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상피성 난소종양에서의 bcl-2 발현과 그의 예후적 의의
이동헌(DH Lee),김종혁(JH Kim),허주령(JR Huh),김대진(DJ Kim),김용만(YM Kim),김영탁(YT Kim),남주현(CH Nam),목정은(JE Mok) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.5
The expression of bcl-2 protein was studied in epithelial ovarian tumors by immunohistochemical analysis. We immunostained a series of epithelial ovarian tumors to assess the prevalence of bcl-2 expression in benign, borderline and malignant tumors respectively, and its clinicopathologic correlations and prognostic implications in malignant one. The study population comprised 108 patients with epithelial ovarian tumor, 10 with benign tumor, 24 with borderline one and 74 with malignant one respectively, treated at Asan Medical Center from June, 1989 to December, 1995. In benign tumors, there was none showing bcl-2 immunoreactivity. Among 24 borderline tumors, bcl-2 immunoreactivity, strictly confined to the neoplastic cells, were detected in 5 (20.8%) including 1 moderate expressor (10% to 50% immunoreactive tumor cells) and 4 high expressors (>50%). In malignant tumors, there were 11 low expressors (1% to 10%), 15 moderate expressors and 7 high expressors, resulting 44.6% (33/74) of positivity and the prevalence of bcl-2 immunoreactivity did not show association with any of the clinicopathologic variable such as FIGO stage, histologic type, tumor grade, residual tumor volume, ascites volume or CA 125 level after second chemotherapy. Life table analysis demonstrated that the presence or absence of bcl-2 expression did not show any difference in the patient`s survival (p=0.63 by Log-rank test), while FIGO stage (P=0.032), tumor grade (P=0.036), residual tumor volume (P=0.0091) and CA 125 level after second chemotherapy (P<0.036) did. Residual tumor volume (relative risk=2.06) and CA 125 level after second chemotherapy(relative risk=4.04) were revealed to be independent prognostic factors in Cox regression model. According to these results, we concluded that although bcl-2 has been strongly suggested to play a certain role in tumorigenesis, there seems to be no definite relationship between its expression and prognosis of patients with epithelial ovarian cancer.
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태아 스트레스 호르몬들과 산ㆍ염기 상태에 대한 분만 방법의 영향
김대한(DH Kim),방준배(JB Bang),김진홍(CH Kim),김삼식(SS Kim),이택후(TH Lee),전상식(SS Jeon),조영래(YL Cho) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.4
To evaluate the effect of delivery mode on fetal stress hormones and acid-base status and also to investigate the relationship between fetal acidemia and these hormones. 44 women with term pregnancies were studied. All had singleton, healthy pregnancies. Twenty five women were delivered by spontaneous vaginal route, 10 by vacuum extraction and 9 by elective caesarean section. Umbilical cord blood samples were obtained immediately following the delivery. Blood gas (pH, pCO2, pO2) and hormonal analysis (ACTH, cortisol, dehydroepiandrosterone sulfate) were done in arterial and venous cord blood samples respectively. The cord blood ACTH values were higher in the vacuum extracted group compared to the normal spontaneous vaginal delivery group and caesarean section group (p<0.05). There was also a significant effect of mode of delivery on fetal plasma cortisol levels among three study groups (p<0.05). In contrast, the mean umbilical cord plasma DHEAS levels were similar for all three study groups. High pO2 levels were found in caesarean section group compared to other two groups (p<0.05). Low pH group had higher cortisol and ACTH level compared to high pH group. In conclusion, method of delivery may affect acid-base and stress hormonal status of human fetus.
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김동호(DH Kim),지정석(JS Chi),김정구(JK Kim),김대원(DW Kim) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.3
To investigate the prevalence of endometriosis and its associated risk factors which influence the development of endometriosis in korean women in special, we have performed prospective case-control study for endometriosis in multicenter since May, 1, 1996. For 14 months from May 1, 1996 to June 30, 1997, 110 women with endometriosis were detected by laparoscopic operation. To conduct a case-control study, 226 patients with no evidence of endometriosis were randomly selected from a group of women who underwent laparoscopic surgery. Information obtained through physical examination and a questionnaire was studied by multivariate logistic regression analysis. The results are as follows: 1. Endometriosis was significantly higher among 30s age group[age 30∼39] 2. Educational and socioeconomic factors did not appear to be associated with the development of endometriosis. 3. Endometriosis was significantly greater in unmarried women than in married women[p=0.0001]. 4. The risk of development of endometriosis was higher in the group of patients with family history of endometriosis[OR=2.5, p<0.05]. 5. There were no ssignificant association between the constitutional factors, weight and height, and smoking and endometriosis. 6. The probability of endometriosis was lower among women with regular exercise[OR=0.6]. 7. Menarche age was not related with the development of endometriosis. 8. The risk for emdometriosis was significantly greater among women with menstrual cycle length 27 or less, moderate degree or more of dysmenorrhea, and longer duration of menstruation[8 day or more]. 9. The number of abortion, age of first pregnancy did no appear to be associated with the presence of endometriosis. 10. There seemed to be a trend for increasing risk among women with no experience of pregnancy and child birth[OR=1.4]. 11. The other factors such as vaginal douch after menstruation, use of oral contraceptives and intrauterine devices did not appear to be related with development of endometriosis.
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자궁내막증 발생에 있어서 유전적 요인: 자궁내막증의 발생과 HLA 항원과의 관계
김동호(DH Kim),김태철(TC Kim),허민(M Hur),이미경(MG Lee),박애자(AJ Park),김정구(JK Kim),김대원(DW Kim),최두석(DS Choi) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.4
Objective: Many of previous reports have demonstrated a hereditary tendency to development of endometriosis and the incidence of the disease varies in different ethnic groups. However, the genetic background to these differences has not been clearly explained. Our investigation was performed to seek a possible association between certain HLA antigens and the development of the endometriosis. Methods: From May 1997 to the end of October 1998, 70 patients, 39 patients who have endometriosis [34 nonfamilial and 5 familial subjects] and 31 control subjects, were typed for HLA-A, B, C, and DR. To evaluate differences in HLA antigen frequencies between endometriosis and control subjects, X2 tests were performed. Analysis was performed on the entire sample of 39 as well as separatively for familial[n=5] and nonfamilial subjects[n=34]. A two-tailed P value was calculated for each X2 value. Fisher`s exact P value was calculated for small numbers. Results: Increased frequency of HLA-A24, B61, and DR15 antigen were found as compared the entire sample of 39 endometriosis to 31 control subjects [p〈0.05]. In turn, there was a reduced frequency of DR2 antigen in endometriosis. Also, increased frequency of HLA-B61 and DR3 antigen were found as compared 5 familial subjects to 31 control subjects[p〈0.05]. Conclusion: We suggest that the development of endometriosis may be associated with HLA antigens, specially A24, B61, DR15 and negatively associated with DR2, and that HLA-B61 and DR3 antigens may be associated with the development of the familial endometriosis. We think that HLA typing may be valuable in detecting those women with a tendency to develop endometriosis, and further study is needed.
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김도형(DH Kim),박찬규(CK Park),란세관(SK Lan),김재욱(JU Kim),최동희(DH Choi) 대한산부인과학회 1991 Obstetrics & Gynecology Science Vol.34 No.6
Primary carcinoma of the fallopian tube is extremely rare malignant tumor of the female genital tract. Clinical aspect of 7 cases of primary adenocarcinoma of the fallopian tube are presented with the review of literature.
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자궁내막암조직에서 c-erbB-2 암유전자 단백산물과 예후인자와의 연관성
김영태(YT Kim),윤혜정(HJ Yoon),김동현(DH Kim),이학천(HC Lee),김세광(SK Kim),김재욱(JU Kim) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.4
The c-erbB-2 oncogene encodes a 185,00 dalton transmembrane glycoportein with tyrosine kinase activity, and the aberrant overexpression of which has been implicated in the indution of a malignat phenotype. Overexpression of the c-erbB-2 has been found in many human adenocarcinomas, especially mammarian and ovarian carcinomas, and that is associated with poor prognosis. We used an enzyme-linked immunosorbent assay(ELISA) to explore the relationship between c-erbB-2 oncoprotein and prognostic factors of endmetrial cancer and analyzed the tissued form the 24patients with endometiral cancer and 10 control cases. patinens with endometrial cancer were found to bave 20% of c-erbB-2 oncoprotein overexpression rate and signficiantly higher c-erbB-2 median oncoprotein expression than conterol C-erbB-2 oncoprotein overexpression showed no statistically significant association with known prognostic factors including stage, grade, histologic cell type, myometrial invasion and lymph node metastases, although the c-erbB-2 oncoprotein overexpression rate was increased by stage, and was higher in lymph node metastatic group than in confined to the uterus goup. High c-erbB-2 oncoprotein overexpression was correlated with absence of estrogen receptor (Rs=-0.46, p=0.047) and progestreone receptor (Rs=-0.57, p=0.045), further studies are needed to determine the significance of the c-erbB-2 everexpression in endometrial cancer.
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김낙근(NK Kim),김동현(DH Kim),김영태(YT Kim),양영호(YH Yang),김재욱(JU Kim),박영년(YN Park) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.7
Hydatidiform moles are generally separated into two clasifications. Complete hydatidiform moles are characterized by cystic swlling of all villi, often pronounced trophoblastic hyperplasia, lack of fetal parts, all 46 chromosomes of paternal origin(androgenesis), and a major risk for persistent trophoblastic tumor. Partial hydatidiform moles appear to be a milder version of complete moles with both normal and cystic villi, focal trophoblastic hyperplasia, a fetus or indications of previous fetal existence, 69 chromosomes with a maternal contribution, and a malignant potential less than described for complete moles. Hydatidiform mole with coexistent fetus is a very rare phenomenon, with an estimated incidence of 0.005 to 0.01 percent of all pregnancies. The rarity of live-born, surviving children may in part be due to termination of pregnancies, when molar parts are observed and without access to current advanced diagnostic procedures. Progress in techniques for first trimester prenatal diagnosis and improved surveillance of first trimester pregnancies through prenatal chromosomal analysis, ultrasound scan, maternal serum-hCG and serum- AFP screening has created complex situation, allowing confirmation of hydatidiform mole with coexisitng fetus. We recently experienced one case of unusual pregnancy with complete hydatidiform mole and coexisiting live fetus.
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