모체의 혈중 단백 및 스테로이드 호르몬 측정을 이용한 절박유산의 예후 판정

김기원(KW Kim),함재홍(JH Ham),김대훈(DH Kim),김도강(DK Kim),이진우(JW Lee) 대한산부인과학회 1980 Obstetrics & Gynecology Science Vol.23 No.4

임신 제5-20주의 정상임신(대조군) 241예와 절박유산(실험군) 82예중 정상임신 진행군 38예 및 유산군 44예의 832 가검물로부터 24시간 뇨중 hCG, 혈중hPL, hPRL, AFP, estradiol-17β, estriol, progesterone, testosterone 및 cortisol을 측정하여 대조군 및 절박 유산 각군의 임신 주수에 따른 변동상황을 관차하고 측정치들의 분포와 절박유산의 예후를 비교 관찰한 결과 다음과 같 은 결론을 얻었다. 1. 대조군의 뇨중 hCG, 혈중 hPL, AFP, estradiol-17β, estriol, progesterone, testosterone 및 cortisol등 9가지 호르몬 또 는 혈청단백의 임신 각주에 따른 변동을 측정하였던 바 대다수의 다른 관찰자들과 일치 하였다. 2. 일반적으로 이들 9가지 호르몬 또는 혈청단백 측정의 모든 경우에서 절박유산군 중 정상임신 진행군의 임신 각주에 따른 측 정치는 대조군보다는 낮았지만 유의한 차는 없었다. 3. 일반적으로 이들 9가지의 호르몬 또는 혈청단백 측정의 모든 경우에서 절박유산군 중 유산군에서 임신 각주에 따른 측정치는 대조군보다는 현저하게 낮았고 이들중 대조군 및 정상임신 진행군 양자 모두에 비하여 유의한 차를 보인 것은 뇨중 hCG, 혈중 hPL, hPRL 및 estradiol-17β로서 이 4가지 호르몬 측정이 절박유산 예후판정의 가장 좋은 지표이었다. 4. 대조군에서 임신 각주의 평균-표준편차 이상의 측정치를 정상범위로 그 미만의 측정치를 정상범위 미만으로 간주하였을 때 뇨중 hCG, 혈중 hPL, hPRL 및 estradiool-17β의 절박유산 예후판정율은 각각 76.8, 80.9, 86.1 및 83.7%이었다. 5. 이들 4가지 호르몬 측정치중 임의의 2, 3 및 4가지를 동시에 고려하였을 때의 전반적인 정상임신 진행판정율은 각각 92.7, 97.7 및 100.0%이었다. 6. 이들 4가지 호르몬 측정치중 임의의 2, 3 및 4가지를 동시에 고려하였을 때의 전체적인 유산판정율은 각각 95.9, 99.1 및 100.0%이었다. 7. 이상의 결과로 보아 절박유산의 예후를 생화학적 검사로 측정 감시하기 위하여는 뇨ㅈ hCG, 혈중 hPL, hPRL 및 estradiol-17 β의 변동 중 적어도 3가지 이상을 동시에 관찰함으로써 거의 완전한 결과를 얻을 거승로 기대된다. For the purpose of evaluating the prognosis of the patients of threatened abortion the 24 hour-urinary titer if human chorionic gonadotropin, serum levels of placeful lactogen, prolactin, alpha-fetopretein, estradiol-17b, total estriol, progesterone, testosteronr and cortisol in 862 urine and serum samples from 241 cases of narmal pregnancy and 82 cases of threatemed abortion were measures weelky from 5th to 20th gestational weeks. Thw group of threatened abortion was again divided into 2 subgroups, that of 38 cases of favorable outcome in which the cases progress to narmal pregnancy up to at least 28th gestational weeks and that of 44 cases poor pregbosis in which the cases terminated in abortion within 28th gestational weeks. Thw changing patterns of all the data of 3 groups according to their gestational weeks were compared with each other. And considering certain data above the value of Mean minus I.S.D. of control group as normal and those below that value as subnormal all the data were compared with their own prognosis. Thw result were as follows. 1) In the subgroup of favorable outcome of threatened abortion, the levels of all 9 parameters of urinary hCG, serum hPL, hPRL, AFP, estradiol-17b, total estriol, progesterone, testosterone andcortisol were considerably lower than those of control group in geneal but were not significant statistically. 2) In the subgroup of abortion all those of 9 parameters were signifiantly lower than those of control group but those of only 4 parameters of urinary hCG, serum hPL, hPRL and estradiol-17b were significantly lower than those of both the control group and the subgroup of favourable putcome in general. 3) The accuracy rates to predic: the prognosis of threatened abortion with each of most rliable 4 hormonal parameters- urinary hCG, serum gPL, hPRL and estradiol-17b - were 76.8, 80.9, 86.1 and 83.7% respectively. 4) The overall accuracy rates to predict favorable outcome with any 2, 3 and all 4 normal rnages among most reliable above 4 hormaonal parameters were 92.7, 97.7 and 100.0% respectively. 5) The overall accuracy rates to predict abortion with any 2, 3, all 4 subnormal ranges among most reliable above 4 hormonal parameters were 93.9, 99.1 and 100.0% respectively. 6) Considering the results mentioned above, measurement of 4 parameters of urinary hCG, serum hPL, hPRL and estadiol-17b evaluating at least 3 ones simultaneously can be preferred in evaluating and predicting the prognosis of threatened abortion.

Brain abnormalities in Sjogren syndrome with recurrent CNS manifestations: association with neuromyelitis optica

Min, JH,Kim, HJ,Kim, BJ,Lee, KW,Sunwoo, IN,Kim, SM,Kim, BJ,Kim, SH,Park, MS,Waters, P,Vincent, A,Sung, JJ,Lee, KH SAGE Publications 2009 Multiple sclerosis journal: clinical and laborator Vol.15 No.9

<P><B>Background and objectives</B></P><P>Optic neuritis or longitudinally extensive myelitis in Sjogren syndrome (SS) suggests a neuromyelitis optica spectrum disorder (NMOSD). However, brain abnormalities of SS remain to be elucidated for the association with neuromyelitis optica (NMO).</P><P><B>Methods</B></P><P>Twelve primary SS patients (all women, 42?±?13.2?years) who had recurrent central nervous system (CNS) manifestations with brain involvement were retrospectively identified. Brain MRI, and neurologic and serologic findings were analyzed with the measurement of anti-aquaporin-4 antibody (AQP4-Ab).</P><P><B>Results</B></P><P>All patients showed brain lesions characteristic of NMO as follows: 1) the involved sites adjacent to the third and fourth ventricles and in the posterior limb of the internal capsule, 2) unique configurations, such as the longitudinal course from the internal capsule to the midbrain, large cerebral or cerebellar lesions over 3?cm, and cavity-like formations. AQP4-Ab was positive in six of eight patients tested, and all the seropositive patients showed lesions with increased diffusion, suggestive of vasogenic edema. Four patients met the revised criteria of NMO, and nine had features of NMOSDs. Of the remaining three patients showing only brain involvement, one had AQP4-Ab.</P><P><B>Conclusions</B></P><P>This study demonstrates that SS patients with recurrent CNS involvement have brain abnormalities characteristic of NMO and AQP4-Ab in Korea. The presence of AQP4-Ab in one SS patient with only brain involvement may suggest that the coexistence of NMO should be explored in SS patients with recurrent CNS manifestations, even without optic neuritis or myelitis.</P>

Dysregulation of the Wnt/β-catenin signaling pathway via Rnf146 upregulation in a VPA-induced mouse model of autism spectrum disorder

Park Gaeun,Jang Wooyoung Eric,Kim Seoyeon,Gonzales Edson Luck,Ji Jungeun,Choi Seunghwan,Kim Yujin,Park Ji Hwan,Mohammad Hazara Begum,Bang Geul,Kang Minkyung,Kim Soobin,Jeon Se Jin,Kim Jin Young,Kim Kw 생화학분자생물학회 2023 Experimental and molecular medicine Vol.55 No.-

Autism spectrum disorder (ASD) is a neurodevelopmental disorder associated with impaired social behavior and communication, repetitive behaviors, and restricted interests. In addition to genetic factors, environmental factors such as prenatal drug exposure contribute to the development of ASD. However, how those prenatal factors induce behavioral deficits in the adult stage is not clear. To elucidate ASD pathogenesis at the molecular level, we performed a high-resolution mass spectrometry-based quantitative proteomic analysis on the prefrontal cortex (PFC) of mice exposed to valproic acid (VPA) in utero, a widely used animal model of ASD. Differentially expressed proteins (DEPs) in VPA-exposed mice showed significant overlap with ASD risk genes, including differentially expressed genes from the postmortem cortex of ASD patients. Functional annotations of the DEPs revealed significant enrichment in the Wnt/β-catenin signaling pathway, which is dysregulated by the upregulation of Rnf146 in VPA-exposed mice. Consistently, overexpressing Rnf146 in the PFC impaired social behaviors and altered the Wnt signaling pathway in adult mice. Furthermore, Rnf146-overexpressing PFC neurons showed increased excitatory synaptic transmission, which may underlie impaired social behavior. These results demonstrate that Rnf146 is critical for social behavior and that dysregulation of Rnf146 underlies social deficits in VPA-exposed mice.

導入 機器의 效率的 活用을 위한 敎授-學習 敎材의 開發 : 8 個 學科 共同 硏究

李昌甲,孟琦錫,李載元,朴萬植,廷吉煥,金鍾悟,朴景采,李英浩,李東周,邕章祐,柳盛淵,趙澤東,姜理錫,李殷雄,李興浩,金健中,韓相玉,金良模,張錫明,朴俊灝,洪鳳植,金太均,金再韓,宋海永,盧載星 충남대학교 공업교육연구소 1982 論文集 Vol.5 No.1

In this study, through the combined effort and collaboration of 8 engineering education departments, teaching-learning processes and models were reviewed, and printed and bound student manuals developed on 120 different tasks and subjects. Audio-visual supportive material, already in use in laboratories, was added to form a complete teaching-learning package. In addition to promoting the maximum use of the newly acquired equipment, this study will also contribute to the development of laboratory practice, the in-service training of technical high schools teachers and help in the development of their own instructional program.

우측 대장암 환자 문맥혈에서의 Cytokeratin 19 및 20의 발현

김홍,김봉완,김혜진,서광욱 대한대장항문학회 2003 Annals of Coloproctolgy Vol.19 No.5

임신 16 주의 자궁파열 1 예

김영신,김장흡,김수평,정기욱,노성희,정대영 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.11

자궁파열은 빈도가 적고 합병증이 생기기 전에 진단이 어려워서 태아사망률, 산모의 이환률 및 사망률이 높은 응급을 요하는 산과적 질환이다. 저자들은 임신 16주에 자연 자궁파열 1예를 응급자궁경상부 적출술로 치료하였기에 간단한 문헌고찰과 함께 보고하는 바이다. Spontaneous rupture of the uterus is one of the most formidable accidents resulting in rapid exsanguination and high mortality despite of prompt therapy and massive trasfusion. Maternal and fetal mortality were decreased due to obstetrical and hosalizational development. But it was important and difficult work in early deection, porper treatment, and prevention. We present a case of spontaneous rupture of the uterus in 16 weeks of pregnancy with brief literature.

Membranous Nephropathy after Allogeneic Hematopoietic Stem Cell Transplantation in a Patient with Aplastic Anemia: A Case Report

Kim KW 대한의학회 2003 Journal of Korean medical science Vol.18 No.2

Bacterial Pathogens in the Lower Respiratory Tract of Infants and Children

(Kim KW),(Amarales L),(Dab I),(De Schutter I),(Malfroot A),(Pierard D) 대한 소아알레르기 호흡기학회(구 대한소아알레르기 및 호흡기학회) 1998 Supplement Vol.8 No.2

여러가지 형태의 난관결찰 부인에서 고정대를 이용한 미세난관문합수술

김장흡,김수평,김진홍,임용택,김은중,정기욱,권동진,고영미 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.6

저자들은 고정대를 이용한 미세난관복원수술 후 난관의 소통성과 여러가지 난관복원수술에 영향을 미치는 요인들에 따른 임신율을 알아보고져 1988년 3월부터 1994년 2월까지 가톨릭 의과대학부속 성모병원 산부인과 불임크리닉을 내원하여 고정대를 이용한 난관복원수술을 받았던 285예중 1년이상 추적이 가능했던 110예를 분석하여 다음과 같은 결론을 얻었다. 1. 난관복원술 당시의 환자의 평균 연령은 30.4±1.3(24~39)세 였으며 불임수술 후 복원수술까지의 기간은 평균 6.5±2.7(1~16)년 이었다. 2. 과거에 시술 받았던 불임수술의 종류중 복강경 시술이 88.2%로 대부분을 차지하였고 그중 전기소작법이 47.3%, ring을 이용한 난관결찰술이 40.9%였다. 3. 시행된 난관문합술의 부위별 분포는 협부-팽대부 문합이 49.1%로 가장 많았으며 그 다음으로는 협부-협부 문합이 36.4%로 많았다. 4. 고정대를 이용한 난관복원수술 후 전체적인 임신율은 80.0%였고 그 결과를 보면 만삭분만이 40.9%, 현재 진행중인 임신이 32.8%, 자연유산이 4.5%, 자궁외임신이 1.8%였다. 5. 불임시술방식에 따른 임신율과 복원수술 후 난관길이를 보면 복강경에 의한 ring삽입의 경우 각각 93.3%와 7.3±1.2cm로 전기소작술의 69.2%와 5.1±1.3cm보다 통계적으로 의의있게 높고 길었다. 6. 난관문합 부위에 따른 난관소통성과 임신율은 협부-협부 문합에서 각각 100.0%와 90.0%로 가장 높았다. 7. 임신이 된 군의 복원수술 후 평균 난관 길이는 6.6±1.5cm으로 임신이 안된 군의 4.4±1.6cm보다 통계적으로 의의있게 길었다. 8. 복원수술 후 양쪽 난관의 길이가 모두 4cm이상인 경우, 한쪽만 4cm 이상인 경우, 양쪽 모두 4cm이하인 경우의 순으로 임신율이 통계적으로 의의있게 높은 것으로 나타났다. 9. 고정대 삽입기간(3일 또는 7일)에 따른 난관소통성과 이신율의 차이는 없었다. 10. 복원수술 당시의 월경주기(중식기 또는 분비기)에 따른 임신율의 차이는 없었다. 이상의 결과로 이미 저자들에 의한 가토 난관에서 실험결과 고정대의 잔존이 난관의 점막세포 및 난관의 운동성에 영향을 주지 않고 난관의 소통성을 높여준다는 사실이 확인된 바와 같이 영구피임 목적으로 여러가지 형태의 난관결찰 수술을 받은 부인들에서 난관복원 수술시 1주일 동안의 고정대 삽입은 난관의 소통성과 임신율을 증대시킬 뿐만 아니라 문합부위의 노출을 좋게하여 문합수술의 시간을 단축시켜 수술 후 입원기간의 단축에도 많은 도움이 될 것으로 생각된다. Many methods have been tried to raise the rate of success of tuboplasty. The purpose of tuboplasty is to maintain tubal patency, to prevent postoperative adhesion, and to prevent abortion and tubal pregnancy for term delivery. Various kinds of tubal splints have been used to maintain the tubal patency after tubal anastomosis of experimental animals and human. Therefore, this investigation was performed to examine the clinical effectiveness of the Nylon splint for women who had underwent various types of tubal ligation and wanted tubal reversal. For target of study, 110 splinted women among 285 women who had underwent the tubal reversal using splint at Department of Obstetrics and Gynecology in St.Mary`s Hospital affiliated to Catholic University Medical College from Mar. 1989 to Feb. 1995 were selected and could be traced more than one year. The were assorted by tubal ligation method, tubal length after anastomosis, splint duration, menstrual phase at the time of operation, age and postoperative hysteroalpingopragphy. The results were as follows; 1. The mean age was 30.4 years and 88.2% of them had been sterilized by laparoscopic ring or cauterization. 2. The most common site of anastomosis was isthmic-ampular portion(49.1%). 3. The overall pregnant rate was 80.0% and the outcome of the pregnancy were as follows; term pregnancy(40.9%), on going pregnancy(32.8%), spontaneous abortion(4.5%), ectopic pregnancy(1.8%). 4. The mean pregnancy rate and postoperative tubal length of women who received the tubal ligation by laparoscopic ring were(93.3%, 7.3cm), statistically significantly higher and longer than that of the women by laparoscopic cauterization(69.2cm, 5.1cm). 5. The postoperative tubal patency patency and pregnancy rate of isthmic-isthmic anastomosis were the higher rate(100%, 90%). 6. The mean postoperative tubal length of pregnant group(6.6cm) was statistically significantly longer than that of non-pregnant group(4.4cm). 7. No statistical differences were found in pregnancy rates according to the time of splint removal(3 days or 7 days after operation) and menstrual phase at that time of operation.

토끼난관 미세문합수술에서 문합부의 성장인자 (TGF) 발현의 비교

김장흡,이진우,김수평,김진홍,김은중,정기욱,권동진,노승혜 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.11

Twenty seven rabbits were divided into 3 groups of 1, 2-1 and 2-2(n=9 in each group). Arbitarilly cut ends of mid-ampullar portion of each tubes were microscopically reanastomosed using vicryl as suture material without intraluminal splint in group 1, using vicryl as suture material with intraluminal splint in group 2-1 and coagulation by Nd-YAG Laser beam as ref-usion method with intraluminal splint in group 2-2. A week after operation, the tubal tissue segments of reanastomosis were embedded into paraffin to examine the expression rate and intensity of TGF-β1, 2 and 3 by immunohistochemical staining. The results were as follows. 1. The expression rate of TGF-β1, 2 and 3 revealed no stastically significant difference between group 1 and 2. 2. Among comparisons group 2-1 and 2-2, the TGF-β1 expression rate in group 2-2 showed lower value than that in group 2-1 with stastical significance(P$lt;0.05). The above fact that tuboplasty with Nd-YAG Laser using intraluminal splint resulted in lower expression rate of TGF β1 may suggest raising the succe ss rate of pregnancy.