자궁근종 환자에서 자궁적출술 전후 혈청 인슐린 유사 성장인자 결합단백질들의 양상에 관한 연구

김정구,노경록 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.5

순환 IGFBP가 자궁근종의 성장에 관여 가능성이 있는지와 자궁 조직에서의 국소적 IGFBP 생산이 순환 IGFBP계에 영향을 미칠 수 있는지를 알아보고자 난관재문합술을 시행하는 자궁근종이 없는 환자(대조 환자)와 자궁적출술이 시행되는 자궁근종 환자에서 수술 전 및 수술 후 2일째 및 6일째에 채취된 혈액 내 IGFBP들을 Western ligand blot과 면역침전법으로 측정하여 수술 전 혈청 IGFBP의 양상을 비교분석하고 수술 후 경과 시기 및 자궁적출술 시행 유무에 따라 혈청 IGFBP들의 양상을 비교 분석하여 다음과 같은 결과를 얻었다. 1) 자궁근종 환자에서 혈청 IGFBP-2의 농도는 대 조 환자보다 유의하게 낮았으나 다른 IGFBP의 농도 와 총 IGFBP 농도 및 각 IGFBP의 분포율은 유의한 차이가 없었다. 2) 자궁근종 환자와 대조 환자에서 수술 후 2일째 혈청 IGFBP-3 농도가 수술 전보다 유의하게 감소하 였다가 수술 후 6일째 수술 전 수준으로 회복되었으 며 혈청 IGFBP-2 및 IGFBP-1 농도도 이와 유사하게 변화하였다. 3) 자궁근종 환자와 대조 환자에서 수술 후 혈청 IGFBP-4 농도가 수술 전보다 유의하게 증가하였다. (4) 자궁근종 환자 및 대조 환자에서 혈청 IGFBP- 1과 IGFBP-2의 분포율은 수술 후 경과 시기에 따라 변화하지 않았으나 수술 후 혈청 IGFBP-4의 분포율 은 수술 전보다 증가하는 양상을 보였다. (5) 수술 후 6일째 자궁근종 환자에서의 혈청 IG FBP-2 농도가 대조 환자에서 보다 높았으나, 다른 IGFBP들의 농도 및 각 IGFBP의 분포율은 수술 후 각 시기에서 자궁근종 환자와 대조 환자 사이에 차 이가 없었다. 이상의 결과로 보아 혈중 IGFBP 양상이 자궁근종 의 성장에 관여할 수 있고 자궁 조직에서의 IGFBP 생산이 혈중 IGFBP 양상에 영향을 미치치 않으며 수술 후 초기 회복기에 IGFBP 양상의 변화는 수술 에 의해서 유도된 이화작용의 증가에 대한 생체방어 기전의 하나일 수 있다고 사료된다. It has been suggested that insulin-like growth factor (IGF) system plays an pivotal role in the growth of uterine myoma. Recent reports have shown that serum IGF-I levels are normal in women with uterine myoma. IGF-binding proteins (IGFBPs), as elements of IGF system, are known to be involved in the transport of IGFs to the tissue and in the modulation of IGF`s action at target cell. The synthesis of IGFBPs in uterine myoma has been demonstrated. The purposes of this study are to examine the possible involvement of circulating IGFBPs in the growth of uterine myoma and to investigate whether the synthesis of IGFBPs in uterine tissue can affect their own levels in the peripheral blood. IGFBPs were measured by Western ligand blot and immunoprecipitation in sera obtained from patients (n=16) with uterine myoma undergoing hysterectomy and from patients (n=14, control patients) undergoing tubal reanastomosis before and after operation. The preoperative level of serum IGFBP-2 in patients with uterine myoma was significantly lower than that in control patients but there were no significant differences in the preoperative levels of any other IGFBPs and the preoperative proportions of IGFBPs. The serum IGFBP-3 level in both group decreased significantly on 2 day after operation and restored toward the preoperative level on 6 day after operation. Serum IGFBP-2 and IGFBP-1 levels show similiar patterns in both groups. In contrast the postoperative level of serum IGFBP-4 increased significantly in both groups. Postoperatively, the proportion of serum IGFBP-4 increased significantly whereas the proportions of IGFBP-1 and IGFBP-2 did not changed significantly in both groups. Serum IGFBP-2 level on 6 day after operation was significantly higher in patients with uterine myoma than in control patients, but there were no significant differences in the postoperative levels of any other IGFBPs and the postoperative proportions of IGFBPs between patients with uterine myoma and control patients. These data indicate that circulating IGFBP profiles can contribute to the growth of uterine myoma and may not be affected by local production of IGFBPs in uterine tissues and that the postoperative changes in these profiles may reflect one of host defense mechanism during the early postoperative period.

부인과 의사의 호르몬 대체요법에 대한 인식도 조사

장윤석,노경록,최영민,김정구,김석현,신창제 문신용,이진용 대한폐경학회 1996 대한폐경학회지 Vol.2 No.1

Questionnaires were mailed to 1000 Korean gynaecologists in order to obtain their views on the use of hormone replacement therapy(HRT). A total of 401 gynaecologists responded. Most of gynaecologists(91.3%) were prescribing HRT to the perimenopausal or postmenopausal women. The most common indication of HRT was the treatment of vasomotor symptoms(84.0%) in symptomatic postmenopausal women and the prevention of osteoporosis(61.6%) in asymptomatic postmenopausal women. The most common routes of HRT were the oral(85.8%) administration. About two third of respondents prescibed HRT by cyclic estrogen-progestogen combined therapy(67.3%), and 43.4% of respondents by the continuous estrogen-progestogen combined therapy. About 90% of respondents thought that HRT must be started within 5 years after menopause. The duration of HRT was variable and 16.6-42.6% of respondents thought that HRT should be continued through the life. This survey suggests that most of Korean gynaecologists favors the use of HRT in postmenopausal women but varies in the length of time they would prescribe it. $quot;

Forced Eruption of Severe Angulated and Impacted Permanent Teeth after Marsupialization of Dentigerous Cyst: Case Report

남정훈,노경록,유우근,이병민,전지현,박수현,안장훈,김정희,Nam, Jeong-Hun,Noh, Kyung-Lok,Yoo, Woo-Geun,Lee, Byeong-Min,Jeon, Ji-Hyeon,Park, Su-Hyun,Ahn, Jang-Hoon,Kim, Jung-Hee Korean Association of Maxillofacial Plastic and Re 2011 Maxillofacial Plastic Reconstructive Surgery Vol.33 No.1

The goal of this treatment is the surgical-orthodontic eruption of impacted permanent teeth associated with a large dentigerous cyst in a preadolescent patient. Although enucleation of the entire cyst and the extraction of impacted teeth are common treatments, missing permanent teeth cause several problems in young patients. In this report, an 11-year-old female visited with the chief complaint of a large radiolucent lesion from the mandibular anterior area to the left mandibular posterior area. The permanent left canine and premolars were displaced toward the mandibular inferior border area. The extraction of infected deciduous teeth and marsupialization were performed. After 4 months, orthodontic buttons for forced eruption were applied to the impacted permanent teeth. The teeth emerged into the oral cavity 3 months after the orthodontic treatment. Although the root form was abnormal, there were no other pathogenic signs. The alveolar bone had a normal trabecular pattern and the teeth appeared to be well maintained at postoperative 24 months.

하악 후구치 삼각부에 발생한 후천성면역결핍증 관련 카포시육종: 증례보고

박영주,남정훈,노경록,방은오,김다영,김준현,정재안,신진업,강응선,Nam, Jeong-Hun,Park, Young-Ju,Noh, Kyung-Lok,Pang, Eun-O,Kim, Da-Young,Kim, Jun-Hyun,Chung, Jae-An,Shin, Jin-Eob,Kang, Eung-Seon 대한구강악안면외과학회 2009 대한구강악안면외과학회지 Vol.35 No.3

There are several oral lesions related with AIDS, such as candidiasis, hairy leukoplakia, Kaposi's sarcoma, aphthous stomatitis, lichen planus, and other opportunistic infectious diseases. Among the others, Kaposi's sarcoma, the most common malignant tumor associated with AIDS, is closely linked to the number of CD4+ T cell. Kaposi's sarcoma often occurs in palate, the most prone site, and has characteristic clinical features in most cases. Sometimes, the tumor induces underlying bone destruction at late stage. We report a case of a 27 year-old man with AIDS-associated Kaposi's sarcoma at left lower retromolar triangle, parapharyngeal area and discuss the management of AIDS patients in dentistry.

전신성 흉반성 낭창이 합병된 임신의 경과 및 주산기 예후

신희철,윤보현,박교훈,이희선,노경록,김성훈 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.9

Objectives: The purpose of this study was to evaluate the course of systemic lupus erythematosus(SLE) during pregnancy and the outcome of pregnancy in patients with SLE. Methods: This retrospective study was done by the review of medical records of 73 pregnancies complicated with SLE in 24 patients between January, 1983 and April, 1996. Results: SLE was exacerbated in 28% during pregnancy. The most common clinical finding of the exacerbation was renal dysfunction such as increased proteinuria and/or increased level of blood urea nitrogen(BUN) and creatinine. Among 34 cases of viable pregnancies after diagnosis of SLE, there were 4 cases of spontaneous abortion(12%), 4 cases of stillbirth(12%), 7 cases of preterm birth(21%), 2 cases of neonatal death(6%), 4 cases of intrauterine growth retardation(12%), and 4 cases of pregnancy induced hypertension(PIH))12%). Among 25 neonates born by women with SLE, there was no case of neonatal lupus or congenital complete heart block. Therapeutic abortion, stillbirth, preterm birth, PIH occurred more frequently in women with renal involvement, but the difference was not statistically significant. And we compred the outcome of 26 pregnancies before the diagnosis of SLE with that of 43 pregnancies after the diagnosis of SLE. Preterm birth, PIH, low birth weight infant occurred more frequently after diagnosis of SLE, but the difference was not statistically significant. Con clusion: Our data suggest that 1) the risk of pregnancy induced exacerbation of SLE is not high enough to do serious harm to patients with SLE, 2) the incidence of stillbirth, preterm birth, intrauterine growth retardation, PIH, and neonatal death increases in patients with SLE, 3) the risk of neonatal lupus or congenital complete heart block is very low in neonates whose mothers have SLE, 4) there is no significant difference in the outcome of pregnancy whether the patients have lupus nephritis or not, 5) there is no significant difference in the outcome of pregnancies between after and before the diagnosis of SLE.

위축된 치조골에서 치조골 수평 확장술을 이용한 임플란트 이식술에 관한 임상연구

박영주,남정훈,송준호,연병무,노경록,방은오,정재안,신진업,강응선,Park, Young-Ju,Nam, Jeong-Hun,Song, Jun-Ho,Yeon, Byung-Moo,Noh, Kyung-Lok,Pang, Eun-O,Chung, Jae-An,Shin, Jin-Eob,Kang, Eung-Seon 대한악안면성형재건외과학회 2009 Maxillofacial Plastic Reconstructive Surgery Vol.31 No.4

The aim of this study was to evaluate the clinical applicability of a ridge splitting technique for reconstruction of narrowed edentulous alveolar ridges for dental implantation. 41 patients with 47 edentulous areas were included in this study. After corticotomy of a rectangular buccal segment and about 3-4 weeks healing period, the alveolar ridge was splitted, implant was placed. The initial ridge width varied between 2.5 and 7.0mm, average was 3.99mm. 68 dental implants were placed, and the gap between the implants and the bone is filled with various bone graft material, or none. All splitted sites showed sufficient bone volume for insertion of the implants at the moment of implantation. Over 1 year of follow-up period, five implants(7.3%) had mobility in two patients, among them, 2 implants(2.9%) sustained infection and removed. And any other complications were not noted. Our conclussion is that ridge splitting of the narrow edentulous area is a reliable and safe procedure in horizontally deficient ridges.

산전진단된 Fetus in Fetu 1 례

신희철,윤보현,전종관,이희선,노경록,김성훈 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.11

저자등은 매우 드문 선천성 기형인 fetus in fetu 1례를 산전진단후 외과적 절제술을 통해서 성 공적으로 치료하였기에 간단한 문헌고찰과 함께 이를 보고하는 바이다. Fetus in fetu is a very rare pathologic condition, presenting as a congential tumor of infant. This entity is distinguished from teratoma by its embryological origin, its unusual location in the retroperitoneal space, its benignity, and by the presence of vertebral organization with limb buds and well-developed organ system. The authors present a retroperitoneal fetus in fetu that was diagnosed prenatally and removed immediately after birth. A 4 x 10 cm sized cystic mass was containing a fetus-like structure and covered by amniotic membrane. It was consisted of vertebral column, cranial bone, extremities, primitive respiratory tract, intestinal mucosa, osteochondral junction and mature chorionic villi. Diagnosis was made by ultrasonography, X-ray plain film and CT. This is probably a case of fetus in fetu that showed well-developed internal organs.

태아의 제대기저부탈장이 동반된 임신의 임상적 양상과 예후

신희철,윤보현,박교훈,이희선,노경록,김성훈 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.11

Objective: To evaluate pregnancy course, and the perinatal outcomes of pregnancies with fetal omphalocele. Materials and Methods: The retrospective study was done by the review of medical records of 24 pregnancies with fetal omphalocele found between January, 1986 and June, 1996. Results: Fetal omphalocele was found one in 818 births during the study period: Two were terminated before 25 weeks of gestation. Associated anomalies were detected in 71%(17/ 24) of cases; cardiac(n=16), skeletal(n=5), chromosome(n=3), central nervous system(n=3), cleft lip and palate(n=2), etc. Five died in utero(23%, 5/22). Seven fetuses were growth-retarded(32 %, 7/22). Seventeen were liveborn. However, 41%(7/17) had low Apgar scores at 5 minutes ($lt;7). Cesarean section was performed in 12(71%). Five newborns died immediately after birth. Nine newborns received corrective operation, and seven survived; three had no associated anomalies and four had heart anomalies. Conclusions: Associated anomalies were found in 71%(17/24) of cases with omphalocele. Perinatal mortality was 55%(12/22): five died in utero, and seven during the neonatal period. However, 78%(7/9) of newborns who received corrective operation survived.

골밀도와 인슐린유사 성장인자-1 유전자내 (CA) 다형성과의 연관성

김정구 ( Jung Gu Kim ),노경록 ( Kyong Rock Roh ),김석현 ( Seok Hyun Kim ),최영민 ( Young Min Choi ),문신용 ( Shin Yong Moon ),이진용 ( Jin Yong Lee ) 대한폐경학회 2001 대한폐경학회지 Vol.7 No.1

N/A Objective:To examine the relationship between cytosine-adenine (CA) polymorphism in insulin-link growth factor-Ⅰ (IGF-Ⅰ) gene and bone mineral density (BMD). Material & Method: IGF-Ⅰ gene CA polymorphism were analyzed in 125 postmenopausal Korean women, and BMD was determined at the lumbar spine and proximal femur using dual energy X-ray absorptiometer. Results: Nine IGF-Ⅰ alleles were observed with product sizes ranging between 176-196bp, and their distribution was as follows: 194bp 22.4%, 188bp 21.2%, 186bp 20.4 %, 192bp 16.0%. 190bp 14.8% etc. The Z scores of BMD at the lumbar spine and trochanter in homozygous 194/194bp genotype group were higher than any other genotype. The frequency of 194/194bp genotype in osteoporotic women was different from that in normal BMD or osteopenic group. Conclusion: IGF-Ⅰ gene CA polymorphism may be a genetic factor which affects BMD at the lumbar spine and trochanter.

백서 두개골결손모델에서 실크단백과 골형성단백 이식체가 골재생에 미치는 영향

남정훈(Jeong-Hun Nam),노경록(Kyung-Lok Noh),방은오(Eun-O Pang),유우근(Woo-Geun Yu),강응선(Eung-Sun Kang),권해용(Hae-Yong Kweon),김성곤(Seong-Gon Kim),박영주(Young-Ju Park) 대한구강악안면외과학회 2010 대한구강악안면외과학회지 Vol.36 No.5

Introduction: This study evaluated the capability of silk fibroin (SF) and recombinant human bone morphogenetic protein-2 loaded SF (SF-BMP) as a bone defect replacement matrix when grafted in a calvarial bone defect of rats in vivo. Materials and Methods: A total 70 calvarial critical size defects (5.0 mm in diameter) made on 35 adult female Sprague-Dawley rats were used in this study. The defects were transplanted with (1) rhBMP-2 loaded silk fibroin graft (SF-BMP: 0.8+10 μg), (2) Silk fibroin (SF: 10 μg), and (3) no graft material (Raw). The samples were evaluated with soft x-rays, alkaline phosphatase activity, calcium/phosphate quantification, histological and histomorphometric analysis at postoperative 4 and 8 weeks. Results: The SF-BMP group (48.86±14.92%) had a significantly higher mean percentage bone area than the SF group (24.96±11.01%) at postoperative 4 weeks.(P<0.05) In addition, the SF-BMP group (40.01±12.43%) had a higher % bone area at postoperative 8 weeks than the SF group(33.26±5.15%). The mean ratio of gray scale levels to the host bone showed that the SF-BMP group (0.67±0.08) had a higher mean ratio level than the SF group (0.61±0.09) at postoperative 8 weeks. These differences were not statistically significant.(P=0.168 and P=0.243, respectively) The ratio of the calcium and phosphate contents of the SF-BMP (0.93±0.22) group was lower than that of the SF (1.90±1.42) group at postoperative 4 weeks. However, the SF-BMP group (0.75±0.31) had a higher Ca/PO4 ratio than the SF (0.68±0.04) at postoperative 8 weeks. These differences were not statistically significant.(P=0.126 and P=0.627, respectively) For the bone-specific alkaline phosphatase (ALP) activity, which is recognized as a reliable indicator of the osteoblast function, the SF-BMP (23.71±8.60 U/L) groups had a significantly higher value than the SF group (12.65± 6.47 U/L) at postoperative 4 weeks.(P<0.05) At postoperative 8 weeks, the SF-BMP (21.65±10.02 U/L) group had a lower bone-specific ALP activity than the SF group (16.72±7.35 U/L). This difference was not statistically significant.(P=0.263) For the histological evaluation, the SF-BMP group revealed less inflammation, lower foreign body reactions and higher bone healing than the SF group at postoperative 4 and 8 weeks. The SF group revealed more foreign body reactions at postoperative 4 weeks. However, this immunogenic reaction decreased and the remnant of grafted material was observed at postoperative 8 weeks. For histomorphometric analysis, the SF-BMP group had a significantly longer bone length to total length ratio than those of the SF group at postoperative 4 and 8 weeks.(P<0.05) Conclusion: The rhBMP-2 loaded silk fibroin graft revealed fewer immunoreactions and inflammation as well as more new bone formation than the pure silk fibroin graft. Therefore, silk fibroin may be a candidate scaffold for tissue engineered bone regeneration.