난소암 환자에 대한 복합 화학요법 ( PAC Regimen ) 의 독성에 관한 연구

김두상(DS Kim),김문신(MS Kim),김용철(YC Kim),박형무(HM Park),유명숙(MS Yoo),신호문(HM Shin),김동명(DM Kim),조수현(SH Cho),조태승(TS Cho),환윤영(YY Hwang),심재철(JC Sim) 대한산부인과학회 1984 Obstetrics & Gynecology Science Vol.27 No.2

한양의대 산부인과학교실에서 1978년 10월부터 1982년 9월까지 PAC regimen(제1일에 adriamycin 50mg/㎡, 제2일에 cis-platinum 50mg/㎡, 제3~7일에 cyclophosphamide 150mg/ ㎡)으 로 화학치료를 받은 상피성난소암환자 16예를 대상으로 그 독성을 조사 분석하여 타 보고 자들의 성적과 비교 관찰한 바 다음과 같은 결론을 얻었다. 1. 혈액학적 독성은 총 16예중 10예(62.5%)에서 발생하였으며 혈소판 감소증은 3예 (18.8%), 백 혈구감소증 6예(37.5%), 빈혈 6예(37.5%)로 나타났으며 수혈은 1예(6.3%)에 실시하였다. 2. 신장에 대한 독성은 총 16예중 7예(43.8%)에서 각각 BUN증가 4예(25%) 혈청 creatinine 증 가 3예(18.8%)로 나타났으나, 전예가 경증이었다. 3. 가장 빈발하고 고통스러운 독성은 오심 구토로 전예에서 발생하였으며 perphenazine과 diazepam으로 어느정도 극복할 수 있었다. 4. 기타 말초신경독성은 5예(31.3%), 청력장애 1예(25%), 주관적인 시력장애 3예(18/8%), 간장 독성 1예(6.3%)였고 탈모증은 전예(100%)에서 발생하였다. The toxicity of PAC regimen was evaluated in 17 patients of ovarian epithelial carcinoma at the Edpartmane of Obstet. Nad Gynecol., Hanyang University Hospiatal from October, 1978 through september 1982. The PAC regimen consists of adriamycin 50mg/㎡ on the first day, cis-platinum 50mg/㎡ on the second day, and cyclophos-phanide 150mg/㎡ on the third to seventh day. It was repeated every 4 weeks. The results were as follow: 1. The hematologic toxicity occurred in 62.5%(10/16) of the patients, including thrombocytenia 18.8%(3/16), leukipenia 37.5%(6/16), and anemia 37.5%(6/16). For only one case, transfusion was require. 2. Nephrotoxicity occurred in 43.8%(7/160), including an elevation of BUN 25.0%(4/16) and an elevation of serum creatinine 18.8%(3/16). But all were in mild degree. 3. For the symptoms of gastrointestinal tract were nausea and vomiting which occurred in all cases and most distressing problems. All patients, however, were well tolerated with perphenazine and diazepam. 4. Peripheral neurotoxicity occurred in 31.3%(5/16), ototoxicity in 25.0%(1/4), blurred vision in 18.8%(3/16), hepatotoxicity in 6.3%(1/16) and alopecia in 100%.

The heat-shock protein 90 inhibitor, geldanamycin, induces apoptotic cell death in Epstein–Barr virus-positive NK/T-cell lymphoma by Akt down-regulation

Jeon, YK,Park, CH,Kim, K-Y,Li, YC,Kim, J,Kim, YA,Paik, J-H,Park, B-K,Kim, C-W,Kim, Y-N John Wiley Sons, Ltd. 2007 The Journal of pathology Vol.213 No.2

<P>NK/T-cell lymphoma (NKTL) is strongly associated with latent Epstein–Barr virus (EBV) infection. Recently, latent membrane protein 1 (LMP1), an EBV oncoprotein, was reported to activate the phosphatidylinositol-3 kinase (PI3K)/Akt pathway for cell survival. Because geldanamycin (GA) and its derivative, 17-allylamino-17-demethoxygeldanamycin (17-AAG), exhibit anti-tumour activity by degrading HSP90 client proteins, including Akt, we investigated the effect of GA and 17-AAG on the survival of NKTL cell lines. EBV-positive NKTL cell lines, Hank-1 and NK-YS, and an EBV-negative NK leukaemia cell line, NK-L, were treated with PI3K and Akt inhibitors, GA, and 17-AAG, and were subjected to apoptosis and cell viability assays, and immunoblot analysis. EBV-positive B-lymphoblastoid cell lines IM9 and LMP1-transfected IM9 (IM9-LMP1) were also included. Hank-1 and NK-YS cell viability was compromised and apoptosis was induced by LY294002 (PI3K inhibitor) or Akt inhibitor II. GA or 17-AAG administration resulted in the apoptosis of NKTL cells, accompanied by Akt and pAkt down-regulation, caspase 3 activation, and mitochondrial membrane potential disruption. The intrinsic level of pAkt was higher in EBV-positive NKTL cells than in EBV-negative NK-L, and GA or 17-AAG decreased the viability of NKTL cells more efficiently than NK-L. Moreover, IM9-LMP1 was more sensitive to Akt inhibitor II or HSP90 inhibitors than IM9. Importantly, GA showed little effect on the viability of normal peripheral NK cells as non-neoplastic counterparts for comparison. In conclusion, this study suggests that the PI3K/Akt pathway is frequently activated in EBV-positive NKTL and that therapeutic modalities based on targeting the PI3K/Akt pathway with HSP90 inhibitors could be useful for achieving NKTL control. Copyright © 2007 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.</P>

Presence of <i>Porphyromonas gingivalis</i> and plasma cell dominance in gingival tissues with periodontitis

Kim, YC,Ko, Y,Hong, S-D,Kim, KY,Lee, YH,Chae, C,Choi, Y Blackwell Publishing Ltd 2010 Oral Diseases Vol.16 No.4

<P><I>Oral Diseases</I> (2010) <B>16</B>, 375–381</P><P>Objective: </P><P><I>Porphyromonas gingivalis</I> can invade and survive within its host epithelial cells. The aim of this study was to test our hypothesis that persistent presence of intracellular periodontal pathogens in gingival tissue causes the chronic inflammation and that an inappropriate immune response is a risk factor for periodontitis.</P><P>Methods: </P><P>Together with the presence of <I>P. gingivalis</I>, the distribution of B cells, plasma cells, and CD4<SUP>+</SUP>, CD8<SUP>+</SUP>, and FOXP3<SUP>+</SUP> regulatory T cells was evaluated in gingival tissues from healthy (<I>n </I>=<I> </I>7) and periodontitis (<I>n </I>=<I> </I>8) sites by <I>in situ</I> hybridization and immunohistochemistry, respectively.</P><P>Results: </P><P><I>Porphyromonas gingivalis</I> was detected in proximity to inflammatory infiltrates in three and seven biopsies from the healthy and periodontitis sites, respectively. Compared with healthy sites, periodontal lesions contained a significantly increased number of each immune cell studied with a relative dominance of plasma cells over T cells.</P><P>Conclusions: </P><P>Persistent bacterial invasion of gingival tissues in combination with a plasma cell-dominant immune response may be involved in the pathogenesis of periodontitis.</P>

폐경 여성에서 지속적 에스트로젠 대체요법시 병행투여된 황체 호르몬제제가 지질대사에 미치는 영향

김철,김영철,백경돈,김태영,권상칠,고영훈 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.9

복합 호르몬 대체요법시 자궁내막의 증식을 예방하기위해 투여하는 황체호르몬 제제중 비교적 안드로젠 성향이 낮은 MPA를 저용량으로 매일 지속적으로 사용할 때 MPA가 혈중 지질 대사에 미치는 영향을 알아보고자 본 연구를 시행하였다. 1994년 1월부터 1997년 2월까지 부산 성분도병원 산부인과로 내원한 여성환자 중 자궁의 양성 질환으로 자궁적출술을 시행받고 폐경상태인 88명의 여성에게 매일 CEE 0.625 mg을 12개월간 단독 투여하고 자궁이 있는 폐경 후 여성 70명에게 매일 CEE 0.625 mg과 MPA 2.5 mg을 12개월간 병용투여하여 자궁내막의 증식을 예방하기 위해 복합투여하는 MPA가 혈중 지질대사에 미치는 장기적인 영향을 평가하기 위해 각 군의 호르몬제제 투여 직전과 투여 12개월 후 혈중 지질 및 지단백질 값을 상호 비교, 다음과 같은 결론을 얻었다. 1. 혈중 총 콜레스테롤치는 CEE 단독 투여군과 MPA 병용 투여군 모두에서 투여 12개월 후 유의한 감소를 보였으며, 두 군간의 통계학적 유의한 차이는 없었다(90.81% vs 89.54%). 2. 혈중 HDL 콜레스테롤치는 두 군 모두에서 투여 12 개월 후 유의한 증가를 보였으며 두 군간의 통계학적 유의한 차이는 없었다(117.42% vs 115.92%). 3. 혈중 LDL 콜레스테롤치는 두 군 모두에서 투여 12 개월 후 유의한 감소를 보였으며 두 군간의 통계학적 유의한 차이는 없었다(89.80% vs 85.02%). 4. 혈중 TG치는 두 군 모두에서 투여 12개월 후 유의 한 증가를 보였으며 두 군간의 통계학적 유의한 차이는 없었다(122.49% vs 126.22%). 이상의 결과로 볼 때 폐경 여성에서 지속적 에스트로 젠 대체 요법시 자궁내막의 증식을 예방하고 환자의 순응도를 높이기 위하여 병용하는 저용량인 MPA 2.5 mg 의 지속적인 투여는 에스트로젠에 의한 혈중 지질 대사의 유익한 변화를 상쇄시키지 않는 것으로 사료된다. The purpose of this study is to evaluate the effects on serum lipid and lipoproteins of continuously added oral progestogen (Medroxyprogesterone Acetate) to conjugated equine estrogens in postmenopausal women. We studied on 158 menopausal women who had no hormonal therapy and no contraindication of hormonal replacement therapy. Group I patients (n: 88) after hysterectomy were given daily conjugated equine estrogen 0.625 mg for 12 months. Group Ⅱ patients (n: 70) with uterus received dalily conjugated equine estrogen 0.625 mg and medroxypro gesterone acetate 2.5 mg for 12 months. Pre-and post-treatment evaluations of serum lipid profiles demonstrated significant decreases in total cholesterol (9.19% and 10.46%) and low-density lipoprotein cholesterol (10.20% and 14.98%) and significant increases in high-density lipoprotein cholesterol (17.42% and 15.92%) and triglyceride (22.47% and 26.22%) in group Ⅰ and group Ⅱ (p<0.05). Besides, there was no significant difference in the degree of changes of post-treatment serun levels in total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and triglycerides between the two groups. In conclusion, medroxyprogesterone acetate at low doses in continuously combined estrogen replacement therapy doses not oppose the beneficial estrogen induced lipoprotein changes.

Interrelationship between the Concentration of Heavy Metals in Normal Korean Tissues

YC Yoo,SK Lee,JY Yang,SW In,KW Kim,SC Kim,KH Chung 대한약학회 1999 大韓藥學會 總會 및 學術大會 Vol.48 No.-

고위험 임신에서 수정된 생물리학적 계수검사법을 이용한 태아안녕평가의 유용성에 관한 연구

김동옥,김은성,양재혁,한호원,김문영,류현미,강창성,채난희,한정열,정영철 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.7

목적: 고위험 임신에서 일차적 태아안녕평가검사로서 수정된 생물리학적 계수[modified biophysical profile:MBPP]검사법의 유용성을 평가하고자 하였다. 연구 대상 및 방법: 1996년 1월 1일부터 1996년 12월 31일까지 삼성제일병원에서 산전 진찰중 고위험 임신군으로 분류되어 MBPP를 시행했던 단태임신 1,270례를 대상으로 하였다. 매주 1-2회로 음향자극을 포함한 비수축검사[nonstress test:NST]와 초음파를 이용한 양수지수[amniotic fluid index;AFI] 검사를 시행하였다. 비정상 MBPP 결과는 무반응성 비수축검사 소견, 양수지수가 5 이하 및 의미있는 태아심박수 감소[significant fetal heart rate deceleration]가 있는 경우로 하였다. 결과: MBPP가 시행되었던 임산부들의 평균 연령은 28.0±6.4세이었으며, 검사시 평균 임신주수는 38.1±2.7주였다. 검사는 총 2,275회 시행되었고, 1인당 평균 1.8회 시행하였다. 분만전 1 주일 내 검사의 적응증은 지연임신[postdate] 368례[29.0%], 태아발육지연 232례[18.3%], 태동감소 215례[16.9%], 정기 초음파검사에서 양수가 감소되어 있는 경우 169례[12.8%], 자간전증 56례[4.4%], 임신성 당뇨병 34례 [2.7%] 등의 순이었다. 분만 전 1주일 내에 시행한 MBPP검사 결과 중 1,182례에서 정상소견을 보였다. 비정상 소견은 88례에서 있었으며, 이들중 무반응성 비수축검사 가 20례[22.7%], 의미있는 태아심박동수 감소가 19례[21.6%], 무반응성 수축검사와 양수과소증이 함께 있는 경우가 5례[5.7%], 단지 양수과소증만 있는 경우가 44례[50.0%]였다. MBPP 정상군과 비정상군간에 임산부의 연령, 임신횟수, 검사시 임신주수, 분만시 임신주수, 태아출생체중 간에는 통계학적으로 유의한 차이가 없었다. 그러나, 정상군과 비정상군간에 주산기 예후[perinatal outcome]을 비교하여 보았을 때 비정상군에서 분만 후 5분 Apgar score 7점 미만, 양수내 진한 태변착색 유무, 조산, 태아곤란증으로 인한 제왕절개 빈도, 제태연령에 따른 신생아의 체중이 10 분위수 이하인 경우[small for gestational age:SGA]가 통계학적으로 유의하게 더 높은 빈도를 보였다. 다만 주산기 사망은 정상군과 비정상군에서 각각 1례로 통계학적으로 유의한 차이는 없었다. 정상군에서 주산기사망 1례는 임신 37.6일에 시행한 MBPP의 결과는 정상소견이었지만, 검사 후 5일째 조기 양수 파막에 따른 제대 탈출로 태아가 사망한 경우로 MBPP검사의 위음성률은 0.4/1,000이었다. 결론: 고위험 임신에서 MBPP검사는 위음성률이 매우 낮은 효과적인 일차적 태아안녕평가검사라고 할 수 있겠다. Objective: Our purpose was to evaluate the effectiveness of the modified biophysical profile[MBPP] for antepartum fetal wellbeing assessment in high risk pregnancies. Materials and Methods: From Jan.1,1996, through Dec.31,1996, 2,275 tests in 1,270 patients with singletone high risk pregnancies were performed for antepartum fetal wellbeing assessment using a MBPP consisting of nonstress test[NST] with acoustic stimulation and ultrasound evaluation of amniotic fluid index[AFI] weekly or twice a week. Nonreactive NST, significant fetal heart rate deceleration, and AFI $lt;5 were regarded as positive results. Results: Those patients were 28.0±6.4 years old in mean age and the MBPPs were performed in mean 38.1±2.7 weeks` gestation. 1,182 patients had negative MBPPs on the last test before delivery. 88 patients had positive MBPPs such as 20 nonreactive NST[22.7%], 19 significant fetal heart rate deceleration[21.6%], 5 nonreactive NST plus oligohydramnios[5.7%], and 44 oligohydramnios alone[50.0%]. Population characteristics were not significantly different between negative and positive MBPPs. Perinatal outcome parameters included 5-minute Apgar score less than 7, thick meconium stained amniotic fluid, prematurity, cesarean section for fetal distress, small for gestational age, and perinatal death. They were significantly different between negative and positive MBPPs except perinatal death. There were two perinatal death. One perinatal death resulted from cord prolapse on the 5th day after negative MBPP of the last screen test. The false negative rate was 0.4/1000. The other occurred in positive MBPP. Conclusion: The MBPP appears to be a effective primary mean of fetal surveillance in high risk pregnancies.

Characteristics of wind pressures on retractable dome roofs and external peak pressure coefficients for cladding design

YC, Kim,SW, Yoon,DJ, Cheon,JY, Song Elsevier 2019 Journal of wind engineering and industrial aerodyn Vol.188 No.-

<P><B>Abstract</B></P> <P>This study investigates the characteristics of wind pressures on retractable dome roofs. Wind tunnel tests were conducted on spherical dome roofs with various wall height-span ratios (0.1–0.5) and opening ratios (0%, 10%, 30% and 50%). After the characteristics of mean and peak pressure coefficients were examined, the peak pressure coefficients on closed dome roofs were compared with those of the current Japanese wind load code (AIJ-RLB (2015)), and peak pressure coefficients on dome roofs with openings for cladding design were proposed. The analysis results can be summarized as follows. As wall height-span ratio increases, the absolute values of mean and minimum pressure coefficients increase, and the absolute values of minimum pressure coefficients on the outermost interior of open dome roofs increase with opening ratio. For cladding design of dome roofs with openings, dome roofs were divided into two zones, and negative and positive peak pressure coefficients were proposed based on experimental results.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Characteristics of external pressures on retractable spherical dome roofs were investigated. </LI> <LI> Five wall height-span ratios and four opening ratios were considered. </LI> <LI> Absolute values of peak pressure coefficients were larger for the flow with <I>α</I> = 0.21. </LI> <LI> Absolute values of <I>C</I> <SUB> <I>pi,min</I> </SUB> increased with opening ratio and those for <I>α</I> = 0.21 were larger. </LI> <LI> Zones and external peak pressure coefficients for cladding design were proposed. </LI> </UL> </P>

자궁내번증 1예

김영철(YC Kim),김득구(DK Kim),장윤석(YS Chang),신면우(MW Shin) 대한산부인과학회 1963 Obstetrics & Gynecology Science Vol.6 No.6

A case of puerperal inversion of the uterus was presented which was caused by mismanagement in the 3rd stage of labor. And a brief review of literature on the puerperal inversion of the uterus was made.

Shigella sonnei KNIH104S로부터 aroA 유전자 결실 돌연변이주 제조

박용춘(YC Park ),황순영(SY Hwang),신희정(HJ Shin ),이광준(KJ Lee),주영란(YR Ju),배용수(YS Bae),김영창(YC Kim) 大韓微生物學會 1998 大韓微生物學會誌 Vol.33 No.4

태아감시장치가 제왕절개술의 빈도에 미치는 영향

김용철(YC Kim),이우홍(WH Lee),박완석(WS Park),김영제(YJ Kim) 대한산부인과학회 1982 Obstetrics & Gynecology Science Vol.25 No.3

1976년 9월 1일부터 1981년 8월 31일까지 만 5년간 국립의료원 산과에 입원 분만한 1,500gm 이상의 출산하 총 5,953예를 대상으로 조사 분석한 결과 다음과 같은 결과를 얻었다. 1. 총 분만 5,953예중 5,074예(85.2%)는 질식 분만을 하였고 869예(14.8%)는 제왕절개 분만을 시행하였다. 2. 이상태위는 총 253예이며 192예(75.9%)에서 제왕절개 분만을 실시하였다. 3. 난산으로 인한 제왕절개 분만은 277예로써 총 제왕절개 분만의 31.5%에 해당된다. 4. 태아 절박증의 빈도는 총 분만 5,953예 중 254예(4.3%)이며 이중 142예(2.4%)에서 제왕절개술을 시행하였다. 5. 총 분만 5,953예중 제왕절개술의 적응증은 난산이 277예로 가장 많고 제왕절개술의 기왕력 211예, 이상태위 192예, 태아 절박증 142예 및 전치태반 51예의 순이다. 6. 태아감시 장치의 적응빈도는 1978.9-1979.8은 2.7%이며 본격적으로 시행한 1979.9이후는 평균 16.8%이다. 7. 태아 감시 장치의 적응증은 과숙아(24.7%), 임신중독증(22.0%), 유도분만(18.4%) 및 태변착색 (13.1%)등의 순이었다. 8. 태아 절박증으로 제왕절개술을 시행한 142에중 태아 감시 장치를 시행한 예는 92예(67.7%)이다. 9. 총 분만 5,953에중 주산기 사망율은 19.7이며 매년 감소 추세이다. Many authors had found a moderate increase in Cesarean section rate, after the introduction of fetal monitoring system whereas others no change or decrease in its rate. To determine the effect of fetal mornitoring on Cesarean section rate, we studied and analysed cases underwent Cesarean section at National Medical Center from sep. 1976 to Aug. 1981. Fetal morntoring was employed in 455 patients, most of whom were thought to be at high risk group of pregnancy. The results were obtained as follows. 1. the mean Cesarean section rate was 14.8% and showed a gradually increasing tendency by year. 2. the factors leading to Cesarean section included dystocia (31.5%), repeat C/S (24.0%), abnormal presentation (21.8%), fetal distress (16.2%) and others. 3. the incidence of fetal monitoring application was 7.6%, because of the introduction and liberal using from the late part of 1978. and its rate was trend to increase gradually by year. 4. The incidence of fetal distress leading to Cesarean section increased by year(mean: 2.4%), the reason for this increment was thought to overemphasized fetal distress andn not-well established criteria for fetal distress. 5. Perinatal mortality rate was decreased, especially after the period of fetal mornitoring application (27.1/1976-77, 15.7/1980-1981).