Detection of Proteins in Sodium Dodecyl Sulfate -Polyacrylamide Gel Electrophoresis Using a Counter Ion Dye Staining Technique with Coomassie Brilliant Blue R / Neutral Red

Choi Jk,Yoo GS,Lee JK 대한약학회 2000 大韓藥學會 總會 및 學術大會 Vol.49 No.-

METABOLISM OF A NEW PROTON PUMP INHIBITOR DBM-819 by LC-MS/MS

Choi SJ,Ji HY,Lee JW,Lee HY,Choi JK,Lee DH,Lim H,Lee HS 대한약학회 2000 大韓藥學會 總會 및 學術大會 Vol.49 No.-

만삭임신과 동반된 거대난소종양

최종길(JK Choi),박은정(EJ Park),권해영(HY Kwon),김태선(TS Kim) 대한산부인과학회 1983 Obstetrics & Gynecology Science Vol.26 No.3

본 부산대학교 의과대학 부속병원 산부인과에서 최근에 36주의 산모에서 4.5Kg의 거대성 점액성 난소낭종을 경험하였기에 간단한 문헌적 고찰과 함께 보고하 는 바이다. A case of huge ovarian tumor associated with term pregnancy is presented with a brief review of its literatures. Authors recently have met a case of huge ovarian tumor associated term pregn- ancy, to report it as well as a brief review of literature concerning to incidence, diagnosis and management.

인간 정자의 수정 능력 평가에 있어서 SPA 검사의 유용성에 관한 연구

최영민,이진용,문신용,김정구,김석현,오선경,방명걸,정병준,지병철,서창석,김희선,류범용,김명희 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.9

저자들은 서울대학교병원 산부인과 불임크리닉을 방문한 불임환자를 대상으로 설정된 정상 가임역을 기준으로 SPA 검사의 수정 능력 예측도를 알아보고자 SPA 검사와 체외수정시술 결과를 비교 분석하여 다음과 같은 결과를 얻었다. 1. SPA 검사의 결과 해석시 난자 침투지수(PI)의 cut- off value를 3.0으로 정하였을 때 민감도 87.0%, 특이도 94.7%, 양성 예측도 95.2%, 음성 예측도 85.7%, 위양성률 5.3%로서 SPA 검사는 인간 정자의 수정 능력을 평가하는데 있어서 매우 우수한 검사 방법이 될 수 있다는 결론을 얻었다. 또한 이 수치는 다른 연구자들이 보고한 난자 침투지수와는 다소 상이하지만 민감도, 특이도, 양성 예측도, 음성 예측도는 유사하거나 탁월하여 SPA 검사는 불임증의 진단 및 치료시 본 실험실에 고유하고도 적절한 임상 검사 방법으로서 확립될 수 있었다. 2. SPA의 임상적 타당성을 검증하기 위하여 299명의 체외수정시술 환자를 대상으로 난자 침투지수와 체외수정률을 비교 분석하였다. 체외수정시술을 시행하는 대상 환자 299명의 평균 연령은 33.6±3.7세이었으며, 남편의 평균 연령은 39.2±5.4세이었다. 정액의 평균양은 2.18± 1.01 ml(0.7∼5.5 ml)이었으며, 정자의 평균 농도는 102.15 ×106±68.34×106/ml(18.5×106/ml∼301.5×106/ml)이었다. 정자의 운동성의 평균은 59.5±22.7%(9.9∼84.3%)이었으며, 운동성지수는 40.5±21.6(4.9∼81.0)이었다. 3. SPA 검사상 PI값이 3.0 이상으로 판정된 정상군은 227명이었으며, 72명은 3.0 미만으로 판독되어 비정상군으로 분류되었다. 4. 정상군 227명 중 체외수정시술시 정자의 난자 수정률이 30% 이상인 경우는 223명이었으며, 4명은 30% 미만의 수정률을 보였다. 비정상군 72명 중 체외수정시술 시 정자의 난자 수정률이 30% 이상인 경우는 15명, 30% 미만인 경우는 57명이었다. 5. SPA 검사상 정상으로 판정된 환자에서 채취된 난자의 수는 11.4±7.0이었으며, 수정률은 60.3±19.1%, 임신율은 28.6% 이었다. SPA 검사상 비정상으로 판정된 환자에서 채취된 난자의 수는 10.1±5.3이었으며, 수정률은 36.2±32.0%, 임신율은 5.9%이었다. 6. 체외수정시술시 정자의 수정 능력을 예측하는데 있어 SPA 검사법의 민감도, 특이도, 양성 예측도, 음성 예측도는 각각 93.7%, 93.4%, 98.2%, 79.2% 이었다. 본 연구 결과 인간 정자의 수정 능력 평가에 있어서 SPA 검사가 유용하게 이용될 수 있으며, 특히 임상적으로 체외수정시술시 수정률 등의 시술 결과를 정확하게 예측할 수 있을 것으로 사료된다. The objective of this study was to test the validity of zona-free hamster ova sperm penetration assay (SPA) prospectively as a prognostic indicator of male infertility. Fifty infertile patients undergoing in vitro fertilization and embryo transfer (IVF-ET) were selected and classified as fertile and subfertile groups. The fertile group consisted of 25 men in whom fertility was already identified with pregnancy within 1 year before this study, and the subfertile group consisted of 25 men who had the previous history of fertilization failure or less than 30% fertilization rate without oocyte defects in IVF-ET cycles. The effectiveness of SPA as a prognostic indicator for fertilization capacity of human spermatozoa was evaluated after establishing the normal value in SPA. The results of SPA were significantly different in penetration index (PI) and penetration rate (PR) between two groups. Mean PR was 97.4±7.4% in fertile group, and 64.9±36.2% in subfertile group (p=0.003), and mean PI was 5.4±2.9 in fertile group, and 1.5±1.5 in subfertile group (p=0.0001). In evaluating the effectiveness of SPA, ROC curve was used. Among the various thresholds for the prediction of fertilizing ability, PI 3.0 corresponded to the value with higher sensitivity and lower false positve rates, and was determined as a cut-off value. Using this cut-off point, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SPA for the prediction of fertilization capacity was 87.0%, 94.7%, 95.2%, and 85.7%, respectively. To evaluate the clinical validity of SPA, this cut-off point was applied to 299 patients undergoing IVF-ET. The sensitivity, specificity, PPV, and NPV of SPA for the prediction of fertilization capacity in IVF-ET was 93.7%, 93.4%, 98.2%, and 79.2%, respectively. In conclusion, our results clearly show that SPA can be a valuable tool as a prognostic indicator of fertilization capacity of human spermatozoa, and can be also useful in performing IVF-ET in male factor infertile patients.

남성인자 불임환자에서의 체외수정시술시 난자 세포질내 정자 주입술을 이용한 미세보조 수정술의 임상적 효용성에 관한 연구

최영민,이재훈,이진용,문신용,김정구,김석현,채희동,서창석,김광례,정경남,김희선 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.12

The proportion of male factor infertility due to quantitative and qualitative sperm disorders is about 50%~60% in infertile couples. Although IVF-ET is widely applied in the treatment of couples with male factor infertility, it may fail in many couples with severe andrological problems, and certain couples cannot be even accepted for standard IVF-ET if the number of motile spermatozoa is too low. Recently, several procedures of microassisted fertilization(MAF) using micromanipulation have been introduced, and pregnancies and births have been obtained after intracytoplasmic sperm injection(ICSI). This clinical study was performed to develop and establish ICSI as an effective procedure of MAF using micromanipulation, and to apply ICSI clinically to infertile couples who could not be accepted for standard IVF-ET because of extremely impaired semen characteristics such as$lt;500,000 progressive motile spermatozoa present in the total volume of ejaculate. From March, 1995 to May, 1996, 39 cycles of IVF-ET with ICSI in 24 couples with severe male factor infertility were inculded in study group, and the outcomes of ICSI were analyzed according to fertilization rate, cumulative embryo score(CES), and pregnancy rate. Patients were evaluatied with semen score such as number of total motile sperms, and then divied into 4 groups according : Group I with $lt; 5,000 normal motile sperms, Group II with 5,000-50,000, Group III with 50,000-500,000 and Group IV with $gt; 500,000. In 39 ICSI cycles, the number of oocytes retrieved after controlled ovarian hyperstimulation(COH) was 13.23±6.99, and the number of oocytes optimal for ICSI procedure was 10.07±5.2. The fertilization rate of 59.7±23.1% coould be obtained after ICSI. The number of embryos transferred was 4.26±2.22 with the mean CES of 50.7±30.5 in ICSI cycles. The overall pregnancy rate was 23.1%(9/39) per cycle and 37.5%(9/24) per patient with the clinical pregnancy rate of 15.4%(6/39) per cycle and 25.0%(6/24) per patient. There were no significant differences in the pregnancy rates among 4 groups. Especially, although more mature oocytes were retrieved in Group I compared with Groups III and IV, the fertilization rate and the pregnancy rates were not significantly different. In conclusion, MAF of human oocytes with ICSI could be used successfully for IVF-ET ininfertile couples who had few spermatozoa for the conventional methods of in vitro insemination, and sperm parameters did not clearly affect the outcomes of ICSI in couples with severe male factor infertility. In addition, this development of gamete and embryo micromanipulation will lead to the new potentially exciting techniques such as enucleation for correction of polyspermy, and blastomere biopsy for primplantation genetic diagnosis.

희발월경을 동반한 불임여성의 임상적 분석

최영민,박중신,이진용,장윤석,문신용,김정구,신창재,김석현 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.5

서울대학교병원 산부인과 불임상담실을 방문한 환자중 희발월경을 동반한 불임여성 164명과 대조군으로 정상월경 주기를 가진 불임여성 100명을 대상으로 불임증유형, 내분비학적 이상 소견, 배란유무, 불임의 자궁인자유형 등을 분석하여 다음과 같은 결과를 얻었다. 1. 희발월경군에서의 1차성 불임빈도는 58.6%였고 대조군에서는 60.0%로서 유의한 차이가 없었다. 2. 희발월경군에서 내분비학적 이상이 있는 경우는 45.7%로 대조군에서의 28.0%보다 유의하 게 높았다. 다낭성 난소증후군의 내분비학적 양상은 희발월경군의 21.3%에서 관찰되어 대조 군보다 높았으나 조기 난소부전증, 고 PRL혈증, 갑상선 기능저하증은 두 군간에 차이가 없었다. 3. 배란 장애는 희발월경군에서는 38.4%에서 나타나 정상월경군의 4.0%보다 유의하게 높았다. 4. 불임증의 원인인자중 자궁인자는 희발월경군에서 14.6%, 대조군에서는 21.0% 로서 두군 간에 유의한 차이가 없었다. 그러나 황체기 결함은 대조군에서 더 높은 빈도로 나타났고 희 발월경군의 2.4%에서만 자궁기형이 발견되었다. 이상의 결과로 보아 희발월경을 동반한 불임여성들은 무배란 및 내분비학적 이상, 특히 다 낭성 난소증후군이 빈번한 특별한 환자군을 구성한다고 사료되었다. Oligomenorrhea is defined as a reduction in the frequency of menses with intervals between 40 days and 6 months and one of common menstrual disorders. In the study, the clinical characteristics of 164 infertile patients with oligomenorrhea were analyzed compared with 100 infertile patients with normal menstrual cycles as control group . Pathological hormone levels were found in 45.7% of oligomenorrheic group but 28.0% of control group (p$lt;0.05). The endocrine and ultrasonographic patterns of polycystic ovarian disease (PCOD) were observed more frequency in the former group than in the latter group (p$lt;0.05). The incidence of prematrue ovarian failure, hyperprolactinemia and hypothyroidism had no statistical differences between two groups. Anovulation was detected more frequency in oligomenorrheic group whereas luteal phase defect was more common in control group (p$lt;0.05). There was no significant difference in the incidence of uterine factors of infertility between two groups. Our data show that infertile women with oligomenorrhea comprise a special group in which anovulation and endocrine abnormality, for example, PCOD can be observed frequently.

체외수정시술시 Acid Tyrode 용액을 이용한 배아 보조부화술의 임상적 유용성

최영민,이진용,문신용,김정구,김석현,오선경,지병철,서창석,김희선,류범용,김미하,이기주 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.5

목적: 체외수정시술시 배아이식 후 부화 과정의 실패에 의하여 임신이 이루어지지 않는 것으로 추정되는 불임환자를 대상으로 acid Tyrode 용액을 이용한 보조부화술의 임상적 안정성 및 유용성을 규명하고자 하였다. 연구방법: 1997년 1월부터 12월까지 체외수정시술을 시행받은 환자 중 과거력상 3회 이상 임신성립에 실패한 환자[Group Ⅰ; 56명, 66주기], 연령이 37세 이상인 환자[Group Ⅱ; 32명, 38주기], 기초 혈중 FSH 농도가 15mIU/ml 이상인 환자[Group Ⅲ; 12명, 14주기]를 대상으로 acid Tyrode 용액을 이용한 배아의 보조부화술을 시행하였다. 보조부화술은 미세조작기를 이용하여 체외배양 3일째 아침에 6-8-세포기 배아를 대상으로 acid Tyrode 용액을 방출하여 8-세포기 배아의 할구 크기로 구멍을 뚫어주는 방법으로 실시하였다. 결과: 전체 대상 환자의 연령은 36.0±3.5세 이었고, 채취된 난자의 수는 8.6±5.7개, 자궁내로 이식된 배아의 수는 4.5±2.0개, 임상적 임신율은 시술주기당 13.3%[10/75], 시술환자당 15.4%[10/65] 이었다. 3군을 비교하였을 때 채취된 난자의 수, 이식된 배아의 수, 임상적 임신율은 각각 통계학적으로 유의한 차이가 없었다. 결론: 체외수정시술시 acid Tyrode 용액을 이용한 배아의 보조부화술은 기존의 투명대 부분 절개술을 이용한 보조부화술과 비교하여 유사한 임신율을 얻을 수 있어 임상적 안전성 및 효용성이 증명되었으며, 특히 과거력상 3회 이상 체외수정시술에 실패한 환자, 37세 이상인 환자, 기초 혈중 FSH 농도가 15 mIU/ml 이상인 환자 등에서 임신율을 증진시킬 수 있는 유용한 시술 방법이라고 사료된다. Objective : To investigate the clinical efficacy of assisted hatching[AH] using acid Tyrode`s solution in vitro fertilization and embryo transfer[IVF-ET] patients who had previous repeated failure cycles ≥ 3[Group I ; 66 cycles in 56 patients], age of ≥ 37 years[Group II ; 38 cycles in 32 patients], or basal serum FSH level ≥ 15 mIU/ml[Group III ; 14 cycles in 12 patients]. Materials and Methods : From January to December, 1997, a total of 75 IVF-ET cycles in 65 patients was enrolled in this descriptive study. In preimplantation embryos, AH was performed with the application of acid Tyrode`s solution on zona pellucida to create an opening just before ET. Results : The number of oocytes retrieved after controlled ovarian hyperstimulation[COH] was 8.5±5.3[mean±SD] in Group I, 7.9±6.2 in Group II, and 6.8±4.7 in Group III. The number of embryos transferred after AH was 4.6±2.0, 3.9±1.9, and 3.6±1.9, respectively, and the mean cumulative embryo score[CES] was 88.7±49.2, 80.3±45.0, and 78.9±59.6, respectively. There were no significant differences in the numbers of oocytes retrieved and embryos transferred, and CES among three groups. The clinical pregnancy rates per cycle and per patient were not different significantly among three groups : 13.6%[9/66] and 16.1%[9/56] in Group I, 13.2% [5/38] and 15.6%[5/32] in Group II, and 14.3%[2/14] and 16.7%[2/12] in Group III. Conclusion : AH of human preimplantation embryos using acid Tyrode`s solution might be promising in the improvement of pregnancy rates for IVF-ET patients, especially with the previous history of repeated failure, old age, or high basal serum FSH level. Further prospective and randomized study is necessary to determine if the micromanipulation procedure of AH would be beneficial to IVF-ET patients.

자궁경부암 환자의 수술전 임파절 전이평가에 있어서 Iliopelvic Lymphoscintigraphy의 유용성

최영민,강순범,이효표,박진완,송현진,정준기,이명철 대한산부인과학회 1991 Obstetrics & Gynecology Science Vol.34 No.3

1989년 3월부터 1990년 2월까지 서울대학병원 산부인과에 입원한 자궁경부암 환자중 임상기 Ⅰb 및 Ⅱa 환자 34명을 대상으로 수술전 골반 임파절 및 방대동맥 임파절 전이정도를 평가하기 위하여 iliopelvic lymphoscintigraphy(IPL)를 시행하였으며 이와 동시에 CT 및 MRI를 시행하여 수술후 조직학적 검사를 통해 그 효용성을 비교 검토하여 다음과 같은 결과를 얻었다. 1. 임파절 전이판정에 있어 IPL의 민감도는 77%(7/9), 특이도는 84%(21/25), 정확도는 82%(28/34), 위양성율은 36%(4/11), 그리고 위음성율은 9%(2/23)를 보였다. 2. IPL의 민감도(77%)는 CT(11%)나 MRI(0%)보다 의미있게 높았고(P0.05), 특이도(84%)는 CT(95%)나 MRI(100%)보나는 낮았으나 통계적으로 유의하지는 않았다(p$gt;0.05). 3. IPL시행시 위양성율(36%)은 CT(50%)보다는 낮았으나 통계적으로는 의미가 없었으며(p$gt;0.05), 위음성율(9%)는 MRI(38%)에 비해 의미있게 낮았다(p0.05). 4. IPLdml wjdghkrehsms 82% CT(70%0나 MRI(62%)보다는 높았으나 통계적으로유의하지는 않았다(p$gt;0.05). 이상의 결과로 자궁경부암 환자에서의 iliopelvic lymphoscintigraphy에 의한 임파절 전이유무의 평가는 간편성과 민감도를 고려할 때 자궁경부암 환자에서 사용을 고려해 볼 가치는 충분히 있는 것으로 생각되며 주입되는 radiocolloid의 종류, 양, 주입경로, gamma camera의 노출시간 및 노출위치, 판독시 해부학적 상관관계등에 대해서는 더 많은 경험과 연구가 필요할 것으로 사료된다. In patients with invasive carcinoma of the cervix, it is very important to determine the presence of pelvic lymph node metastases in order to plan the successful treatment and predict the prognosis of the patient. From March 1989, to February 1990, the three imaging techniques of iliopelvic interstitial lymphoscintigraphy, computerized tomography(CT) and magnetic resonance imaging(MRI) were compared in 34 patients with invasive cervical cancer. Results were correlated with histologic examination of the actual lymph nodes in each patients and each technique was assessed for sensitivity, specificity, and overall accuracy. In the assessment of lymph node metastases, lymphoscintigraphy had an accuracy of 83%, sensitivity of 77%, specificity of 84%, false positive rate of 36%, and false negative rate of 9%. Lymphoscintigraphy had a significantly higher sensitivity rate than CT(11%) or MRI(0%). And accuracy of lymphoscintigraphy was higher than CT(70%) or MRI(62%), although the difference was not statistically different. These data suggest that lymphoscintigraphy might be a more informative tool than CT or MRI for the assessment of lymph node metastases in patients with invasive cervical carcinoma.

침윤성자궁경부암에 대한 임상적 고찰

최훈,이홍균,김복린,김명주,유태환,김용범,김종국,서정식,양창현 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.11

The carcinoma of the uterine cervix is the most prevalent life-threatening cancer among female genital tract cancers. However, it can be cured by early diagnosis and treatment. So, the purpose of this study was to improve the prognosis of this disease by early detection, diagnosis, and treatment through analyzing the clinical profiles. From September 1989 to December 1994, 159 cases of the carcinoma of the uterine cervix diagnosed and treated at department of obstetrics and gynecology, Sanggye hospital were evaluated through medical records. The results were as follows: 1) the common chief complaint were abnormal Pap smear without symptome(40.3%), vaginal spotting(40.9%), and contact bleeding(11.9%). 2) The distribution of clinical stage by FIGO classification were stage I a1(32.6%), stage I a2 (6.3%), stage I b(28.9%), stage II a(16.3%), stage II b(11.4%), stage III(3.8%), and stage IV(1.2%). 3) The most common histologic type was squamous cell carcinoma(94.3%). 4) The types of treatment were operation alone(65.5%), operation and radiotherapy(12.6%), radiotherapy(13.9%), neoadjuvant chemotherapy and operation(3.2%), radiotherapy and chemotherapy(3.7%), and conservative treatment(1.2%). 5) Median follow up time was 48.3 months and median disease free survival interval were I a(48.3 months), I b(44.4 months), II a(41.5 months), II b(33.3 months), III(21.2 months), and IV(14.1 months). With these results, we concluded that the cervical intraepithelial neoplasam and early carcinoma of uterine cervix are expected to be cured completely and even the advanced carcinoma of uterine cervix can be treated with better prognosis by early detection, diagnosis, and treatment through periodical Pap smear and systematic examination.

골반경술을 이용한 난소병변의 처치

최영민,강순범,이효표,송용상,전혜원,김재원,박노현,이진용,장윤석,문신용,김정구,김석현 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.2

난소종괴 및 병변에 대한 골반경수술은 수술로 인한 물리적 손상을 줄이고, 회복이 빠르며 입원기간을 단축할 수 있는 방법이며 적절한 기준에 의해 시행되는 경우 악성종양의 가능성은 거의 없는 안전한 방법으로 난소병변에 의한 충분한 지식과 수술술기의 향상 및 개량된 장비의 사용으로 더욱 효과적인 치료가 이루어질 수 있을 것이다. A retrospective study was underaken to review the spectrum of pelviscopic ovarian surgery. The purpose of this study was to assess the scope of pelviscopic ovarian surgery, and to identify any advantages or disadvantages associated with the procedure. 96 patients with ovarian pathology were managed pelviscopically from August 1990 to July 1993 at the Seoul national University Hospital. The patient`s ages ranged from 16 to 66, and their mean age was 31.88 patients(91.7%) were premenopausal, 2(2.1%) were postmenopausal and 6(6.2%) were amenorrhic state; Presenting complaints included persistent pelvic mass, acute and chronic pelvic pain, infertility and so on. A protocol involving clinical examination, CA-125, ultrasound and color doppler studies were introduced to rule out the risk of incidental malignant ovarian tumors. The size of the cysts on ulrasound ranged from 3.5 to 9.9 cm with a mean of 5.8 cm. The operations performed were 6 biopsies, 2 with ovarian fenestration and biopsy, 21 with cystectomy, 55 with oophorectomy or adnexectomy and 5 with other procedures. There was a 7.3%(7/96) conversion rate to laparotomy. In 8 cases, cyst were bilateral. Mean operative time was 58 minutes and mean postoperative hospital stay was 2.4 days. There were 7 surgical complications including 1 vessel injury, 3 wound infection, and 3 postoperative shoulder pain. No malignancies were found postopertively and the most common pathology was teratoma, endometrioma, serous or mucinous cyst in order. The advantages of pelviscopy are minimal physical strain, better postoperative quality of life, and short hospital stay with acceptable complication rate. We concluded that management of ovarian pathology via pelviscopy is a method of treatment choice in carefully selected patients.