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체외수정시술시 에스트로겐 수용체 유전자 PvuII 및 XbaI 다형성이 과배란유도 및 임신 결과에 미치는 영향
황규리 ( Kyu Ri Hwang ),최영민 ( Young Min Choi ),윤지성 ( Ji Sung Yoon ),이원돈 ( Won Don Lee ),구승엽 ( Seung Yup Ku ),지병철 ( Byung Chul Jee ),서창석 ( Chang Suk Suh ),김석현 ( Seok Hyun Kim ),김정구 ( Jung Gu Kim ),문신용 ( S 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.8
목적: 체외수정시술을 받는 불임 여성에서 에스트로겐 수용체 유전자의 PvuII 및 XbaI 다형성이 난포 및 획득된 난자의 개수, 배란유도제의 총 투여량, 이식된 배아의 개수 등의 과배란유도 결과와 착상율 및 임신율에 미치는 영향을 살펴보고자 하였다. 연구 방법: 2001년 3월부터 2003년 10월까지 과배란유도 및 체외수정시술을 시행하였으며, 배란 장애가 없는 40세 미만의 189명의 불임 환자를 대상으로, 이들 환자에서 에스트로겐 수용체 유전자의 Objective: The purpose of this study was to investigate the association of the estrogen receptor α gene polymorphism (PvuII and XbaI) with outcomes of controlled ovarian hyperstimulation for in- vitro fertilization and embryo transfer (IVF-ET). Methods: T
자궁내막증 환자에서 Interleukin-10 유전자 -592 다형성 양상
황규리 ( Kyu Ri Hwang ),최영민 ( Young Min Choi ),김종미 ( Jong Mee Kim ),김진주 ( Jin Ju Kim ),박경아 ( Kyoung Ah Park ),지병철 ( Byung Chul Ji ),구승엽 ( Seung Yup Ku ),서창석 ( Chang Suk Suh ),김석현 ( Seok Hyun Kim ),김정구 ( 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.7
목적: 한국 여성에서 interleukin-10 (IL-10) 유전자 -592 다형성과 자궁내막증의 연관성에 대하여 조사하고자 하였다. 연구 방법: 수술 소견 또는 조직검사상 자궁내막증으로 진단된 254명의 여성을 환자군으로 하였으며, 복강경 검사 또는 개복술을 시행하였으나 자궁내막증의 증거를 발견할 수 없었던 236명을 대조군으로 하였다. 이들 대상인들에서 IL-10 유전자 -592 다형성 양상을 PCR 및 RFLP를 이용하여 분석하였다. 결과: 자궁내막증 환자군과 대조군 사이에 IL-10 유전자 -592 다형성의 유전자형 및 대립유전자의 분포 양상은 유의한 차이가 없었다 (AA: AC: CC, 41.3%: 51.2%: 7.5% vs 44.9%: 50.8%: 4.2%). 또한 자궁내막증 환자군을 I-II기와 III-IV기로 세분하였을 때에도 IL-10 유전자 -592 다형성의 유전자형 및 대립유전자의 분포 양상은 대조군과 유의한 차이가 없었다. 결론: 한국 여성에서 IL-10 유전자 -592 다형성은 자궁내막증 발생과 연관이 없는 것으로 사료된다. Objective: To explore the association of the interleukin-10 (IL-10) gene -592 promoter polymorphism with endometriosis in a Korean population. Methods: This study comprised 254 women with surgically or histologically diagnosed endometriosis, 236 control women with no evidence of endometriosis by laparoscopy or laparotomy. Following extraction of genomic DNA, genotyping of the IL-10 gene -592 polymorphism was performed by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) analysis. Results: The distribution of genotypes and allele frequencies of IL-10 gene -592 polymorphism in the endometriosis group did not differ from those in the control group (A/A: A/C: C/C, 41.3%: 51.2%: 7.5% vs. 44.9%: 50.8%: 4.2%). And when classified by stage, there was also no significant difference in the distribution of IL-10 gene -592 polymorphism between patients with stage I-II (ASRM, 1997) endometriosis or patients with stage III-IV endometriosis and controls. Conclusion: These results suggest that IL-10 gene -592 promoter polymorphism is not associated with the risk for endometriosis in the Korean women.
다낭성 난소 증후군 환자에서 메트포민 치료의 효과와 인슐린 저항성
황규리 ( Kyu Ri Hwang ),최영민 ( Young Min Choi ),최두석 ( Doo Seok Choi ),백광현 ( Kwang Hyun Baek ),전혜원 ( Hye Won Jeon ),배광범 ( Kwang Bum Bae ),손영수 ( Young Soo Son ),구승엽 ( Seung Yup Ku ),지병철 ( Byung Chul Jee ),서 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.10
목적 : 한국의 다낭성 난소 증후군 여성에 있어서 배란 및 월경 회복에 미치는 메트포민의 효과와 인슐린 저항성의 관련 여부를 파악하고자 한다. 연구 방법 : 2001년 9월부터 2003년 9월까지 서울대학교병원 산부인과에 내원한 여성 중 다낭성 난소 증후군으로 진단된 23명을 대상으로 메트포민을 하루 1500㎎ 투약하였다. 3개월간 복용 후 규칙적인 월경 또는 배란의 유무를 조사하여 메트포민의 반응을 평가하였고 반응군과 무반응군의 인슐린 저항성을 비교하 Objective : This study was performed to investigate the effect of metformin treatment and insulin resistance in the patients with polycystic ovary syndrome. Methods : Twenty three patients with polycystic ovary syndrome were included at Seoul National Uni
최영민(Young Min Choi),황규리(Kyu Ri Hwang),정현훈(Hyun Hoon Chung),서창석(Chang Suk Suh),김석현(Seok Hyun Kim),김정구(Jung Gu Kim),문신용(Shin Yong Moon),이진용(Jin Yong Lee) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.10
Testicular regression syndrome is representative of a clinical range of 46,XY agonadal persons, in which the testes of the victim`s are irreparably damaged at a critical stage in fetal development. The critical stage of testicular regression syndrome is represented by a range of abnormalities of genital development. Recently, we experienced a case of early fetal testicular regression syndrome with no definite gonad and a cloacal anomaly associated with imperforate anus, so we present it with brief review of literature.
자기공명영상에 의한 자궁내막암의 자궁근층 , 자궁경부 침윤 판별과 수술적 병기와의 비교
전용탁(Yong Tark Jeon),황규리(Kyu Ri Hwang),김재원(Jae Weon Kim),박노현(Noh Hyun Park),송용상(Yong Sang Song),강순범(Soon Beom Kang),이효표(Hyo Pyo Lee) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.9
N/A Objective : The aim of this study was accuracy evaluation of MRI in prediction of myometrial, cervical invasion in endometrial carcinoma by comparing with histopathologic findings and to find causes of inaccurate MRI readings. Method : Fifty patients with endometrial carcinoma who were evaluated with MRI imaging prior to surgery were reviewed. And then, we compared MRI findings and histopathologic findings in view of myometrial, cervical invasion. Results : Overall accuracy of MRI in prediction of myometrial invasion was 48%. Sensitivity/specificity/ PPV/NPV in prediction of no myometrial invasion were 100%/42.9%/42.9%/100% respectively, in prediction of superficial myometrial invasion were 20.0%/86.7%/50.0%/61.9% respectively, in prediction of deep myometrial invasion were 33.3%/94.3%/71.4%/76.7%, respectively. Accuracy in prediction of cervical invasion was 84% and sensitivity/specificity/PPV/NPV were 50.0%/88.6%/37.5%/92.9% respectively. Among the probable causes of inaccurate MRI readings, polypoid tumor occupies large portion. Conclusion : MRI has some value in pre-operative evaluation of patients with endometrial carcinoma. We should cautiously accept the MRI readings when tumor shows polypoid growth.
불임환자에서 체외수정시술시 난소내 기질 동맥 Doppler 초음파검사 및 혈청 Glycodelin 측정의 임신 예측인자로서의 임상적 효용성
김선미 ( Sun Mie Kim ),황규리 ( Kyu Ri Hwang ),김진주 ( Jin Ju Kim ),문정애 ( Jung Ae Moon ),방영주 ( Young Joo Bang ),지병철 ( Byung Chul Jee ),구승엽 ( Seung Yup Ku ),서창석 ( Chang Suk Suh ),최영민 ( Young Min Choi ),김정구 ( J 대한산부인과학회 2005 Obstetrics & Gynecology Science Vol.48 No.3
목적: 불임환자의 체외수정시술 (IVF-ET)시 난소내 기질 동맥의 도플러 초음파검사 및 황체기 자궁내막의 주요 단백질 생산물인 glycodelin (placental protein 14, PP14)의 혈청 농도 측정의 체외수정시술 후 임신 예측인자로서의 임상적 효용성을 평가하고자 하였다. 연구 방법: 2003년 4월부터 2004년 3월까지 서울대학교병원 산부인과 불임클리닉에서 체외 수정시술을 시행받은 정상 난소 반응이 기대되는 불임환자 57명의 57주 Objective: To assess the clinical efficacy of intraovarian artery stromal Doppler ultrasonography and serum glycodelin (placental protein 14, PP14) as prognostic factors of pregnancy in vitro fertilization and embryo transfer (IVF-ET) cycles. Methods: Fif
체외수정시술시 난포자극호르몬 수용체 유전자 다형성이 과배란유도 및 임신 결과에 미치는 영향
윤지성,최영민,임경실,허창영,강영제,정재훈,이원돈,임진호,황규리,지병철,구승엽,서창석,김석현,김정구,문신용,Yoon, Ji-Sung,Choi, Young-Min,Lim, Kyung-Sil,Hur, Chang-Young,Kang, Young-Je,Jung, Jae-Hoon,Lee, Won-Don,Lim, Jin-Ho,Hwang, Kyu-Ri,Jee, Byun 대한생식의학회 2004 Clinical and Experimental Reproductive Medicine Vol.31 No.2
Objective: To investigate the association of FSH receptor (FSHR) polymorphism at position 680 with outcomes of controlled ovarian hyper-stimulation for IVF-ET in Korean women. Design: Genetic polymorphism analysis. Materials and Methods: The FSHR polymorphism was analyzed by PCR-RFLP in 172 ovulatory women below the age of 40 year. Patients with polycystic ovary syndrome, endometriosis, or previous history of ovarian surgery were excluded. Results: Genotype distribution was 41.9% for the Asn/Asn, 47.7% for the Asn/Ser, and 10.5% for the Ser/Ser FSHR genotype group. There was no difference in age of subjects and infertility diagnosis between genotype groups. When the patients were grouped according to their FSHR genotype, the basal levels of FSH (day 3) were significantly different among the three groups ($6.0{\pm}0.3\;IU/L$ (mean $\pm$ SEM), $5.8{\pm}0.3\;IU/L$, and $8.6{\pm}1.2\;IU/L$ for the Asn/Asn, Asn/Ser, and Ser/Ser groups, respectively, p=0.002). The Ser/Ser group showed a higher total doses of gonadotropins required to achieve ovulation induction, and a lower serum estradiol levels at the time of hCG administration compared with other two groups, but the differences were of no statistical significance. The numbers of oocytes retrieved were significantly different among the three groups ($8.6{\pm}0.8$, $9.9{\pm}0.6$, and $6.3{\pm}0.9$, for the Asn/Asn, Asn/Ser, and Ser/Ser groups, respectively, p=0.049). Clinical pregnancy rates were 42.4%, 25.9%, and 29.4% for the Asn/Asn, Asn/Ser, and Ser/Ser groups, respectively. Conclusion: Homozygous Ser/Ser genotype of FSHR polymorphism at position 680 was associated with decreased ovarian response to gonadotropin stimulation for IVF-ET.
Methotrexate를 투여하여 보존적 치료를 시행한 감입태반
김명신 ( Myung Sin Kim ),이현의 ( Hyun Ui Lee ),윤정민 ( Jung Min Yoon ),황규리 ( Kyu Ri Hwang ),전혜원 ( Hye Won Jun ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.11
Placenta increta is a kind of placental adhesion which can cause severe postpartum hemorrhage and life-threatening condition. It might necessitate a hysterectomy, but conservative management can be considerable for preserving reproductive potential when possible. A 34-years-old woman in her 41st week of pregnancy had normal full term spontaneous delivery. Retained placenta after removal by placenta forceps resulted in mild bleeding. Placenta increta was clinically diagnosed on computerized tomography. Remnant placenta in situ was nearly disappeared 2 months later after five-time intramuscular injection of 50 mg methotrexate and three-times curettage was done for conservative management.
임신중절에 대한 사회적 여건 변화에 따른 임신 중기 양수검사의 감소
전혜원 ( Hye Won Jeon ),이택상 ( Taek Sang Lee ),배광범 ( Kwang Bum Bai ),황규리 ( Kyu Ri Hwang ),김병재 ( Byung Jae Kim ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.12
목적: 임신중절에 대한 사회적 여건변화가 임신 중기 양수검사 수용에 미치는 영향을 알아보고자 하였다. 연구 방법: 2009년 2월 1일부터 2010년 8월 31일까지 외래에 방문한 임신 20주 미만의 단태임신 산모를 대상으로 의무기록을 후향적으로 조사하였다. 2009년 11월까지(2009년 군)와 그 이후 기간(2010년 군)의 양상을 비교하였고, 개인병원에서 의뢰된 산모와도 비교하였다. 결과: 임신중절이 엄격하게 제한되기 시작한 2009년 12월 이후 임신중기 양수검사 빈도가 이전의 19% (19/101)에서 11% (10/93)로 감소하였으나 통계적 차이는 없었다(P=0.16). 35세 이상인 산모에서는 2010년 군(5/30, 25%)이 2009년 군(15/30, 50%)보다 유의하게 양수검사 수용도가 낮았고(P=0.01), 선별검사에서 고위험군으로 양수검사를 권유 받은 경우를 포함하여 분석하였을 때에도 유의하게 낮았다(9/35, 26% vs 19/34, 56%; P=0.02). 개인병원에서 이상소견이 있었거나, 고령으로 양수검사를 권유 받아 의뢰된 35명의 산모에서는 2009년 군(15/21, 71%)에 비해 2010년 군(13/14, 93%)에서 양수검사를 시행하는 빈도가 오히려 증가하는 양상이었지만, 유의한 차이는 없었다(P=0.20). 결론: 임신중절에 대한 사회적인 여건의 변화로 염색체 이상 및 신경관결손증의 고위험군에서 양수검사를 수용하는 빈도가 유의하게 감소하였는데, 외부병원에서 의뢰된 경우에는 변화가 없었다. Objective: To investigate the effect of alteration of social conditions towards pregnancy termination on the acceptance of genetic amniocentesis. Methods: Retrospective review of medical records was conducted for women (<20 weeks` gestation, singleton pregnancy) who visited our outpatient department between February 1, 2009 and August 31, 2010. Acceptance of genetic amniocentesis was compared between two groups of women: one from February 1, 2009 to November 30, 2009 (2009 group) and the other from December 1, 2009 to August 31, 2010 (2010 group) after strict regulation of pregnancy termination. The acceptance rate of those who were referred to our center for genetic amniocentesis in same time period was also evaluated. Results: Overall, 19 of 101 (19%) women in the 2009 group and 10 of 93 (11%) in the 2010 group, opted for invasive diagnostic methods (P=0.16). Women > 35 years in the 2010 group (5/30, 17%) were less likely to accept genetic amniocentesis than 2009 group (15/30, 50%; P=0.01). Similar results were observed in those who were indicated for genetic amniocentesis. (9/35, 26% vs 19/34, 56%; P=0.02). Acceptance rate of genetic amniocentesis was increased for those who were referred from private clinic, but without statistical significance (15/21, 71% vs 13/14, 93%; P=0.20). Conclusion: After strict regulation of pregnancy termination, acceptance rate of genetic amniocentesis was significantly decreased among women who had increased risk for chromosomal abnormalities or neural tube defect at our center. Whereas, there were no significant change in acceptance rate for those who were referred for amniocentesis from private clinic.