반복 배아 이식이 임신율에 미치는 영향: 이식관의 점액 유무

정병준,김종식,권처진,유미진,김명신,강은희,심종옥,송현진,오익환,Jung, Byeong-Jun,Kim, Jong-Sik,Kwon, Cheo-Jin,Ryu, Mi-Jin,Kim, Myung-Sin,Kang, Eun-Hee,Sim, Jong-Ok,Song, Hyun-Jin,Oh, Ik-Hwan 대한생식의학회 2003 Clinical and Experimental Reproductive Medicine Vol.30 No.1

Objective : We investigate the effects of multiple attempts of embryo transfer because of retained embryos in the catheter and of contaminated mucus on the transferred catheter. Materials and Methods: We respectively analysed data between November 1998 and August 2002 from 305 patients of 369 cycles who underwent IVF-ET. Of these patients, 47 patients of 50 cycles (Group 2) were required multiple trial of embryo transfer. They were compared with an age-matched control groups (Group 1) with female factor infertility. Pearson's $?^2$ and Fisher's tests were used to compare proportions between discrete variables. Noncategorical data were compared using t-test. Statistical significance was set at p<0.05. Results: Embryos were significantly more likely to be retained when catheter was contaminated with mucus (Group 1: 22.4%; Group 2: 44.0%). The clinical pregnancy rates, however, for the contaminated mucus or not, were 46.8%, 43.5% respectively. There was no significant difference clinical pregnancy rate between those who had all their embryos transferred at the first attempt (45.4%) and those who required more than one attempt (48.0%). Conclusions: Contaminated mucus in the catheter is associated with failed embryo transferred at the first attempt. Embryo transfers, however, that are repeated attempts do not adversely affect pregnancy rates following IVF-ET.

체외수정시술시 Sequential ET의 효용성에 관한 연구

정병준,김종식,송현진,Jung, Byeong-Jun,Kim, Jong-Sik,Song, Hyun-Jin 대한생식의학회 2000 Clinical and Experimental Reproductive Medicine Vol.27 No.1

Objective: The objective of this study is to influence of sequential embryo transfers in an invitro fertilization was examined. Method: After in vitro fertilization, a maximum of 6 fertilized oocytes was enrolled in this study. At day 3 after an oocytes retrieval, embryos with good quality were transferred (mean 4.9), remaining embryos (mean 2.0/cycle) were cryopreserved at blastocyst stage (Group 1). At day 5 after oocytes collection, second a embryo transfer (mean 1.2/cycle) was performed, if one of these embryos had reached the blastocyst stage (Group 2) using P1 supplemented with 10 SSS and 30% Follicular fluid. No statistical difference in the pregnancy rate could be seen between the group without a second embryo transfer (n=21; 28.6%) and the group with a second transfer (n=52; 28.8%). Results: The incidence of multiple pregnancy rate per embryo transfer was not statistically different between both group and no high-rank multiple pregnancy (greater than triplete) were observed (0.9%, 15.4%, respectively, p=0.74, ${\chi}^2$). Out of 114 cycles (506 embryos) cultured embryos in group 2, 52 cycles (159 embryos, 29.8%) reached the blastocyst stage. Conclusion: The second transfer did not have a significant effect on the pregnancy rate. The most important factor for the pregnancy seems to be the quality of the embryos transferred on day 3 following oocyte retrieval. We recommend embryo transfer is performed only one, day $2{\sim}3$ or D5.

Progesterone 및 Acetyl-L-Carnitine이 정자의 동결-융해에 미치는 영향

정병준,김윤진,최형민,전명권,이응수,나오순,Jung, Byeong-Jun,Kim, Yun-Jin,Choi, Hyung-Min,Jun, Myung-Kwon,Lee, Eung-Soo,Nah, O-Soon 대한생식의학회 2001 Clinical and Experimental Reproductive Medicine Vol.28 No.4

Objective : To assess the effects of progesterone and acetyl-L-carnitine used after treated with Isolate?? gradient before semen cryopreservation-thawing on sperm parameters and membrane integrity. Material and Methods : From April 2001 to July 2001, ten normal male partner of couples who were visited in vitro fertilization (IVF) clinics. the semens were treated with $Isolate^{(R)}$ gradient before cryopreservation, spermatozoa was incubated with progesterone (1, 5 and $10{\mu}M$), acetyl-L-carnitine (2.5, 5 and $10{\mu}M$), or both (progesterone, $1{\mu}M$; and acetyl-L-carnitine, $5{\mu}M$) for 30 min. Results: There were no differences in sperm parameters and vital stain among isolate only treated group, progesterone (1, 5 and $10{\mu}M$), acetyl-L-carnitine (2.5, 5 and $10{\mu}M$) and both (progesterone, $1{\mu}M$; and acetyl-L-carnitine, $5{\mu}M$). But, in high concentration of acetyl-L-carnitine ($10{\mu}M$) treated group, sperm parameters and vital stain were decreased. The statistical method was used ANOVA (Kruskal-Wallis test) and p value was <0.01. Conclusions : Neither progesterone nor acetyl-L-carnitine show to be protective effect on the cryodamage assessed by sperm parameters and vital stain (eosin-Y stain) in normal sperm. High concentration of acetyl-L-carnitine ($10{\mu}M$), however, was harmful effect on cryoprevention.

Comparison between $Isolate^{(R)}$ gradient and Swim-up Procedures for Sperm Preparation: Effects on Freeze-thawing in Normal Semen Sample

정병준,Jung, Byeong-Jun The Korean Society for Reproductive Medicine 2001 Clinical and Experimental Reproductive Medicine Vol.28 No.1

연구목적: $Isolate^{(R)}$ gradient와 swim-up 방법이 정자의 형상 및 정밀정자형태 (strict morphology)에 미치는 영창을 비교분석하고, 이러한 정자처리방법이 정자의 동결-융해과정에 미치는 영향을 비교하고자 하였다. 연구재료 및 방법: 20명의 정상 정자를 대상으로 하였으며 각각의 정자는 두 가지 정자처리방법으로 나누어 정자의 형상과 정밀정자형태를 컴퓨터를 이용한 정자자동분석기를 통하여 측정하였고, 동결보호제의는 TYB 용액을 사용하였으며, 동결 및 융해는 cryo Magic사의 기계를 사용하였다. 통계는 SPSS PC+(version7.0)를 이용하였으며 통계학적인 유의성은 p<0.05로 하였다. 결과: 정자의 농도는 $Isolate^{(R)}$ gradient 처리군이 swim-up 처리군보다 유의성 있게 높았으나 ($51.2{\pm}40.1,\;156.6{\pm}64.3$), 운동성 VCL, VSL, VAP, Linearity, 및 ALH는 swim-up 처리군에서 유의성 있게 높았다. 정밀 정자형태는 swim-up 처리군과 $Isolate^{(R)}$ gradient 처리군에서 차이가 없었다 ($53.7{\pm}6.8$ vs $50.3{\pm}9.1%$). 동결-융해과정 중 두 가지 정자 처리군에서 정자의 형상들은 swim-up 처리군에서 전반적으로 높은 양상을 보였으나, 정밀정자형태는 $Isolate^{(R)}$ gradient 처리군이 swim-up 처리군 보다 감소율이 컸지만 두 군간에 유의한 차이는 없었다 ($12.8{\pm}8.5$ vs $8.6{\pm}6.6$). 결론: 정상 정자에서 swim-up 방법이 $Isolate^{(R)}$ gradient 방법보다 정자 회수율은 우수하였으나, 동결-융해과정 중 정밀정자형태에는 차이가 없어 두 방법을 상호보완적으로 사용할 수 있을 것으로 사료된다.

원인불명의 불임환자에서 림파구 정맥주입에 의한 면역 치료의 효능에 관한 연구

정병준,이상훈,허민,Jung, Byeong-Jun,Lee, Sang-Hoon,Hur, Min 대한생식의학회 1997 Clinical and Experimental Reproductive Medicine Vol.24 No.3

The aim of present study was to determine the efficacy of immunotherapy with paternal lymphocytes for unexplained infertility. It has been apparent that reproductive success may be affected by the presence of abnormal autoantibodies. Unexplained infertility and repeated pregnancy wastage has been reported in the presence of abnormal autoantibodies. These data suffest that abnormal immune function may be an important pathologic entity contributing subfertility in patients with unexplained infertility. Therefore, immunotherapy may be a possible treatment modality for patients with unexplained infertility. Some investigators have reported that a proportion of infertile couples with repeatedly unsuccessful ET showed close histocompatibility similar to those of spontaneous recurrent abortion. Recently, it has been noted that immunotherapy with paternal lymphocytes achieves a high efficacy in preventing subsequent abortion in women with primary recurrent abortion of unknown cause, which was mediated by immune reaction including blocking antibody. To substantiate the hypothesis, we applied immunotherapy preceding Peritoneal Oocyte and Sperme transfer (POST) to 43 patients, 47 cycles of 82 patients, 89 cycles with at least three previous IUI failure from April, 1993 to February, 1995. There were no significant differences between treatment and control group in clinical response and hormonal response to controlled hyperstimulation. there was no significant difference between treatment and control group in pregnant rates per cycles (42.6% versus 28.6%), but a significantly lower abortion rate per pregnancy in treatment group, with 10.0% (2/20) compared with 50.03% (6/12) in control group. This study may suggest that immune therapy for patients with unexplained infertility with paternal lymphocytes might be beneficial.

자궁내막증을 갖는 불임환자의 체외수정시술에 관한 연구

정병준,송현진,오익환,Jung, Byeong-Jun,Song, Hyun-Jin,Oh, Ik-Hwan The Korean Society for Reproductive Medicine 2002 Clinical and Experimental Reproductive Medicine Vol.29 No.3

연구목적: 전반적인 자궁내막증이 체외수정시술에 미치는 영향을 알아보고, 특히 stage III-IV 자궁내막증을 갖는 불임환자 체외수정시술 결과에 대하여 알아보고자 본 연구를 시행하였다. 연구재료 및 방법: 1998년 9월부터 2001년 9월까지 진단복강경을 통해 자궁내막증으로 진단된 환자 중 체외수정시술을 시행 받은 91명 131주기를 대상으로 하였으며 이중 stage III-IV의 자궁내막증을 갖는 환자는 27명 34주기였다. 비교군은 이시기에 진단된 순수 난관원인으로 체외수정시술을 시행한 40명 56주기를 대상으로 하였다. 통계학적 검사는 Student's t-test와 Chi-square test를 시행하였고, p<0.05를 유의성이 있는 것으로 판정하였다. 결 과: 전체 자궁내막증 환자와 난관인자의 체외수정시술에서 두 군간의 나이는 $31.6{\pm}3.3$, $32.6{\pm}3.6$세로 비슷하였다. 채취된 난자의 수 ($10.3{\pm}6.6$ vs $11.7{\pm}5.1$), 성숙난자 수 ($7.4{\pm}4.7$ vs $7.7{\pm}4.9$), 수정율 ($70.2{\pm}32.4%$ vs $73.7{\pm}20.0%$), Good embryo quality rate (8세포 (G1+G2)를 2PN의 개수로 나눈 값) (32.6% vs 32.4%) 및 배아이식 수 ($4.6{\pm}1.4$ vs $4.8{\pm}1.1$)로 두 군간에 차이는 없었다. 또한 임상적 임신율의 경우도 각각 30.7%, 42.8%로 비슷하였다. 중등도 및 중증의 자궁내막증과 난관인자의 비교에서 성숙난자 및 채취된 난자의 개수는 각각 $8.8{\pm}4.9$, $7.7{\pm}3.9$, $11.3{\pm}7.0$, $11.7{\pm}5.1$개로 두 군간에 차이는 없었다. 수정율은 stage III와 IV 군에서 감소되는 경향을 보였으나 통계학적인 유의성은 없었다 ($66.2{\pm}30.0%$ vs $73.7{\pm}20.0%$). Good qulity embryo rate (GQER)는 stage III-IV 자궁내막증 환자군에서 22.0%로 순수 난관인자의 32.4%에 비하여 감소하는 경향을 보였으나 통계학적인 유의성은 없었다 (p=0.15, Chi-square test). 배아이식 수의 경우는 각각 $4.7{\pm}1.5$, $4.8{\pm}1.1$개로 차이가 없었다. 배아이식 주기당 임상적 임신율의 경우는 stage III-IV군에서 25.0% (8/32), 난관인자 군의 42.8% (24/56)로 통계학적인 유의성은 없었으나 (p=0.06, Chi-square test), 중등도 및 중증의 자궁내막증을 갖는 환자에서 임신율이 감소하는 경향을 보였다. 결 론: 체외수정시술시 자궁내막증이 임신율에 나쁜 영향을 미치지 않지만, 중등도 및 중증의 자궁 내막증을 갖는 불임환자의 체외수정시술에서는 임신율에 나쁜 영향을 끼칠 가능성이 있을 것으로 사료된다.

인간 자궁동맥에서 내피세포 비의존성 기전을 통한 에스트로겐의 혈관 수축 억제 효과

정병준(Byeong Jun Jung),박형무(Hyoung Moo Park),허민(Min Hur),이무열(Moo Yeool Lee) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.8

목적: 본 연구는 자궁적출때 얻은 자궁동맥을 재료로 하여 (1) 에스트로겐이 인간자궁동맥의 긴장도에 미치는 영향을 관찰하고 (2) 내피세포 비의존성 혈관확장이 세포막내 칼슘통로를 통해 이루어 질 수 있는지를 증명하여 보고자 한 것이다. 연구방법: 본 연구는 자궁적출술 환자에서 내경 3mm 이상의 자궁동맥을 적출하여 혈관내피를 제거한후 생리적 용액내에서 길이 10mm, 폭 2mm정도의 직사각형 모양의 혈관 평활근 절편을 만들고 용량 30ml의 실험 용기에 옮긴 후 등장성 장력변환기에 연결하여 다양한 실험 조건하에서 수축력을 측정함으로서 에스트로겐이 혈관수축에 미치는 영향을 관찰하였다. 결과: 혈관 평활근 절편에 수용체 의존성 칼슘이온 통로를 활성화시키는 α-아드레날린성 수용체 자극제인 노에피네프린을 투여하면 경축현상이 일어난다. 경축이 일어난 절편에 아세틸콜린을 투여하면 별다른 변화가 나타나지 않지만 내피세포 비의존성 혈관이완제인 sodium nitroprusside와 α-수용체 차단제인 tamsulosin를 투여하면 이완효과가 나타난다. 경축이 일어난 절편에 에스트로겐을 투여하면 20분 후 이완현상이 관찰되고 에스트로겐을 30분 동안 전처치한 경우에는 경축으로 인한 수축력의 크기가 농도 의존적으로 감소하였다. 막전압 의존성 칼슘이온 통로를 활성화시키는 고농도의 포타슘용액(80mM)으로 경축을 유발한 후에 에스트로겐의 이완효과를 관찰한 경우에는 경축 유발 후에 투여한 때와 30분간 전처치한 경우에 모두에서 관찰되었으며 농도 의존성 억제효과가 관찰되었다. 이러한 이완효과에 대한 NO의 관련여부를 확인하기 위하여 NO 전구체인 L-arginine이나 산화질소 합성효소 억제제인 L-NAME와 같은 NO 합성에 영향을 미치는 물질을 전처치하였으나 별다른 변화가 기록되지 않았다. 결론: 이상의 연구결과를 종합해보면 에스트로겐은 인체 자궁동맥 평활근의 수축력에 대하여 이완효과를 나타내며 그 효과는 혈관 평활근 세포에 존재하는 수용체 및 전압 의존성 칼슘이온 통로에 대한 직접적인 길항 효과를 통해서 이루어지는 것으로 생각되며 이러한 이완효과에 NO는 관여하지 않을 것으로 사료된다 Objective: This study was performed to investigate whether 1) estrogen induces the change of vascular tone in endothelium-denuded human uterine artery, and 2) endothelium-independent vascular reactivity may be mediated by intracellular calcium ion modulation. Methods: The uterine arteries from 34 premenopausal women were obtained at the time of hysterectomy due to various indications and endothelium was denuded. Vascular reactivity was monitored by using Isometric force transducer and recorded by physiograph. Endothelial integrity was assessed by sequential administration of 1μM norepinephrine(α-adrenergic stimulant) and 10 μM acetylcholine (endothelium -dependent vasorelaxant). Integrity of smooth muscle was measured by administration of 10μM sodium nitroprusside (endothelium - independent vasorelaxant) and 10μM tamsulosin(α-adrenergic blocker). A dose-dependent action of estrogen was measured on denuded uterine arteries, pretreated with norepinephrine and potassium chloride. In media contained denuded uterine arteries pretreated with 70mM potassium chloride and estradiol(3×10-5M), nitric oxide and its inhibitor, N-nitro-L-arginine methyl ester(L-NAME) was administered, respectively, in order to verify the vasodilation effect. Statistical tests were performed at the 5% level of significance using the SPSS PC+ package. Results: Acethylcholine has little effect but sodium nitroprusside & talmsulosin showed marked relaxation, which suggested loss of endothelial function and adequacy of smooth muscle function. The contraction by norephinephrine(1 M) revealed estrogen induced relaxation which was concentration-dependent from 3 10-8M to 3 10-5M in concentration of 17 -estradiol. The contraction by high potassium solution 70mM was also inhibited by estrogen in concentration-dependent manner. This vasorelaxant effect of estrogen on endothelium-denuded uterine artery was not affected by addition of nitric oxide(NO) precursor, L-arginine and nitric oxide synthase(NOS) inhibitor, L-NAME. Conclusion: The results of this study revealed that estrogen has vasorelaxant effect on endothelium endothelium-denuded uterine artery by calcium antagonistic property through direct inhibitory effect on receptor- and voltage dependent calcium ion channels of smooth muscles. This vasorelaxant effect of estrogen on endothelium-denuded uterine artery was NO independent.

Pd 코팅 된 중공사형 La_0.1Sr_0.9Co_0.2Fe_0.8O_3-δ 촉매의 제조 및 미량 산소 제거 특성 연구

정병준 ( Byeong Jun Jeong ),이홍주 ( Hong Ju Lee ),김민광 ( Min Kwang Kim ),이승환 ( Seung Hwan Lee ),박정훈 ( Jung Hoon Park ) 한국화학공학회 2019 Korean Chemical Engineering Research(HWAHAK KONGHA Vol.57 No.6

본 연구에서는 저온에서 매립지 가스(LFG)하에서 메탄의 완전 산화 특성 분석을 위한 고성능 Pd 코팅La_0.1Sr_0.9Co_0.2Fe_0.8O_3-δ (LSCF-1928)촉매를 개발하였다. LSCF-1928 촉매를 분말형과 중공사형으로 성형한 후 중공사형의 표면을 무전해도금법으로 Pd를 코팅하였다. 성형된 촉매는 TPR을 통해 촉매에 흡착 된 산소종과 그 흡착 량을 분석하였고, SEM을 통해 중공사형 기공구조를 확인하였으며, XRD를 통해 촉매의 안정성을 확인하였다. 메탄 산화 실험 결과 LSCF-1928 촉매의 메탄 완전산화 온도는 475 oC 이었으나, Pd코팅 된 LSCF-1928 촉매는 이보다 낮았으며, O2 전화 율 또한 일반 LSCF-1928 촉매보다 Pd 코팅 LSCF-1928 촉매가 높았음을 확인하였다. An efficient Pd-coated La_0.1Sr_0.9Co_0.2Fe_0.8O_3-δ (LSCF-1928) catalyst for total oxidation of methane under landfill gas at low tmeperature has been developed. Synergism was observed between Pd coating and LSCF-1928 substrate. When Pd coating on LSCF-1928, we used electroless plating method and conformed characteristic of catalyst through TPR(Temperature Programmed Reduction) analysis, XRD(X-ray Diffraction) analysis, SEM(Scanning Electron Microscope). The results demonstrated that the Pd coated LSCF-1928 catalysts showed higher performance than non-Pd LSCF-1928. Pd coated LSCF-1928 had low total oxidation temperature of methane (< 475℃) which is lower than total oxidation temperature of methane about non-Pd LSCF-1928 catalysts (= 475℃). Also, O₂ conversion rate was higher than non-Pd LSCF-1928 at same temperature.

체외수정 및 배아이식 후의 일란성 쌍태임신 3례

최성연,정병준,최형민,강영제,이응수,송현진,Choi, Sung-Yun,Jung, Byeong-Jun,Choi, Hyung-Min,Kang, Young-Jae,Lee, Eung-Soo,Song, Hyun-Jin 대한생식의학회 2000 Clinical and Experimental Reproductive Medicine Vol.27 No.3

Objective: To report three cases of monozygotic twinning after IVF-ET transfer. Methods: Private practice in two different assisted reproductive technology clinics. Results: Three intrauterine monozygotic twin pregnancies occurred after IVF-ET. One of them was complicated by cord entanglement, another is progressing normal pregnancy without complication and the other was had a normal pregnancy without complication and delivered twin by cesarean section. Conclusion: The reported prevalence of multiple gestations in IVF-ET is a approximately 30%, and it is only 2.7% to be monozygotic twinning in IVF-ET. We report three cases of monozygotic twining after IVF-ET.

부고환 및 고환 정자를 이용한 세포질내 정자주입술에 관한 임상 연구

이영일,정병준,이상훈,김영선,Lee, Young-Il,Jung, Byeong-Jun,Lee, Sang-Hoon,Kim, Young-Sun 대한생식의학회 1999 Clinical and Experimental Reproductive Medicine Vol.26 No.3

Objective: The purpose of this study was to evaluate outcome of intracytoplasmic sperm injection (ICSI) using epididymal and testicular sperm in patients with azoospermia. Methods: From March, 1993 to May, 1999, a retrospective clinical analysis was done of a total of 140 cycles in 112 patients who underwent ICSI. Subjects were divided into three groups: ejaculated-ICSI group included 42 cycles in 34 patients with ejaculated sperm who underwent ICSI due to severe oligospermia and past history of failed or poor fertilization in the previous in vitro fertilization and embryo tranfer (IVF-ET) cycles, microsurgical epididymal sperm aspiration and intracytoplasmic sperm injection (MESA-ICSI) group included 50 cycles in 42 patients with congenital absence of the vas deferens (CAVD) or unreconstructable obstructive azoospermia and testicular sperm extraction and intracytoplasmic sperm injection (TESE-ICSI) group included 48 cycles in 36 patients with no spermatozoa which can be retrieved from epididymis or non-obstructive azoospermia. Results: Normal two-pronuclear fertilization rates were similar in three groups: 64.4% for ejaculated-ICSI group, 59.4% for MESA-ICSI group and 60.4% for TESE-ICSI group. The pregnancy rates were 26.2%, 26.0% and 25.0% respectively. There were no significant differences in the fertilization, cleavage, and clinical pregnancy rates among ICSI cycles using ejaculated, epididymal and testicular sperm. Conclusion: Epididymal and testicular sperm obtained in azoospermic patients can fertilize oocyte successfully and may lead to be similar fertilization rates and clinical pregnancy rates to ejaculated sperm.