자궁근종 환자의 임신과 분만

양회생,박인서,조성진,박혜성,이소영,천관영,남미현 대한산부인과학회 1993 대한산부인과학회 학술대회 Vol.72 No.-

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.

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.

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.

난소와 난소암에서 성선자극분비호르몬-Ⅰ과 Ⅱ의 잠재적 기능

양회생 東國大學校醫學硏究所 2003 東國醫學 Vol.10 No.2

시상하부-뇌하수체-성선축의 신경내분비 조절물질로 성선자극분비호르몬은 대단히 중요한 역할을 한다. 성선자극분비호르몬과 그 수용체는 시상하부와 뇌하수체뿐 아니라 성선, 태반 및 이러한 조직으로부터 유래된 종양에서도 발견된다. 최근에는 성선자극분비호르몬-Ⅱ 및 그 수용체가 정상난소상피세포와 그 종양에서 발견되었다. 성선자극분비호르몬의 2형태 모두 생식기 기능 및 난소 종양 성장에 대한 자가분비/주변분비 조절 인자로서 중요한 역할을 한다. 본 논문에서는 난소세포와 난소암에 있어 성선자극분비호르몬 -Ⅰ과 성선자극분비호르몬-Ⅱ 및 각각의 수용체의 분포와 기능을 알아보고자 한다. Gonadotropin-releasing hormone (GnRH) functions as a key neuroendocrine regulator of the hypothalamic-pituitary-gonadal axis. In addition to the hypothalamus and pituitary gland, GnRH and its receptor have been detected in other reproductive tissues including the gonads, placenta and tumors arising from these tissues. Recently a second form of GnRH (GnRH-Ⅱ) and type Ⅱ GnRH receptor have been found in normal ovarian surface epithelium (OSE) and neoplastic counterparts. The two types of GnRH may play an important role as an autocrine/paracrine regulator of reproductive frunctions and ovarian tumor growth. In this review, the distribution and potential roles of GnRH-Ⅰ/-Ⅱ and their GNRHRs in the ovarian cells and ovarian cancer will be discussed.

일반연제 발표 : 고도태포형성 자궁경관무력증 예에 대한 Cerclage 수술시 양수천자감압의 효과

양회생,정경원,박창서,박인서 대한산부인과학회 1992 대한산부인과학회 학술대회 Vol.69 No.-

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.

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.

The Management of Foreign Body Sensation in the Throat after Stroke by Trigger Point Injection on Posterior Belly of Digastric Muscles

김하워드,양회생,천지환,원기홍 고신대학교(의대) 고신대학교 의과대학 학술지 2021 고신대학교 의과대학 학술지 Vol.36 No.1

Foreign body (FB) sensation in the throat is often a common symptom encountered in clinical practice. FB sensation in throat has numerous causes mainly caused by reflex diseases such as laryngopharyngeal reflux. Its treatment has been focused on organic problems or hysteria while musculoskeletal problem has been neglected. We hereby report a patient with dysphagia and complaint of FB sensation in the throat after nasogastric tube removal. It was relieved by trigger point injection on the posterior belly of digastric muscles.

자궁선근증의 질식초음파와 Color doppler 초음파검사의 유용성

심재철,양회생 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.2

This study was designed to evaluate the diagnostic capability of transvaginal sonography and color doppler findings in detecting adenomyosis. We compared the preoperative transvaginal and color doppler findings with the pathological findings of the surgical specimen in a series of women who underwent hysterectomy. From January 1996 to through December 1997, we studied 142 women (mean age of 48.7) with enlarged uterus and recurrent menorrhagia. The sensitivity of transvaginal ultrasonogram was 79%, the specificity 72%, the predictive value of a normal test 80%, and that of an abnormal test 72%. However, color doppler findings had no usefulness for diagnosis of adenomyosis. The mean resistance index of the flow detected within the myometrium of adenomyosis was covering the value of 0.77, while the RI of the uterine arteries was 0.57. In contrast, the mean resistant index of the myometrium was 0.75 and RI of the uterine arteries was 0.74. In conclusion, we can suggest that the transvaginal sonogram might be useful to detect the adenomyosis. But the color doppler findings were not useful to differentiate the adenomyosis and leiomyoma.