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한세열(Se Yul Han),윤태기(Tae Ki Yoon),차광열(Kwang Yul Cha),최동희(Dong Hee Choi),남윤성(Yoon Sung Nam) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.1
Systemic lupus erythematosus(SLE) is a multisystem disorder with a peak age of onset in the second and fourth decades of life predominantly occuring in females who will usually have the potential to become pregnant. This female to male predominance is greatest during childbearing years approaching a ratio of 13:1, after the menopause it declines to a ratio of 3:1, the ratio also seen in prepubertal years. In practice, despite the higher prevalence of rheumatiod arthritis, pregnancy in SLE is the most common management problem confronting physician and obstetrician amongst the connective tissue disorders and it is particularly important as the outcome of pregnancy is more unpredictable in this disease. As well as having clinical consequences for the health of both mother and fetus, pregnancy in lupus provides a model for studying the importance of other biological phenomena characterizing the disease. For example, the transplacental passage of maternal antibodies to Ro(SSA) and La(SSB) and their strong association with the neonatal lupus syndrome suggests a pathogenetic role for these autoantibodies. Other relevant issues are feto-meternal immunological tolerance and hormonal interaction with the immune system. We have experienced a case of recurrent pregnancy loss associated with systemic lupus erythematosus. So we report this case with a brief review of literatures.
한세열(Se Yul Han),윤태기(Tae Ki Yoon),차광열(Kwang Yul Cha),최동희(Dong Hee Choi),남윤성(Yoon Sung Nam) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.2
Toxoplasma gondii, an intracellular coccidian protozoan, is the causative agent of toxoplasmosis, a widespread infection affecting various birds and mammals including humans. In immunocompetent hosts, the infection is usually asymptomatic and benign. Toxoplasmosis is either congenital or acquired. In general prenatal therapy of congenital toxoplasmosis is beneficial in reducing the ncy of infant infection. Therapies are based primarily on spiramycin because of the relative lack of toxicity and high concentration achieved in the placenta. Clindamycin is the standard drug for chemoprophylaxis in newborn infants, and is directed at preventing the occurrence of retinochoroiditis as a late sequel to congenital infection. The standard treatment for acquired toxoplasmosis in both immunocompetent and immunodeficient patients is the synergistic combination of pyrimethamine and sulphonamides. Toxoplasmic encephalitis is tbe most common manifestation of acquired toxoplasmosis in immunocompromised patients and if not treated is fatal. However, because of toxicity, the therapeutic efficacy of pyrimethamine sulphonamide combinations may be seriously limited in immunodeficient patients. We have experienced a case of toxoplasmosis during the workup of habitual aborter. So we report this case with a brief review of literatures.
Bromocriptine 질투여로 치료된 프로락틴과다증 1례
남윤성,이우식,박찬,윤태기,차광열,Nam, Yoon-Sung,Lee, Woo-Sik,Park, Chan,Yoon, Tae-Ki,Cha, Kwang-Yul 대한생식의학회 1999 Clinical and Experimental Reproductive Medicine Vol.26 No.3
Objective: To report the efficacy of vaginally administered bromocriptine. Material and Method: Case report. Results: The prolactin level was significantly decreased after the administration of bromocriptine vaginally. Conclusions: The vaginal administration of bromocriptine can be an alternative to oral administration in patients with hyperprolactinemia who show severe side effects.
유전자 재조합 난포자극호르몬과 성선자극호르몬 분비호르몬 길항제를 이용한 임신 1례
남윤성,김남근,김은경,정형민,차광열,Nam, Yoon-Sung,Kim, Nam-Keun,Kim, Eun-Kyung,Chung, Hyung-Min,Cha, Kwang-Yul 대한생식의학회 2001 Clinical and Experimental Reproductive Medicine Vol.28 No.1
Objective: To report the pregnancy which was made by in vitro fertilization using recombinant follicle stimulating hormone and gonadotropin releasing hormone antagonist. Material and Method: Case report. Results: Six oocytes were retrieved and all were fertilized by intracytoplasmic sperm injection. Six embryos were transferred and the pregnancy was confirmed. Conclusion: It is envisaged that the availability of recombinant gonadotropins and gonadotropin releasing hormone antagonists will ultimately lead to shorter, cheaper and safer treatments, using reduced dosages.
남윤성,김남근,강명서,오도연,차광열,Nam, Yoon-Sung,Kim, Nam-Keun,Kang, Myung-Seo,Oh, Do-Yeon,Cha, Kwang-Yul 대한생식의학회 2001 Clinical and Experimental Reproductive Medicine Vol.28 No.2
Objective: To evaluate the abnormality of protein S in patients with recurrent spontaneous abortion due to antiphospholipid syndrome. Material and Method: Antigen and activity of protein S were analyzed by enzyme immunoassay and clotting method, respectively. Results: Of 18 patients with antiphospholipid syndrome, 4 patients were found to have no abnormality of protein S. There were 14 cases of protein S abnormality. Among them, there were 8 cases of type 1, 1 case of type 2, and 5 cases of type 3 protein S deficiency. Conclusion: So in the workup of patients with recurrent spontaneous abortion due to antiphospholipid syndrome, the evaluation for protein S is required.
동결 보존된 고환 정자로 ICSI 시술 후 수정된 수정란의 이식에 의한 임신 1례
이우식,김종식,김현규,김영찬,박찬,김시영,고정재,차광열,Lee, Woo-Sik,Kim, Jong-Sik,Kim, Hyun-Kyoo,Kim, Young-Chan,Park, Chan,Kim, Si-Young,Ko, Jung-Jae,Cha, Kwang-Yul 대한생식의학회 1998 Clinical and Experimental Reproductive Medicine Vol.25 No.1
This case report describes the pregnancy following the transfer of embryos generated from intracytoplasmic sperm injection (ICSI) using frozen-thawed sperms obtained by testicular sperm extraction (TESE) in patient with hypoplasia of vas deferens.
착상전 유전진단을 이용하여 성공적으로 분만한 반복자연유산 1례
남윤성,이숙환,엄기붕,이은정,정형민,차광열,Nam, Yoon-Sung,Lee, Sook-Hwan,Oum, Ki-Bung,Lee, Eun-Jung,Chung, Hyung-Min,Cha, Kwang-Yul 대한생식의학회 2000 Clinical and Experimental Reproductive Medicine Vol.27 No.3
Objective: To report the successful delivery in a patient of recurrent spontaneous abortion caused by chromosomal abnormality. Material and Method: Case report. Results: Twelve oocytes were obtained by in vitro fertilization. Of eleven oocytes fertilized, two embryos turned out to be normal by using fluorescent in situ hybridization on blastomere biopsy. The patient succeeded in pregnancy and the result of amniocentesis was found to be normal. She delivered the healthy female baby by cesarean section. Conclusions: The successful delivery is possible in recurrent spontaneous abortion related with reciprocal translocation by using preimplantation genetic diagnosis.
항정자항체가 일반적 체외수정 방법 및 정자직접 주입법(ICSI)에 미치는 영향에 관한 연구
오종훈,엄기붕,최동희,정미경,한세열,차광열,정길생,Oh, Jong-Hoon,Oum, Ki-Boong,Choi, Dong-Hee,Chung, Mi-Kyung,Han, Sei-Yul,Cha, Kwang-Yul,Chung, Kil-Saeng 대한생식의학회 1997 Clinical and Experimental Reproductive Medicine Vol.24 No.3
The purpose of this study was to examine the effects of anti-sperm antibody (ASA) on the fertilization processes using conventional IVF and ICSI procedure in human and hamster oocytes. In human IVF, we have observed restricted fertilization with sperm testing positive for ASA. ($23{\sim}90%$ IgA, 60-97 % IgG). However, if ICSI was perform in the next IVF cycle with the same patients, we could successfully fertilize the oocytes (37%; p<0.001), thus achieving pregnancy and delivery. When the sperm were cocultured in medium containing ASA, there were binding of ASA to sperm surface. In addition, the mean rate of the acrosomal reaction in an in vitro acrosome reaction test was lower for Ab-bound sperm (43.5%) than for Ab-free sperm group (51.3%, p<0.05). We used human sperm and hamster oocytes to confirm the negative effects of the ASA on fertilization. The sperm and/or oocytes have been expose to medium containing ASA before IVF and ICSI. In this experiment, the ASA was bound to the oocyte and sperm surface. The following results were obtain by using various combinations of ASA free or ASA bound sperm with ASA free or ASA bound oocytes for IVF. When ASA free sperm were inseminate with ASA free and ASA bound hamster oocytes, the fertilization rates are 89.6% and 74.3% respectively. However, when ASA bound human sperm were use the results were 62.5% and 55.6% respectively. These shows the fertilization rate was significantly decreased in both ASA bound and ASA free oocytes when using ASA bound sperm. No difference found when ASA are present on the oocyte surface. When the hamster oocytes was treated by ICSI with ASA free or ASA bound human spermatozoa, no significant difference was found. These results showed that ICSI is the most promising method for couples who fertilization was not possible by conventional IVF because of ASA.
Pinopode Development 2-days after Oocyte Retrieval in the Human IVF Patients
이경아,한세열,최동희,이우식,윤태기,차광열,Lee, Kyung-Ah,Han, Sei-Yul,Choi, Dong-Hee,Lee, Woo-Sik,Yoon, Tae-Ki,Cha, Kwang-Yul The Korean Society for Reproductive Medicine 1998 Clinical and Experimental Reproductive Medicine Vol.25 No.1
본 연구는 체외수정 프로그램에 참여하는 환자에 있어서 난자회수 이틀째의 자궁내막의 발달상태를 알아보기 위하여 pinopode의 발달상태, 에스트로젠 및 프로제스테론 수용체의 발현을 관찰하였다. 생검한 자궁내 막 조직 을 양분하여, 절반은 전사전자 현미경 (scanning electron microscope)으로 pinopode를 관찰하기 위하여 2.5% glutaraldehyde와 2% paraformaldehyde로 고정하였고, 나머지 절반은 dating 및 스테로이드 수용체의 면역조직화학적 측정 (immunocytochemistry)을 위하여 10% formalin으로 고정하였다. 모두 12명의 환자중 8명에서 pinopode가 관찰되었으며, pinopode 발달이 관찰되지 않은 환자들은 hCG 주사를 맞는 날의 estradiol (E2)의 혈중농도가 600 pg/mL이하로 낮았다. 본 연구의 결과로부터 자궁내막의 발달상태를 알아보기 위해서는 지금까지 일반적으로 사용되어 오던 dating이나 스테로이드 수용체의 면역조직화학적 측정법 이외에도 pinopode를 관찰함으로써 조금 더 정확한 진단을 할 수 있으리라고 사료되며, pinopode의 발달은 E2의 혈중농도와 관계가 있을 것으로 추정된다.
김현규,엄기붕,김현주,고정재,이숙환,윤태기,차광열,Kim, Hyun-Kyoo,Oum, Ki-Boong,Kim, Hyun-Joo,Ko, Jung-Jae,Lee, Sook-Hwan,Yoon, Tae-Ki,Cha, Kwang-Yul The Korean Society for Reproductive Medicine 1997 Clinical and Experimental Reproductive Medicine Vol.24 No.2
폐색성 혹은 비폐색성 무정자증에서 부정소 정자채취법 등이 부적절하다고 여겨질때는 정소 조직을 일부 절제하여 그 조직으로부터 정자를 직접 채취하게 되는데 일반적으로 이렇게 정소로부터 추출한 정소정자는 운동성이 전혀 없거나 매우 약한 운동성을 보이는 경우가 많다. 본 연구의 목적은 이러한 정소정자를 Vero cell과 공배양을 시킴으로써 운동성을 획득시키거나 향상시키고 이를 수정시키는 시기까지 지속시킴으로써 정소정자추출술 (TESE)을 시행하는 환자나 의료진들에게 보다 편안하고 융통성있는 시간대를 부여하고, 아울러 정자직접주입술 (ICSI)을 보다 용이하게 하여 성공적인 수정률과 임신율을 얻음에 있다. 또한 ICSI를 시행한 후, 운동성이 향상된 잉여의 정소정자를 냉동보존함으로써 차후에 TESE을 다시 시행치않고도 시험관 아기 시술을 시도할 수 있는 부가적인 잇점도 있다고 할 수 있다. 대상환자군은 정관폐색증(n=11) 혹은 비정관폐색증(n=2)을 보이는 13명의 무정자증의 남성불임환자였으며 난자회수예정일 3일전에 TESE를 시행하여 정소정자를 얻은 후 이를 정자직접주입술이 시행되는 당일까지 Vero cell과 공배양을 실시하였다. Vero cell과의 공배양에 의하여 운동성이 있는 정소정자의 수는 공배양전과 비교하여 평균 3.3배가 증가하였으며, 특히 공배양전에 운동성이 있는 정소정자의 수가 50,000/ml이하의 미약한 운동성만을 보였던 경우 (n=5)에는 공배양 후에 운동성이 있는 정소정자 수의 평균증가율이 7.7배였다. 공배양전 정자운동성이 전혀 없었던 2례의 비정관폐색증환자중 3일간의 공배양을 통하여 1례에서 운동성을 획득한 정소정자를 얻을 수 있었으며 (14,300/ml), 정자직접주입술을 통하여 성공적인 수정 및 임신에 도달할 수 있었다. Vero cell과 공배양을 하고 ICSI했던 결과, 평균 수정률은 75.0% 이었으며 임신율은 61.5%였다.