• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9679-9685
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• 2014

Background: When evaluating health-economics for cervical cancer prevention policies in Japan, it is important to use Japanese value settings. This study aimed to obtain preference-based measures (preference measures) for hypothesized health states among healthy Japanese women, and to examine differences between the EuroQol-5D (EQ-5D) and standard gamble (SG) instruments. Materials and Methods: The investigation was performed among female students at a nursing university. We used written hypothetical scenarios describing three grades of cervical intraepithelial neoplasia (CIN) and eight stages of cervical cancer, both at diagnosis and after medical intervention. Preference measures were evaluated using both EQ-5D and SG. Results: We received responses from 136 women. The mean number of respondents per stage was 24.6 (SD: 2.7). At diagnosis, average EQ-5D scores for CIN1, CIN2, CIN3, IA1, IA2, IB1, IB2, IIA, IIB, III, and IV stages were 0.84 (0.14), 0.78 (0.12), 0.73 (0.10), 0.78 (0.12), 0.72 (0.12), 0.63 (0.13), 0.64 (0.12), 0.68 (0.08), 0.62 (0.13), 0.55 (0.21), and 0.18 (0.24), respectively. Using one-way analysis of variance with the Tukey-Kramer method for multiple comparisons (each stage vs. CIN1), we found significant differences for IB1 and more advanced stages (p<0.05). After medical intervention, corresponding EQ-5D scores were 0.84 (0.12), 0.81 (0.12), 0.84 (0.12), 0.80 (0.15), 0.78 (0.11), 0.64 (0.15), 0.63 (0.15), 0.71 (0.15), 0.50 (0.17), 0.52 (0.17), 0.21 (0.28). The multiple comparisons identified significant differences for IB1 and more advanced stages, excepting IIA (p<0.05). SG evaluations were more variable and relatively higher than EQ-5D evaluations. Conclusions: We obtained preference measures for three grades of CIN1-3 and eight stages of cervical cancer. In combination with appropriate sensitivity analyses, these preference measures will provide a basis for an economic evaluation of cervical cancer prevention in Japan. We suggest that EQ-5D is appropriate for cost-utility analysis of this topic.

• Clinical and Experimental Reproductive Medicine
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• 제41권3호
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• pp.132-136
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• 2014

Objective: The presence of sperm-head vacuoles has been suspected to be deleterious to the outcomes of assisted reproductive technology (ART). It is difficult to accurately distinguish morphologically abnormal sperm with vacuoles under a light microscope. This study was performed to analyze the result of the observation of sperm-head vacuoles using Papanicolaou staining under a light microscope and whether the male partner's age affects these vacuoles. Methods: Sperm morphology with vacuoles was evaluated using Papanicolaou staining and observed under a light microscope ($400{\times)$) in 980 men. The normal morphology was divided into three categories (group A, <4% of normal morphology; group B, 4%-14% of normal morphology; and group C, >14% of normal morphology). The criteria for the sperm-head vacuoles were those given in the World Health Organization manual. For the analysis of the age factor, the participants were divided into the following groups: 26-30 years, 31-35 years, 36-40 years, 41-45 years, and 46-50 years. Results: The percentage of sperm-head vacuoles increased with normal sperm morphology (group A vs. groups B, C) (p<0.05). In the case of the age factor, a statistically significant difference was not observed across any of the age groups. Conclusion: A majority of the sperm-head vacuoles showed a statistically significant difference among normal morphology groups. Therefore, we should consider the probability of the percentage of sperm-head vacuoles not increasing with age but with abnormal sperm morphology. A further study is required to clarify the effect of the sperm-head vacuoles on ART outcomes.

• 보건행정학회지
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• 제24권1호
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• pp.92-99
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• 2014

Background: Korea's primary care clinics are seeking increase in consultation fees by expanding supply within the frame of the health insurance system, but inequality of physician income between regions and individuals is exacerbating. The purpose of this study lies in analyzing the distribution of patients of primary care clinics, their specialized field, and the degree of inequality between medical fee income according to region. Data was acquired from the Health Insurance Review and Assessment Service on charged bills made by clinic-size medical institutions from 2008 to 2011. Methods: By comparing the outpatient number per clinic according to the clinic's specialized field, results showed that ophthalmology, otolaryngology, dermatology, orthopedics, and internal medicine showed high numbers whereas plastic surgery, neuropsychiatry, cardiothoracic surgery had fewer outpatients. The number of outpatients for clinic according to region showed Chuncheonnam-do, Jeju-do, Gangwon-do, Chungcheongbuk-do, Ulsan to have higher numbers of outpatients. For those four years, clinics in the Seoul area had a rather lower number. Results: As a result of comparing the decile hierarchy distribution ratio between specialized fields according to primary care clinics income from National Health Insurance, the inequality degree showed that obstetrics and gynecology and general medicine were each 0.130, 0.280 for the decile distribution ratio, which was the highest degree of inequality within the specialized field. Their Gini coefficient were also relatively high at 0.691, 0.528 respectively. On the other hand, the decile distribution ratio for otolaryngology and orthopedics were 0.510, 0.468, respectively, while their Gini coefficient each at 0.318, 0.314 makes their inequality degree relatively lower than other fields. Conclusion: This study is limited in that the data used was the health insurance charges submitted by clinics, which does not provide total information of the doctors' income. However, because most clinics are largely dependant on their income to come from health insurance reimbursements. Therefore, the results of this study can be used effectively. In the future, research that includes data on non-covered service income should be conducted to closely examine policy plans with a new medical fee policy which can resolve the medical fee income inequality issue between clinics as well as revitalize primary medical care.

• 한국보건간호학회지
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• 제17권1호
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• pp.58-68
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• 2003

This study was conducted to explore the depression, anxiety, spouse support, and the difference of these variables according to the general characteristics and disease related characteristics in married women who had received gynecologic cancer treatment. The subjects consisted of 62 patients with cervical cancer, 18 patients with ovarian cancer, and 7 patients with endometrial cancer who were admitted to the department of obstetrics and gynecology, 3 education hospital in Seoul from January, 1996 to August, 1999. The data were collected from March 25 to July 25, 2000 by using a mailed questionnaire. The results were as follows : 1. The mean score of depression was 35.1 with the range from 20 to 76. The mean score of the anxiety was 38.6 with the range from 24 to 58. The mean score of the spouse support was 33.8 with the range from 12 to 48. 2. The score of depression was significantly different by the general characteristics: woman's education level(p=.040), economic level(p=.002), and the satisfactory level on married life(p=.009). The score of spouse support was significantly different by the general characteristics: woman's education level(p=.009), spouse's education level(p=.001), spouse's religion (p=.004), economic level(p=.008), and the satisfactory level on married life(p=.000). The scores of depression, anxiety, and spouse support were not significantly different by the disease related characteristics. 3. The score of depression had a positive correlation with anxiety(r=.731), and a negative correlation with spouse support(r=-.425). 4. The main influencing factors on the depression were economic level$(13.4\%)$ and satisfactory level on married life$(4.4\%)$. The main influencing factors on the spouse support were satisfactory level on married life$(23.6\%)$ and spouse's education level$(9.2\%)$. Based upon the above findings, the depression, anxiety, and spouse support of women who had received gynecologic cancer treatment were higher than healthy married women. The score of depression and anxiety had a negative correlation with spouse support. The factors influencing spouse support were satisfactory level on married life and spouse's education level. Therefore it is recommended that nursing intervention for women who had received gynecologic cancer treatment would be focused to improve spouse support for alleviating depression and anxiety level.

• 한국발생생물학회지:발생과생식
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• 제5권1호
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• pp.81-88
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• 2001

GnRH는 10개의 아미노산으로 구성된 호르몬으로서 생식기능을 조절, 관장하는 중요한 역할을 담당하는 것으로 알려져 있다. 특히 임신 중에는 태반에서 hCG의 분비를 조절하는 중요한 역할을 한다. 최근 사람의 두 번째 GnRH 유전자가 발견되었으며 그 10개의 아미노산 서열은 닭에서 두 번째로 발견된 GnRH (chicken GnRH-II)와 동일한 것으로 확인되었다. 이제까지 사람에서의 두 번째 GnRH (GnRH-II)의 발현은 중뇌와 신장에서 보고된 바 있으며, 본 연구자들에 의해서 처음으로 사람의 자궁내막에서의 발현이 보고되었다 (Cheon et al., 2001). 이에 본 연구에서는 임신초기의 태반조직에서 GnRH-II의 mRNA와 Peptide가 발현되는가를 조사하였다. 본 연구결과를 통해 태반에서 발현되는 GnRH-II mRNA는 두 가지 형태라는 것이 확인되었으며, 특히 GAP 부위에 21개의 뉴클레오티드 결실을 갖는 작은 전사체는 조직 특이적인 alternative splicing 기작에 의하여 태반조직에서만 특이적으로 발현되는 것으로 확인되었다. 면역화학염색법을 이용하여 GnRH-II peptide의 발현을 조사한 결과, 세포영양막과 융합영양막의 세포질에서 모두 발현되는 것으로 확인되었으며, 특히 세포영양막에서 더 많은 양이 발현되었다. 이상의 결과는 임신초기 태반에서 기존의 GnRH (GnRH-I)이외에도 다른 아미노산 서열의 GnRH-II가 발현된다는 사실을 말해주며 이는 GnRH-II 역시 태반조직에서 임신의 유지 및 생식기능의 조절에 관여할 가능성을 시사한다 하겠다.

• Clinical and Experimental Reproductive Medicine
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• 제25권2호
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• pp.161-170
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• 1998

Protein expression patterns of matrix metalloproteinases (MMPs) were examined in mouse reproductive organs during estrous cycle. Estrous cycle was classified into diestrus, proestrus, estrus or metestus and MMP expression was analyzed by zymography using gelatin as a substrate. Uterine fluid (UF) obtained both at diestrus and proestrus exhibited 4 major MMPs including 106kDa, 64kDa, 62kDa and 59kDa gelatinases. However, in UF at estrus, the gelatinolytic activity of 64kDa MMP disappeared and that of 106kDa and 62kDa MMPs dramatically decreased. At metestrus, 64kDa MMP activity reappeared and 106kDa and 62kDa MMP exhibited increased activities such that the band intensity of 106kDa was comparable to that in UF at diestrus. Gelatinolytic activity of 59kDa MMP was not changed throughout the cycle. Both ovarian and oviductal tissue homogenate revealed 4 MMPs which corresponded to the 4 MMPs of UF. However, unlike UF MMPs, gelatinolytic activity of these MMPs did not show distinct changes throughout the cycle. Either an inhibitor of MMP, 1,10-phenanthroline, or a metal chelator, EDTA, abolished the appearance of the above MMP activities in gelatinated gel whereas a serine proteinase inhibitor, phcnylmethylsulfonyl fluoride, failed to inhibit the appearance of MMP activities, proving that gelatinolytic activity of the above reproductive tissues were due to the enzymatic activity of MMP. When gclatinolytic activity of mouse serum was examined, it revealed 5 MMPs (131kDa, 106kDa, 89kDa, 64kDa and 62kDa bands) and one gelatinase (84kDa) band. From these results, it is concluded that the protein expression of MMPs of mouse reproductive organs, particularly uterus, is temporally regulated during estrous cycle and uterine 106kDa, 64kDa and 62kDa MMPs are suggested to play an important role in cyclic tissue remodeling of mouse uterus.

• Clinical and Experimental Reproductive Medicine
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• 제43권4호
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• pp.221-227
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• 2016

Objective: The aim of this study was to evaluate the influence of maternal age on fertilization, embryo quality, and clinical pregnancy in patients undergoing intracytoplasmic sperm injection (ICSI) using testicular sperm from partners with azoospermia. Methods: A total of 416 ICSI cycles using testicular spermatozoa from partners with obstructive azoospermia (OA, n = 301) and non-obstructive azoospermia (NOA, n = 115) were analyzed. Female patients were divided into the following age groups: 27 to 31 years, 32 to 36 years, and 37 to 41 years. The rates of fertilization, high-quality embryos, clinical pregnancy, and delivery were compared across maternal age groups between the OA and NOA groups. Results: The rates of fertilization and high-quality embryos were not significantly different among the maternal age groups. Similarly, the clinical pregnancy and delivery rates were not significantly different. The fertilization rate was significantly higher in the OA group than in the NOA group (p< 0.05). Age-group analysis revealed that the fertilization and high-quality embryo rates were significantly different between the OA and NOA groups in patients aged 27 to 31 years old, but not for the other age groups. Although the clinical pregnancy and delivery rates differed between the OA and NOA groups across all age groups, significant differences were not observed. Conclusion: In couples using testicular sperm from male partners with azoospermia, pregnancy and delivery outcomes were not affected by maternal age. However, women older than 37 years using testicular sperm from partners with azoospermia should be advised of the increased incidence of pregnancy failure.

• 생명과학회지
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• 제23권2호
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• pp.324-331
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• 2013

O-GlcNAc 화(O-GlcNAcylation)는 단백질의 serine이나 threonine에 N-acetylglucosamine (GlcNAc) 분자가 결합하는 것으로, 기존의 당단백질과 달리 세포질 및 핵단백질 모두에 일어난다. 또한 수정의 속도가 빠르고 가역적으로 일어남이 인산화 수식과 유사하다. 그러나 수많은 인산화효소와 탈인산화효소가 관여하는 것과 달리 O-GlcNAc 수식은 O-GlcNAc transferase (OGT)와 O-GlcNAcase (OGA) 단 두 개의 효소에 의하여 이루어진다. 이러한 단순한 조절기전은 세포가 내외환경에 즉시 적응할 수 있도록 진화한 것으로 해석된다. 즉, O-GlcNAc 수식은 특정한 단백질 하나 하나의 활성을 켜거나 끄는 것이 아니라, 세포의 신호전달과정의 효율을 전반적으로 조절하는 '가변저항기(rheostat)' 역할을 한다. O-GlcNAc 수식은 흔히 같은 아미노산 혹은 그 주변의 아미노산이 인산화되는 것을 수반하는데, 이는 인산화와 함께 서로 조화를 이루어 세포활성을 조절하는 것으로 해석된다. 최근 O-GlcNAc이 더 나아가 O-GlcNAc-P로 인산화될 가능성이 제시되고 있는 바, 본 총설에서는 이의 가능성을 이론적으로 설명하고, 실제 실험결과를 소개한다.

• 생명과학회지
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• 제29권11호
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• pp.1267-1272
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• 2019

자궁경부암의 주요 원인은 인유두종 바이러스(HPV)로 알려져 있으며, 자궁경부암 환자의 99.7%에서 HPV DNA가 검출된다고 하였다. 또한 세계적으로 HPV 16 및 18의 유병률이 가장 높은 것으로 보고되고 있으나, 한국을 포함한 아시아에서는 HPV 52 및 58의 유병률이 더 높게 나타나고 있다. 따라서 본 연구에서는 부산지역 여성의 HPV 유병률과 고위험군 인유두종 바이러스(HR-HPV) 유전자형을 분석하여 자궁경부암 예방을 위한 기초 자료를 확보하고자 하였다. 2016년 1월부터 2017년 12월까지 부산 산부인과병원을 내원한 여성 중 HPV 유전자형 검사를 시행한 여성 1,995예를 대상으로 분석하였다. 본 연구에서는 부산지역 여성에서 28.3%(565/1995)의 HPV 유병률을 확인하였다. 특히 HR-HPV 감염률은 75.4%(426/565)로 높게 나타났으며, HR-HPV 유전자형은 52형(63/565, 11.2%)이 가장 높게 나타났고, 그 다음으로 58형(56/565, 9.9%), 53형(55/565. 9.7%), 16형(53/565, 9.4%) 순으로 나타났다. 또한 18~39세이하의 젊은 여성들의 HR-HPV 감염률이 60.3%(257/426)로 높게 나타나므로 지속적인 감시가 필요할 것으로 사료된다. 또한 세포학적 결과에서 자궁경부내 상피의 이상소견이 높아지는 HSIL과 SCC에서 HPV 16형이 높은 감염률을 보였으나, 향후 더 많은 검체를 이용하여 자궁경부내 종양 발생과 관련된 HR-HPV 유전자형을 확인해야 될 것으로 사료된다.

• Clinical and Experimental Reproductive Medicine
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• 제32권3호
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• pp.279-286
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• 2005

Objective: Although several genetic factors have been associated with defects in human spermatogenesis, the unambiguous causative genes have not been elucidated. The male infertility by haploinsufficiency of PRM1 or PRM2 has been reported in mouse model. The aim of this study was to identify the single nucleotide polymorphisms (SNPs) of PRM1 and PRM2, related to the genotype of Korean infertile men. Methods: Genomic DNAs were extracted from peripheral bloods of infertile men with oligozoospermia or azoospermia, and analyzed using polymerase chain reaction (PCR) and direct sequencing. We carried out the direct sequencing analysis of amplified fragments in PRM1 (557 nucleotides from -42 to 515) and PRM2 (599 nucleotides from 49 to 648) genes, respectively. Results: Three SNPs of coding region in the PRM1 gene was found in the analysis of 130 infertile men. However, the SNPs at a133g (aa 96.9%, ag 3.1% and gg 0.0%), c160a (cc 99.2%, ca 0.8% and aa 0.0%) and c321a (cc 56.9%, ca 35.4% and aa 7.7%) coded the same amino acids, in terms of silence phenotypes. On the other hand, as results of the PRM2 gene sequencing in 164 infertile men, only two SNPs, g398c (gg 62.2%, gc 31.1% and ga 6.7%) and a473c (aa 63.4%, ac 29.9% and cc 6.7%), were identified in the intron of the PRM2 gene. Conclusions: There was no mutation and significant SNPs on PRM1 and PRM2 gene in Korean infertile men. These results suggest that the PRM1 and PRM2 genes are highly conserved and essential for normal fertility of men.