MAPKkinase is related with cAMP - induced inhibition of eosinophil apoptosis

HS Chang,SY Ki,MR Lee,ST Uh,YH Kim,IY Chung,CS Park 대한천식 및 알레르기학회 ( 구 대한알레르기학회 ) 1999 춘계학술대회 초록집 Vol.1999 No.-

면역학적 임신진단법의 한국산 참개구리 임신진단법의 비교 관찰

장항순(HS Chang) 대한산부인과학회 1963 Obstetrics & Gynecology Science Vol.6 No.9

Attempts to identify chorionic gonadotrophic hormone by methods other than animal assay had been unsuccessful until the recognition of the specific antigenicity of the protein hormone. The identfication by complement-fixation test, precipitin test and hemagglutination inhibition test of human chorionic gonadotrophic hormone in serum and urine became feasible with the advant of adjuvant along with a recently developed technique in purifying HCG. Regrettably enough, the procedure isn`t clinically applicable because it involves a highly complicated setting which is not yet commercially available. The Ortho Pregncy Test is based on an agglutination in which anti-human chorionic gonadotrophic hormone antibody reacts with the antigen latex particles coated with human chorionic gonadotrophic horomone. In the pregnant woman, the urinary chorionic chorionic gonadotrophin reacts with the anti-HCG antibody, inhibiting the agglutination with HCG-ceated latex particles. In this reaction the latex particles take no part, producing no precipitation. The final solution remains cloudy. In the non-pregnant woman, the anti-HCG antibody remains free, allowing the latex particles coated with HCG to react with the antibody. This reaction yields visible precipitation with the resultant clear supernatant. A comparative study simultaneously employing the Frog Test was conducted in the pregnant and non-pregnant cases and the results were as follows: 1) Of 35 Cases collected from normal pregnant women, there 32 positive results by the Ortho Pregnancy Test, showing a diagnostic accuracy of 91.4%, as compared with the slightly lower percentage of 86.2% by the Frog Test, 25 positive instances among 29 cases. 2) No false positive reaction was encountered in 13 non-pregnant cases including one male case in either tests. 3) In addition the test was positive in one case of hydatiform mole and one case of choricarcinoma respectively.

응급의료기관평가와 응급의료의 질 관리

장한석 ( Chang Hs ),김길훈 ( Kim Kh ),오미라 ( Oh Mr ),이명화,이재현 ( Lee Jh ),윤한덕 ( Yoon Hd ),이진희 ( Lee Jh ) 한국품질경영학회 2017 한국품질경영학회 학술대회 Vol.2017 No.1

자성 미꾸리 임신반응의 추시

장향순(HS Chang),신면우(MW Shin) 대한산부인과학회 1963 Obstetrics & Gynecology Science Vol.6 No.7

The purpose of this report is a further evaluation of pregnancy test using loaches which Dr. J W. Kim released in 1961 for the utility a as test for the determination of pregnancy and hydatidi- formmole. This experiment was carried out from May to July this year at the Dept. of Ob. & Gyn., College of Medicine, Sun., using urine specimens collected from both sexes who visited the Out-Patieent Clinic during this period. One hunderd and twenty-four urine specimens were submitted for the evaluation, 88 from normal pregnancy cases, 34 from non-pregnancy cases inclusive of the malecases, and one case respectively from hydatidiform mole and choriocarcinoma. A comparative study simultaneously employing the Frog test was conducted were as follows: 1) Of 84 urine specimens collected from normal pregnancy cases exclusive of 4 cases in which the test failed, there were 70 positive results, showing 83,2% diagnostic accuracy. 2) Of 13 from non-pregnancy cases exclusive of 3 cases in which the test failed and 18 from the male cases, false positive response was encountered in 6 cases with the resultant false reaction rate of 19.3%. 3) With regard to the singie case of hydatidiform mole, the positive reaction was obtained preoperatively and on the 10th postoperative day with the intervening doubtful result on the 5 th postoperative day, while the Frog test remained positive in the whole urine throu ghout the 10 th postoperative day. 4) The urine from the choriocarcinoma case gave ++, reaction in the whole urine and in 10×dilution with the slightly weak reaction of in +, 50×dilution on the 7 th postoperative day. On the 11 th postoperative day, the reaction was again ++, but with diminishing reactivity with the increasingly higher dilution The Frog test, conducted at the same time, was all positive. 5) In the first trimester, there were 26 positive results including the four particularly strong positive cases, showing 89.6% diagnostic accuracy. This result is considered to be in good accord with the fact that chorionic gonadotropic hormone is strikingly increased in the early stage of pregnancy.

착상 전후 생쥐 배아의 체외 성장에 대한 선택적인 레티노이드 수용체 작용물질의 기형 형성 역할

장윤석,강병문,김정훈,채희동,강은희,추형식,이춘배 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.7

목적: 레티노이드 수용체 [Retinoic acid receptor : RAR α, RAR β and RAR γ] 작용물질의 특이적인 기형 형성 역할을 알아 보고자함이다. 연구 방법: 생후 6-8주된 생쥐에서 난소 자극으로 포배를 얻고 배양하여 α, β와 γ 레티노이드 작용물질을 첨가하였다. 배아는 레티노이드 작용물질[대조군 : 작용물질이 없는 군, α, β, γ] 에 따라 네 군 으로 분류되었고, 각 군의 배아는 분해 정도에 따라 각각 세가지 세부군[정상 배아군, 비정상 난원주군, 난원주 결핍군]으로 재분류되었으며, 레티노이드 작용물질을 첨가하여 착상 주위기의 생쥐 체외 배아 성장을 조사하였다. 결과: 403개의 정상 포배가 획득되었고, 배양 3일째에는 모든 배아가 정상 성장을 보였다. 4일째 배아에서 비정상 난원주 배아는 α 작용물질 군에서만 나타났다. 배양 제 6, 8일에, 정상배아로의 발달율과 비정상 난원주나 난원주 결핍 배아까지의 발달율은 작용물질 군에 따라 유의하게 다르게 나타났다. 기형배아로의 발달율은 α작용물질군에서 가장 높았고 그다음이 γ작용물질군이었다. 이때 정상배아로의 발달율은 배양기간이 증가함에 따라 감소하였다. 결론 : 레티노이드 작용물질의 기형 형성 작용은 α$gt;γ$gt;β의 순으로 나타났고, 주로 매개하는 수용체는 RAR α이었다. Objective: To identify the specific teratogenic role of retinoic acid receptor [RAR] α, β and γ-agonist, the growth of murine embryos that were exposed to the retinoids agonists was examined in periimplantation and early postimplantation stage in vitro. Materials and Methods: Blastocysts were obtained by ovarian stimulation of 6 to 8 weeks old Swiss Webster female albino mice, and cultured with CMRL1066 media containing 1mM glutamine, 1mM sodium pyruvate, 50IU/ml penicillin and 50 g/ml streptomycin. Alpha, β and γ-retinoids agonists were added. The embryos were categorized into 4 groups on the basis of retinoids agonists [control: no agonist, α, β and γ]. The embryos in each group were reclassified into three subgroups according to the degree of degradation [normal embryo group, abnormal egg cylinder group and devoid of egg cylinder group]. Results: Four hundred and three grossly normal blastocysts were confirmed. On day 3 culture all embryos showed a normal growth. On day 4 culture, the embryos with abnormal egg cylinder region appeared only in α-agonist group. On day 6 and 8 culture, the rates of development to normal LEC and ES, to embryo with abnormal egg cylinder region, and to embryos devoid of egg cylinder region were significantly different according to the specific retinoids agonists. The production rates of malformed embryos were highest in α-agonist group. Gamma agonist group was the next. The development rates to normal embryo were decreased as the culture duration increased. Conculsion: The order of intensity and the time sequence of the teratogenic effect of retinoids agonists were α$gt;γ$gt;β.

Anti-thrombotic effects of YS-49 and YS-51, 1-naphthylmethyl analogs of higenamine

HS Yun-Choi,MK Pyo,KM Park,KC Chang,DH Lee,JC Ryu 대한약학회 1999 大韓藥學會 總會 및 學術大會 Vol.48 No.-

저반응군에서의 과배란유도시 Pyridostigmine 병합요법이 혈청 및 난포액내 성장호르몬 및 인슐린유사성장인자 : 농도와 체외수정시술 결과에 미치는 영향

장윤석,강병문,김정훈,채희동,강은희,추형식 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.6

목적: 저반응군에서 체외수정시술을 위한 과배란유도시 acetylcholinesterase inhibitor인 pyridostigmine 병합투여가 성장호르몬[growth hormone, GH]과 인슐린유사성장인자-1[insulin- like growth factor-1, IGF-1]의 혈중 및 난포액내 농도에 미치는 영향과 이에 따른 체외수정시술 결과에 미치는 영향을 알아보고자 본 연구를 시행하였다. 방법: 1995년 8월부터 1998년 5월까지 과거의 체외수정시술주기에서 과배란유도에 대하여 불량한 반응을 보였던 70명의 환자들을 대상으로 본 연구를 시행하였다. 총 70명의 대상환자들은 무작위로 pyridostigmine을 투여하는 치료군 [n=35]과 대조군 [n=35]으로 분류되었다. 모든 대상환자들에서 과배란유도를 위하여 gonadotropin-releasing hormone agonist [GnRH-a] 장기투여법이 사용되었다. 치료군에서는 pyridostigmine 120 mg을 과배란유도 시작일부터 human chorionic gonadotropin [hCG] 투여일까지 경구로 투여하였고, 대조군에서는 동일기간동안 위약을 투여하였다. 체외수정시술의 결과와 함께 과배란유도 시작일, 과배란유도 제 5일, hCG 투여일의 혈중 GH과 IGF-I의 농도 및 난자채취일에 얻어진 난포액내의 GH과 IGF-I의 농도를 측정하여 두 군간에 비교 분석하였다. 결과: 과배란유도를 위하여 사용된 외인성 성선자극호르몬의 총 투여용량 및 투여기간 모두 치료군에서 대조군에 비하여 유의하게 감소되었다 [p $lt; 0.001, p $lt; 0.05]. HCG 투여일의 혈중 estradiol 농도, 회수된 난자의 수, 수정된 난자의 수, 그리고 난할된 난자의 수에 있어 모두 치료군에서 대조군에 비하여 유의하게 증가되었다 [p $lt; 0.05, p $lt; 0.05, p $lt; 0.05, p $lt; 0.05]. 임상적 임신율은 치료군의 경우 25.7%로 대조군의 11.4%에 비하여 높았으나 통계적 유의성은 보이지 않았다. 과배란유도 시작일, 과배란유도 제 5일, 그리고 hCG 투여일에 각각 측정한 혈중 GH의 변화 양상은 대조군의 경우 과배란유도에 따른 유의한 변화없이 다소 감소하는 양상을 보였던 반면 치료군에서는 점차적으로 증가하는 양상을 보여 hCG 투여일에는 치료군에서 대조군에 비하여 유의하게 더 높은 농도를 보였다 [p $lt; 0.05]. 과배란유도 기간동안의 혈중 IGF-1 농도 변화 양상은 대조군의 경우 유의한 변화를 보이지 않았던 반면 치료군에서는 혈중 IGF-1의 농도가 과배란유도 제 5일에 기저치보다 유의하게 증가하였다가 [p $lt; 0.05], hCG 투여일에는 오히려 기저치 이하로 감소하는 양상을 보였다. 혈중 IGF-1 농도는 과배란유도 제 5일에는 치료군에서 대조군에 비하여 유의하게 높았으나 [p $lt; 0.01], hCG 투여일에는 두 군간에 차이를 보이지 않았다. 한편, 난포액내 GH과 IGF-1의 농도 모두 치료군에서 유의하게 증가되어 있었다 [p $lt; 0.05, p $lt; 0.0001]. Pyridostigmine 투여로 인하여 2명의 환자에서 혀 근육의 경미한 연축으로 인한 발음장애 증상이 일시적으로 나타났으나 모두 특별한 조치없이 자연소실되었다. 결론: 저반응군에서의 과배란유도시 pyridostigmine의 투여는 내인성 GH 및 IGF-1의 분비에 영향을 미쳐 이들의 난포액내 농도를 증가시키는 효과가 있으며, 이러한 영향은 과배란유도에 필요한 외인성 성선자극호르몬의 총 투여용량 및 투여기간을 감소시켜 환자의 신체적, 경제적 부담을 덜어줄 수 있고, 난소에서의 steroid 호르몬 생성 및 난포성장을 촉진시킬 수 있으며 또한 사용이 간편하고 경제적인 유용한 치료방법이라고 사료된다. Objectives: To investigate whether pyridostigmine, acetylcholinesterase inhibitor, supplementation during controlled ovarian hyperstimulation [COH] affects the serum and intrafollicular levels of growth hormone [GH] and insulin-like growth factor-1 [IGF-1] and, hence, in vitro fertilization and embryo transfer [IVF-ET] outcome in low responders. Methods: From August 1995 to May 1998, 70 infertile women with previous history of poor response to COH in IVF-ET cycles were allocated randomly to the treatment group and the control group. The COH using luteal long protocol of gonadotropin releasing hormone agonist [GnRH-a] was used in all patients. In the treatment group [n = 35], 60 mg pyridostigmine were orally administered twice daily from the first day of COH to the day of human chorionic gonadotropin [hCG] injection. The patients without pyridostigmine supplementation served as control [n = 35]. The serum concentrations of GH and IGF-1 were measured in all patients on the beginning day of COH, the 5th day of COH, and the day of hCG injection and intrafollicular concentrations of them were also measured. Results: The total number of ampules of gonadotropin required was significantly lower in the treatment group than that in the control group [p $lt; 0.001], and the duration of gonadotropin administration was also significantly shorter in the study group [p $lt; 0.05]. There was significantly higher concentration of serum estradiol on the day of hCG injection in the treatment group than in the control group [p $lt; 0.05]. The mean numbers of oocytes retrieved, oocytes fertilized, and oocytes cleaved in the treatment group were also significantly higher than those in the control group [p $lt; 0.05, p $lt; 0.05, p $lt; 0.05]. The mean numbers of grade I, II embryos and embryos transferred seemed to be increased in the treatment group, but the differences were not statistically significant. The clinical pregnancy rate was higher in the treatment group, but the difference did not achieve significance [25.7% vs 11.4%]. Serum GH level on the day of hCG injection was significantly higher in the treatment group than in the control group [p $lt; 0.05]. In the treatment group, serum IGF-1 concentrations decreased to a minimal level on the day of hCG injection, after an initial rise at the midfollicular phase. Serum IGF-1 level on the 5th day of COH was significantly higher in the treatment group than in the control group [p $lt; 0.01], but serum IGF-1 levels on the day of hCG injection were comparable between the two groups. There were significantly higher concentrations of intrafollicular GH and IGF-1 in the treatment group than in the control group [p $lt; 0.05, p $lt; 0.001 respectively]. Due to the use of pyridostigmine, mild transient muscle fasciculation of tongue was occurred in only 2 patients, but this side effect was subsided pontaneously. Conclusion: This study suggests that pyridostigmine supplementation during COH could affect the serum and intrafollicular GH, IGF-1 concentrations and, hence, improve the ovarian response to COH and clinical outcome in low responders undergoing IVF-ET.

무월경 여성에서의 원인적 분류에 따른 임상적 고찰

장윤석,강병문,김정훈,채희동,강은희,추형식 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.5

목적: 한국 여성에서의 무월경의 원인을 알아보기 위함이다. 연구방법: 1989년 7월부터 1997년 12월까지 울산대학교 의과대학 서울중앙병원 산부인과를 방문한 158명의 무월경 환자를 대상으로 무월경의 원인적 분류를 시행하였다. 총 158명의 무월경 환자를 원발성 무월경군과 속발성 무월경군으로 나누었다. 결과: 원발성 무월경 환자는 14명[8.9%]이었고, 속발성 무월경 환자는 144명[91.1%]이었으며 무월경이 진단된 환자의 나이는 양 군간 유의한 차이가 없었다. 염색체 핵형은 원발성 무월경 14예중 6예[42.9%]에서 비정상 염색체 핵형을 보였으며, 속발성 무월경에서는 144명 중 3명[2.1%]만이 비정상 염색체 핵형을 나타내었다. 원발성 무월경 환자중 중추계 병변[central lesion]은 14.3%[2/14]이었고, 생식선 병변[gonadal lesion]은 64.3%[9/14]으로 이중 Turner 증후군 환자가 28.6%[4/14], 조기 난소부전[premature ovarian failure] 환자가 21.4%[3/14]이었으며, 말단 기관 병변[end organ lesion]은 21.4%[3/14]으로, 각각 뮐러관 무발육 증후군[Mayer-Rokitansky-Kuster-Hauser syndrome] 환자가 14.3%[2/14], 뮐러관 발육이상[M llerian anomaly] 환자가 7.1%[1/14]이었다. 속발성 무월경 환자중 중추계 병변[41.7%, 60/144]은 다낭성난소증후군[polycystic ovarian syndrome] 환자가 40.3%[58/144]를 차지하였고, 생식선 병변[22.9%, 33/144]중에서는 조기 난소부전 환자 21.5%[31/144]로 가장 빈도가 높았으며, 말단 기관 병변은 모두 Asherman 증후군 환자로 20.8%[30/144]이었고, 전신 병변[systemic lesion]은 14.5%[21/144]이었다. 결론: 본 연구에서 한국 여성에서의 무월경 환자의 원인에 따른 빈도를 살펴볼 때 원발성 무월경의 빈도는 Turner 증후군, 조기 난소부전, 그리고 뮐러관 무발육 증후군의 순으로 나타났다. 또한 속발성 무월경의 경우 다낭성난소증후군, 조기 난소부전, 그리고 Asherman 증후군에 의한 무월경의 빈도가 많았던 것으로 조사되었다. Objective: To investigate the causes of amenorrhea in Korean women. Materials and Methods: Total 158 patients with amenorrhea who visited the department of Obstetrics and Gynecology, Asan Medical Center were included in this study between July 1989 and December 1997. Patients were divided into two main groups: primary amenorrhea group and secondary amenorrhea group. They were classified according to the causes of amenorrhea. Results: The number of patients with primary amenorrhea was 14 [8.9%] and the number of patients with secondary amenorrhea was 144 [91.1%]. The mean age of the patients at diagnosis was not different between the two groups. Six of 14 patients with primary amenorrhea and 3 of 144 with secondary amenorrhea were found to have chromosomal abnormalities. The causes of primary amenorrhea were as follows: 1] central lesions that all were Kallmann`s syndromes [14.3% [2/14]], 2] gonadal lesions [64.3% [9/14]] which were composed of Turner`s syndromes [28.6% [4/14]], Swyer syndromes [7.1% [1/14]], testicular feminization [TF] syndrome [7.1% [1/14]], and premature ovarian failure [POF] [21.4% [3/14]], and 3] end organ lesions [21.4% [3/14]] which were composed of Mayer-Rokitansky-Kuster-Hauser [MRKH] syndromes [14.3% [2/14]], and M llerian anomaly [7.1% [1/14]]. The causes of secondary amenorrhea were as follows: 1] central lesions [41.7% [60/144]] which were composed of polycystic ovarian syndromes [PCOS] [40.3% [58/144]] and Sheehan`s syndromes [1.4% [2/144]], 2] gonadal lesions [21.5% [33/144]] which were composed of Turner`s syndromes [1.4% [2/144]] and POF [20.8% [31/144]], 3] end organ lesions [20.8% [30/144]] that all were Asherman`s syndromes, and 4] systemic lesions [14.5% [21/144]] which were composed of thyroid diseases [1.4% [2/144]], adrenal diseases [2.1% [3/144]], hyperprolactinemia [11.1% [16/144]]. Conclusion: Our data shows that the common causes of primary amenorrhea are Turner`s syndrome, POF and MRKH syndrome, and the common causes of secondary amenorrhea are PCOS, POF and Asherman`s syndrome in Korean women.

표피성장인자의 처리가 생쥐 배아내의 Matrix Metalloproteinase-2 , 9[MMP-2 , 9] mRNA의 발현에 미치는 영향

장윤석,강병문,김정훈,채희동,강은희,추형식,전용필 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.4

목적: 표피성장인자[Epidermal growth factor, EGF]의 처리가 과배란유도후 수정된 생쥐 배아내의 기질 금속단백효소-2, 9[matrix metalloproteinase-2, 9, MMP-2, 9]의 발현에 어떤 영향을 미치고 있는가를 알아보기 위함이다. 연구 대상 및 방법: 1998년 1월부터 6월까지 과배란유도에 의하여 얻어진 생쥐의 상실배 시기의 배아 10개씩을 0.1, 1.0, 10 그리고 100 ng/ml 농도의 EGF로 각각 처리한후 48시간 동안 배양하였고 배아 10개는 대조군으로 EGF 처리없이 배양하였다. 배아 내에 발현된 MMP-2, 9 mRNA의 상대적인 양을 알아보기 위하여 역전사 중합효소연쇄반응[reverse transcription -polymerase chain reaction, RT-PCR]을 시행하여 처리된 EGF의 농도에 따라 MMP-2 또는 9의 발현양에 차이가 있는지 관찰하였다. 관찰 결과의 통계적 유의성 검정은 Student t-검정[t-test]으로 하였으며, p $lt; 0.05인 경우에 통계학적으로 유의한 차이가 있는 것으로 판정하였다. 연구 결과: 배아내에 발현된 MMP-2의 mRNA의 상대적 양[relative quantity; relative volume x intensity]은 각각 대조군이 457.7, 0.1 ng/ml군이 525.0, 1 ng/ml군이 455.0, 10 ng/ml군이 562.7, 그리고 100 ng/ml군이 584.5이었으며 각 군간에 유의한 차이는 관찰되지 않았다. 또한, 배아내에 발현된 MMP-9의 mRNA의 상대적 양은 각각 대조군이 653.3, 0.1 ng/ml군이 425.4, 1 ng/ml군이 360.2, 10 ng/ml군이 394.8, 그리고 100 ng/ml군이 443.5이었으며 역시 각 군간에 통계적으로 의미있는 차이는 나타나지 않았다. 결론: 본 연구의 결과로 미루어 생쥐 배아의 MMP-2 또는 9의 발현에 EGF 자체가 촉진 효과를 나타내지는 않는 것으로 추측된다. Objective: To investigate the influence of epidermal growth factor [EGF] on expression of matrix metalloproteinase-2, 9 [MMP-2, 9] mRNA in mouse embryos Materials and Method: From January to June 1998, morula stage mouse embryos were cultured for 48 hours with EGF at concentrations of 0.1, 1.0, 10 and 100 ng/ml. Embryos not treated with EGF were served as control. Reverse transcription-polymerase chain reaction [RT-PCR] has been used to examine the expression of MMP-2, 9 mRNA in developed blastocysts. Following reverse transcription, strategically designed nested primers, optimized for specificity, were used for amplification from the cDNA equivalent of a single embryo. The products were then verified by restriction enzyme digestion and sequence analysis. Results were analyzed with student t-test and statistical significance was defined as p $lt; 0.05. Results: The relative quantity [relative volume x intensity] of MMP-2 mRNA expressed in embryos of each group were not differed significantly [control ; 457.7, 0.1 ng/ml group; 525.0, 1 ng/ml group ; 455.0, 10 ng/ml group ; 562.7, and 100 ng/ml group ; 584.5]. There were also no significant differences in the relative quantity of MMP-9 mRNA expressed in embryos among each group [control ; 653.3, 0.1 ng/ml group ; 425.4, 1 ng/ml group ; 360.2, 10 ng/ml group; 394.8, and 100 ng/ml group ; 443.5]. Conclusion: This study suggests that EGF itself may not induce the expression of MMP-2 or 9 mRNA in mouse blastocysts.

체외수정시술후 포상기태와 동반된 쌍태아 임신 1 례

장윤석,강병문,김정훈,채희동,강은희,추형식 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.4

포상기태는 임신성 융모성 질환이다. 이러한 포상기태가 정상 태아와 동반된 쌍태아 임신은 매우 드물어, 그 빈도는 1/22,000에서 1/100,000 정도로 알려져 있다. 특히 이러한 경우 지속성 또는 전이성 융모성 종양의 발생률이 높기 때문에 그 진단은 매우 중요하지만, 아직까지 완전 포상기태를 동반한 쌍태아 임신의 자연 경과와 그 적절한 처치에 대한 규정은 확립되지 않은 실정이다. 한편, 체외수정시술후 포상기태를 동반한 다태임신의 빈도는 일반적인 임신의 경우와 비교하여 유사하리라고 생각되나, 아직까지 그 보고는 드문 것으로 나타나고 있다. 본 저자들은 체외수정시술후 임신에 성공하였으나 포상기태를 동반한 다태임신으로 진단되어 임신 21주에 임신이 종결되었으나 지속성 융모성 종양으로 MTX-CF 항암 요법을 1회 시행하여 완치된 임신 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Twin pregnancy consisting of complete hydatidiform mole [H-mole] and a coexisting fetus occurs in an estimated incidence of one per 22,000-100,000. This entity is different from a partial molar pregnancy because there are two separate conceptuses with a normal placenta in one twin and a complete molar gestation in the other. Because of the high risk of persistent or metastatic gestational trophoblastic tumor, the diagnosis and management of twin pregnancy consisting of complete H-mole and a coexisting fetus is very important. However, there are limited data to guide the antenatal management of this pregnancy. The incidence of this twin pregnancy with complete H-mole and a coexisting fetus after in vitro fertilization and embryo transfer [IVF-ET] is not increased compared with that of general population, however, with the more widespread use of ovulation induction, it is expected that multiple gestations containing complete H-mole will occur with increasing frequency. Because of their propensity to develop medical complications and persistent gestational trophoblastic tumor, patients with complete H-mole and a coexisting fetus remain an imposing clinical challenge. We present an unusual pregnancy with complete H-mole and a coexisting fetus that occured following IVF-ET and was evacuated at 21 weeks gestation and developed into nonmetastatic gestational trophoblastic disease that required the MTX-CF [methotrexate-citrovorum factor] chemotherapy to achieve complete remission with brief review of literatures.