• Clinical and Experimental Pediatrics
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• 제50권3호
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• pp.268-271
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• 2007

목 적 : 태아 순환에서 난원공은 제대정맥의 혈류가 좌심방으로 가는 단락 역할을 하며 심박출량의 46%에 이른다. 산전에 좌심형성부전, 대동맥 판막 폐쇄, 승모판 폐쇄 및 협착증 등의 선천성 심기형과 동반된 난원공 조기 협착은 비교적 흔하며 출생 후의 경과에도 중요한 영향을 미칠 수 있다. 그러나 자궁 내에서 난원공 협착 혹은 폐쇄가 선천성 심기형 없이 발생하는 경우는 매우 드물다. 산전의 난원공 협착 혹은 폐쇄는 우심실부전, 태아수종, 삼첨판역류, 좌심폐쇄성질환, 상심실성빈맥 등의 임상소견을 보일 수 있고, 이는 태아의 사망률 혹은 유병률에 영향을 미칠 수 있으므로 조기 진단 및 치료가 매우 중요하다. 방 법 : 충남대학교병원에서 2001년 1월부터 2005년 6월까지 태아 심초음파검사에서 자궁 내 난원공의 협착으로 진단받은 5명을 대상으로 하였다. 자궁 내 난원공 협착의 진단기준은 4강면에서 난원공의 최대직경이 2.5 mm 이하, 그리고 난원공에서 측정한 도플러검사에서 연속파이며 0.6 m/s 이상인 경우로 하였다. 산모의 임신력, 주소, 태아심초음파검사 소견과 출생 후의 임상경과를 조사하였다. 결 과 : 태아 난원공 협착의 진단 시 태아의 재태연령은 34-37주였고, 내원 시 주소는 태아 부정맥이 2례, 엡스타인 기형 의증, 심낭삼출, 좌심형성부전이 각각 1례였다. 출생시 재태연령은 36-40주였다. 동반기형은 관찰되지 않았다. 태아수종과 상심실성 빈맥증으로 진단된 2례는 응급으로 분만하였고, 태아수종 환아는 호흡부전이나 가사는 없었고, 심폐 소생술이나 인공호흡기 등의 치료가 필요하지는 않을 정도의 경도였고, 상심실성 빈맥증 환아는 분만 후 심방조동이 발생하여 심장율동전환 후 동조율로 전환되었고, 그 후 디곡신 1개월 사용 후 중단하였다. 출생 후 시행한 심초음파검사에서 5례 모두에서 우심실과 우심방 비대가 관찰되었고, 생후 7일경에 시행한 심초음파검사에서 우측 심장의 확장은 정상화되었다. 결 론 : 태아 난원공 협착은 아주 드물지 않으며 부가적인 심장내외의 이상을 보여 예후에 영향을 줄 수 있다. 심부전이나 태아수종 등의 위험성이 있을 경우 조기 분만하여 태아의 사망률과 유병률을 줄일 수 있다.

• 한국수정란이식학회지
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• 제27권2호
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• pp.113-119
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• 2012

Epigenetic modification including genome-wide DNA demethylation is essential for normal embryonic development. Insufficient demethylation of somatic cell genome may cause various anomalies and prenatal loss in the development of nuclear transfer embryos. Hence, the source of nuclear donor often affects later development of nuclear transfer (NT) embryos. In this study, appropriateness of porcine embryonic germ (EG) cells as karyoplasts for NT with respect to epigenetic modification was investigated. These cells follow methylation status of primordial germ cells from which they originated, so that they may contain less methylated genome than somatic cells. This may be advantageous to the development of NT embryos commonly known to be highly methylated. The rates of blastocyst development were similar among embryos from EG cell nuclear transfer (EGCNT), somatic cell nuclear transfer (SCNT), and intracytoplasmic sperm injection (ICSI) (16/62, 25.8% vs. 56/274, 20.4% vs. 16/74, 21.6%). Genomic DNA samples from EG cells (n=3), fetal fibroblasts (n=4) and blastocysts from EGCNT (n=8), SCNT (n=14) and ICSI (n=6) were isolated and treated with sodium bisulfite. The satellite region (GenBank Z75640) that involves nine selected CpG sites was amplified by PCR, and the rates of DNA methylation in each site were measured by pyrosequencing technique. The average methylation degrees of CpG sites in EG cells, fetal fibroblasts and blastocysts from EGCNT, SCNT and ICSI were 17.9, 37.7, 4.1, 9.8 and 8.9%, respectively. The genome of porcine EG cells were less methylated than that of somatic cells (p<0.05), and DNA demethylation occurred in embryos from both EGCNT (p<0.05) and SCNT (p<0.01). Interestingly, the degree of DNA methylation in EGCNT embryos was approximately one half of SCNT (p<0.01) and ICSI (p<0.05) embryos, while SCNT and ICSI embryos contained demethylated genome with similar degrees. The present study demonstrates that porcine EG cell nuclear transfer resulted in hypomethylation of DNA in cloned embryos yet leading normal preimplantation development. Further studies are needed to investigate whether such modification affects long-term survival of cloned embryos.

• Toxicological Research
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• 제26권3호
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• pp.209-216
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• 2010

Limb bud (LB) and central nerve system (CNS) cells were prepared from 12.5 day old pregnant female Crj:CD (SD) rats and treated with olaquindox and vitamin A. Cytotoxicity and inhibition on differentiation were measured in each cell. Three doses of olaquindox (4, 21 and 100 mgkg), and 0.2 and 75 mg/kg of vitamin A were administered to pregnant rat for 11 days from $6^{th}$ to $16^{th}$ of pregnancy. $IC_{50}$ values of olaquindox for proliferation and differentiation in CNS cell were 22.74 and $28.32\;{\mu}g/ml$ and 79.34 and $23.29\;{\mu}g/ml$ in LB cell and those values of vitamin A were 8.13 and $5.94\;{\mu}g/ml$ in CNS cell and 0.81 and $0.05\;{\mu}g/ml$ in LB cell, respectively. Mean body weights of pregnant rats were decreased at high dose of olaquindox (110 mg/kg) but relative ovary weight, number of corpus lutea, and number of implantation were not changed. Resorption and dead fetus were increased at high dose of olaquindox, and relative ovary weight, the number of corpus lutea and implantation, and sex ratio of male to female were not significantly changed in all dose of olaquindox. Mean fetal and placenta weights were significantly (p < 0.01) decreased in rats of high group. Seven fetuses out of 103 showed external anomaly like bent tail, and 10 out of 114 fetuses showed visceral anomalies at high group. The ossification of sternebrae and metacarpals were significantly (p < 0.01) increased by low and middle dose of olaquindox but it was significantly (p < 0.01) prohibited by high dose of olaquindox. In rats treated with vitamin A, the resorption and dead fetus were increased by high dose. Mean fetal weights were significantly (p < 0.01) increased by low dose but significantly (p < 0.01) decreased by high dose. Thirty four fetuses out of 52 showed external anomaly; bent tail (1), cranioarchschisis (14), exencephaly (14), dome shaped head (22), anophthalmia (15), brcahynathia (10) and others (19). Forty five fetuses out of 52 showed soft tissue anomaly; cleft palate (42/52) and anophthalmia (22/52) by high dose of vitamin A. Sixty one fetuses out of 61 (85.2%) showed skull anomaly; defect of frontal, partial and occipital bone (21/61), defect of palatine bone (52/61) and others (50/61). In summary, we support that vitamin A is strong teratogen based on our micromass and in vivo data, and olaquindox has a weak teratogenic potential in LB cell but not in CNS cell. We provide the in vivo evidence that a high dose of olaquindox could have weak embryotoxic potential in rats.

• 대한한방부인과학회지
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• 제32권1호
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• pp.85-93
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• 2019

Objectives: The aim of this study was to demonstrate the benefit of Traditional Korean Medicine as an adjuvant therapy in management of mid-trimester oligohydramnios. Methods: It is a case report of a 31 year-old woman hospitalized for oligohydramnios at $24^{+4/7}$weeks of gestation. This patient diagnosed with special oligohydramnios had no abnormal findings such as fetal urinary abnormalities or other anomalies. Also, symptom of PPROM (preterm premature rupture of membrane) was not confirmed. The decoction, Gami-danggui-san (DG) was prescribed for the purpose of reducing unnecessary contraction of uterine muscle during pregnancy and promoting blood circulation and metabolism, thereby improving placental function and contributing to the increase of the fluid. DG decoction was administered twice a day until 19th of June, which was 10 days in total. During the treatment, level of amniotic fluid had been monitored by measuring AFI (amnioti fluid index). Results: After these conventional therapies, the amount of amniotic fluid increased steadily, and eventually reached the optimal level. AFI was found to be 3.2 on the $24^{+4/7}$ weeks, 8 on the $26^{+1/7}$ weeks, 11.5 on the $27^{+0/7}$ weeks of gestation. In the same periods, EFW (expected fetal weight) was also found to be increasing gradually: 545 g, 630, and 760 g. Conclusions: Our report implies the potential of herbal medicine as a effective therapy for oligohydramnios tratment. Further studies are needed to assess the efficacy of TKM herbal medicine and reveal the mechanisms of the decoction.

• 대한장애인치과학회지
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• 제5권2호
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• pp.92-95
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• 2009

1. 이 증례는 Pierre Robin Sequence로 진단받은 14개월 남아로 PRS의 3요소 중 하악왜소증, 설하수증의 소견을 보이고 있었으며 기도확보는 측와위를 통하여, 섭식은 PEG 도관삽입술을 시행하여 유지하고 있었다. 2. PRS는 해부학적 폐쇄 질환이기도 하지만 성장 장애이기도 하므로 여러 분야의 다원적 접근 및 치료계획이 필요하며, 다른 증후군들과 연관되어 심장질환, 신경질환, 안과질환, 청력문제 등이 동반될 수 있으므로 치과 진료실 에서 PRS 환아의 진료시 이 점을 유의해야할 것이다.

• 대한장애인치과학회지
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• 제13권2호
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• pp.104-107
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• 2017

본 증례는 가부키 증후군 환아의 상악 좌측 제2유구치의 심한 우식으로 인하여 좌측 협부 종창이 관찰되었고, 물리적 속박 하에 절개 및 배농술을 시행 후 유구치는 발거되었다. 이후 전신마취 하에 남은 우식치아의 치료가 진행되었다. 가부키 증후군은 환자에 따라 다양한 의학적 소견을 보이므로 전신마취 하 치과 치료가 계획 될 경우, 의과와의 협진 및 철저한 치료계획이 필수적이다.

• 한국한의학연구원논문집
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• 제16권2호
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• pp.143-157
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• 2010

Objectives : The objective of this study was to access the effect of Artemisiae capillaris herba Extracts on the organogenetic reproductive toxicity of New Zealand White rabbits when administered by oral gavage. Methods : Gestational New Zealand White rabbits were dosed from 6 days of gestation to 18 days of gestation. It was conducted in accordance with the recommendations of the KFDA Guideline for Detection of Toxicity to Reproduction for Medicinal Products. In addition, serum AST, ALT, LDH and ALP levels were detected with their necropsy and histopathological observation Results: No significant changes of body weights, gains and food consumption were demonstrated in all dosed groups compared to those of vehicle control group except for 2,000mg/kg-dosing group, which showed significantly increase of body weight compared to that of vehicle control group. Normal gross findings were demonstrated in all tested groups. No significant changes of number of corpora lutea, implantation, implantation rate, number of fetal death, loss rate of post-implantation, number of live youngs at C-section, survival rate of post-implantation, number of male live youngs at C-section, number of female live youngs, sex ratio of live young, external anomalies of live youngs and body weight of live youngs were demonstrated in all dosed groups compared to those of vehicle control group. Although some visceral variations such as thymic reminant in the neck, dilation of renal pelvis, dilated ureter and malpositioned left common carotid artery, no significant changes were demonstrated in all dosed groups compared to that of vehicle control group. Some malformations and variation were demonstrated with retardations. However, no significant changes were demonstrated in all dosed groups compared to that of vehicle control group. In addition, similar ossification numbers were detected in sternebrae, metacarpals, metatarsals, phalanges, cervical vertebrae, and sacral and caudal vertebrae. No Artemisiae capillaris herba Extracts treatment-related changes of serum AST, ALT, LDH and ALP levels were demonstrated in all dosed levels in this study. Conclusions : We could conclude that oral administration of Artemisiae capillaris herba Extracts hasn't an influence on the organogenetic reproductive toxicity.

• 대한방사선기술학회지:방사선기술과학
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• 제41권2호
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• pp.157-162
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• 2018

This study is a search for radiation protection effects of radiation exposure on the organogenic period during the prenatal period, which is known to be the most likely to have congenital malformations by radiation exposure. To study the radiation protection for the mixture of selenium that is strong antioxidant and folic acid that is essential vitamin for DNA synthesis, 2 Gy of radiation was irradiated to pregnant female rats. then, after 14 days of fetal birth, observing blood components, SOD(Superoxide Dismutase), histological changes and external malformations. There was a significant protective effect to reduce blood cell damage(p<0.05) in the irradiation group after selenium and folic acid mixture were administered than irradiation group, and the activation of SOD which is antioxidant enzymes was increased. In addition, confirmed the effect of suppressing the expression of apoptosis of small intestinal cells and the reduction of cerebral cortex layer reduction by radiation. thus, it was confirmed that the congenital malformations were reduced as a result of these protective effects. Based on these results, selenium and folic acid mixture may reduce the incidence of congenital malformations, and it will reduce the damage of the fetus caused by the exposure of the organogenic period due to accidents.

• Clinical and Experimental Pediatrics
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• 제58권10호
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• pp.392-397
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• 2015

Purpose: Alagille syndrome is a complex hereditary disorder that is associated with cardiac, hepatic, skeletal, ocular, and facial abnormalities. Mutations in the Notch signaling pathway, such as in JAG1 and NOTCH2, play a key role in embryonic development. A cardiac or hepatic presentation is a critical factor for determining the prognosis. Methods: We conducted a retrospective study of 41 patients with Alagille syndrome or a JAG1 mutation between 1983 and 2013. Results: The first presentations were jaundice, murmur, cyanosis, and small bowel obstruction at a median age of 1.0 months (range, 0-24 months). The JAG1 mutation was found in 27 of the 28 genetically-tested patients. Cardiovascular anomalies were identified in 36 patients, chronic cholestasis was identified in 34, and liver transplantation was performed in 9. There was no significant correlation between the severity of the liver and cardiac diseases. The most common cardiovascular anomaly was peripheral pulmonary stenosis (83.3%), with 13 patients having significant hemodynamic derangement and 12 undergoing surgical repair. A total bilirubin level of >15 mg/dL with a complex surgical procedure increased the surgical mortality (P=0.022). Eight patients died after a median period of 2.67 years (range, 0.33-15 years). The groups with fetal presentation and with combined severe liver and heart disease had the poorest survival (P<0.001). Conclusion: The group with combined severe liver and heart disease had the poorest survival, and a multidisciplinary approach is necessary to improve the outcome.

• Advances in Traditional Medicine
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• 제6권3호
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• pp.245-251
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• 2006

We examined the radioprotection effects of acupoint (acupuncture point) stimulation during organogenesis stages of ICR mice. Pregnant mice received 1.5 Gy whole body X-irradiation on day 8 of gestation, which is the early stage of organogenesis. The embryonic death rate and teratogenesis rate by radiation were examined. Electroacupuncture to the leg acupoints and/ or transcutaneous stimulation to the back acupoints on the pregnant mice showed no protective effect against irradiation on embryonic or fetal death rate. On the contrary, the strong stimulation resulted in increase in the mortality after irradiation rather than protection. However acupoint stimulation to the pregnant mice never showed harmful effects by itself on embryos. It tended to reduce the skeletal malformations induced by X-ray irradiation. We suspect that acupoint stimulation removed the cells injured by irradiation during embryonic development, resulting in an increase in embryonic death rate and reduction in skeletal anomalies.