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태반 영양모세포주의 혈관내피성장인자 분비에 미치는 Th1형 사이토카인들의 영향
정인배(In Bai Chung),최선주(Sun Ju Choi),홍민(Min Hong),최현일(Hyun Il Choi),이영심(Young Sim Lee),고춘명(Choon Myung Koh),박주영(Joo Young Park) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.5
N/A Embryo implantation and development are critically dependent upon the regulation of angiogenesis and adequate immunologic acceptance. These local angiogenesis and vascular permeability are regulated by the interaction between fetal trophoblast, uterine decidua, and endothelial cells through the key mediator, vascular endothelial growth factor (VEGF). Problem : The mechanism through which VEGF regulation occurs at the feto-maternal interface is poorly understood. The Th1 type cytokines are known to be harmful to the successful maintenance of early pregnancy at the feto-maternal interface. Objective : To clarify whether the Th1 type cytokines could be involved in the regulation of VEGF secretion at the feto-maternal interface. Method of Study : we investigated the effects of Th1 type cytokines on VEGF secretion in human first trimester trophoblast cell-line by using reverse transcription polymerase chain reaction(RT-PCR)and enzyme-linked immunosorbent assay (ELISA). Results : The trophoblast cells expressed VEGF constitutively and the main isoforms were VEGF121 and VEGF165. When cultured in the presence of IFN-γ or IL-2, VEGF secretion was most significantly increased by IFN-γ treatment but not affected by IL-2 treatment. The level of intracellular VEGF was also increased by IFN-γ treatment. Conclusion : These results suggest that IFN-γ, despite of harmful Th1 type cytokine to the maintenance of early pregnancy, may regulate the production of VEGF in early gestational trophoblasts.
체외수정 및 배아이식술후 임신과 자연 임신된 임신부에서 임신중기 삼중표지물질 검사결과의 비교분석
이정렬(Jeong Lyol Lee),이영심(Young Sim Lee),이상학(Sang Hag Lee),최중호(Jung Ho Choi),정인배(In Bai Chung),이영진(Young Jin Lee) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.9
N/A Objective : To compare and analysis the result of second trimester maternal serum triple marker screening test for Down syndrome and open neural tube defects in singleton pregnancies conceived by conventional in vitro fertilization- embryo transfer (IVF-ET) with that of the naturally conceived pregnancies. Methods : Maternal serum screening tests during the second trimester in 49 singleton pregnancies conceived by IVF-ET and 813 singleton pregnancies conceived naturally of whom delivery outcome was normal in each other were analyzed from April 1997 to June 2000. Results : 4 (8.2%) out of 49 cases of IVF-ET singleton pregnancies compared with 62 (7.6%) out of 813 cases of naturally conceived pregnancies had a positive results for Down syndrome or open neural tube defects. The median level of the triple markers were 1.03 0.47 multiples of the median (MoM) in IVF-ET pregnancies vs 1.05±0.39 MoM in natural pregnancies for alpha-fetoprotein (AFP), 1.11±0.64 vs 1.19±1.13 MoM for unconjugated estriol (uE3) and 1.21±0.56 vs 1.11±0.59 MoM for human chorionic gonadotropin (hCG). Conclusion : The positive rate of triple test and the median values of triple markers for Down syndrome and open neural tube defect between two groups were not different in terms of statistical significance. To provide an objective assessment of an individual patient's risk of fetal abnormality, the impact of IVF-ET on triple marker biochemistry should be studied further in larger samples and adjustments made if appropriate.
태반 영양모세포주의 class I 인체백혈구 항원 발현에 미치는 감마 인터페론의 역할
정인배 ( In Bai Chung ),한혜경 ( Hey Kyoung Han ),김나옥 ( Na Ok Kim ),하정식 ( Jung Sik Ha ),박현숙 ( Hyun Sook Park ),박주영 ( Joo Young Park ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.2
지난 반세기 동안 태아가 모체의 면역 거부반응으로부터 회피될 수 있는 기전은 아직까지 정확히 규명되지 못하고 있다. 태아모체간 계면에서의 면역학적 기전이상은 자연 유산 및 습관성 유산을 비롯한 각종 임신 합병증들의 병인으로 작용하므로 그 기전 규명은 매우 중요하다. 핵심은 융모외 세포영양모세포 (extravillous cytotrophoblasts)가 표현하는 인체백혈구 항원 (HLA-C, E, G)과 NK 세포 수용체 (receptor)들과 상호 관계 Precise mechanism which the fetus can escape from mother`s immune rejection is not well understood yet during last 50 years. The clarification of immune mechanism at the feto-maternal interface is very important, because this can be a common pathogenesis
발육제한 태아에서 placental ratio 와 신생아 이환률과의 관계
이준희(Jun Hee Lee),정인배(In Bai Chung),이영심(Young Sim Lee),최중호(Jung Ho Choi),이정렬(Jeong Yel Lee),한혁동(Hyuck Dong Han),이영진(Young Jin Lee) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.12
N/A An increased placental ratio has known to be associated with the occurrence of cardiovascular complications in adulthood among the intrauterine fetal growth restriction. A retrospective study on 202 singleton growth-restricted infants without major congenital anomalies born from Jan. 1995 to Feb. 2001 was performed to determine the relationship between placental ratio and neonatal morbidity. The cases were categorized into three groups according to the placental ratio (<1SD below the mean, within 1SD of the mean, >1SD above the mean). There were no differences in the maternal characteristics and antenatal complications except pregnancy induced hypertension between high placental ratio group and the other groups. It presented the trend that was toward the increase of placental weight and the decrease of birth weight in high placental ratio group. The infants with a high placental ratio had increasing tendencies of meconium stained amnionic fluid, hypocalcemia, phototherapy, asphyxia.
인공적 보조생식기술에 의하여 임신된 쌍태임신에 대한 삼태임신의 임산부 및 주산기 예후비교
최창익(Chang Ik Choi),정인배(In Bai Chung),오갑영(Gab Young Oh),최기동(Ki Dong Choi),최현일(Hyun Il Choi),한혁동(Hyuck Dong Han),이영진(Young Jin Lee) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.9
본 연구는 인공적 보조생식기술에 의하여 임신된 쌍태임신에 대한 삼태임신의 임산부 및 주산기 예후를 비교하고자 시행되었다. 제태기간이 18주 이상 유지된 18예의 삼태임신 각각은 임산부 연령, 분만 예정일, 분만 과거력, 조산의 과거력, 인공적 보조생식기술의 적응증에 따라 2예의 쌍태임신과 짝을 이루어 비교 분석 되었다. 삼태임신에서 쌍태임신보다 유의하게 짧은 제태기간(30.4주 대 34.6주)과 저체중(1,514 gm대 2,286 gm)소견을 보였다. 평균 입원기간도 삼태임신에서 유의하게 길었으며 (22.3일 대 10.1일) 7점 이하의 5분 Apgar 치인 경우와 신생아 사망의 빈도도 18(33.3%)예 대 6(8.3%)예, 15(27.8%)예 대 7(9.72%)예로서 삼태임신에서 더 흔하였다. 신생아 호흡 곤란증은 14(25.9%)예 대 7(9.72%)예, 기계적 호흡보조가 필요했던 예는 18(33.3%)예 대 5(6.9%)예, 신생아 발작은 9(16.7%)예 대 0예 로서 신생아 합병증에서도 통계적으로 유의하게 삼태임신에서 불량하였다. 그러나 선천성 기형, 고빌리루빈 혈증, 뇌실 출혈, 기관폐분절 이형성증 같은 신생아 이환율과 임산부 합병증에서는 통계적으로 유의한 차이를 보이지는 않았다. 따라서 이러한 삼태임신시의 불량했던 연구결과는 인공적 보조생식기술의 결과로 임신한 삼태 임신의 주산기 예후에 대한 상담 및 처치에 기초자료로 이용될 수 있다고 사료된다. The present study was performed to compare maternal and perinatal outcomes in triplet and twin pregnancies with the result of ART(Assisted Reproductive Technology). Each pregnancy of 18 triplet pregnancies with 18 weeks or more was matched for maternal age, EDC(estimated date of confinement), parity, history of preterm delivery, indication of ART with two sets of twin pregnancies. Triplet pregnancies had a significantly shorter gestational age at delivery than twin pregnancies(30.4 versus 34.6 weeks), and a significantly lower mean birth weight(1,514 versus 2,286g). The mean hospital stay was significantly longer in triplets(22.3 versus 10.1 days). The incidences of 5 min Apgar score less than 7, neonatal deaths were significantly more often in triplets than twins ; 18(33.3%) vs 6(8.3%), 15(27.8%) vs 7(9.72%), respectively. There were significant differences in the incidence of neonatal complications such as respiratory distress syndrome ; 14(25.9%) vs 7(9.72%), ventilatory support ; 18(33.3%) vs 5(6.9%) , neonatal seizure ; 9(16.7%) vs 0, btween the two groups. However, there were no significant differences between the groups in maternal complications or neonatal morbidity such as congenital malformations or hyperbilirubinemia, intraventricular hemorrhage, or bronchopulmonary dysplasia. We suggest that counseling patient regarding the anticipated perinatal outcomes of triplet pregnancies with the result of ART should be conducted with our data.