폐쇄성 무정자증과 비폐쇄성 무정자증에서 체외수정시술 후의 임신 결과 비교

박찬우,궁미경,양광문,김진영,유근재,서주태,송상진,박용석,강인수,전진현,Park, Chan-Woo,Koong, Mi-Kyoung,Yang, Kwang-Moon,Kim, Jin-Young,Yoo, Keun-Jai,Seo, Ju-Tae,Song, Sang-Jin,Park, Yong-Seog,Kang, Inn-Soo,Jun, Jin-Hyun 대한생식의학회 2003 Clinical and Experimental Reproductive Medicine Vol.30 No.3

Objective: To compare the pregnancy outcomes after in vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI) between obstrucvtive and non-obstrucvtive azoospermia. Methods: From January 1994 to December 2002, 524 patients with obstructive azoospermia (886 cycles) and 163 patients with non-obstructive azoospermia (277 cycles) were included in this study. Microsurgical epididymal sperm aspiration (MESA) or testicular sperm extraction (TESE) in obstructive azoospermia and TESE in non-obstructive azoospermia were perfomed to retrieve sperm, which was used for ICSI and then fertilized embryos were transferred. The results of ICSI - fertlization rate (FR), clinical pregnancy rate (CPR), clinical abortion rate (CAR) and delivery rate (DR) - were statistically analysed in obstructive versus non-obstructive azoospermia. Results: There were no differences in the number of retrieved oocytes, injected oocytes for ICSI and oocyte maturation rate. FR was significantly higher in obstructive than non-obstructive azoospermia (71.7% vs. 61.1%, p<0.001). There was no difference in CPR per embryo transfer cycle. After pregnancy was established, however, CAR was significantly higher in non-obstructive than obstructive azoospermia (25.6% vs. 12.5%, p=0.004). DR per clinical pregnancy cycle was significantly higher in obstructive than non-obstructive azoospermia (78.0% vs. 64.4%, p=0.012). In the karyotype ananlysis of abortus, abnormal karyotypes were found in 75.0% (6/8) of obstructive and 55.6% (5/9) of non-obstructive azoospermia. Conclusion: Our data show significantly higher FR in obstructive than non-obstructive azoospermia. Though there was no differrence in CPR, CAR was significantly higher in non-obstructive than obstructive azoospermia. The abortion may be related to the abnormal karyotype of embryo, but further investigations are necessary to elucidate the cause of clinical abortion in azoospermia.

Effect of Testicular Histopathology on Pregnancy Outcomes in Non-Obstructive Azoospermia

박찬우,서주태,박용석,김혜옥,양광문,김진영,궁미경,강인수,송인옥,Park, Chan-Woo,Seo, Ju-Tae,Park, Yong-Seog,Kim, Hye-Ok,Yang, Kwang-Moon,Kim, Jin-Young,Koong, Mi-Kyoung,Kang, Inn-Soo,Song, In-Ok The Korean Society for Reproductive Medicine 2008 Clinical and Experimental Reproductive Medicine Vol.35 No.4

목 적: 비폐쇄성 무정자증 환자에서 고환의 조직병리학적 진단에 따라 고환조직내 정자채취술 (Testicular sperm extraction, TESE) 후 난자세포질내 정자주입술 (Intracytoplsmic sperm injection, ICSI)의 체외수정시술 결과를 알아보고자 하였다. 연구방법: 비폐쇄성 무정자증으로 고환조직내 정자채취술 후 난자세포질내 정자주입술을 이용하여 배아 이식을 시행한 122주기를 분석하였다. 고환의 조직병리학적 진단에 따라 Germ-cell aplasia (GA, 40주기), Maturation arrest (MA, 32주기) and severe hypospermatogenesis (S-HS, 50주기)로 구분하여 체외수정시술 결과를 비교하였으며, 이들 결과를 난자세포질내 정자주입술을 이용한 폐쇄성 무정자증 환자의 체외수정시술 결과와 비교하였다. 결 과: 고환조직내 정자채취술 후 난자세포질내 정자주입술시 수정율은 각각 58.1% in GA, 42.2% in MA and 48.0% in S-HS로 조직병리학적 진단에 따른 차이는 없었으며, 폐쇄성 무정자증 환자의 72.9%에 비해 유의하게 낮은 수정율을 보였다 (p<0.001). 고환조직내 정자채취술시 채취된 정자 (spermatozoa, 94주기)로 난자세포질내 정자주입술을 시행한 주기의 배아 이식 후 임신율은 각각 22.6% in GA, 29.4% in MA와 26.1% in S-HS이었으며, 출생률은 각각 16.1%, 29.4%와 19.6%로 조직병리학적 진단에 따른 차이는 없었다. 정자세포 (spermatid, 16주기)를 사용하여 난자세포질내 정자주입술을 시행한 주기의 임신율은 각각 0.0% (0/3 주기), 9.1% (1/11주기)와 0.0% (0/2주기)이었으며, 출생률은 각각 0.0%이었다. 정모세포 (spermatocyte, 12주기)를 사용한 주기의 임신율은 각각 0.0% (0/6주기), 0.0% (0/4주기)와 0.0% (0/2주기)이었으며, 출생률도 각각 0.0%이었다. 결 론: 비폐쇄성 무정자증환자의 배아이식을 시행한 주기에서 고환의 조직병리학적 진단에 따른 난자세포질내 정자주입술시 수정율은 차이가 없었으며, 폐쇄성 무정자증 환자에 비해 유의하게 낮은 수정율을 보였다. 비폐쇄성 무정자증환자에서 고환조직내 정자채취술시 정자를 채취하여 난자세포질내 정자주입술을 시행한 주기의 체외수정시술 결과는 고환의 조직병리학적 진단에 따라 차이를 보이지 않는다. Objective: To evaluate outcomes of patients with non-obstructive azoospermia (NOA) undergoing the testicular sperm extraction (TESE) combined with intracytoplasmic sperm injection (ICSI) with different histopathologic subgroups. Method: A total of 122 embryo-transferred TESE/ICSI cycles were compared among NOA subgroups; Germ-cell aplasia (GA, 40 cycles), Maturation arrest (MA, 32 cycles) and severe hypospermatogenesis (S-HS, 50 cycles). Obstructive azoospermia (OA, 667 cycles) patients were served as a control. TESE/ICSI outcomes such as fertilization rate (FR), clinical pregnancy rate (CPR) and live birth rate (LBR) were evaluated. Results: The 2PN FR of embryo-transferred TESE/ICSI cycle was 58.1% in GA, 42.2% in MA and 48.0% in S-HS, which was significantly lower than that of OA (72.9 %, p<0.001). For ICSI-spermatozoa cycles, there were no significant differences in CPR (22.6%, 29.4% and 26.1%) and LBR (16.1%, 29.4% and 19.6%) among NOA subgroups. The CPR of ICSI-spermatid cycles was 0.0%, 9.1% and 0.0% without a live birth. For ICSI-spermatocyte cycles, no clinical pregnancies occurred in any group. Conclusion: There was no significant difference in the FR of embryo-transferred TESE/ICSI cycles among NOA subgroups. The FR among all NOA subgroups was significantly lower than that of OA. Testicular histopathology in NOA did not affect successful pregnancy if spermatozoa extraction from the testis is successful and embryo transfer is possible.

난류 발생기의 형상에 따른 수직 PCB채널에서의 열전달 및 압력손실 변화

박찬우,장승일,정종수,남평우,Park, Chan-U,Jang, Seung-Il,Jeong, Jong-Su,Nam, Pyeong-U 대한기계학회 1996 大韓機械學會論文集B Vol.20 No.7

This study was performed to analyze the cooling effect of heated ribs which are frequently used for cooling of electronic parts, using the numerical method. To prevent the excessive pressure drop due to turbulence promoters for the enhancement of heat transfer rate especially, the effect of the angle of turbulence promoter was investigated by the numerical analysis. Heat transfer rate with turbulence promoters with rectangular cross-section increased by 13% in average, but the coefficient of pressure drop increased by 1.68 times than that without them. In the present study, triangular cross-sectional shape turbulence promoters were suggested and numerically tested. Pressure drop of turbulence promoter with the 30 degree triangular cross-sectional shape decreased by 30% from that of rectangular cross-section promoters while heat transfer rate was almost the same. While with 4 turbulence promoters, the heat transfer rate increased by 21%, the pressure drop increased 4 times. It means that the higher capacity of cooling fan should be needed. With the triangular cross-sectional shape, the size of vortex region at the rear of promoters became considerably smaller, so pressure drop became smaller. The effect of the change of cross-sectional shape was not found in the flow pattern near the ribs, so that heat transfer characteristics in the ribs were not changed.

SCG(Secure Communication Group)을 이용한 계층적 VPN(Virtual Private Network) 구성 및 특성

박찬우,한치문,Park, Chan-Woo,Han, Chi-Moon 대한전자공학회 2001 電子工學會論文誌-TC (Telecommunications) Vol.38 No.11

인터넷을 이용한 대부분의 VPN(Virtual Private Network)은 기업 데이터만을 보호하는 형태로 구성되어 있다. 그러므로 다양한 형태의 VPN 구성이 필요하다. 최근에 SCG(Secure Communication Group) 개념을 이용하여 VPN을 구성하는 방법이 연구되고 있다. 본 논문에서는 SCG 구성 방법인 Path-definition 방식과 Arca-definition 방식의 문제점을 분석하고, 인트라넷 VPN 환경에서 SCG 개념을 사용한 VPN 중 적용 가능한 여러 형태의 VPN 모델을 검토한다. 그리고 인터넷에 Area-definition 방식을 적용하고 SCG number를 이용한 계층적 VPN 구성 방법을 제안한다. 제안한 방식의 특성을 각 entity가 관리해야 할 키수 및 인증 회수에 대해 정량적으로 분석하고, 본 방식이 유효함을 나타낸다. Currently most of VPNs within internet has only capability to protect cooperate data. Recently, various types of VPNs are being studied based on the concept of SCG(Secure Communication Group). This paper analyses the problems of path-definition method and area-definition method of VPNs using SCG technology, and discusses the possible models among VPNs using SCG technology. This paper proposes the hierarchal VPN configuration method using SCG number and internet based area definition method, and analyze the characteristics of the proposed VPN model on the point of the authentication frequency and the number of managements keys.

동의나물 섭취 후 발생한 서맥을 동반한 쇼크 2례

박찬우,옥택근,조준휘,최동욱,허애영,이희영,김용훈,조병렬,김성은,최기훈,배지훈,서정열,정재봉,Park,, Chan-Woo,Ok, Taek-Gun,Cho, Jun-Hwi,Choi, Dong-Wook,Her, Ae-Young,Lee, Hee-Young,Kim,, Yong-Hoon,Cho, Byung-Ryul,Kim,, Sung-Eun,Choi, Ki-Hoon 대한임상독성학회 2004 대한임상독성학회지 Vol.2 No.1

With a recent well-being boom, our interest in chemical-free vegetables is also increasing. So, some people are trying to take in wild plants chosen by themselves. However, others often come to their rescue in an emergency department after eating them, caused by their misunderstanding poisonous herbs as edible vegetables. We have ever seen two persons carried into the emergency department with bradycardia and shock incurred by his intake by confusion between Caltha palustris and Ligularia fischeri lately. There were symptoms such as epigastric pain, nausea, vomiting and so on in their cases, and the symptoms of bradycardia and hypotension continued. Owing to sustained bradycardia and hypotension states, we applied a dopamine to a patient, and then the in-patient left the hospital two days later. We presumed the cause of the two symptoms appeared in two cases to be a saponin in Caltha palustris. For that reason, if someone has the bradycardia and hypotension symptoms from an unknown cause after taking in wild plants, they have to consider a toxication by the Caltha palustris. Therefore, this paper focused on the issue that unexpected poisoning would have to be prevented by studying about wild plants much more and informing the toxic risk from the plants.

난관 폐쇄에 기인한 불임 환자에서 난관 개통술의 효용성

박찬우,차선화,양광문,한애라,유지희,송인옥,김혜옥,강인수,궁미경,이경상,Park, Chan-Woo,Cha, Sun-Hwa,Yang, Kwang-Moon,Han, Ae-Ra,Yoo, Ji-Hee,Song, In-Ok,Kim, Hye-OK,Kang, Inn-Soo,Koong, Mi-Kyoung,Lee, Kyung-Sang 대한생식의학회 2010 Clinical and Experimental Reproductive Medicine Vol.37 No.4

목적: 불임을 주소로 내원한 환자들을 대상으로 자궁 난관 조영술을 이용한 난관 불임 선별검사에서 난관 막힘의 소견을 보인 경우 선택적 난관 조영술을 시행 후 실패 시 난관 개통술을 시행하여 난관 불임치료에 있어 난관 개통술의 효용성을 알아보고 난관 막힘 부위 및 형태에 따른 난관 개통률을 비교하고자 하였다. 연구방법: 난관 불임 선별검사로서 자궁 난관 조영술을 시행하였으며 자궁 난관 조영술 상 난관 막힘 소견을 보인 215명의 342개의 난관을 대상으로 후향적 연구를 진행하였다. 결과: 난관 개통술을 시행하여 342개의 난관 가운데 248개의 난관이 개통되어 72.5%의 난관 개통률을 보였다. 막힘 부위에 따른 난관 개통률은 근위부 83.8% (197/235예), 협부 45.6% (47/103예), 원위부 100% (4/4예)를 보여 자궁-난관 접합부에 가까운 막힘 일수록 높은 개통률을 보였다. 막힘 형태에 따른 개통률은 점진형은 92.3% (157/170예), 오목형은 80.2% (69/86예), 볼록형은 25.5% (22/86예)의 난관 개통률을 보였다. 난관 막힘 부위와 형태를 종합하여 볼때 난관 근위부 점진형 막힘의 경우 91.6% (143/156예)의 높은 개통률을 보인 반면 난관 협부 볼록형 막힘의 경우에는 개통률이 11.3% (6/53예)에 불과하였다. 난관 개통에 성공한 156명 가운데 98명에서 임신에 성공하여 62.7%의 임신율을 보였다. 결론: 난관 개통술은 자궁 경부를 통한 시술로 수술적 방법이나 체외수정시술의 난자 채취에 비해 덜 침습적인 방법으로 입원치료가 필요하지 않으며 비교적 적은 비용으로 불임의 원인을 극복할 수 있는 장점이 있어 난관 원인에 의한 불임 환자에서 우선적으로 시행해 볼 수 있는 효과적인 치료 방법이라 할 수 있다. Objective: To evaluate the significance and efficacy of trans-cervical fallopian tube catheterization (TFTC) in diagnosis and optimal treatment modality for tubal blockage. Methods: The retrospective study was performed in those underwent TFTC from January 2005 to December 2009. A total of 342 fallopian tubes in 215 patients which showed tubal blockage in hysterosalpingography (HSG), were subjected to TFTC. Recanalization rate (RR) was compared according to portion of tubal blockage; proximal, isthmic and distal portion and blockage type; tapering, concave, and convex type. Results: In total, RR was 72.5% (248/342 tube). According to the portion of tubal blockage, RR was 83.8% in proximal, 45.6% in isthmic and 100% in distal portion. RR was 92.3% in tapering, 80.2% in concave and 25.5% in convex type, respectively. There were 98 pregnancies in 156 patients after successful recanalization, which shows 62.7% pregnancy rate. Conclusio: TFTC were capable of recanalizing tubal blockage in 248 of 342 tubes in 156 of 215 patients (72.5%). The RR was increased with proximal portion and tapering type tubal blockage.

온실가스 배출규제와 기업전략

박찬우,Park, Chan-U 환경보전협회 2008 환경정보 Vol.30 No.375

엣칭용 염화철폐액의 처리에서 미반응철의 재생방법

박찬우,정우원,이만호 ( Chan Woo Park,Woo Won Jeung,Man Ho Lee ) 한국공업화학회 1997 공업화학 Vol.8 No.4

철 환원법에 의한 엣칭용 염화철 폐액의 처리에서 니켈이 부착된 미반응 철분을 재생하기 위해서 볼밀 및 초음파 처리를 사용하였다. 철분을 2회 재생하였을 때 니켈 제거 효율은 볼밀을 2시간 처리한 경우와 초음파를 4시간 처리한 경우 각각 94.0%와 82.1%이었다. 재생 처리하지 않고 철분을 3회 사용하였을 때 니켈 제거 효율은 40.0%이었다. 처리시간이 증가함에 따라 볼밀처리에서는 철분의 크기가 감소하였으나, 초음파 처리에서는 철분의 크기 변화가 거의 없었다. The regeneration of the iron powders in the treatment of FeCl₃ etching solution containing nickel by ball-mill and ultrasonic treatments has been studied. When the unreacted iron powders were treated twice, the removal efficiency of nickel was 94.0% for the ball-mill treatment and 82.1% for the ultrasonic treatment. But the removal efficiency of nickel was 40.0% for the untreated iron powders. As the treatment time was increased, the particle size of iron powders was decreased for ball-mill treatment and almost not changed for ultrasonic treatment.

난관 불임환자에서 난관 개통술시 진단복강경의 효용성

박찬우,김혜옥,허걸,양광문,김진영,송인옥,유근재,전종영,이경상,강인수,궁미경,Park, Chan-Woo,Kim, Hye-Ok,Hur, Kuol,Yang, Kwang-Moon,Kim, Jin-Young,Song, In-Ok,Yoo, Keun-Jae,Jun, Jong-Young,Lee, Kyung-Sang,Kang, Inn-Soo,Koong, Mi-Kyoung 대한생식의학회 2003 Clinical and Experimental Reproductive Medicine Vol.30 No.2

Objective: To evaluate whether diagnostic laparoscopy before transcervical fallopian tube catheterization (TFTC) would improve tubal recanalization rate and pregnancy rate in patients with bilateral proximal tubal blockage in hysterosalpingogram (HSG). Methods: The retrospective study was performed in those underwent TFTC from January 1998 to December 2001. A total of 50 patients with bilateral proximal tubal blockage in HSG were subjected to TFTC sequentially using repeated HSG (rHSG), selective salpingography (SS) followed by tubal catheterization (TFTC). Each procedure was terminated once patency had been achieved without proceding to the next technique. In Group A patients (n=35, 64 tubes), diagnostic laparoscopy was performed before TFTC was taken to exclude the tube combined with peritubal adhesion or distal tubal pathology. In Group B, patients (n=15, 26 tubes) were performed TFTC without diagnostic laparoscopy. Results: There were significant difference in clinical pregnancy rate (45.7% vs 15.4%, p=0.034) but no differences were found in recanalization rate (75.0% vs 73.1%) and complication rate (8.6% vs 13.3%). Although there is no signficant difference, more tubes were canalized by SS, which means tubal obstruction rather than occlusion, in Group A (25.0% vs 5.3%, p=0.069). Conclusion: Diagnostic laparoscopy would be effective in the selection of tube for the relatively inexpensive and less invasive TFTC or patients in need of assisted reproductive technologies. With the tubes without combined peritubal adhesion or distal tubal pathology, pregnancy rate was significantly increased.

37세 이상의 환자에서 체외수정시술시 GnRH Agonist 주기와 GnRH Antagonist 주기의 비교 연구

박찬우,차선화,김해숙,김혜옥,양광문,김진영,송인옥,유근재,강인수,궁미경,Park, Chan Woo,Cha, Sun Wha,Kim, Hae Suk,Kim, Hye Ok,Yang, Kwang Moon,Kim, Jin Young,Song, In Ok,Yoo, Keun Jae,Kang, Inn Soo,Koong, Mi Kyoung 대한생식의학회 2005 Clinical and Experimental Reproductive Medicine Vol.32 No.3

Objective: To compare the clinical results and pregnancy outcomes of in vitro fertilization (IVF) between GnRH antagonist cycles and GnRH agonist (GnRH-a) cycles including flare-up and long protocol in women with advanced age. Materials and Methods: Retrospective clinical study. From January 2001 to September 2003, IVF cycles of female patient 37 years over were included in this study. GnRH-a long protocol (62 cycles, 61 patients) and GnRH antagonist multi-dose flexible protocol (66 cycles, 51 patients) were compared with the control group of GnRH-a flare-up protocol (151 cycles, 138 patients). IVF cycles for non-obstructive azoospermia (NOA), endometriosis III, IV and polycystic ovarian syndrome (PCOS) were excluded in this study. Clinical results such as total gonadotropin dose, serum E2 on hCG administration, the number of retrieved oocytes and the pregnancy outcomes - clinical pregnancy rate (CPR), implantation rate (IR) and live birth rate (LBR) per embryo transfer - were compared. Results: There were significant differences in the total dose of gonadotropin (GnRH-a flare-up vs. GnRH-a long vs. GnRH-antagonist; 41.8 vs. 54.7 vs. 24.8), serum E2 on hCG administration (1787.2 vs. 1881.6 vs. 788.0), the numbers of retrieved oocytes (8.1 vs. 11.1 vs. 4.5) and endometrial thickness (9.1 vs. 10.4 vs. 8.0) which were significantly lower in GnRH-antagonist cycles. But pregnancy outcomes shows no significant differenced in CPR (25.0% vs. 35.8% vs. 24.5%), IR (11.7% vs. 12.3% vs. 10.1%) and LBR (15.8% vs. 28.3% vs. 15.1%) Conclusion: In women with advanced age, GnRH-antagonist cycles can result in comparable pregnancy outcomes to GnRH-a cycles including flare-up and long protocol. GnRH-a long protocol show higher CPR, IR and LBR than GnRH antagonist multi-dose flexible protocol and flare-up protocol without significant differences.