체외수정 생쥐 배아에서의 배아 줄기세포 확립

문신용,박용빈,김희선,오선경,천대우,서창석,최영민,김정구,이진용,김석현,Shin, Yong-Moon,Park, Yong-Bin,Kim, Hee-Sun,Oh, Sun-Kyung,Chun, Dae-Woo,Suh, Chang-Suk,Choe, Young-Min,Kim, Jung-Gu,Lee, Jin-Yong,Kim, Seok-Hyun 대한생식의학회 2002 Clinical and Experimental Reproductive Medicine Vol.29 No.1

Objective: In order to acquire the technique for the establishment of human embryonic stem cells (ESe) derived from the human frozen-thawed embryos produced in IVF-ET program, this study was performed to establish mouse ESC derived from the in vitro fertilized embryos. Materials and Methods: After Fl hybrid (C57BL female $\times$ CBA mael) female mice were superovulated with PMSG and hCG treatment, their oocytes were retrieved and inseminated, and the fertilized embryos were cultured for 96-120 hours until the expected stages of blastocysts were obtained. To isolate the inner cell mass (ICM), either the blastocysts were treated with immunosurgery, or the whole embryos were cultured for 4 days. Isolated ICMs were then cultured onto STO feeder cell layer, and the resultant ICM colonies were subcultured with trypsin-EDTA treatment. During the subculture process, ESC-like cell colonies were observed with phase contrast microscopy. To identify ESC in the subcultured ESC-like cell colonies, alkaline phosphatase activity and Oct-4 (octamer-binding transcription factor-4) expression were examined by immunohistochemistry and RT-PCR, respectively. To examine the spontaneous differentiation, ESC-like cell colonies were cultured without STO feeder cell layer and leukemia inhibitory factor (LIF). Results: Seven ESC-like cell lines were established from ICMs isolated from the in vitro fertilized embryos. According to the developmental stage, the growth of ICMs isolated from the expanded blastocysts was significantly better than that of ICMs isolated from the hatched blastocysts (80.3% vs. 58.7%, p<0.05). ESC-like cell colonies were only obtained from ICMs of expanded blastocysts. However, the ICMs isolated from the embryos treated with immunosurgery were poorly grown and frequently differentiated during the culture process. The established ESC-like cell colonies were positively stained with alkaline phosphatase and expressed Oct-4, and their morphology resembled that observed in the previously reported mouse ESC. In addition, following the extended in vitro culture process, they maintained their expression of cell surface markers characteristic of the pluripotent stem cells such as alkaline phosphatase and Oct-4. When cultured without STO feeder cell layer and LIF, they were spontaneously differentiated into the various types of cells. Conclusion: The findings of this study suggest that the establishment of mouse ESC can be successfully derived from the in vitro fertilized embryos. The established ESC-like cells expressed the cell surface markers characteristic of the pluripotent stem cells and spontaneously differentiated into the various types of cells.

남성 불임의 진단 및 체외수정의 예후인자로서 정자 형태의 정밀 분석과 정자 첨체반응 및 햄스터 난자 침투 분석의 비교 연구

문신용,류범용,방명걸,오선경,이재훈,서창석,김석현,최영민,김정구,이진용,Moon, Shin-Yong,Ryu, Buom-Yong,Pang, Myung-Geol,Oh, Sun-Kyung,Lee, Jae-Hoon,Suh, Chang-Suk,Kim, Seok-Hyun,Choi, Young-Min,Kim, Jung-Gu,Lee, Jin-Yong 대한생식의학회 2002 Clinical and Experimental Reproductive Medicine Vol.29 No.1

Objective : This study was designed to investigate the interrelationship and clinical usefulness of sperm morphology by strict criteria (SM), acrosome reaction following ionophore challenge test (ARIC) and sperm penetration assay (SPA) using zona-free hamster ova as prognostic factors in in vitro fertilization. Materials and Methods: Semen samples were provided by 83 patients undergoing IVF. We first evaluated the differences between normal fertilization group and poor fertilization group on three andrologic tests. Secondly, we analyzed the relationship between the three andrologic tests and in vitro fertilization on IVF settings. Finally, we evaluated the effectiveness of the three andrologic tests as the prognostic indicators for fertilizing ability. Results: The fertilization rate of all men in the poor fertilization group was less than 30%; but there was no evidence that this poor fertilization was due to oocyte defects. The results of three andrologic tests were significatly higher in normal fertilization group. Fertilization rate (%) in vitro was highly correlated (p<0.001) with % normal sperm by SM, ARIC value (%), and SPA result. By using Receiver-Operator-Characteristic curve (ROC), we evaluated the effectiveness of these three tests. The sensitivity and specificity of SM, ARIC test and SPA in predicting fertilization potential in IVF setting were 76% and 75%, 84% and 90%, and 76% and 95%, respectively. Conclusion: Our data suggest that the three andrologic tests can be reliable tools as prognostic factors of sperm fertilizing ability. Among these test, ARIC test and SPA gave more accurate information on fertilizing capacity. ARIC test was shown to have a predictive value for fertilizing ability comparable to that of SPA that appears to be a simple and cost-effective addition to current andrology laboratory. Combined application of these three tests may give more information on predicting sperm fertilizing capacity.

Clomiphene Citrate 부하검사와 난소 반응 예측 인자와의 연관성에 관한 연구

문신용,채희동,김광례,서창석,김석현,최영민,신창재,김정구,이진용,Moon, Shin-Yong,Chae, Hee-Dong,Kim, Kwang-Rye,Suh, Chang-Suk,Kim, Seok-Hyun,Choi, Young-Min,Shin, Chang-Jae,Kim, Jung-Gu,Lee, Jin-Yong 대한생식의학회 1996 Clinical and Experimental Reproductive Medicine Vol.23 No.3

Objective: To determine the cutoff value of clomiphene citrate challenge test(CCCT) that can predict the normal and abnormal(diminished) ovarian response group and to assess the usefulness of CCCT as a predictor of ovarian reserve. Materials and Methods: From March 1994 to Februry 1996, CCCT was performed to 129 infertile patients and among them, 20 patients whose basal FSH on the third day of menstrual cycle was more than 20 mIU/ml were excluded. At the same time, the same CCCT was performed to the fifteen healthy volunteers with proven fertility to determine the cutoff value of CCCT. Results; 1) A FSH value higher than 23.4 mIU/ml, measured on the 10th day of menstrual cycle, was defined as a abnormal ovarian response. The cutoff value of 23.4 mIU/ml is more than 2 standard deviations(SD) above the mean value of 15 healthy women after CCCT. 2) The abnormal CCCT group, the subpopulation with a FSH value of 23.4 mIU/ml or more, was 7.3%(8/109) and their mean age was higher than the normal CCCT group($36.5{\pm}4.5$ vs. $32.9{\pm}4.8$, P = 0.059). And the percentage of the patients older than 35 years of the abnormal CCCT group was significantly higher than that of the normal CCCT group(62.5% vs. 38.6%, p <0.05). 3) There was no correlation between the hormone values of the third day and the 10th day of menstrual cycle before and after CCCT except between FSH of the third day and the 10th day. Conclusion: The CCCT is a good method to predict the individual ovarian response to COH for ART, especially in the patients who has no other abnormal findings that predict poor prognosis. And it is neccessary to determine the cutoff value of CCCT by the large numbers of randomized study, and combining the previously proven prognostic factors, it can be applicated in many individual centers for evaluate the ovarian response before ART program.

인간 정자의 생식력 평가에 있어 첨제반응율과 햄스터 난자 침투 분석법의 비교연구

문신용,류범용,오선경,서창석,김석현,최영민,신창재,김정구,장윤석,이진용,Moon, Shin-Yong,Ryu, Buom-Yong,Oh, Sun-Kyung,Suh, Chang-Suk,Kim, Seok-Hyun,Choi, Young-Min,Shin, Chang-Jae,Kim, Jung-Gu,Chang, Yoon-Seok,Lee, Jin-Yong 대한생식의학회 1995 Clinical and Experimental Reproductive Medicine Vol.22 No.2

This study was designed to determine the relationship between sperm acrosome reaction following ionophore challenge(ARIC) and hamster ovum sperm penetration assay(SPA) as assessment of fertilizing capacity of male. ARIC test and SPA were performed in 23 fertile and 19 subfertile men. The results were as follows; Sperm concentration was significantly higher in fertile group compared with subfertile group: $114.6{\pm}64.40$ vs $61.3{\pm}46.50{\times}10^6/ml$. However, there were no significantly differences in seminal volume, motility and motility index, respectively. There was a significantly correlation between spontaneous and induced AR in fertile and subfertile group, respectively. ARIC value was significantly higher in fertile group, compared with subfertile group: $12.0{\pm}5.57%$ vs $2.6{\pm}4.96%$. Both Penetration rate(PR) and Penetration index(PI) were significantly higher in fertile group, compared with subfertile group: $97.4{\pm}7.40%$ vs $64.9{\pm}36$. 20% and $5.4{\pm}2.88$ vs $1.5{\pm}1.47$, respectively. The Positive predictive value(PPV), Negative predictive value(NPV), sensitivity and specificity of ARIC test (cut-off: 8.5) and SPA(PI cut-off : 3.0) in predicting fertility were 95.0%, 81.8%, 82.6%, 94.7% and 95.2%, 85.7%, 87.0% and 94.7%, respectively. There was no significantly difference in predicting fertility between ARIC test and SPA. In conclusion, ARIC test was shown to have a predictive value for fertilizing capacity comparable to that of the hamster ovum sperm penetration assay. Therefore, ARIC test may be a simple and cost-effective addition to existing semenology instead of SPA.

인간 배아 줄기세포의 초자화 동결 및 초급속 융해에 관한 연구

문신용,박용빈,김희선,성기청,오선경,천대우,서창석,최영민,김정구,이진용,김석현,Moon, Shin-Yong,Park, Yong-Bin,Kim, Hee-Sun,Sung, Ki-Chung,Oh, Sun-Kyung,Chun, Dae-Woo,Suh, Chang-Suk,Choi, Young-Min,Kim, Jung-Gu,Lee, Jin-Yong,Kim, Seok-H 대한생식의학회 2002 Clinical and Experimental Reproductive Medicine Vol.29 No.1

Objective: This study was carried out to establish the effectiveness of the vitrification method and the optimal cryoprotectants in the cryopreservation of human embryonic stem cells (ESC). Materials and Methods: Human ESC clumps established at Seoul National University Hospital (SNUhES 1) were cryopreserved with the vitrification method using the EM grid. EDS and EFS40 were used as vitrification solutions. Results: Between the EDS and EFS40 groups, there was no significant difference in the recovery rate after cryopreservation of human ESC. The formation rates of ESC colonies in the vitrified groups were significantly lower than those in the control ESC group (p<0.05, p<0.05). In addition, the formation rate of ESC colonies in the EDS group was significantly higher than that in the EFS40 group (p<0.05). The ESC colonies in the vitrified groups were significantly smaller after culture duration of 2 and 4 days, respectively, compared with the control ESC group (p<0.1, p<0.05). However, these effects could be reduced to nonsignificant level by the additional culture of ESC colonies. The vitrified human ESC retained the properties of pluripotent cells, including the expression of cell surface. markers for the undifferentiated cells such as alkaline phosphatase and SSEA-4 (stage-specific embryonic antigen-4), and the expression of transcription factor Oct-4 (octamer-binding transcription factor-4), and the normal karyotype. Conclusion: The vitrification method using the EM grid and EDS solution was confirmed to be very effective for the cryopreservation of human ESC.

과배란유도에 의한 난소과자극증후군 발생 고위험군에 있어서 알부민 정맥투여요법의 효과에 관한 연구

문신용,노재숙,이경순,서창석,김석현,최영민,신창재,김정구,이진용,장윤석,Moon, Shin-Yong,Roh, Jae-Sook,Lee, Kyung-Soon,Suh, Chang-Suk,Kim, Seok-Hyun,Choi, Young-Min,Shin, Chang-Jae,Kim, Jung-Gu,Lee, Jin-Yong,Chang, Yoon-Seok 대한생식의학회 1995 Clinical and Experimental Reproductive Medicine Vol.22 No.2

Ovarian hyperstimulation syndrome(OHSS) is one of the well-known complication of controlled ovarian hyperstimulation(COH). Though there have been numerous measures to prevent the occurrence of OHS, it has not been completely preventable until now. The fluid shift from the intravascular space to the third space is due to decreased oncotic pressure of the serum. The objective of this study was to evaluate if IV administration of 20% albumin in those patients with OHSS risk can make prevention of severe OHSS. We retrospectively analysed 70 patients undergoing IVF-ET who had serum peak estradiol($E_2$) level of >2,500 pg/ml and/or the number of oocytes retrieved over 20. The treatment group(n=39) received albumin while the control group(n=31) did not. After 40 grams of human albumin diluted in 1,000 ml of 0.9% sodium chloride solution, the treatment group received half of the fluid during oocyte retrieval, the remainder in the recovery suite. The results were as follows; There were significant differences in the levels of serum peak $E_2$ and number of oocytes retrieved between the two groups(p<0.05). However, there were no significant differences in the incidence of OHSS and pregnancy rate or multifetal pregnancy rate. In conclusion, administration of albumin to OHSS risk patients did not reduce the rate of OHSS in IVF-ET. However, if we consider the fact that there were differences in the level of peak serum $E_2$ and oocyte numbers, further prospective study may be needed.

인간정자의 처리에 있어서 Percoll과 Sil-Select 방법의 비교

문신용,류범용,신현아,오선경,서창석,김석현,최영민,김정구,최규홍,이진용,Moon, Shin-Yong,Ryu, Buom-Yong,Shin, Hyun-Ah,Oh, Sun-Kyung,Suh, Chang-Suk,Kim, Seok-Hyun,Choi, Young-Min,Kim, Jung-Gu,Choi, Kyu-Hong,Lee, Jin-Yong 대한생식의학회 2000 Clinical and Experimental Reproductive Medicine Vol.27 No.4

Objective: To evaluate silane-coated silica particles (Sil-select) as an alternative to polyvinylpyrrolidone-coated particles (Percoll) for gradient separation of spermatozoa, for use in assisted reproduction. Methods: 20 normal semen based on WHO criteria were included in this study. Recovery of motile and morphologically normal spermatozoa after using two-layer Percoll and Sil-select gradient respectively was recorded. Motility, HOST (hypoosmotic swelling test) and the detection of malondialdehyde for LPO (lipid peroxidation) after 24 h of incubation at $37^{\circ}C$ in a 5% $CO_2$ incubator were compared. Results: Percoll (78.5%) and Sil-select (79.1%) showed a significant increase in the motility compared to ejaculate (60.9%) but no difference between Percoll and Sil-select. Normal sperm morphology significantly increased after Percoll (57.6%) and Sil-select (53.7%) compared to ejaculate (35.8%) but no difference between Percoll and Sil-select. No differences in the recovery of motile spermatozoa and motility, HOST and the production of malondialdehyde after 24 h incubation were found when comparing the use of Percoll and Sil-select. Conclusion: Sil-select seems to be an attractive alternative to Percoll for sperm separation in assisted reproduction.

인간 배아의 동결보존에 관한 연구

문신용,김정훈,김석현,최영민,신창재,김정구,이진용,장윤석,Moon, Shin-Yong,Kim, Chung-Hoon,Kim, Seok-Hyun,Choi, Young-Min,Shin, Chang-Jae,Kim, Jung-Gu,Lee, Jin-Yong,Chang, Yoon-Seok 대한생식의학회 1994 Clinical and Experimental Reproductive Medicine Vol.21 No.2

Controlled ovarian hyperstimulation(COH) for in vitro fertilization and embryo transfer(IVFET) often results in the production of more embryos than can be efficaciously transferred at one time. However, embryo cryopreservation provides a mechanism by which additional embryos can be stored for later thawing and transfer. From November, 1990 to October, 1992, we completed 42 transfer cycles of cryopreserved pronucleus(PN) l-cell embryos using the fixed protocol of hormonal replacement therapy in a physiological manner regardless of individual ovarian function. Artificial endometrial stimulation was performed with only exogenous estradiol and progesterone(E-P) in 36 transfer cycles (Group I) and with gonadotropin-releasing hormone agonist(GnRHa) and exogenous estradiol and progesterone(GEEP) in 6 transfer cycles(Group II ). The results were as follows. 1. The Survival rate of total cryopreserved-thawed embryos was 64.9%(198/305): 64.9% (172/265) in Group I and 65.0% (26/40) in Group II. 2. Total 168 embryos were transferred with an average of 4.7 per ET in Group I and total 26 embryos were transferred with an average of 4.3 per ET in Group II. 3. The pregnancy rate(PR) per cryopreserved-thawed ET and the implantation rate was 33.3 %(14/42) and 6.7%(13/194), respectively. The PRs per cryopreserved-thawed ET were 30.6% (11/36) in Group I and 50.0% (3/6) in Group II without significant difference. 4. The take home baby rate was 11.1%(4/36) in Group I and 33.3% (2/6) in Group II.

과배란유도시 난포기 LH의 생물학적 활성이 성숙난자의 수정율 및 난할율에 미치는 영향에 관한 연구

문신용,김석현,황태영,신창재,이진용,장윤석,Moon, Shin-Yong,Kim, Seok-Hyun,Hwang, Tae-Young,Shin, Chang-Jae,Lee, Jin-Yong,Chang, Yoon-Seok 대한생식의학회 1991 Clinical and Experimental Reproductive Medicine Vol.18 No.1

To investigate the factors that affect the fertilization and cleavage rates of mature oocytes, 44 patients undergoing controlled ovarian hyperstimulation(COH) with FSH/hMG/hCG regimen for IVF - ET were analyzed. During follicular phase, serum LH levels were measured by radioimmunoassay and bioassay. Based on the mean follicular immunoactive LH(i-LH) and bioactive LH(b-LH) levels, patients were divided into 3 groups, respectively. There were no significant differences in basal serum FSH levels on menstrual cycle day 3, serum estradiol($E_2$) and progesterone ($P_4$) levels on the day of hCG administration, and the numbers of follicles aspirated and oocytes retrieved among groups. In relation to the mean follicular i-LH levels, the fertilization and cleavage rates of mature oocytes did not show a significant difference among groups. However, in groups with higher mean follicular b-LH levels, the fertilization and cleavage rates were reduced significantly. During late follicular phase, day-to-day variance in b-LH levels was not significant, but there was a significant difference among groups. There was no significant correlation between serum P. and b-LH levels. These data suggest that the fertilization and cleavage rates of mature oocytes are adversely affected by the raised mean follicular b-LH levels, and monitoring of serum b-LH levels is more useful in COH when compared with i-LH. It appears that the reduced rates are not due to the attenuated endogenous LH surge.

Klinefelter 증후군 및 Y염색체 이상으로 진단된 환자들의 염색체 결과 및 임상 양상

문신용,최석태,고희정,오선경,한정호,서창석,김석현,최영민,김정구,이진용,Moon, Shin-Yong,Choi, Seok-Tae,Ko, Hee-Jung,Oh, Sun-Kyung,Han, Jung-Ho,Suh, Chang-Suk,Kim, Seok-Hyun,Choi, Young-Min,Kim, Jung-Gu,Lee, Jin-Yong 대한생식의학회 1999 Clinical and Experimental Reproductive Medicine Vol.26 No.1

Klinefelter's syndrome is a very important disease in gynecologic endocrinologic fields, because the patients with this karyotype complain of infertility, azospermia and ambiguous genitalia. Y chromosome is an important chromosome which determine genetic sex and the structure of gonad and genitalia. In this study, to elucidate the cytogenetic characteristics and clinical features of Klinefelter's syndrome and Y chromosomal abnormalities in Korea, we studied 303 cases of Klinefelter's syndrome and 11 cases of Y chromosomal abnormalities which were diagnosed by chromosomal analysis at the Cytogenetic Laboratory, Institute of Reproductive Medicine and Population, Seoul National University for 12 years from January 1984 to December 1996. The results of this study showed as follows: 1. In a total of 9275 cases, there were 303 cases (3.3%) of Klinefelter's syndromes, 11 cases (0.1%) of Y chromosomal abnormalities. 2. In 102 cases of patients showed typical clinical features of Klinefelter's syndrome, 101 cases (99%) of them were diagnosed to Klinefelter's syndrome in karyotyping. 3. In 303 cases of Klinefelter's syndrome, there were 277 cases (91.4%) of 47,XXY complement, 16 cases (5.3%) of mosaicism, 2 cases (0.7%) of 48,XXXY, 5 cases (1.7%) of 48,XXYY and 3 cases (1.0%) of 49,XXXXY. 4. In 303 cases of Klinefelter's syndrome, 284 cases (93.7%) of them were diagnosed after puberty and only 19 cases (6.3%) of them were diagnosed before puberty. 5. In 303 cases of Klinefelter's syndrome, there were 146 cases (48.2%) of patients with infertility-associated chief complaints, 101 cases (33.3%) of patients with typical clinical features of Klinefelter's syndrome, 22 cases (7.3%) of patients with ambiguous genitalia. 6. In patients with Klinefelter's syndrome, 48,XXYY and 49,XXXXY had serious symptoms such as mental retardation, developmental delay, Down syndrome-like features, congenital anomalies, but 48,XXYY and other mosaicisms had infertility-associated symptoms or ambiguous genitalia. 7. The 8 cases of polysomy Y (XYY complement) showed several serious symptoms such as Down syndrome-like features, mental retardation, fragile X syndrome-like feature, congenital anomalies, ambiguous genitalia which could be detected before puberty.