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체외수정시술 환자에서 황체기 보강 시 근주 투여와 경구 투여의 연속적 이용
김상돈,지병철,이정렬,서창석,김석현,문신용,Kim, Sang-Don,Jee, Byung-Chul,Lee, Jung-Ryeol,Suh, Chang-Suk,Kim, Seok-Hyun,Moon, Shin-Yong 대한생식의학회 2010 Clinical and Experimental Reproductive Medicine Vol.37 No.1
목 적: 체외수정시술 시 황체기 보강은 근주, 경질, 경구 등의 다양한 방법으로 이루어지고 있는데, 경구 투여법은 환자의 순응도가 높고 비교적 안전한 방법이다. 본 연구에서는 황체기 보강을 근주로 시작하여 경구 투여로 전환하는 방법의 효용성과 전환 시기에 따른 결과를 비교 분석하고자 하였다. 연구방법: 2003년 9월부터 2009년 6월까지 분당서울대학교병원에서 체외수정시술을 시행받은 환자에서 배아 이식 후 태아 심박동까지 확인된 76주기를 대상으로 하였다. 과배란유도는 GnRH agonist long protocol (n=7) 또는 GnRH antagonist protocol (n=66)을 이용하였으며 3주기에서는 냉동배아 이식을 시행하였다. 황체기 보강을 위하여 난자 채취일부터 매일 progest in oil 50 mg을 근주하였고, 태아 심박동이 확인된 후 임신 6~7주 (n=17) 또는 8주 이후 (n=59)에 micronized progesterone (Utrogestan, Laboratoires Besins International, France) 300 mg을 매일 경구로 투여하였다. 결 과: 대상군 전체의 유산율은 3.9% (3/76)이었으며, 경구 투여 전환시의 임신 주수는 평균 8주 4일 (난자 채취일로부터 $46{\pm}5.8$일)이었다. 황체기 보강을 임신 6~7주 사이에 경구 투여로 전환한 17주기 중에서 1례의 자연유산이 확인되었으며 유산 시 주수는 9주 4일이었다. 8주 이후에 경구 투여로 전환한 59주기 중에서는 2례의 자연유산이 확인되었으며 (11주 3일, 11주 4일), 두 군의 자연유산율은 각각 5.6%와 3.4%로 두 군 간에 통계적으로 유의한 차이는 없었다 (p=0.678). 결 론: 체외수정시술 후 황체기 보강을 시행하는 경우 태아 심박동이 확인된 이후에 근주 투여를 경구 투여로 전환하는 방법은 비교적 낮은 유산율을 보임을 확인하였으며, 특히 8주 이전에 전환하는 것도 유용한 방법이라 사료된다. Objectives: The aim of this study was to assess appropriate time to convert intramuscular progesterone support to oral administration for luteal phase support in in vitro fertilization (IVF). Methods: Seventy-six cycles of IVF in which fetal heart beat was identified after treatment were included. Patients underwent controlled ovarian hyperstimulation with GnRH agonist long protocol (n=7) or GnRH antagonist protocol (n=66). Cryopreserved embryo transfer was performed in three cycles. Luteal support was initiated by daily intramuscular injection of progesterone, and after confirmation of fetal heart beat, converted to oral micronized progesterone (Utrogestan, Laboratoires Besins International, France) 300 mg daily before or after 8 gestational weeks. The oral progesterone was continued for 11 weeks. Results: Overall clinical abortion rate was 3.9% (3/76) and mean time to conversion was $8^{+4}$ gestational weeks ($46{\pm}5.8$ days after oocytes retrieval). The abortion rate was 5.6% (1/17) and 3.4% (2/59) in patients with conversion before 7 weeks and after 8 weeks, respectively, which were not statistically significant (p=0.678). The miscarriages were occurred at $9^{+4}$ weeks, $11^{+3}$ weeks and $11^{+4}$ weeks. Conclusion: Sequential luteal support using intramuscular and oral progesterone yields a relatively low clinical abortion rate. If fetal heart beat confirmed, sequential regimen appears to be safe and convenient method to reduce patients' discomfort induced by multiple injections.
다가구매입임대주택이 주변지역에 미치는 외부효과에 관한 연구
김상돈,이주형,Kim, Sang-Don,Lee, Joo-Hyung 한국주거학회 2008 한국주거학회 논문집 Vol.19 No.5
The objective of his study is to research the effect of the 'Dagagu' housing purchase and the public rental housing supply on the nearby community. In the case of public rental housing, many studies have demonstrated that the perception that a public rental house is a low income dwelling has an external effect on the residents immediately outside the area such as the perception of the lowering of house prices. However, an advanced research concerning the 'Dagagu' housing purchase and public rental housing has not been carried out because it has only recently been enforced. Through a survey conduced of residents who live nearby the 'Dagagu' housing purchase and public rental housing the aim of his study is to show how the residents perceive the renal houses and are influenced by them. At the same time, this study demonstrates the external effect of rental house supply by analyzing the housing price around the area. Most people who live in the near by 'Dagagu' housing purchase and public renal housing have a negative opinion of his housing because they believe that the residential prices will depreciate. However, only about 40% of the people felt that the residential price depreciation as a result of the 'Dagagu' housing purchase and public rental housing supply was not visible.
파종성 악성 핍지신경교종 환자에서 시행한 뇌실내 Methotrexate의 효과 - 증례보고 -
김상돈,정용구,김세훈,임동준,조태형,이훈갑,서중근,이기찬,Kim, Sang-Don,Chung, Yong-Gu,Kim, Se-Hoon,Lim, Dong-Jun,Cho, Tae-Hyung,Lee, Hoon-Gap,Suh, Jung-Keun,Lee, Ki-Chan 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.7
Oligodendrogiomas account for about 4 per cent of intracranial gliomas and surgery is known to be an essential first step to establish an accurate diagnosis and when oligodendrogliomas recur with or without anaplastic features after initial resection, radiation and chemotherapy consisting of the administration of procarbazine, lomustine, and vincristine are usually indicated. We report our experience of an excellent result with intraventricular methotrexate chemotherapy for a patient with disseminated anaplastic oligodendroglioma. A 29-year-old male patient presented with diplopia and headache for two months. MRI showed a irregular, faintly enhanced mass in the posterior fossa. The hisotological diagnosis was an anaplaplastic oligodendroglioma and he was treated with chemotherapy of PCV regimen and radiotherapy followed by surgery. CSF dissemination was revealed by a follow-up MRI during the period. Intraventricular methotrexate(0.175mg/kg) was given twice a week for 4 weeks through ommaya reservoir and the size of the multiple tumors was decreased significantly on follow-up MRI. This case report suggests that an aggressive treatment involving intravent-ricular chemotherapy may be helpful even when anaplastic oligodendrogliomas disseminates to leptomeninges.
하수처리장의 내분비계장애물질에 대한 Yeast Two-hybrid Assay와 Enzyme-Linked Immunosorbent Assay에 의한 에스트로겐활성도 평가
이병천(Byoung Cheun Lee),나진성(Jin Sung Ra),김상돈(Sang Don Kim),Kawai Hukiko,이철희(Chul Hee Lee) 大韓環境工學會 2007 대한환경공학회지 Vol.29 No.7
가정계열과 공단계열로 분리하여 처리되는 하수처리장에서 에스트로겐 활성을 평가하기 위하여 yeast two-hybrid assay와 enzyme-linked immunosorbent assay(ELISA)를 이용하여 내분비계장애물질의 농도와 활성도를 측정하였다. 그 결과 가정계열 유입수 중에서 estrone(E1), 17β-estradiol(e₂), 17α-ethinylestradiol(Ee₂) 그리고 APE의 농도는 각각 최대 167.1, 39.7, 7.3, 145.4 ng/L까지 검출되었다. 활성슬러지법에 의한 처리로, 17β-estradiol의 평균제거율은 77.5%, 고도처리 공정인 모래여과와 오존산화를 거친 후에는 80.8%까지 제거되는 것으로 나타났다. 동시에 Yeast two-hybrid assay로 각 내분비계장애물질의 농도-반응곡선으로부터 반응식을 구하여, 에스트로겐 활성에 미치는 각 물질의 기여도를 분석한 결과, 가정계의 활성슬러지법에 의한 처리수에서 estrone, 17β-estradiol, 17α-ethinylestradiol, APE가 각각 70.7, 23.3, 3.7, 2.32%로 나타났다. 즉, 생물학적 처리공정을 통해 배출된 처리수의 에스트로겐 활성에 영향을 미치는 주된 기여물질은 estrone과 17β-estradiol인 것으로 나타났다. Several endocrine disrupting chemicals(EDCs) were monitored to evaluate the estrogenic activities and the concentrations by yeast two-hybrid assay and enzyme-linked immunosorbent assay(ELISA) in sewage treatment plant(STP) which consist of industrial and domestic line. In the influent of domestic line, estrone, 17β-estradiol, 17α-ethinylestradiol and alkylphenolethoxylate(APE) were detected up to 167.1, 39.7, 7.3 and 145.4 ng/L, respectively. The average removal efficiency of 17β-estradiol after the activated sludge process was 77.5% and further removed to 80.8% after the sand filtration-ozonation step. These results suggests that the activated sludge process has limited potential to remove the estrogenic activity effectively. The contributions of the estrogenic chemicals to the estrogenic activities were 70.7, 23.3, 3.7 and 2.3% for estrone, 17β-estradiol, 17α-ethinylestradiol and APE, respectively, in the domestic line effluents. Therefore, 17β-estradiol and estrone contributed most of the estrogenic activity in the domestic line effluents.