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윤태기(Tae Ki Yoon),정형민(Hyung Min Chung),임정묵(Jeong Mook Lim),차광렬(Kwang Yul Cha) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.12
배아 및 생식세포의 동결보존술은 지난 20여년동안 생식보조술 시행에 있어서 임신율의 향상에 많은 기여를 해왔다. 최근 냉동생물학을 비롯한 유관학문의 발전에 따라 효과적으로 인간배아를 동결하는 것이 가능하게 되었고 몇 종류의 동결보존법도 개발되었다. 생식보조술에 있어서 배아동결술은 난자채취 당 임신율을 제고할 수 있으며 또한 난소과자극증후군이나 부적합한 자궁내막의 상태등과 같이 임신율에 좋지 않은 영향을 미치는 요인들을 나타내는 환자들에게 이용될 수 있으며 난자공여에 있어서도 공여자와 수혜자간의 생리주기가 맞지 않았을 경우에도 배아동결은 효과적으로 이용될 수 있다. 본 논문에서는 이러한 배아동결에 대한 현재까지의 학문적, 임상적 결과를 고찰하며 또한 난자은행 설립을 위한 난자동결보존에 관한 연구동향을 살펴보기로 한다. echnology for the long-term preservation of gamete and embryo has improved greatly over the past 20 years and currently is used for supporting various assisted reproductive technologies (ART). Recent progress in cryobiology and its related sciences have made it possible to preserve human embryos effectively, and several cryopreservation methods also have been developed. Successful freezing of supernumerary embryos has allowed patients undergoing ART the opportunity to achieve pregnancies from more than one embryo transfer without being subjected to controlled ovarian hyperstimulation and oocyte retrieval each time. It also allows a delay in embryo transfer where certain adverse conditions exist for fresh transfer, e.g. when the patient is at risk for ovarian hyperstimulation syndrome or when there is poor endometrial development during the retrieval cycle. Cryopreservation of all available embryos from retrieval is utilized when an oocyte recipient is not properly synchronized with oocyte donor's cycle. In this paper is to review the current status and perspectives of embryo cryopreservation in ART program. Also, briefly discuss the oocyte cryopreservation for the establishment of ovum bank.
남윤성 ( Yoon Sung Nam ),김남근 ( Nam Keun Kim ),장성운 ( Sung Un Jang ),이숙환 ( Sook Hwan Lee ),윤태기 ( Tae Ki Yoon ),차광열 ( Kwang Yul Cha ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.1
Premature ovarian failure is a condition causing amenorrhea, hypoestrogenism, and elevated gonadotropins in women younger than 40 years. A karyotype should be performed as part of basic laboratory evaluation for all patients with premature ovarian failure
시험관아기 시술 후 자궁천골인대에 발생한 일차성 복강임신 1예
원형재,윤태기,석현하,김유신,이경주,권태희,Won, Hyung-Jae,Yoon, Tae-Ki,Seok, Hyun-Ha,Kim, Yu-Sin,Lee, Kyung-Ju,Kwon, Tae-Hee 대한생식의학회 2007 Clinical and Experimental Reproductive Medicine Vol.34 No.2
시험관아기 시술 후 발생한 복강임신은 난관이나 난소 이외에 생기는 매우 드문 자궁외 임신으로 다른 자궁외 임신에 비해 특이증상이 없기 때문에 진단이 어려울 뿐만 아니라 높은 사망률을 보인다. 복강임신이 생기는 대표적인 부위는 간, 비장, 장간막, 횡격막 등이 보고된 바 있다. 본 저자들은 시험관아기 시술 후 발생한 복강임신 중 자궁천골인대에 발생한 자궁의 임신을 간단한 문헌고찰과 함께 최초로 보고하는 바이다. Abdominal pregnancy is a very rare form of ectopic pregnancy following IVF-ET procedure. Because the symptoms of abdominal pregnancy is not typical, it is difficult to diagnose early and the mortality rate is higher than other ectopic pregnancies. Liver, spleen, omentum and diaphragm are main implantation sites of abdominal pregnancy. We reported an unusual first case of an etopic pregnancy on uterosacral ligament following in vitro fertilization and embryo transfer with brief review of literature.
정자직접주입법시술시 동결보존된 인간정소정자에 의한 수정 및 임신성공
엄기붕(Ki Boong Oum),윤태기(Tae Ki Yoon),차광열(Kwang Yul Cha),김현주(Hyun Joo Kim),남윤성(Yoon Sung Nam),김현규(Hyun Kyoo Kim),곽인평(In Pyung Kwak),한세열(Sei Yul Han) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.1
N/A There are not much reports concerning with clinical results using frozen-thawed testivular sperm in ICSI program. It is speculated that the necessity of cryopreservation of testicular sperm to avoid repeating surgical procedure for obtaining sperm for ICSI. This study was carried out to confirm whether frozen-thawed testicular sperm could be fertilized and pregnancy could be achieved using embryos fertilized with frozen-thawed testicular sperm in ICSI program or not. Testicular sperm obtained from obstructive- or non-obstructive azoospermia patients were co-cultured for 3 days with Vero cells to improve sperm motility. By co-culturing with Vero cells for 3 days, O-ll% of sperm motility after thawing increased up to 8-42% after co-culturing. ICSI was performed using frozen-thawed, and co-cultured sperm with 66 oocytes obtained from 8 patients and 62 oocytes were survived and 49(79.0%) oocytes were fertilized normally. Embryo transfer was possible in 7 out of 8 patients, and pregnancy was achieved in 6 patients(85.7%). These results indicated that not only fresh testicular sperm but frozen-thawed testicular sperm can be used in ICSI program.
Pinopode Development 2-days after Oocyte Retrieval in the Human IVF Patients
이경아,한세열,최동희,이우식,윤태기,차광열,Lee, Kyung-Ah,Han, Sei-Yul,Choi, Dong-Hee,Lee, Woo-Sik,Yoon, Tae-Ki,Cha, Kwang-Yul The Korean Society for Reproductive Medicine 1998 Clinical and Experimental Reproductive Medicine Vol.25 No.1
본 연구는 체외수정 프로그램에 참여하는 환자에 있어서 난자회수 이틀째의 자궁내막의 발달상태를 알아보기 위하여 pinopode의 발달상태, 에스트로젠 및 프로제스테론 수용체의 발현을 관찰하였다. 생검한 자궁내 막 조직 을 양분하여, 절반은 전사전자 현미경 (scanning electron microscope)으로 pinopode를 관찰하기 위하여 2.5% glutaraldehyde와 2% paraformaldehyde로 고정하였고, 나머지 절반은 dating 및 스테로이드 수용체의 면역조직화학적 측정 (immunocytochemistry)을 위하여 10% formalin으로 고정하였다. 모두 12명의 환자중 8명에서 pinopode가 관찰되었으며, pinopode 발달이 관찰되지 않은 환자들은 hCG 주사를 맞는 날의 estradiol (E2)의 혈중농도가 600 pg/mL이하로 낮았다. 본 연구의 결과로부터 자궁내막의 발달상태를 알아보기 위해서는 지금까지 일반적으로 사용되어 오던 dating이나 스테로이드 수용체의 면역조직화학적 측정법 이외에도 pinopode를 관찰함으로써 조금 더 정확한 진단을 할 수 있으리라고 사료되며, pinopode의 발달은 E2의 혈중농도와 관계가 있을 것으로 추정된다.
수정에 실패한 인간 난자에 있어서의 염색체의 수의 이상
손원영,이경아,박상희,한세열,윤태기,정형민,곽인평,차광열,Son, Weon-Young,Lee, Kyung-Ah,Park, Sang-Hee,Han, Sei-Yul,Yoon, Tae-Ki,Jung, Hyung-Min,Kwak, In-Pyung,Cha, Kwang-Yul 대한생식의학회 1995 Clinical and Experimental Reproductive Medicine Vol.22 No.2
Many oocytes fail to fertilize and cleave in vitro and many embryos transferred back to uterus fail to implant or maintain implantation. Chromosomal abnormalities in the male and female gametes may contribute to this loss. The higher incidence of meiotic chromosomal abnormalities bas been found in oocytes than in sperm. The wide range of incidence of chromosomal abnormalities in unfertilized oocytes has been reported in human IVF program (26-63%). However, factors affecting chromosomal abnormalities are not well understood. The present study has been conducted to investigate effects of the method for ovarian hyperstimulation, women's age, and the number of oocytes retrieved per patients on the incidence of numerical chromosomal abnormalities. Five hundred eighty four unfertilized metaphase II oocytes were subjected to chromosomal analysis. Included unfertilized oocytes were from 220 patients (mean $age=32.7{\pm}3.0$) and three hundred thirty oocytes were legible for analysis. Two hundred fourty five oocytes out of 330 (73.3%) were normal, while 38 (11.5%) were hyperploidy, 35 (10.6%) were hypoploidy, and 12 (3.6%) were diploidy. Significant difference in chromosomal abnormalities was not found between two patient groups stimulated by follicular stimulating hormone/human menopausal gonadotrophin (FSH/HMG) (25.9%) and gonadotrophin-releasing hormone agonist/follicular stimulating hormone/human menopausal gonadotrophin (GnRHa/FSH/HMG) (28%). There was a tendency of increasing chromosomal abnormalities in unfertilized oocytes from older patients (<30 yrs: 20.3%, 30-34yrs: 26.9%, >34 yrs: 35.3%). The number of oocytes retrieved per patient had no effect the incidence of chromosomal abnormalities (1-5: 31. 4%, 6-10: 29.8%, 11-15: 28.6%, > 15: 16.5%). These results from the present study suggest that the chromosomal abnormalities observed in the unfertilized oocytes has not affected by the stimulation methods, patient's age, and the number of oocytes retrieved per patients.
이숙환(Sook Hwan Lee),윤태기(Tae Ki Yoon),차광열(Kwang Yul Cha),남윤성(Yoon Sung Nam),곽인평(In Pyung Kwak) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.1
Prenature ovarian failure is a condition causing amenarrhea, hypoestrogenism, and elevated genadotropins in women younger than 40 years. A karyotype should be performed as part of basic laboratory evaluation for all patients with premature ovarian failure and prodromal premature ovarian failure. Development of a malignancy in a dysgenetic gonad is of major concern. The presence of a fragment of the Y chromosome is thought to be a key to the oncogenic potential of these gonads. The search for the testicular determining factor(TDF) has engendered much confusion about which part of the Y chromosome plays a role in malignancy. This was initially postulated to be the H- Y antigen. More recent data, however, localize the area near the centromere of the Y Chromosome, on the long arm(Yq). Malignant potential is clearly not linked to the testicular determining factor itself(SRY). This is a critical point in clinical medicine. Feilure to display SRY or a closely related sequence does not rule out the presence of the segment of the Y chromosome postulated to be associated with the development of malignancies. We have experienced a case of premature ovarian failure with chtomosomal abnormality involving Y chromosome fragment. So we report this case with a brief review of literatures.
양측 난관절제술 환자에서 체외수정 후 5회째의 자궁외임신으로 발생한 병합임신 1례
윤내영(Nae Young Youn),윤태기(Tae Ki Yoon) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.9
Although a higher incidence of ectopic pregnancy has been reported after in vitro fertilization(IVF) and embryo transfer(ET), five ectopic pregnancies in one patient is very rare. We experienced a case of combined interstitial and intrauterine pregnancy as fifth ectopic pregnancies after in vitro fertilization and embryo transfer in one patient with history of bilateral salpingectomy due to previous four tubal pregnancies. Repeated transvaginal ultrasound examinations confirmed heterotopic pregnancy. In IVF-ET, bilateral salpingectomy does not remove the risk of interstitial or cornual pregnancy.