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The effect of levonorgestrel releasing intrauterine device on lymphangiogenesis of adenomyosis
조시현,전영은,정지안,서석교,최영식,이병석 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.98 No.-
Adenomyosis defined by the presence of endometrial mucosa within the myometrium and often associated with heavy menstrual bleeding and dysmenorrhea. Although, it has been shown that levonorgestrel releasing intrauterine device (LNG-IUD) can effectively treat adenomyosis related symptoms, the exact mechanism has not been fully understood yet. Under the assumption that lymphangiogenesis may be involved in the pathogenesis of adenomyosis, we investigated and compared the occurrence of lymph vessels and lymphangiogenic growth factors in patients with adenomyosis and in those with LNG-IUD treated adenomyosis. Full thickness uterine samples from patients who underwent hysterectomy were collected and immunohistochemical statining using antibodies against podoplanin (D2-40), and lymphatic vessel endothelial hyaluronan receptor 1 (LYVE-1) were performed on 20 samples of adenomyosis, 20 samples of adenomyosis treated with LNG-IUD. Endometrial samples of cervical intraepithelial neoplasia served as controls. The lymphvascular density(LVD) was analyzed for each sample. Determination of LVD of the control tissue was identified by the ‘hot spot’ method. The data were evaluated using a one-way analysis of variance in combination with the Dunnett multiple comparison test and the unpaired t- test and statistical significance was defined as P <0.05. LVs were identified by immunohistochemical staining with specific lymphatic endothelial cell markers D2-40 and LYVE-1. The immunostaining patterns of all markers showed a high to moderate staining. The LVD of D2-40 and LYVE-1 were significantly higher in endometrium of adenomyosis, in comparison to the endometrium of control and LNG-IUD treated adenomyosis group. Also significant difference in LVD of endometrium was noted between the control and LNG-IUD treated adenomyosis. When the LVD was evaluated according to the menstrual cycle, no significant difference was noted between and within the group. In myometrium, the LVD was significantly higher in adenomyosis than the control and LNG-IUD treated adenomyosis group, however, no significant differences were noted between the control and LNG-IUD treated adenoymosis group. This study showed that lymphangiogenesis is increased in endometrium and myometrium of adenomyosis in comparison to the controls, and that increased LVD in adenomyosis is reduced by use of LNG-IUD. The results suggest that effect of LNG-IUD on lymphangiogenesis could be one possible mechanism of treating adenoymosis related symptoms.
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조시현(趙時顯) 한국법사학회 2014 法史學硏究 Vol.49 No.-
최근 일본정부는 일본군‘위안부’ 문제에 대한 법적 책임 부정에 이어 이를 역사문제로 치부하고 사실의 존재 자체도 부정하려고 하고 있다. 이 글에서는 ‘위안부’ 문제의 성격이 역사만이 아니라 법의 문제이기도 하다는 입장에서 이에 대한 국제법의 적용이 가지는 의미를 살펴본다. ‘위안부’ 문제에 국제법을 적용하는 것은 밝혀진 사실에 대한 위법 여부의 판단에 그치는 것이 아니다. 역사적 배경이나 맥락이 법적용에 있어서도 문제가 되기도 하고 책임의 유무와 내용에 있어서도 어떠한 사실에 대한 법적인 이해내지 평가는 결정적이다. 법적 책임의 전제로서 사실을 살펴보는 것은 회고적인 의미만을 가지는 것이 아니고 오늘의 현실에 법적으로 어떻게 개입하여야 하는가하는 실천적인 의미도 가지게 된다. 또한 가해행위가 이루어졌던 시점에 법이 없었던 것이 아니라 존재하였음을 확인하고 이러한 법이 현실에 있어서 왜 적용되지 못했는가에 대한 규명을 통하여 법을 둘러싼 진실을 밝히는 것도 중요하다. 실정법의 해석과 적용에서 벗어나 법의 사회적, 정치적 의미를 역사 차원에서 포괄하는 작업은 ‘위안부’들의 실상에 대한 현상적인 이해에서 한걸음 나아가서 어떻게 또 무엇 때문에 그러한 일이 생겨났는지 원인에 대한 이해로 진전시키고 이 문제에 대한 해결 논의 또한 심화시킬 수 있을 것이다. 일제가 ‘위안부’들에게 가한 행위에 대한 공분은 적어도 조선시대 이래로 형성된 성폭력과 인신매매에 관한 법의식의 연속으로서 세계인의 의식과 합류한다. ‘위안부’ 문제에 대한 법적 책임의 확립은 그러한 행위가 잘못되었다는 공통규범을 확인하는 장이 되고 이러한 규범은 다시 한일관계는 물론 변동하는 동아시아 국제체제 속에 피해자의 인권을 존중하는 구체적인 미래와 법치주의를 가져오게 할 것이다. While continuing to deny the legal responsibility for the Japanese military ‘comfort women’ issue, the Japanese government tries to deny the factual existence itself by characterizing the issue as a matter solely for historians and experts. This article starts from the point that the nature of the issue is a legal matter as well as a historical one, and examines the meaning of the application of international law to the issue. Such an application is not merely confined to judgment as to the illegality of the established facts. In the practice of various courts and tribunals, historical backgrounds or contexts have been frequently questioned, and the legal understanding or evaluation of a particular fact is critical in the establishment of responsibility and its contents. The examination of facts as a premise of legal responsibility has not merely the retrospective meaning, but the practical one as to how to intervene in a legal way in the present reality. It is also important to find the truth revolving around the law by ascertaining that the law had been actually in existence at the time of wrong-doings and by inquiring into the reason why the law had not been observed in reality. The endeavour to enclose the social and political meaning of law at the level of history beyond the interpretation and application of positive law will make it possible to reach an understanding as to the causes such as how and why such things occurred apart from the phenomenological one, leading also to in-depth debates on the settlement of the issue. Public indignation at the acts perpetrated to ‘comfort women’ by the Japanese imperialism must be understood as a continuation of legal consciousness as to sexual violence and human trafficking formed since the Chosun Dynasty at least, concurrent with that of the modern Western ‘civilized’ States. The establishment of legal responsibility for the ‘comfort women’ issue will become a venue for confirming the common norms that hold such atrocities wrong, and such norms in turn will bring forth the concrete picture of the future based on the respect of human rights of victims and the rule of law in the changing international regime of East Asia as well as in the Korean-Japanese relationship.
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