폐경 후 인지력 장애에 대한 호르몬치료

유영옥 ( Young Oak Lew ) 대한폐경학회 2006 대한폐경학회지 Vol.12 No.4

갱년기 호르몬치료의 부작용과 그 대처방법

유영옥 ( Young Oak Lew ) 대한폐경학회 2004 대한폐경학회지 Vol.10 No.1

임신능이 확인된 가임 여성에서의 Deciduosis의 유병율

김미란,유영옥,노덕영,류순원,권동진,김장흡,김진홍,임용택,김은중,정재근,이진우,Kim, Mee-Ran,Lew, Young-Oak,Ro, Duck-Yeong,Ryu, Sun-Won,Kwan, Dong-Jin,Kim, Jang-Heub,Kim, Jin-Hong,Lim, Yong-Taik,Kim, Eun-Jung,Jung, Jae-Keun,Lee, Jin-Woo 대한생식의학회 2000 Clinical and Experimental Reproductive Medicine Vol.27 No.4

Objective: Extrauterine formation of decidua of stromal cells has been well described, particularly in the cervix and ovary. The apparent hormonal mechanisn of this phenomenon suggestes a relationship to endometriosis. Whether formation of ectopic decidua represents a marked progestational response of endometriosis or an independent peritoneal-stromal reaction to pregnancy is unclear. This study was designed to determine the prevalence of deciduosis in the patients whose fertility were proven. Design: Prospective study of patients who had undergone cesarean delivery without history of endometriosis. Materials and Methods: The study was performed in 179 full tenn pregnant women. During the cesarean section, the pelvic organs were thoroughly investigated and the biopsies were collected at the lesions suspicious endometriosis. And then microscopic examination of removed tissues were done. Results: Of the 179 patients who underwent cesarean delivery, 48 women (26.8%) had the lesions suspicious endometriosis such as adhesion, pigmented spots. The ovary was the most frequently ocurred site (79.2%). Microscopically, decidual cells were observed in 34 cases (70.8%) of 48 biopsed patients. Conclusion: Endometriosis has been known to be associated with subfertility. Our observations found the prevalence of deciduosis was 19.0% (34/179) in tenn pregnant women whose fertilites were proven. We suggests that the deciduosis maya manifestation of endometriosis during pregnancy. However, further follow up study should be done to confirm this clinicopathologic process.

자궁외임신에서 내 외과적 치료의 비용 절감 효과 비교

정대영(Dae Young Chung),신종철(Jong Chul Shin),백은정(Eun Jung Baik),이영(Young Lee),유영옥(Young Oak Lew),이종건(Jong Kun Lee),김창이(Chang Yi Kim),김대훈(Dae Hoon Kim),김수평(Su Pyung Kim) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.12

N/A The incidence of ectpic pregnancy has increased rapidly over the past decade. Currently, the complications of this disorder make it one of the leading causes of maternal mortality and morbidity. In the late 1980s, reports of successful use of methotrexate (MTX) as a non surgical treatment for ectopic pregnancy (EP) also began to appear in the literature. With MTX emerging as a possible alternative management of selected women with an EP, an analysis of its comparative costs is now needed. We examined retrospectively the costs associated with management of EP in our hospital. We selected 30 women with EPand divided them into two groups of MTX treated group (n= l0) and surgically treated group (n=20). There were no statistically significant differences in the doctors fee, room, charge and cost of laboratory and radiologic examination between two groups. But We found significant reduction in cost with regard to pharmacy, injection, procedure and operation of MTX treated group compared to surgically treated group (p<0.05). Consequently the use of MTX for EP should still be considered investigational; we recognize and agree that the evolution of this remedial option should be based primarily on its ability to decrease morbidity and mortality rather than on its ability to reduce costs. If medical treatment proves to be effective, the potential cost savings demonstrated in this report will become an important influential factor on selecting alternative remedy.

임신오조증으로 발생한 Wernicke`s Encephalopathy 1 예

김수평(Soo Pyung Kim),유영옥(Young Oak Lew),김대훈(Dae Hoon Kim),양용재(Yong Jae Yang),이형근(Hyung Gun Lee),임채춘(Chae Chun Rhim),나순숙(Soon Sook Nah),박동춘(Dong Chun Park),정대영(Dae Young Jeong),김재훈(Jae Hoon Kim) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.1

Hyperemesis gravidarum is a complication defined as nausea and vomiting during early pregnancy. Wernickes encephalopathy is an illness of acute onset characterized by mental disturbance, paralysis of eye movements, and ataxia of gait cause by thiamine deficiency. We recently experienced a case of Wernickes encephalopalhy due to hyperemesis gravidarum, which is treated by administration of thiamine even though outcome of serious healthy problem to both mother and fetus, and reported it with a brief review of the literature.

성선 자극 호르몬과 사이토카인이 인간 황체 세포의 아포프토시스에 미치는 영향

김민정 ( Min Joung Kim ),허수영 ( Soo Young Hur ),유영옥 ( Young Oak Lew ),권동진 ( Dong Jin Kwon ),김장흡 ( Jang Heub Kim ),이진우 ( Jin Woo Lee ),이원선 ( Weon Sun Lee ),박상희 ( Sang Hi Park ),김은중 ( Eun Jung Kim ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.3

목적 : 초기 황체기 동안에 성선 자극호르몬 (gonadotropin)과 사이토카인 (cytokine)이 황체 세포의 아포프토시스 (apoptosis)에 미치는 영향과 아포프토시스 관련 인자인 Fas, Fas-L, Bcl-2, Bax, p53과 caspase-8의 발현 변화 및 상호 관련성을 조사하여 황체의 성장과 퇴화에 관여하는 기전의 단서를 알아내고자 하였다. 연구 방법 : 황체 세포를 배양액만으로 24시간 배양한 것을 대조군으로 하였고, 다양한 농 Objective : Our object is to evaluate the detailed mechanisms of support and regression of the human corpus luteum. Methods : To investigate the regulation of luteal function by gonadotropins, cytokines, and prostaglandins, the frequency of apoptosis and

난소 질환에서 혈청 VEGF의 임상적 유용성

윤주희 ( Joo Hee Yoon ),김대훈 ( Dae Hoon Kim ),유영옥 ( Young Oak Lew ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.1

목적: 본 연구의 목적은 난소 질환에서 혈청내 VEGF농도를 측정하여 다른 임상 요소와 종양 표지 인자들과의 상관 관계를 평가하는 것이다. 연구방법: 사전 동의를 한 76명의 양성 난소 질환자, 9명의 정상인, 4명의 경계성 암환자, 53명의 난소암 환자들의 혈청 VEGF를 ELISA 법으로 측정하였다. 결과: 혈청 VEGF값이 난소 양성 질환자군 (157.7±197.8 pg/ml)과 난소 악성 질환자군 (344.7±372.2 pg/ml)에서 통계적으로 유의한 차이를 보였다 (p<0.005). 결론: 혈청 VEGF값은 난소 양성 질환과 악성 질환에서 감별 진단에 도움을 줄 수 있을 것으로 기대된다. 그래서 우리는 혈청 VEGF 값이 난소질환에서 하나의 진단요소로서 유용하리라 기대하는 바이다. Objective: The aim of this study was to evaluate the concentration of serum VEGF and its relationship with the clinical parameters and the tumor markers in ovarian diseases. Methods: We measured the serum VEGF concentrations by ELISA in 76 patients with benign ovarian disease, as well as 9 normal volunteers, 4 patients with ovarian borderline malignancy and 53 patients with ovarian cancer. Results: There is a significant statistical difference between the serum VEGF levels in patients with benign ovarian disease (157.7±197.8 pg/ml) and ovarian cancer (344.7±372.2 pg/ml) (p<0.005). Conclusion: Serum VEGF may help in the differential diagnosis between benign and malignant ovarian disease. We suggest that serum VEGF may be useful as a diagnostic tool in ovarian disease.

자궁외 임신에 대한 최근 5년간의 임상적 고찰

천민정(Min Jung Cheon),권용일(Yong Ill Kwon),유영옥(Young Oak Lew),이방현(Bang Hyun Lee),이희중(Hee Joong Lee),김찬주(Chan Joo Kim),권동진(Dong Jin Kwon),이진우(Jin Woo Lee),박태철(Tae Chul Park) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.2

목적 : 최근 증가되는 자궁외임신에 대한 5년간의 고찰로 자궁외임신의 임상 및 역학적 특성을 분석함으로써 자궁외임신의 조기진단과 치료의 발전을 도모하기 위하여 본 연구를 시행하였다. 연구 방법 : 1995년 1월부터 1999년 12월까지의 가톨릭대학교 의정부성모병원에서 수술 후 조직병리학상 자궁외임신으로 확정된 입원기록을 중심으로 임상 및 역학적인 특성 등을 분석하였다. 결과 : 자궁외임신의 빈도는 20개의 분만당 1건 이였으며 26-30세에서 가장 많이 호발 되었다(34.4%). 과거력상 복부나 골반수술을 시행한 경우가 42.1%이였고 난관 불임술은 14.4%이였으며 골반염이 있었던 경우가 8.3%이였다. 헤모글로빈은 10gm/dl이상이 79.2%이였고 8gm/dl이하가 4.5%이였으며 입원 당시 수축기 혈압은 100mmHg이상이 79%이었다. 마지막 생리 기간과 초기증상이 나오기까지의 기간은 6-8주가 56%로 가장 많았고 임상적 증거는 마지막 생리 후 4∼8주가 지나서 나타나는 경우가 78.8%이였는데 증상 중에서 무월경 91.7% 하복통 88.3% 질 출혈이 47.3%이였다. 난관 내에 이소성 임신이 97.1%, 난소임신 1.1%, 자궁경부 임신 0.7%, 복강내 임신에 0.9% 그리고 1례는 자궁내벽임신이었다. 복강내 출혈은 100-999ml인 경우가 59.5%이였고 1000ml이상은 37.5%이였으며 100ml 이하는 3.0%이였다. 448례 중에 개복술 229례(51.0%), 복강경 수술 219례(49.0%)이었고, 평균 재원일수는 복강경 수술 3.1일, 개복술은 5일이였다. 수술방법은 난관 절제가 87.5%, 난소 난관 절제 4.9%, 자궁각절제 6.3%, 난소 쐐기 절제술이 0.7%이었고 난소 절제술이 0.2%이었다. 복강경 수술시 개복술에 비해 입원일수가 약 2일 정도 감소되었고 합병증은 개복수술의 경우 1.7% 복강경 수술의 경우 1%정도로 측정되었다. 결론 : 자궁외임신의 빈도를 증가시키는 여러 가지 요인들에 대한 관리와 인식이 필요하며다양한 진단방법을 통한 조기진단과 함께 보존적, 약물적, 수술적 치료방법을 시행함으로써 모체의 이환율 및 사망률을 감소시킬 수 있고, 또한 향후 임신가능성의 예후를 향상시킬 것으로 기대된다. Objective : The incidence of ectopic pregnancy is increasing recently. To establish the quick and accurate diagnosis of ectopic pregnancy, we reviewed and analyzed the cases during recent 5 years Methods : Study datas was acquired from the 448 cases of the ectopic pregnancies who were managed and confirmed histopathologically at the our hospital from Jan. 1 1995 to Dec. 31 1999. Results : The incidence of ectopic pregnancy was 1 in 20 deliveries. The most common age group was 26 - 30 years of age(34.4%). A previous history of abdominal or pelvic surgery was in 42.1% and tubal sterilization was in 14.1%, pelvic inflammatory disease was in 8.3%. Hemoglobin value over 10.0 gm/㎗ was in 79.2% and below 8.0 gm/㎗ in 4.5%. Initial systolic blood pressure risen above 100mmHg was in 79.0%. The most frequent intervals between last menstrual period and the onset of symptom was 6∼8 weeks in 56.0%. The clinical manifestations were appeared in 78.8% from the last menstrual period to the next 4∼8 weeks. In clinical symptoms, amenorrhea was encountered in 91.7%, lower abdominal pain in 88.3% and vaginal spotting in 47.3%. Ectopic gestation was implanted on the fallopian tube in 97.1%, the ovary in 1.1%, the cervix in 0.7%, the intraabdominal in 0.9% and 1 case was intramural pregnancy. Total amount of intraperitoneal hemorrhage between 100-999ml was in 59.5%, above 1,000ml in 37.5% and less than 100 ml in 3.0%. Of total 448 cases, laparotomy was done in 229 cases(51.0%) and pelvisopic surgery in 219 cases(49.0%). The mean hospital stay was 3.1 days in pelviscopy procedure and 5.0 days in laparotomy. The operative precedures were salpingectomy in 87.5%, salpingo-oophorectomy in 4.9%, cornual resection in 6.3%, ovarian wedge resection in 0.7%, and oophorectomy in 0.2%. There was no dead case in all ectopic pregnancy. Average admission period after laparoscopy was 3.1 day and after laparotomy was 5.0 day Conclusion : The cognizing of increasing incidence of ectopic pregnancy, early diagnosis and early treatment is presumed to decrease mortality and increase fertility. The successful treatment and decision is a challenge to the clinician who must consider the patient's needs with appropriate tactfulness.

황산마그네슘이 인간제대정맥내피세포의 VEGF와 Caspase-3에 미치는 영향

이귀세라 ( Gui Se Ra Lee ),김사진 ( Sa Jin Kim ),김소영 ( So Young Kim ),이영 ( Young Lee ),박상희 ( Sang Hi Park ),신종철 ( Jong Chul Shin ),유영옥 ( Young Oak Lew ),김수평 ( Soo Pyung Kim ) 대한주산의학회 2004 大韓周産醫學會雜誌 Vol.15 No.3

목적 : 황산마그네슘이 혈관 내피 세포의 caspase-3와 VEGF의 농도에 어떠한 영향을 미치는지를 알아보기 위하여 본 연구를 하였다. 방법 : 임신 말기에 계획된 제왕절개를 시행한 태아의 제대로부터 정맥내피세포(HUVECs)를 추출하여 TNF-α로 처리한 군과 처리하지 않은 두 군으로 나누어 황산마그네슘을 각 농도 별(0, 4, 8, 12 mM)로 가하여 배양한 후 배양 상청액으로 VEGF에 대한 ELISA assay를, caspase-3에 대하여 colorimeter assay를 시행하여 그 농도를 측정하였다. 결과 : HUVECs에서의 VEGF의 발현 농도는 TNF-α로 처리한 경우가 처리하지 않은 경우에 비하여 유의적으로 증가하였다. TNF-α를 가한 경우는 황산마그네슘의 농도에 따른 VEGF의 농도에 유의적인 차이가 없으나 TNF-α를 가하지 않은 경우 황산마그네슘의 농도가 4 mM 및 8 mM인 경우에 가장 낮은 농도로 발현되었다. caspase-3의 농도는 TNF-α와 황산마그네슘의 농도에 따른 유의적인 차이가 없었다. 결론 : HUVECs에서의 VEGF의 발현은 TNF-α에 의하여 증가되나 황산마그네슘의 농도 변화에 따른 영향은 없고, TNF-α에 의한 자극이 없는 경우는 황산마그네슘의 치료적 농도에서 그 발현은 감소되는 반면 caspase-3의 발현은 TNF-α와 황산마그네슘의 영향을 받지 않는 것 같다. Objectives : To determine the effects of magnesium sulfate on Caspase-3 and Vascular endothelial growth factor (VEGF) of human umbilical vein endothelial cells (HUVECs) under presence or absence of Tumor necrosis factor (TNF-α). Methods : HUVECs were isolated from normal term umbilical cords and cultured in several physiolo-gically relevant concentrations of magnesium sulfate with or without exposure of TNF-α. The concentrations of VEGF and caspase-3 were estimated by colorimetric assay and ELISA assay, respectively. Results : The concentration of VEGF in HUVECs significantly increased in the presence of TNF-α compared with in the absence of TNF-α. However, the concentration of VEGF did not show significant difference in several concentrations of magnesium sulfate concentrations with addition of TNF-α and it showed the lowest concentration under 4 mM and 8 mM of magnesium sulfate concentration without addition of TNF-α. The concentration of caspase-3 in HUVECs did not show statistically significant difference with the addition of TNF-α and magnesium sulfate. Conclusion: TNF-α induce HUVECs to stimulate the VEGF, and magnesium sulfate might not have the effects on the expression of VEGF with addition of TNF-α. However, the concentration for treatment of magnesium sulfate inhibits the expression of VEGF without addition of TNF-α. Magnesium sulfate might not have an effect of the expression of caspase-3 with or without addition of TNF-α.

고주파 자궁근종용해술 후 크기 증가를 보인 자궁근종 2예

조현희 ( Hyun Hee Jo ),김미란 ( Mi Ran Kim ),권동진 ( Dong Jin Kwon ),유영옥 ( Young Oak Lew ),김장흡 ( Jang Heb Kim ),김진홍 ( Jin Hong Kim ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.1