천식으로 오인된 폐동맥 슬링 1례

천은경,김기수,임재우,고경옥 대한소아청소년과학회 2004 Clinical and Experimental Pediatrics (CEP) Vol.47 No.10

Anomalous left pulmonary artery(pulmonary artery sling) is a congenital anomaly in which the vascular structure arises either from the posterior surface of the right pulmonary artery, or from the main pulmonary artery and courses to the left lung between the posterior surface of the trachea and the anterior surface of the esophagus. It may compress on the tracheobronchial tree causing significant symptoms on the part of the respiratory system such as dyspnea, stridor, or cyanosis. It is a rare condition leading to death in the first months of life, if it is not corrected. We present a case of pulmonary sling who was suffering from recurrent lower respiratory tract diseases, expiratory wheezing, and intermittent dyspnea since birth, thus she was treated for bronchial asthma. We confirmed the diagnosis with computerized tomography, especially with three dimensional reconstruction, which provided information regarding the spatial relationship between the anomalous pulmonary artery branch and the trachea and bronchi 저자들은 신생아기부터 반복되는 천명음과 호흡 곤란을 동반한 호흡기 감염으로 천식으로 치료받아오던 3세 여아에서 뒤늦게 폐동맥 슬링이 진단된 증례를 경험하였기에 보고하는 바이다. 폐동맥 슬링은 3차원 전산화 단층 촬영으로 확진하였다.

8주간 복합운동이 초등학생의 건강 관련 체력과 혈중 지질에 미치는 영향

천은경(Chun, Eun-Gyeong),김정원(Kim, Jeong-Weon) 한국체육과학회 2021 한국체육과학회지 Vol.30 No.6

The purpose of this study was to investigate the effect of a combined exercise program consisting of aerobic exercise using skipping rope and resistance exercise using weight-bearing on health-related physical fitness factors and blood lipid factors of elementary school students. The study subjects of this study were 20 elementary school students. We divided the study subjects into two groups by equal division. We applied a combined exercise training to one group (10 people), and the other group (10 people) was organized as a control group. The control group controlled the exercise program outside of daily life. As a result of the study, the 8-week complex exercise program did not show significant improvement in the health-related physical fitness factors and blood lipid factors of elementary school students, but there was an improvement potential. In conclusion, combined exercise training of aerobic exercise using jumping rope and resistance exercise using bodyweight is worth reviewing to improve children"s health-related physical fitness and blood lipids on the premise of increasing exercise intensity or exercise time. Therefore, researchers conducting follow-up studies should consider adding exercise intensity and exercise time.

체외수정시술을 위한 과배란유도에 있어 GnRH Antagonist의 임상적 효용성과 혈중 호르몬 농도의 변화

문신용,천은경,김상돈,최영식,지병철,구승엽,서창석,최영민,김정구,김석현,Moon, Shin-Yong,Chun, Eun-Kyung,Kim, Sang-Don,Choi, Young-Sik,Jee, Byung-Chul,Ku, Seung-Yup,Suh, Chang-Suk,Choi, Young-Min,Kim, Jung-Gu,Kim, Seok-Hyun 대한생식의학회 2004 Clinical and Experimental Reproductive Medicine Vol.31 No.4

Objectives: To evaluate the efficacy of GnRH antagonist cetrorelix in women undergoing controlled ovarian hyperstimulation (COH) for in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) and to determine changes in serum hormone concentrations during cetrorelix administration. Methods: We performed a clinical trial on 30 patients undergoing COH with highly purified follicular stimulating hormone (HP-FSH) and gonadotropin releasing hormone antagonist (GnRHant), cetrorelix. FSH was administrated from day 2 or 3 of cycle with fixed dose and adjusted according to individual response. 0.25 mg of cetrorelix was injected daily subcutaneously from stimulation day 5 until the day of hCG administration. Daily ultrasound monitoring was performed for growing follicles and serum levels of luteinizing hormone (LH), estradiol ($E_2$) and progesterone were measured daily during cetrorelix administration. Up to 4 embryos were transferred. Results: Mean age of enrolled patients was $32.0{\pm}3.4$ years (mean $\pm$ S.D.). All of 30 patients underwent oocyte pick-up, and embryo transfer was done in 28 patients. The total and mean numbers of received oocytes were 196 and $6.5{\pm}4.7$, the number of fertilized eggs was 111, and the fertilization rate was 56.6%. Total duration of FSH administration was $9.2{\pm}2.2$ days and mean of $24.3{\pm}7.7$ ampules of HP-FSH was administered. Total duration of cetrorelix administration was $5.7{\pm}1.9$ days. Serum LH and progesterone levels were maintained in the range of $1.4{\sim}2.9\;mIU/mL$ and $0.3{\sim}0.6\;ng/mL$, which respectively reflected effective prevention of premature LH surge. Clinical pregnancies were achieved in 9 patients, and overall clinical pregnancy rate was 30.0% per oocyte retrieval, and 32.1% per embryo transfer. Conclusion: GnRH antagonist is safe and convenient for COH for IVF-ET and effective with optimal pregnancy rate.

모성 심 질환이 동반된 임신의 임상양상

윤상호(Sang Ho Yoon),천은경(Eun Kyung Chun),심순섭(Soon Sup Shim),임준희(June Hee Lim),박중신(Joong Shin Park),전종관(Jong Kwan Jun),윤보현(Bo Hyun Yoon),신희철(Hee Chul Syn) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.7

목적 : 전체 임신의 약 1%를 차지하고 있는 모성 심 질환이 동반된 임신의 결과에 대해 알아보기 위함이다. 연구 방법 : 1994년부터 2001년까지 최소한 임신 20주 이후에 분만하였으며 모성 심 질환이 동반된 산모의 의무기록을 고찰하였다. 결과 : 심장질환을 동반한 산모는 총 195명으로 224예의 분만이 있었다. 224예의 임신 중 류마티스성 심질환군이 117예 (52.2%), 선천성 심 질환군이 96예 (42.9%)에 해당하였으며, 나머지는 11예로 부정맥, 심근병증, 승모판막 탈출 증후군 등이었다. 임신과 관련된 모성사망은 2예 (0.9%)가 있었으며, 대부분의 산모 (91.9%)가 분만 전, 분만 중, 분만 후의 뉴욕 심장협회 운동기능 평가상 class I, Ⅱ에 해당하였다. 태아의 평균 재태 기간과 출생시의 평균체중은 37.9주와 2883 gm 이었다. 주산기 사망률이 17.9/1000이며, 선천성 기형은 6예로 전체의 2.7%를 차지하였으며, 선천성 심기형의 재발률은 2.1%였다. 결론 : 모성 합병증 및 조산, 저 체중아의 대부분이 뉴욕 심장협회 운동기능 평가상 class Ⅲ, Ⅳ 심 질환 산모군에서 발생하였다. 산모의 운동기능상태 평가가 산모 및 태아의 예후에 중요한 인자라 할 수 있다. Objective : To assess the pregnancy outcomes complicated by maternal heart diseases. Methods : From 1994 to 2001, medical records of pregnant women who had reached at least 20 weeks of gestation with maternal heart diseases were reviewed. Results : 224 deliveries of 195 women were enrolled in this study. In 117 (52.2%) cases the heart diseases were of rheumatic origin, in 96 (42.9%) cases congenital, and the remaining 11 (4.9%) cases were miscellaneous group that included arrhythmia, cardiomyopathy, and mitral valve prolapse. There were 2 (0.9%) cases of maternal death related to pregnancy. Majority (91.9%) were in New York Heart Association functional classes I, Ⅱ before, during, and after delivery. Mean gestational age at birth and birth weight were 37.9 weeks and 2883 gm. Perinatal mortality rate was 17.9/1000 and the rate of congenital malformation was 2.7%. Recurrence risk of neonatal congenital heart disease was 2.1%. Conclusion : Most complications were developed in the pregnancies complicated by maternal heart diseases with New York Heart Association functional classes Ⅲ, Ⅳ. Functional status of the pregnant women is the important risk factor in maternal and fetal outcomes.

황체호르몬 수용체의 발현이 저반응 환자군의 임신에 미치는 영향

이정복,도병록,김은수,김명희,천은경,정현정,노성일,김문규,윤현수,Lee, Jung-Bok,Do, Byung-Rok,Kim, Eun-Soo,Kim, Myung-Hee,Chun, Eun-Kyung,Jeong, Hyeon-Jeong,Roh, Sung-Il,Kim, Moon-Kyoo,Yoon, Hyun-Soo 대한생식의학회 2004 Clinical and Experimental Reproductive Medicine Vol.31 No.2

Objectives: To investigate the effect of LH receptor in folliculogenesis, we confirm the expression level of LH receptor (LH-R) mRNA in human granulosa cells (GCs) and its expression levels were analyzed by comparison to embryo developmental rate and pregnancy rate. Materials and Methods: GCs were obtained at the time of oocyte retrieval from the patients undergoing IVF-ET program. The patients were divided into two groups: Group I (n=20) is poor responder (retrieved oocyte(s)$\leq$3ea), Group II (n=80) is normal responder (retrieved oocytes>3ea). After the extraction of total RNA, semiquantitative RT-PCR was performed and the expression level of LH-R mRNA was normalized by $\beta$-actin. Statistical analysis was performed by using $X^2$ test, Student's t-test and Pearson correlation. Results: In Group II, the relative values of LH-R mRNA (0.680 vs. 0.463, p<0.005) and pregnancy rate (54.7% vs. 23.1%, p<0.05) were significantly higher than in Group I. Number of retrieved oocyte(s) was gradually increased when the expression of LH-R mRNA was increased (p<0.05). But the quality of retrieved oocyte and transferred embryo were not related with the expression of LH-R mRNA. When the pregnancy rate was compared with FSH only group and FSH combined with hMG group in the ovarian stimulation protocol, FSH combined with hMG group was significantly higher than FSH only group in Group I (37.5% vs. 0%), and the expression of LH-R mRNA was significantly higher in hMG combined group than FSH only group (p<0.05). Conclusion: Expression level of LH-R mRNA has important role in ovarian function related with the response to gonadotrophin in human folliculogenesis. Furthermore these data might provide the evidence that additional use of hMG is helpful to poor responders.

임신기간 중에 진단된 악성 종양에서 모성 및 태아의 성적에 대한 임상적 고찰

서상수 ( Sang Soo Seo ),천은경 ( Eun Kyoung Chun ),김병재 ( Byoung Jae Kim ),김문홍 ( Moon Hong Kim ),노주원 ( Ju Won Roh ),김재원 ( Jae Won Kim ),박중신 ( Joong Shin Park ),전종관 ( Jong Kwan Jun ),박노현 ( Noh Hyun Park ),송용상 대한주산의학회 2000 大韓周産醫學會雜誌 Vol.11 No.4

A Personalized and Learning Approach for Identifying Drugs with Adverse Events

신선균,권영옥,허호,천은경,오옥희,이정선,고우진,김범석 연세대학교의과대학 2017 Yonsei medical journal Vol.58 No.6

Purpose: Adverse drug events (ADEs) are associated with high health and financial costs and have increased as more elderly patientstreated with multiple medications emerge in an aging society. It has thus become challenging for physicians to identify drugs causing adverse events. This study proposes a novel approach that can improve clinical decision making with recommendations on ADE causative drugs based on patient information, drug information, and previous ADE cases. Materials and Methods: We introduce a personalized and learning approach for detecting drugs with a specific adverse event, where recommendations tailored to each patient are generated using data mining techniques. Recommendations could be improvedby learning the associations of patients and ADEs as more ADE cases are accumulated through iterations. After consulting the system-generated recommendations, a physician can alter prescriptions accordingly and report feedback, enabling the systemto evolve with actual causal relationships. Results: A prototype system is developed using ADE cases reported over 1.5 years and recommendations obtained from decision tree analysis are validated by physicians. Two representative cases demonstrate that the personalized recommendations could contribute to more prompt and accurate responses to ADEs. Conclusion: The current system where the information of individual drugs exists but is not organized in such a way that facilitates the extraction of relevant information together can be complemented with the proposed approach to enhance the treatment of patientswith ADEs. Our illustrative results show the promise of the proposed system and further studies are expected to validate its performance with quantitative measures.

고용량 MTX/EMA-CO, 경막내 MTX 및 전뇌방사선 치료로 완전관해된 뇌전이 융모상피암 1예

김재원,박노현,송용상,이효표,강순범,서상수,윤형동,천은경,노주원 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.1

뇌에 전이된 융모상피암은 항암치료에 불응성인 경우가 많고, 완전관해 이후에도 재발율이 높아 예후가 불량한 것으로 알려져 있다. 따라서 환자를 개개인에 적합하게 다양한 치료방법을 적극적으로 적용해야 치료 성공을 기대할 수 있다고 알려져 있다. 저자들은 뇌로 전이된 융모상피암으로 인한 뇌출혈로 두 차례의 응급 개두술과 장천공으로 응급 시험적 개복술을 받은 환자를 대상으로 고용량 MTX/EMA-CO, 경막내 MTX 그리고 전뇌 방사선조사를 시행하여 완전관해에 이른 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Patients of choriocarcinoma with brain metastases are considered to have a very poor prognosis due to chemo-refractoriness and recurrence. So, selection and individualization of patients then followed by multimodality therapy are very important. We present a case of a patient who experienced twice of craniotomies due to intracranial hemorrhage and an emergent explorative laparotomy due to intestinal perforation of the metastatic sites of choriocarcinoma. She was treated with 12 cycles of high-dose MTX/EMA-CO, intrathecal MTX and WBRT. Eventually she has obtained a complete remission that ongoing for 2 years. So, we report this case with a brief review of the literatures.

논문 : 수정된 배아의 전핵상태가 배아 발달 및 임신률에 미치는 영향

김희선 ( Kim Hui Seon ),성기청 ( Seong Gi Cheong ),오선경 ( O Seon Gyeong ),천은경 ( Cheon Eun Gyeong ),천대우 ( Cheon Dae U ),서창석 ( Seo Chang Seog ),김석현 ( Kim Seog Hyeon ),최영민 ( Choe Yeong Min ),김정구 ( Kim Jeong Gu 서울대학교 인구의학연구소 2001 人口醫學硏究論集 Vol.14 No.1

임신 중 처음 진단된 원발성 간암 3예

김성일,이지영,이택상,윤보현,한수연,전종관,박중신,신희철,윤형동,천은경 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.12

B형 간염은 우리 나라를 비롯한 동아시아의 풍토병으로 이에 따른 간경변 및 원발성 간암의 빈도가 서구에 비하여 매우 높다. 그러나, 대개의 간경변 및 원발성 간암은 가임 기간이 지난 후에 발병하고 간질환 자체가 임신능력을 감소시켜, 원발성 간암이 임신과 동반되는 경우는 흔치 않기 때문에 임신과 원발성 간암 사이의 상호관계에 대해 확실히 알려진 바는 없다. 임신이 원발성 간암의 진행에 미치는 영향은 아직 확실히 알려진 바는 없지만, B형 간염 항원을 보유하고 있는 산모 혈액에서 AFP의 측정과 복부 초음파를 통한 조기진단이 가장 중요하다. 이에 저자들은 임신 중 산전 진찰을 통해 처음 진단된 원발성 간암 3례를 경험하였기에 이와 관련된 문헌고찰과 함께 보고하는 바이다. Korea is an endemic area for hepatitis B virus infection, so incidence of hepatocellular carcinoma resulting from liver cirrhosis is higher than in western countries. But pregnancy is rarely encountered in women with hepatocellular carcinoma, since hepatocellular carcinoma usually develops after childbearing ages. Additionally severe menstrual irregularity and infertility with disturbance of estrogen metabolism often accompany cirrhosis that is a most common underlying disease of primary hepatocellular carcinoma. Whether hepatocellular carcinoma progresses abruptly in pregnancy remains equivocal, because the experiences are lack. Anyway, early diagnosis by maternal serum AFP and abdominal sonography offers the potential for prevention of the disease progression and longer survival. Thus, we report 3 cases of primary hepatocellular carcinoma first detected on prenatal check during pregnancy with brief review of the literature.