난소에서 Mullerian Inhibiting Substance의 발현

김미란,김장흡,김수평,김진홍,나종구,권동진,강창석,김경미 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.3

Mullerian inhibiting substance(MIS) has been known as a non-steroidal testicular Sertolicell product responsible for the regression of Mullerian duct in male embryos. More recently MIS was also found to be present in an bioactive form in the bovine and rat ovaries but the function of MIS in the ovary has not been fully delineated. In this study, in order to understand its function in the ovary the ontogeny of the production profile of MIS and the pattern of its localization in ovaries from adult normal cycling women were studied by immunohistochemical staining using the rabbit polyclonal antibody against human recombinant MIS that almost completely blocks its biological activity. MIS was detected specifically and exclusively in the cytoplasm of granulosa cells. The flattened granulosa cells in primordial follicles failed to stain for MIS, but the cuboidal cells of growing follicles stained intensely. The granulosa cells of both single and multiple layered growing follicles showed strong specific staining for MIS. Within the multiple layers of granulosa cells, closer to the oocyte, stained more intensely than those near the basement membrane. Similarly, in antral follicles, cumulus cells and periantral granulosa cells stained more intensely than those in the periphery. MIS staining waned in the mature follicles just before ovulation and could not be found in atretic follicles, corpus albicans. In conclusion, this specific localization suggest that MIS may act as an intraovarian regulator of follicular development and oocyte maturation during the adult reproductive cycle.

부인과적 병소에 대한 선택적인 골반장기혈관 조영술

김철성(CS Kim),김성기(SK Kim),송승규(SK Song),김승조(SJ Kim),신경섭(KS Shin) 대한산부인과학회 1975 Obstetrics & Gynecology Science Vol.18 No.11

Pelvic Angiography is simple and safe procedure, may be of great help in early diagnosis and management of gynecologic lesions, especially malignant trophoblastic neoplasms. Malignant trophoblastic neoplasm is a relatively common disease in Korea as other countries. We have attempted to analyze the pelvic angiographic findings in 15 patients. who were 6 cases of trophoblastic disease, 6 cases of cervical cancer and 3 cases of other diseases. The results were obtained as follows; 1. Malignant trophoblastic neoplasms were found more typical changes consisting of opacified irregular vascular spaces with early draining vein, pooling of contrast medium around central avascular areas, displacement of vessels by tumor masses and persistnet stains 2. By pelvic angiography it is valuable diagnostic procedure to make an early diagnosis of choriadenoma destruens which can not be deteceted by curettage and hCG test. 3. By pelvic angiography the metastatic lesion and location can be detected in cervical cancer over clinical stage III.

자간전증 환자의 혈청 , 양수 및 태아 혈청 요산농도

박창수,변지수,송태복,김윤하,최진,김석모,이계율,김경훈 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.7

목적: 정상 임신과 자간전증 환자의 혈청, 양수 및 태아 요산농도를 분석하여 자간전증시 이들의 변화와 상호간의 상관관계를 파악하여 임신과 태아 예후에 어떤 관련이 있는가를 평가하고자한다. 연구 방법: 1996년 1월부터 1998년 4월까지 전남대학교병원 산부인과를 내원하거나 입원하였던 환자를 대상으로하였다. 임신 28주이상의 자간전증 환자 47례와 임신주수가 비슷한 정상 산모 28예에서 혈액과 분만시 제대동맥 혈액을 얻었다. 임신 17주에서부터 27주사이의 정상 산모에서 양수채취는 염색체 배양검사를 하기위해 양수천자를 할 때 얻었고 이들 중 염색체 이상소견이 없는 태아의 양수 84예와 임신 28주이상의 정상 산모 양수는 제대혈액채취적응증인 경우 양수천자를 하여 정상 태아 양수와 제왕절개술을 시행하면서 28예를 얻었으며 임신 28주 이상의 자간전증 환자 47예에서는 양수천자와 제왕절개시 양수를 채취하였다. 요산은 Uricase법으로 측정하였다. 결과: 정상 임신시 양수내 요산은 17주 3.38±0.3 mg/dl, 24주 4.23±0.33 mg/dl, 28주 5.23±0.97 mg/dl, 34주 5.87±1.58, 38주 6.97±0.76 mg/dl으로 임신 주수가 증가할수록 농도가 증가하였다[n=112, r=0.75, p$lt;0.01]. 임신 28주 이 상에서 환자군의 산모 혈청 요산 6.33±1.55 mg/dl, 양수 요산 9.62±2.65mg/dl, 제대동맥 혈청 요산 6.44±1.49 mg/dl는 정상군의 산모 혈청 요산 4.37±0.64 mg/dl, 양수 요산 6.36±1.95 mg/dl, 제대동맥 혈청 요산 4.30±0.92 mg/dl보다 유의하게 높았다 [p$lt;0.01]. 결론: 정상임신에서 양수내 요산농도가 임신주수가 증가 할수록 증가하였고, 자간전증에서 산모 혈청, 양수 및 태아 혈청의 요산 농도가 정상 임신보다 유의하게 증가하였다. 이에따라 자간전증에서 산모의 고요산혈증은 신장기능의 장애로 인한 요산배설의 감소 뿐 만 아니라 태반 및 태아에서 생성된 것도 반영된 것으로 여겨지며 태아 예후 판정에 의미있는 지표로 이용될 수 있을 것으로 사료된다. Objective: Our purpose was to investigate uric acid concentrations of maternal serum, amniotic fluid, and fetal serum in normal pregnancy and preeclampsia. Methods: 112 samples of amniotic fluid obtained from normal pregnancies 17 to 38 weeks gestation, and 28 samples of maternal serum and umbilical arterial cord serum obtained from normal pregnancies in third trimester. Samples of maternal serum, amniotic fluid, and umbilical arterial cord serum were collected from 47 women with preeclampsia in third trimester. Uric acid concentration was measured by enzymatic spectrophotometric method using the enzyme uricase. Results: Amniotic fluid uric acid concentrations increased progressively from 17 to 38 weeks gestation in normal pregnancy [17; 3.38±0.3, 24; 4.23±0.33, 28; 5.23±0.97, 34; 5.87±1.58, 38 weeks; 6.97±0.76 mg/dl, n=112, r=0.75, p$lt;0.01]. In third trimester, amniotic fluid uric acid concentration was significantly increased in women with preeclampsia than with normal pregnancy [9.62±2.65 vs. 6.36±1.95 mg/dl, p$lt;0.01]. Maternal serum [MS] and umbilical arterial cord serum [CS] uric acid concentration were significantly increased in women with preeclampsia than with normal pregnancy [MS; 6.33±1.55 vs. 4.37± 0.64, p$lt;0.01, CS; 6.44±1.49 vs. 4.30±0.92 mg/dl, p$lt;0.01]. Conclusions:Serum uric acid concentrations were significantly increased in pregnant women and fetuses with preeclampsia. Increased production of uric acid in fetus and placenta may contribute to maternal hyperuricemia and high amniotic fluid uric acid concentration in preeclampsia partly.

제왕절개술이 주산기사망율에 미치는 영향에 관한 연구

김석중(SJ Kim),김문종(MJ Kim),김재욱(JU Kim),김철수(CS Kim),곽현모(HM Kwak) 대한산부인과학회 1987 Obstetrics & Gynecology Science Vol.30 No.1

1965년부터 1985년까지 5년간격으로(1965, 1970, 1975, 1980, 1985) 연세대학교 의과대학 세브란스병원에서 분만한 체중 501gm이상의 총 출산아 9,303예를 분석하여 다음과 같은 결론을 얻었다. 1. 혼혈아를 제외한 한국인의 평균 제왕분만율은 18.8%로 1965년 6.9%에서 1985년 25.8%로 증가하였으며, perinatal period II rate는 평균 47.8로 연도간 변화는 파동적으로 약간 감소하는 듯 하였으나 그 통계학적 의의는 없었다. 2. 1965년부터 1985년까지 만 21년동안 체중 1,001gm이상의 39,181예의 분만을 대상으로 조사한 연도별 제왕분만율과 perinatal period I rate의 상관계수는 -0.25로 역상관관계를 보였고 특히 신생아사망율은 -0.36으로 통계학적 의의가 있는 역상관관계를 보였다. 3. 모체연령의 분포는 고위험 임신군인 19세 이하와 48세 이상에서 현저한 감소를 보였으나 perinatal period II rate에는 5.6%의 감소효과밖에 보여주지 않았다. 4. 임신회수와 반만회수의 분포는 각각 4회이상, 3회이상에서 현저한 감소를 보였으나 perinatal oeriod II rate에는 각각 9.9%, 10.0%의 감소효과밖에 보여주지 않았다. 5. 제태연령의 분포는 42주 이상의 의의있는 감소에도 불구하고 20∼24주에서 현저한 증가를 보여서 perinatal period II rate에 35.6%의 악화요인이 되었다. 6. 출산체중의 분포는 비교적 안정되어 있었으나 501∼1,000gm에서만 의의있는 증가를 보여서 perinatal period II rate에 30.4%의 악화요인이 되었다. 7. 태위의 분포는 둔위만 의의있게 증가하였으나 둔위시 제왕분만율이 도리어 높아서 1.9%의 perinatal period II rate 감소효과를 보엿다. 8. 제왕분만 적응증의 연도별 변화는 둔위의 경우만 의의있게 증가하였다. 9. 혼혈아는 한국인에 비하여 모체연령이 젊고, 임신회수가 많은 반면 분만회수는 적으며, 저체중아가 적고 제왕분만율은 다소 높아 평균 perinatal period II rate는 현저히 낮았다. During the past few decades, the incidence of cesarean section had steadily increased with the developments of advanced surgical techniques. Increased rates of cesarean birth partly due to broadened fetal indications coincided with the improvement in perinatal survival. Perinatal mortality is influenced by numerous factors such as socioeconomic class, cultural and geographic characteristics as well as accessibility of sophisticated materno-fetal medicine, and obstetrical and neonatal care. Therefore, whether or not the increase in cesarean section has contributed significantly to reducing perinatal mortality in recent years remains controversial. Based on these, a total of 9,303 cases of birth with birth weights more than 500 grams which were delivered from 1965 to 1985 in 5-year interval at Yonsei University College of Medicine, Severance Hospital and obtained the following results. 1. From 9,302 cases of total births, we excluded the babies of mixed race and selected 8,719 cases. Total cesarean births were 1,635 and the overall cesarean birth rate was 18.8%; the rate rose gradually from 6.9% in 1965 to 22.5% in 1985, and the highest was achieved in 1980 with 28.6%. 2. Perinatal mortality was resulted in 417 cases and the overall perinatal mortality rate was 47.8%, including 190 cases of fetal death and 227 cases of neonatal death. There were no significant differences in the quinquennial perinatal mortality rate. By another analysis based on perinatal period I rate, there were marked decreases in perinatal mortality from 50.7 in 1965 and 34.1 in 1975 to 25.5 in 1985. The correlation of cesarean birth rate with perinatal mortality rate and with neonatal mortality rate showed inverse relationship. Pearson correlation coefficients were -0.24 and -0.36 repectively; the former was statistically not significant(p=0.15), but the latter was significant(p=0.60).

우리나라 대장용종의 임상 특성 -대한장연구학회 다기관 공동연구-

한동수 ( Han DS ),양석균 ( Yang S-K ),김원호 ( Kim WH ),김진오 ( Kim JO ),김진호 ( Kim J-H ),김태일 ( Kim TI ),김효종 ( Kim HJ ),명승재 ( Myung S-J ),박영숙 ( Park YS ),은창수 ( Eun CS ),이문성 ( Lee MS ),이상혁 ( Lee SH ),정문관 ( Jung MK 대한소화기학회 2002 대한소화기학회 추계학술대회 Vol.2002 No.-

EFFECTS OF CHITOSAN ON WOUND HEALING IN PIGS

Kim, MC,Byun, HS,Kim, MJ,Lee, JY,Jeong, KH,Cho, SW,Park, CS 충남대학교 형질전환복제돼지연구센터 2007 논문집 Vol. No.10

17 a-Hydroxylase 결핍으로 인한 남성가성반음양 1 예

김장흡,김진홍,나종구,최소영,강창석,김재훈 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.4

A 21-year-old phenotypic female with 46,XY genotype presented with primary amenorrhea, headache, absence of secondary sex characteristics, and hypertension. Further evaluation confirmed male pseudohermaphroditism having no nterus and adnexase. After basic hormonal study and ACTH stimulation test, we concluded 17 a-hydroxylase deficiency. Owing to the high risk of gonadal neoplasia in XY gonadal streaks, prophylactic removal of the steaks is recommended. Traditionally this procedure has been performed by laparotomy, but in this case laparoscopic gonadctomy was performed. Following treatment with hydrocrtisone, potassium, progesterone, 11-deoxycorticosterone, corticosterone and urinay pregnanediol levels were normalized. normal blood pressure measurements were achieved during treatment with hydrocortisone and estrogen with the patient. We report this case with a breif review of the literatures.

전이성 뇌종양 환자의 예후 인자

김철수,강삼석,정 신,김재휴,이정길,김태선,김수한,이제혁 대한신경외과학회 2002 Journal of Korean neurosurgical society Vol.31 No.3

30-day and In-hospital Mortality after Curative Resection of Gastric Cancer and Its Clinicopathologic Characteristics

CS Gong,MW Yoo,IS Lee,HS Kim,BS Kim,JH Yook,ST Oh,BS Kim 대한종양외과학회 2015 대한임상종양학회 학술대회지 Vol.2015 No.2

Cytotoxic Effect of Urushiol on Human Stomach Cancer Cells

Kim SH,Lee JH,Im EO,Jung NC,Na CS,Kim KW,Jung HY,Kim ND 대한약학회 2000 大韓藥學會 總會 및 學術大會 Vol.49 No.-