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배상욱,정병화,정봉철,전진동,이현정,권한성,정경아,김세광,박기현,Bai, Sang-Wook,Jung, Byung-Hwa,Chung, Bong-Chul,Jeon, Jin-Dong,Lee, Hyun-Jung,Kwon, Han-Sung,Chung, Kyung-Ah,Kim, Sei-Kwang,Park, Ki-Hyun 대한생식의학회 2001 Clinical and Experimental Reproductive Medicine Vol.28 No.4
Objective: To elucidate 1) whether there are any differences in the urine concentrations of steroid hormone metabolites between patients with leiomyoma and normal controls 2) the correlation between urinary profiles of steroid hormones and leiomyomas of the uterus according to their type, location, volume, and weight. Materials of Methods : The study population consisted of 37 premenopausal patients with uterine leiomyoma and the control group consisted of 25 premenopausal normal volunteer women without uterine leiomyoma. Confirmation of the existence of uterine leiomyoma was done by ultrasonography and histopathological examination after surgery. The volume of the leiomyoma was estimated by trans-abdominal and/or trans-vaginal ultrasonography. The Leiomyomas were divided into 3 types (subserosal, intramural and submucosal). Seventeen patients had subserosal type of leiomyoma, 10 with the intramural type and 10 with the submucosal type. The locations of the leiomyoma were also divided into 3 groups (fundus, body and isthmus). Seventeen patients showed a fundus location, 10 in body, and 10 in isthmus. We compared urinary profiles of the endogenous steroids between patients with leiomyomas and normal controls, and also investigated the relationship between urinary profiles of the endogenous steroids and leiomyomas according to their type, location, volume and weight by using highly sensitive Gas Chromatography-Mass Spectrometry (GC-MS) system. Results: The mean ages of the patients with leiomyomas and the control group were $43.1{\pm}5.6$ and $40.6{\pm}7.2$ years, the weights were $63.4{\pm}7.3$ and $59.4{\pm}8.1\;kg$, and their heights were $155.4{\pm}4.8$ and $159.3{\pm}4.8\;cm$ respectively. Seventeen patients had subserosal, 10 had intramural, and 10 had submucosal leiomyomas. There were 17 patients with leiomyoma located in fundus, 10 in body and 10 in isthmus. $17{\beta}$-estradiol, 5-AT, 11-keto ET, $11{\beta}$-hydroxy An, $11{\beta}$-hydroxy Et, THS, THA, THE, a-cortolone, a-cortol, $\beta$-cortol, $11{\beta}$-OH Et/$11{\beta}$-OH An and E2/E1 were significantly increased in patients with leiomyoma than in the control group. $17{\beta}$-estradiol was significantly increased in the intramural and the submucosal types than in the subserosal type. There was no significant difference in the concentrations of urinary steroids according to the locations of leiomyomas. There was no significant relationship between the concentration of urinary steroids and the volume of the leiomyomas. $17{\beta}$-estradiol significantly decreased as the weight of uterus increased (r=-0.322, p=0.04). Conclusion: The concentrations of steroid hormone metabolites were generally increased in patients with leiomyoma but were not significantly related to the volume and weight of the leiomyomas. Our study suggests that steroid hormones may be involved in the initiation of leiomyomas but may not be involved in their progression. In addition, the concentrations of steroid hormone metabolites are not related to the leiomyoma type and location.
보조 생식술 결과에 있어서 기저혈중 Inhibin-B의 예후인자로서의 유용성
배상욱,김진영,이경술,원종건,이용주,이지원,장경환,이병석,박기현,조동제,송찬호,Bai, Sang-Wook,Kim, Jin-Young,Lee, Kyung-Sool,Won, Jong-Gun,Lee, Yong-Joo,Yi, Ji-Won,Chang, Kyung-Hwan,Lee, Byung-Seok,Park, Ki-Hyun,Cho, Dong-Jae,Song, Cha 대한생식의학회 1997 Clinical and Experimental Reproductive Medicine Vol.24 No.2
This study was performed to determine if women with day 3 serum inhibin-B concentrations <45pg/ml (conversion factor to SI unit, 1.00) demonstrate a poor response to ovulation induction and assisted reproductive technology outcome to women with inhibin-B${\ge}45pg$/ml, independant of day 3 FSH, E2 and patient age. From Jan 1996 to Dec 1996, 16 volunteers patients who underwent 25 IVF cycles with luteal phase GnRH agonist suppression and HMG stimulation were allocated to the study group. We evaluated day 3 serum inhibin-B, FSH, E2, peak E2, cancellation rate per initiated cycle (%) and clinical pregnancy rate per initiated cycle (%) according to the above two groups and independent of patient age, day 3 FSH, day 3 E2 and all of above combined. Women with day 3 serum inhibin-B${\ge}45pg$/ml demonstrated higher average day 3 inhibin-B level, clinical pregnancy rate per initiated cycle ($20.3{\pm}2.5$ pg/ml vs $80.9{\pm}5.0$ pg/ml, p<0.05; 24.8% vs 8.5%, p<0.05) and lower day 3 FSH level, cancellation rate per initiated cycle ($6.9{\pm}0.3$ mIU/ml vs $8.5{\pm}0.5$ mIU/ml, p<0.05; 1.5% vs 9.0%, p<0.05). Women with day 3 serum inhibin${\ge}45pg$/ml and age<40 year demonstrated higher pregnancy rate per initiated cycle (28.2% vs 7.4%, p<0.05) and lows. day 3 FSH level, cancellation rate per initiated cycle ($6.9{\pm}0.5$ mIU/ml vs $8.2{\pm}0.7$ mIU/ml, p<0.05; 1.0% vs 9.0%, p<0.05). Women with day 3 serum inhibin${\ge}45pg$/ml and day 3 FSH<15mIU/ml demonstrated higher pregnancy rate per initiated cycle (33.5% vs 9.5%, p<0.05) and lower day 3 FSH level, cancellation rate per initiated cycle ($7.7{\pm}0.2$ mIU/ml vs $8.5{\pm}0.5$ mIU/ml, p<0.05; 1.5% vs 10.0%, p<0.05). Women with day 3 serum inhibin${\ge}45pg$/ml and day 3 E2<50pg/ml demonstrated higher pregnancy rate per initiated cycle (30.0% vs 9.5%, p<0.05) and lower cancellation rate per initiated cycle (1.5% vs 9.5%, p<0.05). Women with day 3 serum inhibin${\ge}45pg$/ml, age<40 year, day 3 FSH<15mIU/ml and day 3 E2<50pg/ml demonstrated higher pregnancy rate per initiated cycle (30.0% vs 10.8%, p<0.05) and lower day 3 FSH level, cancellation rate per initiated cycle ($6.8{\pm}0.6$ mIU/ml vs $8.4{\pm}0.9$ mIU/ml, p<0.05; 1.5% vs 7.8%, p<0.05). Therefore women with low day 3 serum inhibin-B concentrations demonstrate a poorer response to ovulation induction and are less likely to conceive a clinical pregnancy though ART relative to women with high day 3 inhibin-B and day 3 serum inhibin-B, in addition to a day 3 FSH, E2 and patient age, appears helpful in prediction in IVF-ET outcome.
체외수정시술을 위한 과배란 유도결과와 혈중 Inhibin의 상관관계
배상욱,정창진,장경환,이병석,박기현,조동제,송찬호,Bai, Sang-Wook,Jung, Chang-Jin,Chang, Kyung-Hwan,Lee, Byung-Suk,Park, Ki-Hyun,Cho, Dong-Jae,Song, Chan-Ho 대한생식의학회 1996 Clinical and Experimental Reproductive Medicine Vol.23 No.3
Serum inhibin concentrations, determimed by radioimmunoassay, were measured in women undergoing pituitary suppression with Decapeptyl and subsequently ovarian stimulation with Highly Purified-Metrodin(HP-FSH) to appraise follicular development. Early follicular basal serum inhibin level correlated with the number of oocytes retrieved(r=0.89, n=8, p<0.05). The number of oocytes retrieved showed a significant correlation with serum inhibin level on the day of hCG administration(r=0.73, n=8, p<0.05). The number of mature oocytes showed a significant correlation with serum inhibin level on the day of hCG administration(r=0.73, n=8, p<0.05). These data suggest that: (1) In the early follicular phase, basal serum inhibin may be a valid index to predict ensuing follicular growth : (2) In the preovulatory phase, maximum serum inhibin may be one of the indexes of follicular development during hyperstimulation cycles.
배상욱 ( Sang Wook Bai ),( Yoo Jin Lee ),( Soo Rim Kim ),( Sei Kwang Kim ) 대한산부인과학회 2015 대한산부인과학회 학술대회 Vol.101 No.-
Objective: To demonstrate the significance of bladder outlet obstruction (800) in preoperative urodynamic studies (UDS) in women who have been diagnosed with pelvic floor dysfunction including pelvic organ prolapsed (POP) and stress urinary incontinence (SUI). Methods: The medical records of 150 patients with pelvic ~oor dysfunction who underwent preoperative UDS at Vensei University Health System from 2006 to 2012 were reviewed. Under the criteria of BOO, as a maximal flow rate in free-flow study (Qrrex) less than 12 mLJsec and a detrusor pressure at 0""", in pressure-flow study (PdetOmax) higher than 20 cmH20 in UDS, they were divided into two groups: a group of 50 patients with BOO and a group of 100 patients without BOO. Comparisons were made between the patients with and without BOO in preoperative UDS. Results: In the POP-with-SUI group, 25 patients with BOO had lower mean Omax (10.0 vs. 25.4 mLJsec, P<O.OO1), higher PooIO""", (49.6 vs. 21.5 cmH20, P<O.OO1), lower maximum cystometric capacity (422.7 vs. 454.0 mL, P=0.007), and higher postvoi-dal residual volume (44.3 vs. 21 .1 mL, P=0.021) than the patients without BOO. In the SUI-only group, the mean Omax was significantly lower in the 25 patients with BOO (9.4 vs. 25.4 mUsec, P< 0.001). The mean PdetQmax was significantly higher with BOO (39.6 vs. 25.4 cmHzO, P=0.OO4). In the univariate analyses, menopause, maximum cystornetric capacity, and cystoscopic bladder trabeculation were associated with BOO. Conclusion: In the univariate analysis, menopause, MCC and cystoscopic bladder trabeculation were associated with BOO. In the multivariate model, however, no significant association with BOO was found.
배상욱(Sang Wook Bai),정병하(Byung Ha Chung),양승철(Seung Chul Yang),이무상(Moo Sang Lee),박상원(Sang Won Park),김재욱(Jae Wook Kim) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.11
N/A Alteration in the hormone level associated with menstrual cycle influences the interaction between the urethra and bladder as well as detrusor function, maybe due to the common embryological origin of lower female genital and urinary tract. We tried to investigate the effect of the menstrual cycle on cystometric diagnosis through this retrospective study. 60 women with regular menstruation were enrolled in this study. The study groups were divided into 2 groups, Group I was women whose symptoms were not influenced by the menstrual cycle, Group II was women whose symptoms were adversely affected premenstrually. The majority of normal cystometric diagnosis were made in the luteal phase (Group I: 42.9% vs 4.4%, p<0.05; Group II: 50.0% vs 22.2%, p<0.05). But diagnosis of genuine stress incontinence, detrusor instability, mixed genuine stress incontinence and detrusor instability were frequently made in the follicular phase of mentruation. Normal cystometric diagnosis in the group II were more commom than the group II ( 36.8% vs 19.7%, p<0.05 ). The results of this study reveal that the timing of cystometric evaluation may influence the the detection of a positive diagnosis. In patients whose symptom are influenced by their menstrual cycle, the luteal phase may not be the correct time to make an accurate diagnosis.
체외수정시술시 배아이식 후 배아이식도관 말단부에서의 미세균주 배양율과 임상적 임신율과의 관계
이경진,배상욱,김정연,김진영,이병석,박기현,조동제,송찬호,Lee, Kyoung-Jin,Bai, Sang-Wook,Kim, Jeong-Yeon,Kim, Jin-Young,Lee, Byung-Seok,Park, Ki-Hyun,Cho, Dong-Jae,Song, Chan-Ho 대한생식의학회 1999 Clinical and Experimental Reproductive Medicine Vol.26 No.3
Objective: To evaluate incidence of microbial growth from the tip of the embryo transfer catheter after embryo transfer in relation to clinical pregnancy rate following in-vitro fertilization and embryo transfer. Method: This study was performed prospectively at the time of transcervical embryo transfer following conventional in-vitro fertilization and intracytoplasmic sperm injection procedures. Sixty three patients were enrolled in this study. Microbiological cultures were performed on endocervical swabs and embryo transfer catheter tips. Results: Positive microbial growths were observed from endocervical swabs in 45 (71.4%) women and from catheter tips in 30 (47.6%) women. There was no statistically significant difference seen in the mean number of oocytes fertilized or number and grade of embryos transferred between the group of patients without growth and the group of patients with positive microbial growth from catheter tips. The clinical pregnancy rate were 30.3% in the group of patients without growth and 13.3% in the group with positive microbial growth from catheter tips. This difference in clinical pregnancy rates was statistically significant. Conclusion: Our finding is that microbial contamination at embryo transfer may influence implantation rates. The major questions arising from our finding are whether eradication of endocervical micro-organisms is possible and whether their eradication will improve implantation rates.
Urinary Profiles of the Endogenous Steroids in Pre-Menopausal Women with Uterine Leiomyoma
정병화,배상욱,정봉철,김세광,박기현,Jung, Byung-Hwa,Bai, Sang-Wook,Chung, Bong-Chul,Kim, Sei-Kwang,Park, Ki-Hyun The Korean Society for Reproductive Medicine 2003 Clinical and Experimental Reproductive Medicine Vol.30 No.1
목 적: 본 연구의 목적은 내인성 성호르몬이 자궁근종의 성장에 미치는 영향을 알아보고자 연구를 시행하였다. 연구대상 및 방법: 폐경전 자궁근종 환자 27명과 같은 연령대의 정상여성 25명을 대상으로 하였다. 모든 대상군의 여성에서 24시간 소변을 모아서 소변내 estrogen, androgen의 대사체들을 GC-MS를 이용하여 측정하였으며 두 군에서의 차이를 비교분석 하였다. 결 과: 소변내 $17{\beta}$-estradiol, 5-androstene-$3{\beta}$, $16{\beta}$, $17{\beta}$-triol, 11-keto-ethiocholanolone, $11{\beta}$-hydroxy-androsterone, THS, THA, THE, a-cortolone, a-cortol 및 $\beta$-cortol가 환자군에서 의의있게 증가하였으며 $17{\beta}$estradiol/estrone 및 $11{\beta}$-hydroxy-ethiocholanolone/$11{\beta}$-hydroxy-androsterone도 환자군에서 의의있게 증가하였다. 결 론: 자궁근종의 성장은 요중 estrogen과 androgen의 농도와 밀접한 관련이 있으며 이는 환자의 스테로이드 호르몬 대사 감소에 기인한 것으로 사료된다.