자궁경을 이용한 자궁내강유착증 치료의 임상적 고찰

박은주 ( Eun Ju Park ),김성훈 ( Sung Hoon Kim ),장윤석 ( Yoon Seok Chang ),채희동 ( Hee Dong Chae ),김정훈 ( Chung Hoon Kim ),강병문 ( Byung Moon Kang ),전대준 ( Dae Joon Cheon ),박견 ( Kyun Park ),차지만 ( Ji Man Cha ),음현진 ( 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.7

N/A Objectives: To evaluate the causes of intrauterine adhesion (IUA) and the efficacy of hysteroscopic adhesiolysis in patients with IUA Methods: From January 1995 to June 1999, a total of 63 patients with IUA were underwent hysteroscopic adhesiolysis. The patients with IUA only were trying to be pegnant spontaneous whereas, intrauterine insemination (IUI) or in vitro fertilization and embryo transfer (IVF-ET) were performed in the patients who have other infertility factors and IUA as well. The data such as the changes of menstrual amount and pattern, fertility, and full-term live birth rate were analyzed. Results: The most common cause of IUA was curettage related problems; after incomplete abortion 20.6%, postpartum bleeding 9.5%, elective abortion 47.6%, missed abortion 11.1%, and for treatment of hydatidiform mole 1.6%. All patients with amenorrhea or oligomenorrhea had improvement of their menstrual patterns. Forty seven patients wanted pregnancy and 31 patients achieved pregnancy (68.4%). Full-term live birth rate 38.3% and there was one placenta accreta in full-term live birth case, which was resolved by postpartum curettage. Conclusion: Hysteroscopic adhesiolysis of IUA could be effective for restoring the normal menstrual pattern and fertility.

폐경기 여성에서 혈중 에스트라디올 농도 및 골밀도와 청력 기능과의 연관성

박은주 ( Eun Ju Park ),이동선 ( Dong Sun Lee ),김성훈 ( Sung Hoon Kim ),채희동 ( Hee Dong Chae ),김정훈 ( Chung Hoon Kim ),강병문 ( Byung Moon Kang ),전대준 ( Dae Joon Cheon ),박견 ( Kyun Park ),유항조 ( Hang Jo You ),음현진 ( Hy 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.7

N/A Objective: To clarify whether hearing sensitivity in postmenopausal women is associated with serum estradiol level or bone mineral density (BMD) Materials and Methods: From January 1999 to December 1999, serum concentration of estradiol, bone mineral densities of the lumbar vertebrae and femoral neck, and hearing sensitivity were measured in 1162 postmenopausal women. Serum concentration of estradiol was measured by radioimmunoassay. Dual energy X-ray absorptiometry (DEXA) was used to measure bone mineral densities of the lumbar vertebrae and femoral neck. Pure tone thresholds were evaluated by screening pure tone audiometry. All data were analyzed with Student`s t-test, multiple logistic regression analysis, and multiple linear regression analysis. Results: A total of 1155 patients were analyzed; 155 patients were in the hearing-loss group and 1000 patients were in the control group. On univariate analysis, significant differences were found in mean age, concentration of serum estradiol, and BMD of the fernoral neck between the two groups (mean±SD, 58.1±5.2 vs 56.0±4.3, 11.6±6.0 vs 13.1±12.0, 0.67±0.11 vs 0.70±0.11; p-value: 0.0001, 0.01, 0.02). On multiple logistic regression analysis and multiple linear regression analysis, significant association was found between age and hearing loss and between age and pure tone threshold (p-value: 0.0001, 0.0001, respectively). However, neither seum concentration of estradiol nor BMD was associated with hearing loss or pure tone threshold. Conclusion: This study suggests that hearing sensitivity in postmenopausal women is not directly associated with serum estradiol level or BMD.

설치류 자궁 세포주를 통한 에스트로젠과 프로게스테론에 의한 COX-2 조절 기전에 관한 연구

강병문(Byung Moon Kang),박은주(Eun Ju Park),김성훈(Sung Hoon Kim),전대준(Dae Joon Cheon),채희동(Hee Dong Chae),김정훈(Chung Hoon Kim),박견(Kyun Park),장윤석(Yoon Seok Chang) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.4

N/A Objective : To evaluate the regulatory mechanism of cyclooxygenase(COX)-2 by estrogen and progesterone in uterine cell lines of rodents. Materials and Methods : CUE-P cells, originated from the uterine endometrial epithelial cells, and CUE-V2 cells, originated from the uterine endometrial stromal cells, were incubated in the Dulbecco's modified Eagle's medium(DMEM) and F12 medium. The cellular proliferation were evaluated every 24 hours. The expression of COX-2 was measured after estrogen and progesterone supplementation by western blot. Results : CUE-P cells have cuboidal morphology and CUS-V2 cells resemble fibroblast and exhibit a spindle-like morphology. When CUE-P and CUS-V2 cells were co-cultured with estrogen and progesterone supplementation, the expression of COX-2 was decreased after 24 hours of estrogen supplementation. The decreased expression of COX-2 was observed only when estrogen was supplemented after 9 hours of initial progesterone supplementation. Conclusion : The sex steroid, such as estrogen and progesterone could regulate COX-2 expression in uterine cell lines.

체외수정시술 후 삼태 임신에서 다태 임신 감수술의 시행으로 성립된 쌍태 임신의 주산기 예후

이해림(Hae Rim Lee),이동선(Dong Sun Lee),박은주(Eun Ju Park),김성훈(Sung Hoon Kim),전대준(Dae Joon Cheon),채희동(Hee Dong Chae),김정훈(Chung Hoon Kim),강병문(Byung Moon Kang),박견(Kyun Park),장윤석(Yoon Seok Chang) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.3

N/A Objective:To investigate the perinatal outcome and complications of reduced twin pregnancies from triplet by multifetal pregnancy reduction (MFPR) in patients who underwent in vitro fertilization and embryo transfer. Materials and methods:From January 1995 to December 1999, a total of 71 twin pregnancies were included in this study. The patients were grouped into the MFPR group (n = 19) and the non-MFPR group (n = 59). The pregnancies in the MFPR group were reduced to twin from triplet by the MFPR. MFPR was performed by transvaginal sonography-guided fetal aspiration or mechanical trauma. The obstetric and perinatal outcomes were compared between the two groups. Statistical analysis was performed using Student's t-test, Fisher's exact test, and χ2 test as appropriate. Statistical significance was defined as p < 0.05. Results:There were no significant differences in mean gestational age and distribution of gestational age between the two groups. However, the fetal loss rate before 24 weeks of gestation was significantly higher in the MFPR group than the non-MFPR group. We did not find any significant differences in mean birth weight and weight discordancy between the two groups. There were no differences in obstetric and perinatal outcomes between the MFPR and non MFPR groups as well. Conclusion:These data suggest that pregnancy outcome of reduced twin pregnancies from triplet by MFPR in patients underwent IVF-ET might be comparable to that of non-reduced twin pregnancies.

자궁내막기질인 Type I Collagen을 이용한 생쥐 배아의 착상에 관한 연구

김정훈(Chung Hoon Kim),채희동(Hee Dong Chae),강병문(Byung Moon Kang),장윤석(Yoon Seok Chang),강은희(Eun Hee Kang),전용필(Yong Pil Cheon),박견(Kyun Park) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.1

목적: Type I collagen을 이용하여 3차원적 배양체계와 유사한 구조적인 환경을 조성하여 생쥐 배아의 착상전후의 상태를 보기 위한 연구를 중심으로 하였다. 연구방법: 포배단계의 배를 획득하기 위해서 자궁과 수란관의 일부를 적출하고 배양액으로 관류하여 배를 획득한 후 실험에 사용하였다. 멸균된 centrifuge용 시험관에 collagen이 polymerization되게 하였다. 배아는 착상과정의 비교를 위하여 type I collagen군(실험군)과 대조군으로 나누었으며, 대조군에서는 type I collagen 없이 배양액만 사용하여 배아를 배양하였다. 배의 성장과 분화는 24시간 단위로 해부현미경하에서 관찰하였다. 결과: 배양 제 3일에 배아의 부착율은 차이가 없었으나, 배아의 크기는 대조군에 비하여 실험군에서 뚜렸하게 컸다. 배아의 성장이 대조군에서 배양용기의 표면을 따라 수평적으로 진행되는 것과는 달리 실험군에서는 구형을 이루며 입체적으로 성장하기 때문에 색깔이 훨씬 진하게 나타났다. 배아의 발달단계를 관찰한 결과 배양 제 4일과 5일에는 실험군에서 대조군에 비하여 유의하게 발달단계가 높았다. 결론: Type I collagen을 사용한 본 연구는 착상연구의 모델로서 실험적으로 원하는 환경을 설정할 수 있고 관찰이 용이한 장점을 보여주었으나, 생체의 자궁내막세포와 같은 dynamic milieu가 결여되어 있어, 실제의 자궁내막과 유사한 체계를 이루는 배양체계를 어느 정도 수준까지 완성하려면 지속적인 연구가 필요할 것으로 사료된다. Objectives: To examine the in vitro interactions of blastocyst attachment using type I collagen. Materials and methods: ICR mice were used and follicular growth was stimulated by pregnant mare serum gonadotropin and human chorionic gonadotropin. On day 4 of pregnancy, the uteri were removed and blastocysts were flushed. Mixtures of 1mL sterile water, 0.5mL DMEM, 2mL type collagen solution and 0.5mL 0.1M NaOH were prepared and transferred to an incubator where the collagen solution polymerized. Blastocysts were transferred to dishes previously coated with type I collagen. CMRL 1066 was used as the basic culture medium. It was supplemented with 1mM glutamine and 1mM sodium pyruvate plus 50 IU/ml penicillin and 50 mg/ml streptomycin. During the first 4 days the culture medium was supplemented with 20% fetal calf serum and thereafter with 20% heat inactivated human cord serum. All blastocysts were initially cultured for 2 days without media change. After 2 days, fresh medium was renewed daily. The stages of embryo growth were examined and recorded everyday under a dissecting microscope and classified according to the standard in vivo criteria set forth by Witschi. Results: By 48h, nearly all blastocysts had attached to the surface of collagen pad. Following adhesion to the collagen pad, the blastocysts maintained their 3-dimensional integrity in contrast to control. The embryos in collagen pad were not flattening and kept polarity and spherical shape during culture. The polar trophoblast invaded the type I collagen downward unlike the horizontal growth in control. In the developmental stage of mouse blastocyst, there were significant differences between control and type I collagen group during day 4 and 5 culture. Conclusion: Blastocyst development was better in type I collagen group than control. Therefore, in vitro culture study using type I collagen could provide improved model for the establishment of blastocyst implantation study.