다낭성 난소 증후군 환자에서 비만군과 비비만군에서의 인슐린 저항성

임영구,이병석,조은정,차동현,박원일,박기현,조동제,이국,송찬호,이은직,Lim, Y.K.,Lee, B.S.,Cho, E.J.,Cha, D.H.,Park, W.I.,Park, K.H.,Cho, D.J.,Lee, K.,Song, C.H.,Lee, E.J. 대한생식의학회 1994 Clinical and Experimental Reproductive Medicine Vol.21 No.1

This study was designed to investigate the relationship between insulin resistance and obesity in the pathogenesis of polycystic ovarian syndrome(PCO). Twenty-two women with PCO, of whom thirteen were non-obese with body mass index(BMI, kg/$m^2$) of <25 and nine were obese with BMI${\geq}$25 were studied. Eight non-obese control women and seven obese control women were studied. Serum concentrations of testosterone, lutenizing hormone(LH)/follicle-stimulating hormone(FSH) ratio, and insulin-like growth factor I (IGF-I) were found to be significantly higher(P<0.05) in PCO women compared with control women, which clearly is not related to obesity. Serum glucose, insulin, and C-peptide levels were measured during a 2-hour oral glucose tolerance test(OGTT). Non-obese and obese women with PCO both(P<0.05) compared with control women demonstrated significant hyperinsulinemia after OGTT. The degree of hyperinsulinemia was found to be significantly higher in the obese women with PCO compared with the non-obese women with PCO. We concluded that obesity may contribute to hyperinsulinemia, however may not playa central role in the pathogenesis of PCO.

지구과학Ⅰ 교과서 어휘 등급 분석 : 살아있는 지구 단원을 중심으로

임영구,박혜진,이효녕,김태수,오희진 경북대학교 과학교육연구소 2008 과학교육연구지 Vol.32 No.2

The purposes of this study were to analyze vocabularies used the section of ‘Living Earth’ in 11-grade Earth science textbooks with the Science Word Analysis (SWA) program and to investigate the vocabularies selected by the 11th grade students as difficult ones. For the purpose, we extracted the Earth science vocabularies from six textbooks, and classified into the scientific and non-scientific vocabularies with SWA program based on the standard Korean language dictionary. Also, we investigated the difficulty of each vocabulary by using questionnaire to three hundred sixty students. From the results analyzed with the program, it was found that the frequency of the scientific vocabularies out of the level was the largest any other level in all textbooks. And from the survey, most of the vocabularies selected by students as difficult to understand were classified into out of the level. From these results, it were suggested that the students’ cognitive level should be considered in developing science textbooks and difficult vocabularies should be replaced to easy ones within the limits of changeless in the meanings 이 연구의 목적은 11학년 지구과학 I 교과서의 ‘살아있는 지구’ 단원의 지구과학 어휘들을 SWA프로그램을 통해 분석하여 그 중 학생들이 어려워하는 어휘들을 알아보는데 있다. 연구 목적을 위해, 먼저 6종의 11학년 지구과학 I 교과서에서 지구과학 어휘들을 추출한 다음, 표준국어대사전을 기반으로 한 SWA 프로그램으로 과학 전문어와 비과학 전문어로 분류를 하였다. 분류된 과학 전문어와 비과학 전문어에 대해 360명의 11학년 학생들에게 이해하기 어려운 어휘를 선택하도록 하였다. 프로그램을 통해 어휘의 수를 분석한 결과, 교과서별로 다소 차이는 있지만, 등급 외의 과학 전문어 빈도가 모든 교과서에서 다른 등급에 비해 가장 높았다. 또한 학생들에게 설문한 결과, 어렵다고 하는 용어들의 대부분이 등급 외에 속해 있었다. 이 연구 결과를 통해, 교과서 집필 과정에서 학생들의 인지 수준을 고려해야 하며 어려운 용어는 과학적 의미의 변화가 없는 범위 내에서 쉬운 용어로 대체되어야 한다는 것을 제안하였다.

포스타 : 내분비,불임학 ; 다낭성 난소증후군 환자에서 Obese군과 Non-Obese군의 혈중 C-Peptide, Glucose, Insulin 치의 변화

임영구,이병석,박원일,박기현,조동제,이국,송찬호 대한산부인과학회 1993 대한산부인과학회 학술대회 Vol.72 No.-

일반연제 발표 : 산과학 1 ; 조산 및 만삭 임신에서 제대혈청내 Leptin의 농도

임영구,임문환,한지연,송은섭,이병익,고승권,이우영 대한산부인과학회 1998 대한산부인과학회 학술대회 Vol.82 No.-

포스타 : 산과학 ; 지속적인 Late deceleration의 예측에 있어 도플러 초음파의 효용성

임영구,조재성,김경수,김석영,박용원,김재옥 대한산부인과학회 1996 대한산부인과학회 학술대회 Vol.78 No.-

초음파를 이용한 분만 체중 백분율과 과체중아의 조기 예측

임영구(Young Goo Lim),김세련(Se Ryun Kim),오관영(Gwan Young Oh),박지현(Jee Hyun Park),노인화(In Hwa Noh),송은섭(Eun Sub Song),임문환(Moon Hwan Lim),이병익(Byung Ik Lee),김종화(Jong Hwa Kim),이우영(Woo Young Lee) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.11

Objective : To evaluate the accuracy of predicted birth weight percentile and large for gestational age(LGA) fetuses by the gestation-adjusted projection method using estimated fetal weight. Methods : From 462 low-risk pregnancies with singleton fetus, fetal biometry including fetal biparietal diameter(BPD), head circumference(HC), abdominal circumference(AC), and femur length(FL) was made from 30 weeks of gestation until term. Estimated fetal weight(EFW) by combinations of fetal biometry were made by Campbell, Hadlock1, Hadlock2, and Shepard formulas respectively. The diagnostic accuracy according to 4 formulas was assessed by correlation between EFW percentile and birth weight percentile, prediction of LGA fetuses, and prediction error(percentile difference between birth weight and EFW). Results : The mean gestational age on ultrasound and on birth, and birth weight were 33.21 ± 2.08(30-40) weeks, 38.43 ± 1.72(30-42) weeks, and 3.14 ± 0.47(0.99-4.38) Kg, respectively. The diagnostic accuracies of gestation-projection method using EFW were similar result to predict birth weight percentile and LGA fetuses according to 4 formulas. Correlation between EFW percentile and birth weight percentile(correlation coefficient, r) were Campbell: 0.644(p〈0.001), Hadlock 1: 0.682(p〈0.001), Hadlock 2: 0.681(p〈0.001), Shepard: 0.638(p〈0.001), respectively. Youden's index(sensitivity + specificity - 1) in prediction of LGA fetuses were Campbell: 0.532, Hadlock1: 0.525, Hadlock2: 0.520, Shepard: 0.549, respectively. Prediction error were Campbell: 18.14±16.56, Hadlock1: 16.19±14.35, Hadlock2: 16.10±14.29, Shepard: 19.68±17.00, respectively. The prediction error was increased according to increasing of lapse time(p〈0.001), gestational weeks on ultrasound, and estimated fetal weight percentile, and decreasing birth weight percentile(p〈0.001)(R square=0.411, p〈0.001). But, amniotic fluid index did not affect to prediction error(p=0.199). Conclusion : Our study presented relatively accurate prediction for birth weight percentile and LGA fetuses from remote sonographic examination. If LGA fetuses was suspected by antenatal ultrasound, adequate therapy and periodic observation are recommended for good perinatal outcome.

제대혈 Leptin : 출생 체중 , 임신성 고혈압 , 태아 성별 , 산모의 비만도 , 분만 주수와의 상관 관계

임영구(YG Lim),전용훈(YH Jeon),송은섭(ES Song),고승권(SK Koh),임문환(MH Im),이병익(BI Lee) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.6

Objective: Leptin is a 16-kD protein encoded by the ob/ob gene and produced mainly by adipocytes. Leptin signals the amount of fat stored in the body to the brain and affects food intake, energy expenditure, and thermogenesis to maintain a constant amount of stored body fat. In pregnancy, it was demonstrated that leptin is produced by non-adipose cell line, i.e. by placental trophoblasts as well as fetal adipocytes. In this study, we investigated the effect of birth weight, fetal sex, preeclampsia, maternal body mass index[BMI] on cord blood leptin concentrations. Methods: We determined serum leptin levels using radioimmunoassay[RIA] in cord veins of 115 pregnant women that included 28 preeclampsia. Fetal sex were 63 male and 52 female. Results: Cord leptin levels were significantly correlated with birth weight in multivariate analysis controlling potential confounders[γ= 0.6125, P < 0.001 ]. Leptin levels in female fetus[ 7.35±5.03 ng/mL ] were significantly elevated than male fetus[ 5.37±4.64 ng/mL ][ γ= 0.3849, P < 0.001 ], independent of obesity. But preeclampsia, maternal BMI, and gestational weeks on delivery had no significant effect on cord blood leptin levels[ preeclampsia: γ= -0.006, P = 0.950, maternal BMI: γ= 0.1732, P = 0.069, gestational weeks on delivery: γ= -0.1132, P = 0.105, respectively ]. Conclusion: These data suggest that the effect of fetal birth weight and sex on cord leptin level was more pronounced than utero-placental and maternal effect.

양수과다증의 평가에 있어 초음파검사의 유용성

임영구(YG Lim),조재성(JS Cho),김지수(JS Kim),이용주(YJ Lee),박용원(YW Park) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.6

This study was undertaken to evaluate the efficiency of ultrasonography for the prenatal assessment of Polyhydramnios. From May 1988 to October 1993, 2,320 subjects had single gestations undergoing fetal testing after 20 gestational weeks at the Severance Hospital. The incidence of Polyhydramnios diagnosed by amniotic fluid index was 6.8%(157/ 2,320). Maternal diabetes mellitus and fetal congenital anomalies diagnosed by ultrasonography were found in 6(3.8%) and 73(46.5%) patients among the polyhydramnios group. The causative factor of the other cases(49.7%) was unknown. The most common fetal malformations were central nervous system(26.0%) and gastrointestinal system anomalies(24.7 %). And they were followed by abdominal wall defect(8.2%), skeletal dysplasia(8.2%), cardiac lesion(6.8%), facial lesion(5.5%), and thoracic or diaphragmatic lesion(4.5%). The incidence of Cesarean section due to fetal distress, low 5-min Apgar score, large for getational age, admission to intensive care nursery, and perinatal mortality was not significantly different in the idiopathic polyhydramnios group compared with that of the control group(p <0.05). We found ultrasonic examination seems to be valuable diagnostic tool to assess the amount of amniotic fluid volume and detect fetal anomalies. Also it might be essential to perform the follow-up examination in idiopathic polyhydramnios to predict the perinatal outcome.

자궁태반 기능부전증의 예측에 있어 Doppler 초음파검사의 유용성

임영구(YG Lim),김경수(KS Kim),최형민(HM Choi),김태윤(TY Kim),조재성(JS Cho),박용원(YW Park) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.5

This study was designed to investigate a possible role for Doppler velocimetry as a predictor of uteroplacental insufficiency with fetal heart rate(FHR) tracing. From January 1994 to through May 1996, we studied 419 high risk pregnant women who underwent Doppler velocimetry within 1 week of intrapartum cardiotocogram or contraction stress test (CST) after 30 gestational weeks. The presence of a diastolic notch in uterine artery, elevated systolic/diastolic(S/D) ratios in umbilical artery(more than 3.0), or in uterine artery (more than 2.6) were considered abnormal. All of the 419 subjects were performed intrapartum cardiotocogram or CST within 1 week after Doppler veocimetry. Seventeen cases were associated with persistent late deceleration or positive CST. The sensitivity, specificity, positive predictive value, negative predictive value, and relative risk of umbilical artery S/D ratio for predicting abnormal FHR tracing were 23.5%(4/17), 89.3%(359/402), 8.5%(4/ 47), 96.5%(359/372), and 0.97. those of uterine artery S/D ratio and diastolic notch were 29.4%(5/17), 92.5%(372/402), 14.3%(5/35), 96.9%(372/384), 1.35 and 35.3%(6/17), 90.3% (363/402), 13.3%(6/45), 97.6%(363/374), 3.88 respectively. The presence of uterine artery diastolic notch in Doppler velocimetry seems to be a better predictor for abnormal FHR tracing after 30 weeks gestation than are S/D ratios in umbilical or uterine arteries. In conclusion, we can suggest that the presence of diastolic notch in uterine artery Doppler velocimetry might be useful to predict the uteroplacental insufficiency after 30 gestational weeks.

임신 중기 양수와 산모 혈청 leptin 농도: 임신 주수, 태아 성별, 초음파 측정 태아 체중, 산모 체질량 지수와의 상관관계

임영구(Young Koo Lim),송은섭(Eun Seop Song),송경은(Kyung Eun Song),임문환(Mun Hwan Lim),이병익(Byoung Ick Lee),김종화(Jong Wha Kim),최원식(Won Sick Choe) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.12

Objectives: Leptin is a 16-kD protein encoded by the ob/ob gene and represent the amount of body fat. In pregnancy, it is thought to act in intrauterine fetal growth and energy metabolism. In this study, we investigated the effect of gestational age, fetal sex, maternal body mass index (BMI), and fetal weight estimated by ultrasound on amniotic fluid and maternal serum leptin levels at mid-trimester, respectively. Methods: Amniotic fluid and maternal blood sampling were collected from women who was performed for genetic amniocentesis at mid-trimester (n = 26). Leptin concentrations were measured by a specific radioimmunoassay (RIA) employing human recombinant leptin. Mean gestational age was 18.19±1.77 weeks. Mean maternal BMI was 23.83 ±5.12kg/m2. Male fetus was 10, and female 16. Mean fetal weight estimated by ultrasound was 254.42±83.80gm. Results: Mean maternal leptin level( 12.49±4.46 ng/mL) was significantly higher than mean amniotic leptin level(5.06±3.20 ng/mL)( p = 0.0001) at mid-trimester. But there was no significant correlationship between maternal and amniotic leptin levels( p = 0.1376). Maternal leptin concentrations at mid-trimester were correlated positively with maternal BMI(y = 2.24 + 0.43 x, R2 = 0.494, p = 0.0103). In contrast, leptin levels in amniotic fluid did not correlate with maternal leptin levels, gestational age, fetal sex, maternal BMI, and fetal weight estimated by ultrasound respectively. Conclusion: Maternal leptin level was higher than amniotic leptin level and could represent maternal fat mass. It was suggested that amniotic leptin level was not associated with several factors such as maternal, fetal, and amniotic factors.