Effect of Testicular Histopathology on Pregnancy Outcomes in Non-Obstructive Azoospermia

박찬우,서주태,박용석,김혜옥,양광문,김진영,궁미경,강인수,송인옥,Park, Chan-Woo,Seo, Ju-Tae,Park, Yong-Seog,Kim, Hye-Ok,Yang, Kwang-Moon,Kim, Jin-Young,Koong, Mi-Kyoung,Kang, Inn-Soo,Song, In-Ok The Korean Society for Reproductive Medicine 2008 Clinical and Experimental Reproductive Medicine Vol.35 No.4

목 적: 비폐쇄성 무정자증 환자에서 고환의 조직병리학적 진단에 따라 고환조직내 정자채취술 (Testicular sperm extraction, TESE) 후 난자세포질내 정자주입술 (Intracytoplsmic sperm injection, ICSI)의 체외수정시술 결과를 알아보고자 하였다. 연구방법: 비폐쇄성 무정자증으로 고환조직내 정자채취술 후 난자세포질내 정자주입술을 이용하여 배아 이식을 시행한 122주기를 분석하였다. 고환의 조직병리학적 진단에 따라 Germ-cell aplasia (GA, 40주기), Maturation arrest (MA, 32주기) and severe hypospermatogenesis (S-HS, 50주기)로 구분하여 체외수정시술 결과를 비교하였으며, 이들 결과를 난자세포질내 정자주입술을 이용한 폐쇄성 무정자증 환자의 체외수정시술 결과와 비교하였다. 결 과: 고환조직내 정자채취술 후 난자세포질내 정자주입술시 수정율은 각각 58.1% in GA, 42.2% in MA and 48.0% in S-HS로 조직병리학적 진단에 따른 차이는 없었으며, 폐쇄성 무정자증 환자의 72.9%에 비해 유의하게 낮은 수정율을 보였다 (p<0.001). 고환조직내 정자채취술시 채취된 정자 (spermatozoa, 94주기)로 난자세포질내 정자주입술을 시행한 주기의 배아 이식 후 임신율은 각각 22.6% in GA, 29.4% in MA와 26.1% in S-HS이었으며, 출생률은 각각 16.1%, 29.4%와 19.6%로 조직병리학적 진단에 따른 차이는 없었다. 정자세포 (spermatid, 16주기)를 사용하여 난자세포질내 정자주입술을 시행한 주기의 임신율은 각각 0.0% (0/3 주기), 9.1% (1/11주기)와 0.0% (0/2주기)이었으며, 출생률은 각각 0.0%이었다. 정모세포 (spermatocyte, 12주기)를 사용한 주기의 임신율은 각각 0.0% (0/6주기), 0.0% (0/4주기)와 0.0% (0/2주기)이었으며, 출생률도 각각 0.0%이었다. 결 론: 비폐쇄성 무정자증환자의 배아이식을 시행한 주기에서 고환의 조직병리학적 진단에 따른 난자세포질내 정자주입술시 수정율은 차이가 없었으며, 폐쇄성 무정자증 환자에 비해 유의하게 낮은 수정율을 보였다. 비폐쇄성 무정자증환자에서 고환조직내 정자채취술시 정자를 채취하여 난자세포질내 정자주입술을 시행한 주기의 체외수정시술 결과는 고환의 조직병리학적 진단에 따라 차이를 보이지 않는다. Objective: To evaluate outcomes of patients with non-obstructive azoospermia (NOA) undergoing the testicular sperm extraction (TESE) combined with intracytoplasmic sperm injection (ICSI) with different histopathologic subgroups. Method: A total of 122 embryo-transferred TESE/ICSI cycles were compared among NOA subgroups; Germ-cell aplasia (GA, 40 cycles), Maturation arrest (MA, 32 cycles) and severe hypospermatogenesis (S-HS, 50 cycles). Obstructive azoospermia (OA, 667 cycles) patients were served as a control. TESE/ICSI outcomes such as fertilization rate (FR), clinical pregnancy rate (CPR) and live birth rate (LBR) were evaluated. Results: The 2PN FR of embryo-transferred TESE/ICSI cycle was 58.1% in GA, 42.2% in MA and 48.0% in S-HS, which was significantly lower than that of OA (72.9 %, p<0.001). For ICSI-spermatozoa cycles, there were no significant differences in CPR (22.6%, 29.4% and 26.1%) and LBR (16.1%, 29.4% and 19.6%) among NOA subgroups. The CPR of ICSI-spermatid cycles was 0.0%, 9.1% and 0.0% without a live birth. For ICSI-spermatocyte cycles, no clinical pregnancies occurred in any group. Conclusion: There was no significant difference in the FR of embryo-transferred TESE/ICSI cycles among NOA subgroups. The FR among all NOA subgroups was significantly lower than that of OA. Testicular histopathology in NOA did not affect successful pregnancy if spermatozoa extraction from the testis is successful and embryo transfer is possible.

37세 이상의 환자에서 체외수정시술시 GnRH Agonist 주기와 GnRH Antagonist 주기의 비교 연구

박찬우,차선화,김해숙,김혜옥,양광문,김진영,송인옥,유근재,강인수,궁미경,Park, Chan Woo,Cha, Sun Wha,Kim, Hae Suk,Kim, Hye Ok,Yang, Kwang Moon,Kim, Jin Young,Song, In Ok,Yoo, Keun Jae,Kang, Inn Soo,Koong, Mi Kyoung 대한생식의학회 2005 Clinical and Experimental Reproductive Medicine Vol.32 No.3

Objective: To compare the clinical results and pregnancy outcomes of in vitro fertilization (IVF) between GnRH antagonist cycles and GnRH agonist (GnRH-a) cycles including flare-up and long protocol in women with advanced age. Materials and Methods: Retrospective clinical study. From January 2001 to September 2003, IVF cycles of female patient 37 years over were included in this study. GnRH-a long protocol (62 cycles, 61 patients) and GnRH antagonist multi-dose flexible protocol (66 cycles, 51 patients) were compared with the control group of GnRH-a flare-up protocol (151 cycles, 138 patients). IVF cycles for non-obstructive azoospermia (NOA), endometriosis III, IV and polycystic ovarian syndrome (PCOS) were excluded in this study. Clinical results such as total gonadotropin dose, serum E2 on hCG administration, the number of retrieved oocytes and the pregnancy outcomes - clinical pregnancy rate (CPR), implantation rate (IR) and live birth rate (LBR) per embryo transfer - were compared. Results: There were significant differences in the total dose of gonadotropin (GnRH-a flare-up vs. GnRH-a long vs. GnRH-antagonist; 41.8 vs. 54.7 vs. 24.8), serum E2 on hCG administration (1787.2 vs. 1881.6 vs. 788.0), the numbers of retrieved oocytes (8.1 vs. 11.1 vs. 4.5) and endometrial thickness (9.1 vs. 10.4 vs. 8.0) which were significantly lower in GnRH-antagonist cycles. But pregnancy outcomes shows no significant differenced in CPR (25.0% vs. 35.8% vs. 24.5%), IR (11.7% vs. 12.3% vs. 10.1%) and LBR (15.8% vs. 28.3% vs. 15.1%) Conclusion: In women with advanced age, GnRH-antagonist cycles can result in comparable pregnancy outcomes to GnRH-a cycles including flare-up and long protocol. GnRH-a long protocol show higher CPR, IR and LBR than GnRH antagonist multi-dose flexible protocol and flare-up protocol without significant differences.

생리혈에 존재하는 자궁내막조직에서 자궁내막증 관련 유전자의 발현 양상

박찬우,전진현,궁미경,송인옥,Park, Chan-Woo,Jun, Jin-Hyun,Koong, Mi-Kyoung,Song, In-Ok 대한생식의학회 2007 Clinical and Experimental Reproductive Medicine Vol.34 No.4

목 적: 본 연구에서는 생리혈에 존재하는 탈락된 자궁내막조직에서의 자궁내막증 관련 유전자들의 발현 양상과 자궁내막증 병태생리와의 관련성을 살펴보고자 하였다. 연구방법: 자궁내막증으로 확진된 환자 (n=16)와 정상 대조군 (n=26)에서 생리주기 2$\sim$3일째 Wallace catheter로 채취한 생리혈로부터 탈락된 자궁내막조직을 분리하였다. 기존의 연구들에서 보고된 12종류의 자궁내막증 관련 유전자들의 mRNA 발현 양상을 semi-quantitative RT-PCR 방법으로 비교, 분석하였다. 결 과: 생리혈에서 분리한 탈락된 자궁내막조직은 조직학적 관찰을 통해 자궁내막조직임을 확인하였다. 총 12가지 종류의 자궁내막증 관련 유전자에 대한 RT-PCR 분석에서 telomerase, c-kit, aromatase등의 mRNA 발현이 관찰되지 않았다. 세포사멸 (apoptosis)과 관련성이 있는 fas, fas ligand, bcl-2, bax 유전자와 stem cell factor, ER-$\alpha$/$\beta$, endometriosis protein-I, secretory leukocyte protease inhibitor 등의 mRNA 발현 양상은 자궁내막증으로 확진된 환자군과 대조군에서 통계적으로 유의한 차이를 나타내지 않았다. 결 론: 결론적으로 자궁내막증과 관련된 다양한 유전자들의 발현 양상을 생리혈에 존재하는 탈락된 자궁내막조직에서 분석하였지만 의미성이 있는 유전자를 동정하지는 못하였다. 이는 자궁내막조직의 생리학적 특징인 생리주기에 따른 유전자 발현의 역동적인 변화와 관련이 있을 것으로 생각된다. Objective: This study was performed to investigate the expressions of endometriosis related genes in shed endometrial tissues from menstrual blood of patients with or without endometriosis. Methods: The shed endometrial tissues were collected on 2$^{nd}$ or 3$^{rd}$ day of menstrual cycle with Wallace catheter in patients with endometriosis (n=16) and without endometriosis (n=26). The mRNA expressions of twelve kinds of endometriosis related genes were compared between two groups using semi-quantitative RT-PCR. Results: The collected shed endometrium was confirmed by histological observation. Expressions of telomerase, c-kit and aromatase mRNA were not detected by RT-PCR in shed endometrial tissues. The mRNA expressions of apoptosis related genes (fas, fas ligand, bcl-2, bax), stem cell factor, estrogen receptor-$\alpha$/$\alpha$, endometriosis protein-I and secretory leukocyte protease inhibitor gene were similar between shed endometrial tissues with endometriosis and without endometriosis. Conclusion: We could not find the difference of mRNA expressions of tested endometriosis related genes between shed endometrial tissues with or without endometriosis by semi-quantitative RT-PCR analysis. It may be related to the dynamical changes of gene expressions in the endometrium with menstrual cycle.

주요 사찰에 일제가 심은 전나무 노거수의 식재의미 연구

박찬우,정미애,이연희,Park, Chan-Woo,Jeong, Mi-Ae,Lee, Yeon-Hee 한국조경학회 2015 韓國造景學會誌 Vol.43 No.4

본 고는 주요 사찰에 노거수로 현존하는 대부분의 전나무는 일제에 의해 구한말부터 일제강점기 동안 신목(神木)으로 심어졌다는 가설을 증명하기 위해 연구되었다. 전나무 노거수의 현존량과 식재위치 특성, 전나무 노거수의 식재시기 특성, 일본의 고대신앙과 전나무의 연관성을 분석하였다. 전나무 노거수를 신목이라고 판단하는 이유는 다음 세 가지이다. 첫째, 일본 신사에서는 가도로부터 뻗은 참배로에 가장 많은 신목이 심겨지는데, 우리 사찰에서는 일본의 참배로와 비슷한 공간인 일주문에서 누문 사이에 가장 많이 심겨진 식재위치의 공통점 때문이다. 둘째, 몇 개의 주요 사찰에서 가슴높이 직경이 가장 큰 전나무를 조사한 결과, 100cm에서 60cm 사이의 범주여서 일본 불교의 조선 개교 원년인 1877년부터 일제강점기 1945년 사이, 2015년 현재 70년생에서 138년생 사이에 포함되는 크기로 판단되기 때문이다. 셋째, 1877년 일본 불교계가 조선개교를 시작하면서 일본 고대사에 있는 신공황후의 삼한출병을 보살펴준 스와대사의 신(神)을 일제의 수호신으로 삼고, 우리나라 주요 사찰에 현신시키기 위하여 전나무를 심었을 것이라고 하는 연관성이 너무도 자연스럽기 때문이다. 우리 사찰의 전나무 노거수는 강제적이었든지 부지불식간에 식재되었든지 그 식재의미에 대한 적절한 평가가 이루어지지 않은 채 현재의 거목으로 성장하였다. 본고의 주장에 대한 철저한 검증과 본 이슈에 대한 논의를 기대한다. This study investigates how Abies holophylla was planted as a tree sacred to the gods by Japan during the late Chosun and Japanese colonial periods. This study surveyed the current conditions of old Abies holophylla geological information, year planted, and the relationship between Abies holophylla and traditional Japanese values. The reasons that Abies holophylla was considered a tree sacred to the gods are as follows. Firstly, trees are planted on the spaces between Iljumun and Numun in Buddhist temples of Korea in the same way as trees are planted on the roads for worship in traditional temples of Japan. Secondly, tree diameter at breast height ranged from 60cm to 100cm. This means that the Abies holophylla trees range in age from 70 years to 138 years, showing that the trees were planted at the period between the beginning of Japanese Buddhism(1877) and the Japanese Colonial Period (1945). Thirdly, conclusions regarding why the Abies holophylla were planted in Korean temples at the beginning of Japanese Buddhism will be drawn based on the records that Jingu-Kogo's Conquest of Silla was taken care of the Suwataisha as a tree sacred to the gods in Japanese tradition. The reason for which Abies holophylla was planted in Korean temples should be evaluated through the remnants of Japan in the past. The issue of the old Abies holophylla in Korean temples should be investigated and further discussed in depth.

동의나물 섭취 후 발생한 서맥을 동반한 쇼크 2례

박찬우,옥택근,조준휘,최동욱,허애영,이희영,김용훈,조병렬,김성은,최기훈,배지훈,서정열,정재봉,Park,, Chan-Woo,Ok, Taek-Gun,Cho, Jun-Hwi,Choi, Dong-Wook,Her, Ae-Young,Lee, Hee-Young,Kim,, Yong-Hoon,Cho, Byung-Ryul,Kim,, Sung-Eun,Choi, Ki-Hoon 대한임상독성학회 2004 대한임상독성학회지 Vol.2 No.1

With a recent well-being boom, our interest in chemical-free vegetables is also increasing. So, some people are trying to take in wild plants chosen by themselves. However, others often come to their rescue in an emergency department after eating them, caused by their misunderstanding poisonous herbs as edible vegetables. We have ever seen two persons carried into the emergency department with bradycardia and shock incurred by his intake by confusion between Caltha palustris and Ligularia fischeri lately. There were symptoms such as epigastric pain, nausea, vomiting and so on in their cases, and the symptoms of bradycardia and hypotension continued. Owing to sustained bradycardia and hypotension states, we applied a dopamine to a patient, and then the in-patient left the hospital two days later. We presumed the cause of the two symptoms appeared in two cases to be a saponin in Caltha palustris. For that reason, if someone has the bradycardia and hypotension symptoms from an unknown cause after taking in wild plants, they have to consider a toxication by the Caltha palustris. Therefore, this paper focused on the issue that unexpected poisoning would have to be prevented by studying about wild plants much more and informing the toxic risk from the plants.

상시 근골격 모니터링과 재활을 위한 온스킨 센서 디바이스 기술

박찬우,구재본,진한빛,김윤정,임채현,홍찬화,김혜진,Park, C.W.,Koo, J.B.,Jin, H.,Kim, Y.,Lim, C.,Hong, C.H.,Kim, H.J. 한국전자통신연구원 2022 전자통신동향분석 Vol.37 No.2

As the society is superaging, the number of patients with movement disabilities due to musculoskeletal or nervous system illness is rapidly increasing. To improve public health and reduce medical expenses, it is essential to develop rehabilitation systems that allow patients to resume their daily-life activities. However, the existing musculoskeletal illness diagnosis and rehabilitation method is limited in terms of precision and efficiency because it is based on an empirical diagnosis and prescription without regard for individual characteristics. To overcome these limits, it is critical to design a novel concept of routine rehabilitation therapy device that is capable of inducing musculoskeletal balance by the precise analysis of musculoskeletal usage patterns via the motion and the muscle activity tracking of linked muscles. This study introduces the trend of on-skin sensor device technology for routine musculoskeletal monitoring and therapy. For on-skin rehabilitation systems, skin-adhesive and stretchable motion/posture, electromyography, pressure sensors, small-size and low-power wireless sensor interfaces, and user-friendly rehabilitation contents based on new algorithms are combined.

난류 발생기의 형상에 따른 수직 PCB채널에서의 열전달 및 압력손실 변화

박찬우,장승일,정종수,남평우,Park, Chan-U,Jang, Seung-Il,Jeong, Jong-Su,Nam, Pyeong-U 대한기계학회 1996 大韓機械學會論文集B Vol.20 No.7

This study was performed to analyze the cooling effect of heated ribs which are frequently used for cooling of electronic parts, using the numerical method. To prevent the excessive pressure drop due to turbulence promoters for the enhancement of heat transfer rate especially, the effect of the angle of turbulence promoter was investigated by the numerical analysis. Heat transfer rate with turbulence promoters with rectangular cross-section increased by 13% in average, but the coefficient of pressure drop increased by 1.68 times than that without them. In the present study, triangular cross-sectional shape turbulence promoters were suggested and numerically tested. Pressure drop of turbulence promoter with the 30 degree triangular cross-sectional shape decreased by 30% from that of rectangular cross-section promoters while heat transfer rate was almost the same. While with 4 turbulence promoters, the heat transfer rate increased by 21%, the pressure drop increased 4 times. It means that the higher capacity of cooling fan should be needed. With the triangular cross-sectional shape, the size of vortex region at the rear of promoters became considerably smaller, so pressure drop became smaller. The effect of the change of cross-sectional shape was not found in the flow pattern near the ribs, so that heat transfer characteristics in the ribs were not changed.

SCG(Secure Communication Group)을 이용한 계층적 VPN(Virtual Private Network) 구성 및 특성

박찬우,한치문,Park, Chan-Woo,Han, Chi-Moon 대한전자공학회 2001 電子工學會論文誌-TC (Telecommunications) Vol.38 No.11

인터넷을 이용한 대부분의 VPN(Virtual Private Network)은 기업 데이터만을 보호하는 형태로 구성되어 있다. 그러므로 다양한 형태의 VPN 구성이 필요하다. 최근에 SCG(Secure Communication Group) 개념을 이용하여 VPN을 구성하는 방법이 연구되고 있다. 본 논문에서는 SCG 구성 방법인 Path-definition 방식과 Arca-definition 방식의 문제점을 분석하고, 인트라넷 VPN 환경에서 SCG 개념을 사용한 VPN 중 적용 가능한 여러 형태의 VPN 모델을 검토한다. 그리고 인터넷에 Area-definition 방식을 적용하고 SCG number를 이용한 계층적 VPN 구성 방법을 제안한다. 제안한 방식의 특성을 각 entity가 관리해야 할 키수 및 인증 회수에 대해 정량적으로 분석하고, 본 방식이 유효함을 나타낸다. Currently most of VPNs within internet has only capability to protect cooperate data. Recently, various types of VPNs are being studied based on the concept of SCG(Secure Communication Group). This paper analyses the problems of path-definition method and area-definition method of VPNs using SCG technology, and discusses the possible models among VPNs using SCG technology. This paper proposes the hierarchal VPN configuration method using SCG number and internet based area definition method, and analyze the characteristics of the proposed VPN model on the point of the authentication frequency and the number of managements keys.

Artificial Intelligence in Health Care: Current Applications and Issues

박찬우,서성욱,Kang Noeul,Ko BeomSeok,Choi Byung Wook,Park ChangMin,Chang Dong Kyung,김휘영,Kim Hyunchul,이현나,Jang Jinhee,Ye Jong Chul,Jeon Jong Hong,Seo Joon Beom,Kim Kwang Joon,Jung Kyu-Hwan,Kim Namkug,Paek Se 대한의학회 2020 Journal of Korean medical science Vol.35 No.42

In recent years, artificial intelligence (AI) technologies have greatly advanced and become a reality in many areas of our daily lives. In the health care field, numerous efforts are being made to implement the AI technology for practical medical treatments. With the rapid developments in machine learning algorithms and improvements in hardware performances, the AI technology is expected to play an important role in effectively analyzing and utilizing extensive amounts of health and medical data. However, the AI technology has various unique characteristics that are different from the existing health care technologies. Subsequently, there are a number of areas that need to be supplemented within the current health care system for the AI to be utilized more effectively and frequently in health care. In addition, the number of medical practitioners and public that accept AI in the health care is still low; moreover, there are various concerns regarding the safety and reliability of AI technology implementations. Therefore, this paper aims to introduce the current research and application status of AI technology in health care and discuss the issues that need to be resolved.

난관 불임환자에서 난관 개통술시 진단복강경의 효용성

박찬우,김혜옥,허걸,양광문,김진영,송인옥,유근재,전종영,이경상,강인수,궁미경,Park, Chan-Woo,Kim, Hye-Ok,Hur, Kuol,Yang, Kwang-Moon,Kim, Jin-Young,Song, In-Ok,Yoo, Keun-Jae,Jun, Jong-Young,Lee, Kyung-Sang,Kang, Inn-Soo,Koong, Mi-Kyoung 대한생식의학회 2003 Clinical and Experimental Reproductive Medicine Vol.30 No.2

Objective: To evaluate whether diagnostic laparoscopy before transcervical fallopian tube catheterization (TFTC) would improve tubal recanalization rate and pregnancy rate in patients with bilateral proximal tubal blockage in hysterosalpingogram (HSG). Methods: The retrospective study was performed in those underwent TFTC from January 1998 to December 2001. A total of 50 patients with bilateral proximal tubal blockage in HSG were subjected to TFTC sequentially using repeated HSG (rHSG), selective salpingography (SS) followed by tubal catheterization (TFTC). Each procedure was terminated once patency had been achieved without proceding to the next technique. In Group A patients (n=35, 64 tubes), diagnostic laparoscopy was performed before TFTC was taken to exclude the tube combined with peritubal adhesion or distal tubal pathology. In Group B, patients (n=15, 26 tubes) were performed TFTC without diagnostic laparoscopy. Results: There were significant difference in clinical pregnancy rate (45.7% vs 15.4%, p=0.034) but no differences were found in recanalization rate (75.0% vs 73.1%) and complication rate (8.6% vs 13.3%). Although there is no signficant difference, more tubes were canalized by SS, which means tubal obstruction rather than occlusion, in Group A (25.0% vs 5.3%, p=0.069). Conclusion: Diagnostic laparoscopy would be effective in the selection of tube for the relatively inexpensive and less invasive TFTC or patients in need of assisted reproductive technologies. With the tubes without combined peritubal adhesion or distal tubal pathology, pregnancy rate was significantly increased.