35 세 이하에서 발생된 자궁경부암조직의 인유두종 바이러스 16 형 및 18 형에 의한 종양억제 유전인자 p53 의 동태변화

신정환(JH Shin),조삼현(SH Cho),황윤영(YY Hwang),조수현(SH Cho),유중배(JB Yoo),문형(H Moon),이재억(JA Lee),조율희(YH Cho) 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.3

소의 약년층(35세이하)에 발생된자궁경부암 환자들의 치료 및 예후에 인유두종 바이러스가 관계되는지, 관계된다면 항암인자로 악성종양 연구의 최근 목표가 되고있는 p53의 동태와 어떠한 연관이 되어 있는지를 구명하고자 35세 이하의 자궁경부암 환자 20예를 연구군으로, 45세 이상의 환자 10예를 대조군으로 하여 인유두종 바이러스 16형 및 18형의 발현도를 Southern 핵산 교접법과 type specific primers와 L1 consensus primer를 이용한 2 step nested protocol의 핵산 증폭방법으로 구하였으며 p53 종양 억제 유전자의 exon별 핵산증폭과 single stranded conformation polymorphism에 이은 직접 분자배열법으로 p53의 돌연변이 유무를 검증하여 임상상과 비교한 바 다음과 같은 결과를 얻었다. 1. 35세 이하에서 발생한 자궁경부암 20예의 임상 병기는 대조군보다 조기이나 임파절 전이빈도는 7예(35%)로 대조군의 3예(30%)보다 상회하였으며 사망예는 20예중 3예로 3년 생존율이 85%이었다. 2. 35세 이하에서 발생한 자궁경부암 20예중 인유두종 발현빈도는 16예(80%)로 16형이 14예(87.5%), 18형이 2예(12.5%)이었으며 45세 이상군에서는 10예 중 9예에서 검출되었으며 그 유형은 공히 16형이었다. 3. 연구군 20예중 1예에서 P53유전자의 codon 189의 2변째 base에 위치한 C가 T로 전환된 transition의 돌연변이가 관찰되었을뿐 19예에서는 정상이었고 대조군 10예중 1예에서 변이가 관찰되었는데 intron 5와 exon 6의 경계부위의 splicing mutation으로 51 bases가 소실되었음이 밝혀졌다. 이들의 인유두종 감염형은 공히 16형 이었다. 4. p53돌연변이가 관찰된 2예의 임상특성은 병기가 IVa, IIa로 모두 골반임파절에 전이가 관찰되어 부수적 치료를 추가하였으나 각기 1년만에 재발하여 연구군(IIa)은 사먕하였으나 대조군의 경우는 지금까지 40개월간 건강하게 생존하고 있다. 따라서 약년층에 발생한 자궁경부암 환자의 인유두종 바이러스에 따른 항암인자 p53의 동태변화는 유의한 차이가 인정되지 않았으나 자궁경부암 세포중 p53 wild type의 안정화를 도모하는 어떤 특수 물질이 분비되어서인지, 유식세포분석 방법에 의한 세포분열기의 상태연구는 계속되어야 하며 아울러 방향을 전환하여 retinoblastoma와의 관계 설정이 필요한 것으로 사료되었다. To evaluate the influence of human papillomavirus to the modulation of p53 in younger ptients with the uterine carvical carcinoma, comparative analysis was undertaken with the clinical variants. The prevalence and types of human papillomavirus was obtained by means of 2 steps polymerase chain reactions with the primers of HPV L1 consensus, type 16 and 18 E6specific primers and confirmed by southern blot hybridization. The status of p53 was evaluated with the 2 steps nested ploymerase chain reation-single strand conformation polymorphism/direct sequencing with the primers of p53 exon 4,5-6,7,8-9, and their nested primers of exon 4,5,6,7,8 and 9 from the biopsy specimens of the 20 patients less than 36 years lod(study group) and 10 patients over 45 years old(control group). The incidence of lymph node metastases in the study group was higher than that of control group(35% in study group vs. 30% in control group) in spite of less advanced FIGO stage and 85% in 3-year survival in the study group. The prevalence rate and types of human papillomavirus were 16/20(80%), 14/16(87.5%) with type 16, 2 with type 18 in the former, and 9/10, type 16 only in the latter. There was one missense mutation in the younger patient group and one splicing mutation in the older patient group B ; the missense mutation revealed a transition from C to T of the 2nd base in the codon 189 of exon 4, and splicing mutation was found to delete 51 bases at the junction between intron 5 and 6. The clinical end results of the two cases with mutation of p53 were all recurrence within a year following the combined modalities with the induction chemotherapy and subseqint radical hysterectomy and paraaortic, pelvic lymph node dissection. These suggest that the HPV could not modulate tumor suppressor gene p53 universally in patient with cervical carcinoma with no relation to the age factor. However, the sequential research whether the products in cancer cell to induce stabilization of p53 is present or not, and the flow cytometric analysis for

Symposia : Gastric Carcinogenesis ; Clinical significance of CD99 downregulation in gastric adenocarcinoma

( Lee JH ),( Kim SH ),( Wang LH ),( Choi YL ),( Kim YC ),( Kim JH ),( Park TS ),( Hong YC ),( Shin YK ) 한국생화학분자생물학회 (구 한국생화학회) 2007 생화학분자생물학회 춘계학술발표논문집 Vol.2007 No.-

Amitriptyline Modulation of Sodium Channels in Rat Dorsal Root Ganglion Neurons

JH Song,SS Ham,H Ha,YY Jang,YK Shin,CS Lee 대한약학회 1999 大韓藥學會 總會 및 學術大會 Vol.48 No.-

자가통증조절법의 기저주입량 추가에 따른 술후 진통 효과의 비교

신상욱,전재휴,백승완 釜山醫師會 2001 釜山醫師會誌 Vol.37 No.7

신장이식술을 시행받은 여성에서의 임신

신희철,윤보현,전종관,허창영,권재희 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.11

Background:Renal transplantation remains the best form of treatment for women with end-stage renal failure who wish to have children. Successful pregnancies have been reported after transplantation, but they are often associated with increased fetal and maternal risks. Therefore data about the outcome of pregnancy in renal transplant recipients should be available to facilitate the decision making process. Objective:To study the outcome of pregnancy in renal transplant recipients. Study Design:A retrospective review. Subjects:Pregnant women beyond the period of third trimester who had renal transplantation between 1969 and 1996. Results:There was a total of 10 patients and 12 pregnancies and 13 offsprings. One patient had a twin pregnancy and two patients had 2 pregnancies after renal transplantation. All patients continued their immunosuppressive regimens during the entire pregnancy. The mean interval from the time of transplantation to conception was 46.6 months(range, 11 to 97 months). There were complications of 3 cases of hypertension and 2 cases of acute rejection before conception. All had normal prior values of serum creatinine before conception(range, 0.8 to 1.2 mg/dl) except three patients whose serum creatinine values before conception were not available. The mean gestational age at delivery was 37+5 weeks(range, 32+6 to 41+1 weeks) with an incidence of prematurity(gestation <37 weeks) of 50%, and their offspring weighed from 1.46 kg to 3.13 kg(mean, 2.46 kg), presenting a high incidence of low birthweight(46.2%). There was one stillborn who had congenital anomaly of anencephaly. The obstetric complications were distributed as follows:premature rupture of membranes in 2 cases(16.7%), preterm labor in 2 cases(16.7%), pregnancy induced hypertension in 2 cases(16.7%), pregnancy aggravated hypertension in 1 case(8.3%), and intrauterine growth restriction detected before delivery in 1 case (8.3%). Cesarean section was necessary in 1 of 12 cases(8.3%). Neonatal complication was found in one case, pnuemonia. No patient had any rejection episode or graft loss during pregnancy, but 5 cases had experienced chronic renal rejection after delivery(range, 3 to 18 months). Conclusion:Women with a renal transplant can have a successful pregnancy, but there are definite risks for both mother and fetus. Pregnancy should be discussed with the woman wish ing to have pregnancy and encouraged only if there is good renal graft function.

상부요관석의 체외충격파쇄석술 중 투여한 수액과 이뇨제가 요석의 분쇄와 배출에 미치는 효과

신지현,문영태 大韓泌尿器科學會 2003 Korean Journal of Urology Vol.44 No.2

전립선비대증 환자에서 알파차단제 (Terazosin) 처치에 따른 전립선특이항원의 변화

신재혁,오문목 大韓泌尿器科學會 2003 Korean Journal of Urology Vol.44 No.6

임신중 인슐린 치료가 필요한 임부의 혈당조절 상태에 따른 주산기 결과

신희철,윤보현,배광범,최진,전종관,최석태,권재희 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.2

Objective: To compare the pregnancy outcomes according to the status of maternal blood glucose control during pregnancy in women with diabetes requiring insulin therapy. Study design: Between 1986 and 1996, 83 pregnant women with diabetes who requires insulin therapy during pregnancy were identified; 29 cases with pregestational diabetes and 54 with gestational diabetes. The status of maternal blood glucose control was determined according to the mean HbA1c concentration(below or above 6.0% of HbA1c) during the third trimester of pregnancy. Pregnancy outcomes were compared between two groups of patients. Results: 1) Patients with poor blood glucose control (HbA1c > 6.0%) had a significant higher rate of adverse outcome including cesarean delivery due to either fetal distress or cephalo-pelvic disproportion (20.0% vs. 2.9%, p<0.05), macrosomia of the newborn (> 90th percentile for gestation; 44.0% vs. 5.7%, p<0.0001), higher mean birth weight (3.61±1.12 kg vs 3.08±0.48 kg, p<0.005), and neonatal hypoglycemia at birth (42.2% vs. 12.1%, p<0.005); 2) The rate of preterm delivery (< 37 weeks of gestation) and pregnancy-induced hypertension was higher in patients with poor control(HbA1c > 6.0%) than those with good control (HbA1c< 6.0%) (16.0 % vs. 5.7% for each) without reaching statistical significance; 3) There was no statistical differences in the mean gestational age at birth and the rate of perinatal death between the two groups of patients. Conclusions: Poor maternal glucose control is a risk factor for the development of adverse perinatal outcome including higher rate of fetal macrosomia, cesarean section, and neonatal hypoglycemia at birth.

Inhibitory Action of Thimerosal, a Sulfhydryl Oxidant, on Sodium Channels in Rat Dorsal Root Ganglion Neurons

JH Song,YY Jang,YK Shin,MY Lee,CS Lee 대한약학회 1999 大韓藥學會 總會 및 學術大會 Vol.48 No.-

난소의 미성숙기형종 1 예

신면우,최유덕,박지홍,이명임,전우식,우연숙 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.1

저자 등은 난소 미성숙기형종 1례를 경험하여 문헌고찰과 함께 보고하는 바이다. Immature teratoma of ovary is a type of malignant germ cell tumor, comprising less than 1% of ovarian tumors and 20% of malignant germ cell tumors. It has a specific age incidence, occurring most commonly in the first two decades of life and being almost none after menopause. Histopathologically, immature teratomas are composed of tissue derived from the three germ layers-ectoderm, mesoderm, and endoderm. Treatment consists of complete excision of tumor at early stage, followed by adjuntive combination chemotherapy. We had experienced a case of immature teratoma of the ovary, which presented, with a brief review of the literatures.