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불임환자의 세척정자에 의한 자궁내 인공수정의 임상적 평가
이승헌,윤영욱,이보연,이병석,박기현,황동훈,Lee, S.H.,Yoon, Y.W.,Lee, B.Y.,Lee, B.S.,Park, K.H.,Hwang, D.H. 대한생식의학회 1992 Clinical and Experimental Reproductive Medicine Vol.19 No.1
The sucess of intrauterine inseminations with washed human spermatozoa was evaluated in 92 patients. In according to indication of insemination, intrauterine inseminations of women with hostile cervical mucus yield a 35.3% and 12.8% with male factors and 27.3% with unexplained infertility. In ovulation induction group with variable agents including clomiphen, human menopausal gonadotropin (HMG) and GnRH analog, the pregnancy rate was 27.8% (22/79) and in natural cycle group, 15.4% (2/13). The fetal loss rate in insemination group was 12.5% (3/24). Multiple pregnancies were 7 cases and ovulation induction were performed in 6 cases among them. Intrauterine insemination with washed human spermatozoa therefore represents an effective and safe procedure selected infertile couples.
박기헌,박원일,이보연,이병식,조동제,송찬호,Park, K.H.,Park, W.I.,Lee, B.Y.,Lee, B.S.,Cho, D.J.,Song, C.H. 대한생식의학회 1993 Clinical and Experimental Reproductive Medicine Vol.20 No.1
Salpingoscopy may be helpful in the diagnosis of subclinical epithelial, vascular damage and stricture formation, which may playa significant role in infertility, or predispose women to tubal pregnancy, despite of clear demonstration of tubal patency on hysterosalpingogram. We explored the fallopian tube from the fimbriae to the ampullary-isthmic junction with small rigid flexible endoscope during laparoscopy in sixteen patients from July 1991 to Jan. 1992. All patients have been observed following salpingoscopy for several months. Three pregnancies were achieved in seven patients with bilaterally normal or minimally damaged tubal mucosa. In another five patients with moderate to severe tubal damage, we noted one tubal pregnancy. The other remaining patients are being followed up now. As conclusions, salpingoscopy seems to be an useful tool in the diagnosis of tubal lesions which are not identified by H.S.G., give much help to refine the indications for tubal microsurgery and the selection of patients for GIFT or IVF-ET and to determine the prognostic value in terms of risk for ectopic pregnancy.
자궁근종시 LHRH agonist (D-Trp6-LHRH) 치료에 따른 근종세포내 미세구조의 변화
박기현,신명철,이보연,이병석,송찬호,Park, K.H.,Shin, M.C.,Lee, B.Y.,Lee, B.S.,Song, C.H. 대한생식의학회 1991 Clinical and Experimental Reproductive Medicine Vol.18 No.2
Long-term administration of luteinizing hormone-releasing hormone(LHRH) agonists, through a process of pituitary desensitization and down-regulation of receptors, inhibits the secretion of gonadotropin and sex-steroids and induces a reversible suppression of gonadal activity. This approach can be used as an effective endocrine therapy for some hormone-dependent tumors. We have used D-Trp6-LHRH, a long acting LHRH agonist, for the treatment of eleven patients with uterine leiomyomas, thereafter myomectomy was performed in seven cases and observed the ultrastructural changes of leiomyoma with an electron microscope. The use of LHRH agonist may be effective in reducing the size of a myoma considerably by primarily inducing medical hypophysectomy and would allow easier surgical removal. Electron microscopic findings of myoma cells after the use of LHRH agonist included the following: loss of cristae and swelling nuclear chromatin, perinuclear vacuolation in cytoplasm. Bone mineral density was slightly decreased, however, the difference was not statistically significant.
도정태,전수현,최종태,강영선,이보연,김승보,김남형,이훈택,정길생,Do, J.T.,Jun, S.H.,Choi, J.T.,Kang, Y.S.,Lee, B.Y.,Kim, S.B.,Kim, N.H.,Lee, H.T.,Chung, K.S. The Korean Society for Reproductive Medicine 1997 Clinical and Experimental Reproductive Medicine Vol.24 No.3
본 연구에서는 체외수정, 난자내 정자 직접주입, 난자내 정자 두부 미두 주입 후의 핵과 미세소관의 변화를 관찰하였다. 핵과 미세소관의 움직임은 형광염색을 실시한 후 공초점주사현미경을 이용하여 관찰하였다. 체외수정에서 관찰된 바와 동일하게 정자를 난자에 직접주입 한 직후 정자 중편부에서 성상체가 형성되었고, 이 성상체에 의해 자성 웅성 전핵이 융합되는 것으로 관찰되었다. 그러나 난자내 정자를 직접주입하였을 경우 웅성전핵으로 발달하는 비율이 낮았다. 이는 주입된 정자가 원형질막과 perinuclear theca에 싸인 체 난자내로 들어가 난자내의 sperm nucleus decondensing factor와 정자 핵과의 반응이 억제되기 때문으로 생각된다. 정자 두부 만을 주입하였을 경우 성상체가 형성되지 않았지만 자성 웅성 전핵 사이 또는 그 주위에서 두터운 미세소관층이 관찰이 되었다. 따라서 소에 있어서는 정자의 중편부에 위치하여 microtubule organizing center (MTOC)의 역할을 하는 중심립 또는 중심체 없이도 모계에서 유래된 미세소관이 형성되어 이것이 전핵의 융합과 세포분열에 관여하는 것으로 생각된다. 정자의 미부 만을 주입하였을 경우 성상체가 형성이 되지 않았으며, 자성핵 사이에 형성된 미세소관과 떨어져서 관찰되었다. 따라서 주입된 정자의 꼬리는 미세소관형성과 관련이 없는 것으로 생각된다. 이러한 결과는 소에 있어서, 수정 시 정자로부터 유래되는 중심립 또는 중심체가 없이도 미세소관을 형성하여 미세소관에 의해 이후의 배발달이 정상적으로 일어남을 보여주고 있다. The objective of this study was to determine the microtubule assembly and chromatin configuration during the first cell cycle in bovine oocytes following injection of spermatozoon, sperm head and tail. The microtubule and chromatin configuration was imaged with fluorescent labeled monoclonal ${\alpha}$-tubulin antibody and propidium iodide under laser scanning confocal microscope. Microtubule and chromatin dynamics in bovine oocytes following intracytoplasmic sperm injection (ICSI) were not different from those observed during in vitro fertilization (IVF). Following ICSI, the microtubular aster was observed around sperm midpiece. During pronuclear formation, the sperm aster was enlarged and seen around male and female pronuclei. At mitotic metaphase, the microtubular spindle assemble astral poles and chromosomes were aligned on the spindle equator. At mitosis, asters were concentrated to each spindle pole and they filled the cytoplasm. After injection of the isolated sperm head, the microtubular aster was not seen around sperm head in any cases (0/18). Instead, microtubules were organized from the cytoplasm, which filled the whole cytoplasm during pronuclear apposition. These microtubules seem to move male and female pronuclei. These results suggest that isolated sperm head can develop into normal pronucleus in mature bovine oocytes, and competent to participate syngamy with the ootid chromatin. The functional microtubules following isolated sperm head injection in bovine oocytes appeared to be organized solely from maternal stores.
배란유도시 내인성 Estrogen이 칼슘대사에 미치는 영향에 관한 연구
윤달영,박기현,이병석,이보연,송찬호,Yoon, D.Y.,Park, K.H.,Lee, B.S.,Lee, B.Y.,Song, C.H. 대한생식의학회 1991 Clinical and Experimental Reproductive Medicine Vol.18 No.2
The role of estrogen in calcium metabolism has not been well documented. To further investigate the effects of endogenous estrogen on the calcium regulating hormones in women, we correlated the changes of estrogen level with those of calcium regulating hormones during ovulation induction in 12 hypogonadal and 8 normally menstruating women. During ovulation induction, the serum leveles of estradiol rose from 40.0 to 831.0pg/ml. There were no significant changes in the serum leveles of total calcium, inorganic phosphorus, parathyroid hormone, calcitonin. However, 1, $25-(OH)_2D_3$ rose significantly from 31.0 to 47.2pg.ml as the endogenous $E_2$ increaed (p<0.005).
이보연,정미정,박기현,이병석,조동제,황동훈,송찬호 中央醫學社 1992 中央醫學 Vol.57 No.4
To evaluate the clinical effects of transdermal estrogen replacement therapy in postmenopausal women, especially cardiovascular effect by change of serum lipid profiles after the treatment, 32 postmenopausal women - 18 natural menopausal women, 14 women with premature ovarian failure - were studied before and after 6 8 weeks of treatment withE2 containing transdermal therapeutic systems. 1. The postmenopausal symptoms were improved or disappeared in all cases. 2. Significant changes of serum LDL level, HDL/LDL ratio were noted. 3. The side effects of transdermal estrogen replacement therapy were noted with skin eruption (7 cases), vaginal spotting (3 cases) and breast pain (2 cases), but no discontinuation of the treatment was resulted. This study was concluded that the transdermal estrogen replacement therapy was effective on the prevention of cardiovascular diseases in postmenopausal women.