골반경 수술 135례에 대한 고찰

양회생 東國大學校醫學硏究所 1997 東國醫學 Vol.4 No.-

골반경수술의 진단 및 치료의 적용은 광범위하다. 골반경수술은 입원기간과 비용을 줄일 수 있을 뿐 아니라 조직손상과 출혈을 줄일 수 있다고 보고되어 왔다. 부인과환자에서 골반경수술의 효용성을 고찰하기 위하여 동국대학교 경주병원에서 1992년 3월부터 1996년 12월까지 골반경수술을 시행한 총 135례를 조사하였다. 결과는 다음과 같다. 1. 적응증으로는 불임이 39.3%, 자궁외임신이 21.5%, 난소종양이 11.9% 였다. 2. 수술방법은 진단복강경이 40.5%, 난관절제술이 15.5%, Endocoagulation 이 11.1%, 유착제거술이 6.6% 였다. 3. 환자의 평균 연령은 31.6세였다. 4. 평균출산력은 0.74였다. 5. 평균입원기간은 2.94일 이었다. 6. 가장 흔한 합병증은 삽입부위의 출혈이었으나 극히 적은 숫자였다. The therapeutic and diagnostic applications of pelviscopic surgery are various. Pelviscopic surgery has been reported to reduce inpatient duration of hospitalization and cost in addition to minimizing tissue damage and bleeding. To evaluate the efficacy of pelviscopic surgery in gynecologic patients, we reviewed 135 patients diagnosed and treated pelviscopically at Dongguk University Medical center from March, 1992 to December 1996. The results were as follows; 1. The common indications were evaluation for infertility(39.3%), ectopic pregnancy(21.5%), ovarian tumor(11.9%). 2. The major types of surgery were diagnostic laparoscopy(40.5%), Salpingectomy(15.5%), endocoagulation(11.1%), adhesiolysis(6.6%). 3. The mean age of the patients was 31.6 years. 4. The mean parity of the patients was 0.74. 5. The mean duration of hospitalization was 2.94 days. 6. The most common complication was hemorrhage at the puncture site, but in a few patients.

IntraCytoplasmic Sperm Injection(ICSI)치료의 임상적 유용성

양회생,이은주,심재철 동국대학교 경주대학 1998 東國論集 Vol.17 No.2

IntraCytoplasmic Sperm Injection(ICSI) as treatment for male-factor infertility has been introduced worldwide on the past few years in many laboratories using assisted reproduction techniques. In spite of much progress in in vitro fertilization and embryo transfer(IVF-ET) program, the pregnancy rate remains at 20-30% and the endometrial implantation rate per embryo transferred at 10%. Although IVF-ET is widely applied in the treatment of couples with male factor infertility, it may fail in many infertile couples with normal seman parameters, and certain couples cannot be accepted for standard IVF-ET due to unfertilization or extremely low fertilization rate of oocytes. Recently, several procedures of microassisted fertilization(MAF) using micromanipulation have been introduced, and pregnancies and births have been obtained after IntraCytoplasmic Sperm Injection(ICSI). In conclusion, MAF of human oocytes with ICSI is a promising fertilization method for IVF-ET patients, especially with few spermatozoa for the conventional methods of in vitro insemination and with the past history of failure in fertilization or low fertilization rate in the previous cycles, and ICSI using micromanipulation procedures applied to human oocytes will provide a range of novel technique which may dramatically improve the pregnancy rate in IVF-ET program and contribute much to the effective management of infertile couples.

The Association of Social Support and Quality of Life in Gynecological Cancer Related of Lymphedema in a Hospital: A Pilot Study

( Hoe Saeng Yang ),( Kwan Lee ),( Do Sung Kim ),( Young Joo Sim ),( Ho Joong Jeong ),( Ghi Chan Kim ),( Won Gyu Kim ) 대한산부인과학회 2011 Obstetrics & Gynecology Science Vol.54 No.7

The aim of this study was to investigate the association of social support and quality of life in patients with gynecological cancer related lymphedema. Methods We interviewed to patients with gynecology related lymphedema (n=27) for psychosocial effects, economic affects by questionnaire that we developed. Short form-36 ver. 2 questionnaire was used to assess quality of life of the patients. Beck`s depression index questionnaire was used to assess mood change of the patients. In addition, we identified support need for patients with gynecology cancer related lymphedema. Data were collected from 2009 to 2010. Results Patients with gynecology cancer related lymphedema have limitations to do lives such as activity of daily living, participate to leisure and exercise. Patients perceived symptoms were heaviness, limitation of range of motion, pain, weakness and feeling expansion in lower extremity. There was negative effect for financial status because of increase medical cost and decrease income. However, there was not affect to relationship with family. Half of the patients have some depression symptoms and there was significant decrease in quality of life such as especially, body pain and social functioning, compared to general population. Conclusion Gynecological cancer related lymphedema have negative effect in quality of life, socioeconomic state and patients needed more social support. Therefore, more attention and social support for patients with gynecology cancer related lymhedema are needed.

Effects of alpha-Tocopherol on Cadmium-Induced Toxicity in Rat Testis and Spermatogenesis

Hoe Saeng Yang,Dong Keun Han,Jung Ran Kim,Jae Chul Sim 대한의학회 2006 Journal of Korean medical science Vol.21 No.3

A Case of Antenatal Diagnosed Twin Twin Transfusion Syndrome

( Hoe Saeng Yang ),( Chan Yong Park ),( Chang Seo Park ),( So Young Lee ),( Kwan Young Cheon ),( Mi Huen Nam ) 대한산부인과학회 1994 대한산부인과학회 학술대회 Vol.73 No.-

A Case of Bowel Metastasis from Carinoma of the Uterine Cervix

( Hoe Saeng Yang ),( Ok Kyoung ),( Kwan Young Cheon ),( Hong Yeon Lee ),( Chan Yong Park ),( Myoung Ah Lee ) 대한산부인과학회 1994 대한산부인과학회 학술대회 Vol.73 No.-

난관수종액이 생쥐 체외수정과 배아 발달에 미치는 영향

양회생(Hoe Saeng Yang) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.7

N/A Objective : To ascertain if hydrosalpinges are associated with reduced pregnancy rates and increased pregnancy loss after IVF-ET, a study was conducted. Increased volume and leakage of hydrosalpinx fluid may exert negative effects on follicular development and embryo quality and/or render the uterine environment hostile to embryogenesis. This study was undertaken to examine the effect of hydrosalpinx fluid an mouse embryogenesis in vitro. Methods :The study was designed by comparison of mouse embryo blastulation rate in media containing increasing concentrations of hydrosalpinx fluid. In vitro fertilization rate and the development of one-, two-, four-cell mouse embryos in medium containing 0% (Control), 0.3%, 0.6%, 0.9%, 5%, 10% and 20% of human hydrosalpinx fluid-containing media was observed. Results :In vitro fertilization and culture of mouse embryo at 0% (control), 0.3%, 0.6%, 0.9%, 5%, 10%, 20% hydrosalpinx fluid concentrations demonstrated significantly 1ower blastulation rate at each level compared with the controls (p<0.05). In vivo fertilization and culture of embryo at the same increasing concentration of hydrosalinx fluid showed the same results (p<0.05). And the difference of each embryo development (zygote, 2cell, 4cell) was not significant. Conclusion :Hydrosalpinx fluid is highly embryotoxic. Procedures such as, salpingectomy ar proximal tubal occlusion to circumvent the passage of hydrosalpinx fluid into the uterine cavity may have beneficial effects on the developmental environment for embryos in vivo.

불임부부에서 Clomiphene과 hMG 병용 과배란유도후 자궁강내 인공수정시술의 임상적 고찰

양희생(Hoe Saeng Yang),김종호(Jong Ho Kim),심재철(Jae Cheol Sim) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.2

목적 : Clomiphene/hMG 병합 과배란유도후 자궁강내 인공수정술에 대한 효율성을 알아보고자 하였다. 연구방법 : 1997년 7월부터 2000년 4월까지 43명의 불임환자를 대상으로 총 81주기의 과배란유도 후 자궁강내 인공수정술을 시행하였으며, 과배란유도의 방법은 월경주기 제 3일째부터 7일째까지 클로미펜을 투여하고 hMG을 제 3일째부터 격일로 투여하여 자궁강내 인공수정을 시행했다. 결과 : 시술 환자당 임신율은 39.5%(17/43)이였으며, 시술 주기당 임신율은 20.9%(17/81)였고 불임의 원인으로는 배란장애로 인한 불임이 16명으로 총 32주기였고, 자궁내막증으로 인한 불임은 4명에서 총 8주기, 일측 난관폐쇄인 경우가 2명에서 총 3주기 그리고 자궁근종인 경우가 1명으로 1주기 시행되었다. 과배란유도 후 자궁강내 인공수정술시의 각각의 임신율은 배란장애인 경우가 43.8%, 원인불명의 경우 40.0%이였고, 자궁내막증의 경우 25.0%, 일측 난관 폐쇄의 경우 50%, 자궁근종인 경우는 0%이였으며 각 주기 당 임신율은 배란장애인 경우가 21.9%, 원인불명인 경우 21.6%, 자궁내막증의 경우 12.5%, 일측 난관 폐쇄인 경우 33.3% 그리고 자궁근종의 경우 0%이었다. hCG 투여일에 시행한 질식 초음파 검사상 16mm이상인 난포수가 1개일 때 주기당 임신율은 7.9%, 2개일 때 42.3%, 3개일 때 41.7%, 4개 이상일 때 42.6%로 난포의 수가 증가함에 따라 임신율이 증가하나 2개이상인 경우 큰 차이를 보이지 않았다. 생존표분석(life table analysis)로 얻어진 누적 임신율은 1주기 21.3%, 2주기 후 36.7 %, 3주기 후70.0 %였다. 결론 : Clomiphene/hMG병합 사용한 과배란유도후 자궁강내 인공수정술은 남성 불임인자가 아닌 최소한 일측 난관이 건재한 불임 환자에서 임상적으로 유용하게 사용할 수 있는 간편하고 경제적인 불임증 치료 방법으로서 생각된다. Objectives : To determine the effect of clomiphene/hMG combined superovulation with intrauterine insemination on pregnancy outcomes. Materials and methods : Eighty-one cycles of clomiphene/hMG combined superovulation with intrauterine insemination in forty-three infertile couples were analysed retrospectively. Results : The overall pregnancy rate was 39.5% per patient and 20.9% per cycle. Each pregnancy rate of infertility due to ovulatory dysfunction, unexplained infertility and endometriosis was 43.8%, 40.0%, and 25.0% per patient respectively. Conclusions : Clomiphene/hMG superovulation with intrauterine insemination is a simple, cost effective and safe treatment modality in the management of infertility, and may improve a pregnancy rate.

Cyclophosphamide와 Paclitaxel 항암치료 시 GnRH agonist 1, 2 및 GnRH antagonist 투여에 의한 생쥐난포 보존효과

양회생 ( Hoe Saeng Yang ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.8

목적: 생쥐에서 cyclophosphamide와 paclitaxel의 용량에 따른 원시난포의 파괴정도와 일시적으로 난소를 억제시켜 항암제의 세포독성을 회피하는 GnRHa I과 II 그리고 GnRH antagonist를 병행 투여하여 각기 다른 용량에서 원시난포의 보존효과를 알아보기 위하여 실험하였다. 연구 방법: 생쥐에 각각 50 mg/kg, 75 mg/kg의 cyclophosphamide와 12.5 mg/kg, 19 mg/kg의 paclitaxel을 투여하여 대조군과 비교하여 원시난포의 파괴 정도와 세포자멸사 지표를 측정하였다. 또한 GnRHa I, GnRH antagonist 그리고 GnRHa II를 각각 0.1 mg/kg을 병용투여해서 원시난포의 증가정도와 세포자멸사지표의 감소정도를 측정하였다. 결과: 원시난포의 경우 cyclophosphamide와 paclitaxel의 저용량에서 GnRHa I, II, GnRH antagonist 모두 원시난포 보존효과가 있었고 고용량에서는 GnRH antagonist에서만 보존효과가 있었다. 효과가 있었던 GnRH analogues 각 군 간의 차이는 없었다. 세포자멸사 지표에서는 cyclophosphamide, paclitaxel의 저용량, 고용량 모두에서 GnRHa I, II 및 GnRH antagonist 투여 시 감소하였다. 저용량에서 GnRH analogues 각 군 간의 비교에서는 GnRHa I이 가장 효과적 이었다. 결론: GnRH analogue의 병행투여 군에서 통계적인 유의성을 보인 것으로 보아 항암치료를 받는 가임여성에서도 비슷한 효과를 기대할 수 있으며 이를 뒷받침할 임상연구가 필요할 것으로 생각된다. Objective: The degree of destruction of primordial follicles was investigated following the administration of cyclophosphamide or paclitaxel respectively in mouse ovaies. And then the effect of GnRHa I, GnRH antagonist and GnRHa II on the primordial follicles was evaluated following the administration of cyclophosphamide or paclitaxel. Methods: Saline or cyclophosphamide (50 mg/kg or 75 mg/kg) were intraperitoneally injected into seven-week old female ICR mice. GnRHa I (Leuplin(R)), GnRH antagonist (Cetrotide(R)) or GnRHa II (H-6038) was injected into mice, and administered with 50 mg/kg and 75 mg/kg of cyclophosphamide following 9 days treatment with GnRH analogues. After collecting ovaries, H&E staining was performed and the number of primordial follicles was counted. To confirm the induction of apoptosis, TUNEL assay was performed. Another experimental groups of mice were administered with a low concentration (12.5 mg/kg) or a high concentraion (19 mg/kg) of paclitaxel. Results: Cyclophosphamide and paclitaxel cause mild to moderate destruction of primordial follicles in mouse ovaries. The number of primordial follicles in the group of high dose was noted less than in that of low dose treated with cyclophosphamide or paclitaxel. Increased the apoptotic indices were shown in the group of cyclophosphamide or paclitaxel compared to in saline only treated group. Treatment with GnRHa I, GnRH antagonist and GnRHa II significantly increased the number of primordial follicles at a low concentration of cytotoxic agents (P<0.05), whereas the number of primoridal follicle increased only in GnRHa I antagonist treated group at a high concentration of cyclophosphamide or paclitaxel (P<0.05). Conclusion: The present study shows that GnRH analogues alleviate destruction of primordial follicles caused by cyclophosphamide and paclitaxel in mouse ovaries, suggesting that GnRH analogues may be applicable to increase fertility opportunity in malignant cancer patients of reproductive age planning future pregnancies.

인간배아의 공동배양 : REVIEW

양회생,이은주,김종호,최석철,심재철 동국대학교 경주대학 1999 東國論集 Vol.18 No.-

One of the contributory causes to poor pregnancy rates in assisted reproduction has been the decreased viability of transferred embryos and the transfer of four-cell embryos into and environment that naturally would be receptive only to 5-day-old blastocysts. In this paper, we have reviewed on the role of helper cells(cocultures) to mimic the in vivo, environment to bring about improved embryo quality and an increased number of blastocysts for replacement in IVF patients. The behavior of helper cell is first presented, followed by their use as cocultures for fertilization and cleavage of embryos. The mode of action and specificity of helper cells are also discussed. The currently available results of pregnancies after cocultures are presented together with future aspects of research that are necessary to refine the coculture system, The ultimate aim is to mimic in vivo conditions in vitro, so that at least the pregnancy rates of assisted conception can be parallel to normal fecundity in the human. Therefore, a very attractive future includes the freezing of blastocysts generated from coculture, thawing, and replacing them in natural cycles.