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보조 생식술 결과에 있어서 기저혈중 Inhibin-B의 예후인자로서의 유용성
배상욱,김진영,이경술,원종건,이용주,이지원,장경환,이병석,박기현,조동제,송찬호,Bai, Sang-Wook,Kim, Jin-Young,Lee, Kyung-Sool,Won, Jong-Gun,Lee, Yong-Joo,Yi, Ji-Won,Chang, Kyung-Hwan,Lee, Byung-Seok,Park, Ki-Hyun,Cho, Dong-Jae,Song, Cha 대한생식의학회 1997 Clinical and Experimental Reproductive Medicine Vol.24 No.2
This study was performed to determine if women with day 3 serum inhibin-B concentrations <45pg/ml (conversion factor to SI unit, 1.00) demonstrate a poor response to ovulation induction and assisted reproductive technology outcome to women with inhibin-B${\ge}45pg$/ml, independant of day 3 FSH, E2 and patient age. From Jan 1996 to Dec 1996, 16 volunteers patients who underwent 25 IVF cycles with luteal phase GnRH agonist suppression and HMG stimulation were allocated to the study group. We evaluated day 3 serum inhibin-B, FSH, E2, peak E2, cancellation rate per initiated cycle (%) and clinical pregnancy rate per initiated cycle (%) according to the above two groups and independent of patient age, day 3 FSH, day 3 E2 and all of above combined. Women with day 3 serum inhibin-B${\ge}45pg$/ml demonstrated higher average day 3 inhibin-B level, clinical pregnancy rate per initiated cycle ($20.3{\pm}2.5$ pg/ml vs $80.9{\pm}5.0$ pg/ml, p<0.05; 24.8% vs 8.5%, p<0.05) and lower day 3 FSH level, cancellation rate per initiated cycle ($6.9{\pm}0.3$ mIU/ml vs $8.5{\pm}0.5$ mIU/ml, p<0.05; 1.5% vs 9.0%, p<0.05). Women with day 3 serum inhibin${\ge}45pg$/ml and age<40 year demonstrated higher pregnancy rate per initiated cycle (28.2% vs 7.4%, p<0.05) and lows. day 3 FSH level, cancellation rate per initiated cycle ($6.9{\pm}0.5$ mIU/ml vs $8.2{\pm}0.7$ mIU/ml, p<0.05; 1.0% vs 9.0%, p<0.05). Women with day 3 serum inhibin${\ge}45pg$/ml and day 3 FSH<15mIU/ml demonstrated higher pregnancy rate per initiated cycle (33.5% vs 9.5%, p<0.05) and lower day 3 FSH level, cancellation rate per initiated cycle ($7.7{\pm}0.2$ mIU/ml vs $8.5{\pm}0.5$ mIU/ml, p<0.05; 1.5% vs 10.0%, p<0.05). Women with day 3 serum inhibin${\ge}45pg$/ml and day 3 E2<50pg/ml demonstrated higher pregnancy rate per initiated cycle (30.0% vs 9.5%, p<0.05) and lower cancellation rate per initiated cycle (1.5% vs 9.5%, p<0.05). Women with day 3 serum inhibin${\ge}45pg$/ml, age<40 year, day 3 FSH<15mIU/ml and day 3 E2<50pg/ml demonstrated higher pregnancy rate per initiated cycle (30.0% vs 10.8%, p<0.05) and lower day 3 FSH level, cancellation rate per initiated cycle ($6.8{\pm}0.6$ mIU/ml vs $8.4{\pm}0.9$ mIU/ml, p<0.05; 1.5% vs 7.8%, p<0.05). Therefore women with low day 3 serum inhibin-B concentrations demonstrate a poorer response to ovulation induction and are less likely to conceive a clinical pregnancy though ART relative to women with high day 3 inhibin-B and day 3 serum inhibin-B, in addition to a day 3 FSH, E2 and patient age, appears helpful in prediction in IVF-ET outcome.
조직별 및 나이에 따른 마이토콘드리아 DNA 결손 (${\Delta}mtDNA^{4977}$)의 축적
정혜진,정형민,조성원,김현아,이경술,권황,최동희,곽인평,윤태기,이숙환,Jeong, Hye-Jin,Chung, Hyung-Min,Cho, Sung-Won,Kim, Hyun-Ah,Lee, Kyung-Sool,Kwon, Hwang,Choi, Dong-Hee,Kwak, In-Pyung,Yoon, Tae-Ki,Lee, Sook-Hwan 대한생식의학회 2003 Clinical and Experimental Reproductive Medicine Vol.30 No.3
Objectives: Controversial arguments exists on both the case for and against on the accumulation of mitochondrial DNA (mtDNA) deletion in association to tissue and age. The debate continues as to whether this mutation is a major contributor to the phenotypic expression of aging and common degenerative diseases or simply a clinical insignificant epiphenomenon. The objective of this study was to determine whether the accumulation of mtDNA deletion is correlated with age-related and tissue-specific variation. Materials and Methods: One hundred and fifty-seven tissues from blood, ovary, uterine muscle, and abdominal muscle were obtained from patients ranging in age from 31$\sim$60 years. After reviewing the clinical reports, patients with mitochondrial disorder were excluded from this study. The tissues were obtained at gynecological surgeries with the consent of the patient. Total DNA isolated from blood, ovary, uterine muscle, and abdominal muscle was amplified by two rounds of PCR using two pairs of primers corresponding to positions 8225-8247 (sense), 13551-13574 (antisense) for the area around deleted mtDNA and 8421-8440 (sense), 13520-13501 (antisense) for nested PCR product. A statistical analysis was performed by $x^2$-test. Results: About 0% of blood, 94.8% of ovary, 71.4% of uterine muscle, and 86.1% abdominal muscle harbored mtDNA deletion. When we examined the proportion of deleted mtDNA according to age deletion rate was 90% of ovary, 63.6% of uterine muscle, 77.7% of abdominal muscle in thirties and 100% of all tissue in fifties. Conclusion: The findings of this study suggest that the mtDNA deletion is varied in tissue-specific pattern and increases with aging.
태아 심에코로 진단한 심실중격결손이 없는 대혈관 전위 2 례
김인규,조진호,김경률,김병성,이경술,서동만 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.9
Transposition of the great arteries with intact ventricular septum (TGA IVS) is a cyanotic congenital heart disease with high neonatal mortality without early diagnosis. But TGA IVS is known to have good prognosis if treated by arterial switch operation (ASO) within 2 weeks after birth with early diagnosis. We diagnosed two cases of TGA IVS prenatally by fetal echocardiography. A case was diagnosed at 26th weeks of gestation, and the mother was transferred to a cardiac center for planned delivery. The baby had received ASO on postpartum 7th day, but he died of right ventricular failure on postoperative 8th day. The second case was diagnosed at 37th gestational weeks and was transferred to Asan medical center immediately after birth. And he is doing well without any treatment after ASO.
지용헌,김정수,조동제,정창조,신명철,이미화,이경술,원종건 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.8
Actinomycoces is a gram positive, anaerobic, branching and non-acid fast bacterium which is a normal habitant of the skin, oral cavity, tonsil and gastrointestinal tract and its human infection is rare. Pelvic actinomycoses is frequently caused by Actinomycoces israel-ii. It is chronic, progressive, and more suppurative than granulomatous disease, and the symptoms are usually persistent and gradual, therefore the misdiagnosis and improper trea-tment are not uncommon. Actinomycoses is generally classified as cervicofacial, abdominal and thoracic type ac- cording to the site of the primary infection. Many actinomycotic pelvic infections in women used intrauterine device with long du- ration were reported, in contrast, others suggest that actinomycoces developed opportunistic infection irrespective of intrauterine device presence. We have experienced 4 cases of pelvic actinomycoses, one case with IUD(Lippes` loop) in a 47 year old woman, the other case with abdominal wall ctinomycoses in a 34 year old woman, the third case without IUD in a 41 year old woman, the fourth case with IUD(Cu-7) in a 37 year old woman and reported them with a review of literature.
김재욱,조동제,이위현,차선희,이미화,이경술,원종건,강승룡 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.10
In this presentation, we describe a case of unruptured rudimentary uterine horn preg-nancy. The patient was diagnosed by laparoscopy and removed by laparoscopic resection of the pregnant rudmentary uterine horn, and then some articles concerned to this subject are reviewed briefly in order to discuss relevant method of diagnosis, treatment, and clinical characteristics.
원종건,배상욱,김진영,이지원,이병석,김정수,이경술,박기현,조동제,송찬호,Won, J.G.,Bai, S.W.,Kim, J.Y.,Yi, J.W.,Lee, B.S.,Kim, J.S.,Lee, K.S.,Park, K.H.,Cho, D.J.,Song, C.H. 대한생식의학회 1997 Clinical and Experimental Reproductive Medicine Vol.24 No.2
To evaluate the efficacy of transabdominal myomectomy in the management of infertile patients, and to analyze on the results of abdominal myomectomy in 38 infertile patients with no other detectable cause except myomas were undertaken at the Department of Obstetrics and Gynecology in Yonsei University Hospital from 1990 to 1996. The results are as follows; 1. Average age of patients was 31.1 years. The infertility duration ranged 12 months to 144 months, and average infertility period of patients was 29.4 months. 2. Fourteen of the 38 patients (8 of 23 patients with primary infertility, 6 of 15 patients with secondary infertility) conceived following myomectomy, with a pregnancy rate of 36.8%. 3. Patients with less than 4 years of infertility showed a higher pregnancy rate after myomectomy than those with more than 4 years of infertility (42.4% vs 0%, p<0.05). 4. Patients younger than 35 years showed significantly higher pregnancy rate than those older than 35 years (46.4% vs 9.0%, p<0.05). 5. The removal of a solitary myoma produced a significantly higher pregnancy rate than that of multiple myomas (47.8% vs 20.0%, p<0.05), and the size of the myomas did not influenced the pregnancy rate after myomectomy (p>0.1). 6. The average time period from operation to conception was 12.1 months. Eight of the 14 patients (57.1%) conceived in the first year after operation and 12 patients (85.7%) condeived within two years. In conclusion myomas are a possible cause of infertility and myomectomy can be strongly recommended with good success expectation for the infertile women if uterine myoma be considered as the main cause of infertility. And factors affecting the pregnancy rate after myomectomy in these patients are the age of the patient, the duration of infertiluty, and the number of myoma.