인유두종 바이러스 16/18형 감염이 있는 자궁경부암에서 c-erb B2와 p53 단백의 과발현에 관한 연구 : 자궁경부암의 원인 및 임상병리학적 연구 Genesis and Clinicopathologic Analysis

박은동,허만하,김원규,이상민,이천준,허방,조무연,정인철 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.11

The 43 cases of the primary uterine cervical carcinoma were analyzed for HPV type 16/18 infection and also analyzed for overexpression of p53 and c-erb B2 oncoprotein to evaluate theirs oncogenic and clinicopathologic relationships. HPV type 16/18 infection was examined by polymerase chain reaction(PCR) and the overexpression of p53 and c-erb B2 protein by usi-ng immunohistochemical method. The results were as follow: 1. The HPV infection rate in primary uterine cervical carcinomas was 83.7% respectively.The standard clinicopathologic characteristics(age, histologic type, koilocytosis, mitosis, clinical stage, tumor size, cervical invasion depth, lymph node metastasis, parametrial invasion) were nat significantly correlated with HPV type 16/18 infectivity. 2. The overexpression rate of p53 protein was 72.1% and there was no Significant correlation between expression of p53 protein and the Clinicopathologic characteristics. 3. The overexpression of c-erb B2 oncoprotein was 44.2% and there was no significant correlation between the overexpression of c-erb B2 oncoprotein and the clinicopathologic char-acteristics. 4. There was no significant correlation between HPV type 16/18 infection and overexpression of p53 and c-erb B2 oncoprotein.

폐경후 여성에서 에스트로젠 보충요법시 병행투여된 황체호르몬제제가 지질대사에 미치는 영향

박은동,유건재,김흥열 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.7

Estrogen replacemetn therapy is known to reduce the incidence of cardio-ascular disease in postmenopausal women, and its beneficial effect is thought to be mediated in part by favorable changes in serum lipoprotien levels. However, the long-term effects on serum lipoproein levels of estrogen in low doses currently used have not been precisely evaluated in Korea. In postmenopausal women with uterus, progestogen should be added to protect the endometrium from the hyperplasia or carcinoma induced by unopposed estrogen. However, progestogens may adversely influence the beneficial effects of oral estrogen. To evaluate the impacts of progestogen on the lipid and lipoprotein levels during estrogen replacement therapy, we conducted the 1-year trial of conjugated equine estrogen(Premarine, 0.625mg/day) with or without cyclic prgoestogen(medroxy-progesterone acetate: MPA, 10mg/day for 12 days) in 120 postmenopausal women. Serum total cholesterol, triglyceride, HDL cholesterol, LDL cholesterol levels in fasting state were measured in all subjects before treatment & at 12 months during treatment. The value of post-treatment levels were compared with that of baseline levels. In patients who received either premarine only or premarine plus MPA, serum HDL cholesterol levels increased significantly. While premarine plus MPA group showed a smaller increase in HDL cholesterol than premarine only group. And premarine plus MPA group showed a significant decrease in LDL cholesterol, total cholesterol, and triglyceride. While premarine only group showed a significant decrease in LDL cholesterol, but no statistical significance in total cholesterol and triglyceride levels. These results suggest that the addition of MPA at the daily dose of 10mg for 12 days cyclically in estrogen repalcement treatmetn appears to lessen the change to lipid and lipoprotein levels induced by unopposed estrogen, therefore maintain the longterm favorable effects on serum lipoprotein levels in postmenopausal women.

폐경기 여성에서 에스트로젠 보충요법시 병행투여된 프로게스테론제제가 골밀도와 골대사에 미치는 영향

박은동,김흥열 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.2

In postmenopausal women with uterus, progestogen should be added to protect the endometrium from the hyperplasia or carcinoma induced by unopposed estrogen. However the effect of progestogen on bone mineral density & bone metabolism had not been precisely evaluated in Korean post menopausal women. To evaluate the impacts of progestogen on bone mineral density & bone metabolism during estrogen replacement therapy, we conducted the randomized 2-year trials of 3 group: Group I was 145 women recieved estrogen only (premarine 0.625mg/day), Group II was 55 women received estrogen with cyclic addition of progestogen (medroxyprogesteron, MPA, 5mg/day for 2 days for month), Group III was 55 women received estrogen with daily addition of progestogen (MPA 2.5mg daily). In all subjects, bone mineral density was measured in the lumber vertebrae (L2-L4) and femur neck using dual energy X-ray absorptiometry (DEXA) and serum osteocalcin and urine calcium/creatinine was measured at the beginning of the treatment 12 months and 24 months later, repectively. BMD of femur neck in Group I, Group II and Group III increased but not significantly compared to basal level at 12 months and/or 24 months of treatment. As for BMD of lumbar spine, it increased significantly during the treatment in Group I, Group II and Group III. Serum osteocalcin in Group I, Group II and Group III decreased significanly at 12 months and 24 months of treatment compared with initial value. Urinary calcium/creatinine ratio in Group I, Group II and Group III decreased significantly at 12 months and 24 months of treatment compared with initial value. And compared with Group I, Group II and Group III did not significant difference. From the above results, it might be suggested that added progestogen during Estrogen Replacement Therapy is more effective in post menopausal women with the protection on bone mineral density.

자궁내 피임장치와 동반된 여성 생식기 방선균증 3 예

박은동,김원규,이영미 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.2

본 고신의료원 산부인과에서는 비교적 드문 것으로 알려진 여성생식기내 방선균증 3예를 경험하였는바 이는 모두 자궁내 피임장치와 동반되어 이었다. 이중 2예는 정기적 자궁경부 세포진검사를 통하여 경미한 증세의 방선균증이 진단되었으며 특히 한예는 2달뒤 재발하여 자궁내막조직검사로 방선균증이 재확인된 예였다. 또 한예는 방선균으로 인하여 골반내 농양을 형성한 경우로 총 3예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. It has been known that actinomycosis rare in human, especially in the female genital tract without any predisposing factors. some cases of actinomycotic pelvic inflamatory disease in IUD users were reported and its correlation has been studied by sereral investigators. Someone reported that actinomycotic pelvic infection occured more in IUD users especially, plastic device and with long duration. In contrast, Others suggested that actinomycoces was commmensal in the female genital tract and it developed opportunistic infection irrespective of IUD presence. It was supposed that actinomycosis was screened by Papanicolaou stain and confirmed by culture with immunofluorescent staining. We have experienced 3 cases of actinomycosis-two cases detected on routine Pap. smear and one case of pelvic abscess confirmed by pathologic specimen-in IUD users and reported them with a review of literature.

Proliferating Cell Nuclear Antigen : Relation to Histologic Grade and Prognosis

박은동,신승화 대한부인종양 콜포스코피학회 1995 Journal of Gynecologic Oncology Vol.6 No.3

The measurement of tumor cell proliferation is becoming increasingly recognized in defining prognostic groups. Proliferating cell nuclear antigen(PCNA) immunolocalization can be used as an index of cell proliferation and rnay define the extent of deppature from normal growth control. PCNA is considered to be maker of cell proliferation. The aim of this study was to evaluate the expression of PCNA in epithelial ovarian cancer as well as the possible correlation with degree of differentiation, tumor stage and overall survival. The material consisted of 35 epithelial ovarian cancer. The PCNA labelling index (LI) ranged from 7.5% to 92.5% with a median value of 46.7%. PCNA labelling index (LI) is 30% in grade 1, 63% in grade 2, and 100% in grade 3 in epithelial ovarian cancer(p$gt;0.05). Also, a positive correlation was found between PCNA labelling index (LI) and clinical stage (P$lt;0.05) The estimated 3 year survival in patients with a tumor LI below the median (low proliferative group) was higher than those with a tumor LI greater than the median(high proliferation group) (87.5% VS 50%, P$lt;0.05).

현장 / 잊을 수 없는 만남 / 예수의 흔적과 향기

박은동 기독교대한성결교회 활천사 1992 활천 Vol.462 No.-

초기 자궁경부암 환자에서 난소전이는 극히 드물게 볼 수 있다

박은동,박지욱,유건개,김동희,김홍열 大韓婦人腫瘍,콜포스코피學會 1992 Journal of Gynecologic Oncology Vol.3 No.1

하계학술발표 - 실무자를 위한 병원설비의 이해

박은동,김효준,Park, Eun-Dong,Kim, Hyo-Jun 대한기계설비건설협회 2012 기계설비 Vol.265 No.-

폐경 후 여성에서 활성형 비타민 D의 골밀도 및 골대사에 미치는 영향에 관한 연구

박은동,김흥열 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.3

폐경 후 여성에서 1년간 활성 vitamin D, 에스트로젠, 에스트로젠과 활성 비타민의 병합투여가 골밀도 및 골대사에 미치는 영향을 알기 위해 1996년 9월 1일부터 1997년 8월 31일까지 고신대학교 복음병원 산부인과를 방문한 환자 중 자연 폐경된 여성으로 마지막 월경 후 최소한 12개월 이상 무월경인 여성중에서 폐경과 관련된 증상이 있는 환자로서 이미 자궁의 양성 질환으로 인하여 자궁적출술을 받은 환자를 대상으로 무작위적으로 3종류의 치료군, 즉 활성 비타민 D 투여군[제Ⅰ군], 프레마린 투여군[제Ⅱ군], 프레마린과 활성 비타민 D 병용투여군[제Ⅲ군]에 각 군별로 35, 145, 70명씩을 배정하여 아침 첫 소변의 중간뇨[midstream]에서 혈중 osteocalcin, 요중 칼슘/creatinine비, 척추[L2∼L4] 및 대퇴골 경부의 골밀도를 측정하였으며 6개월 및 12개월 간격으로 소변내 칼슘/creatinine 비의 변화, 척추 및 대퇴골 경부의 골밀도 변화를 측정한 결과 다음과 같았다. 1. 척추[L2, L4] 골밀도의 변화는 6개월, 12개월째에 기저치에 대한 척추 골밀도의 비는 활성비타민을 단독으로 투여한 제Ⅰ군에서는 기저치에 대한 유의한 변화를 보이지 않았으나 에스트로젠 단독으로 투여한 제Ⅱ군, 에스트로젠과 활성 비타민을 병용한 제Ⅲ군에서는 기저치에 비해 12개월 치료 후의 결과가 통계학적으로 유의한 척추골밀도의 증가를 보였다.치료군간의 비교에서는 제Ⅰ군에 비해 Ⅲ군은 유의한 척추골밀도의 증가를 보였다. 2. 대퇴골 경부 골밀도의 변화는 6개월, 12개월째에 기저치에 대한 척추 골밀도의 비는 활성비타민을 단독으로 투여한 제Ⅰ군, 에스트로젠 단독으로 투여한 제Ⅱ군, 에스트로젠과 비타민 D를 병용한 제Ⅲ군 모두에서 기저치에 대한 유의한 변화를 보이지 않았다. 3. 혈청 osteocalcin의 변화는 6개월, 12개월째에 기저치에 대한 혈중 osteocalcin치는 vitamin D를 단독으로 투여한 제Ⅰ군에서는 기저치에 비해 유의한 감소를 보이지 않았다. 에스트로젠 단독으로 투여한 제Ⅱ군에서는 투여 12개월째 유의한 감소를 보였으며, 프레마린에 활성 비타민을 병용한 제Ⅲ군에서도 투여 12개월째 유의한 감소를 보였다. 세 군 모두 통계적으로 유의하지는 않았지만 제Ⅰ군에 비해 Ⅱ군, Ⅲ군 모두 혈중osteocalcin의 감소를 보였다. 4. 요중 칼슘/creatinine비의 변화는 6개월 12개월째에 기저치에 대한 요중칼슘/creatinine의 비는 활성 비타민을 단독으로 투여한 제Ⅰ군에서는 유의한 감소를 보이지 않았다.에스트로젠 단독으로 투여한 제Ⅱ군에서는 투여 12개월째 유의한 감소를 보였으며, 프레마린에 활성 비타민를 병용한 제Ⅲ군에서도 투여 12개월째 유의한 감소를 보였다. 세 군 모두 통계적으로 유의하지는 않았지만 제Ⅰ군에 비해 Ⅱ군, Ⅲ군 모두 요중칼슘/creatinine의 감소를 보였다. 이상의 결과로 활성 비타민 및 에스트로젠 단독 투여보다 에스트로젠과 활성 비타민을 병용투여함으로써 골밀도 증가에 보다 나은 효과를 달성할 수 있으리라 사료된다. The purposes of this study were to evaluate the effect of vitamin-D on the bone mineral density and bone metabolism in the postmenopausal women, and to compare the effect of vitamin D alone with those of premarin or premarin plus vitamin D. 250 postmenopausal women were randomly submitted to the 3 groups of treatment with 0.5㎍ of vitamin D daily by oral administration [Group Ⅰ], 0.625mg of premarin once a day [Group Ⅱ], and 0.625mg of premarin once a day plus 0.5㎍ of vitamin D daily by oral administration [Group Ⅲ]. Ⅰn all subjects, bone mineral density [BMD] of lumbar spine and femur neck, urinary calcium/creatinine ratio, and serum osteocalcin were measured before treatment and after 6 and 12 months of treatment. BMD of femur neck in Group Ⅰ, Group Ⅱ and Group Ⅲ increased but not significantly compared to basal level at 6 months and/or 12 months of treatment. As for BMD of lumbar spine, it increased significantly during the treatment in Group Ⅱ and Group Ⅲ, but not in Group Ⅰ. Serum osteocalcin in Group Ⅱ and Group Ⅲ decreased significanly at 12 months of treatment compared with Group Ⅰ. Urinary calcium/creatinine ratio in Group Ⅱ, Group Ⅲ, decreased significantly at 12 months of treatment compared with Group Ⅰ. From the above results, it might be suggested that combined therapy is more effective in post menopausal women with the protection on bone mineral density.

자궁육종 16 례에 대한 임상적 고찰

박은동,김홍열,유건상,석원일,서남원 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.11

Sarcoma of the uterus is very rare malignant tumor arising from the muscle or connective tissue, and there are only a few cases reported in Korea. We have experienced 16 cases of uterine sarcomas for 10 years from 1986 to 1995. The results are as follows: 1. The incidence of uterine sarcomas in uterine leiomyomas was estimated to 0.69%. 2. The pathologic types were 5 cases(31.3%) of leiomyosarcoma, 3 cases(18.8%) of endometrial stromal sarcoma, 6 cases(37.5%) of malignant mixed Mllerian tumor 2 cases(12.5%) of rhabdomyosarcoma in order. 3. The mean age was 46.4 years. 4. Seven(58.7%) were stage Ⅰ, 2(16.7%) were stage Ⅲ, and 3(25.6%) were stage Ⅳ. 4. The chief complaints on admission were abdominal mass(50%), abnormal bleeding(25%), and pelvic or abdominal pain(25%). 5. The estimated median survival was 43 months, and there was no correlation between survival and number of mitotic figure per 10 high power fields, stages, or radiation therapy.