정상월경주기 및 남성화 호르몬 기능이상자에서의 방사면역측정법을 이용한 혈청 Testosterone

최성기(SK Choi),김윤호(YH Kim),나종구(Rha CG),정병래(BL Chung) 대한산부인과학회 1975 Obstetrics & Gynecology Science Vol.18 No.6

In this study serum testosterone levels of 4 normal women through full menstrual cycle , 4 female patients with various androgenic disorders and a healthy adult man were measured by modified Midgley method of double antibody technique using radioimmunoassay kit obtained from Serono Immunochemical Company. The results were as follows; 1. The recovery of testosterone after extraction with ethanol was 89.2%. However, ethanol and benzene was improper as extractive solvent because of difficulty in its separation and evaporation. The recoveries of testosterone with ether, petroleum ether and benzene were 68.9%, 15.6% and 67.7% respectively thus it was found that ethyl ether is most suitable for extraction of testosterone. 2. The mean serum testosterone level after extraction of female patients with androgenic disorders was 2.06+-1.09 ng/ml, while that without extraction was above 4 ng/ml. The difference in testosterone value between before and after extraction was sighnificantly 3. The mean serum testosterone level through menstrual cycle in normal women was 1.27 ng/ml. The average serum testosterone levels in menstrual phase and premenstrual phase were 0.97 ng/ml and 1.06 ng/ml, respectively. On the other hand, the level in ovulatory phase was 1.96 ng/ml, which is sighnificantly higher than those in menstrual and premenstrual phase.

조기파수로 인한 태반염의 임상병리학적 연구

최성기(SK Choi),송승규(SK Song),박찬동(CD Park),이경희(KH Lee) 대한산부인과학회 1969 Obstetrics & Gynecology Science Vol.12 No.7

The clinico-pathological studies on the placentitis were based on 32 cases of the premature ruprure of membranes which were selected on dept. of obstetrical service, St, Mary`s Hospital, Catholic Medical College, from Aug. to November 1968. 1. The prevalence of neutroptilic infiltration, especially in the decidua of the membranes, in placentas of women who were delivered on our service, is described. 2. Of the placentas examined by the 4 section method, 75 per cent had neutrophilic infiltration in the cases of premature rupture of membranes. 3. Moderate or severe placentitis (GradeII,III) could be correlated with premature rupture of mombranes. 4. No significant differences between normal and infected placental were noted in the matermal ages, parities, and dutation of labor. 5. The distal and proximal portion of the umbilical cord were found to be useful areas for determining whether or not severe placentitis is present, in as much as the presence of a definite neutrophilic infiltration in microscopic sections from both of these cord areas almost invaria- bly meant the presence of a severe placentitis. 6. Maternal blood leukocytes were likely seemed to be proportionate to degree of placentitis. 7. Of the amniotic fluid cultivated, 53.1 per cent had microorganisms in the placentitis due to premature rupture of membranes. Staphyloclccus and Escherichia coli were more prevalent pathogens in the premature rupture of membranes. 8. Furadantion and kantrex were useful antibiotics in the management of the placentitis.

한국부인에 있어서 융모성 질환의 임상적 특징

최성기(SK Choi),김경태(KT Kim),김수평(SP Kim),박종각(JK Park),김승조(SJ Kim) 대한산부인과학회 1976 Obstetrics & Gynecology Science Vol.19 No.9

가톨릭 의과대학 부속 성모병원 산부인과에 설치된 가톨릭 융모성질환연구소에 1971년 1월 부터 1975년 12월까지 등록된 257예의 융모성 질환 즉 포상기태 187예, 파괴성기태 11예와 융모상피암 59예를 대상으로 임상적 특징과 역학적 분석, 포상기태의 조직병리학적 분류에 따른 hCG치의 변화와 예후, 방사면역측정법을 이용하여 융모성질환의 관리 및 경쾌판정 기 준을 마련한 결과는 다음과 같다. 1. 분만수에 대한 융모성종양의 발생빈도는 151분만 중 1예였으며, 포상기태가 208:1, 파괴성 기태가 3524:1, 융모상피암이 634:1이었고, 해마다 증가하는 경향을 보였다. 2. 융모성질환의 발생에 관여하는 요인으로서 연령, 빈곤한 생활층과 교육정도를 들수 잇었 고, 임신회수와 분만회수는 무관하였으며, 서울 중심부에서는 포상기태, 시골에서는 융모상 피암의 빈도가 높았다. 3. 혈액형에 따른 융모성종양의 발생은 A형에서 40.7%로 가장 많았으나, 일반혈액형 분포비 율과 일치하였다. 즉 A , O형, B형, AB형의 순이었다. 4. 선행임신이 정상분만이었던 예는 포상기태가 19.9%, 융모상피암이 15.3%였고 유산이었던 예는 포상기태, 파괴성 기태, 융모상피암이 각각 49.2%, 45.5% 및 39.1%로 가장 많았으며, 반복포상기태가 1.6%, 포상기태가 선행임신이었던 융모상피암은 37.3%였다 5. 융모성질환의 가장 많은 임상증상은 성기출혈로서 포상기태, 파괴성기태 및 융모상피암이 각각 71.7%, 81.8% 및 36.6%였으며, 출혈기간은 1개월이 가장 많았다. 6. 포상기태에서 자궁증대가 무월경 기간보다 컸던 예는 60.4%였고, 적었던 예는 10.7%였다. 7. 융모성질환의 전이부위는 포상기태의 6.6%에서 파괴성기태에서는 18.0%에서 전이를 보였 고, 융모상피암에서는 89.1%로서 폐, 질, 자궁경부의 순서로 전이하였다. 8. Goldstein의 치료기준분류법으로 분류한바 class 1 이 56.8%로 가장 많앗고 class 5가 14.8%, class 3가 10.9%, class 4 가 10.9%, class 2가 5.4%의 순이었다. 1. The each incidence of hydatidiform mole, destructive mole and choriocaricinoma was 0.48%, 0.03% and 0.66% Trophoblastic diseases seemed to be annually increasing 2. Maternal age and poor socioeconomic status were related to probable etiologic factors of the tropphoblastic disease, but gravidity and parity were not proportinated . 3. By classifying with ABO blood type among 162 trophoblastic patients, A type was most common(40.7%) but the orders of frequency were accordance with the expected distribution of blood types in korean women. 4. Antecedent pregnancy was abortion in 49.2% of hydatidiform mole, 45.5% of destructive mole and 39.1% of choriocaricinoma and it was most common. 37.3% of choriocarcinoma occured after hydatidiform mole. 5. The most common symptom among trophoblastic patients was vaginal spotting or bleeding and its average duration was about 1 month. 6. 60.4% of hydatidiform mole had increased uterine size comparing for gestational date, and 10.7 had small-for-date uteri. 7. metastasis among 187 hydatidiform mole was discorved in 12 cases (6.6%) Among 52 patients with metastatic choriocaricinoma (89.1%) 50.8% of them had lung metastasis, 8.5% to the cervix and 6.8% to the vagina. 8. By goldsteins therapeutic classification class 1 was most common (56.8%) and then class 5 (14.8%) class 3(10.3%) class 4 (10.9%) and class 2 (5.4%) in order.

배란유발촉진법

최성기(SK Choi) 대한산부인과학회 1979 Obstetrics & Gynecology Science Vol.22 No.8

배란유발제를 사용하여 시상하부-뇌하수체-난소계를 자극하여 배란유발을 시도하여야 할 환자들은 우선 무배란 내지 월경주기이상의 원인분류를 해야하며 다른 환자군에 따른 개인별 치료계획이 무엇보다 효과적치료결과를 얻게 되나 과연 정상 생식생리현상과 동일한 배란현상이 일어날 수 있는지의 여부 또는 이와 같은 약제가 인체에 미치는 영향에 대한 자기간에 걸친 지중한 기초연구와 함께 현재 임상에서의 세심한 주의가 필요할 것으로 생각된다.

제왕절개후 자궁반흔의 X선 자궁조영술에 의한 관찰

송승규(SK Song),최성기(SK Choi),김영환(YW Kim) 대한산부인과학회 1970 Obstetrics & Gynecology Science Vol.13 No.10

Understanding of the morphology and morbidity of the uterine scars that form following cesarean section is of freat help in preventing possible rupture of the uterus and to select the type of delively on the subsequent pregnancy. The present study has been undertaken to make observation on the uterine changes revealed by hysterogram. The clinical materials were consisted in 44 women who had at least one previous cesarean section, and also in 10 normal parous women after normal vaginal delivery as the control. The hysterogram was performed by Kjellberg`s method employing fractionation of the contrast medium(Lipiodolⓡ 25%) according to Hyam`s recommendation. The following results and conclusions were obstained. 1. Of 44 women with previous cesarean section, 31.8% showed normal hysterofram, In the remain- ing patients, hysterographic abnormalities of various degree were noted. The most frequent type od X-ray changes was a mild outpouching at the site of previous surgery, i.e., isthmus or so-called lower uterine segment(during pregnancy). 2. The deformation of the uterus on husterogram in the patients with multiple cesarean sections was more prominent and marked than in the patients with single operation. 3. There is no relationship between the degree and type of deformation and such periparturient complications as prematured rupture of the membrance, prolonged delivery, post-operative febrile episode (a fever higher than 38℃), or post-operative abdominal infection. On the other hand, all these factorts excepting premature rupture of the membrance seem to have some form of influence on the incidence of the scar formations.

항HCG B-Subunit 혈청을 이용한 혈중 융모성 성선자극호르몬의 특이방사면역측정

김승조(SJ Kim),최성기(SK Choi),김철성(CS Kim),김응호(YH Kim) 대한산부인과학회 1975 Obstetrics & Gynecology Science Vol.18 No.7

항 hCG B-subunit혈청을 융모성 성선자극호르몬의 방사면역 측정에 이용하여 일반 단백호 르몬의 방사면역 측정이 갖는 교차반응을 극복할 수 잇는 특이 면역측정법에 대한 검토를 한 바 다음과 같은 결론을 얻었다. 1. 125 I-hCG와 표지하지 않는 hLH를 여러항 혈청에서 경쟁결합시킨 결과 항 hLH Batch 1 혈청과 항 hTSH혈청에서 유의한 교차반응을 보였다. 2. 항 hCG혈청에서 125I-hCG와 표지하지 않은 hCG, 2nd IRP-HMG그리고 hLH를 경쟁결합 시킨결과 상호 교차 반응을 관찰할 수 잇었고 hCG와 2nd IRP-HMG는 거의 유사한 결합반 응을보였다. 3. 항 hCG B-subunit혈청에서 125 I-hCG와 표지되지 않는 hLH, 2nd IRP-HMG, hCG 그리고 hCG B-subunit를 경쟁결합 시켰을 때 특이 결합반응을 hCG, hCG B-subunit에서 관찰할 수 있었다. 4. 항 hCG B-subunit 혈청을 이용한 hCG의 방사면역 측정을 소수의 환자에서 시행한 결과 항 hCG 혈청을 이용한 환자의 혈청중의 hCG보다 낮은 수치를 보엿고 특이 측정이 된 것을 볼 수 잇었다. 5. 이상으로서 좀더 hCG B-subunit에 대한 연구가 진척되면 교차반응을 감별할 수 잇는 특 이 방사면역 측정법이 개발되리라 생각된다. Assay of glycoprotein hormones have wide and numerous applications in research of human reproduction and clinical practice. Because it is cheaper, easier to replicate, and more sensitive, immunoassay is rapidly replacing bioassay for these human hormones in research and in clinical practice. Radiommunoassay varies widely in their degree of specificity for different molecular forms, so the specificity of assay systmes for each hormone should be rigorously assessed. The problem is especially complex with the glycoprotein hormones because of their close structural similarity . Recent researches reveal that the a-subunit, comprising about half the molecule of pituitary FSH, TSH, LH and hCG are very similar to each other for these hormones. Hence one method might be the use of a specific antiserum to the B-subunit of hCG, which would react with both the B-subunit and intact hCG, but not with LH. 1. Binding of 125I-hCG after iodination with anti hCG serum were 23.34+-1.62% at the 3rd week, 13.66+-1.02% at the 4th week, and 6.90+-1.11% at the 6th week. 2. In the displacement study of 125 I-hCG unlabelled hormones from anti-hLH and anti-hTSH sera native hCG cross-reacted with both antisera. 3. Antisera to the B-subunit of hCG discriminated hCG from hLH and hMG while most of antisera produced by immunization with intact hCG did not. 4. None of glycoprotein hormones preparation tested cross reacted at physiological levels in the patients by the hCG B-subunit radioimmunoassay system. The development of that radioimmunoassay and some applications will reflect the potential clinical usefulness of the specific hCG radioimmunoassay.

항 황체화 호르몬 및 갑상선 자극호르몬 혈청의 면역학적 및 생물학적 특성에 관한 연구

김승조(SJ Kim),최성기(SK Choi),나종구(Rha CG),정구윤(KY Chung),남궁성은(SE Namkoog),김수평(SP Kim) 대한산부인과학회 1975 Obstetrics & Gynecology Science Vol.18 No.10

Although major contributions to protein structure have been made by studies on such protein and carbohydrate containing hormones of the pituitary gland, thyrotropin(TSH), luteinizing hormone (LH or ICSH) and related placental glycoproteins, presents chemists and endocrinologists with more difficulties Certainly of major biological importance and of possible importance in clinical investigation is the discovery that one of the TSH chains TSH-a is so similar to one of the chains of LH, the LH-a chain , that they are indistinguishable in amino acid composition and probably, in amino acid sequence These similar chemical and physical properties of the two hormonoes perphaps make immunological cross reaction with some antisera to TSH and LH in vivo. petrusz et al. had made the polymorphism of protein hormone as antigen, clear by doing the biological assay for the neutralizing potency of the anti-gonadotropin serum. Lauternce and Kim investiaged that the biological action and histochemical activity in the ovary was restrained as the endogenous LH is neutralized in the rats and rabbits as the result of passive immunization with anti-LH serum Rats have two clear peak of progesterone release at proestrus and diestrus. High peak of progesterone concentration usually occur about 2 hours after LH surge during proestrus in the rats. The present experiment were desinged to determined how anti-LH and TSH antibody would react with endogenous hormones in the rat and would alter the reproductive system of the treated animals, and how was differences between Anti-LH and Anti-TSH serum on immunologic neutralizing potency of endogenous TSH in the mice and progesterone synthesis in the antibody treated rats.

난소낭종으로 오진된 요막관 악성종양의 1 예

박종각(JK Park),조윤원(YW Cho),최성기(SK Choi) 대한산부인과학회 1975 Obstetrics & Gynecology Science Vol.18 No.8

최근 가톨릭의대 부설 성모병원 산부인과학교실에서 나소낭종으로 진단되어 개복수술중 요막관기형에 악성종양이 발생된 희귀한 증례를 경험하였기에 간단한 문헌적 고찰과 함께 보고하는 바이다. Malignant tumor of the urachus is very rare. The urachus develops in early fetal life from the allatois primitive excretory organ. After the second or third month of fetal life, this tubular structure was normaly obliterated and gradually disappeared. But variation of this normal pattens of development makes various urachal anomlies. We experienced a malignant tumor originaed from urachus which was impresed as an ovarian cyst before operation. We present a case of malignant tumor of urachus with a brief review of the concerned literature.

Desamino-Oxytocin ( Oral Pitocin, Sandopart ) 의 유도분만경험

박원상(WS Park),노영철(YC Roh),최성기(SK Choi),김윤호(YH Kim) 대한산부인과학회 1974 Obstetrics & Gynecology Science Vol.17 No.6

1973년 11월부터 1974년 2월까지 본 가톨릭의대 부속 성모병원 산부인과에 입원 분만한 산모 중 19예를 대상으로 oral pitocin을 사용하여 유도 분만을 시도한 결과 아래와 같은 결과를 얻었다. 1) 유도 분만은 총 19예 중 16예가 이 방법으로 성공하여 평균 85%의 성공률을 보였으며 2) 분만전의 연령층은 21세에서 40세까지로 초산부 9명 경산부 10명이며 4명은 임신 33주 -39주, 11명이 40주-42주 사이였고 4명은 임신 43주였다. 3) Pelvic score는 3-11 사이였으며 평균 Pelvic score는 5.8로서 분만의 성공율은 Pelvic score의 점수와 관련이 있는 것 같았다. 4) 진통 유발 시간은 약제 투여 후 15분에서 4시간 사이였으며 평균 30분에서 2시간 사이였 다. 5) 진통 유발에 필요한 약용량은 평균 465 I.U.로서 초산부 429 I.U., 경산부 422 I.U.로서 양 자간에는 별 차이가 없었다. 6) 초산부에 있어서 평균 분만시간은 8시간 51분, 경산부는 5시간 9분으로서 Pelvic score가 높을수록 분만시간은 단축되었다. 7) 약제 투여 후의 Friedman의 곡선과 정상 Friedman 곡선을 비교할 때 본 방법으로 행한 예에서는 정상 Friedman 곡선보다 좌측 이동의 양상을 보였다. 8) 평균 Apgarrscore는 분만 후 1분에서 91.0이었으며 9) 산후 출혈 1예와 과다 진통 1예를 제외하고서는 특별한 부작용은 없었고 또한 모성 및 태아 이환율은 없었다. 10) Oral Pitocin을 사용한 유도 분만은 다른 투여 방법으로 행한 방법보다 더욱 안전하고 간편하며 환자나 의사에게 더욱 받아들여 질 수 있는 방법이라고 생각된다. From November 1973 to February 1974, transbuccal administation of Pitocin, (Desamino-Oxytocin.) to 19 patients for induction of labor was studied and compared with intraveneous administation of unusal Pitocinin. The results were as follows : 1) Labor of 85% of gravida were induced successfully by transbuccal method. 2) Theie ages ranged from 21-40 years prior to delevery, 9 were para 0, 10 were multupara, 4 were 33-39 wek gravid, 11 between 40-42 weeks, and 4 were consideres to be pregnant 43 week. 3) The success rate seemed to be related to high pelvic score. 4) The latent period approximately 1/2-2 hour. 5) The average total dose necessary induce labor was 465 I.U. 6) The average duration of labor for primipara was 8:15 hour and for multipara 5:9 hour. 7) Friedman curve arter using of Sandoprat(R) showed shift to left in comparable with normal Friedman curve. 8) The average infant Apgar score at 1 minutes after delivery was 9.0. 9) Remarkable side effects were not observed in infant but a case of postartum bleeding was seen. 10) An oral method of inducing labor using transbuccal pitocin is safer, simpler, and more acceptable to the patient and physician than previously used routes of administration.

Chiari-Frommel 증후군 치료 1예

허필형(PH Hur),조봉춘(BC Cho),최성기(SK Choi),박찬동(CD Park) 대한산부인과학회 1976 Obstetrics & Gynecology Science Vol.19 No.11

The chiari-frommel syndrome is presently taken to refer to postpartum persistent amenorrhea and galactorrhea in the absence of an identifiable intracranial neoplasm. Chiari et al, in 1852 described 2 patient with a syndrome of postpartum galactorrhear, amenorrhea and atrophy of the uterus and ovaries. Frommel in 1882 reported that the incidence of postpartum atrophy of the uterus was less than 1% and associated galactorrhea of these 2men and applying the term chiai frommel syndrome to this combination of clinical findings in 1923. We experienced a patient of typical chiari-frommel syndrome who has been amenorrhea for 4 years and galactorrhea for 4 years and 9 months. It is the purpose of this report with brief literature to describe a patient of chiari-frommel syndrome whom ovulation has been induced by the administration of Regulen-K1 with consequent pregnancy and delivered normal female infant.