• Clinical and Experimental Reproductive Medicine
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• 제29권3호
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• pp.215-222
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• 2002

Objective : Previous studies have suggested that hyperhomocysteinemia and methylenetetrahydrofolate reductase (MTHFR C677T) mutations are associated with increased risk of recurrent spontaneous abortion (RSA). Recently, a second site polymorphism in MTHFR, 1298A-->C, which changes a glutamic acid into an alanine residue, was shown to be associated with a decreased enzyme activity. We tested whether the variant alleles of MTHFR C677T and A1298C are risk factor (biomarker) for RSA. Materials and Methods: We analyzed DNA from a case-control study in the Korean DNA was extracted from blood samples of 118 patients with RSA and 123 healthy fertile patients as the controls. MTHFR variant alleles were determined by a PCR-restriction fragment length polymorphism assay. Results: We found no evidence for an association between 677TT genotype and risk of RSA (OR=1.95, 95% CI=$0.84{\sim}4.50$, p=0.12). However, the MTHFR 1298AC (OR=0.36, 95% CI=$0.20{\sim}0.63$, p=0.0004) and 1298AC+CC (OR=0.35, 95% CI=$0.20{\sim}0.61$, p=0.0002) genotypes were lower among 118 RSA cases compared with 123 controls, conferring a 2.8-fold decrease in risk of RSA, respectively. Moreover, the combined genotypes of MTHFR 677CC/1298AC (OR=0.30, 95% CI=$0.10{\sim}0.88$, p=0.029) and 677CT/1298AC (OR=0.77, 95% CI=$0.60{\sim}0.99$, p=0.043) also showed significantly lower risk than those with MTHFR 677CC/1298AA type. Conclusion: MTHFR 1298AC, MTHFR 677CC/1298AC and 677CT/1298AC genotypes may represent genetic markers for the protection of RSA at least in Korean women.

• 여성건강간호학회지
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• 제6권4호
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• pp.549-565
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• 2000

Comprehensive review of the literature was conducted to determine 1) selected risk factors and its impact that affect pregnancy outcome such as smoking, alcohol consumption, and substance abuse 2) these factors can facilitate future strategies for health promotion and prevention for both pregnant women and fetus. Review of literature were extracted from searching MEDLINE(1966 - Oct. 2000). CINAHL (1982 - Oct. 2000) and the domestic literature. The following factors were identified: 1. The effects of risk behaviors on pregnancy. ${\cdot}$Maternal smoking was associated with the occurrence of premature or LBW delivery, fetal growth retardation, extremities defects, heart defects and sudden infant death syndrome. ${\cdot}$Maternal alcohol consumption was associated with spontaneous abortion, premature or LBW delivery, morphologic/neurologic problems, especially fetal alcohol syndrome. ${\cdot}$Heroin was associated with withdrawal after birth in which were born to heroine addicts for gestational age and lung maturation in animal studies. ${\cdot}$Cocaine was associated with spontaneous abortion, abruptio placenta and a poor response to environmental stimuli. ${\cdot}$So far, the effects of caffeine on pregnancy was controversial, but severe caffeine consumption was associated with premature or LBW delivery, spontaneous abortion, still birth and dystocia. 2. Intervention methods and its effects identified were as follows ${\cdot}$Conducted intervention for smoking, alcohol and drug consumption were single or combined. ${\cdot}$Intervention methods were counseling, phone contact, mailing, use of educational videotape, booklet, support person and alternatives such as nicotine patch. ${\cdot}$The interventions increased the rates of smoking cessation during pregnancy and awareness of the risk of drug consumption, and decreased amount of alcohol consumption. ${\cdot}$The intervention outcome found positive effect on birth weight and length. 3. Our recommendations were as follows ${\cdot}$The personal and social cognition should be enhanced through education and the mass media. ${\cdot}$It's necessary to educate and give information of preconceptional care, planned pregnancy and early prenatal care for optimal pregnancy outcome. ${\cdot}$It's necessary to develop comprehensive assessment tool which is reliable and valid on smoking, alcohol consumption and substance abuse to identify supportive or interventional program.

• Clinical and Experimental Reproductive Medicine
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• 제32권3호
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• pp.217-222
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• 2005

Objectives: We aimed to investigate the clinical effect of low-dose intravenous immunoglobulin treatment in unexplained recurrent spontaneous aborters (RSA) with elevated peripheral CD56+ natural killer (NK) cell levels and to determine the pre-conceptional NK cell percentage predictive of subsequent successful pregnancy outcome. Materials and Methods: Sixty four cases of unexplained recurrent miscarriage with elevated peripheral NK cells (>15%) were received low dose IVIg infusion at the dosage of 400 mg/Kg/month after confirmation of gestational sac and continued until 20 weeks. The patients were divided into two groups according to the pregnancy outcome: Group I was success of treatment defined as live birth at or after 25 gestational weeks and Group II was failure of treatment. The preconceptional levels of the peripheral blood NK cells were compared between two groups. Results: Fifty-three pregnancies resulted in live births after 25 weeks and 11 resulted in abortion (Overall success rate of IVIG treatment was 82.8%). Preconceptional CD56+ NK cell percentage in group II ($27.4{\pm}1.9%$) was higher than those in group I ($22.3{\pm}0.8%$). By using ROC curve, optimal discrimination between success and failure of treatment was achieved with ${\leq}27%$ of preconceptional NK cell percentage. Conclusion: In RSA patients with elevated NK cells, we suggest that preconceptional peripheral blood CD56+ NK cell level could be a useful marker for predicting successful treatment outcome of low-dose IVIg infusion.

• Clinical and Experimental Reproductive Medicine
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• 제24권3호
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• pp.293-300
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• 1997

The aim of present study was to determine the efficacy of immunotherapy with paternal lymphocytes for unexplained infertility. It has been apparent that reproductive success may be affected by the presence of abnormal autoantibodies. Unexplained infertility and repeated pregnancy wastage has been reported in the presence of abnormal autoantibodies. These data suffest that abnormal immune function may be an important pathologic entity contributing subfertility in patients with unexplained infertility. Therefore, immunotherapy may be a possible treatment modality for patients with unexplained infertility. Some investigators have reported that a proportion of infertile couples with repeatedly unsuccessful ET showed close histocompatibility similar to those of spontaneous recurrent abortion. Recently, it has been noted that immunotherapy with paternal lymphocytes achieves a high efficacy in preventing subsequent abortion in women with primary recurrent abortion of unknown cause, which was mediated by immune reaction including blocking antibody. To substantiate the hypothesis, we applied immunotherapy preceding Peritoneal Oocyte and Sperme transfer (POST) to 43 patients, 47 cycles of 82 patients, 89 cycles with at least three previous IUI failure from April, 1993 to February, 1995. There were no significant differences between treatment and control group in clinical response and hormonal response to controlled hyperstimulation. there was no significant difference between treatment and control group in pregnant rates per cycles (42.6% versus 28.6%), but a significantly lower abortion rate per pregnancy in treatment group, with 10.0% (2/20) compared with 50.03% (6/12) in control group. This study may suggest that immune therapy for patients with unexplained infertility with paternal lymphocytes might be beneficial.

• 대한생식의학회:학술대회논문집
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• 대한불임학회 2004년도 제47차 추계학술대회
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• pp.98-98
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• 2004

• Clinical and Experimental Pediatrics
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• 제55권10호
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• pp.393-396
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• 2012

Trisomy 14 mosaicism is a rare chromosome disorder characterized by delayed development, failure to thrive, and facial dysmorphism. Only approximately 30 trisomy 14 mosaicism cases have been reported in the literature because trisomy 14 is associated with early spontaneous abortion. We report a case of a 17-month-old girl with abnormal skin pigmentation, delayed development, facial dysmorphism, and failure to thrive with the 47,XX,+14/46,XX chromosome complement.

• 한국발생생물학회지:발생과생식
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• 제22권2호
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• pp.199-203
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• 2018

Although trisomy 16 is commonly detected in spontaneous abortions and accounts for over 30% of cases of autosomal trisomy detected after spontaneous abortion, trisomy 16 mosaicism is rarely detected by amniocentesis in the second trimester. Here, we report a case of level III trisomy 16 mosaicism (47,XX,+16[8]/46,XX[31]) diagnosed by cytogenetic analysis of independently cultured amniotic fluid cells. The female baby was delivered at full term with low birth weight and intrauterine growth retardation, and interestingly, her karyotype was normal (46,XX). Given the difficulty in predicting the outcomes of fetuses with this mosaicism, it is recommended to inform the possibility of mosaicisms including this trisomy 16 mosaicism during prenatal genetic diagnosis and genetic counseling for parents.

• 여성건강간호학회지
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• 제1권1호
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• pp.119-137
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• 1995

Maternity nurses' roles are to find out women's various responses related to the health problems during pregnancy, to intervene adequate nursing and supports, and to help them adapt satisfactorily to new situation, such as hospitalization. The purposes of this study are : firstly, to inquire about women's emotional status, feeling of discomfort, and the nursing need during hospitalization because of discomfort, and the nursing needs during hospitalization because of the possibility of abortion by threatened and habitual abortion : secondly, to provide fundamental data for developing adequate nursing intervention and improving hospital management. The subjects of this study were 62 women who were hospitalized, visited out-patient clinic for follow-up, and stayed at home after discharge since August, 1993 from one hospital located in Seoul, from March 23 to April 13, 1994. The questionnaire was consisted of 21 items of emotion(Reliability Cronbach's alpa, .77), 19 items of feeling of discomfort(.79), and 21 items of nursing needs (.89), and nurses' performance according to nursing needs,(.90). These were measured by using Likert Scale and analyzed by using SPSS / $PC^+$ with the descriptive statistics, $X^2$-test, and ANOVA. Research findings are as follows : 1) The subjects' average age, hospitalized days, and gestational age are 32.2, 15.7, 12.9 by respectively. 2) 88.7% of the subjects are getting antepatal care, 66.1% are experiencing 1.75 times of spontaneous abortion, and 82.3% are nuclear family. 3) The Emotions were mainly comprized negative and subjective state of minds such as uneasiness, anxiety, and discomfort. The domains of emotions were related to 'fetus', 'herself', 'hospitalization', and 'husband's 'families', in rank. The highest scored item was "I, above anyone else, am mostly stressed from abortion." 4) The feelings of discomforts were firstly related to 'personal discomfort arising from absolute bed rest', 'meals provided', Usage of hospital, perse', 'health team', in rank. 5) The nursing needs frequently pointed out were 'Nurses kindly explain of me the purpose, method, and results of the lab. test', 'Nurses sincerely pay attention to my word in communication'. The least nursing needs were 'Nurses observe my feces and whether I have constipation or not'. 'When I can't move, nurses help me by holding my arms or pulling my bed'. 6) The highest performed items were 'Nurses observe whether I bleed or not', and 'Nurses give me drug with exact dose in time'. The least performed items was about hospital environment, such as 'Temperature, ventilation & humidity in the room should be controlled'. 7) Besides religion that is related to nursing need with statistically significant difference, none of general characteristics were related to emotion, feeling of discomfort, and nursing needs.

• Clinical and Experimental Reproductive Medicine
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• 제30권3호
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• pp.233-240
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• 2003

연구목적: 본 연구에서는 정상 환자와 습관성 유산 질환 환자에서 유래된 융모막 조직 내에서의 면역억제유전자들의 발현 양상에 대해 알아보고자 하였다. 연구재료 및 방법: 임신 6주와 8주의 습관성 유산 질환 환자와 정상 환자로부터 융모막 조직을 채취하였다 (Normal N=6; RSA N=6). 면역조직화학적 분석을 통해서 조직을 관찰하고 세포가 살아있음을 확인한 후에, 역전사 중합효소연쇄반응을 통해서 면역억제유전자인 placenta protein 14 (PP14), indoleamine 2, 3-dioxygenase (IDO) 그리고 mucin1 (MUC1) 유전자의 발현 정도를 비교하였다. GAPDH 발현에 기준한 면역억제유전자 발현을 정량 분석하여 Student's t-test를 시행하였고, p<0.05를 유의성이 있는 것으로 판정하였다. 결 과: 습관성 유산 질환 환자의 경우, 임신 6주와 8주의 융모막 조직에서의 면역억제유전자 (PP14, IDO, MUC1) 발현이 현저하게 낮은 양상을 보이고 있었다. 습관성 유산과 면역억제유전자의 발현이 통계학적으로 유의성 있는 연관성을 가지고 있다는 것이 확인되었다. 결 론: 면역억제유전자 (PP14, IDO, MUC1)의 발현이 습관성 유산 질환 환자에서 특이적으로 낮게 나타나는 것으로 보아 습관성 유산 질환의 진단과 치료 연구 방안에 이 유전자들의 발현이 이용될 수 있을 것으로 사료된다.

• Clinical and Experimental Reproductive Medicine
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• 제32권2호
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• pp.113-119
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• 2005

Objective: The purposes of this study were to investigate the types and the incidences of chromosomal abnormalities, and to provide an explanation for the genetic causations of recurrent spontaneous abortions in Korean population. Methods: Cytogenetic studies were carried out in 535 couples with at least two spontaneous first trimester abortions from January 1981 to December 2003. For karyotype analysis, we used modified Moorhead method by Giemsa staining and Giemsa-Trypsin-Giemsa banding Results: The overall incidence of chromosome abnormality was 32 out of 535 cases (5.98%). There were 25 cases (4.67%) of translocation and 7 cases (1.31%) of inversion. In translocation, 5 cases (0.93%) of Robertsonian translocation and 20 cases (3.74%) of reciprocal translocation were observed. In inversion, 6 cases (1.12%) of inversion of chromosome 9 and one case (0.19%) of inversion of chromosome 18 were found. Conclusion: In this study, overall chromosomal abnormality rate in couples with recurrent spontaneous abortions is much higher than that in the general population. So, chromosomal analysis should be offered for the prognostic information in genetic counseling such as prenatal diagnosis in couples with repetitive reproductive failure.