가토 태아에서 성별에 따른 폐내 β-adrenergic반응의 차이

이종건(CK Lee),김수평(SP Kim) 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.1

The increased incidence and severity of the respiratory distress syndrome in male versus female infants have long been appreciated. And the role of β-adrenergic responses in surfactant secretion and reabsorption of alveolar fluid was also reported. To elucidate the possible mechanism for the increased incidence and severity of the respiratory distress syndrome in male versus female infants, we studied the pulmonary β-adrenergic responses in male and female rabbit fetus. Pulmonary β-adrenergic responses were evaluated by measuring the β-adrenergic receptor concentration and cAMP generation in the fetal lung tissues. The results were as follows: 1. There was no difference in the body weight, pulmonary weight, placental weight and liver weight between male and female rabbit fetus. 2. The β-adrenergic receptor concentration was 141.178±10.414fmol/mg protein in male rabbit fetus and 157.264±8.318fmol/mg protein in female rabbit fetus. But there was no statistical difference between these two groups. 3. There was no difference in cAMP content, cAMP basal, 10-7M, 10-6M, 10-5M isoproterenol-stimulated cAMP generation and 7.5 x 10-6M forskolin-stimulated cAMP generation between male and female fetal lung tissues. But there was statistical difference in 10-6M prostaglandin E2-stimulated cAMP generation(p<0.05) between these two groups. 4. The ratio 10-6M isoproterenol-stimulated cAMP/cAMP content was 13.636±1.428 in male fetus and 15.073±1.485 in female fetus. But there was no statistical difference between these two groups. It was concluded that the difference in pulmonary β-adrenergic responsiveness between male and female rabbit fetus was not found.

반음향 환자에 있어서의 LHRH 및 Estrogen 부하검사

이준모(JM Lee),이종건(CK Lee),정윤조(YJ Chung),김기원(KW Kim),이진우(JW Lee) 대한산부인과학회 1980 Obstetrics & Gynecology Science Vol.23 No.6

반음양환자에 있어서의 성염색체, 성선 및 이소성 요인등이 시상하부-뇌하수체축의 기능에 미치는 영향을 관찰하고저 LHRH 및 estrogen 부하시험을 실시하여 뇌하수체의 기능 및 시상하부의 고유기능인 음성 및 양성되먹이기전의 유무와 반응도를 관찰하여 다음과 같은 결론을 얻었다. 1. LHRH검사결과 모든 반음양환자에서 성염색체, 성선 및 이소성요인(ectopic steroid)들과 무관하게 뇌하수체의 성선자극호르몬의 생산분비기능은 소실되지 않았다. 2. estrogen 투여에 의한 시상하부의 음성되먹이기전은 반음양의 모든 환자에서 성염색체, 성선 및 이소성 요인들과 무관하게 보존되어 있었다. 3. 남성 및 여성위반음양 환자에서의 estrogen 투여로 일어난 시상하부의 양성되먹이기전은 Y-염색체를 가진 환자에서는 모두 나타나지 않았고, 성선 및 이소성 요인에 의한 환자군에서는 제한된 여성형으로 나타났다. 4. 진반음양환자의 estrogen투여에 의한 양성되먹이기전은 성염색체 및 성선의 공존상태와 무관하게 여성형의 반응을 보여 주었다. 5. 이상의 결과로 보아 반음양환자의 시상하부-뇌하수체축의 기능적인 모형은 남성반음양환자를 제외하고는 여성형 또는 제한된 여성형의 기능을 나타내는 것으로 보인다. To evaluate the functional unit of the hypothalamopituitar axis in various groups of intersex luteinizing hormone releasing hormone (LHRH) and estrogen provocation tests were perfomed in the 5 clinically classified groups of intersex. They included four cases of Turner`s syndrome, five cases of feminizing male intersex, six cases of adrenogenital syndrome, three cases of feminizing female intersex and three cases of true intersex. Among them six cases of adrenogenital syndrome were followed up after treatment; three of them manifested normal or spotting mentruation 6 months after steroid therapy. LHRH test, injecting 100μg of LHRH intravenously, were performed according to the procedures proposed by Nillus and Wide (1972) and for the estrogen provocation thest 20mg of premarin, a conjugated estrogen, was used as done by Aono etal. (1978).

임신 18 주미만에서 경질초음파에 의한 제대동맥 혈류속도파형의 양상

이원희(WH Lee),신종철(JC Shin),박미숙(MS Park),장석일(SI Jang),이종승(JS Lee),나덕진(DJ Rah),이종건(CK Lee),김수평(SP Kim) 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.10

The value of Doppler studies during the pregnancy is well known and documented. Most Doppler investigations of the umbilical artery, however, have been comfined to 16 weeks or greater in gestation and the experience with Doppler measurement in early pregnancy is very limited. Recently, the introduction of transvaginal color and pulsed wave Doppler system has allowed the possibility of studying fetal blood flow velocity in early pregnancy. The purpose of this study was to explore the evolution of the umbilical-placental circulation before 18 weeks in gestation. We studied 79 normal singleton prenanacies with a transvaginal color and pulsed wave Doppler system on 79 occasions between 7 and 17 weeks in gestation. Systolic/diastolic(S/D) ratio, pulsatility index(PI) and resistance index(RI) were used for flow velocity waveform analysis. We observed the umbilical waveforms as early as 7 weeks. End-diastolic velocity(EDV) was observed in 11 weeks, then progeressive development of EDV appeared from 11 to 15 weeks. And EDV was developed after 15 weeks gestation in all cases. RI and S/D ratio progressively decreased from 11 and 12 weeks with advancing gestational age, respectively. A decrease in PI from 15 weeks preceded by and increase from 8 to 14 weeks. This study suggests tat Doppler velocimetry of the umbilical artery in early pregnancy may provide a functional display of the evolution of the placental vasculature.

Ritodrine 이 신생아 혈당값에 미치는 영향

노덕영(DY Ro),이충훈(CH Lee),이종건(CK Lee),나종구(JG Na),김수평(SP Kim),이헌영(HY Lee),성인경(IK Sung),이병철(BC Lee),조성훈(SH Cho) 대한산부인과학회 1988 Obstetrics & Gynecology Science Vol.31 No.11

저자들은 ritodrine이 신생아 탄수화물 대사에 미치는 영향을 알아보고져 ritodrine주입을 받은 모성에서 태어난 신생아 40예를 실험군으로 그리고 ritodrine주입이 없었던 모성에서 태어난 신생아 18예를 대조군으로하여 다음과 같은 결론은 얻었다. 1. 실험군과 대조군간에는 성비, 임신주수, 신생아체중, 1분, 5분 Apgar score, 분만통의 유 무, 제왕절개술 빈도에서 유의한 차이가 없었다. 2. 혈당값은 실험군에서 37.9±2.4 ml/dl 대조군에서 63.1±13.0 ml/dl 로 두군간에는 통계적으 로 유의한 차이가 없었다. 3. 저혈당증의 발생빈도는 실험군 40예중에서 9예 대조군 18예중 2예에서 발생하여 두 군간 에는 P value 0.06으로 통계적으로 유의성은 없었다. 그러나 저혈당의 임상증상을 보인 3예 는 모두 실험군에서 발생하였다. 4. 실험군 혈당값중에서 질식분만 예들은 43.3±4.8 mg/dl, 분만통을 갖고 제왕절개술한 예들 에서 36.3±15.0 mg/dl 분만통없이 제왕절개술한 예들에서 35.9±2.7 mg/dl엿으며 각군간에 혈당값은 유의한 차이가 없었다. In order to assess the effect of ritodrine on neonatal carbohydrate metabolism the sugar levels of the neonate delivery by ritodrine treated women were compared with those of the neonate delivery by non-treated women The results were as follows; 1. There was no significantly difference in sex ratio, gesational age, birth weight 1-minute and 5-minute Apgar score the presence of labor and the number of cesarean section delivery between these two groups. 2. The sugar levels were 37.9±2.4 mg/dl in experimental group and 63.1±13 mg/dl in control group . But there was no significantly difference 3. The hypoglycemia occured in 9 of 40 cases of experimental group and 2 of 18 cases of control group , respectively. But there was no significantly difference. All of the symptomatic hypoglycemic cases (3cases) occured in the experimental group . 4. In the experimental group , the blood sugar levels of vaginal delivery group , cesarean section with labor group and cesarean section without labor group were 43.3±4.8 mg/dl, 36.3±15.0 mg/dl and 35.9±2.7 mg/dl ,respectively. There was no significantly difference in each other.

내인성 성호르몬과 인체 자궁평활근의 β-아드레날린성 수용체와의 관계

이경숙(KS Lee),문봉태(BT Moon),홍경선(KS Hong),노정숙(JS Noh),신진웅(JW Shin),이종건(CK Lee),나종구(JG Na) 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.1

The adrenergic response of the myometrium and concentration of adrenergic receptors in influenced by exogenous gonadal steroids in rabbit uteri. In human studies, it was also observed many years ago that the uterine contractile response to catecholamine stiumlation could be modulated by changes in the gonadal steroid environment. The ability to inhibit uterine contractions by activation of β-adrenergic receptor (myometrial relaxation) has clinical applications for the treatment of preterm labor. In order to prove the hypothesis that endocrine changes at different phases of the reproductive cycle and gestation might alter the β-adrenergic receptor concentration and affinity, we quantitated β-adrenergic receptor concentration and affinity in myometrium from women during the mid-follicular phase, mid-luteal phase, in postmenopausal women and from women at term pregnancy. Using the radiologand idione 125-labeled iodocyanopindolol with high specific activity and high affinity, the β-adrenergic receptor concentrations were determined. The results were as follows; 1. β-adrenergic receptor concentration and dissociation constant (Kd) were 63.4± 22.2fmol/mg protein and 32.4±13.6pmol/L, respectively from women during the mid follicular phase (estradiol:75~75pg/ml, progesterone:<1ng/ml) of the cycle which corresponded to pure but mild estrogen stimulation. 2. β-adrenergic receptor concentration and dissociation constant (Kd) were 40.8± 12.7fmol/mg protein and 30.8±11.7pmol/L, respectively from women during the midluteal phase (estradiol; 100~300pg/ml, progesterone; 5~20ng/ml) of the cycle which correspond to increased estrogen stimulation, combined with progestestational stimulation. 3. β-adrenergic receptor concentration and dissociation constant (Kd) were 52.8± 11.0 fmol/mg protein and 28.1±8.1pmol/L, respectively from women in postmenopaual phase (estradiol;10~20pg/ml, progesterone; <0.1ng/ml) which are characterized by low circulating levels of gonadal steroid homones. 4. β-adrenergic receptor concentration and dissociation constand (Kd) were32.5± 10.3 fmol/mg protein and 36.9±15.7pmol/L, respectively from women with term pregnancy (estradiol; 10~45ng/ml, progesterone; 75~250ng/ml) which are characterized by very high levels of both estrogen and progesterone. 5. The concentration of β-adrenergic receptor during the mid-follicular phase were significantly increased compared with those during the mid-luteal phase and at term pregnancy. 6. The concentration of β-adrenergic receptor at term pregnancy were significantly decreased compared with those from the non-pregnancy myometrium. But there was no significant difference in dissociation constant (Kd) among the mid-follicular phase, mid-luteal phase, postmenopausal and term pregnancy. The findings suggest that the β-adrenergic receptors in the myometrium might be modulated by endogenous gonadal steroid hormones. But the alteration of myometrial contractility during menstrual cycle and pregnancy may not be directly mediated by β-adrenergic system.

여러가지 임신조건에서의 Toxoplasma 항체역가의 진단적 의의

김영일(YI Kim),이종건(CK Lee),김수평(SP Kim),이헌영(HY Lee),남궁성은(SE Namkoog) 대한산부인과학회 1980 Obstetrics & Gynecology Science Vol.23 No.6

본 연구는 Toxoplasma증이 임신에 미치는 영향과 혈중 Toxoplasma 항체치 측정에 의한 진단적 가치판정을 목적으로 1978년 9월부터 1979년 8월까지 카톨릭의대부속 성모병원, 성바오로병원, 성가병원 및 부평성모병원에 내원하였던 절박유산 및 습관성유산 환자 127예, 조산 및 사산환자 20예 및 정상분만산모 100예를 대상으로 적혈구 응집반응을 이용하여 혈중 Toxoplasma 항체치 측정을 시행한 결과 다음과 같은 결론을 얻었다. 1. 정상분만(대조군)의 경우 Toxoplasma 항체치는 1:16 90.0%, 1:32 8.0%, 1:64 2.0%로 대부분 낮게 나타났다. 2. 대조군과 비교하여 병적 임신에서는 Toxoplasma 항체치가 1:32 이상으로 나타난 경우가 절박유산 19.6%, 습관성유산 30.0%, 조산 16.7%, 사산 50.0%로 현저하게 증가되었으며 Toxoplasma 항체치가 증가함에 따라 병적임신 출현율이 급격히 증가되었다. 3. 이상으로서 혈중 항체치가 1:16일 경우에는 Toxoplasma증을 부인할 수 있고, 1:32-1:64일 때는 으심되는 경우로 계속 추적을 요하며, 1:128이상일 경우에는 Toxoplasma증으로 진단할 수 잇는 판정기준을 설정할 수 있었으며 이러한 예에서는 적극적인 치료를 시행하여 그 예후를 추적하는 것이 타당할 것으로 사료된다. In order to evaluate diagnostic value and influence of toxeplasmosis on pregnancy, semiquantitative titers of serum toxoplasma antibody were measured by Toxotest-MT(Eiken, Japan). One hundred and seven cases of threatened abortion, twenty cases of stillbirth delivery and one hundred cases of control group were evaluated from September, 1978 to August, 1979 in the Department of Obstetrics and Gynecology of Catholic Medical College.

난소 Krukenberg종양 30 예의 임상통계적 관찰

현병규(BK Hyun),이충훈(CH Lee),이종건(CK Lee),김수평(SP Kim),이헌영(HY Lee) 대한산부인과학회 1986 Obstetrics & Gynecology Science Vol.29 No.3

1. 발생빈도는 악성 종양증 11.3%이었으나 연령분포에 따른 발생빈도는 30~49세이었다. 2. 임상적 주소는 종괴촉지, 하복부 팽만감, 소화불량, 복통 및 복수월경이상 순위였다. 3. 임상증상 출현후 Krukenberg 종양 확진시까지의 평균시간은 6.5개월이었다. 34. 일반 외과적 개복수술시 확진된 예가 40%(12예)이었다. 5. 병변이 양측성인 경우가 18예(60%)였으며 일측성이 9예(30%)였다. 6. 원발부위는 위, 대장 순위였으며 위 병소가 76%(23)를 차지했다. 7. 원발병소 확진후 Krukenberg 종양으로 진단내릴때까지의 기간은 13.6개월이었다. 8. 원발성 Krukenberg 종양은 6.6%(2예)이었다. 9. 17예에서 chemotherapy를 시행했으며 regimen은 CCNU, 5-FU, adriamycin, mitomycin 등이었으며 이중 radiation therapy는 1예에서 있었다. 그후 가능했던 추적검사 2예에서 15개월 이상의 생존율을 보였다. A high incidence of stomach carcinoma revealed in Korea led to the general impression that there are large number of Krukenberg tumors. We have observed 30 cases of Krukenberg tumor among 958 cases of ovarian tumor who were admitted, operated and diagnosed at Department of Obstetrics and Gynecology, Catholic Medical Hospital from January, 1975 to June, 1985. The following results were obtained: 1. The incidence of Krukenberg tumor was 3.1% and 11.3% respectively among ovarian tumors(958 cases) and malignant ovarian tumors(265 cases). 2. The highest incidence was shown in the group of 30~49 year of age. 3. Clinical symptoms and signs were palpable abdominal mass, abdominal pain and distension, ascites, menstual irregularity and other gastrointestinal symptoms in order. 4. Mean duration from appearance of clinical symptoms and signs until confirmation of Krukenberg tumor was 6.5 months. 5. Krukenberg tumor was confirmed in 12 cases(40%) by surgical exploratory laparotomy in General Surgery Department. 6. Bilateral involvements were shown in 18 patients(60%) and unilateral confinements were shown in 9 patients(30%). 7. Primary site of carcinoma was found as stomach in 23 cases and colon in 2 cases. 8. Mean duration from confirmation of primary site until confirmation of Krukenberg tumor was 13.6 months. 9. Primary Krukenberg tumor was found in 2 cases(6.6%). 10. Chemotherapy was performed in 17 cases and regimens were CCNU, 5-Fu, Adriamycin and Mitomycin. Among these, radiotherapy was done in 1 case. 11. Survival rate of more than 15 months was shown in 2 cases in which follow-up was possible.

조기진통억제재로서의 Nifedipine과 Ritodrine Hdrochloride가 심혈관 및 대사에 미치는 영향

신종철(JC Shin),백은정(EJ Baik),김사진(SJ Kim),이종승(JS Lee),이종건(CK Lee),김수평(SP Kim) 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.8

Theselection of a tocolytic agent must weight both the safety and the efficacy of the treatment regimen. Ritodrine hydrochloride, a B-sympathomimetic drug, was approved for use as a tocolytic agent. However, there has been growing concern about the side effects induced by this agent. Recent investigations have indicated that nifedipine, a calcium channel entry blocker, may be useful in the treatment of preterm labor. This prospective study compared cardiovascular and metabolic effects measured in associated with nifedipine and ritodrine. Nifedipine caused generally minimal cardiovascular changes. On the other hand, ritodrine caused more pronounced cardiovascular changes than nifedipine. Nifedipine makes no significant alteration in serum electrolytes except calcium. However, ritodrine makes significant changes in serum potassium, calcium and chloride(p

모체 말초혈액내에서 중합효소연쇄반응을 이용한 Y-특이 DNA 염기서열의 검색

신종철(JC Shin),백은정(EJ Baik),박종섭(JS Park),이종승(JS Lee),이종건(CK Lee),나종구(JG Na),남궁성은(SE Namkoong),김수평(SP Kim) 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.1

The detection of a Y-specific DNA sequence from the peripheral blood of a pregnant woman who bears a male fetus has theoretical and practical importance as it would open up the possibility of prenatal diagnosis of genetic diseases, especially X-linked recessive inheritance, using small amount of maternal peripheral blood. Numerous attempts have been to identify XY cells in the blood of mother bearing male fetus. However, the results have been controversal. In this study, we have investigated the use of a dual polymerse chain reaction for the detection of a Y-specific DNA sequence(DYS14) from unsorted peripheral blood of 43 pregnant women who had a gestatinal age of 5 to 40 weeks. The Y-specific band was detected as early as 6 weeks in gestation. The sensitivities for 25 male fetuses were 16%, 40% and 76% in the 18, 21 and 24 cycles of the second PCR, respectively. In the 24 cycles of the second PCR, the sensitivities for male fetuses were 72.7%(8/11), 75%*6/8) and 83.3%(5/6) in the first, second and third trimester, respectively. The corresponding specificities were 83.3%(5/6), 71.4%(5/7) and 80.0%(4/5). Overall 19 of 25 male fetus were positive(76%) and 14 of 18 female fetus were negative(specificity 77.8%). Thus, the positive predictive value was 82.6%(19/23) and the negative predictive value was 70%(14/20). This study was suggested the usefulness of dectection of T-specific DNA sequence from the maternal peripheral blood by using polymerse chain reaction. However, further inverstigatio is necessary to increase the reliability for clinical application because of its false-negative and especially false-positive results.

임신성 고혈압 환자에서 혈소판과 적혈구 용적비의 변화

신재인(JI Shin),김인배(IB Kim),김종호(JH Kim),이종승(JS Lee),이종건(CK Lee),나종구(JG Na),김수평(SP Kim) 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.10

Hematologic abnormalities that accompany preeclampsia and eclampsia have long been recongnized but their clinical significance in the prediction and monitoring remains controvertial. It was noted that the erythrocyte morphologic changes take place in the severe preeclampsia and that it might be caused by altered composition of the cell membrane and microangiopathic hemolysis. The platelet activation followed by its consumption plays an active role in the pathophysiology of this disorder, Increase in platelet size was noted even though platelet count remains within the normal range. In order to investigate the clinical significance of mean platelet volume/mean corpuscular volume ratio(RAT1) in this disorder, RBC platelet morphologic parameters, RAT1 and the correlation between other laboratory and clinical marker and RAT1 were assessed. The results were as follows 1. Mean platelet volume was significantly increased in the servere preeclamptic group compared with normal pregnant control(p