급성 하벽 심근경색에서 측부 유도의 ST분절의 특성과 병변 동맥의 관계

이숙진,임헌길,조한표,신대희,최성일,이 상,이재웅,김경수,김순길,김정현,이방헌,이정균 대한순환기학회 2001 Korean Circulation Journal Vol.31 No.10

Q- 및 비Q-파 심근경색증에서 표준화 QT 간격변이

김순길,염명걸,이철범,이재웅,이상,김경수,김정현,임헌길,이방헌,이정균 대한순환기학회 2001 Korean Circulation Journal Vol.31 No.12

Piezoelectric Shock Wave(EDAP LT01과 LT02)를 이용한 충격파 쇄석술의 치료 효과 : 5,000례 치료 경험

이지현,이선주,이충현,김진일,장성구 大韓泌尿器科學會 2003 Korean Journal of Urology Vol.44 No.3

Tamoxifen에 의해 증식이 억제된 자궁내막암 세포주의 가역성에 관한 시험관내 연구

이순곤,이순미,원성윤,서희승,이권해 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.11

Tamoxifen, which is often used in breast cancer therapy, has also been used in the treatment of patients with advanced and recurrent endometrial carcinoma. The growth inhibitory effects of tamoxifen were tested on the long-established endometrial carcinoma cell lines(RL 95-2) and on SCHE-1, a new endometrial carcinoam cell lines established in our laboratory. The MCF-7 breast cancer cell line was used as a control. Ten days of feeding with 5μM tamoxifen produced a 96% reduction in cell number in MCF-7 and a 83% reduction in SCHE-1 cultures. No viable cells remained in RL 95-2 cultures after 10 days of feeding with a 5μM tamoxifen. Tamoxifen-induced growth inhibition was reersible. All cell lines resumed logarithmic growth when tamoxifen was removed from the culture medium. In RL 95-2 and SCHE-1 cultures, addition of 17 β-estradiol to the culture medium did not accelerate recovery. Reversal of tamoxifen-induced growth inhibition was not seen when tamoxifen and 17 β-estradiol were added simultaneously. In MCF-7 cultures, tamoxifen-induced growth inhibition has been shown to be partially reversed by simultaneous use of 17 β-estradiol and 17 β-estradiol has been shown to increase the rate of recovery from tamoxifen blockade. Our results show that a potent growth inhibitory effect of tamoxifen is not reversed by estrogen and may thus be mediated through a mechanism different from blockade of estrogen receptor.

정상 임신부에서 혈청내 Interleukin-2와 Tumor Necrosis Factor-α 값의 변화

이임순,이순곤,이해혁,김동희,이슬기,양회경,최경훈 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.7

목적: 태아는 면역학적으로 반동종이식(semiallograft)이고, 일부의 반복유산이 숙주와 이식편 사 이의 반응때문이라면, 숙주와 이식편 관계에 있어서 중요한 역할을 한다고 알려져 있는 interleukin-2[IL-2]와 tumor necrosis factor-α(TNF-α)의 측정이 흥미롭다고 할 수 있다. 본 연구에서는 임신중 일어나는 면역학적 변화에 대한 예비연구로 임신부의 혈청내의 IL-2와 TNF-α 값을 측정하였다. 연구방법: 혈청 TNF-α와 IL-2는 효소 결합 면역흡착검사[ELISA kit: R&D system, Mineapolis, MN]를 사용하여 측정하였고, 대상은 50명의 합병증 없는 임신부, 30명의 건강한 비임신부, 적어도 2번 이상의 유산경력이 있는 5명의 임신부를 대상으로 하였으며, 이 5명의 임신부는 임신 6-14주였고, 채혈당시 질출혈과 절박유산 증상으로 세번째 결국 유산 하였다. 통계적 처리는 student t test를 사용하였다. 결과: 혈청 IL-2값은 비임신부와 정상임신부에서 각각 11.0 22.5pg/mL 와 66.2 47.5pg/mL로 검출되어 임신부에서 증가하였으며, 임신 초기에 증가하여 임신 기간중 일정하였다. 혈청 TNF-α 값은 비임신부와 정상임신부에서 각각 11.6 28.1pg/mL와 11.4 21.8pg/mL로 검출되어 차이가 없었다. 숫자는 적으나 원인불명의 반복유산환자에서 혈청 IL-2값은 어떤 규칙을 찾을 수가 없어 의미가 없었으나, 혈청 TNF-α값은 29-34pg/mL로 정상임신부에 비하여 높게 나타나는 경향을 보였다. 결론: 비임신부와 정상임신부의 IL-2값에 차이가 있으며, 임신부에서 IL-2값이 증가하였다. 비임신부와 정상임신부의 TNF-α값은 차이가 없었다. 수는 적으나 원인불명의 반복유산 환자에서 정상임신부에 비하여 TNF-α값이 증가되는 경향을 보였다. Objective: Because the fetus exists immunologically as a semiallograft, pregnancy loss may be a manifestation of host versus graft rejection in some cases. So we undertook a preliminary study to determine IL-2 and TNF-α levels in serum during normal pregnancy. Methods: Samples were taken for serum TNF-α and IL-2 enzyme linked immunosolvent assays (ELISA: R&D systems, Minneapolis, MN) from 50 pregnant women without any complications, 30 healthy non pregnant women and 5 women with at least two previous abortions between 6-14 weeks. 5 women had symptoms of an threatened abortions as evidenced by a vaginal bleeding and ultimately had a third abortion. Statistical analysis was used student t test. Results: Serum IL-2 levels were determined respectively 11.0 22.5pg/mL and 66.2 47.5pg/mL in control and normal pregnant women. The peak IL-2 level was reached as early as the first month and was stable during pregnancy. Serum TNF-α levels were determined respectively 11.6 28.1pg/mL and 11.4 21.8pg/mL in control and normal pregnant women. Serum TNF-α levels in women with unexplained recurrent abortion were 29-34pg/mL. Conclusions: In normal pregnant women we found an increase in serum levels of IL-2 compared to the non-pregnant women. As regards serum levels of TNF-α, no differences could be observed between normal pregnant and non-pregnant women. In women with URA an increase in serum levels of TNF-α were found compared to the normal pregnant women.

신생아 쇄골 골절에 대한 임상적 고찰

이권해,이순곤,김도형,이정재,김보연 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.8

쇄골골절은 분만시 골절이 가장 잘 일어나는 뼈로서, 질식분만시 두정분만이 어렵거나 둔위시 팔분만이 어려울 때 잘 일어난다. 저자들은 1991년 1월부터 8월까지 분만한 총 6138예를 대상으로 신생아를 쇄골골절에 관한 분석을 하여 다음과 같은 결과를 얻었다. 1. 쇄골골절의 빈도는 총 분만 6158예중 17예로 0.28%이었으며, 16예가 정상분만시 발생하였으며 1예만이 제왕절개술에 의해 발생하였다. 2. 태위에 따른 쇄골골절의 빈도는 정상분만시 두정위가 15예였으며, 제왕절개시에는 두정위 1예에서 만 쇄골골절을 보였다. 3. 쇄골골절의 좌우측 빈도는 좌측이 7예(41.2%), 우측이 10예(58.2%)였다. 4. 쇄골골절이 위치에 따른 발생빈도는 중간 1/3이 10예(58.8%), 내측 1/3이 5예(29.4%), 외측 1/3이 2예(11.8%)로 중간 1/3부위에서 가장 높은 발생율을 보였다. 5. 분만시 체중과의 관계는 질식분만시 쇄골골절이 있었던 16예중 3,000 gm이하는 1,147예중 3예(0.26%), 3,000-3500 gm이 1,803예중 5예(0.28%)였고, 3,500-4,000 gm이 758예중 7예(0.92%)였으며, 4,000 gm이상이 68예중 1예(1.47%)로 신생아의 몸무게가 증가할수록 쇄골골절의 빈도가 증가함을 볼 수 있었고 이들의 평균체중은 3,480 gm이었다(p$lt;0.05). 6. 분만시 쇄골골절로 인한 합병증으로 혈관 및 신경손상, 가골의 과도형성으로 인한 잔여변형, 부정유합, 불유합, 외상성 관절염은 한 예에서도 발견되지 않았다. The clavicle is the most frequently fractured bone in the full-term newborn during vaginal delivery. In the new-born, the breaking force may arise from compression of the shoulders during a difficult delivery at virth. An asymptomatic fracture in the neonate may be ignored. It will unite without external immobilization and any malalignment will correct itself with growth. The typical clinical signs of the clavicle fractures are diminished movement of the affected side arm. On palpation, there is local swelling, tenderness, crecipatation over the fracture site. Fracture in the middle third of the clavicle will be clearly depectied in the anterior posterior radiogram. To demonstrate fractures of the medial and lateral end of the clavicle, however, special oblique, lateral, or lordotic 40-degee cephalic tilt views may be required. This study was analized 6,158 live births, who were delivered at the Soonchunhyang university hospital from January 1991 to August 1993. The results were as follows: 1. The incidence of clavicle fracture was 0.28%(17cases), and 16 cases were in normal spontaneous vaginal delivery, only one case was occured in cesarean section. 2. The incidence of clavicle fracture by presentation was following; 15 cases of vertex presentation and 1 case of breech presentation in the vaginal delivery, 1 case of vertex presentation in secarean section. 3. The incidence of site(riht or left) of clavicle fracture was left with in 41.2%(7 cases), right site in 58.2%(10 cases), but there was no statistical difference between incidence of fracture site(right or left). 4. The incident site of clavicle fracture was at mid 1/3 in 58.8%(10 cases), inner 1/3 in 29.4%(5cases), outer 1/3 in 11.8%(2cases). 5. During vaginal delivery, the correlation between the incidence of clavicle fracture and body weight are as follows: below 3000 gm in 0.26% (3 out of 1147 cases), 3000-3500 gm in 0.28% (5 out of 1803 cases). 3500-4000 gm in 0.92%(7 out of 758 cases), above 4000 gm in 1.47%(1 out of 68 cases), the mean body weight was 3480 gm. The clavicle fracture incidence was increased as fetal body weight was increased(p$lt;0.05). 6. In our study, we did not find any fetal complications vessel, nervel injury remnant deformity, non-union and traumatic arthritis in clavicular fractured infants.

초음파검사에 의한 한국인 태아의 임신주수별 태아성장지표의 정상치에 관한 연구

이재훈,김승욱,이진용,신희철,윤보현,전종관,이성구 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.10

본 연구는 1993년 서울대학교 의과대학 교육연구재단 산부인과학교실 지정연구기금의 보조로 이루어진 것임. Fetal weight and other fetal growth parameter gestational age tables have been calculated for 442 singleton fetuses by ultrasonic measurement. Twin pregnancies, stillborn and malformed infants were excluded as were those born to mothers with diabetes mellitus, preeclampsia, eclampsia and any medical and surgical illness during pregnancy that have any possibilities of altering fetal growth. The 5th, 10th, 25th, 50th, 75th, 90th and 95th percentiles were determined for 25-42th nearest weeks of gestation and compared with preexisting reportes by postnatal study. The results were as follows. 1. Fetal weight calculated by ultrasonic measurement in our prenatal study showed significant difference compared with that in previous postnatal studies before 37th nearest week of gestational age. 2. There were no significant growth velocity deceleration after 40th nearest week of gestational age. It is concluded that any growth standards based on prenatal study by ultrasonic measurement of fetal grwth parameters can be used as our standard without significant problems.

염색체균형 전좌 보인자에 있어서 산전 세포유전학적 진단에 관한 연구

이권해,이순곤,김용진,김현승,이충일,오신정,최경준 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.9

Retrospective analysis of chromosomal abnormalities was performed on 75 couples who had recurrent spontaneous abortion. Karyotyping of their peripheral blood lymphocytes was made on 75 patients and 75 their husbands. The overall incidence of chromosomal aberrations was 22.7 %(17 in 75 couple). Number of chromosomal abnormalities in wives was twelve. Another chromosomal abnormalities were found in five husbands. All of them were balanced form and their phenotypes were normal. The incidence of translocations among total chromosomal abnormalities was 64.7 % (11/17). The incidence of reciprocal translocation(72.7 %) was higher than that of Robertsonian translocation (27.3 %). There were six other abnormalities including one case of inversion and five cases of polymorphisms. amniocentesis or chorionic villi sampling was performed during subsequent pregnancy to couples who had balanced chromosomal abnormalities. The karyotypes were classified as balanced translocation in seven cases, inversion in one case and normal karyotype in one case. This study suggests that prenatal diagnosis should be emphasized in couples in which one person is the carrier of a balanced chromosomal abnormality.

양측성 다낭종신의 산전초음파 진단 1례

이정규,장하종,김병수,이길형,이만종,홍성기 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.7

Ultrasound can be considered a well-established diagnostic tool for evaluation of fetal renal anatomy. Ultrasonography is non-invasive and non-hcermfal method to fetus. It useful diagnostic method in fetal anomaly detestion. The authors of this report found a fetus aged 22 weeks old with bilateral polystic kidney. It has deteated by prenatal ultrasonographic examination. Final diagnosis was established at autopsy and pathology. Authors reported a case of bilateral polycystic kidney with review of literature.

임신중 중증 자간전증 및 자간증에 대한 임상적 고찰

이기동(GD Lee),조충래(CR Cho),김수임(SI Kim),이순곤(SG Lee),이임순(IS Lee) 대한산부인과학회 1987 Obstetrics & Gynecology Science Vol.30 No.10

1980년 1월부터 1985년 12월까지 순천향 서울병원에서 분만한 총 9,105예 중 중증 자간전증 및 자간증 환자 170예와 순천향 구미병원에서 분만한 총 7,389예 중 중증 자간전증 및 자간증 환자 34예 및 1983년 8월부터 1985년 12월까지 천안 병원에서 분만한 총 2,481예 중 중증 자간전증 및 자간증 환자 91예를 대상으로 정상 대조군과 비교후 통계학적으로 서로 비교 분석하여 다음과 같은 결론을 얻었다. 1. 임신중 중증 자간전증 및 자간증의 발생 빈도는 서울 1.9%, 구미 0.5%였고, 천안 3.7%를 나타내어 이중 순천향 천안 병원의 발생 빈도가 가장 높은 빈도를 보였다. 2. 경증 자간전증은 구미 병원에서 88.5%로 가장 높았고, 중증 자간전증은 천안 병원에서 47.5%로 가장 높았고, 자간증은 천안 병원에서 9.5%로 가장 높은 치를 보였다. 3. 연령별 발생 빈도는 서울, 천안 병원에서는 40셰 이상에서 가장 높았으나, 구미 병원에서는 20세 미만에서 가장 높은 빈도를 보였다. 4. 분만횟수별 빈도를 보면 서울, 천안, 구미병원에서 모두 초산부에 가장 높은 빈도를 보였다. 5. 계절별 발생 빈도는 서울, 천안 병원에서는 각각 4, 3월게 가장 높았으나, 구미 병원에서는 1월에 가장 높았다. 6. 쌍태 임신의 발생 빈도는 단일 임신에 비해 서울, 천안, 구미 병원에서는 각각 7, 15, 7배로서 이중 천안 병원에서 가장 높은 빈도를 보였다. 7. 태아 성별에 의한 발생 빈도의 차이는 없었다. 8. 동반된 질환은 서울, 천안, 구미 병원에서 빈혈, 조기파수가 가장 많았고, 쌍태임신, 태반 조기박리등이 동반되었다. 9. 분만방법은 자연질식분만이 가장 높았으나 다른 보고자에 비해 낮으며 제왕절개술이 약간 높았으며 이중 천안 병원에서 39.6%로 가장 높았으나, 통계적 의의는 없었다. 10. 임신 기간은 서울, 구미 병원에서는 37∼40주에서 각각 61.2%, 55.9%로 가장 높았고, 천안 병원에서는 25주 미만에서 38.5%로 가장 높았다. 11. 신생아 체중은 단일 임신군보다 비교적 적었으며, 2,500gm미만이 서울 20%, 구미 32.4%였고, 천안 병원에서는 60.4%로 가장 높았다. 12. 주산기 합병증으로는 저체중 출생아, 사산아, 신생아 사망등이 있었으며, 천안 병원에서 가장 높은 빈도를 보였다. It is well known that pregnancy induced hypertension is one of the important problems in Obstetrics, which has one of the leading causes of maternal and perinatal mortality and morbidity. Despite extensive investigation along many different lines, the pathogenesis has remained obscure and the treatment was done only for symptoms and signs. So complete prenatal care can only prevent the development of pregnancy induced hypertension and complications. A clinical study was undertaken on 170 cases of severe form of preeclampsia and eclampsia among the 9105 pregnants who were admitted to Seoul and 34 cases among the 7389 pregnants to Kumi Soonchunhyang hospital for delivery from Jan. 1980 to Dec. 1985 and 91 cases among the 2481 pregnants admitted to Chunan Soonchunhyang hospital from Aug. 1983 to Dec. 1985. The results were as follows: 1. The total incidence of severe form of preeclampsia and eclampsia in pregnancies was 1.6%(295) of 18,975 deliveries. 2. The incidence of Seoul, Kumi and Chunan hospital was 1.9%, 0.5% and 3.7% rrespectively. The incidence of Chunan hospital was highest. 3. The rate of mild form of preeclampsia was highest at Kumi hospital(88.5%). The rate of severe form of preeclampsia was highest at Chunan hospital(47.5%). The rate of eclampsia was highest at Chunan hospital(9.5%). 4. At Seoul and Chunan hospital, the frequency of disease was higher in the age group above 40 years old but at Kumi hospital, higher under 20 years old. 5. According to parity, the higher frequency was noted in primipara at three hospitals. 6. Among 12 months, at Seoul and Chunan hospitals, the disease was more frequently seen in April and March but at Kumi hospital, higher in January. 7. The incidence of the disease in twin pregnancy was 7.0%, 7.0% and 15.0% at Seoul, Kumi and Chunan hospital respectively and then at Chunan hospital was highest.