Jin Hoon Chung),조용균(Yong Kyoon Cho),최훈(Hoon Choi),김복린(Bok Rin Kim),이홍균(Hong Kyoon Lee),유태환(Tae Hwan Yoo),고수진(Soo Jin Ko),박교훈(Gyo Hoon Park),서정식(Jeong Sik Seo) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.11
N/A Objective: The objective of this study was to compare perinatal outcomes of pregnancy-induced hypertensive and normotensive women experiencing abruptio placentae, Our hypothesis is that pregnancy-induced hypertensive women have a less favorable perinatal outcome than do normotensive women. Methods: Women with the diagnosis of abruptio placentae delivered between August 1,1989 and December 1,1996, composed the study group (n-92) in this case-control study. The women with abruptio placentae were divided according to their hypertensive (n 37) or normotensive (n 55) status. Maternal and neonatal medical records were reviewed and abstracted for demographic variables, antepartum complications, delivery route, abruptio placentae grade, neonatal gender, birth weight, Apgar score and perinatal mortality. We compared these perinatal outcome variables between the pregnancy-induced hypertensive and normotensive pregnant women. Results: The incidence of abruptio placentae was 0.35%. The two groups of woman wne similar with regard to age and parity. Abruptio placentae grades 2 occurred more often in hypertensive women (P=0.0053). Pregnancy-inducedhypertensive women were similar to normotensive women with regard to antenatal complications. The mean gestational age of delivery, delivery route, neonatal weight and sex were similar between two groups of women. Neonates from pregnancy-induced hypertensive women were no more likely to have low 1 and 5-minute Apgar score or to die than those from normotensive women. Statistical analysis was performed with two-tailed independent t-test and Kruskal-Wallis analysis. Conclusion: Although pregnancy-induced hypertensive women experiencing abruptio placentae are more likely to have grade 2 abruptio placentae with fetal distress, the overall perinatal outcome was not significantly different from that of normotensive women experiencing abruptio placentae.
질식 분만된 조산아에서 아프가 점수 , 제대 동맥혈 가스분석의 임상적 의의
박지용(Ji Yong Park),정진훈(Jin Hoon Chung),박교훈(Kyo Hoon Park),조용균(Yong Kyoon Cho),최훈(Hoon Choi),김복린(Bok Rin Kim),이홍균(Hong Kyoon Lee),고수진(Su Jin Ko),서정식(Joung Sik Seo),유태환(Tae Hwan Yoo) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.11
N/A Objective: The Apgar score has long been used to determining birth asphyxia and assessing early neonatal status and long-term outcome. Unfortunately, some components of this system depend upon subjective interpretation. Also, although, low Apgar score, Most of newborns are relatively healthy. The objective of our studt is attempt to assure the linical significance of Apgar score and umbilical cord blood gas analysis on assessing status of uncomplicated preterm infants delivered vaginally. Methods: The present study was performed in attempt to compare umbilical arterial blood gas values for uncomplicated preterm infants delivered vaginally with low 1 and 5 minutes Apgar score (<7) with those for term or preterm infant with normal 1 and 5 minutes score (>7), each other, The present study included 82 uncomplicated term infants delivered vaginally and 24 preterm infants. Inclusion criteria of our study is as follows: 1) Singleton neonate with vertex presentation, 2) No congenital malformation, 3) Infants whose mother had no obstetrical and medical complications, 4) Immediately after delivery, umbilical arterial blood was sampled, before first breathing of neonate, 5) Infants applied Apgar score at I minute and again 5 minutes after birth, and 6) Infants whose mothers gestational age was estimated by ultrasonography during first-trimester of pregnancy. The statistical analysis was performed by Mann-Whitney U test and Fishers exact test. Results: 1) There was no significant difference in umbilical arterial blood gas values between uncomplicated preterm infants delivered vaginally with low 1 and 5 minutes Apgar score (<7) and term infants with normal score (>7). 2) There was no significant difference in umbilical arterial blood gas values between uncomplicated preterm infants delivered vaginally with low 1 and 5 minutes Apgar score (<7) and preterm infants with normal score (>7). 3) There was significant difference in frequency of lower Apgar score (<7) between term (2%[2/82]) and preterm infants (38%[9/24]), but not in frequency of acidemia (defined as less than pH 7.2) (28%[23/82] Vs 33%[8/24]). Conclusion: The Apgar score is not a reliable indieator of well-being in preterm neonate. We recommend umbilical arterial blood sampling at delivery of preterm infant with low Apgar score, because umbilical cord blood gas indices on objective means of assessing birth status of the newbarn and more useful than Apgar score in ruling out birth asphyxia.
임신 중기 원인불명 모체혈청 인간 융모성 성선자극호르몬이 상승된 임부에서의 임신 예후
박지용(Ji Yong Park),정진훈(Jin Hoon Chung),고수진(Su Jin Ko),박교훈(Kyo Hoon Park),서정식(Jung Sik Seo),유태한(Tae Hwan Yoo),조용균(Yong Kyoon Cho),최훈(Hoon Choi),김복린(Bok Rin Kim),이홍균(Hong Kyoon Lee) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.11
N/A Objective: Our purpose was to determine whether unexplained elevation in maternal serum human chorionic gonadotropin without abnormal elevation in matemal serum alpha-fetoprotein (MSAFP) in the second trimester may be associated with adverse pregnancy outcomes. Methods: Between January 1997 and December 1997, we evaluated 906 pregnant women undergoing second trimester triple marker screening tests who delivered at our hospital. Multiple pregnancy, fetal anomaly, intrauterine fetal death before 20 completed weeks of gestational age, insulin dependent diabetes mellitus and maternal serum alpha-fetoprotein level greater than 2.0 multiple of the median (MoM) were excluded fiom the study. Seventy-two women with hCG level greater than 2.0 MoM were included in the study group while 809 women with hCG level less than 2.0 MoM served as the control group. Adverse pregnancy outcomes were obtained from hospital delivery records and neonatal records. Statistical analysis were performed by students t-test and chi square test. Results: Women with unexplained elevation of human chorionic gonadotropin level showed increased risks for intrauterine growth retardation (P<0.01) and pregnancy induced hypertension (P<0.05). There were no significant differences between study and control groups with respect to preterm delivery, placental abruption, fetal anomaly and intrauterine fetal death. Conclusion: Unexplained elevation of human chorionic gonadotropin in the second trimester was associated with intrauterine growth retardation and pregnancy induced hypertension.
정희정 ( Hee Jung Jung ),조용균 ( Yong Kyoon Cho ),최훈 ( Hoon Choi ),고지경 ( Ji Kyung Ko ),김명환 ( Myoung Hwan Kim ),김복린 ( Bok Rin Kim ),신은아 ( Eun Ah Shin ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.10
Primary ovarian transitional cell carcinoma (TCC) is extremely rare type of tumor and resembles transitional cell carcinoma of the bladder. Primary ovarian TCC has been classified as a different subtype from malignant Brenner tumor for it`s histologic and clinical characteristics. It usually presents at an advanced stage .Though more aggressive than malignant Brenner tumor, it shows more favorable prognosis because of better response to the chemotherapy than other epithelial ovarian carcinomas. We experienced a case of primary ovarian transitional cell carcinoma in a premenopausal woman who underwent staging operation and chemotherapeutic treatment, and herein report the case with a brief review of related literatures.