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인간 난소에서 생리 주기에 따른 Mullerian Inhibiting Substance와 그 수용체의 발현
김장흡 ( Jang Heub Kim ),정서호 ( Seo Ho Chung ),최은주 ( Eun Joo Choi ),황성진 ( Hwang Seong Jin ),조현희 ( Hyun Hee Jo ),김미란 ( Mee Ran Kim ),김은중 ( Eun Jung Kim ),김진홍 ( Jin Hong Kim ),류기성 ( Ki Sung Ryu ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.9
목적 : Mullerian inhibiting substance (MIS)의 주 생산 장기인 가임기 여성 난소에서 MIS와 MIS가 결합하는 MIS type II 수용체 (MISR II)의 정확한 발현위치와 월경에 따른 변화를 알아보고 생식생리에 미치는 역할을 밝히고자 연구를 시행하였다. 연구 방법 : 월경주기와 난소기능이 정상이면서 난소종양이 없는 부인과 환자의 난소조직을 월경주기별 (난포기, 배란기, 황체기)로 구분하여 각각 7예씩 총 21예를 대상 In this study, in order to further understanding of function of Mullerian inhibiting substance (MIS) and the ontogeny of the production profile of biologically active MIS and MIS type II receptor (MISR II), the patterns of their localization according to
난포발달에 따른 Mullerian Inhibiting Substance Type 2 수용체의 발현
김장흡 ( Jang Heub Kim ),정서호 ( Seo Ho Chung ),황성진 ( Seong Jin Hwang ),조현희 ( Hyun Hee Jo ),김미란 ( Mee Ran Kim ),권동진 ( Dong Jin Kwon ),유영옥 ( Young Ok Lew ),김진홍 ( Jin Hong Kim ),이진우 ( Jin Woo Lee ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.11
월경주기에 따른 Inhibin A와 B의 혈중 농도 변화
김장흡 ( Jang Heub Kim ),이윤진 ( Yoon Jin Lee ),황성진 ( Seong Jin Hwang ),조현희 ( Hyun Hee Jo ),권동진 ( Dong Jin Kwon ),김은중 ( Eun Jung Kim ),김진홍 ( Jin Hong Kim ),이진우 ( Jin Woo Lee ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.6
목적 : Inhibin은 α-subunit와 β-subunit로 구성된 이질 이량체의 당단백으로 β-subunit의 차이에 의해 inhibin A (α-βA)와 inhibin B (α-βB)로 구분된다. 여성에서 inhibin은 난소의 과립막세포 및 황체에서 생산되어 뇌하수체 FSH 분비를 억제한다고 알려져 왔으나, 뇌하수체, 대뇌, 골수, 신장, 부신을 비롯하여 임신중 태반에서도 생산된다는 사실이 밝혀져 다양한 생리적 작용이 추정되고 있으며 최근에 i Objective : To understand the physiologic effects and secretion pattern of inhibin A and inhibin B throughout menstrual cycle in the normal reproductive women, serum values of inhibin A and inhibin B were measured. Methods : Inhibin A and inhibin B levels
폐경이행기 여성에서 Inhibin A와 Inhibin B의 혈중농도와 난소에서의 발현변화
김장흡 ( Kim Jang Heub ),김미란 ( Kim Mi Lan ),이윤진 ( Lee Yun Jin ),황성진 ( Hwang Seong Jin ),조현희 ( Jo Hyeon Hui ),류기성 ( Lyu Gi Seong ),유영옥 ( Yu Yeong Og ),한구택 ( Han Gu Taeg ),나종구 ( Na Jong Gu ),김진홍 ( Kim Jin 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.12
목적 : Inhibin은 α-subunit와 β-subunit로 구성된 이질 이량체의 당단백으로 β-subunit의 차이에 의해 inhibin A (α-βA)와 inhibin B (α-βB)로 구분된다. 여성에서 inhibin은 주로 난소의 과립막세포 및 황체에서 생산되어 뇌하수체의 FSH 분비를 억제한다고 알려져 왔으나, 임신중 태반과 남성의 고환에서도 생산된다는 사실이 밝혀져 다양한 생리적 작용이 추정되고 있으며 최근에 inhibin A와 B를 분리 Objective : To understand the physiologic effects and secretion pattern of inhibin A and inhibin B during menstrual cycle and menopausal transition, inhibin A and inhibin B levels were measured. And to detect any changes in expression of inhibins in human
임신주수에 따른 Mullerian Inhibiting Substance 의 혈중농도 변화
김진홍 ( Jin Hong Kim ),김미란 ( Mi Ran Kim ),권동진 ( Dong Jin Kwon ),이진우 ( Jin Woo Lee ),서미영 ( Mi Young Seo ),남궁성은 ( Sung Eun Namkoong ),송민경 ( Min Kyung Song ),김장흡 ( Jang Heub Kim ),김은중 ( Eun Jung Kim ),임채춘 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.10
N/A Objective : To obtain information on the variation of Mllerian Inhibiting Substance (MIS) levels according to gestational age and to understand the physiologic effects of MIS during pregnancy. Methods : We measured MIS levels in 325 serum samples from pregnant women and in 59 serum samples from nonpregnant women by ELISA. This study was also designed to enlighten the possibility for early diagnosis of genetic diseases by discriminate the fetal sex at early stage of pregnancy by measuring maternal MIS serum level. Results : These data showed that the mean MIS serum concentration plus or minus standard error was 2.66±0.12 ng/ml in pregnant women, which was significantly higher than 2.05±0.29 ng/ml in non-pregnant women (P<0.05). The median MIS level for pregnant women (2.2 ng/ml) was approximately two-fold greater than that for non-pregnant women (1.2 ng/ml). There was significant negative relationship between MIS concentration and gestational age (r2=0.0434, P<0.01). The MIS concentration of the pregnant women decreased 0.0069 ng/ml per day as gestational age increased. There was no significant difference in MIS levels for women pregnant with males (2.75±0.17 ng/ml) versus females (2.43±0.19 ng/ml). Conclusion : The MIS may play an important role as a inhibiting hormone of quiescent ovary during pregnancy. These data will enable normal and abnormal levels of MIS during pregnancy to be differentiated with higher precision and will facilitate the clinical application of MIS determination as a tumor marker for selected gonadal tumors during pregnancy.
김현정 ( Hyun Jung Kim ),신현미 ( Hyun Mee Shin ),송재연 ( Jae Yen Song ),김수연 ( Sue Yeon Kim ),정재은 ( Jae Eun Chung ),권동진 ( Dong Jin Kwon ),김진홍 ( Jin Hong Kim ),김장흡 ( Jang Heub Kim ),유영옥 ( Young Ok Lew ),임용택 ( 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.12
목적: 선천성 자궁기형이 있는 여성들에서 임상적 증상, 진단방법, 생식력, 산과적 문제점, 자궁성형술과의 관계를 밝히고자 하였다. 방법: 1990년 1월부터 2007년 12월까지 가톨릭대학교 의과대학 강남성모병원 산부인과에 입원한 자궁기형을 가진 환자 110명을 대상으로 자궁기형의 빈도, 증상, 진단 방법, 태위와 생식력, 자궁성형술과의 관계를 조사하였다. 선천성 자궁기형은 American Fertility Society (1988)의 분류법에 의해 분류를 했으며 의무기록을 이용한 후향적 연구방법을 사용하였다. 결과: 자궁기형은 입원환자 752명당 1명 (0.13%)의 빈도로 발견되었다. 대부분이 골반초음파와 내진에 의해 진단되었고(45.5%), 제왕절개술 도중에 발견된 경우가 24.5%, 그 외 수술적 방법, 자궁난관조영술 등에 의해 진단되었다. 두뿔자궁, 두자궁이 42예 (38.2%), 39예 (35.5%)로 많았으며 전체 110명 중 21명 (19.1%)이 신장기형을 동반하였는데 두뿔자궁과 두자궁의 경우가 많았다. 26명이 자궁성형술을 시행받았고 이들 중 9예 (34.6%)가 두뿔자궁이었고 8예 (30.8%)가 중격자궁이었다. 처음 병원을 방문한 증상은 산전진찰을 받다가 초음파상 자궁기형이라는 진단을 받고 전원된 경우가 35.5%였다. 그 외 월경통, 골반통, 습관성 유산으로 병원을 방문하였고 일차적 불임은 3예 (2.7%)로 유산보다 적었으며 일차성 무월경이 2예 (1.8%), 골반염과 무증상이 1예 (0.9%)씩 있었다. 241예의 임신 중 만삭임신 46.9%, 유산 24.34%, 조산 9.5%, 자궁외임신 0.83%였다. 자궁기형 환자의 태위는 둔위 16.67%, 횡위 1.51%였으며 81.3%의 환자가 제왕절개 분만을 하였다. 결론: 자궁기형이 있는 여성은 주로 월경통과 같은 증상을 호소하기도 하지만 무증상이고 우연히 발견되는 경우가 많았다. 그리고 비뇨기계통의 기형과 잘 동반되었고, 산과적 합병증 즉, 조산, 반복유산, 이상태위, 자궁내 태아성장지연, 자궁수축부전 등과 밀접한 관련이 있었다. 자궁기형이 진단되었을 때, 그 환자의 생식 예후, 임신 시 예상되는 결과를 상담하고, 발생할 수 있는 산과적 합병증에 대한 정보를 주며 적절한 치료를 시행하는 것이 중요하겠다. Objective: To investigate the clinical characteristics of symptoms, diagnostic procedures, infertility, obstetrical complications, and surgical corrections in women with congenital uterine anomalies. Methods: Between January 1990 and December 2007, 110 patients diagnosed with uterine anomalies from Kangnam St. Mary`s Hospital, the Catholic University of Korea were included in this study. The charts of patients were reviewed retrospectively for uterine anomaly type, clinical symptom, diagnostic workup, fertility, fetal presentation, and uteroplasty. Congenital anomaly was categorized according to classification by the American Fertility Society (1988). Results: Uterine anomaly was noticed in 1 in 752 patients (0.13%) who visited the inpatient department. The diagnosis was made by pelvic ultrasonography and manual examination (45.5%), incidental discovery during Cesarean section (24.5%), and other surgical procedures and salpingography. Most common types of uterine anomaly were bicornuate uterus (42 cases, 38.2%) and uterine didelphys (39 cases, 35.5%). Renal anomaly was accompanied in 21 patients (19.1%), frequently associated with bicornuate uterus and uterine didelphys. Uteroplasty was performed in 26 patients with 9 cases of bicornuate uterus (34.6%) and 8 cases of septate uterus (30.8%). The cases diagnosed incidentally during prenatal ultrasound examination were 35.5%. Other initial symptoms were dysmenorrhea, pelvic pain and habitual abortion. Primary infertility was reported in 3 cases (2.7%) which was fewer than abortion. Primary dysmenorrhea was observed in 2 cases (1.8%). One case of PID (0.9%) and one asymptomatic case were noted. Among 241 pregnancies, there were 46.9% full term birth, 24.34% abortion, 9.5% preterm birth, and 0.83% ectopic pregnancy. Fetal presentations were 16.67% breech and 1.51% transverse lie. Cesarean section rate was 81.3%. Conclusions: Women with uterine anomaly complain symptoms such as dysmenorrhea and pelvic pain, but most are aymptomatic and diagnosed incidentally. They are frequently accompanied with urologic anomalies and complicated with obstetrical challenges such as preterm labor, habitual abortion, malpresentation, intrauterine growth retardation and uterine atony. Thus, when diagnosis of uterine anomaly is made, it is crucial to discuss sufficiently with patients about their expected prognosis on fertility and possible obstetrical outcomes and complications and to provide appropriate therapy accordingly.
접촉성 Nd-YAG 레이져와 봉합사를 이용한 토끼의 미세난관 문합술에서 난관의 소통성과 임신율 비교
김진홍(Jin Hong Kim),류순원(Sun Won Yoo),조현희(Hyun Hee Jo),김현영(Houn Young Kim),김미란(Mi Ran Kim),권동진(Dong Jin Kwan),임용택(Yong Taik Lim),김장흡(Jang Heub Kim),이진우(Jin Woo Lee) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.3
N/A Objective : Many different methods have been undertaken to increase the success rate of tuboplasty. The development of a new generation of surgical lasers has offered a possibility for the practical use of the laser technique in microsurgical fields. In gynecology, the laser beam has been reported to be a precise instrument for successful tubal surgery with minimal bleeding and postoperative reaction. The authors studied the effect of the infrared laser beam in the area of tubal reanastomosis. Methods : To compare tubal patency, pregnancy rate, and histologic difference in site of anastomosis, total 120 tubes of 60 rabbits were used for experimental tuboplasty. The study groups were divided according to the kinds of reanastomosis methods. Group I : 1 layer(right tube) and 2 layer(left tube) anastomosis without using splint, group II : 1 layer(right tube) and 2 layer(left tube) anastomosis with using splint, group III : reanastomosis using laser with splint(III-b) and without splint(III-a). Results : 1. The infiltration of inflammatory cell were observed in all group by optical microscopic examination. Group II revealed more fibrotic change and inflammatory cell without significant statistical difference and there was no significant difference between left and right tubes in each group. 2. The tubes of group II were significantly more patent(75%) than that of group I(50%). Especially the patency of group III performed Nd-YAG laser with splint was the highest(90%). 3. The pregnancy rates in groups without splint were 40%(one layer without splint, group I-right tube), 60%(two layer without splint, group I-left tube), 30%(Nd-YAG laser without splint, group III-a), were significantly lower than that of group with splint, 60%(one layer with splint, Group II-right tube), 60%(two layer with splint, Group II-left tube), 80%(Nd-YAG laser with splint, Group III-b). Especially the group IIIb showed the hightest pregnancy rate(80%). Conclusion : From the above results, it is considered that the tubal reanastomosis using splint and Nd-YAG laser will improve the pregnancy rate and could be the procedure of choice in the future.