융모성질환의 치료에 있어서 요중 Pseudouridine의 동태

오성택(ST Oh) 대한산부인과학회 1991 Obstetrics & Gynecology Science Vol.34 No.1

Pseudouridine excretion was monitored in the urine of patients with trophoblastic diseases and compared with the changes in serum chorionic gonadotrophin(hCG) levels during anticancer chemotherapy. Separation and quantitation of urinary pseudouridine were accomplished by using high performance liquid chromatography. The excretion levels of pseudouridine were expressed as a function of urine creatine concentration. Significantly elevated pseudouridine levels(60.55+29.43) nanomoles/u moles creatinine,n=24) were found in trophoblastic diseases as compared to normal levels of non-pregnant women(24.54+8.87,n=28). pseudouridine elevations over the value of normal mean plus 2 standard deviations were found in 92% of the patients. The follow-up study in 12 patients under chemotherapy showed that although both the tumor markers showed a similar pattern in returning to normal levels, urinary pseudouridine levels returned to normal 1.6 weeks earlier than the serum hCG levels, In the case of recurrence which occurred in 3 patients, urinary pseudouridine levels also re-elevated about one week earlier than the serum hCG levels. Furthermore, when chemotherapeutic agents were found to be ineffective and consequently changed to another effective agents, urinary pseudouridine excretion promptly began to decline while the serum hCG levels were still elevated. These results suggest that urinary pseudouridine can be useful as a more sensitive tumor marker than the conventional serum hCG for evaluating the effectiveness of anticancer chemotherapy for trophoblastic diseases.

Clomiphene과 hMG과배란후 자궁강내 인공수정의 임신율에 관한 고찰

오성택(ST Oh),조주은(JE Cho) 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.6

Ninthy-six infertility patients were studied who visited to Department of Obstetrics and Gynecology of Chonnam University Hospital and who received intrauterine insemination (IUI) due to husbands male factor abnormality or poor postcoital test(PCT) with normal husbands sperm finding. Twenty-five(group 1) received IUI without hyperstimulation, and 35 received IUI after clomiphene medication (group 2). Clomiphene/hMG combined hyperstimulation was done in 25 patients (group 3), and 13 received only hMG hyperstimulation (group 4). Pregnancy rates between group 1 and group 2 were not statistically different. Statistically significant difference between group 1 and group 3 or 4 was found (p<0.05), but significant difference between group 3 and group 4 was not found in overall pregnancy rates and in pregnancy rates of poor PCT with normal serm finding. Although we could not done statistical analysis in male factor infertility, pregnancies were observed only in group 3 and group 4 with asthenospermia husband. Therefore we can suggest clomiphene/hMG combined hyperstimulation is best method economically and at the point of acceptability to patients in order to increase pregnancy rates after IUI.

자궁내막증의 병인에 있어서 혈관내피세포 성장인자의 역할

오성택(ST Oh),이민철(MC Lee),박창수(CS Park) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.5

There were many reports about the development of endometriosis and progression of endometriotic lesions, but not exactly established. Recently angiogenic factors as well as various growth factors and cytokines were reported to be involved in the progression of endometriotic lesions. Several researches about the role of vascular endothelial growth factor (VEGF), one of an angiogenic factor, in endometriosis were reported, but the role of VEGF was not certain yet. In order to investigate the role of VEGF in endometriosis we studied VEGF expression in normal endometrium (n=10) and endometriotic lesions (n=10) by immunohistochemistry, and the effect of VEGF on proliferation of endometrial stromal cell after adding VEGF into culture system by autoradiography. The tissues from 10 patients with endometriosis were all early proliferative phase due to preoperative treatment with gonadotropin releasing hormone (GnRH) agonist and those of control women were 5 proliferative and 5 secretory phases. Followings were the results. 1. In control women, the expression of VEGF in endometrial stromal cells was weak in proliferative phase but progressively strong in edematous area of secretory phase. The expression of VEGF in stromal cells of endometriotic lesions was strong in spite of early proliferative phase due to preoperative GnRH agonist therapy. 2. The addition of VEGF into endometrial stromal cells stimulated the proliferation of stromal cells in both normal endometrium and endometriotic lesions. However there was no statistical differences among stimulation effect of growth after adding VEGF. Above results indicated that VEGF was thought to have the effect of stimulation of the proliferation of stromal cells in normal endometrium and endometriotic lesions. Expression of VEGF in normal endometrium suggest autocrine mechanism of increased expression in secretory phase and decreased expression in proliferative phase. However in endometriosis, it is suggested that this autocrine mechanism was failed and increased production of VEGF during proliferative phase. Therefore this failure of autocrine action resulted in progression of endometriosis by continuous proliferation of endometrial tissue. In conclusion, VEGF plays important role in the pathogenesis of endometriosis.

자궁내막종의 임상적 진단과 조직학적 진단의 차이에 관한 고찰

오성택(ST Oh),이경민(GM Lee),김병룡(BR Kim) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.5

Objective: The purpose of this study is to find the proper clinical diagnostic criteria of clinical diagnosis for endometrioma by comparing to histologic diagnosis. Methods: Our study was performed in 140 patients, who were diagnosed hemorrhagic ovarian cyst by diagnostic laparoscopy or MRI and received the laparoscopic cyst wall stripping. The our clinical diagnostic criteria for endometrioma are as follows: 1] endometrioma is diagnosed if endometrial epithelium, gland or stroma is histologically proven. 2] it is not diagnosed to endometrioma if cystic content is not thick but watery. 3] if more than two findings are present among hemosiderin-laden macrophages, moderate to severe adhesion, endometrial spot in peritoneal cavity, we diagnosed as endometrioma. Results: If histologically proven endometrial epithelium, gland or stroma was only included in diagnostic criteria, 63/140[45%] patients were diagnosed as endometrimas. If hemosiderin-laden macrophage findings with severe adhesion and presence of surface endometriotic spots were included in diagnostic criteria although histologically not proven endometrial tissue, 86/140 [61.4%] patients were diagnosed. If they are diagnosed by our criteria, 124/140[87.9%] patients were diagnosed. The endometrial tissue was not found in 77/140 patients, and 70/77 patients had preoperative dysmenorrhea, dyspareunia or chronic pelvic pain. The 69/70 patients were diagnosed as endometriomas by our criteria, and the pains were markedly subside in 60/69 patients postoperatively and moderately subside in 9/69 patients. The hemorrhagic cysts were recurred in 5/77 patients, and endometrial tissues were proved in 3/5 patients on second operation. Conclusion: The clinical diagnostic criteria is needed on histologic diagnosis for more perfect postoperative management of endometrioma patients, and the establishment of this criteria for clinical diagnosis is necessary by future many investigations.

골반경하 난관말단부 신개구술후 난관소통율 및 임신율에 대한 고찰

오성택(ST Oh),김석모(SM Kim) 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.2

The purpose of this study is to determine the usefulness of opertive pelviscopy for treatment of terminal tubal obstruction and to know the best operation method of salpingneostomy . Sixty-four patients who were diagnosed to one or both terminal tubal obstructions by hysterosalpingogram were treated by three types of terminal salpingneostomy under the operative pelviscopy, and their postoperative tubal patency and pregnancy rates were observed and those of each operation type were compared with them of other operation type. clubbed fimbria was incised by scissors only and everted by 4-0 polydioxanon suture in 16 of 64 cases (type I), andincised by low-current needle diathermay and everted by endocoagulator in 19 of 64 cases (types II). In 29 of 64 cases, perforation of clubbed tube was performed by needle diathermy and then openning was perforation of clubbed tube was performed by needle diathermy and then openning was dilated by grasping forceps and fimbria was everted by intussuception methods and suture (type III). On postoperative hysterosalpingogram that were checked 2 months later, one or both tubes were patent in 8 of 16 cases (50%) at type I and patent in 16 of 19 cases (84.2%) at type II and patent in 28 of 29 cases (96.2%). Therefore type III operation revealed significantly higher postoperative tubal patency rate than other two operation types (p

난관 기시부 폐쇄성 불임 환자의 치료를 위한 자궁경하 난관삽관술의 유용성

정진(J Jeong),오성택(ST Oh),이현수(HS Lee) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.6

The purpose of this study is to evaluate the efficacy of modified hysteroscopic catheterization for treatment of proximal tubal occlusion. This study was performed in 17 patients who were dignosed to proximal obstructions of both tubes by hysterosalpingography (HSG) from January 1st., 1994 to october 31st, 1997. Hysteroscopic catheterization could be performed without concomittent laparoscopy, because observation of dye-flow in uterine cavity was possible by gentle injection of dye through the catheter and by gentle control of continuous expansion media flow. On hysteroscopic exam, 4 of 17 patients revealed the normal ostia without any fibrosis and they seems to be obstruction by spasm or by microplug. 6 of 17 patients showed mild fibrosis, and the other 7 patients revealed the severe fibrosis of ostia. Catheterizations of ostia were easily succeed in all 4 no fibrosis patients and 6 mild fibrosis patients. In 6 patients of severe fibrosis, catheterizations were succeed although they were very difficult. However in one patients of severe fibrosis, fibrosis of ostia was too hard to pass the catheter. Therefore overall success rate was 94% (16 of 17 patients). In follow-up one month later by HSG, 2 patients of no fibrosis revealed proximal occlusion findings of both tubes again. In coclusions, this modified hysteroscopic catheterization is simple and effective method for diagnosis and treatment for proximal obstruction of fallopian tube.

융모성질환에 있어서 혈청 α-FP 및 β-hCG에 관한 연구

오성택,윤영돈 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.2

전남대학교 의과대학부속병원 산부인과에서 내원한 임신 519주사이의 정상임부 80명과 무월경 주수가 정확한 융모성질환 38예의 각 주수별 혈청 α-FP, β-hCG 및 β-hCG/α-FP치를 비교한 결과 다음과 같은 결론을 얻었다. 1. 혈청 α-FP치에서는 융모성질환이 정상임부보다 8주이후에서 통계학적으로 의의있게 낮았다(p $lt; 0.01). 2. 혈청 β-hCG치는 융모성질환이 정상임부보다 임신 8~11주에서는 통계학적으로 유의한 차가없고, 6주,7주 및 12주이후에서 의의있게 높았다(P$lt;0.05). 3. β-hCG/α-FP치는 융모성질환이 정상임부보다 임신 6주이후에서 통계학적으로 의의있게 높았다(P$lt;0.05). 이와같은 결과로 임신 6주이후 혈청 α-FP을 혈청 β-hCG와 같이 측정하므로써 융모성질환의 진단에 도움을 줄수있을 것으로 사료되었다. This study was performed for the early diagnosis of trophoblastic disease (TRD) by the measurement of serum -fetoprotein (α-FP) and -human chorionic gonadotropin (β-hCG). Serum α-FP, β-hCG levels were respectively measured by enzyne immunoassay (EIA), radioimmunoassay (RIA). The 38 cases with TRD were compared with 80 cases in normal pregnancy at 5- to 19 weeks of gestational period by measurement of α-FP, β-hCG and β-hCG/α-FP. The following results were obtained: Serum α-FP levels of cases with TRD were significantly lower than those of normal pregnancy at 8- to 19 weeks of gestational period (p $lt; 0.01). Serum β-hCG levels of cases with TRD were significantly higher than those of normal pregnancy at 6th, 7th and after 12th gestational week, while not at 8- to 11 weeks of gestational period (p $lt; 0.05). β-hCG/α-FP ratio of cases with TRD were significantly higher than those of normal pregnancy after the 6th gestational week (p $lt; 0.05). In conclusion, it is suggested that the measurement of serum α-FP and β-hCG after 6th gestational week may be valuable for the early diagnosis of TRD.

난소임신의 복강경하 보존적 수술 1 예

이소윤(SY Lee),오성택(ST Oh) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.8

Ovarian pregnancy is a very rare of extrauterine pregnancy, and it`s is difficult to diagnose prior to surgery and distinguished from distal tubal pregnancy. In past, traditional treatment for ovarian pregnancy was oophrectomy or salphigooophrectomy. However if patients are young, and desire of future childbearing, recently conservative managements such as wedge resection or removal of only gestational products are performed. Furthermore according to development of laparoscopic operation, laparoscopic consevative surgery is more preferred now. We report a case of ovarian pregnancy that treated by only removal of gestational product under the operative laparoscopy and postoperative methotrexate single therapy.

골반경하 자궁내막종적출술에 대한 수술전 GnRH agonist치료의 효과에 관한 고찰

이지영(JY Lee),오성택(ST Oh) 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.6

From September 1992 to August 1995, at the Department of Obstetrics and Gynecology, Chonnam University Hospital, we performed preoperative GnRH agonist treatment(1-6 months) and pelvicopic surgery for 48 patients with endometrioma, and also performed pelviscopic surgery only 2~3 months after initial diagnostic laparoscopy for 17 cases. This retrospective study was conducted to evaluate the effect of preoperative GnRH agonist treatment on laparoscopic cystectomy for endometrioma by comparing changes in size of cyst, presence of endometrial spots and degree of adhesion and diffculty in stripping of cyst between GnRH agonist-treatment group and control group. The results were as follows. The size of cysts were decreased in none of 8 cases with 1 month-treatment and in 2 of 8 cases with 2 month-treatment. These data showed no significant difference from that of control group(decrease in size of cyst in 1 of 17 patients). However the sizes of the cysts were decreased in 5 of 9 patients with 3 month-treatment, 6 of 10 patients with 4 month-treatment and all 13 patients with 5 or 6 month-treatment. These revealed significant differences from that of control group(p

자궁내막종의 치료로서 수술골반경을 이용한 낭종절제술의 유용성

김재훈(JH Kim),오성택(ST Oh) 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.7

Twenty-two patients diagnosed to endometrioma by ultrasonography and diagnostic laparoscopy were treated with cystectomy under the operative pelviscopy, and the duration of operation and postoperative recovery time and duration of hospital stay were recorded and we compared these data in 48 laparotomy cases. The mean durations of operation were 2.4±0.7 hours in laparotomy and 2.1±0.4 hours in pelviscopy, and so the duration of the pelviscopic operation was significantly shorter than laparotomy(p