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난소과립막세포 스테로이드호르몬 생성 및 증식에 대한 Mullerian Inhibiting substance의 효과
김장흡,이진우,김수평,나종구,김은중,김태응,신재인,제동성 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.12
Ovarian follicular growth is a consequence of granulosa cell proliferation, and steroid production by these cells appears to be a major determinant of the endocrine microenvironment of ovum maturation. The gonadotropins, FSH ad LH, regulate directly the growth and differentiation of the granulosa cells in the ovary, but there is evidence to suggest that the gonadotropins act partly through locally produced growth factors and that this interaction is complex. A number of growth factors, such as epidermal growth factor(EGF), insulin-like growth factor-I(IGF-I), and transforming growth factor-β(TGF-β) are produced in the ovarian follicle and might act in an autocrine and/or paracrine manner to directly control granulosa cell proliferation and differentiation. While it has been demonstrated that steroid hormones, gonadotropins and growth factors regulate proliferation and differentiation of ovarian follicles, little is known concerning the fators involved in the inhibition of ovarian function. Recently, Mullerian inhibiting substance(MIS), a non-steroidal testicular Sertoli cell product responsible for the regression of Mullerian duct in male embryo, has been shown to be produced by ovarian granulosa cells in adolescnet and ault females. Although the function of MIS in the ovary has not been fullydelineated, MIS appears to be a regulator of oocyte maturation and follicular development in the rat. In this study, in order to investigate the influence of MIS on steroidogenesis and proliferation of human granulosa cells, we performed culture of human granulosa cells. The cells were cultured for 2 to 12 days under two conditions, with and without MIS(20 ng/ml). Each condition was additionally defined by the presence and absence of EGF(20 ng/ml), FSH(10 ng/ml), or LH (10 ng/ml). Estradiol, progesterone, and testosterone were mearsured form the spent media by radioimmunoassay and the cell number was determined by trypsinizing the cells and counting them with a Coulter counter. The result were as follows: 1. There was about 6-fold increase in the final granulosa cell number when the culture were maintained for 12 days in Ham`s F-10 supplemented with 10% MIS-free female fetal calf serum(control). FSH and EGF caused a significant increase in granulosa cell number compared with the control but LH significantly suppressed cell number after 8 days in culture. 2. MIS caused a significant decrease in granulosa cell number compared with the control after 8 days in culture in the 20 ng/ml dose, and on day 12 in the 2 ng/ml dose(p$lt;0.05). MIS(20ng/ml)also significantly blocked EGF induced proliferation of granulosa cells after 6days in culture and the maximum effect was observed on day 12 of culture(p$lt;0.01). 3. Estradiol production from granulosa cells was significantly stimulated by both gonadotropins, with LH having the greater effect than FSH after 6 days in culture(p$lt;0.05). However, EGF significantly suppressed estradiol production of granulosa cells, but significantly decreased FSH induced estradol production of granulosa cells after 4 days in culture(p$lt;0.05). 4. Progesterone production from granulosa cells was significantly stimulated by both gonadotropins and EGF, with LH having the greatest effect. However, MIS had no effect on basal progesterone production of granulosa cells after 4 days in culture(p$lt;0.05) with havint the greatest effect on day 10 of culture(p$lt;0.01). 5. Testosterone production from granulosa cells was not detected in all conditions. In conclusion, these experiments demonstrate that MIS may have relevant funciton in the ovay as a regulatior of follicular development and steroidogenesis maturation during the adult reprodu-ctive cycle.
난소암에서 대식구 집락자극인자 , 과립구 대식구 집락자극인자와 그 수용체들의 발현
송승규,이헌영,남궁성은,김수평,한구택,류기성,류부학,박혜정,제동성 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.8
Colony-stimulating factors(CSFs) are a family of glycoprotein that are involved in the survival, proliferation, differentiation and activation of hematopoietic cells at various stages of their development. The clinical ramification and therapeutic evalutation of hematopoietic growth factors are a rapidly growing field taht holds promise for the treatment of various medical illness. Many nonhematopoietic tumors produce hematopoietic growth factor that mayinfluence cellular proliferation either by autocrine or by paracrine mechanism. So hematopoietic growth factors have been implicated in protean nonhematopoietic process. In this study, expression of macrophage colony-stimulating factor(M-CSF), M-CSF receptor(M-CSF-R), granulocyte macrophage CSF(GM-CSF) and GM-CSF receptor(GM-CSF-R)was investigated in 37 gynecologic tissues including 31 samples of malignant ovarian tumor and 6 samples of benign ovarian tumor by RNA dot blot method. We systematically examined the relationship between the expression of CSFs and their receptors and clinical disease status. The results were as follows; 1. In 31 ovarian malignincies, RNA expression of CSFs and their receptors was detected from 15 cases(48.4%) in M-CSF,20(64.5%) in M-CSF-R, 13(41.9%) in GM-CSF-R, Co-expression of M-CSF-R was found in 13 cases(41.9%) and that of GM-CSF and GM-CSF-R in 10 cases(30.3%). In 6 benign ovarian cysts, GM-CSF and GM-CSF-R expressions were not detected, but M-CSF-R expressions were detected in one case even though at very low intensity 2. CA125, the most sign tumor maker in ovarian career, was significantly elevated in the ground that expressed the M-CSF(p=0.045), but not in M-CSF-R and GM-CSF-R. 3. There were significantly high rates of RNA expression of M-CSF, M-CSF-R. GM-CSF and GM-CSF-R in poorly differentiated tumors(grade 3) compared with well and moderately differentiated tumors(p=0.001, p=0.035, p=0.005, respectively). By means of Mantel-Haenszel Chi-square analysis, the intensity of RNA expression also showed significant correlation with the histologic grades in M-CSF(p=0.041). 4. Age of patinent tumor size, pathologic diagnosis and FIGO Stage did not show any significant relation with the expression of CSFs and their receptors. This results indicate that hematopoietic growth tactor modulate tumorigenesis by autocrine and paracrine mechanisms and the expression of hematopoietic growth factor and its receptor in ovarian malignancies could coptribute to their proliferative and invasive characteristics in vivo.
조윤성 ( Yun Sung Jo ),권지영 ( Ji Young Kwon ),임희순 ( Hee Sun Lim ),문영주 ( Young Joo Mun ),이상형 ( Sang Hyoung Lee ),제동성 ( Dong Sung Jae ),한구택 ( Gu Taek Han ),류기성 ( Ki Sung Ryu ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.12
Myoma is the most common tumor in gynecologic field. As ultrasonography because popular in antenatal care, the more cases of myoma and those adverse effects during pregnancy are more frequently detected. The management of myoma during pregnancy is conservative, but in rare circumstances, surgical intervention including myomectomy may be required. We have experienced a case of protruded subserosal myoma with the uterine cervix in midtrimester of pregnancy. The patient was managed surgically by transvaginal myomectomy and had successfully maintained pregnancy. We report a case of protruded subserosal myoma through pelvic floor in pregnancy with brief review of literatures.