조기임신 및 융모성질환이 혈청 Testosterone 값

정재근(JK Jung),조봉춘(BC Cho),강성원(SW Kang),정구윤(KY Chung),김승조(SJ Kim) 대한산부인과학회 1979 Obstetrics & Gynecology Science Vol.22 No.9

저자들은 융모성질환의 보조진단법으로서 요중 hCG값과 혈중 testosterone값과의 관계와 이 질환에서 치료전후에 따른 혈중 testosterone값의 변동을 추구하고자 포사기태 환자 9명 및 융모상피암 환자 10명과 대조군으로 정상비임신 10명, 정상임신 20명에서 혈중 testosterone값을 방사면역측정법으로 측정한 결과 다음과 같은 결론을 얻었다. 1. 정상비임신부의 중간황체기의 혈청 testosterone값은 평균 0.57±0.09ng/ml이었고, 조기임신의 혈청 testosterone값은 0.87±0.09ng/ml로서 임신주수에 따른 변화는 없었다. 2. 포상기태 및 융모상피암의 혈청 testosterone값은 정상임신보다 높았고, 포상기태가 융모상피암보다 높았으며, 포상기태 및 융모상피암의 치료 후의 혈청 testosterone값은 감소하는 경향을 보였으며, 혈청 testosterone값과 요중 hCG값 사이에는 양적인 관계는 없었다. 3. 융모서질환에서 포막황체낭종을 가진 환자에서는 포막황체낭종을 촉지할 수 없는 환자보다는 혈청 testosterone값이 높았으나 융모상피암에서는 유의한 차이는 없었다.

부인의 자궁경부 및 직장 도찰 피검물에서의 혐기균의 분리빈도

정재근(JK Jung),배석년(SN Bae),박종섭(JS Park),윤순옥(SO Yoon),김은중(EJ Kim),이종훈(CH Lee) 대한산부인과학회 1984 Obstetrics & Gynecology Science Vol.27 No.3

부인 생식기 계통 및 직장내에서의 혐기균의 분리빈도를 알아보기 위하여 산부인과 외래환자 87명, 임신부 68명, 정기 신검자 및 단순 검사의뢰자 60명 합해서 215명을 대상으로 하였다. 일부 검사 대상자에서는 자궁경부 도찰과 직장 도찰을 동시에 하였다. 이들 도찰물을 thioglycollate배 양액에서 증균시킨후 BHIBSA평판 배지에 획선 도말하여 Gas Par Jar내에서 협기균을 분리 배양하였 다. 배양 후 분리균주에 대한 그람염색상의 형태, 생화학적 성상, 연령별 분포를 관찰 조사하고 또한 항생제에 대한 감수성 실험을 실시하여 다음과 같은 결론을 얻었다. 1. 총 검사물 297건중 혐기성 세균이 218주(73.4%)가 분리되었다. 자궁경부 도찰물 190건 중에서 혐 기균주는 142주가 분리되었고 (74.7%), 직장 도찰물에서는 107건중 76주가 분리되었다.(71.0%). 자궁경부 에서는 그람음성 간균이 70.4%, 그람양성 구균이 26.8%였으며, 직장에서는 그람음성 간균이 27.6%였다. 2. 연령별로는 21세에서 40세 사이가 전체의 72.9%였으며, 자궁경부에 78%, 직장에 63.2%를 점유하였 다. 3. 자궁경부에서 분리된 혐기균 주에서는 Bacteroides ovatus, B. fragilis, B. vulgatus, Peptostretococcus products 순으로 많았고, 직장도찰물에서는 Eubacterium aeroficience, b. fragilis, Peptostreptococcus productus순이었다. 4. 자궁경부 및 직장에서 분리된 혐기성균주의 대부분이 항생제에 대하여 내성이 높았으나 Chloramphenicol과 kanamycin에 대하여는 다소 감수성을 나타냈다. To observe the distribution and frequency of anaerobes from the uterine cervix and rectum in women, a total of 297 specimens (cervix; 190, rectum; 107) were obtained from 123 swabs from healthy women (n=60), 106 swabs from out-patient women(n=87) and 68 swabs from pregnant women (n=68). 82 swabs (n=41) of 229 specimens were abtained both from the uterine cervix and rectum in the same persons. Cervical and rectal swabs were put into thioglycollate medium and immediately transferred to the labortory. After 48 hours incubation in thiogly collate medium at 37℃, anaerobes were isolated by culture on the brain heart in fusion blood supplemented agar (BHIBSA). Sugar fermentation on isolated anaerobes was performed by miniteck plate and sensitivity to antiiotics was measured by_Kirby-Bauer method. All procedures were performed under the anaerobic condition. The results were as follows: 1. Total 218 strains of anaerobes were isolated from 297 specimens. 142 strains were isolated from 190 specimens of uterine cervix (74%), 76 strains from 107 specimens of rectal swabs(71%). In uterine cervix, gram negative bacilli (70.4%) were predominantly isolated, and the next was gram positive cocci (26.8%). In rectal swabs, the rate of isolated anaerobes between gram positive (32.9%) and negative (39.5%) bacilli were similar. 2. Most strains of anaerobes isolated from uterine cervix (78.1%) and rectal swabs (63.2%) were distributed in 20∼40 year old age. 3. Of total 142 strains isolated from uterine cervix, the most frequent strains were Bacteroides obatus, B. fragilis, B. vulgatus and Peptostreptococcus productus in the decreasing order of frequency. Of total 76 strains isolated from rectal swabs, the most frequent strains were Eubacterium aeroficience, B. frgilis, P. productus in the decreasing order of frequency. 4. Isolated anaerobic strains were mostly resistant to tested antibiotics. A few strains were susceptible in some degree to chloramphenicol and kanamycin.

임상적 및 생화학적 위험인자를 이용한 포상기태 임신의 임상적 분류

정병헌(BH Jung),마수영(SY Ma),정재근(JK Jung),고광덕(KD Ko),김대훈(DH Kim),김승조(SJ Kim) 대한산부인과학회 1991 Obstetrics & Gynecology Science Vol.34 No.2

Forty nine cases (spontaneous remission 25, persistent gestational trophoblastic tumor 24) of untreated hydatidiform mole who were registered at Korean Research Institute of Trophoblastic Disease (KRI-TRD) in Catholic University Medical College were evaluated regarding clinical and biochemical risk factors such as -hCG, SP1, SP1/ -hCG(%), PP10, human placental lactogen, prolactin, and steroid hormones. And then, all factors were analyzed for measuring degree of discrimination used with Stepwise Discriminant Analysis through SPSS computer program. The results were as follows; 1. In comparison of clinical factors, parity and uterine size and weeks difference were different significantly(P<0.05)in student-test.

전자간증 환자의 혈청 Antithrombin-Ⅲ 값의 임상적 의의

배석년(SN Bae),정재근(JK Jung),이헌영(HY Lee) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.9

1983년 6월 1일부터 1983년 12월 31일까지 강남성모병원 및 성바오로병원 산부인과에서 입원, 분만한 정상 산모(18명) 및 전자간증 산모(경증 13명 : 중증 16명)를 대상으로 분만전, 분만후 24시간, 72시간에 모체의 혈소판, 혈청 FDP 및 혈청 AT-Ⅲ 값을 측정분석하여 다음과 같은 결론을 얻었다. 1. 질환의 중증도에 따라 평균 혈소판값은 감소되었으나 대조군에 비해 경증군에서는 현저한 변화가 없었지만 중증군에서는 1 SD이상의 감소를 보였고 분만후에는 통계적으로 유의한 증가를 보였다 (P<0.05). 2. 대조군 및 경증군에서의 분만전후의 FDP 값은 모두 정상범위(10㎍/㎖ 이하)였으며 중증군에서는 분만전에는 75%, 분만후 72시간에는 6%가 비정상(10㎍/㎖)이였다. 3. 대조군에서의 분만전후 평균 AT-Ⅲ값은 모두 정상범위내(23.1∼37.5㎍/㎗)에 있었다. 전자간증군에 서는 질환의 중증도에 따라 통계적으로 유의한 감소가 있었다(P<0.05). 대조군에 비해 경증군과 중증 군에서는 각각 1 SD, 2 SD이상의 감소가 있었고 분만후 증가하였다(P<0.05). In oreder to evaluate the significance of antithrombin-Ⅲ value in preeclampsia we studiedf antepartum and postpartum changes of platelets count, serum fibrin degradation products and serum antithrombin-Ⅲ in 18 normal pregnant women as a control group and 29 preeclamptic patients as a mild and a severe group who were delivered between June 1, 1983 December 31, 1983 at the Kangnam St Mary`s Hospital and St. Paul`s Hospital The results were as follows: 1. Mean platelet counts in the control and the mild and severe group were within normal limits(15-40x104/mm2) Mean platelets count were decreased in proportion to the degree of severity of diseas Compared with the control group there were no significant changes in the mild group But platelet counts were decreased over ISD before delivery and it showed significant increase after delivery (P<0.05) in the severa group 2. Serum fibrin degradation products were negative(below 10g/ml) in the control and mild groups but positive(10-40m/) in 75% of severe group 3.Mean antithrombin-Ⅲ value in the control value in the control group was within normal ranges in proportion to the severity of disease. Compared with the control group there were decrease over 1 SD and 2 SD in the mild and the severe group respectively adn significnat increase agter delivery(P<0.05) We concluded from the above results that serum antithombin-Ⅲ test is important to make diagnosis and to predict the prognosis of preeclampsia.

만삭임신에서 거대난소암의 자연파열 1예

김명서(MS Kim),정재근(JK Jung),함재홍(JH Ham),허필형(PH Hur) 대한산부인과학회 1981 Obstetrics & Gynecology Science Vol.24 No.6

저자들은 1979년 1월 가톨릭의과대학부속 성모자애병원에서 수술후 병리학적으로 확진된 난 소의 점액소성낭선암의 자연파열과 자간을 수반한 만삭임신의 1예를 경험하였기에 간략한 문헌고찰과 아울러 증례를 보고하였다. Primary ovarian carcinoma associated with pregnancy is quite uncommon. In view of its rarity, complications and policy of the management of mother and fetus, it could offer real problems in clinical practice. After presenting a clinical history of the following case, a review of the previously reported cases of ovarian cancer, including benign ovarian tumor, in pregnancy is represented.

임신성 융모성 질환과 Telomerase 활성도의 관계

배석년(SN Bae),정재근(JK Jung),최은아(EA Choi),김재선(JS Kim),김동주(DJ Kim),안현영(HY Ahn),김승조(SJ Kim) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.6

The purpose of this study was to evaluate the significance of telomerase activity in gestational trophoblastic disease and the association of telomerase activity in complete hydatidiform mole and subsequent development of persistent gestational trophoblastic tumor. By using the standard telomerase repeat assay, we examined telomerase activity in 2 normal placentas, 31 complete hydatidiform moles, 7 invasive moles, 5 choriocarcinoma tissues and choriocarcinoma cell line (JEG-3). Telomerase activity was detected in 13 of 15 (86.7%) complete hydatidiform mole patients who eventually had chemotherapy for the treatment of persistent gestational trophoblastic tumor. All of the 9 patients with metastatic disease (FIGO Stage Ⅲ) had telomerase activity in their initial molar tissue. In contrast, telomerase activity was evident in only two of 16 (12.5%) complete hydatidiform mole patients with spontaneous remission. While telomerase activity was not detected in normal placentas, high level of telomerase activity was detected in all of 7 invasive moles, 5 choriocarcinoma tissues and choriocarcinoma cell line (JEG-3). The presence of telomerase activity in a complete hydatidiform mole is associated with the development of persistent gestational trophoblastic tumor, such as invasive mole and choriocarcinoma.

고위험 포상기태의 예측인자로서 혈중태반 단백 ( SP1 ) 과 유리 B-Human Chorionic Gonadotropin의 측정값

김미란(MR Kim),김장흡(JH Kim),정재근(JK Jung),김승조(SJ Kim) 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.2

To evalute the role of serum pregnancy-specific B1-glycoprotein and free B-subunit of human chorionic gonardotropin(B-hCG) as a prognostic predictor, 55cases of hydatidiform mole and 22 cases of normal pregnancy were studied Using RIA procedures, we determined the concentration of serum total B-hCG, free B-hCG and SP1 at initial diagnosis. The patients had adequate follow up to clearly estabilish eventual outcome, in regrad to spontaneous regression (33 patients ) or presistent trophoblastic disease (22 patients ). And then , we compared hydatidiform mole scoring system (KRI-TRD, 1983) with SP1/total B-hCG ratio and free B-hCG/total B-hCG ratio for prediction of high risk mole. The results were as followes: 1. The mean serum levels of total B-hCG, Free B-hCG and free B-hCG/total B-hCG ratio were significantly increased in hydatidiform mole patients compared with normal pregnant women (P

자궁경부암 근치술후의 성생활의 변화에 관한 연구

지용헌(YH Chee),이원(W Lee),정재근(JK Jung),김대훈(DH Kim),김도강(DK Kim),남궁성은(SE Namkoong),김승조(SJ Kim) 대한산부인과학회 1991 Obstetrics & Gynecology Science Vol.34 No.1

This study was designed to investigate physical and psychological stress and depression after radical hysterectomy by means of clinical interview and Hamilton`s rating scale for depression. The structured interviews of 53 radical hysterectomy patients as experimental group and 51 total hysterectomy patients as control group were performed. The results were as follows. 1. The educational and economical levels of radical hysterectomy patients were lower than that of total hysterectomy patients. 2. The two groups were significantly different in terms of loss of orgasm, loss of sexual desire and frigidity. While there was no significant difference in impotence, premature ejaculation, retarded ejaculation and extramarital sex on the part of the husband except in sexual desire. 3. Significantly more patients of radical hysterectomy thought of loss of husband`s affection, loss of womanliness and change of husband`s attitude as the problem of life than total hysterectomy patients. More radical hysterectomy patients replied that their disease had come from husband and the conversations with the same disease were helpful to them. 4. Depression of radical hysterectomy patients was inclined to be higer than that of total hysterectomy patients. 5. Hamilton`s depression score of radical hysterectomy patient is significantly different from that of total hysterectomy patients in depressive mood, guilt, suicide, insomnia, work and interest, retardation, agitation, psychic and somatic anxiety, somatic general, hypochodriasis, helplessness, hopelessness and worthlessness. In the process of radical hysterectomy patient treating, it is required to advise the patient on change of sexual life and depression, to help the patients to maintain her life through conversations with the same disease and to help the patient to get understanding and cooperation from her husband and members of her family as their attitude has influence on patient`s adaptation.

Placental Site Trophoblastic Tumor의 임상병리학적 특징에 관한 연구

김승조(SJ Kim),이헌영(HY Lee),남궁성은(SE Namkoong),정재근(JK Jung),나덕진(DJ Rah),정기욱(KW Chung),신희정(HJ Shin),이원희(WH Lee) 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.3

Placental site trophoblastic tumor (PSTT) is a rare from of gestational trophoblastic disease and the patients with a placental site trophoblastic tumor clearly present a wide rage of clinical courses. Because of its apparent benign nature, it was originally termed trophoblastic pseudotumor of the uterus. The name was later changed when cases were reported of metastatic tumors resistant to chemotherapy leading to he death of the patients. We have studied clinicopathological study on placental site trophoblastic tumor correlation of PSTT in 4patients from January 1986 to December 1991 at Department of Obstetrics and Gynecology, Catholic University Medical College, and the results were as follows: 1. The mean age of PSTT was 28 years old and mean parity was 0.75. 2. The antecedent pregnnacy ended in term pregnancy in two patients, H-mole in one patiend and premature, preeclampsia with congenital anomaly in one patient. 3. The interval from the antecedent pregnancy to diagnosis of PSTT ranged from 10 to 28 (mean 16.8) months. 4. Presenting symptom was vaginal spotting in 3 patients and secondary amenorrhea in one patient. 5. Pretreatment hCG levels obtained in 3 patients ranged 28-858 mIU/ml but one patient have a high value as 13,480 mIU/ml. The pretreatment hPL levels obtained in 1 patients was a 0.1 mg/ml. 6. All four were diagnosed as having a PSTT by endometrial curretage and all were initially determined to have nonmetastatic lesion. 7. Two patients were treated by total abdominal hysterectomy and adjuvant chemotherapy and two patients were treated with chemotherapy only. All four have remaiend in clinical and gonadotropin remission and two of them have outcome of normal pregnancy.

자궁적출술을 시행한 폐경 후 여성에서 혈청지질 및 지단백질치에 미치는 에스트로겐 보충요법의 영향

원종천(JC Won),조숙(S Cho),정강우(KW Jung),최범(B Choi),황성욱(SW Hwang),고승권(SK Koh),이우영(WY Lee),정재근(JK Jung) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.9

Estrogen replacement therapy in postmenopausal women has been known to reduce the risk of cardiovascular disease, and this effect is thought to be mediated in part by favorable changes in serum lipids and lipoproteins. The other cardiovascular protective effects of estrog-ens are vasodilation, anticoagulation and an antiatherosclerosis effects on blood vessels. To elucidate the main effects of estrogen on the levels of serum lipids and lipoproteins, we conducted the randomized trials of oral and transdermal estrogens in healthy hysterectomized postmenopausal women. In this study, the first group(57 patients) received Premarin(conjugated estrogen) 0.625 mg per day. And the second group(53 patients) received transdermal estradiol patches(Estraderm TTS 50) twice weekly. Serum total cholesterol, triglyceride, HDL cholesterol, and LDL cholesterol levels in fasting state were measured in all subjects before treatment and 6 months after treatment. In both groups, serum total cholesterol levels and serum LDL cholesterol levels were decreased significantly after 6 months of treatment. Also, serum HDL cholesterol levels were increased significantly after treatment. Serum triglyceride level was increased in group 1 and decreased in group 2, but there were no statistical significances. The degrees of change were not differ significantly in both groups. These data suggests that the postmenopausal use of estrogens in hysterectomized women, administered by either oral or transdermal route favorably alters serum LDL and HDL levels that may protect women against cardiovascular disease and there are no significant differences statistically between two regimens on the serum lipids and lipoprotein levels. Considering the costs, the side effects and the compliance of patients on the estrogen replacement therapy, oral forms of estrogen are thought to be the first line of therapy in hysterectomized postmenopausal women.