• Title/Summary/Keyword: 자궁의 혹

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Endobronchial Metastasis of Extrapulmonary Malignancies (폐외 악성 종양의 기관지내 전이)

  • Kim, Do-Hoon;Park, Moo-Suk;Chung, Jae-Ho;Cheong, Jae-Hee;Kim, Se-Kyu;Chang, Joon;Kim, Sung-Kyu;Kim, Young-Sam
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.3
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    • pp.285-293
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    • 2002
  • Background : The lung is the most common site for a metastasis of extrapulmonary malignant tumors. however, reports on an endobronchial metastasis are rare. An endobronchial metastasis is defined as a documented extrapulmonary neoplasms metastatic to the segmental or more proximal central bronchus within a bronchoscopically visible range. The purpose of this study was to define the clinical characteristics of an endobronchial metastasis of extrapulmonary malignancies. Materials and Methods : The clinical features and treatment outcomes of 27 endobronchial metastatic cancer cases were reviewed from June, 1991 to May, 2001 in the Severance Hospital. Results : The patients' age ranged from 18 to 75. There were 17 men and 10 women. The primary tumors included the colorectum in 7, the uterine cervix in 4, the stomach and the breast in 3 patients each, and an osteosarcoma in 2 patients. The main complaint of most patients was coughing and a chest X-ray revealed a hilar mass, a parenchymal, and an atelectasis. The mean recurrence interval time was 45.5 months. The median and mean survival times were 10 and 12.3 months, respectively. Conclusion : An endobronchial metastasis is an ominous finding, and is associated with advanced-stage diseases. It requires differential diagnosis with a primary bronchogenic carcinoma. If atypical clinical features are present or an atypical cell type is discovered by a biopsy of the lesion in the lung mass, the appropriate diagnostic studies should be undertaken.

Role of Trophobolast in Implantation and Placenta Development (착상 및 태반 발달과정에 따른 영양막세포의 역할)

  • Kim, Gi-Jin
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.3
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    • pp.181-189
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    • 2010
  • The placenta, which is a temporary organ derived from the fetus during pregnancy, is critical to support fetus development via optimal regulation between mother and fetus. Trophoblast as a major cell population of the placenta is one of the earliest to differentiate and shows an extensive proliferation or/and differentiation up to the formation of the placenta. The role of the trophoblast show dynamic changes from early embryo implantation to placentation during pregnancy. Implantation of the blastocyst into the endometrium of the maternal uterus is mediated by invasion of the differentiated trophoblast (e.g. syncytiotrophoblast) from the trophectoderm. During pregnancy, the unique role of the trophoblast is to invasion, eroding, and metastasizing in the placenta as well as to ensure appropriate bidirectional nutrient or waste flow required for growth and maturation of the embryo. The dysfunction of the trophoblast during pregnancy can result in several gynecological diseases including preeclampsia and congenital malformation in neonatal medicine. Therefore, trophoblasts act as a conclusive factor in placental and fetal development. This brief review outlines the classification of trophoblast and its function in the placenta during pregnancy. Also, we introduce the latest research in trophoblast for implantation and the placenta development, and the application potential of trophoblast for infertility and obstetrical diseases.

Palliative Irradiation Using Helical Tomotherapy in Recurrent Pelvic Tumors with Prior Radiotherapy (방사선치료 후 재발한 골반암에서 토모테라피를 이용한 고식적 재치료)

  • Kay, Chul-Seung;Yoo, Eun-Jung;Kim, Ji-Hoon;Ro, Duck-Young;Kim, Ki-Jun
    • Radiation Oncology Journal
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    • v.28 no.3
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    • pp.133-140
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    • 2010
  • Purpose: We retrospectively investigated the effect of irradiation using helical tomotherapy in recurrent pelvic tumors that underwent prior irradiation. Materials and Methods: Fourteen patients with recurrent pelvic tumors consisting of rectal cancer (57.1%), cervical cancer (35.7%) and cancer with an unknown origin (7.1%) were treated with tomotherapy. At the time of irradiation, median tumor size was 3.5 cm and 7 patients complained of pain originating from a recurrent tumor. The median radiation dose delivered to the gross tumor volume, clinical target volume, and planning target volume was 50 Gy, 47.8 Gy and 45 Gy, respectively and delivered at 5 fractions per week over the course of 4 to 5 weeks. Treatment response and duration of local disease control were evaluated using the Response Evaluation Criteria in Solid Tumors (ver. 1.0) and the Kaplan-Meyer method. Treatment-related toxicities were assessed through Common Terminology Criteria for Adverse Events (ver. 3.0). Results: The median follow-up time was 17.3 months, while the response rate was 64.3%. Symptomatic improvement appeared in 6 patients (85.7%). The median duration time of local disease control was 25.8 months. The rates of local failure, distant failure, and synchronous local and distant failure were 57.1%, 21.4%, and 7.1%, respectively. Acute toxicities were limited in grade I or II toxicities, except for one patient. No treatment related death or late toxicity was observed. Conclusion: Helical tomotherapy could be suggested as a feasible palliative option in recurrent pelvic tumors with prior radiotherapy. However, to increase treatment effect and overcome the limitation of this outcome, a large clinical study should be performed.

Control of Trophoblast Gene Expression and Cell Differentiation

  • Cheon, Jong-Yun
    • 대한생식의학회:학술대회논문집
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    • 2001.03a
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    • pp.195-205
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    • 2001
  • 태반 영양배엽 (trophoblast)은 포유동물의 발생과정 중 가장 먼저 분화되는 세포로서, 자궁환경내에서 배아가 착상, 발생, 및 분화하기 위해서 반드시 필요한 태반을 형성하는 색심적인 세포이다. 영양배엽 세포의 분화과정중의 결함은 배아의 사산이나 임신질환 등의 치명적 결과를 초래한다. 하지만, 영양배엽 세포의 분화를 조절하는 분자생물학적인 메카니즘은 아직 규명되지 않고 있다. 영양배엽 세포의 분화를 조절하는 경로를 규경하기 위한 선결과제는 분화된 영양배엽 세포에서만 발현하는 많은 유전자들이 밝혀져야만 한다. 본 연구팀은 최근에 분화된 영양배엽 세포에서만 발현하는 두 종류의 새로운 유전자들을 찾았다. 한 종류는 homeobox를 보유하고 있는 조절 유전자 Psx이고, 다른 한 종류는 임신호르몬인 태반 프로락틴 라이크 단백질 유전자 PLP-C${\beta}$이다. 본 연구과제의 목표는 이들 유전자의 기능과 조절 메카니즘을 규명함으로써, 영양배엽 세포의 분화를 조절하는 조절경로를 밝히는 것이다. 이를 위하여 다음과 같은 일련의 연구를 수행할 것이다. 1) Psx 유전자가 분화된 영양배엽 세포에서만 발현케 하는 조절 메카니즘을 규명하기 위해 functional assays, in vitro footprinting, gel mobility shift assays, 생쥐형질전화, UV crosslinking, Southwestern blot 등의 방법을 통해 Psx 유전자의 cis-acting 요인과 trans-acting factor를 밝혀 분석한다. 2) 영양배엽 세포의 분화조절 경로를 규명하기 위해 random oligonuclotide library screening, DD-PCR, subtractive screening 등의 방법을 이용하여 Psx 유전자에 의해 조절되는 하부유전자를 밝힌다. 3) Psx 유전자를 knock-out시켜 영양배엽 세포가 발달 및 분화하는데 미치는 역할을 밝힌다. 4) Yeast two-hybrid screening방법을 이용하여 태반 프로락틴 유전자의 수용체를 찾아 이들의 신호전달 기전을 밝힌다. 제1차년 연구결과로서, mouse와 rat으로부터 각각 Psx 유전자의 genomic DNA를 클로닝하여, 유전자 구조를 비교한 결과, mouse Psx (mPsx2)는 4개의 exons으로 이루어져 있는 반면에, rat Psx (Psx3)는 3개의 exons으로 구성되어 있었다. 즉, rPsx3는 mPsx2의 exon1이 없었다. Notrhern blot과 in situ hybridization 분석에 의해 mouse와 rat에서 Psx 유전자가 다르게 발현 조절되는 현상을 밝혔다. 실제로 mPsx2와 rPsx3의 5'-flanking지역을 클로닝하여 염기서열 분석 결과 전혀 homology를 찾을 수 없었다. 또한, 이들 각각 promoter의 activity를 luciferase reporter를 이용하여 조사한 결과 Rcho-1 trophoblast cells에서 각기 다른 activity를 보여 주는 것을 발견하였다. Psx 유전자의 transcription start sites는 Primer extension에 의해 밝혔다. 또한 Psx2 유전자를 knock-out 시키기 위해 targeting vector를 Osdupde1에 제작하였다. 본 과제를 시작할 때 새로운 프로락틴 유전자 하나를 클로닝하여 이 유전자를 PLP-I라고 이름을 붙였다. 이 후 이 유전자 (PLP-I)는 PLP-C${\beta}$라고 이름을 붙이게 되었다. Mouse PLP-C${\beta}$ 유전자의 counterpart를 rat에서 찾아 염기서열을 비교한 결과 mouse와 rat에서 PLP-C${\beta}$유전자의 homology는 약 79% (amino acid level)였다. 본 연구과정을 통해 또 하나의 새로운 PLP-C subfamily member를 mouse로부터 클로닝 하였고, 이 유전자를 PLP-C${\gamma}$라 하였다. PLP-C${\beta}$와 PLP-C${\gamma}$의 발현 유형은 Northern blot과 in 냐셔 hybridization 분석에 의해 태반의 제한된 spongitrophoblast와 trophoblast giant cells에서만 발현하는 것을 밝혔다. 놀랍게도 이들 두 새로운 유전자는 alternative splicing에 의해 두 종류의 isoform이 있음을 밝혔다. PLP family member 유전자로서 splicing에 의한 isoforms을 보여 주는 유전자로는 PLP-C${\beta}$와 PLP-C${\gamma}$가 최초이다. 이들 isoform mRNAs의 발현 유형은 RT-PCR 방법을 이용하여 규명하였다. 또 하나의 새로운 발견은 PLP-C${\beta}$와 PLP-C${\gamma}$가 독특한 유전자 구조를 갖고 있었다. 즉, PLP-C${\beta}$는 exon3의 alternative splicing에 의해 5개 혹은 6개의 exons을 갖는 two isoforms이 생긴다. 반면에 PLP-C${\gamma}$는 exon2가 alternative splcing이 되면서 7개의 exons을 갖거나 6개의 exons을 갖는 isoforms을 만든다. 그리고, PLP-C${\gamma}$의 promoter activity를 trophoblast Rcho-l${\gamma}$ 세포주를 이용하여 PLP-C${\gamma}$ 의 1.5 kb 5'-flanking 지역이 trophoblast-specific promoter activity를 갖고 있음을 밝혔다. PLP-C${\gamma}$ 유전자의 transcription start site는 Primer extension에 의해 밝혔다. 제 1차 년도의 연구결과를 토대로, 2차년에서는 다음단계의 연구를 수행하고자 한다. 즉, 1) mPsx2와 rPsx3의 promoter를 비교분석 함으로서 mouse와 rat에서 Psx 유전자가 다르게 조절되는 메카니즘 규명, 2) Psx와 PLP-C 유전자의 promoter에 있는 cis-acting elements 탐색, 3) Psx2와 Psx3의 단백질을 이용하여 이들이 binding하는 target sequence 규명, 4) 제작한 Psx2 targeting vector를 이용하여 ES cells에서 Psx2 유전자 knock-out, 5) Psx 유전자를 과발현시키는 세포주를 만들고 Psx에 의해 조절되는 유전자 탐색, 6) 새로 밝히 PLP-C members 유전자들의 조절기전을 Rcho-1 세포주를 이용하여 여러 거지 성장인자와 다른 호르몬에 대한 반응을 탐색, 7) Psx와 PLP-C${\gamma}$ 유전자의 chromosomal mapping 등을 밝힐 것이다.

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Eros, Seduction for Redemption (에로스, 구원을 위한 유혹)

  • Jeeyoun Kim
    • Sim-seong Yeon-gu
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    • v.33 no.1
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    • pp.1-60
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    • 2018
  • The paper was inspired by Jung's words in the Red Book "just as Christ tormented the flesh through the spirit, the God of this time will torment the spirit through the flesh." I propose that the new form of torment in this era could be eroticism as a way of the individuation process because it seems to be one of a very few ways left to modern men to grasp the sense of permanence, the essence of the divine, without religion because of its peculiar nature of transcendence. I suppose that it is not only a man who is tortured but also god is in torment since the divine needs a man as a womb for his incarnation. Therefore I suggest that man and god are fated to seduce each other to be redeemed by each other. I imagine that Eros with numinous sexuality seduces a man who has potentials for the god's incarnation and who would be willing to give in to the god's demand. This god needs a man who desires his essence of perpetuity, the eternal water of life, in ecstasy. Thus the purpose of the divine's seduction is to make a man awake from unconsciousness to pursue god himself, namely the individuation process. I call such divine seduction "eroticism of god" There seem to be a certain type of people who are destined to live eroticism as a way of individuation process. Through investigations, a melancholic tendency appears to be suitable for this type of individuation. Melancholia is deeply related to the poignant awareness of impermanence as the existential condition, which is a precondition for seeking permanence through eroticism. Melancholia essentially causes deep longing for eternity that bears fulfillment, which exists in eroticism, so melancholic agony seems inevitable for eroticism as the path for individuation in that, without knowing about deficiency, we never seek what is lacking in us. It can also be viewed that while a lover is driven to seduce lost love, what actually waits to become seduced for redemption is the god of love itself behind the human beloved. Man and god are fated to seduce each other for redemption. I suppose that the initiation to Eros implies how to seduce Eros. In a woman's psyche, psychological virginity is one of the essential qualities that her ego needs to attain. To the male it is vital to live his sensuality thoroughly and to experience his own and his lover's emotions to their limit. It cannot be an easy task because it demands us to give up our egotism entirely. Through eroticism, unconsciousness seduces us to make us live life as a whole. The god of love brings powerful sexuality as a means of "spiritual crisis" to redeem our lukewarm soul. Only a few can withstand the experience since it requires a strong will to bear the brunt of the sword despite the keen awareness that it may leave us bleeding in pain.

Jungian Interpretation of Creation Myths Focused on Egg Symbolism (분석심리학적 관점으로 고찰한 창조신화 : '알(卵)'의 상징성 중심으로)

  • Jin-Sook Kim
    • Sim-seong Yeon-gu
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    • v.27 no.1_2
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    • pp.28-70
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    • 2012
  • In Jungian psychology, creation myths regard as the story of unconscious and preconscious processes(projection of archaic identity) which describe not necessary the origin of our cosmos, but the origin of man's conscious awareness of the world. Therefore projections have nothing to do with matter itself but experience of one's own unconscious. Jung emphasizes importance to understand projection in individual's conscious experience rather than in philosophical doctrine. The purpose of this thesis is to explore unconscious process of creation myths with egg symbolism in clinical cases to present universal feature of Cosmic/alchemical egg. Psychologically, creation myths retold when human mind needs new order. Depending on the attitude of ego, it can be sudden expansion of consciousness or contamination of ego by unconscious. In this study, 'chaos(messa confusa)' in creation myths as archaic identity, experience of uroboros or infant, and nigredo state in alchemy. 'Separation of primordial parents' as beginning of consciousness refers to separatio operation in alchemical process. 'Light' as attainment of consciousness. Discussion of psychological meaning of egg starts with amplification which include the concept of cosmic/alchemical/philosophical egg. Egg symbolism in this study refers to emergence of egg, tapas/brooding of egg, and separation of egg. Emergence of egg as a state of preconscious totality, psychic wholeness conceived as the thing which came before the rise of ego consciousness. Discussion of conceptssuch as Shiva bindu, hiranyagharba, germ of gold, Tathāgatagarbha follows. 'Tapas/brooding of egg' as concentration of all psychic energy into one point for self reflection. Discussion includes The I Ching Hexagram 61, image of brooding egg identified with inner truth, Wonhyo's concept of jikwansasang, and Gnostic idea of Ennoia, introverted act of thinking, as well as the concept of 'Night Sea Journey'. 'Separation or hatching of egg' regarded as the idea of sudden illumination, Phanes, the shining God, and "sun-point," in alchemy. Birth of fledgling as birth of new personality. As a conclusion, psychological meaning of cosmic egg/creation myths is the story of separating from 'Not-I'(unconscious, object, undifferentiated) to 'I'(ego, subject, differentiated) which shares the same meaning as individuation process.