조기진통임산부에서 C-Reactive Protein검사의 임상적 의의 및 태반조직학적 변화와의 관계

전선희,구혜수 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.7

A test to detect the subclinical intrauterine infection with intact membrane in pretem labor would be helpful in its treatment and would make it possible to prolong the pregnancy, thus allowing the minimizing the sequelae of prematurity and infection. We performaed the qualitative test of serum C-reactive protein(CRP)in 105 cases ofpreterm labor with intact membrane between 24-35 gestational weeks and 25 cases of term labor in 38-42 gestational weeks, who were admitted to the department of Obstetrics and Gynecology of Ewa Womans University Hospital from January 1st, 1991 to August 31st, 1992. The study groups were catagorized to three groups according to the result of CRP, that is 34 cases of CRP positive preterm labor patient (group Ⅰ),71 cases of CRP negative preterm labor patients (group Ⅱ), and 25 cases of term labor women (group Ⅲ) as a control group. The results were as follows: 1. The prevalence of positive CRP was 32.4% in preterm labor women and 24.0% in term labor women. There was no significant difference between them. 2. The gestational weeks at admission of group Ⅰ was significantly shorter than that of group Ⅱ (31.0+_0.6 weeks: 32.3+_03 weeks). The delay of time from admission to delivery and gestational weeks at delivery in group Ⅰ were shorter than those in group Ⅱ(7.1+_2.5 days: 25.9+_3.2days, 31.9+_0.7 weeks: 36.1+_0.4 weeks) 3. White blood cell count at admission of group Ⅰ was 14159+_1005/mm3,which was significantly higher than that of group Ⅱ(11437+_394/mm3)and group Ⅲ(11420+_719/mm3). The microorganism from uterine cervix was isolated in 46.7% and 53.8% in group Ⅰ and ii with no difference between groups. 4. In perinatal outcome, the mean birth weight, one minute, and five minute Apgar score of group Ⅰ were significantly lower than those of group Ⅱ(1795+_146g: 2621+_81g, 6.1+_0.6:8.3+_0.2, 7.1+_0.6:9.3+_0.2). The perinatal morbidity and mortality of group Ⅰ were significantly higher than those of groupⅡ(44.1%:29.6%,23.5%:4.2%). 5. In preterm labor patients who were administerde tocolytics, the delay of time from the initiation of treatment to delivery and the gestational weeks at delivery were significantly shorter in CRP positive group than in CRP negative group(14+_5.7 days:30.0+_4.2days,31.6+_1.4weeks:36.7+_0.5weeks)and the treatment success rate was significantly lower in CRP positive group than in CRP negative group(35.7%:75%) The sensitivity and specificity of CRP as a test to predict failed tocolytics were 64.3% and 75%. 6. Pathologic placental infection was found in 100% of preterm labor patients and in 76% of term labor women, Moreover, more severe placental infection(stageⅢ chorioamniontis)predominated in group Ⅰ, comparing to group Ⅱ and Ⅲ(52.6%:12%:4%). Based on above results CRP test in preterm labor patitnts is helpful for diagnosis of sublinica intrauterine infection and predicting the pregnancy outcome.

Survey of Distributed Training in Imperative Deep Learning Frameworks

DongJin Shin(신동진),Byung-Gon Chun(전병곤) 한국정보과학회 2018 한국정보과학회 학술발표논문집 Vol.2018 No.12

인간 자궁내막에서 IL-6 및 IL-6 수용체의 발현에 관한 연구

김성숙,안정자,전선희,정혜원,김수연,맹신숙,조지연 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.11

Endometrial cells undoergo a series of proliferative and secretory changes. These changes are precisely controlled and prepare endometrium for implantation of the blastocyst. It is thought that these changes are primarily dirven by two steroid hormones, estrogen and progesterone. However, recently it is suggested that many of the endometrial functions are controlled by various cytokines and reported presence of IL-1α, IL-1β, IRAP, IL-6, TGF-α proteins is human endometrium throughout the menstrual phase. Endometrial cells produced IL-6 in response to other inflammation-associated cytokines such as IL-1αorβ, TNF-α, IFN-γ. This secretion was strongly inhibited by 17-β estradiol. This established a novel li-nk between the endocrine and the immune systems. Therefore, this study was designed to examine the cell and site specific distribution of IL-6 and IL-6 receptor and the role of IL-6 in human endometrium during menstrual cycle. Endometrial tissues were obtained from hysterectomy specimens from normally cycling 44 patients in Ewha Womans University Hospital during past 14 months(1995. 1.1~1996. 2.29). The uteri were removed for abnormalities other than endometrial origin including uterine leiomyomas and cervical or ovarian lesions. Immunohistochemical staining was performed for IL-6 and IL-6 receptor in endometrial tissues. The results were as follows: 1. During the proliferative phase, expression of IL-6 was weak to absent in endometrial glands and stroma. 2. During the secretory phase, expression of IL-6 was stronger than that of proliferative phase and progressively increased in the mid- to late secretory phases. Expression of epithelial IL-6 was stronger than stroma. 3. IL-6 receptor was expressed primarily in endometrial glands and to a lesser extent in stroma. Expression of IL-6 receptor did not change throughout the menstrual cycle. Accordingly, this study show a cell and site specific distribution of IL-6 and IL-6 receptor in human endometrium through menstrual cycle. The menstrual cycle dependent expression of IL-6 suggest that this cytokine was controlled by steroid hormones. The menstrual cycle independent expression of IL-6 receptor suggest that IL-6 may act on endometrial function by autocrine and/or paracrine mechanisms. Increased expression of IL-6 in mid- to lat secretory phase suggest that IL-6 may be implicated in the induction of changes in human endometrium during the secretory/menstrual phase.

조직학적으로 확진된 자궁경부 상피내종양 및 침윤암 1000예에서 평가한 자궁경부 세포진검사의 위음성률에 관한 연구

김희수,백희수,손찬우,이기헌,심재욱,박종택,전종수,박인서,김희숙,박종숙 대한부인종양 콜포스코피학회 1995 Journal of Gynecologic Oncology Vol.6 No.1

The cervical smears represent the most effective technique to detect and prevent cancer of the uterine cervix, its false-negative rate is still a reason of concern among pathologists and gynecologists. This study was performed to determine the false - negative rate in cervical smears and to evaluate the causes for false negatives. The histologically confirmed consecutive 1,000 cases of Squamous Intraepithelial Lesion(SIL) and Squamous Cell Carcinoma(SCC) of the uterine cervix from the surgical files of Department of Pathology, Cheil General Hospital, from January 1992 to June 1993 were collected. All cervical smears of 1,000 cases, which obtained prior to pathologic diagnosis made, were evaluated based on cyto-histologic correlation. The false negatives were identified and cervical smears were reviewed. The reasons for false negatives were analysed as well. 'I'he results are as follows : 1. Histologic diagnoses of 1,000 cases include 252 cases of Low grade SIL(LSll.), 484 cases of High grade SlL(HSIL) and 284 cases of SCC. 2. 60 cases were identified as false negatives. The false - negative rate was 6%(60/1000). Those 60 cases of false negatives were 31 cases(51.7%) of LSIL, 23cases (38.3) of HSIL and 6 cases(10%) of SCC. 3. False- negative rate were 12.3%6(31/252) of LSIL, 4.8%(23/484) of HSII. arid 2.1%(6/284) of SCC. 4. In 58 of 60 eases reviewed, the sampling error were 75.9%(44/58) and screening error were 24.1%(14/58). 5. Sampling error were 65.9%(29/44) of LSIL and 2.3%(1/44) of SCC. 6. Screening error were 4 cases of LSIL, 6 cases of HSIL and 4 cases of SCC. In conclusion, the major of false negatives was sampling error and the major lesion of false negativity and sampling error was LSIL. These findings suggest that LSIL should require further investigation by colposcopy, cervicography and HPV Test in order tx reduced the false-negative rate. The supporting of sufficient clinical informations, good supervision and training of cytotechnologist, use of automated cytologic screening system in order to reduced false-negative rate in HSIL and SCC.

혈청 Progesteron과 hCG측정의 초기 정상임신 예측에 대한 연구

우복희,전선희,양선이,강혜승,윤수정,원현주 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.3

혈청 progesterone과 혈청 hCG의 측정이 거의 임신에서 정상임신과 비정상임신을 감별 진단하는데 얼마나 유용한지 알아보기 위하여 1995년 1월부터 1995년 6월까지 이화여자대학교 산부인과를 내원한 최종월경일로 부터 28일에서 49일 사이의 초기임신환자로 질식초음파상 태아 심박동이 보이기전인 92명의 환자를 연구대상으로 혈청 progesterone과 혈청 hCG를 측정한 결과 다음과 같은 결론을 얻었다. 1. 92명의 대상 환자중 정상임신군은 36명, 자연 유산군은 25명, 자궁외임신군은 31명 이었다. 2. 정상임신군(n=36)에서의 평균 progesterone값은 33.92+-2.88 ng/mL(mean +or- SEM)이고, 비정상군에서는 10.74+-1.53 ng/mL로, 자연유산군(n=25)은 13.57+-2.8 ng/mL로, 자궁외임신군(n=31)에서는 8.5+-1.5 ng/mL로 나타났다. 정상군에서의 progesterone값은 비정상임신군에 비해 유의있게 높았다(p$lt;0.0001). 3. 정상임신군(n=30)에서의 1/DT hCG의 평균은 0.46+-0.04(mean+-SEM)이고, 자연유산군(n=20)에서는 0.08+-0.12, 자궁외임신군(n=19)에서는 0.09+-0.07로 나타냈다. 정상군에서의 1/DT hCG 값은 비정상 임신군에 비해 유의있게 높았다(p$lt;0.0004). 4. 정상임신을 예측하는 혈청 progesterone의 임계치는 14ng/ml였다(민감도 75%, 특이도 95%, 양성예측도 95%, 음성예측도 63%). 5.정상임신을 예측하는 1/DT hCG의 임계치는 0.40였다(민감도 87%, 특이도 67%, 양성예측도 77%, 음성예측도 90%). 6. 비정상적인 임신에 대하여 progesterone 농도가 14ng/ml이하일 때와 비정상적인 1/DT hCG이 0.40 이하일 때를 고려했을 때 단독 검사시보다 검사결과가 우수하였다(민감도 90%, 특이도 66%, 양성예측도 78%, 음성예측도 83%). 이상의 결과에서 최종 월경일로부터 28일에서 49일 사이의 초기임신에서 질식초음파상 태아 심박동이 보이기전인 환자에서 정상임신과 비정상임신을 구별하는데 혈청 progesterone과 혈청 hCG가 유용한 검사법으로 사용되며 이 때의 임계치는 혈청 progesterone이 14ng/ml였고, 1/DT hCG 값은 0.40이상임을 알 수 있다. Objective: To assess of the role of a single maternal serum progesterone measurement and serum hCG doubling time in the immediate of early pregnancy failure and in the long term prognosis of fetal viability. Study Design: A progressive comparative study of women presenting with non visible fetal heart beat by vaginal sonography during the first 49 days of gestation. The study groups were defined retrospectively as viable intrauterine pregnancy(n=36) and non viable intrauterine pregnancy(n=56) groups, according to the outcome of the pregnancies. Results: Receiver-operactor characteristic curve analysis indicated that the best discriminatory progesterone concentrations was 14 ng/mL and hCG 1/DT(doubling time) was 0.40 . When progesterone was less than 14 ng/mL, the predictive value of the abnormal test result was 95%. When hCG 1/DT was less than 0.4, the predictive value of the abnormal test result was 77%. Conclusions: A single serum progesterone measurment and hCG doubling times taken in the early pregnancy is valuable in the immediate diagnosis of early pregnancy failure and the long term prognosis of viability.

사지기형증의 2례

강희운(HW Kang),유한선(HS Yoo),전정일(CI Chun) 대한산부인과학회 1977 Obstetrics & Gynecology Science Vol.20 No.12

저자들은 신체 여러 부위에 기형을 동반한 선천성 사지결손증 2예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Congenital skeletal limb deficiencies are rare cases in congenital anomalies of newborn infants. Authors experienced two cases of peromelia, who had multiple anomalies such as absence of external genitalia, anal atresia, hemivertebrae, anencephaly and cephalocele. In case 1, autopsy findimgs revealed the complete duodenal obstruction between second and third portion, and anal atresia. X-ray findings showed multiple bone anomalies such as hemivertebrae, dislocation of femoral head due to incomplete formation of the pelvis. In this case, we could not recognize sex of the baby grossly so we confirmed that is male by chromosomal study and pathologic findings. In the second case, we could observed that the baby was anencephalic monster with cephslocele, but other organs were normal in autopsy findings except multiple skeletal limb deficiencies.

[P9-10] Risk profile of foreign matters in food to develop non-destructive detection technology based on Terahertz

Jeong AR,Cho AR,Chun HS,Choi SW,Chang HJ,Kim HJ 한국식품영양과학회 2010 한국식품영양과학회 학술대회발표집 Vol.2010 No.10

진행된 쌍태아 임신과 동반한 포상기태 1 예

안영준,신향미,전권희,문인근,서홍식,송호영,안혜선 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.1

본 저자들은 31세 임산부에서 진행된 부분포상기태가 있으면서 쌍태아 임신을 경험하였기에 간단한 문헌고찰과 함께 보고하는 바이다. Ultrasonography has become the preferred noninvasive diagnostic imaging modality that enables early confirmation of gestational trophoblastic disease. Twin pregnancy with partial hydatidiform mole and coexisting fetuses was lived at a later gestational age, and had higher preevacuation beta-hCG levels. When disease is not metastatic, chemotherapy is started for a rising or persistantly elevated beta-hCG level. Teh common complications of hydatidiform mole, hemorrhage and infection, decreased in incidence recently due to early diagnosis and evacuation of hydatidiform molar tissue. We recently experienced one case of advanced twin pregnancy with partial hydatidiform mole and coexisting fetuses.

자궁내막암에서의 MIB-1의 발현과 DNA배수성에 관한 연구

심재욱,김희숙,홍성란,정환욱,박인서,임경택,김태진,이기헌,박종택,김혜선,김의정,전이경 대한부인종양 콜포스코피학회 1997 Journal of Gynecologic Oncology Vol.8 No.4

Objective: The monoclonal antibody MIB-1 reacts with the same antigen as Ki67 antigen giving an estimate of growth fraction. The authors investigated whether MIB-1 staining, using semiquantative analysis and DNA ploidy study, could be a prognostic indicator of recurrence in endometrial carcinoma. Methods: The tumors from 45 consecutive patients receiving primary surgical therapy for endometrial carcinoma were evaluated with MIB-1 monoclonal antibody and DNA ploidy status. Growth fraction was quantified by counting stained nucleus in HPF. DNA ploidy study was evaluated by flow cytometry. The patients were followed for 5 years and their charts were reviwed to determine recurrence, stage,and grade. Results: MIB-1 staing was significantly elevated in histologic high grade (grade Ⅱand Ⅲ) as opposed to low grade(grade Ⅰ) carcinoma (P =0.038). Aneuploidy was significantly increased incidence in advaned stage (stage Ⅲand Ⅳ) as opposed to early stage(stage Ⅰand Ⅱ) (P =0.017). MIB-1 staing and aneuploidy were d with increased incidence of recurrence within 5 years of diagnosis, but not statistically significance.. Conclusion: In this series of 45 patients with endometrial carcinoma. MIB-1 monoclonal antibody staining and aneuploidy to be a prognostic indicators of recurrence.

Definitive concurrent chemoradiotherapy in locally advanced pancreatic cancer

Kwak YK,Lee JH,Lee MA,Chun HG,Kim DG,You YK,Hong TH,Jang HS. 대한방사선종양학회 2014 Radiation Oncology Journal Vol.32 No.2

Purpose Survival outcome of locally advanced pancreatic cancer has been poor and little is known about prognostic factors of the disease, especially in locally advanced cases treated with concurrent chemoradiation. This study was to analyze overall survival and prognostic factors of patients treated with concurrent chemoradiotherapy (CCRT) in locally advanced pancreatic cancer. Materials and Methods Medical records of 34 patients diagnosed with unresectable pancreatic cancer and treated with definitive CCRT, from December 2003 to December 2012, were reviewed. Median prescribed radiation dose was 50.4 Gy (range, 41.4 to 55.8 Gy), once daily, five times per week, 1.8 to 3 Gy per fraction. Results With a mean follow-up of 10 months (range, 0 to 49 months), median overall survival was 9 months. The 1- and 2-year survival rates were 40% and 10%, respectively. Median and mean time to progression were 5 and 7 months, respectively. Prognostic parameters related to overall survival were post-CCRT CA19-9 (p = 0.02), the Eastern Cooperative Oncology Group (ECOG) status (p < 0.01), and radiation dose (p = 0.04) according to univariate analysis. In multivariate analysis, post-CCRT CA19-9 value below 180 U/mL and ECOG status 0 or 1 were statistically significant independent prognostic factors associated with improved overall survival (p < 0.01 and p = 0.02, respectively). Conclusion Overall treatment results in locally advanced pancreatic cancer are relatively poor and few improvements have been accomplished in the past decades. Post-treatment CA19-9 below 180 U/mL and ECOG performance status 0 and 1 were significantly associated with an improved overall survival.