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상피성 난소암 세포주에서 1-Cys Peroxiredoxin의 발현과 Cisplatin에 대한 저항성과의 관계
주원덕 ( Won Duk Joo ),박장호 ( Jang Ho Pak ),김종혁 ( Jong Hyeok Kim ),이신형 ( Shin Hyung Lee ),김대연 ( Dae Yeon Kim ),서대식 ( Dae Shik Suh ),김용만 ( Yong Man Kim ),김영탁 ( Young Tak Kim ),목정은 ( Jung Eun Mok ),남주현 ( Jo 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.10
목적: 상피성 난소암 세포주에서 1-Cys peroxiredoxin (Prx)과 cisplatin 저항성의 관계를 연구했다. 연구 방법: 정상 난소 및 상피성 난소암 조직에 1-Cys Prx에 대한 면역조직화학염색을 시행하고 SKOV-3, OVCAR-3, SNU-8에 cisplatin 투여 후 western blot으로 1-Cys Prx를 측정했다. SKOV-3의 cisplatin 투여 후 경과 시간과 투여량에 따른 1-Cys Prx 발현량 및 cisplatin 투여 후 활성산소종 생성과 항산화제 처리시 세포 생존율을 측정했으며 1-Cys Prx를 과발현시키고 cisplatin 투여 후 TUNEL 측정법을 시행했다. 결과: 정상 난소 및 난소암의 상피와 기질에서 1-Cys Prx가 발현되었고 특히 상피세포의 세포질에 강하게 발현되었다. SNU-8과 OVCAR-3는 SKOV-3보다 약 1.5배 더 발현되었고 SKOV-3에 cisplatin 투여 후 48시간 및 cisplatin 3 ㎍/㎖ 투여시 최대발현을 보였다. Cisplatin 투여 후 활성산소종 생성이 증가하였고 항산화제 농도와 세포 생존율 간에 유의한 상관관계를 보였으며 1-Cys Prx 과발현시 cisplatin 투여 후 세포자멸사를 일으키지 않았다. 결론: 상피성 난소암 세포주에서 1-Cys Prx는 cisplatin 저항성을 증가시키는데, 그 기전은 1-Cys Prx의 과발현으로 cisplatin에 의해 생성된 활성산소종이 제거되어 세포자멸사가 일어나지 않기 때문으로 생각된다. Objective: To investigate the relationship between expression of 1-Cys peroxiredoxin (Prx) and resistance to cisplatin in epithelial ovarian cancer cell lines. Methods: Immunohistochemistry of 1-Cys Prx was performed on both normal ovarian tissues and the tissues of epithelial ovarian cancer. Western blot was performed to measure the expression of 1-Cys Prx in SKOV-3, OVCAR-3 and SNU-8 after treatment with cisplatin. Expression of 1-Cys Prx in SKOV-3 was also measured according to both time after treatment with cisplatin and concentration of cisplatin. The generation of reactive oxygen species (ROS) was measured with and without antioxidants in SKOV-3. SKOV-3 was transfected with 1-Cys Prx green fluorescent protein plasmid to overexpress 1-Cys Prx and TUNEL assay was performed after treatment with cisplatin to examine apoptosis. Results: 1-Cys Prx was strongly expressed in both stroma and epithelium of both normal ovary and epithelial ovarian cancer, especially in the cytoplasm of epithelial cells. SNU-8 and OVCAR-3 exhibited about 1.5 fold higher expression than SKOV-3. SKOV-3 showed the peak expression at 48 hours after treatment with cisplatin and in 3 ㎍/㎖ concentration of cisplatin. The generation of ROS was increased after treatment with cisplatin to SKOV-3 and the survival of SKOV-3 against cisplatin was correlated with the concentration of antioxidants (p<0.001). No apoptosis occurred in 1-Cys Prx overexpressed SKOV-3 cells. Conclusion: 1-Cys Prx was shown to increase the resistance to cisplatin in epithelial ovarian cancer cell line. The result suggests that the resistance may be due to overexpression of 1-Cys Prx, which is responsible for removal of ROS generated by cisplatin.
주원덕(Won Duk Joo),김미경(Mi Kyung Kim),이성원(Sung Won Lee),최경찬(Kyung Chan Choi),이동헌(Dong Hun Lee),김종혁(Jong Hyeok Kim),김용만(Yong Man Kim),김영탁(Young Tak Kim),목정은(Jung Eun Mok),남주현(Joo Hyun Nam) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.10
We report a case of squamous cell carcinoma of Bartholin`s gland for the first time in Korea. The patient had diagnosed unexpectedly by an incidental Rt. Bartholin`s cystectomy at Chunchon Sacred Heart Hospital. She was transferred to Asan Medical Center and performed Rt. hemivulvectomy with ipsilateral inguinal-femoral lymph node dissection for staging. She was FIGO stage Ⅱ (T2N0M0) and has been followed up for 9 months without any evidence of recurrence. Squamous cell carcinoma of Bartholin`s gland is very rare among the female genital malignancies. The treatment of this malignancy is not established yet. So it should be individualized to the patient by the resectability and the status of resection margin involvement.
요로감염이 의심되는 환자의 소변검체에서 분리된 Escherichia Coli O26의 임상적 의의
유항조 ( Hang Jo Yoo ),주원덕 ( Won Duk Joo ),김미령 ( Mi Ryung Kim ),이수정 ( Soo Jeong Lee ),구본상 ( Bon Sang Koo ),정윤성 ( Joseph Jeong ),이선호 ( Seon Ho Lee ),김성률 ( Sung Ryul Kim ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.9
목적: 대장균에 의한 요로감염은 중증 질환의 출발점이 되는 경우가 적지 않고, 현재 non-O157 strain이 증가하고 있는 추세이며, 그 중 O26이 가장 흔한 type으로 알려져 있어, 본 연구에서는 E. coli O26 균주가 소변에서 검출될 경우의 임상적 의의를 조사하고자 하였다. 방법: 2005년 1월부터 2007년 12월까지 3년간 요로감염이 의심되는 경우, 소변배양에서 동정된 E. coli 175개 검체를 분석하였다. 균동정은 주로 MacConkey media에서 배양된 집락으로 균액을 만든 후 Vitek 1 (BioMeriaux Vitek Inc., MO., USA)으로 동정하였고, O157, O26, O111 진단용 항혈청 (National Institute of Health, Korea)으로 항혈청검사를 실시했으며, 응집반응을 보인 검체의 경우, 환자의 병력을 후향적으로 고찰하였다. 결과: 본원에 2005년부터 3년 동안, 산부인과에서 배양 의뢰한 모든 검체에서 자란 대장균은 총 331균주였으며, 이 중 요로감염이 의심되는 175개 검체를 대상으로 항혈청검사를 실시하여 O26만이 양성을 보인 경우는 22검체 (12.6%)가 있었다. 이들 검체 중, 수성 설사 (watery diarrhea), 용혈성 요독 증후군, 혈전성 혈소판감소성 자반증의 예는 8, 3, 2건으로 확인되었다. 결론: 요로감염이 의심되는 환자에서 대장균이 소변에서 배양될 경우 병원성이 있고 중증 합병증을 유발한 예가 있으므로, 대장균 균주 중, O157뿐만 아니라 O26에 대해서도 항혈청검사를 실시하여 보고하는 것이 유용할 것으로 판단된다. Objective: Escherichia coli (E. coli) O26 has been the most common type of non-O157 human isolates and it has been related with urinary tract infection and its sequelae. So we investigated the clinical significance of E. coli O26 among the cases of urinary tract infection. Methods: From January, 2005 to December, 2007, the 22 E. coli isolates that were related with urinary tract infection were analyzed. The isolates were identified biochemically by Vitek 1. We performed antisera test by O157, O26, O111 diagnostic antisera about the 22 E. coli isolates. We reviewed clinical history of the same patients retrospectively. Results: 331 E. coli isolates in the urine specimen were isolated from January, 2005 to December, 2007. 175 E. coli isolates that were related with urinary tract infection were analyzed by O157, O26, O111 antisera test. As a result, 22 isolates (13.5%) were O26 antisera positive. There were 8, 3, and 2 cases of watery diarrhea, hemolytic uremic syndrome, thrombotic thrombocytopenic purpura repectively. Conclusion: In our study, because E. coli O26 was pathogenic and developed major complications, we concluded that patients with urinary tract infection with E. coli. should examine the antisera test about E. coli O157 and O26.
단일공법 복강경하 난소낭종절제술과 고식적 방법과의 비교
이윤정 ( Yoon Jung Lee ),김명주 ( Myung Joo Kim ),성석주 ( Seok Ju Seong ),김인현 ( In Hyun Kim ),김미라 ( Mi La Kim ),송태종 ( Taejong Song ),윤보성 ( Bo Sung Yoon ),정용욱 ( Yong Wook Jung ),주원덕 ( Won Duk Joo ),전혜선 ( Hye S 대한산부인과학회 2012 Obstetrics & Gynecology Science Vol.55 No.5
목적 양성 난소낭종절제술에서 단일공과 고식적 복강경수술의 결과를 비교하여 단일공수술의 유용성과 안전성을 알아보고자 하였다. 연구방법2010년 1월부터 2011년 7월까지 단일공 복강경하 양성 난소낭종절제술을 받은 28명을 진단명에 따라 3군(자궁내막종, 성숙기형종, 그외)으로 분류하여 각 1:2비율로 고식적 복강경하 난소낭종절제술 받은 56명을 선정하여, 후향적인 의무기록 분석을 시행하였다. 결과환자의 나이, 체질량지수, 기존의 복강내 수술 여부나 낭종의 양측성 및 낭종의 평균 크기는 두 군 간 유의한 차이가 없었다. 유착박리술여부, 동시에 시행한 수술 여부, 실혈량, 수술시간, 수술 전후 혈색소 수치변화, 추가 진통제 사용 여부, 재원기간의 수술 결과에 있어서 양군 간 유의한 차이가 없었다. 그러나 낭종 종류별 분석결과, 자궁내막증에서 실혈량의 중위값은 단일공군 30 mL (범위, 30-200 mL), 고식적 복강경군 100 mL (범위, 30-450 mL)로 유의한 차이를 보였고( P = 0.017) 수술시간 또한 고식적 복강경 군의 중위값 60분(범위, 40-85분)으로 단일공군의 40분(범위, 30-100분)보다 유의하게 길었다( P = 0.004). 성숙기형종에서는 수술시간, 실혈량은 두 군 간 유의한 차이가 없었으나 수술 후 혈색소 수치감소 중위값은 단일공군에서 2.3 g/dL (범위, 2.0-3.1 g/dL)로 고식적 복강경수술을 받은 군인 1.4 g/dL 범위, 0.1-1.8 g/dL)보다 의미 있게 컸다( P = 0.002). 결론 배꼽 절개를 통한 단일공 복강경수술은 양성 난소낭종절제술에 있어 안전하고 유용하며, 기존의 고식적 복강경하 수술의 대안이 될 수 있다. Objective This study was conducted to compare the surgical outcomes between single-port access (SPA) and conventional laparoscopic ovarian cystectomy. Methods This retrospective, matched case-control study was performed in 84 cases, who underwent SPA laparoscopic ovarian cystectomy (cases: 28) by a single surgeon and conventional laparoscopic ovarian cystectomy (control: 56) by another surgeon who had similar surgical skill at our hospital between January 2010 and July 2011. Results All procedures were performed successfully in both groups without conversion to explo-laparotomy. There was no significant difference in demographic characteristics including size of ovarian cysts, estimated blood loss (EBL), operation time, hemoglobin change, postoperative hospital stay and number of patients needed extra anti-infl ammatory drugs between two groups. Analysis according to the type of cysts, median EBL (30 mL vs. 100 mL, P = 0.017) was higher in conventional group and operation time (40 minutes vs. 60 minutes, P = 0.004) was also longer in conventional group in case of endometrioma. The EBL, median operation time and postoperative hospital days were similar in both group, but median hemoglobin change was less in conventional group (2.3 g/dL vs. 1.4 g/dL, P = 0.002) in mature cystic teratoma patients. There were no signifi cant difference of surgical outcomes in others group. Conclusion SPA laparoscopic ovarian cystectomy using conventional laparoscopic instruments is feasible, effective and reliable technique, which can substitute conventional laparoscopy.
엄정민 ( Jeong Min Eom ),노현진 ( Hyun Jin Roh ),이수정 ( Soo Jeong Lee ),주원덕 ( Won Duk Joo ),이미영 ( Mi Young Lee ),유래미 ( Rae Mi You ),유항조 ( Hang Jo Yoo ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.8
목적: 본 연구는 배꼽을 통한 단일공 복강경하 자궁외 임신 수술의 방법, 유용성과 안전성을 평가하기 위함이다. 연구 방법: 2009년 10월부터 2010년 2월까지 울산대학교병원 산부인과에서 자궁외 임신으로 단일공 복강경 수술을 시행 받은 총 6명의 환자들의 의무기록지를 후향적 연구 방법으로 분석하였다. 결과: 환자의 나이의 중앙값은 33.5세 (범위, 32~36)였고 BMI의 중앙값은 20.6 kg/m2 (범위, 16.5~28.7)이었다. 자궁외 임신낭의 가장 큰 직경의 중앙값은 4.8 cm (범위, 3.0~5.4)이었고 모든 환자에서 임신낭 파열과 복강내 출혈을 보였다. 수술에 소요시간의 중앙값은 77.5분 (범위, 59~95)이었고, 수술 중 실혈량의 중앙값은 40 mL (범위, 20~50)이었다. 수술 후 재원 기간의 중앙값은 2일 (범위, 1~3)이었고, 재원기간과 마지막 추적 관찰 기간 동안에 합병증이 발생한 경우는 없었다. 결론: 배꼽을 통한 단일공 복강경하 자궁외 임신 수술은 자궁외 임신 치료에서 안전하고 유용하였고, 기존 다공법 복강경하 수술에 대안이 될 가능성이 있다. Objective: To evaluate the effectiveness of transumbilical single-port access laparoscopic surgery of ectopic pregnancy. Methods: Retrospective analysis was performed on six patients who underwent transumbilical single-port access laparoscopic management of ectopic pregnancies. Results: The median age of 6 cases was 33.5 years (range, 32 to 36), and the median body mass index was 20.6 kg/m2 (range, 16.5 to 28.7). The median largest diameter of G-sac was 4.8 cm (range, 3.0 to 5.4). Intracorporeal rupture and hemoperitoneum were accompanied in all cases. The median time needed for the surgery was 77.5 minutes (range, 59 to 95). The median estimated blood loss was 40 mL (range, 20 to 50). The median postoperative hospital day was 2 days (range, 1 to 3). There were no complications on postoperative course and follow-up. Conclusion: Transumbilical single-port access laparoscopic surgery for ectopic pregnancy was feasible and safe. This approach might be reasonable alternative to conventional laparoscopic surgery using 3 or 4 port in the management of ectopic pregnancy.
김미령 ( Mi Lyoung Kim ),유항조 ( Hang Jo You ),윤은숙 ( Eun Suk Yoon ),심승혁 ( Sung Hyuk Sim ),구본상 ( Bon Sang Koo ),주원덕 ( Won Duk Joo ),차희정 ( Hee Jeong Cha ),이현우 ( Hyun Woo Lee ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.1
Lymphoepithelioma-like carcinoma (LELC) of the uterine cervix is a rare tumor with 0.7% of all primary cervical malignancies. It may grossly range from no visible cervical lesion to a large exophytic cervical mass and histologically similar neoplasms occur in the nasopharynx. It has been classified as a subtype of squamous cell carcinoma. But, after reviewing the literature, this tumor is a distinct carcinoma of the cervix that differs from squamous cell carcinoma. LELC is composed of undifferentiated cells surrounded by a marked inflammatory infiltrate, characterized by plasma cells and lymphocytes in the stroma. It may represent a better prognostic group than the more common squamous cell carcinoma of the cervix because of lack of lymph node metastasis. Typically affects a younger population of women, is more prevalent in noncaucasian population (especially, those of Asian descent). However, it is not clearly understood, Epstein-Barr virus play in the pathogenesis of cervical LELC while humam papilloma virus (HPV) is a risk factor for squamous cell carcinoma. The prognosis is good only by surgical treatment. Radiation therapy also appears to be effective in eradicating localized, low-stage disease (radiosensitive). The authors have experienced one case of LELC of the uterine cervix. We report a case with a brief review.