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자궁내막증 환자의 복강 액내 IL-6와 TNF-α의 변화 양상에 관한 연구
강정배,이영경,Kang, Jeong-Bae,Lee, Young-Kyeong 대한생식의학회 2006 Clinical and Experimental Reproductive Medicine Vol.33 No.1
목 적: 자궁내막증과 이로 인한 불임의 원인인 면역학적 인자 중 세포-매개성 면역계의 변화 양상을 규명하기 위하여 자궁내막증 환자와 자궁내막중이 없는 환자의 복강 액을 채취하여 면역 세포의 분포양상을 비교 분석하고자 IL-6와 TNF-${\alpha}$를 측정하였다. 연구방법: 자궁내막증으로 육안적 또는 조직검사로 확진된 환자 또는 불임검사를 위해 진단적 복강경을 시행한 34명을 연구군으로 등록하였으며 본 연구 이전에 자궁내막증과 관련된 어떠한 치료도 받은 적이 없거나 복강경 시술이나 개복수술과정에서 자궁내막증 소견과 증상이 없는 환자 37명을 대조군으로 하였다. 두 군의 복강 액을 추출한 다음 30분 이내에 $400g{\times}10$분 동안 원심분리 후 상층액만 검사용기에 모아 밀봉한 후 $-70^{\circ}C$ 냉동실에 보관하여 IL-6와 TNF-${\alpha}$의 농도를 "sandwich" enzyme-linked immunosorbent assays (ELISA: R & D Systems, Minnepolis, MN)로 측정하였다. 결 과: 1. 복강 액의 IL-6의 농도는 자궁내막증으로 확진된 연구군에서는 $38.9{\pm}19.7pg/ml$으로 대조군의 $22.4{\pm}10.2pg/ml$보다 유의하게 증가하였고 (p=0.02), TNF-${\alpha}$의 농도도 자궁내막증이 있는 여성에서 $20.6{\pm}8.6pg/ml$로 대조군의 $6.2{\pm}3.5pg/ml$보다 유의하게 증가하였다 (p=0.01). 2. 자궁내막증여성의 생리주기별 농도에서 IL-6은 증식기보다 분비기에 유의하게 증가한 반면 (p=0.01), TNF-${\alpha}$는 차이가 없었다 (p>0.05). 3. IL-6은 가임여성보다 불임여성에서 유의하게 증가하였고 (p=0.03), TNF-${\alpha}$는 두 군 간에 유의한 차이는 없었다 (p>0.05). 4. IL-6과 TNF-${\alpha}$ 모두 대조군과 자궁내막증 병기 I과 II는 통계학적인 유의성은 없었으나 병기 III과 IV는 유의하게 증가하였다 (p<0.05). 결 론: 자궁내막증인 환자의 복강 액에서 IL-6와 TNF-${\alpha}$가 증가하여 자궁내막증의 생성과 유지, 증상발현에 관여하며 불임의 유발 요인으로 여겨지나 향후 많은 환자를 대상으로 한 연구와 자궁내막증과 각종 cytokine과의 상호 연관관계에 대한 연구가 더 많이 필요하리라 사료된다. Objective: Our purpose was to investigate the relationship between the levels of IL-6 and tumor necrosis factor-${\alpha}$ in the peritoneal fluid of women with and without endometriosis and infertile women. Methods: This study is prospective and case-control study in University hospital, enrolled thirty-four women with laparoscopic findings of minimal to severe endometriosis, and thirty-seven women with no visual evidence of pelvic endometriosis and with benign gynecologic disease. IL-6 and tumor necrosis factor-${\alpha}$ levels in peritoneal fluid were determined using commercial ELISA. IL-6 and tumor necrosis factor-${\alpha}$ concentrations were compared among women with and without endometriosis, and with infertile and fertile women, and then also compared according the revised American Fertility Society classification. Results: IL-6 and tumor necrosis factor-${\alpha}$ concentrations were higher than in the peritoneal fluid of women with endometriosis than in matched normal controls. Cyclic variations in IL-6 concentrations were seen in peritoneal fluid from patients with endometriosis: the concentrations in the secretory phase were significantly higher than those in the proliferative phase. The concentrations were higher than among of infertile women than in fertile women. A significant correlation between IL-6 and tumor necrosis factor-${\alpha}$ concentrations and endometriosis stage III and IV was noted. Conclusion: Increased levels of IL-6 and tumor necrosis factor-${\alpha}$ in patients with endometriosis in the peritoneal fluid may be relate to the pathogenesis of endometriosis suggesting that partially contribute to the disturbed immune regulation observed in patients with endometriosis.
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조민지(Cho, Min-Ji),이영경(Lee, Young-Kyeong),임업(Lim, Up) 대한국토·도시계획학회 2015 國土計劃 Vol.50 No.5
Special schools are often regarded as NIMBY facilities, which hold negative perception in society. Site selection of special school is prone to result in conflict among various stakeholders: not only people directly involved such as disabled students, their teachers and parents, and school founders but also people indirectly involved such as residents. Therefore, more careful considerations are required when selecting the site of special school than regular school. However, in Korea, the same method used in selecting cite for regular school has been also used for special school until now. In order to improve and complement the existing site selection process, we propose a new selecting method by focusing on a special target area - Jungnang-gu. First, we assess the suitability for a large number of candidates to complement the existing site selection process which evaluates the suitability for a single candidate. Second, by reflecting opinions of the non-disabled and people directly involved during the selecting process, we attempt to remove any ambiguity concerning the objectivity and validity of existing site selection process and encourage substantial stakeholders to participate, taking into account their conflicts.
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자궁내막증의 존재유무에 따른 혈장과 복강액내의 TNF - α 농도 ; TNF - α 가 자궁내막증의 병인인가 ?
김호성(Ho Sung Kim),이수미(Soo Mi Lee),신희경(Hee Gung Shin),문혜경(Hye Kyoung Mun),조태일(Tae Il Cho),강정배(Jeong Bae Kang),이영경(Young Kyeong Lee) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.9
Objective : Our purpose of study was to investigate whether in vivo levels of tumor necrosis factor-α in plasma and peritoneal fluid (PF) differ in women with and without endometriosis. Design : Prospective and case-control study. Methods : Fifty-seven women with laparotomy or laparoscopic findings of minimal to severe endometriosis, and forty-two women with no visual evidence of pelvic endometriosis and with benign gynecologic disease. Tumor necrosis factor-α levels in plasma and PF were determined using commercial ELISA. Tumor necrosis factor-α concentrations were compared among women with and without endometriosis, and then also were compared according to the revised American Fertility Society classification. Results : Tumor necrosis factor-α concentrations were not significantly increased in the plasma and PF of women with endometriosis than in matched normal controls. Tumor necrosis factor-α concentrations in endometriosis stage III and IV were sightly increased, which were not increased statistically significant. Conclusions : Plasma and PF tumor necrosis factor-α levels were not different between women with and without endometriosis. Our results do not rule out the hypothesis that tumor necrosis factor-α may be involved in the pathogenesis of some features of endometriosis.
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