성인여자의 Testosterone 활성도에 관한 연구

김승보(SB Kim),이재현(JH Lee) 대한산부인과학회 1983 Obstetrics & Gynecology Science Vol.26 No.3

결론 가임기간중 testosterone 활성도의 연령별 추이가 폐경후 활성도를 추구할 목적으로 20대 여성 21예, 40대 여성 42예 및 폐경후 여성 25예를 대상으로 삼아 혈중 testosterone 농도와 TEBG 농도를 측정하고 유리 testosterone분율 및 유리 testosterone 지표를 계산하여 관찰한 결과 다음과 같은 성적을 얻었다. 1. 혈장 TEBG 농도는 월경주기에 따라 아무런 변동도 보이지 않았으나 20대 여성에 비하여 40대여성의 농도는 유의하게 높았고 폐경후에는 다소 감소 경향을 띠우고 있었다. 2. 혈장 testosterone 농도는 연령 진행에 따라 감소 경향을 띠우고 있었으나 개인차가 심하여 유의한 변동을 보이지는 않았다. 3. 월경주기중 혈장 testosterone 농도는 20대 여성 및 40대 여성에서 각각 유의한 변동을 보이지 않았으나 전가임기 여성들을 통합하면 여포기에 비하여 배란전기에 유의한 증가를 보였다. 4. 유리 testosterone 분율은 연령의 증가와 더불어 유의하게 감소하고 있었다. 5. 배란전기의 유리 testosterone 분율은 여포기에 비하여 증가경향을 띠우고 있었으나 유의한 변동은 아니었다. 6. 유리 testorsterone 지표는 개체차가 심하여 연령에 따라 또는 월경주기에 따라 뚜렷한 차이를 보이지는 않았으나 평균치로 보면 연령의 증가와 더불어 상당수준의 감소경향을 띠고 있다. 7. 이상의 성격을 토대로 아래 사항들을 논급 할 수 있다. 가) 가임기간 중에도 연령의 증가와 더불어 testosterone 활성도가 감소하는 바 이는 testosterone 농도의 감소라기 보다는 TEBG 농도가 증가되기 때문이다. 나) 월경주기중 비록 다소간의 testosterone 농도의 변동이 있기는 하나 TEBG 때문에 testosterone 활성도가 변경되지는 않는다. ln order to evaluate the testosterone activities in reproductive women at different ages and postmenopausal women. the plasma testosterone concentration was measured by radioimmunoassay and binding site concentration of TEBG was analyzed by means of ammonium sulphate precipitation method. The percent testosterone free from TEBG was figured out using Rosenthal`s nomogram and free testosterone index was calculated as the product of the total testosterone concentration and the percentage of testosterone free from TEBG. Differences of active testosterone level between young female and aged reproductive women and between reproductives and postmenopausal women were compared. Cyclic pattern of testosterone activity during menstrual cycle was also checked of the women at reproductive age. Followings were the results; 1. There was no significant fluctuation in the binding site concentration of TEBG in peripheral plasma during the menstrual cycle of the normal reproductive women. But the concentration in women varied somewhat according to their ages; the concentration was noted lowest in young reproductive female and it clevated significantly after the age of fourty, followed by a slight decrease after the meno-pause. 2. Only a decreasing trend in total plasma testosterone concentration with progress of age was observed with wide individual variation. 3. The total concentration of plasma testosterone did not shows any change during menstrual cycle for either young female or aged women . Whereas, for whole reproductive women, small but significant elevation of the concentration was observed in the late follicular phase. 4. Percent testosterone free from TEBG were succesively lower in young women. aged reproductive women and postmenopausal women. 5. Percent testosterone free from TEBG remained constant throughout the cycle although the percent showed in the late follicular phase tended to be higher than the early follicular phase. 6. Although there was no definit changes in free testosterone index in accordance with the age or the cycle, the index tended to decrease with progress of age and to decrease with advance of follicle maturation by the mean values being comparable each other. 7. From above results, followings were suggested. A) A decreasing trend in testosterone actiⅵty wlth progress of age, even in reproductive stage, was induced by elevation of the binding site concentration of TEBG rather than decrease of the concentration of total testosterone. B) Cyclic changes of the plasma concentration of total testosterone could not provide any change in testosterone activity during menstrual cycle.

산후 난관결찰술이 심신에 미치는 영향

김승보(SB Kim),이재현(JH Lee) 대한산부인과학회 1976 Obstetrics & Gynecology Science Vol.19 No.8

1971년 10월부터 1975년 5월까지 경희대학교 의과대학 부속병원 산부인과에서 산후난관결찰 술을 받은 부인 117명에 대한 수술후 심신에 미치는 영향에 관하여 조사한 결과 다음과 같 은 결론을 얻었다. 1. 조사대상자의 연령별 분포는 30-34세가 48.7%로 가장 많앗으며 종교를 가진 부인이 68.4%로 무종교인 부인의 31.6%보다 많았다. 교육수준은 고졸이상이 84.6%로 높은 수준을 나타냈다. 2. 현존자셔수는 3명의 자녀를 가진 부인이 46.2%로 가장 많았고, 자녀가 아들뿐인 경우는 14.6%인데 비하여 딸뿐인 경우는 0.9%에 불과 하였다. 3. 수술을 받게된 동기는 너무많은 자녀수 때문에가 30.8%로 가장 많았고, 경제적 문제 때 문에와 피임에 실패해서 가 각각 23.9%였다. 수술을 권유한 사람은 본인의 의사가 37.6%였 고 남편이 22.2%로 부부의 의사가 59.8%를 차지하였다. 4. 성생활의 변화는 무변화가 71.9%로 가장 높았고 좋아졌다.가 18.0%, 나빠졌다. 10.1%로 좋아진 율이 나빠진 율보다 많았다. 5. 부인과적 수소는 무변화가 80.1%였고, 증가가 14.7%였으며 감소가 5.2%로 수소율의 증가 가 감소보다 많았다. 수소율중 가장 높은 것은 대하의 29.9%였다. 6. 일반건상상태의 변화는 무변화가 82.1%로 가장 많았고, 수소율의 증가가 16.2%, 감소가 1.7%로 감소보다 증가가 많앗다. 가장 높은 수소율을 보인 항목은 피로감의 25.6%였다. 7. 심리적 변화는 무변화가 70.1%엿으며 수소의 증가가 16.6%로 수소의 감소율 13.3보다 약 간 높앗다. 8. 수술에 대한 만족도는 만족하다가 70%였고, 보통이다가 24%였으며, 후회한다가 6%로 만 족한다는 대상이 가장 많았다. 1. The majority of the sample group were from 30 to 34 years of age (48.7%) As to religion the number of those who had religion was 68.4% and those who had no religion was 31.6%. Most had at least a high school education (84.6%) 2. The majority of the sample had more than 3 children alive (46.2%). the rate of sample only with son was 14.5% and only with daughters was 0.9%. Sons are considered much more important in Korean and had a important role for the decision of sterilization. 3. Most predominant reason for seeking postpartum tubal ligation was too many children (30.8%) and inadequate economic problems (23.9%). 4. Summarized data of various sexual pattens represented that no change in 71.9%, improvement in 18%, and deterioration in 10.1%. 5. Summarized data of gynecologic symptoms represented that no change in 80.1%, deterioration in 14.7%, and improvement in 1.7%. 6. Summarized data of somatic complaints represented that no change in 82.1% deterioration in 16.2%, and improvement in 1.7%. 7. Summarized data of psychic complaints represented that no change in 70.1% deterioration in 16.6%, and improvement in 13.3%. 8. In general feeling after postpartum tubal ligation respondents showed satisfaction in 70%, moderate in 24%, and regret in 6%.

자궁경부암에서 수술전 자궁방결합조직과 임파절 전이에 대한 전산화단층촬영의 효용성

김상원(SW Kim),김미영(MY Kim),이선경(SK Lee),김승보(SB Kim),이재현(JH Lee) 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.4

To determine the efficiency of CT scan for predicting parametrial invasion and lymph node metastasis in cervical carcinoma, preoperative CT findings of parametrial invasion and lymph node metastasis were compared with postoperative pathologic results in 77 patients with cervical carcinoma who underwent radical hysterectomy and pelvic lymphadenectomy from January 1990 to February 1993. For detection of lymph node metastasis by CT scan, the accuracy was 75.7%. And for detection of parametrial invasion, the accuracies were 83.1% in CT, while 93.5% in EUA (examination under anesthesia). It was concluded that CT was inferior to clinical evaluation in predicting the parametrial invasion, but CT was useful in detecting the pelvic lymph node metastasis which was nearly impossible by clinical evaluation.

항암화학요법중 상피성난소암의 예후인자로서 혈청 CA 125의 임상적 의의

김응선(ES Kim),김선호(SH Kim),이선경(SK Lee),김승보(SB Kim) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.11

Serum CA 125 was measured during early chemotherapy in 34 patients from January, 1991 to December, 1994 with ovarian cancer to investigate if serial measurmemts of antigen level could be used as a prognostic parameter. Serum CA 125 was determined after the first, second, and third course of chemotherapy. There was significant correlation between high serum CA 125 levels(>35U/ml) after the third course of chemotherapy and advanced FIGO stage, large residual tumor volume after cytoreductive surgery, but there was no significant correlation with patient age, tumor differentiation, and hitologic type. And high serum level of CA 125 after the third course of chemotherapy was significantly correlate with poor response to chemotherapy(p<0.0001), but there was no significant correlation with the finding of second-look laparotomy. CA 125 was a significant parameter in all three courses of chemotherapy but its correlation with 5-year survival was improved with the number of courses of the chemotherapy. Patientswith high serum CA 125 level(>35U/ml) after the third course had a 0% 5-year survival. This should be compared with a 89.5% 5-year survival in patients who had serum CA 125 level of 35U/ml or less(p<0.0001). As a consequence of this study, chemotherapy of patients with high CA 125 levels after the third course may be discontinued and replaced by other chemotherapy or palliative therapy.

대동맥확장증을 동반한 Marfan씨증후군 산모 1 예

김범수(BS Kim),김선호(SH Kim),윤대식(DS Yoon),진규섭(KS Jin),이선경(SK Lee),허주엽(CY Huh),김승보(SB Kim) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.9

The Marfan syndrome is a dominantly inherited disorder of connective tissue with multiple system involvement. The cardiac complications of Marfan syndrome in pregnancy which increases the maternal mortality. We experienced one case of Marfan syndrome in pregnancy with mild aortic dilatation, so we report the case and review of literature briefly.

BEP 복합화학요법후 완전관해을 보인 내배엽동종양 1 례

김미영(MY Kim),허주엽(CY Huh),김승보(SB Kim) 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.8

The endodermal sinus tumor is the second most common malignant germ cell tumor of the ovar, comprising 22% of all malignant germ neoplasms. Unlikely the dysgerminoma, which is only low grade in its malignant potentials, the endonermal sinus trmor is an exceedingly virulent ovarian tumor. Therapeutic approaches and prognosis have been making proces, there have been more emphases in treating the endodermal sinus trmor of the ovary with the adjuvant chemotherapy(BEP regimen)following appropriaate surgery We had experienced a cases of the endodermal sinus trmor of 11year old women We report this case with a review of the concerned literatures.

조기분만에 관한 임상통계학적 고찰

김선호(SH Kim),강인석(IS Kang),이보연(BY Lee),이선경(SK Lee),김승보(SB Kim) 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.10

The importance of preterm delivery as a major obstetric and public health problem is easily demonstrated by virtue of its contribution to total perinatal mortality. Although the perinatal mortality rate decreased markedly over the past years, the preterm birth rate has remained nearly constant. In order to investigate the various risk factors of preterm birth and contribute to prevention of preterm birth hereafter, we performed statistical analysis on 1149 cases of preterm birth delivered at Department of Obstetrics and Gynecology, College of Medicin,e Kyung-Hee University from Jan. 1 1990 to Dec. 31 1994. The results were summarized as follows; 1. The average incidence rate of preterm births during period of recent 5 years was approximately 12.3%, relatively constant. 2. When the preterm births were classified according to the etiology, 36.6% followed spontaneous preterm rupture of membrane, 25.5% followed spontaneous preterm labor, and 37.9% were maternal-fetal problems. 3. The rate of preterm birth to total birth by maternal age was 19.2% in maternal age of under 20 years and 18.0% in maternal age of over 35 years, and these were significantly higher than 12.0% in maternal age of 21-34 years(p

상피성 난소암에서 p21WAF1/CIP1/SDI1의 발현 ( p53 발현과 예후인자와의 상관관계 )

김범수(BS Kim),이선경(SK Lee),이주희(JH Lee),김승보(SB Kim) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.9

The p21WAF1/CIP1/SDI1 protein is a potent inhibitor of cyclin dependent kinases. The tumor growth suppressor WAF1/CIP1/SDI1 was shown to be induced not only by p53 but also by other mechanisms. p21 expression in human neoplasms may be differentially regulated in a tissue specific way. The present study was designed to know the frequency of p21 expression and relationship between p21 expression and p53 expression, prognostic factors in epithelial ovarian cancer. We used paraffine embedded block of epithelial ovarian cancer from 38 patients treated at Kyung-Hee university between 1982 and 1992. Immunohistochemically stained p21 was seen in 47.3% of epithelial ovarian cancer, in 41.7% of borderline malignancy but not in normal ovary. We could not found any relationship between p21 and p53 expression, therefore we suggested that p21 expression was induced not only by p53 dependent pathway but also p53 independent pathway in epithelial ovarian cancer. There was no significant relationship between p21 expression and clinicopathological parameters including stage, grade, histological type, age except tumor size. The present study suggested that p21 expression could not be utilized as a good prognostic factor in epithelial ovarian cancer.

태반조기박리에 대한 임상적 고찰

김응선(ES Kim),정순자(SJ Jung),이보연(BY Lee),이선경(SK Lee),김승보(SB Kim) 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.11

The premature separation of the normaly implanted placenta from its attachment to the uterus after 20 weeks of gestation is called abruptio palcentae. It is the one of third trimester obstetrics hemorrhagic disease that need emergent treatment. Bleeding and uteroplacental insufficiency caused by placental abruption affect to mother as well as fetus that result in maternal and fetal death in severe case. Clinical investigation of abrupto placentae is needed for its early diagnosis and adequate treatment. The data presented here are based on 103 cases of abruptio placentae among 18,199 deliveries at the Department of Obstetrics and Gynecology, Kyunghee university in seoul, from January 1, 1985 to December 31, 1994. The results of this study were followed. 1) The incidence of abruptio placentae was 0.57% of one in 176 deliveries. 2) Abruptio placentae occured between 26 and 30 years old mostly, and more in multigravida(53.4%). 3) The majority of abruptio placentae occured between 33 and 37 weeks of getational age(42.7%), and which occured before 37 weeks was about 65%. 4) 51.5% of patients with abruptio placentae was diagnosed after delivery and 48.5% before delivery. 5) Abruptio placentae was associated with preeclampsia and other hypertensive disorders in 38.8% and unknown causes in 54.4%. 6) The most common symptom in this study was vaginal bleeding(57.3%). Abdominal pain and tenderness was found in 40.8% and intrauterine fetal death in 29.1%. 7) Periantal mortality and morbidity were closely related with grade of placental abruption and gestational weeks. 8) The weight of neonates was under 2,500 gm in 72.8%. 9) the complication of abruptio placentae of this study were followed. Acute anemia occured in 44 patients, uteroplacental apoplexy in 15 patients, disseminated intravascular coagulation in 13 patients. The others were retinal detachment, uterine atony, acute renal failure, pulmonary edema, hypertensive encephalopathy and urticaria. 10) Cesarean sectio was performed in 52.4% and vaginal delivery in 47.6%. Fetal distress was most common indication of cesarean section. 11) perinatal mortality was 39.8% including stillbirth(36.9%) and neonatal death(2.9%).

3 부위 분리절개 ( Three separate Incision ) 를 통한 근치적 외음부절제술 및 양측 서혜대퇴임파절제술로 치료한 외음암 2 예

김상원(SW Kim),이선경(SK Lee),허주엽(CY Huh),김승보(SB Kim),이재현(JH Lee) 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.4

Currently therapeutic concepts in the management of vulvar cancer are replacing the uniform use of classical radical vulvectomy with en bloc bilateral inguinal lymph node dissections. New surgical trends include less extensive vulvar surgery, separate groin incisions with preservation of the skin bridge, and less radical inuinal nodal surgery. This approach lead to improved anatomic and functional preservation and the operation results are not inferior. We experienced two case of vulvar cancer managed by radical vulvectomy and bilateral inguino-femoral lymph node dissection through three separate incisions. Here we report thses cases with the brief review of literatures.