• Clinical and Experimental Reproductive Medicine
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• v.23 no.1
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• pp.11-24
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• 1996

The number of multifetal pregnancies has increased dramatically as a result of the widespread clinical use of ovulation induction and assisted reproductive technology(ART) in infertile patients. In multifetal pregnancies, the adverse outcome is directly proportional to the number of fetuses within the uterus, primarily because of an increased predisposition to premature delivery. It is extremely difficult to counsel patients about the expected outcome of pregnancies involving three or more fetuses. To increase the chances of delivering infants mature enough to survive without being irreversibly damaged by the sequelae of marked prematurity, selective fetal reduction(SFR) to the smaller number of fetuses should be considered in multifetal pregnancies. From January, 1991 to December, 1992, transabdominal SFR in multifetal pregnancies was performed in 22 patients including 13 triplet, 7 quadruplet, 1 quintuplet and 1 heptuplet pregnancies. Transabdominal SFR using intracardiac KCI injection and aspiration of amniotic fluid was carried out in 8-13 weeks of gestation. After procedure, 20 patients were remained as twin pregnancies, and 2 patients as triplet pregnancies. There have been 11 sets of twin delivery including 2 stillbirths, 2 sets of triplet delivery including 1 stillbirth, and 1 singleton delivery. Six cases were delivered after 37 weeks of gestation, 4 cases in 33 - 37 weeks, and 1 case in 30 weeks. Unfortunately, 3 stillbirths occurred in 20-24 weeks of gestation, and 4 cases were aborted. As 7 losses of pregnanancy including 1 case of septic abortion occurred, the delayed fetal loss rate was 38.9%(7/18) in transabdominal SFR. All babies born after 30 weeks of gestation were healthy, and no fetal anomaly directly related to the procedure was encountered. From July, 1993 to February, 1995, transvaginal SFR was performed in 20 patients including 15 triplet, 4 quadruplet and 1 quintuplet pregnancies. Transvaginal SFR using the same method as transabdominal SFR was carried out in 8-11 weeks of gestation. After procedure, 19 patients were remained as twin pregnancies, and 1 patient as singleton pregnancy. There have been 13 sets of twin delivery including 2 stillbirths, and 1 singleton delivery. Six cases were delivered after 37 weeks of gestation, 5 cases in 36-37 weeks, and 1 case in 30 weeks. Unfortunately, 2 still-births occurred in 20 weeks and 21 weeks of gestation, respectively, and 2 cases were aborted. As 4 losses of pregnancy including 1 case of septic abortion occurred, the delayed fetal loss rate was 25.0%(4/16) in transvaginal SFR. No fetal anomaly directly related to the procedure was encountered. It is suggested that transvaginal SFR could be performed more easily and earlier with the lower fetal loss rate as compared with transabdominal SFR. In conclusion, SFR is a rather safe and ethically justified procedure that may improve the outcome of multifetal pregnancies.

• Women's Health Nursing
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• v.5 no.2
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• pp.191-203
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• 1999

A clinical study was made on 365 low birth weight infant and 406 normal birth weight infant who had been born at Kangnam St. mary's Hospital during past 3 years from Jan. 1, 1995 to Dec. 31, 1997. the data of this study were gathered through reviewing of medical records. 1. Comparison of general characteristic with of obstetric characteristic 1) Old maternal age, previous abortion and previous LBWI delivery in the group of low birth weight infant(LBWI) mother were more prevalent than those in the group of normal birth weight infant(NBWI)mother 2) Cesarean section, abnormal presentation and multiple pregnancy in the group of LBWI mother were prevalent than those in the group of NBWI mother. 3) regular antenartal care and visiting rate of tertiary hospital in the group of LBWI mother were more prevalent than those in the group of NBWI mother. 2. Frequency of low birth weight infant 1) Anmual average frequency of LBWI was 6.5% and monthly frequency was the highest in January and december. 2) The frequency of LBWI was the highest in 37-40wks of gestational age and was the highest in 2251-2500 gm of birth weight. 3) The frequency of congenital anomaly in the group of LBWI was more prevalent than that of NBWI. 3. Mortality rate of LBWI The mortality rate of LBWI was 9.2%. The highest mortality rate was noted before 27wks of gestational age, less than 1000gm of birth weight and within 12hrs of delivery. 4. The most common complication of pregnant women was pre-term labor, the most complication relating to placenta was premature rupture of membrane(PROM) and the most fetal complication was fetal distress in delivered LBWI. 5. Significant relating factors of low birth weight infant delivery were associated with maternal age, previous delivery, previous low birth weight delivery, pre-eclampsia, anemia, oligohydramnios, PROM, placenta previa, abruptio placenta, fetal sex, fetal distress and congenital anomaly.

• The Journal of Korean Obstetrics and Gynecology
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• v.18 no.3
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• pp.127-138
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• 2005

Purpose : This study was designed to establish safety and efficacy of using herbal medicine in pregnancy and to investigate patient's treatment satisfaction. Methods : We investigated general pregnancy outcomes of twenty-five gynecological outpatients who visited Dongguk univ. Kangnam Oriental Hospital, from July 1, 2002 through December 31, 2004 and have taken herbal medicine in pregnancy. Additionally we investigated newborn's growth status and patient's treatment satisfaction. Results : The rate of normal delivery of patients used herbal medicine for diseases that possibility of abortion is not high was 100% and there was no malformation in normally delivered 21 cases. Most of Newborn's growth status was normal and the average score of patient's satisfaction was 3.5(absolutely satisfied=5). Conclusion : The results of this study show safety and efficacy of using herbal medicine in pregnancy. And In the future, It is thought that more exactly constructed clinical survey need to be carried out.

• Clinical and Experimental Reproductive Medicine
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• v.43 no.1
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• pp.15-25
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• 2016

Objective: In the present study, we aimed to evaluate the effects of high doses of dexamethasone (DEX) in early pregnancy on pregnancy outcomes. Methods: Pregnant BALB/c mice were treated with high-dose DEX in the experimental group or saline in the control group on gestational days (GDs) 0.5 to 4.5. Pregnant mice were sacrificed on GDs 7.5, 13.5, or 18.5 and their peripheral blood, placentas, fetuses, and uterine tissue were collected. Decidual and placenta cell supernatants were examined to evaluate the effect of DEX on the proliferation of mononuclear cells, the quantity of uterine macrophages and uterine natural killer (uNK) cells, and levels of progesterone and $17{\beta}-estradiol$, as determined by an 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyltetrazolium bromide assay, immunohistochemistry, and enzyme-linked immunosorbent assay, respectively. We also were measured fetal and placental growth parameters on GD 18.5. Results: We found that high doses of DEX were associated with an increased abortion rate, enhancement of the immunosuppressive effect of the decidua, alterations in placental growth parameters, decreased progesterone and $17{\beta}-estradiol$ levels, and a reduced frequency of macrophages and uNK cells. Conclusion: Our data suggest that the high-dose administration of DEX during early pregnancy negatively affected pregnancy outcomes.

• Clinical and Experimental Reproductive Medicine
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• v.13 no.2
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• pp.137-144
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• 1986

A reveiw of 85 patients with uterine anomalies was made in respect to the incidence, chief complaints, the reason of infertility, fetal wastage rate, pregnancy complications, fetal presentations and obstetric outcome after metroplasty from 1980 to 1985. The results were summarized as follows: 1. Incidence of uterine anomaly was 0.18% among all outpatients (85/48,240). 2. Of the 85 patients, there were 36 with bicornuate deformities (42.3%), 21 septate (24.7%), 18 uterus didelphys (21.2%), 8 arcuate (9.4%) and 2 patients with unicornuate anomalies (2.4%). 3. Uterine anomalies were diagnosed by hysterosalpingogram (54.1%), pelvic examination (14.2%) and other operative procedures. 4. Chief complaints were primary infertility (41.2%), secondary infertility (15.3%), repeated pregnancy loss (12.9%), antenatal care (11.8%) and menstural disturbance (10.6%), etc. 5. Twenty-nine patients with uterine anomalies had primary infertility. The cause of infertility was proved nonuterine in 26 cases and remained unknown in 3 cases. 6. The obstetric outcome of 104 pregnancies was spontaneous abortion in 51.0%, premature delivery in 11.50/0 and fetal loss in 57.7%. 7. Complications of 41 present pregnancies were threatened abortion (22%), premature rupture of membrane (12%) and premature labor (10%), etc. The frequency of abnormal presentation was 35.3% and 64.7% of deliveries was made by Cesarian section. 8. Metroplasty was performed in 13 patients who didn't have a baby because of repeated miscarriage and unknown cause of infertility. Subsequently 8 patients had 9 successful pregnancies: 6 patients had 7 healthy babies and 2 patients are now in pregnancy without any complications.

• Clinical and Experimental Reproductive Medicine
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• v.31 no.3
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• pp.169-176
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• 2004

Objective: This study was performed to evaluate and compare the embryonic developmental capacity and pregnancy rates in conventional in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) with ejaculated sperm or testicular sperm cycles. Materials and Methods: Fertilization was examined in the following morning after IVF (group I), ICSI (group II) or TESE-ICSI cycles (group III). Fertilized oocytes were co-cultured with Vero cells until embryo transfer (ET). On day 2 and $5{\sim}7$, grades of embryos (<4- or $\geq$4-cell) and blastocysts (BG1, 2, 3 or early) were evaluated. Clinical pregnancy rate was determined by detecting G-sac with transvaginal ultrasonogram. We analyzed the results by $X^2$ and Student's t-test and considered statistically significant when P value was less than 0.05. Results: Fertilization rate was significantly higher (p<0.05) in group I ($79.0{\pm}21.2%$) than in group II and III ($56.8{\pm}21.6%$ and $36.7{\pm}25.3%$). Cleavage and blastulation rate of group I ($95.8{\pm}13.8%$ and $59.5{\pm}25.3%$) were significantly higher (p<0.05) than those of group III ($83.4{\pm}18.6%$ and $40.4{\pm}36.5%$). Clinical pregnancy rate was significantly higher (p<0.05) in group I and II (40.7% and 41.7%) than that in group III (12.5%). No differences were found in the rates of multiple pregnancy and abortion among three groups. Embryonic implantation rate was higher in group I ($15.1{\pm}20.2%$, p<0.05) and II ($14.7{\pm}20.6%$, NS) than that in group III ($5.1{\pm}15.6%$). However, embryonic implantation rate was increased in ET with blastocyst(s) among three groups. Conclusions: Fertilized oocytes obtained from TESE-ICSI were harder to be successfully cultured to blastocyst stage for 5$\sim$7 days than that from IVF cycles. However, all blastocyst(s) ET increased the embryonic implantation rate equally in IVF, ICSI and TESE-ICSI cycles.

• Clinical and Experimental Reproductive Medicine
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• v.37 no.1
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• pp.41-48
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• 2010

Objectives: The aim of this study was to assess appropriate time to convert intramuscular progesterone support to oral administration for luteal phase support in in vitro fertilization (IVF). Methods: Seventy-six cycles of IVF in which fetal heart beat was identified after treatment were included. Patients underwent controlled ovarian hyperstimulation with GnRH agonist long protocol (n=7) or GnRH antagonist protocol (n=66). Cryopreserved embryo transfer was performed in three cycles. Luteal support was initiated by daily intramuscular injection of progesterone, and after confirmation of fetal heart beat, converted to oral micronized progesterone (Utrogestan, Laboratoires Besins International, France) 300 mg daily before or after 8 gestational weeks. The oral progesterone was continued for 11 weeks. Results: Overall clinical abortion rate was 3.9% (3/76) and mean time to conversion was $8^{+4}$ gestational weeks ($46{\pm}5.8$ days after oocytes retrieval). The abortion rate was 5.6% (1/17) and 3.4% (2/59) in patients with conversion before 7 weeks and after 8 weeks, respectively, which were not statistically significant (p=0.678). The miscarriages were occurred at $9^{+4}$ weeks, $11^{+3}$ weeks and $11^{+4}$ weeks. Conclusion: Sequential luteal support using intramuscular and oral progesterone yields a relatively low clinical abortion rate. If fetal heart beat confirmed, sequential regimen appears to be safe and convenient method to reduce patients' discomfort induced by multiple injections.

• Clinical and Experimental Reproductive Medicine
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• v.21 no.2
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• pp.215-220
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• 1994

We have reviewed the pregnancy rate and outcome of 130 patients who underwent tubocornual anstomosis for correction of proximal tutal occlusion at Dong San Medical Center between September 1983 to May 1994. Tubal occlusion was the result of previous tubal sterilization in 115 patients(99 laparoscopic electrocautery, 16 laparoscopic ring, 1 tubal ligation with partially segmental resection and previous tubal infection in 14. Sixty four of the patients conceived(61.5%). Viable pregnancy was achieved in fifty patients (48%), tubal pregnancy in six (5.7%) and spontaneous abortion in eight(6.1%). No significant difference in pregnancy rates was found between patients with diseased cornua and those previously sterilized by either electrocautery or tubal ligation. We conclude that tubocornual anastomosis still remains the treatment of choice for patients with proximal tubal obstruction.

• Clinical and Experimental Reproductive Medicine
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• v.20 no.1
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• pp.71-78
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• 1993

Since the successful advent of IVF-ET, reproductive surgeons have been forced to compare pregnancy outcomes of surgical procedures for tubal infertility with those of IVF-ET. The current study was designed in an effort to determine the usefulness of pre-operative infertility work-up, especially diagnostic laparoscopy, in predicting the pregnancy rate and in assessing the reversal feasibility. 109 patients who underwent a microsurgical tubal reversal were reviewed. The patients were followed over one year. The total intrauterine pregnancy, spontaneous abortion, and ectopic pregnancy rates were 66.4%, 3.7%, and 7.3%, respectively. The result showed that the use of loupe might increase the chance of the ectopic pregnancy. I found that the final tubal length, especially the longest tubal length, the site of reanastomosis, and the methods of sterilization affected the pregnancy rates. A 85% intrauterine pregnancy rate was achieved in the patients with good preoperative assessments(Group II-1). There was only 10% incidence of intrauterine pregnancy in the patients with bad assessments(Group II-2). It is concluded that the pre-operative infertility work-up, especially diagnostic laparoscopy, is a good diagnostic tool in assessing the reversal feasibility.

• Korean Journal of Veterinary Research
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• v.23 no.2
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• pp.193-198
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• 1983

A servey on bovine fascioliasis in 52,876 cattle of Euiseong, Andong, Yecheon, Wolseong areas in Gyeongbug Province was carried out by the intradermal test, and the clinical side action of the positive cattle administered with DS-6 intramuscularly was observed. In addition pathological examination of 2 cattle died with side action of DS-6 was also conducted. The results of the studies are summarized as follows; 1. The average infestation rate of bovine fascioliasis was 31.1% and regional infestation rates were 35.1% in Eiseong, 34.5% in Yecheon, 32.2% in Andong, 26.9% in Wolseong, respectively. 2. The side actions were occurred in 1.5%(115/7,667) cf cattle administered with DS-6 and the clinical observations were salivation, dyspnea, hyperamia of conjunctiva, lacrimation, perspiration, urticaria, tremor, diarrhea, staggering, convulsion, edema and abortion. 3. Within 1 hour after the injection, side actions were occurred in 61.7% of the 115 cattle while they were observed in 37.4% of the 115 catte from 1 hour to 2 hours post injection. 4. The duration of the side action was less than 2 hours in 29.5%, 2 to 10 hours in 47.0% and more than 10 hours in 23.5% of the 115 cattle. 5. Autopsy findings and histopathological observations indicate that the death of cattle is caused by anaphylactic shock.