배란 전 질식 초음파로 관찰된 자궁내막의 상태와 자궁내막에서의 Esrrogen 및 Progesterone 수용체 농도 사이의 상관관계

김정훈(JH Kim),채희동(HD Chae),황운정(WJ Hwang),김봉희(BH Kim),허주령(JR Huh),강병문(BM Kang),장윤석(YS Chang),목정은(JE Mok) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.3

It is thought that adequate development of the endometrium is important for implantation of fertilized embryos. Implantation is a highly complex process requiring continuous consequences of biochemical, physical interaction between the embryo and the uterus. There must be a communication between the epithelium and the stroma of the uterine endometrium. For the successful implantation, it is necessary that there is synchronization between the embryonic development and the endometrial changes. Hence, it has been suggested that the evaluation of uterine receptivity is important prediction of implantation. Transvaginal ultrasonographic estimation of thickness and texture of the endometrium has been widely accepted for evaluation of uterine receptivity despite of controversies. In recent days, it was reported that steroids receptors in the endometrium itself can be a possible factor for uterine receptivity. This study was performed to evaluate the relationship between ultrasonographic endometrial thickness and texture, and endometrial concentrations of steroids receptors-estrogen receptor[ER] and progesterne receptor[PR] in the pre-ovulatory phase of menstrual cycle. From Novemer 1995 to Octber 1996, forty-five infertile women with tubal factor infertility only were allocated to the study group. Transvaginal ultrasonographic measurement of endometrial thickness and texture was made on the day the leading follicle was up to 19 mm in pre-ovulatory phase of unstimulated, normal menstrual cycle. On the same day, endometrial biopsy was performed for immunohistochemical staining of ER and PR in the endometrium itself. When the patients were grouped into A group[centrally hyperechogenic triple line; n=17] and non-A group[n=28], there was no statistically significant difference in the endometrial thickness between the two groups[10.6±3.28 mm vs. 9.9±7.14 mm]. The proportion of the each steroid receptor that was stained strongly as grade Ⅲ and Ⅳ by immunohistochemical staining of two groups were as follows; 1] ER of the epithelium [ER[epi]], 8/17[47.1%] vs. 13/28[46.4%], 2] ER of the stroma [ER[stro]], 5/17[29.4%] vs. 16/28[57.1%], 3]PR[epi], 5/17[29.4%] vs. 13/28[46.4%], and 4] PR[stro], 16/17[94.1%] vs. 19/28[67.9%], respectively. Although there was no statistical difference, there was tendency that PR[stro] of A group was higher than that of non-A group[p=0.06]. The patients were also grouped into three according to the endometrial thickness[< 6 mm group, 6∼10 mm group, and ≥ 10 mm group]. There were no differences among the three groups in the proportions of the each steroid receptor that was stained strongly as grade Ⅲ and Ⅳ. In conclusion, it was not found that ER and PR have significant association with the endometrial thickness and texture in this study. However, the high PR of the endometrial stroma in the pre-ovulatory phase may be related to an adequate endometrial developmentl.

변조율이 큰 전압형 컨버터의 PWM 변조방법

이사영(SY Lee),오봉환(BH OH),김봉희(BH Kim),박현준(HJ Park),김길동(GD Kim),이승학(SH Lee),이미영(MY Lee) 전력전자학회 1998 전력전자학술대회 논문집 Vol.- No.-

This paper presents PWM method which modulates two third period only during one cycle of power converter. This method is compared with the convention! sinusoidal modulation method applying to the power converter with large capacity necessitating low switching frequency. The presented modulation method enables to reduce power semiconductor rating, minimize switching loss, and improve the current wave form.<br/> <br/>

스텝 모터에 의한 X-Y 평면 구동 제어 시스템 개발

이사영(SY LEE),김봉희(BH KIM),박성대(SD PARK),김홍철(HC KIM),김원철(WC KIM),홍일선(IS HONG),우천희(CH WOO),오봉환(BW OH),이복구(BK LEE) 대한전기학회 1998 대한전기학회 학술대회 논문집 Vol.1998 No.7

임신성 고혈압과 정상 혈압을 보인 임신의 태반에서 면역조직화학 염색을 통해 본 Endothelial Nitric Oxide Synthase의 분포양상

신명신(MS Shin),김봉희(BH Kim),이필량(PY Lee),이인식(IS Lee),김암(A Kim),허주령(JR Huh),목정은(JE Mok) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.5

Objective; Endothelial isoform of nitric oxide synthase[eNOS] regulates the vascular resistance by producing nitric oxide[NO], endothelium-derived relaxing factor. The purpose of this study was to compare the expression of eNOS by immunohistochemical staining in the placentas and umbilical vessels of preeclamptic pregnancies with that of normotensive pregnancies. Method; Placentas and umbilical vessels were examined from 5 preeclamptic pregnancies and 5 normotensive pregnancies. Frozen sections of umbilical cords, chorionic plate vessels, and terminal villi were immuno-stained with a monoclonal eNOS antibody[H32]. Mann-Whitney U test and Fisher`s exact test were used where appropriate, and p value < 0.05 was taken to be significant. Results; No differences in eNOS immuno-staining in the endothelium of chorionic plate vessels and stem villous vessels were found between preeclamptic and normotensive pregnancies. In the syncytiotrophoblast, eNOS immunostaining appeared diffusely in distribution in both the preeclamptic and normotensive placentas. In contrast, eNOS expression was only observed in the small terminal villous vessels with underlying smooth muscle layer in the preeclamptic placentas[p<0.05]. Conclusion; Increased eNOS expression in terminal villous vessels in preeclampsia may be the result of vascular alterations or damage that take place in the placenta, and may be an adaptive response to the increased resistance and poor perfusion in this pathological pregnancies.

자연유산된 초기 임신에서 태반 영양막 Apoptosis의 변화

이필량(PY Lee),김봉희(BH Kim),유혜경(HK Yoo),원혜성(HS Won),박은주(EJ Park),이주학(JH Lee),이인식(IS Lee),허주령(JR Huh),김암(A Kim),남주현(CH Nam) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.6

Objective : Our purpose was to investigate whether trophoblastic apoptosis is related with early pregnancy losses. Methods : Placentas were collected from 22 uncomplicated first-trimester pregnancies undergoing elective surgical abortion for social reason and from 27 women of first-trimester pregnancy loss. Hematoxylin & eosin staining and terminal deoxyuridine triphosphate nick end labeling[TUNEL] were used to identify apoptosis. Over 5,000 cells were exmined at a magnification of x400. Mann-Whitney U test and Spearman rank correlation were used for statistical analysis. Results : There were no cerrelations between the incidence of apoptotic trophoblasts and gestational age in each of the control and failing pregnancies. The incidence of apoptosis was significantly higher in failing pregnancies[median 0.23%, range 0.0% to 0.46%]than in uncomplicated pregnancies[median 0.09%, range 0% to 0.28%][p<0.05]. Apoptotic cells were detected in both syncytiotrophoblast and cytotrophoblasts. However, the relative incidence of apoptosis in syncytiotrophoblast comparing to that in cytotrophoblasts was increased significantly in failing pregnancies than in control pregnancies[23.5 -1.0% vs 12.0 -1.3%:mean -standard error of mean][p<0.05]. Conclustion : Trophoblastic apoptosis, especially that of syncytiotrophoblast, may play a certain role in the phthophysiology of early pregnancy losses.

Krukenberg 종양 32예의 임상병리학적 연구

나준희(JH Na),남주현(CH Nam),김종혁(JH Kim),김병식(BS Kim),김봉희(BH Kim) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.4

Objective The aim of this study was to evaluate the clinicopathologic characteristics of 32 patients with Krukenberg tumor diagnosed and treated in Asan Medical Center, College of Medicine, University of Ulsan from June 1989 to May 1998. Methods Age distribution, symptoms and signs, primary site of tumor, pathologic findings, mode of therapy and survival of patients were analyzed. Results The patients with Krukenburg tumor constituted 10.7% of all ovarian malignancy patients encountered during this period. The patient`s age ranged from 23 to 55 years[mean±S.D. ; 39.9±8.0] and about half of patients were younger than 40. Abdominal pain was the most frequently presenting symptom, palpable mass or abdominal distension being the second. Tumors tended to be large with maximal diameter of 10.4 cm[mean] and showed 59.4% of bilaterality. In 30 cases, the stomach was the primary site and that could not be identified in the other 2 cases. Fifteen[46.9%] were known to have [primary] tumors before they presented with ovarian metastasis. Microscopically, all tumors were of classic type characterized by the presence of the signet-ring cells and a diffuse stromal reaction. Most patients were treated by surgical debulking including total hysterectomy and bilateral salpingoophorectomy with or without omentectomy. Nineteen[59.4%] patients received chemotherapy with regimens such as PF[cisplatin 5-FU], EF[etoposide 5-FU], PEF[cisplatin epirubicin 5-FU] or EAP[etoposide adriamycin cisplatin]. The estimated two-year survival rate was 27.8%. Conclusion Krukenberg tumor is known to be a variant of metastatic ovarian carcinoma. However, the proportion of this tumor to all ovarian malignancies was over 10% in our institute and the prognosis remains extremely poor despite of surgery and chemotherapy.