습관성유산 환자에서 발견된 톡소플라즈마감염 1 례

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.

전신성 홍반성 낭창을 동반한 반복임신손실 1 예

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.

동결-융해 배아 이식에서 손상된 할구의 미세 수술적 제거의 임상적 효과

최원윤,손지온,박은아,이동률,이우식,한세열,박이석,조정현,김수희,차광렬,윤태기,Choi, Won Yun,Sohn, Jie Ohn,Park, Eun A,Lee, Dong Ryul,Lee, Woo Sik,Han, Se Yul,Park, Lee Suk,Cho, Jung Hyun,Kim, Soo Hee,Cha, Kwang Yul,Yoon, Tae Ki 대한생식의학회 2005 Clinical and Experimental Reproductive Medicine Vol.32 No.1

Objective: Human infertility clinics have been faced the demand for improving clinical results. The purpose of this study was to evaluate the effect of microsurgical removal of damaged blastomeres (DB) in frozen-thawed embryos on the clinical outcomes. Methods: From January 2003 to May 2004, out of 258 thawing ET cycles were divided into three groups: Group-1 (n=46): Intact cleavaged embryos after thawing. Remained cycles with embryos containing DB were randomly divided into two groups. Group-2 (n=102): Drilling zona pellucida (ZP) of frozen-thawed embryos by acidified Tyrode's solution. Group-3 (n=110): Drilling ZP and removal of DB. Embryos after microsurgical manipulation were transferred into the uterus of patients. Results: Clinical profiles and the mean number of transferred embryos among three groups were not different. Pregnancy and implantation rates were similar in three groups. It were 30.4% and 9.3% in Group-1, 29.4% and 7.8% in Group-2, and 26.4% and 7.6% in group-3, respectively. Miscarriage rate in Group-3 (37.9%) was slightly higher than those in Group-1 and Group-2 (14.3% and 23.3%), but it was not statistically significant. Conclusion: Intact cleaving embryos after DB removal showed higher potent of pregnancy and implantation. We could not find any improvement of clinical outcome by removal of DB in frozen-thawed embryos.

자궁내 사망한 무뇌증을 동반한 쌍태 임신 1예

김수진 ( Su Jin Kim ),백종우 ( Jong Woo Baek ),박영세 ( Young Se Park ),공두식 ( Du Sik Gong ),이건호 ( Geun Ho Lee ),장태기 ( Tae Kee Jang ),강승룡 ( Syung Ryoung Kang ),백영일 ( Young Ihl Baek ),한세열 ( Se Yul Han ) 대한주산의학회 2006 大韓周産醫學會雜誌 Vol.17 No.3

최근 불임 치료 기술이 발달되면서 쌍태 임신의 빈도는 점차 증가하는 추세이다. 그러나 쌍태 임신에서 기형아가 단태 임신에서 보다 높은 빈도로 발생하고 특히 일측 태아에서 기형이 동반한 쌍태 임신의 경우, 적절한 치료 및 상담에 상당한 어려움이 있다. 본원 산부인과에서는 무뇌아를 동반한 쌍태 임신 산모에게 유전 상담을 통해 정상아의 폐성숙이 완성될 때까지 임신을 유지하기로 하여 임신 35주 6일까지 경과 관찰하던 중 무뇌아가 자궁내 사망하여 비정상 태위로 제왕절개를 통해 2,160 g의 정상아와 600 g의 측만증과 좌측 상지 부재를 동반한 무뇌아를 성공적으로 분만한 1예를 경험하였기에 간단한 문헌 고찰과 함께 보고하는 바이다. Twin Pregnancies are increasing these days due to recent development of the technology in treating infertility. twin pregnancies tend to cause more congenital anomalies than singleton pregnancies do. Especially when twin pregnancies are affected with one anomalous fetus combined to a normal one, the proper management and counseling are difficult. We experienced a twin pregnancy in which one anencephalic fetus was combined to a normal one, after close counseling we decided to continue the pregnancy. At 35 weeks 6 days of gestation, an anencephalic fetus was dead, so we delivered by cesarean section due to breech-cephalic presentation. The birth weight of the normal and anencephalic fetuses were 2160 gm and 600 gm, respectively. The anencephalic fetus was combined with scoliosis, absent left upper limb, and nuchal skin defect, but the healthy one showed good crying and movement and its Apgar score was 8 in 1 minute and 9 in 5 minute. Although the infant needed intensive care for 21days in the nursery room, she was finally discharged in good condition. We present this case with a brief review of the literature.

DIG System을 이용한 후레자일 X 증후군 ( Fragile X Syndrome ) 과 근이영양증 ( DMD ) 의 진단

이숙환(Sook Hwan Lee),조성원(Sung Won Cho),한정희(Jung Hee Han),이교원(Kyo Won Lee),한종설,차광은(Kwang Eun Cha),한세열(Se Yul Han),계정웅(Chung Woong Kay),조세현(Se Hyun Cho),엄기붕(Ki Boong Oum),곽인평(In Pyung Kwak) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.11

N/A The aim of this study was to develop a rapid and safe non-radioactive DIG DNA labeling and detection for Southern blot analysis for fragile X syndrome and Duchenne muscular dystrophy (DMD). Southern blot analysis is accurate test showing expression of the (CGG)n repeat and abnormal methylation pattern of CpG island in hagile X syndrome, and good confirmative secondary test in case of deletion in DMD. But in terms of test rapidity, these conventional radioactive Southern analysis may not be feasible for rapid screening of prenatal samples and at-risk populations to determine their status and to provide genetic counseling to their families. As an alternative radioactive Southern blotting, DIG DNA labeling and detection system does not require handling of radioactive material nor require learning any new technology. The complete procedure of labeling the DNA and hybridization to detection of the first visible signal can be compbsbed witbin 7 days. In addition, hybridization solutions containing labeled DNA can be reused several times after renewed denaturation.

반복적 시험관아기 배아이식 실패 환자에서 정맥내 면역글로블린요법

이숙환(Sook Hwan Lee),윤내영(Nae Young Youn),윤태기(Tae Ki Yoon),곽인평(In Pyung Kwak),이은정(Eun Jung Lee),최동희(Dong Hee Choi),한세열(Se Yul Han) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.1

목적: 반복적인 시험관아기-배아이식 실패 환자에서 정맥내 면역글로블린의 효과를 보고자 하였다. 방법: 총 9예의 반복적인 배아이식 실패 환자에서 새로운 시험관아기 시술시 배아이식 직전에 정맥내면역글로블린을 500mg/kg 투여하였다. 결과: 단 1예에서 착상에 성공하였고, 1예는 화학적임신이었다. 시술중 정맥내면역글로블린의 특이한 부작용은 없었다. 결론: 정맥내면역글로블린요법은 반복적 배아이식 실패환자에서 유용한 방법으로 여겨지지 않으나, 향후 면역요법에 대한 지속적인 연구가 필요할 것으로 사료된다. Objective: The implantation failure after embryo-transfer (ET) is a major continuing problem in in vitro fertilization (IVF). This study was undertaken to determine the effectiveness of intravenous immunoglobulin for treatment of individuals experiencing repeated unexplained in vitro fertilization-embryo transfer (IVF-ET) failure. Methods: A total of nine consecutive infertile patients who failed to become pregnant after previous IVF-ET replacing at least three or more normal developed embryos each were included in our study. During the subsequent new IVF-ET cycle, each women received intravenous immunoglobulin 500㎎/㎏ before the embryo transfer. Results: Only one implantation occurred. There were no remarkable side effects. A specific effect of intravenous immunoglobulin for patients with repeated IVF-ET failure could not be demonstrated. Conclusion: High-dose intravenous immunoglobulin may not be useful for patients with repeated failure of embryo transfer.

유행성 이하선염 감염 후에 발생한 전구성 조기난소부전 1예

한세열,윤태기,차광열,남윤성 대한폐경학회 1998 대한폐경학회지 Vol.4 No.2

"Premature ovarian failure has been arbitrarily defined as failure of ovarian estrogen production occurring in a hypergonadotropic state at any age between onset of menarche and 35, although some authors extend the age at 40. Biopsies obtained from the ovaries of these patients have two differnet histologic patterns. Some have marked generalized sclerosis similar to normal postmenopausal ovaries: others lack follicular development to the antrum stage, although primoudial follicles can be seen (hypofolliculogenesis). The latter finding differs from that seen in patients with gonadal streaks, who have a total lack of follicles. Mumps was one of the first infectious causes that were associated with premature ovarian failure. Cytomegalovirus oophoritis has been described in association with transplantation, lymphoma, and AIDS. One characteristic is the presence of necrosis, which is sometimes accompanied by an inflammatory reaction. We have experienced a case of prodromal premature ovarian failure that occurred after mumps infection. So we report this case with a brief review of literatures. "

항갑상선 항체를 동반한 조기난소부전 1예

최동희,한세열,윤태기,차광열,남윤성 대한폐경학회 1998 대한폐경학회지 Vol.4 No.2

Premature ovarian failure is a condition causing amenorrhea, hypoestrogenism, and elevated gonadotropins in women younger than 40 years. Although chromosomal and genetic abnormalities, enzymatic defects and iatrogenic agents, including cytotoxic drugs, pelvic irradiation and ovariectomy, have been cited as causes of premature ovarian failure, the most common cause is autoimmuity. Circulating antibodies to ovarian tissue have been demonstrated in the sera of patients with premature ovarian failure. In several studies 18-30% of patients with premature ovarian failure had associated autoimmune disorders including Hashimoto's thyroiditis, Grave's disease, Addisons disease, myasthenia gravis, hyperparathyroidism. Pernicious anemia, and mucocutaneous candidiasis. These patients have been grouped by the therm polyglandular syndrome. All patients in the series had a 46,XX chromosome complement and several patients, on ovarian biopsy, had evidence of lymphocytic infiltration of the ovaries. Theories regarding etiology or mechanism for autoimmunity in ovarian failure include genetic factors, antireceptor antibodies, and/or specific tissue antigens in the ovary, including the theca interna or granulosa cells. We have experienced a case of premature ovarian failure associated with antithyroid antibodies. So we report this case with a brief review of literatures.