Prenatal sonographic diagnosis of fetal thymic hyperplasia.

( Youn Sil Choo ),( Won Joon Seong ),( Seong Yeon Hong ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.98 No.-

Prenatal diagnosis of fetal thymic hyperplasia is extremely rare. There is wide variation in the appearance of the thymus on sonographic imgaing and it can often lead to erroneous suspicion of cardiomegaly or mediastinal mass. Here in, we report a case in which fetal thymic hyperplasia was diagnosed by fetal ultrasonography. A 31-year-old primi pregnant woman was referred to our hospital at 30 weeks of gestation because of abnormal pathway of superior vena cava with mediastial mass.The three vessel view of fetal sonogram revealed right lateral deviation of superior vena cava and about 5x3cm sized mass in the mediastium which showed homogeneous echogenecity, seemed to be thymic hyperplasia. It was combined with right MCDK. After term delivery, neonatal CT angiography confirmed thymic hyperplasia with abnormal great vessel pathway because of mass effect. The baby looked grossly healthy and had no respiratory distress after birth.

Prenatal diagnosis of congenital fetal scoliosis caused by uterine synechiae

( Youn Sil Choo ),( Jin Yeong Bae ),( Won Joon Seong ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.98 No.-

We report a case of fetal spinal deformity caused by uterine synechiae. The spine was flexed laterally at the cervicothoracic junction throughout fetal life. The gravida had a history of uterine synechiae. Non-enhanced MRI imaging revealed a distorted amniotic cavity appearing like a snowman, with the fetal spine curving sharply and represented a shoulder presentation Although, a radiograph acquired postpartum showed mild spinal flexion, the spine straightened after two months. There was not any serious morbidity during one year follow up of newborn. We advise caution following a careful evaluation before arriving at a decision of termination.

생식샘자극호르몬 분비호르몬 길항제를 이용한 난소자극 투여법에서의 경구복합피임제의 전처지: 비교 연구

추연실 ( Youn Sil Choo ),한애라 ( Ae Ra Han ),양승헌 ( Seung Heon Yang ),성나영 ( Na Young Sung ),차선화 ( Sun Hwa Cha ),김혜옥 ( Hye Ok Kim ),박찬우 ( Chan Woo Park ),송인옥 ( In Ok Song ),궁미경 ( Mi Kyoung Koong ),강인수 ( In S 대한산부인과학회 2011 Obstetrics & Gynecology Science Vol.54 No.10

목적 생식샘자극호르몬 분비호르몬 길항제를 이용한 난소자극 투여법에서 경구복합피임제의 전처치가 체외수정시술의 결과에 미치는 효과에 대해 평가해 보고자 하였다. 연구방법 2009년 9월 1일에서 2010년 2월 28일까지 본원 불임센터에서 체외수정시술을 위해 총 194회의 생식샘자극호르몬 분비호르몬 길항제 요법을 시행한 환자 중 경구복합피임제를 전처치한 경우와 그렇지 않은 경우의 체외수정 및 배아이식술의 진료 기록을 찾아 후향적으로 분석하였다. 결과 경구복합피임제 전처치군의 경우 사용된 생식샘자극호르몬의 사용량이 전처치하지 않은 군보다 많았다(3019.38±1379.00 vs. 2551.52 ± 1157.05 IU, P = 0.054). 난소 자극 시작부터 난소 채취를 위한 마지막 생식샘자극호르몬의 투여일까지 기간 또한 경구복합피임제 전처치 군(11.5 ± 2.0)에서 전처치하지 않은 않은 군(9.5 ± 1.9)에 비해 통계학적으로 의미 있게 길었다(P = 0.000). 배아 총 획득 갯수(2.8 ± 0.9 vs. 2.5 ± 1.0, P = 0.055) 및 난자수정률(77.2% vs. 65.5%, P = 0.017) 또한 경구복합피임제 전처치 군에서 처치 하지 않은 군에 비해 통계학적으로 의미 있게 높았다. 한편, 임신율에 있어서는 두 그룹 간에 통계학적으로 유의한 차이가 없었다(39.4% vs. 30.0%; P = 0.0304). 결론 체외수정시술을 위한 생식샘자극호르몬 분비호르몬 길항제 사용 시 경구복합피임제를 전처치 하였을 때, 그렇지 않은 군에 비해 최종적인 체외수정시술의 결과적인 측면에서 현저한 장점은 없는 것으로 보인다. 하지만 좀 더 명확한 결론을 도출하기 위해서는 더 많은 연구군을 포함한 전향적인 연구가 필요할 것으로 생각된다. Objective To evaluate whether oral contraceptive pill (OCP) pretreatments in gonadotropin-releasing hormone (GnRH) antagonist ovarian stimulation protocols takes positive effects on in vitro fertilization (IVF) outcomes in respect to retrieved oocyte number, oocyte maturation rate, fertilization rate, good quality embryo rate, cycle cancellation rate, pregnancy rate and clinical abortion rate. Methods A total of 194 cycles using GnRH antagonist protocol was performed at infertility clinic of our institute from September 1st, 2009 to February 28th, 2010. The medical records of GnRH antagonist protocols for IVF with or without OCP pretreatment in our IVF unit were retrospectively analyzed. We compared the IVF outcomes between OCP pretreated (n=41) and no pretreatment group (n=153). Results In cycles with OCP pretreated group, the total used dosage of gonadotropin (3019.38±1379.00 IU) were higher than that of no pretreatment group (2551.52 ± 1157.05 IU, P = 0.054). The duration of ovarian stimulation in OCP pretreated group (11.5 ± 2.0) was significantly longer than that of control group (9.5 ± 1.9, P = 0.000). The number of gained total embryo (2.8±0.9 vs. 2.5±1.0, P = 0.055) and fertilization rate (77.2% vs. 65.5%, P = 0.017) were significantly higher in OCP pretreated group. There is no significant difference in pregnancy rate between two groups (39.4% vs. 30.0%, P = 0.304). Conclusion OCP pretreatment before GnRH antagonist protocol for IVF appears not to have reliable benefit in terms of IVF outcomes. Wellcontrolled and large-scaled studies are needed.

Bone Marrow T Cells are Superior to Splenic T Cells to Induce Chimeric Conversion After Non-Myeloablative Bone Marrow Transplantation

( Hyun Sil Park ),( Seok Goo Cho ),( Min Jung Park ),( So Youn Min ),( Hong Seok Chang ),( Hee Je Kim ),( Seok Lee ),( Chang Ki Min ),( Jong Wook Lee ),( Woo Sung Min ),( Chun Choo Kim ),( Ho Youn Kim 대한내과학회 2009 The Korean Journal of Internal Medicine Vol.24 No.3

Background/Aims: The bone marrow functions not only as the primary B-lymphocyte-producing organ but also as a secondary lymphoid organ for CD4 and CD8 cell responses and a site of preferential homing and persistence for memory T cells. Bone marrow T (BM-T) cells are distinguished from peripheral blood T cells by surface phenotype, cytokine secretion profile, and immune functions. In this study, we evaluated the alloreactive potential of donor lymphocyte infusion (DLI) using BM-T cells in mixed chimerism compared to that using spleen T (SP-T) cells. Methods: Cells were prepared using established procedures. BM-T cells were obtained as a by-product of T-cell depletion in BM grafting and then cryopreserved for subsequent DLI. We performed DLI using BM-T cells in allogeneic mixed chimera mice on post-BMT day 21. Results: When the same dose of T cells, 5-10×105 (Thy1.2+), fractionated from BM and spleen were administered into mixed chimeras, the BM-T group showed complete chimeric conversion, with self-limited graftversus-host disease (GVHD) and no pathological changes. However, the SP-T group showed persistent mixed chimerism, with pathological signs of GVHD in the liver and intestine. Conclusions: Our results suggest that DLI using BM-T cells, even in small numbers, is more potent at inducing chimeric conversion in mixed chimerism than DLI using SP-T cells. Further study is needed to determine whether cryopreserved BM-T cells are an effective cell source for DLI to consolidate donor-dominant chimerism in clinical practice without concerns about GVHD. (Korean J Intern Med 2009;24:252-262)

OB-39 : Comparison of the placental weight according to the cause of preterm birth

( Hyun Hwa Cha ),( Youn Sil Choo ),( Won Joon Seong ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-

The aim of this study is to evaluate placental weight in preterm birth and study whether there is the difference of it depending on the cause of preterm birth. We conducted a retrospective study involving 307 singleton pregnant women who delivered before 37 complete weeks from January 2011 to June 2013. We reviewed the medical records and obtained maternal characteristics and pregnancy outcomes including birth weight and placental weight. We divided our study group into two groups: Spontaneous preterm birth group defined as preterm labor, preterm premature rupture of membranes (PPROM), and incompetent of internal os of cervix (IIOC). The other group included hypertension in pregnancy, maternal medical diseases, placental origin and fetal origin. We compared maternal characteristics and the fetal-placental weight ratio between two groups. The number of spontaneous preterm birth was 195 (63.5%) and the other group was 112 (36.5%). Spontaneous preterm birth group showed younger age than the other groups (31.9 ± 4.8 vs. 33.5 ± 4.5, p=0.003) and lower Cesarean section rate (42.1% vs. 85.1%, p<0.001). From total population, the median placental weight was 700g (range 150-1400g). Though there was no significant difference in gestational age at delivery between two groups (33.3 ± 3.0 vs. 33.1 ± 3.2, p=0.628), the mean birth weight of spontaneous preterm birth group was significantly heavier than other group (2.21 kg vs. 1.89 kg p=0.003). However, there was no significant difference in placental weight (median 700g (range: 150-1400g) vs. median 700g (range: 150-1250g), p=0.881). Our study showed that median placental weight in preterm birth. Our study implied that the difference of birth weight might be revealed without the difference of placental weight.

OB-26 : Usefulness of MDCT in patients with postpartum hemorrhage to predict heavy bleeding and necessity of angiographic embolization

( Ji Yeong Lee ),( Hyun Hwa Cha ),( Youn Sil Choo ),( Won Joon Seong ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-

This study was designed to evaluate retrospectively the usefulness of MDCT in the identification of heavy bleeding as a determinant of angiographic embolization(AE) in patients with PPH. Fifty-seven consecutively registered patients with PPH underwent contrast-enhanced MDCT in Kyungpook National University Hospital from Jan 2009 to Dec 2012. CT scans were retrospectively interpreted by abdominal radiologist. The characteristics of 33 patients who showed extravasation of contrast material in MDCT (EV group) were compared with those of 24 patients who had no extravasation (NoEV group). AE was performed in 23 of 57 cases by clinician`s decision and the direct localization of bleeding site was compared with the result of MDCT. Hysterectomy was done in one case without AE because of unstable vital sign and remaining 33 patients were conservatively managed without AE. EV group needed AE more frequently than NoEV group (64% vs 8%). EV group showed heavier expected blood loss (EBL) [median: 2100 ml (range: 870-6500) vs 1170 ml (700-2420), p=0.000] and was associated with massive blood transfusion [6pint (2-32) vs 3pint (2-9), p=0.000]. Although preCT hemoglobin (Hb) level was not significantly different, postCT (one day) Hb was lower in EV group [8.2g/dl 4.8-10.1) vs 9.0 (7.4-13.1), p=0.008]. Both fibrinogen level and platelet count was also lower and consequenty, DIC was more frequent in EV group (36% vs 8%). Of 33 patients who were managed conservatively without AE, EBL after MDCT was heavier in EV group than NoEV group 410 ml (50-1070) vs 45 ml (0-450), p=0.000]. Comparing CT and angiographic findings, only one case was discordant which resulted from difficulties of left and right decision in case of central contrast extravasation. AE was successful in all cases and resulted no severe morbidity. Contrast-enhanced MDCT is helpful to determine which patients are candidates for AE and to reduce unnecessary angiographic intervention.

Poster Session : Extracellular ATP is generated by OXPHOS complexes Localized in the Lipid rafts of C2C12myocytes

( Bong Woo Kim ),( Joong Won Lee ),( Chang Seok Lee ),( Hyo Jung Choo ),( Soon Young Jung ),( Jae Sung Yi ),( Oh Bong Kwon ),( Young Sil Youn ),( Gye Soon Yoon ),( Young Gyu Ko ) 한국생화학분자생물학회 (구 한국생화학회) 2006 생화학분자생물학회 춘계학술발표논문집 Vol.2006 No.-

VACTERL 연관에서 동반된 결장폐쇄의 1예

황보지혜 ( Ji Hye Hwangbo ),허은영 ( Eun Young Heo ),추연실 ( Youn Sil Choo ),배진영 ( Jin Young Bae ),김미주 ( Mi Ju Kim ),성원준 ( Won Joon Seong ) 대한산부인과학회 2012 Obstetrics & Gynecology Science Vol.55 No.9

척추장애, 직장항문기형, 심장기형, 기관식도기형, 신장기형, 사지장애 등 여섯 개의 선천기형 중 세 개 이상일 때 정의할 수 있는 vertebral, anal, cardiac, tracheoesophageal, renal and limb (VACTERL) 연관은 환아에 따라 임상양상이 다양하다. 산전 초음파상 태아복부에 결장폐쇄 의심 종괴가 관찰되었으며 환아는 단일제대동맥, 반척추뼈증, 비골형성저하, 심실중격 결손 및 동맥관 개존, 결장폐쇄를 가지는 VACTERL연관의 임상 증상을 나타내었다. 출생 후 결장폐쇄의 치료를 위해 총 2차례의 소아외과 수술을 시행하였다. 본 저자는 VACTERL 연관에서 매우 드물게 동반되는 결장폐쇄를 경험하였으며 타과와의 적절한 협진을 통해 빠른 진단 및 치료를 할 수 있었다. Vertebral, anal, cardiac, tracheoesophageal, renal and limb (VACTERL) association is defined by the presence of at least three of the following six congenital malformations: vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies and limb abnormalities. The abdominal cystic mass, suspicious of colon atresia was identified on prenatal ultrasonography. The new born infant exhibited single umbilical artery, hemivertebra, hypoplastic nasal bone, ventricular septal defect, patent ductus arteriosus, colon atresia. For treatment of colon atresia, two staged surgery was provided by a pediatric surgeon. We experienced colon atresia, a very rare comorbid condition in VACTERL association. Prompt diagnosis and surgical correction was possible with the cooperation of pediatric surgeons, obstetricians and pediatricians.

Prognosis Of Endometriosis After Surgical Treatment in Adolescents Below 20 Year Age

( Na Young Sung ),( Bong Seok Kim ),( Yeon Jean Cho ),( Youn Sil Choo ),( Joo Myoung Kim ),( Seung Heon Yang ) 대한산부인과학회 2011 Obstetrics & Gynecology Science Vol.54 No.8

To evaluate the clinical characteristics and prognosis of surgically treated endometriosis in adolescent women below 20 year age. Methods A retrospective review was conducted on patients diagnosed endometriosis on operation below 20 year age at Cheil General Hospital between January 2001 and October 2010. Clinical characteristics, treatment results and follow-up data for 79 women were collected. Results The mean age at operation was 18.5 year age, and in 5 cases (6.3%) the operation was performed at ≤ 15 year age. Mullerian anomalies were accompanied in 6 cases (7.6%). Seventy-nine per cent of patients had pain associated symptoms such as dysmenorrhea, non cyclic pelvic pain, and gastrointestinal pain. Endometriosis was found to be stage I in 20.3% of patients, stage II in 7.6% of patients, stage III in 40.5% of patients and stage IV in 31.6% of patients. We could not find any recurrence in patients with stage I and II endometriosis, however patients with stage III and IV endometriosis showed recurrence rates of 15.6% and 28.0%, respectively, during the mean follow-up period (33.7 ± 28.5 months). During the 36-month follow-up, the cumulative proportion of subjects free from endometrioma recurrence was 82.5%, but the rate increased as the follow-up period was extended. Conclusion Endometriosis can occur in adolescents and the recurrence rate is higher in advanced stage. As endometriosis is a progressive disease, early diagnosis and treatment during adolescence may be necessary.

Poster Session : Two dimensional electrophoretic analysis reveals that oxidation-reduction respiratory chain complex is resident in plasma membrane Lipid rafts

( Ki Bum Kim ),( Joong Won Lee ),( Chang Seok Lee ),( Bong Woo Kim ),( Hyo Jung Choo ),( Soon Young Jung ),( Sung Gil Chi ),( Young Sil Youn ),( Gye Soon Yoon ),( Young Gyu Ko ) 한국생화학분자생물학회 (구 한국생화학회) 2006 생화학분자생물학회 춘계학술발표논문집 Vol.2006 No.-