자궁경부암에서 PCR기법을 이용한 Human Papillomavirus DNA 검출

김수녕 건국대학교 의과학연구소 1995 건국의과학학술지 Vol.5 No.-

The polymerase chain reaction(PCR) was used to analyze human papillomavirus(HPV) DNA sequences to determine if HPV type 16 or 18 has clinical significance in 18 cases of invasive cervical cancer and 20 controls. Of 18 cases of invasive cervical cancer, 94.4% were HPV 16 positive, and none was HPV 18 positive. Thirty-four percent of controls were HPV 16 positive. HPV 18 was not detected in controls. Age, clinical stage, histologic cell type, lesion size were not related to HPV type. The mean age of HPV 16 group was 46 years, compared to 41 years for the control group. Of 16 squamous carcinomas, HPV 16 was detected in 16 cases. Of 2 adenocarcinomas, HPV 16 was detected in 1 case. Of 11 cervical cancer with lesion < 4㎝, HPV 16 DNA was detected in 9 cases, HPV 16 was detected in 7 cases among 7 cervical cancer with lesion ≥ 4㎝.

자궁경부 상피내종양의 선별검사로서 질확대경 검사의 임상적 의의

김수녕 건국대학교 의과학연구소 1999 건국의과학학술지 Vol.9 No.-

The papanicolaou smear is the primary screening tool for cervical intraepithelial neoplasia (CIN) and invasive cervical cancer(ICC). False negative rates of Pap smear have been reported as high as 25-50%. Recent articles suggest that the use of colposcopy in addition to the Pap smear might improve the accuracy of CIN and ICC detection. However, colposcopic screening has not been practical because of its cost and the necessity of expertise in the evaluation of colposcopic findings. Because cervical cancer can be prevented by simple treatment of CIN, combined cytology and screening colposcopy is considered to be an important screening tool for CIN. The present study compared the usefulness of Pap smear with colposcopy in screening for CIN. Two hundred and forty-three gynecology patients were evaluated with cytology, colposcopy, and colposcopically directed biopsy. CIN and human papillomavirus infection were diagnosed by biopsy. We excluded patients with a history of an abnormal Pap smear within the past 12 months, or a history of abnormal vaginal bleeding. Fifteen patients (6.2%) had CIN lesions diagnosed by colposcopically directed biopsies. In 13 patients condylomatous lesions were found, in 7 patients CIN Ⅰ, in 3 CIN Ⅱ, and in 5 patients CIN Ⅲ were diagnosed. Sensitivity and specificity rates of Pap smear were 66.7% and 97.8%, respectively. The corresponding figures for coloposcopy were 80.0% and 98.2%. The combination of both methods led to optimal sensitivity and specificity(100%, respectively) Screening colposcopy is a valuable supplementary strategy for the detection of CIN, otherwise not detected with Pap smears.

한국의 조기난소부전 환자에서 Inhibin 유전자의 변이 분석

김영진,손인숙,이지영,김수녕 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.14 No.-

The clinical models for studying ovary-determining genes may be premature ovarian failure(POF). POF is a condition causing amenorrhea, hypoestrogenism, and elevated gonadotropins in women under 40 years old. The prevalence of POF among reproductive women is 1%. POF is a highly heterogenous condition, but its etiology remains unknown in approximately two-thirds of cases. Many causes of POF were reported, including Turner syndrome, genetic disease, iatrogenic agents such as chemotherapy or radiotherapy, infection and autoimmune disease. FSH receptor, LH receptor, inhibin, GDF-9(growth differentiation factor), BMP-15(bone morphogenetic protein), DIAPH2(diaphanous gene) and XPNPEP2(X-prolyl aminopeptidase) genes were proposed as a possible candidate gene, but only mutations of FSH receptor, LH receptor, inhibin genes were reported in women with POF. The present study was performed to investigate whether the mutation of inhibin gene is observed in Korean patient with premature ovarian failure and whether mutation of these genes is a likely cause of POF. Eighty-six women with premature ovarian failure were studied and thirty-six normal women were enrolled as control. Mutation screening of these genes were established by denaturing HPLC and were confirmed by automatic sequencing. No mutation of inhibin gene was identified in Korean women with POF. In conclusion, premature ovarian failure was not likely caused by mutations of inhibin gene.

고칼륨혈증에서 심전도의 진단적 의의

윤수영,박원녕,정성필,김승호,이한식 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

Background: Hyperkalemia is a common and potentially life-threatening metabolic disorder. The electrocardiogram(ECG) is known to be a relatively sensitive diagnostic tool for hyperkalemia. However many exceptions, in which patients showed normal ECG findings even though hyperkalemic, have been reported. The purpose of this study was to determine the extent of correlation between the ECG findings and hyperkalemia and to determine when the ECG has value for diagnosing hyperkalemia. Methods: Patients who had been diagnosed as having hyperkalemia at two university hospitals during three years were enrolled in this study. We reviewed the medical records of the patients and evaluated the following 6 ECG abnormalities: tall T waves, narrow T waves, QRS widening, atrioventricular block, loss of P waves, and sine waves. We defined tall T waves and narrow T waves as 20 percentiles of heights and widths of the T waves from the 100 patients with normokalemia. Results: During the study period, there were 100 hyperkalemic patients, and we analyzed 69 available electrocardiograms. Abnormal ECG findings were revealed in 67%of 69 patients. The higher the serum potassium level, the more abnormal ECG findings. The common ECG abnormalities were tall T waves and loss of P waves. The patients with normal ECGs even though hyperkalemic had relatively low potassium levels. And whether chronic renal disease was not correlated to the ECG abnormality. Conclusion: The electrocardiogram is a good diagnostic tool for hyperkalemia if it is used with accurate diagnostic criteria. Thus, hyperkalemia should be considered when the ECG shows tall T waves or loss of P waves.

복강경하 질식 자궁적출술 30예의 임상적 고찰 : A Review of 30 Cases

윤병일,김소정,정두용,김수녕,손인숙,이지영 건국대학교 의과학연구소 2003 건국의과학학술지 Vol.13 No.-

Hysterectomy is the most common gynecologic operation. Traditionally, hysterectomy was performed either through an abdominal approach or through a vaginal approach. Recently, laparoscopic hysterectomy is quite often tried. To evaluate the effectiveness and value of LA VH(Laparoscopy Assisted Vaginal Hysterectomy), and to evaluate the possibility whether to rep;ace abdominal hysterectomy to LAVH, we analyzed our clinical cases. This clinical study is a retrospective review of 30 cases of LAVH from May 2002 to February 2003 at the department of Obstetrics and Gynecology, Chung- Ju hospital, Konkuk University. We evaluated age, parity, previous abdominal operations, indications of hysterectomy, combined operation, operating time, hemoglobin change, weight of uterus, hospital stay and postoperativeThe average operating time was 146 ± 42 minutes, the uterine weight was 239 ± 126 grams, and the mean postoperative hemoglobin loss was 1.7 ± 1.4 g/dl. The most common pathologic finding was myoma uteri(37%), and the second most pathologic finding was adenomyosis(20%) and myoma uteri with adenomyosis (20%). Serious complications were not appeared. LAVH provides a shorter hospital stay, quicker recovery, and the acceptable complication rate except incerased operating time than abdominal hysterectomy. This study suggests that LAVH appears more useful than TAH(Total Abdominal Hysterectomy) and could replace abdominal hysterectomy.

난소암에서 CA125의 임상적 의의

윤병일,김수녕,손인숙,유연웅,최원석 건국대학교 의과학연구소 2000 건국의과학학술지 Vol.10 No.-

The concentration of the tumor marker CA125 in serum from patients with ovarian tumor was measured to define the usefulness of them in differentiating malignant ovarian tumor from benign ovarian mass. In the study of 105 patients with gynecologic neoplasm, of whom 38 were myoma uteri, 42 benign ovarian tumor, and 25 ovarian cancer, the level of serum CA125 were measured. CA125 was greater than 35 U/ml in 2.6% of myoma uteri, in 2.4% of benign ovarian tumors and 68.0% of ovarian cancers. Using a cut-off level of 35 U/ml, the results can be characterized by a 68.0% of sensitivity and 97.5% of specificity in detecting an ovarian cancer. Among 25 patients with ovarian cancer, 11 of 14 (78.6%) patients with serous cystadenocarcinoma, 4 of 6 (66.7%) patients with mucinous cystadenocarcinoma and 2 of 5 (40.0%) patients with endometrioid carcinoma had CA125 values greater than 35 U/ml. In relation to a higher tumor stage, there was an increasing incidence of elevated levels of CA125. As a result, it is likely that the measurement of CA125 is useful for early diagnosis of ovarian cancer.

폐경 환자에게 호르몬치료 시 뇨중 N-Telopeptide의 유용성

이성기,윤병일,손인숙,김수녕,최영숙 건국대학교 의과학연구소 1998 건국의과학학술지 Vol.8 No.-

Objective: We evaluated the bone resorption rate in perimenopausal and postmenopausal women and determined whether urinary N-telopeptide of typeⅠ collagen(NTx), a marker of bone resorption, could predict the risk of osteoporosis and the bone turnover following hormone replacement therapy(HRT). Material and Methods: Twenty-eight women received HRT for climacteric symptoms, menopause, osteopenia, osteoporosis, or surgical removal of the ovaries. Serum FSH, LH, estradiol, and NTx were checked for baseline study. After 8 weeks HRT, NTx was rechecked. Result: NTx correlated positively with FSH, but negatively with estradiol. The level of NTx increased during first 5-years after menopause and then gradually decreased. After 8 weeks of HRT, average level of NTx was decreased to 56% of the baseline level. Conclusion: Bone resorption in menopause is closely related hypoestrogenemia. Examination of NTx levels may predict the risk of osteoporosis and the bone turnover after HRT.

갑상선기능저하증에 합병된 중증 전자간증과 심외막 삼출액으로 의한 심장탐폰을 동반한 임신 1예

구희주,최원석,이지영,손인숙,김수녕 건국대학교 의과학연구소 2001 건국의과학학술지 Vol.11 No.-

Hypothyroidism presenting during pregnancy is rare, probably due to the lower incidence of hypothyroidism during reproductive years. And hypothyroidism rarely complicates pregnancy because most hypothyroidism is accompanied by amenorrhea and anovulation. Risk of maternal complications of hypothyroidism including preeclampsia, placental abruption, anemia, postpartum hemorrhage, cardiac dysfunction are increased. Hypothyroidism accompanies pericardial effusion frequently. But the diagnosis of pericardial effusion is usually made incidentally by routine check-up because the patient rarely complains any symptoms of pericardial effusion. Moreover it is extremely rare that pericardial effusion makes the presenting sign of hypothyroidism. We experienced a case of preeclampsia with pericardial effusion in hypothyroid parturient that needed pericardial window operation with emergency cesarean section. So we present this case with a brief review.

Ultra-Minilaparotomy for Large Benign Ovarian Cysts

( Soo Nyung Kim ),( Jae Man Bae ),( Sun Joo Lee ),( Hyo Pyo Lee ) 대한산부인과학회 2011 대한산부인과학회 학술대회 Vol.97 No.-

학술자료의 분석과 발표 : 의학통계 분석의 유의사항

( Soo Nyung Kim ) 대한산부인과학회 2013 서울심포지움 Vol.18 No.-