• Title/Summary/Keyword: 불임여성

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Effects of Aromatase Inhibitor on Reproductive Hormone Profiles and Ovulation Induction (방향화효소억제제의 생식호르몬 분비와 배란유도에 대한 효과)

  • Kim, Sook-Hyun;Kim, Jeong-Ah;Park, Joon-Cheol;Bae, Jin-Gon;Shin, So-Jin;Kwon, Sang-Hoon;Cho, Chi-Heum;Yoon, Sung-Do;Cha, Soon-Do;Kim, Jong-In;Rhee, Jeong-Ho
    • Clinical and Experimental Reproductive Medicine
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    • v.35 no.2
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    • pp.143-153
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    • 2008
  • Objective: To investigate the effects of aromatase inhibitor on reproductive hormone profiles and evaluate it's ovulation inducing capability in anovulatory infertile women. Methods: We quantified the blood levels of reproductive hormones from 30 healthy normal cycling women in natural cycle (control) and letrozole medicated cycle (study). LH, FSH, estradiol, testosterone, DHEA-S were quantified on third, 11th, 21th day in both cycles, and on 21th day, progesterone was added. Sixth anovulatory infertile women received either letrozole or clomiphene citrate for ovulation induction (n=30 in each groups). We compared the clinical parameters such as ovulation rate, pregnancy rate, the day of LH surge, number of follicles and endometrial thickness, cervical mucus amount, spinnbarkeit, mean diameter of follicles on the day of LH surge. Results: Letrozole had no effect on the LH, FSH, estradiol, DHEA-S secretion but there were significant increase in testosterone level on day 11 and progesterone level on day 21 in letrozole medicated cycle compared than control cycle ($0.40{\pm}0.16$ vs $0.28{\pm}0.11\;ng/ml$, p=0.002, $18.18{\pm}13.07$ vs $8.38{\pm}7.64\;ng/ml$, p=0.001, respectively). In comparison between letrozole and clomiphene groups, there were no significant difference in ovulation rate, pregnancy rate, number of mature follicle, mean diameter of follicles, but showed earlier LH surge, thicker endometrium, more cervical mucus, and higher spinnbarkeit in letrozole group ($12.12{\pm}2.46$ vs $14.52{\pm}3.18$ days, p=0.006, $10.48{\pm}1.23$ vs $8.52{\pm}0.93\;mm$, p=0.000, $2.04{\pm}0.61$ vs $1.57{\pm}0.59$, p=0.012, $6.00{\pm}1.12$ vs $4.95{\pm}1.61\;cm$, p=0.003, respectively). Conclusion: Letrozole may augment folliculogenesis and improve the endometrial condition for implantation in normal cycling women. Ovulation efficacy of letrozole in anovulatory women was comparable to clomiphene citrate and letrozole may be more physiological in ovulation induction.

Predominant T Helper 1 Immune Response in Women with Reproductive Failures (반복 유산 및 착상실패를 보이는 환자에서 Th1 면역반응에 대한 연구)

  • Han, Ae-Ra;Yang, Kwang-Moon;KwakKim, Joanne
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.3
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    • pp.231-237
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    • 2010
  • Objective: To evaluate whether T helper 1 (Th1) immune response is predominant in women with reproductive failures (recurrent spontaneous abortion and recurrent implantation failure) and the activation of T cell is related to Th1 propensity. Methods: Women with a history of recurrent implantation failure or recurrent spontaneous abortion comprise the study group (n=37). Controls are normal fertile women without a history of infertility or pregnancy losses (n=11). Th1/Th2 ratios of interferon (INF)-$\gamma$/interleukin (IL)-10 and tumor necrosis factor (TNF)-$\alpha$/IL-10 expression on $CD3^+/4^+$ cells, CD154, and CD69 expression on T cells are measured by flow cytometric analysis. Results: The ratios of TNF-$\alpha$ to IL-10 expressing on $CD3^+/4^+$ cells (Th1/Th2 cell ratios) are significantly higher in study group ($42.1{\pm}2.3$) as compared with that of controls ($28.7{\pm}2.7$) (p=0.002). The overall trend of CD154 and CD69 expression on T cells are elevated in study group than those of controls. The proportion (%) of $CD3^+/4^+/154^+$ cells ($1.7{\pm}0.5$ vs. $0.3{\pm}0.2$, p=0.038) and the % of $CD3^+/8^+/154^+$ cells ($0.6{\pm}0.2$ vs. $0.1{\pm}0.0$, p=0.024) are significantly higher in study group. The % of $CD3^+/69^+$ cells ($5.6{\pm}1.9$ vs. $1.3{\pm}5.4$, p=0.046) and % of $CD3^+/8^+/69^+$ cells ($4.8{\pm}1.3$ vs. $1.8{\pm}0.2$, p=0.035) among $CD3^+/8^+$ cells are significantly increased in study group. Conclusion: Women with reproductive failures have Th1 propensity with increased T cell activation. These finding means that activated T cell has a harmful effect on early pregnancy and implantation by induction of Th1 immunity.

Spatial distribution of Korea-born adoptees in the United States (미국내 한국 입양아의 공간분포)

  • Park, Soon Ho
    • Journal of the Korean Geographical Society
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    • v.30 no.4
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    • pp.411-428
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    • 1995
  • Intercountry adoption, one type of forced migration, has increased significantly in recent decades. The adoption of Korea-born children by Americans has been the strongest intercountry adoption linkage in the world. The intercountry adoption stream was strongly influenced by intercountry adoption policies, and socio-cultural settings in both South Korea and the United States. Socio-cultural factors in South Korea made local adoption undesirable and helped for abandoned children to be adopted by Americans, while socio-cultural factors in the United States had reduced the number of locally available infants for adoption, and increased the demand for infants from abroad. Distribution of Korea-born adoptees shows concentration in the Pacific Northwest, Upper Midwest and Northeast areas which have not attracted Korean immigrants so generally. The trend of concentration shows some increased importances in the outlying states in the northern United States. The location and activity of agencies shaped the spatial distribution of Korea-born adoptees in the United States.

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A study on the pulse wave factor according to BMI and period of sterility on female (난임 여성의 체질량지수(BMI), 불임기간에 따른 맥파 연구)

  • Kim, Gyeong-Cheol;Kim, Yi-Soon
    • Korean Journal of Oriental Medicine
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    • v.18 no.2
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    • pp.139-149
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    • 2012
  • Objectives : This is the study to understand of the pulse wave factor according to BMI and period of sterility on female, and to confirm the relationship of pulse wave factor among left and right inch, bar and cubit. Methods : The Questions and measurement of the pulse wave were operated with subjects(76 sterile females using on public health center). The measurement of the pulse wave was operated in 6 part of left and right inch, bar and cubit. The pulse wave was prior measured in part of left bar (i.e. interior pulsation part of radial process styloides in left hand), and next was measured in part of left inch and bar. And the pulse wave was operated samely in part of right inch, bar and cubit. Results : The results were as follows. The pulse energy of 6 part of left and right inch, bar and cubit was showed statistical significance and decreased in order of left inch, right inch, left cubit, right cubit, left inch, right bar. The left and right inch and cubit were showed numerical value of normal range, but left and right bar were showed lower pulse eneregy than normal range. Also left and right cubit were showed lower than left and right inch, and higher than left and right bar. In BMI, The pulse energy of left and right inch, cubit and the average of right hand was not showed statistical significance in the range of low-weight, normal, over-weight and obesity. But in the left and right bar and the average of left hand, the pulse energy of over-weight and obesity group were showed significantly higher than low-weight group. And the pulse wave factor was divided the pattern of h1 showing high numerical value in inch (Ap, As, Aw) and the pattern of Wm showing high numerical value in bar and cubit (RAI, Ad) Conclusions : The low pulse energy of bar was significant observation on the setting of oriental medical diagnostic index on sterilitas. Also, in the numerical value pattern of diverse pulse wave factor, it was divided the pattern of high numerical value in inch and the pattern of high numerical value in bar and cubit. On this, we think that the studies need in the future.

Comparison of Oral Micronized Progesterone and Dydrogesterone as a Luteal Support in Intrauterine Insemination Cycle (자궁강내인공수정시 황체기 보강으로서 경구 미분화 프로게스테론과 디드로게스테론의 비교)

  • Jang, Eun-Jeong;Jee, Byung-Chul;Kim, Sang-Don;Lee, Jung-Ryeol;Suh, Chang-Suk
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.2
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    • pp.153-158
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    • 2010
  • Objective: To compare the clinical outcomes between oral micronized progesterone and dydrogesterone as a luteal phase support in stimulated intrauterine insemination (IUI) cycles. Methods: A retrospective analysis was performed in 183 IUI cycles during January 2007 to August 2009. Superovulation was achieved by using gonadotropins combined with or without clomiphene citrate. The luteal phase was supported by oral micronized progesterone 300 mg/day (n=136 cycles) or dydrogesterone 20 mg/day (n=47 cycles) from day of insemination. Results: There were no significant differences in clinical characteristics such as age of female, infertility factors, number of mature follicles ($\geq$16 mm), total motile sperm counts, and endometrial thickness on triggering day between the two groups. The clinical pregnancy rates per cycle were similar between the two groups (21.3% in the micronized progesterone group vs. 19.1% in the dydrogesterone group, p=0.92). The clinical miscarriage rate tended to be 3-fold higher in the micronized progesterone group (34.5% vs. 11.1%, p=0.36). Conclusion: Supplementation of oral dydrogesterone as a luteal support has similar clinical outcomes compared with oral micronized progesterone. Large-scaled randomized study would be required to confirm our findings.

Clinical Characteristics of Korean Daegu . Kyungpook PCOS Women (대구.경북 지역 한국인 다낭성 난소 증후군 환자의 임상 양상)

  • Bae, Jin-Young;Kim, Mi-Yeon;Sung, Su-Kyung;Oh, Jeong-Eun;Chun, Sang-Sik;Lee, Taek-Hoo
    • Clinical and Experimental Reproductive Medicine
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    • v.36 no.1
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    • pp.71-80
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    • 2009
  • Objective: PCOS is one of the most common endocrine disorder affecting reproductive age women. It shows wide range of reproductive and metabolic manifestations. This study was to determine the differences of clinical and laboratory characteristics between adolescent and adult Korean Daegu Kyungpook PCOS patients. We also compared clinical and laboratory values of Korean PCOS patients to Turkish and American PCOS patients. Methods: 88 cases were diagnosed and enrolled as PCOS patients, based on 2003 Rotterdam criteria, who visited KNUH Reproductive Endocrinology division between Jan. 2000 and Apr. 2008. We retrospectively reviewed clinical characteristics, serum hormone levels, ultrasono-graphic findings. And we divided into 2 groups, adolescent and adult. We analyzed them with Chi-square test and Student's t-test statistically. Results: There were no statistically significant differences between adult and adolescent Korean PCOS patients. The prevalence of hyperandrogenism such as facial acne or hirsutism, obesity, and insulin resistance of Korean PCOS women was significantly lower than Turkish and American PCOS women. Conclusion: From the results of this study, we can suggest that it is sure that there are differences of clinical and laboratory characteristics of PCOS patients between races. Genetic background, dietary habits and life style affect the expression of clinical symptoms of PCOS. But we could not find out the difference between adolescent and adult PCOS patients of same race. It might be due to the limitation of small patient number and narrow range of age distribution. So, there must be large scale and multi-center and multi-regional study.

Change in Fertility Rates in Korea: Causes and Future Prospect (최근 한국사회의 출산율 변화원인과 향후 전망)

  • Kim, Seung-Kwon
    • Korea journal of population studies
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    • v.27 no.2
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    • pp.1-34
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    • 2004
  • 최근 한국사회에서는 출산율의 저하로 인한 사회경제적 영향을 우려하여 대책방안을 강구하여야 한다는 논의가 증대되고 있다. 그런데 국가정책을 개발${\cdot}$추진하기 이전에 반드시 요구되는 것은 저출산 현상의 올바른 인식과 철저한 원인규명이다. 따라서 본 연구에서는 출산율 변화의 원인을 다각적으로 살펴보고, 향후 변화방향을 전망해 보고자 한다. 먼저 자녀출산의 변화를 결혼상태 변화와 유배우부인의 출산율 변화 부분으로 나누어 살펴본 결과, 과거와는 달리 최근의 출산율 저하는 유배우 부인에 의해서가 아니라 미혼자의 결혼연장 또는 독신생활에서 기인되는 것으로 나타났다. 이들 두 요인에 영향을 주는 변수로는 경기침체 및 직장불안정, 결혼가치관의 변화와 초혼연령의 상승, 자녀양육 관심증대, 자녀양육비 부담, 가정과 직장의 양립을 위한 사회적 인프라 부족, 여성의 자아욕구 및 사회참여 증대, 자녀효용가치 감소, 이혼 등 가족해체의 증대, 그리고 불임부부의 증대 등인 것으로 판단된다. 향후 출산율 변화를 전망해 보면, 저출산을 일찍 경험한 서구 선진국의 경우와는 달리 정책의 추진에 한계가 있어 선진국보다 더 낮은 출산율을 회복하는 데는 많은 어려움이 있을 것이라는 판단이다. 더군다나 젊은 미혼남녀의 가치관이 개인주의화 되는 경향이 있다는 점을 감안한다면 출산율 회복정책을 추진한다 하더라도 한계가 있을 수밖에 없을 것이다. 수년간 실시된 각종 실태조사를 분석한 결과에 의하면 현재의 경기침체가 회복될 경우 약 20%의 출산율 상승 가능성이 있으며, 이 때의 합계출산율은 약 1.43명 수준이 될 수 있을 것으로 예견된다. 또한 종합적 체계적 출산회복정책을 효과적${\cdot}$효율적으로 추진한다면 약 10년 후에는 합계출산율이 약 1.6 수준으로 회복될 것이라는 낙관적 견해를 가져본다. 그렇지만 정책의 강도에 따라서 회복수준은 현저하게 상이할 것이다.를 진단, 치료함에 있어 진행성 신질환의 가능성을 시사하는 예후인자가 없다면 신생검보다는 지속적이고 정기적인 추적관찰만으로도 충분할 것으로 생각된다도 등은 양군 사이에 유의한 차이가 관찰되지 않았다. 발견 당시 혈청 $C_3$치의 감소는 모두 11명(61.1%)에서 관찰되었는데, 증상군에서는 7명(87.5%), 집단뇨검사군에서는 4명(40%)으로 증상군에서 혈청 $C_3$치의 감소가 보다 현저하였다. 그러나 추적관찰 기간 동안 증상군에서는 7명 중 4명, 집단뇨검사군에서는 4명 중 1명에서 혈청 $C_3$치는 정상범위로 증가하여 최종 관찰시점에서는 6명 (33.3%)에서만 혈청 $C_3$치의 감소가 지속되고 있다. 혈청 $C_3$치의 감소를 보인 경우를 다시 병리조직학적 분류에 의해 세분하여보면 발병당시에는 I형 8명(61.5%), II형에 1명(100%), III형 2명(50%)에서 관찰되었는데, 최종 시점에서는 I형 4명(30.8%), II형 1명(100%), III형 1명(33.3%)이었다. 또한 증상군에서 세포성 반월체형성과 세뇨관위축의 빈도가 높았으며, 사구체 혈관벽 비후와 사구체 간질의 증가의 정도가 집단뇨검사군에 비해 통계적으로 유의하게 높았다. 결론: 무증상성 요이상을 가진 환자에서 신장조직검사 실시 후 MPGN으로 진단되는 증례가 증가하고 있고, 오히려 증상을 동반하는 경우보다 빈도가 증가한다는 사실은 집단뇨 검사에서 소변의 이상소견이 발견되어 신장 조직검사를 실시할 경우 혈청 $C_3$치의 감소 여부에 관계없이 MPGN도 진단적 고려 대상이 되어야 한다고 생각한다.신장 조직검사를 시행한 결과 진행성 경과를 취할 수 있는 막 증식성 사구체 신염과 매우 희귀한 증례인 신유전분증 등으로 진단됨으로써 지속성 단백뇨의 경우 정확 진단적 접근이 필수적임을 알 수

Study on Status Changes in Female Infertility who Admitted to Oriental Hospital (한방병원에 내원한 여성 불임 환자의 실태 변화 연구)

  • Jang, Hee-Jae;Kim, Jin-Hwan;Hwang, Deok-Sang;Lee, Jin-Moo;Lee, Chang-Hoon;Cho, Jung-Hoon;Jang, Jun-Bock;Lee, Kyung-Sub
    • The Journal of Korean Obstetrics and Gynecology
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    • v.23 no.3
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    • pp.184-191
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    • 2010
  • Purpose: Examine changes in the aspect and state of patient with infertility who admitted to Korean oriental hospital. Look at the changes in last 8 years and seek how oriental medicine can approach to infertility patients who admitted to Korean oriental hospital in last 8 years. Methods: Total of 7434 new patients with infertility who admitted to Gynecology of Oriental Hospital, $\bigcirc\bigcirc$ University Medical Center, from October 2002 to December 2009 was compared to infertility patients based on bottom collected data in this study, total of 1061 infertility patients were targeted for this study. Results: 1.There is no distinct increases in age between women who admitted to oriental medicine and patient's average age, it has shown constantly increasing trend in their age though. However, the average age of infertility patients have shown significant increasing range than average age of all infertility patients. 2. After analysis the result of infertility patient's rate of overall patients, the rate of infertility patients are remaining the same or slowing down in 2005, as the starting year(Table 2). The significant relationship was found in diagnosis and treatment of gynecology(Table 4~5) for infertility patients. In 2005 as the starting year, as patients who admitted to oriental hospital after diagnosed or treated at gynecology are increasing, the rate of infertility patients of overall patients admitted to hospital is slowing down, which is decreasing. 3. There is increasing number of patient diagnosed with "unknown cause" who admitted to Gynecology of Oriental Hospital after year of 2005. 4. The increasing number of patient diagnosed with "unknown cause" who admitted to oriental hospital has a tendency to be important factor in infertility treatment of oriental medicine. Conclusion: Unknown causes of infertility patients who admitted to oriental hospital will continuously increase as senses of society, economic, and social climate change.

Study on In Vitro Maturation and Culture of Immature Oocytes Collected from Ovaries of Infertile Women (불임 여성의 난소로부터 회수된 미성숙 난자의 체외 성숙과 배양에 관한 연구)

  • Lee, Seok-Yoon;Son, Won-Young;Yoon, San-Hyun;Lee, Won-Don;Park, Chang-Sik;Lim, Jin-Ho
    • Clinical and Experimental Reproductive Medicine
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    • v.30 no.4
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    • pp.333-340
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    • 2003
  • Objective: This study was performed to examine the maturation and the development to the blastocyst stage of immature oocytes collected from patients with high risk of ovarian hyperstimulation syndrome (OHSS). Materials and Methods: Cumulus-oocyte complexes (COCs) were collected following only HCGpriming for non stimulated IVF-ET cycles of the patients. At the time of oocyte collection, COCs were classified into three groups in accordance with their appearance (Group I: oocytes with dispersed cumulus cells; Group II: oocytes with compacted cumulus cells; Group III: oocytes with sparse cumulus cells). The in vitro maturation and blastocyst development rates of the COCs were compared among these groups. From August 2001 to June 2002, 48 IVM/IVF-ET cycles from 42 patients (mean age: $32.4{\pm}3.8$ years) were performed. To prevent the occurrence of OHSS, the patients were primed with 10, 000 IU HCG alone 36 h before oocyte collection without gonadotropin stimulation. Oocytes were aspirated on cycle days from 7 to 13. The normal COCs were classified into three groups according to their appearance. The aspirated immature oocytes were cultured in YS maturation medium containing 30% (v/v) human follicular fluid (HFF), 1 IU/ml FSH, 10 IU/ml HCG and 10 ng/ml rhEGF. Fertilization was induced by intracytoplasmic sperm injection (ICSI). All zygotes were co-cultured with cumulus cells in $10{\mu}l$ YS medium containing 10% HFF until day 7 after oocyte collection. Blastocyst transfer was performed on day 5 after ICSI. Results: Th e mean number of oocytes cultured in the IVM/IVF cycles was $24.7{\pm}10.6$. Of 1185 COCs, those assigned to Group I, II and III were 470 (39.7%), 414 (35.0%) and 301 (25.4%), respectively. The maturation rate (94.5%, 444/470, p<0.05) in Group I was significantly higher than those of Group II (62.8%, 260/414) and Group III (73.1%, 220/301). Especially, 30.9% of COCs in Group I (145/470) was matured on the day of oocyte aspiration. There were no differences in the rates of fertilization and cleavage among the three groups. The development rate to the blastocyst stage in Group I (54.6%, 206/377, p<0.05) was also significantly higher than those in Group II (33.0%, 68/206) and Group III (30.1%, 52/173). Twenty-four clinical pregnancies (50.0%) was obtained and 22 pregnancies (45.8%) are ongoing. Implantation rate in the present study was 24.6%. Conclusion: These results suggest that there is a positive correlation between the appearance of COCs and the developmental competence of the immature oocytes in non stimulated IVM/IVF cycles.

Electrochemical Determination of Bisphenol A Concentrations using Nanocomposites Featuring Multi-walled Carbon Nanotube, Polyelectrolyte and Tyrosinase (다중벽 탄소 나노 튜브, 전도성고분자 및 티로시나아제 효소로 구성된 나노복합체를 이용한 비스페놀A 맞춤형의 전기화학적 검출법)

  • Ku, Nayeong;Byeon, Ayeong;Lee, Hye Jin
    • Applied Chemistry for Engineering
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    • v.32 no.6
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    • pp.684-689
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    • 2021
  • In this paper, we develop a cost effective and disposable voltammetric sensing platform involving screen-printed carbon electrode (SPCE) modified with the nanocomposites composed of multi-walled carbon nanotubes, polyelectrolyte, and tyrosinase for bisphenol A. This is known as an endocrine disruptor which is also related to chronic diseases such as obesity, diabetes, cardiovascular and female reproductive diseases, precocious puberty, and infertility. A negatively charged oxidized multi-walled carbon nanotubes (MWCNTs) wrapped with a positively charged polyelectrolyte, e.g., polydiallyldimethylammonium, was first wrapped with a negatively charged tyrosinae layer via electrostatic interaction and assembled onto oxygen plasma treated SPCE. The nanocomposite modified SPCE was then immersed into different concentrations of bisphenol A for a given time where the tyrosinase reacted with OH group in the bisphenol A to produce the product, 4,4'-isopropylidenebis(1,2-benzoquinone). Cyclic and differential pulse voltammetries at the potential of -0.08 V vs. Ag/AgCl was employed and peak current changes responsible to the reduction of 4,4'-isopropylidenebis(1,2-benzoquinone) were measured which linearly increased with respect to the bisphenol A concentration. In addition, the SPCE based sensor showed excellent selectivity toward an interferent agent, bisphenol S, which has a very similar structure. Finally, the sensor was applied to the analysis of bisphenol A present in an environmental sample solution prepared in our laboratory.