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비만환자에서 발견된 난소의 Steroid Cell Tumor 1 예
서성석 ( Seo Seong Seog ),이정필 ( Lee Jeong Pil ),주희재 ( Ju Hui Jae ),이은주 ( Lee Eun Ju ),김호빈 ( Kim Ho Bin ),장기홍 ( Jang Gi Hong ),유희석 ( Yu Hui Seog ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.5
Ovarian steroid cell tumors are composed exclusively of cells that have the histologic features of steroid hormone secreting cells. And these are rare lesions and have been divided into four subtyes according to their size, location in the ovary, and presence or absence of crystals of Reinke in the cytoplasm as follows: stromal luteomas, hilus cell tumors, Leydig cell tumors (non-hilar type), and steroid cell tumors not otherwise specified. Steroid cell tumors often secret androgens, and manifest themselves with symptoms of virilization. Other presenting manifestations include hirsutism, amenorrhea, obesity, hypertension and alopecia. We experienced a case of ovarian steroid cell tumor, manifested by obesity and amenorrhea and present with a brief review of the literature.
서성석,조미영,김미란,황경주,김영아,유희석,Seo, Seong-Seog,Jo, Mi-Yeong,Kim, Mi-Ran,Hwang, Kyung-Joo,Kim, Young-Ah,Ryu, Hee-Sug 대한생식의학회 2003 Clinical and Experimental Reproductive Medicine Vol.30 No.1
Objective : To evaluate the safety and efficacy of selective fetal reduction (SFR) and compare the outcome of twin pregnancy after SFR in multiple pregnancy induced by assisted reproductive technology (ART) with that of natural twin pregnancy. Methods : From September 1995 to March 2002 in Ajou University Hospital, SFR was performed in 79 patients whose gestational sacs were more than 3. Of these 79 patients, 47 patents resulted in twin pregnancy after SFR. SFR was performed using transvaginal intracardiac KCl injection at gestational age of $6{\sim}9$ weeks. Control group was composed of 264 patients with natural twin pregnancy, who delivered after intrauterine pregnancy at 24 weeks, from June 1994 through December 2002. We compared Obstetric and perinatal outcomes between SFR group and natural twin group. Results: Among 47 patients with twin pregnancy after SFR, 2 spontaneous abortion were occurred at intrauterine pregnancy at 8 and 19 weeks. Obstetrical and perinatal outcomes were available in 43 patients. Single intrauterine fetal death was occurred in 1 of 43 (2.3%) patients in SFR group. Incidence of preterm labor, premature rupture of membrane, preeclampsia and placenta previa were similar, but gestational diabetes mellitus (GDM) was occurred more frequently in SFR group (3 (7.0%) vs 4 (1.5%), p=0.02). Mean gestational age, mean birth weight, incidence of discordancy, use of intubation and ventilation, incidence of fetal anomaly, low (<7) Apgar score and intrauterine growth restriction were similar in both groups. Conclusion: Twin pregnancy after SFR has the increased incidence for GDM but other obstetric and perinatal outcome was similar compared with natural twin pregnancy. So SFR is a safe and effective procedure, so we suggest SFR is needed in multifetal pregnancy more than triplet.
인간 배아 동결 해빙시 액체질소의 분사속도가 배아 발달 및 임신에 미치는 영향
김영아,서성석,김미란,황경주,박동욱,조미영,유희석,Kim, Young-Ah,Seo, Seong-Seog,Kim, Mi-Ran,Hwang, Kyung-Joo,Park, Dong-Wook,Jo, Mi-Yeong,Ryu, Hee-Suk 대한생식의학회 2001 Clinical and Experimental Reproductive Medicine Vol.28 No.4
Objective : To investigate the efficacy of high infusion frequency of liquid nitrogen on pregnancy in human embryo after freezing and thawing. Materials and Methods: 150 infertile patients underwent 162 consecutive thawing-ET cycles. In the high infusion frequency group (Group A), 47 patients (50 cycles) underwent cryopreservation with high infusion frequency of liquid nitrogen. In the low infusion frequency group (Group B), 103 patients (112 cycles) underwent cryopreservation with low infusion frequency of liquid nitrogen. We analyzed the clinical characteristics, fertilization rates, development of embryo, good quality embryo ratio, implantation rates, and pregnancy rates between these two groups. Results: There was no difference between the groups with regard to clinical characteristics (mean age, infertility duration, infertility factors, hormone profile), mean number of oocyte retrieval, fertilization rates, and mean embryo number of transfers. The survival rates in group A was 64.9% (228 of 350 embryos), and among the 228 embryos 190 embryos (83.3%) which progressed to the two- to eight-cell stage. After thawing, the embryo numbers were 65 (34.2%), 29 (15.3%), 35 (18.4%), and 37 (19.5%) of grades 1, 2, 3, and above 4, respectively. The survival rates in group B was 63.8% (482 of 755 embryos), and among the 482 embryos 465 embryos (96.5%) which progressed to the two- to eight-cell stage. After thawing, the embryo numbers were 106 (22.8%), 94 (20.2%), 89 (19.1%), and 112 (24.1%) of grades 1, 2, 3, and above 4, respectively. There was no difference in embryo quality change after the freezing-thawing procedure between the groups. Implantation rates (31.1% vs. 34.3%) were not significant. However hCG positive rates in group A (40%) were higher than group B, but not statistically significant. Clinical pregnancy rate (26% vs. 25.9%), on going pregnancy rates (>20 weeks) were not significant (26% vs. 25%). Conclusion: We compared embryo quality change, survival rates, and pregnancy rates between high infusion frequency group and low infusion frequency group and the results were similar between the two groups. Therefore, high infusion frequency of liquid nitrogen for cryopreservation is a worthy method to preserve in human embryos.
정상 자궁난관조영을 보이는 불임 환자에 있어서 복강경술의 의의
권종희 ( Jong Hee Kwon ),서성석 ( Seong Seog Seo ),김미란 ( Mi Ran Kim ),황경주 ( Kyung Joo Hwang ),장혜진 ( Hye Jin Chang ),장석준 ( Suk Joon Chang ),유희석 ( Hee Sug Ryu ) 대한산부인과학회 2005 Obstetrics & Gynecology Science Vol.48 No.2
목적: 불임의 원인을 정확히 찾아내어 그 원인에 따라 적절한 치료 계획을 세워 성공적으로 임신에 도달하는 것이 불임 검사의 목적이다. 자궁난관조영술은 난관내부 및 자궁내강의 환경을 평가하는데 유용한 방법이기는 하나 난관주변의 유착 및 자궁내막증과 같은 골반강내 질환 등의 진단에는 한계가 있다. 본 연구는 경상 자궁난관조영을 보인 불임환자에서의 복강경술의 의의를 알아보고자 한다. 연구 방법: 본 연구에서는 후향적으로 79명의 자궁난관 조영술상 정상을 보인 Objective: To evaluate the value of laparoscopy in infertile women with normal hysterosalpingograms. Methods: Retrospectively analyzed the laparoscopic findings of 79 infertility patients with normal hysterosalpingograms. Results: Of the 79 patients, 28 (
자궁내막증 환자의 체외수정시술시 저용량 aspirin 과 corticosteroid 치료의 효용성에 관한 연구
김영아(Young Ah Kim),김미란(Mi Ran Kim),황경주(Kyung Joo Hwang),윤종혁(Jong Hyuck Yoon),서성석(Seong Seog Seo),유희석(Hee Sug Ryu) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.3
N/A Objective: To investigate the efficacy of low-dose aspirin and corticosteroid in IVF-ET patients with endometriosis. Materials and Methods: 45 infertile patients with endometriosis underwent 59 consecutive IVF-ET cycles. In the treatment group, 18 patients (23 cycles)underwent controlled ovarian hyperstimulation (COH) and received daily doses of 80 mg of aspirin and 15 mg of prednisone, startingon 3rd day of COH. In the control group, 27 patients (36 cycles)underwent COH without treatment. We analyzed the clinical characteristics, fertilization rates, good quality embryo ratio and pregnancy rates Results: There was no difference between groups in clinical characteristics (mean age, parity, LH, FSH, estradiol, progesterone), fertilization rates, and good embryo ratio. However, implantation rates were significantly different (29.81%vs.11.06%,p=0.019). Furthermore, hCG positive rates (60.89%vs.41.67%), clinical pregnancy rates (56.52%vs.33.33%), and on going pregnancy rates (>20weeks)(47.83%vs.27.78%) were increased in the study group compared to the control group. Conclusions: Combined treatment of low dose aspirin and prednisone improved pregnancy rates and implantation rates in IVF-ET patients with endometriosis. This results confirm the hypothesis that autoantibodies subsequently react with endometrial antigen leading to implantation failure and that we need to further research to the relationship of endometriosis with the immunologic aspect of implantation.