자연유산 환자에서 발견된 류마티스인자 1 예

남윤성(YS Nam),한세열(SY Han),최동희(DH Choi),윤태기(TK Yoon),차광열(KY Cha) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.5

It is not clear whether fertility or parity are altered in patents with rheumatioid arthritis. Pregnancy outcome in rheumatoid arthritis is generally good. Although a small number of patients may be positive for antiphospholipid antibody, values tend to be low titer and not generally associated with complications. Most series find no increased risk of spontaneous abortion, premature labor, or difficult delivery. One older report suggested an increased risk of spontaneous abortion prior to diagnosis of clinical disease, and fetal growth retardation has been described in a case of severe rheumatoid arthritis with vasculitis. We have experienced a case of rheumatoid factor detected in spontaneous patient. So we report this case with a brief review of literatures.

Hashimoto씨 갑상선염과 동반된 희발월경 1 례

남윤성(YS Nam),한세열(SY Han),최동희(DH Choi),윤태기(TK Yoon),차광열(KY Cha) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.5

Thyroid hormone deficiency is among the most common diseases affecting women. Two percent of women suffer overt hypothyroidism and five percent develop subclinical hypothyroidism during their lives. An additional six percent of women have transient postpartum hypothyroidism. Furthermore, complaints consistent with thyroid hormone deficiency[e.g.,fatigue and weight gain] are common in euthyroid individuals and must be distinguished from actual thyroid dysfunction. Finally, clinical manifestations of hypothyroidism may include significant disturbances of reproductive physiology: both precocious and delayed puberty, menstrual dysfunction, and ovulatory disorders that can contribute to infertility. We have experienced a case of Hashimoto`s thyroiditis which was found in infertile patient with oligomenorrhea. So we report this case with a brief review of literatures.

원인별로 분류된 무월경환자에서의 인슐린 유도 저혈당 검사 및 갑상선 호르몬 유리호르몬 을 이용한 시상하부 뇌하수체 기능의 평가 ( Insulin-Induced Hypoglycemia

박병하(BH Park),박기현(KH Park),한세열(SY Han),박찬규(CK Park) 대한산부인과학회 1988 Obstetrics & Gynecology Science Vol.31 No.8

원발성 및 속발성 무월경으 주소로 연세대학교 의과대학 산부인과학교실로 내원한 37명의 환자를 대상으로 시상합부-뇌하수체-난소축의 원인별로 5개군으로 분류하여 insulin유도 저 혈당검사에 의한 성장호르몬, cortisol의 반응 및 TRH투여후의 prolactin,TSH의 반응양상을 조사하여 각 원인별로 비교분석한 결과 다음과 같은 결론은 얻었다. 1. Insulin투여후의 저혈당에 의한 성장 호르몬의 반응은 P.H.H환자군의 sheehan증후군에서 의의있는 저하반응을 나타내었다. 2. Insulin 투여후의 저혈당에 의한 성장 호르몬의 반응은 전형적인 hypergonadotropic hypogonadism 인 sheehan증후군과 P.H.H 환자군과 sheehan증후군에소는 동일 정도의 심한 불량반응을 보인 반면 전형적인 hypergonadotropic hypogonadism인 조기난소부전환자군에서 는 비교적 양호한 반응을 나타내었다. 3. 저혈당에 의한 cortisol의 반응을보면 P.H.H환자군 및 sheehan증후군에서 저하반응을 나타 내었으며, 성장호르몬의 반응양상에서와 마찬가지로 시상하부기능부전 환자군 및 조기난소 부전환자군보다 심한 불량반응을 보였다 4. TRH투여후의 prolactin의 반응은 prolactinoma 환자군 및 sheehan 증후군에서 무반응을 보 였으며 P.H.H환자군에서는 sheehan증후군과 비교하여 비교적 양호한 반응을 보여 저혈당에 의해 나타난 성장호르몬 및 cortisol의 저하반응과는 달리 두질환의 뚜렷한 구별이 있었다. 5. TRH 투여후의 prolactin의 반응은 시상부성 기능부전환자군 및 조기난소부전환자군에서는 P.H.H환자군보다 비교적 잘 보존되어 있었다. 6. TRH투여후의 TRH의 반응은 각 원인별 별다른 차이점이 없었다. IIH and TRH stimulation test were used to study hypothanlamic-pituitary-ovarian function of 36 amenorrheic patients . Of these patients eight were with secondary amenorrhea due to hypothalamic dysfunction, eleven with primary amenorrhea due to hypo-gonadotropic hypogonadism(HH) six with prolactinoma, four with Sheehan`s syndrome, and eight with premature ovarian failure (POF) . the results were obtained as follows; 1. Growth hormone (GH) response after IIH test in patients with primary amenorrhea due to hypogonadotropic hypogonadism and Sheehan`s syndrome revealed a hyporesponsive pattern according to Willian D. Schlaff criteria but a normal pattern in patients with POF. 2. cortisol response after IIH test in patients with primary amenorrhea due to HH and Sheehan`s syndrome demonstrated a hyporesponseve pattern according to William D. Schlaff criteria and compared with the normal response of the patients with hypothalamic dysfunction and POF 3. Prolactin after TRH stimulation test in patients with prolactinoma and Sheehan`s syndrome was nonresponsive but in patients with primary amenorrhea due to HH it showed a better response than that observed in Sheehan`s syndrome. 4. Prolactin response after TRH stimulation test in patients with hypothalamic dysfunction and POF were better than those with primary amenorrhea due to HH. 5. TSH responses after TRH stimulation test were not significantly difference in all groups.

다중중합효소연쇄반응과 써던 블롯팅을 이용한 근이영양증 ( DMD ) 의 진단

이숙환(SH Lee),한정희(JH Han),곽인평(IP Kwak),차광은(KE Cha),조성원(SW Cho),한세열(SY Han),김남근(NK Kim),박찬(C Park),차광열(KY Cha) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.5

Duchene and Becker muscular dystrophy(DMD/BMD) results from mutations in the dystrophin gene, and enormous genetic locus that spans more than two million base paris of DNA on the human X chromosome. Some 60% of DMD patients exhibit deletions, which can be found by cDNA hybridization or, were recently, by polymerase chain reaction analysis. We have used the multiplex PCR to identify deletion mutations in the human dystrophin gene. By simultaneously amplifying genomic regions flanking 17 sepastrate exons in mutational hot spots, we were able to detect 16 exons in one family. The DNA encoding each of the 17 exons in the dystrophin gene is copied a million fold to make it visible in an agarose gel. To be certain that the missing band is not artifact of the amplification procedure, the DNA from the blood sample was analyzed by Southern hybridization.

항갑상선 항체를 동반한 습관성 유산 1 예

윤태기(TK Yoon),차광열(KY Cha),최동희(DH Choi),한세열(SY Han),남윤성(YS Nam) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.1

An autoimmune etiology has been proposed as the cause of recurrent abortions in couples with no other obvious explanation for their reproductive failure. It has been known for quite sometime that women with systemic lupus erythematosus(SLE) have an increased risk of pregnancy loss. Pregnancy loss in these women has been associated with the presence of non-organ-specific antibodies not only in the presence of active SLE but also in subclinical autoimmune disease. The most common autoantibodies associated with pregnancy loss are antiphospholipid antibodies(in particular anticardiolipin and the lupus anticoagulant)and antinuclear antibodies. These autoantibodies along with other non-organ-specific antibodies are implicated not only in pregnancy loss but other aspect of infertility. Among organ-specific autoantibodies, antithyroid antibodies specifically have been linked to repeated pregnancy loss. We have experienced a case of recurrent pregnancy loss associated with antithyroid antibodies. So we report this case with a brief review of literatures.

시험관아기 시술시 정자직접주입법을 이용한 2146 예의 임상 결과

엄기붕(KB Oum),오종훈(JH Oh),손지온(JO Sohn),정형민(HM Jung),고정재(JJ Ko),한세열(SY Han),최동희(DH Choi),윤태기(TK Yoon),차광열(KY Cha) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.1

Since Palermo and coworkers(1992) reported the first ICSI-baby, ICSI has been widely accepted as a treatment of male factor infertility. ICSI techniques have also been used to treat abnormal semen parameters in order to overcome fertilization failures and to increase clinical outcomes. From January 1994 to December 1996, 2146 ICSI cycles were performed at the Infertility Center of Cha General Hospital and we achieved a 75.1% of fertilization rate with 713 subsequent pregnancies(34.8%). The ICSI fertilization rate using 1-day old oocytes which failed to fertilize using conventional IVF method was lower than the ICSI fertilization rate using fresh oocytes(75.7% vs 65.9%). However, we achieved 13 pregnancies out of 125 embryo transfers from the total fertilization failure group. There was no statistical difference in the fertilization rates using normal semen or semen with single defect, but statistical differences were observed between normal semen and semen with two or more defects. No statistical difference was found in pregnancy rates between normal and defective semen groups. In our MESA, PESA and TESE programs, we achieved high fertilization rates(69.2∼82.5%) and a 45.8%(mean) pregnancy rate. Categorizing the female patients by age, ie., ≤29, 30∼34, 35∼39, ≥40, fertilization rates were consistently in the range of 74.5∼ 75.7%, but pregnancy rates significantly decreased in patients older than 35 yrs(31.3%) or 40 yrs(14.2%). Of the 713 pregnancies, we were able to obtain follow-up information of the babies in 527 cycles, of which we found 8abnormalities.