• 제목/요약/키워드: clinical stage

검색결과 2,608건 처리시간 0.024초

투명대 존재/부재 햄스터 난자의 동결보존;1-단계 평형과 2-단계 융해의 효과 (Cryopreservation of Zona-intact/-free Hamster Oocytes;Effect of 1-Step Equilibration and 2-Step Thawing)

  • 정구민;방명걸;김석현;신창재;김정구;문신용;이진용;장윤석
    • Clinical and Experimental Reproductive Medicine
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    • 제19권2호
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    • pp.143-152
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    • 1992
  • The present experiments were focussed to modify a short slow-cooling protocol used for freezing of early stage embryo(Testart et al., 1986) and also to apply the modified method for the cryopreservation of hamster oocytes with Zona or without. The protocol was modified by changing the 4-step equilibration into 1-step and the 1-step thawing into 2-step. The oocytes were added in 1.5M PROH and 0.1M Sucrose, seeded at $-7^{\circ}C$, slow cooled($0.3^{\circ}C$/min) to $-30^{\circ}C$ before plunging to $-196^{\circ}C$. The oocytes were thawed at $23-25^{\circ}C$ air(20sec/150sec) and/or 33-35 water(10sec). The survival of the frozen-thawed oocytes was determined by morphologic criteria and their fertilizing ability was also estimated by Sperm Penetration Assay(SPA) system(Chang et al, 1990) using fertile men semen sample. One-step equilibration showed slightly higher survival rate(83.9% vs. 71.0%) and fertilization rate(83.9% vs. 71.0%) compared with four-step(p>0.05). And two-step thawing(air & water exposing) of oocytes frozen after 1-step equilibration showed significantly higher survival rate(96.3%) than one-step thawing at air(85.2%) or water(65.0%) only(p<0.05). Therefore, by the modified method(l-step equilibration & 2-step thawing), Zona-intact(ZI) and Zona-free(ZF) oocytes were frozen and thawed. ZI-oocytes showed significantly higher survival rate(95.4%, 308/323 vs. 67.6%, 240/355) than ZF-oocytes(P<0.01). But the survival of ZF-oocytes was as high as ZI-oocytes in fourteen of twenty-four replicates. ZI-oocytes was also significantly higher fertilization rate($92.4{\pm}8.9%$ vs. $63.7{\pm}18.5%$) and higher mean number of penetrated sperm($6.2{\pm}4.2$ vs. $3.9{\\pm}3.3$) than ZF-oocytes, but not higher than control(fresh oocytes;$99.3{\pm}2.4%$, $8.4{\pm}4.2$)(P<0.001). Conclusively, this modified method will contribute to freeze effectively the hamster oocytes for simplifing of the logical consideration of performing SPA and also to freeze the human and other animal oocytes.

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배양액 내의 마그네슘 이온이 생쥐 초기 배아 발생에 미치는 영향 (Effect of Magnesium Ion in the Culture Medium on the Development of Preimplantation Mouse Embryos In Vitro)

  • 최수진;전진현;박용석;배인하
    • Clinical and Experimental Reproductive Medicine
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    • 제28권3호
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    • pp.199-207
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    • 2001
  • Objective: The present study was undertaken to examine the effects of magnesium ion in the culture medium on the development of mouse fertilized oocytes either before or after pronuclear formation, and to investigate whether the effect of magnesium ion is related with the redistributional change of mitochondria. Methods : Fertilized oocytes obtained from the oviducts of mice at 15 hr after hCG injection before pronuclear formation (pre-PN) or 21 hr after hCG injection after pronuclear formation (post-PN) were used. The embryos were cultured for 3 days with basic T6 medium-magnesium free and various concentrations of magnesium ion, 0.0, 0.5, 1.0, 2.0, 4.0 or 8.0 mM, respectively. After culture, the developmental stages of embryos and the number of nuclei were evaluated. To observe the effects of magnesium ion on the mitochondrial distribution, fertilized oocytes were collected at 21 hr after hCG injection and cultured for 6 hr with various concentration of magnesium ion. As a control, fertilized oocytes with pronuclei at 27 hr after hCG injection were used. Results: The concentration of magnesium ion to accelerate the in vitro development of mouse fertilized oocytes appeared to be at 2.0 mM for the pre-PN and the post-PN stage embryos. In the mitochondrial redistribution patterns, the embryos cultured in 2.0 mM concentration of magnesium ion showed the highest percentage (22.6%) of distinct perinuclear clustering pattern comparing to other experimental group. Conclusion: The effect of magnesium ion may be related to the cytoplasmic redistribution of mitochondria. This relationship seems to connect the developmental competence of preimplantation mouse embryos in vitro. These results can suggest that higher concentration of magnesium ion (2.0 mM) than those of conventional culture medium ($0.2{\sim}1.2\;mM$) is more suitable for in vitro culture of preimplantation mouse embryos.

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생쥐와 인간배아의 완만동결-급속융해 후 생존률과 배아발생에 미치는 Ethylene Glycol (EG)과 1,2-Propanediol (PROH)의 영향 (Effect of Ethylene Glycol (EG) and 1,2-Propanediol (PROH) on the Survival and the Development of Mouse and Human Embryos after Slow Freezing/Rapid Thawing Protocol)

  • 김태형;차수경;이동률;한지은;이우식;윤태기;차광렬;정형민
    • Clinical and Experimental Reproductive Medicine
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    • 제31권1호
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    • pp.9-17
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    • 2004
  • Objective: The aim of this study were to compare the effects of EG and PROH on cryopreservation of mouse and human embryos, and to find the optimal protocol for embryo freezing. Methods: Human embryos derived from fertilized eggs showing 3 pronuclei (PN) and mouse embryos were divided into two groups respectively: dehydrated with 1.5 M EG + 0.2 M sucrose or 1.5 M PROH + 0.2 M sucrose using the slow freezing method. Moreover mouse embryos were controlled the exposure time of cryoprotectant during dehydration or rehydration steps. Results: The survival rates of human embryos were 79.2% (84/106) in EG group and 77.9% (88/113) in PROH group. In mouse embryos, the survival and development rates up to blastocyst were 70.6% (245/347), 44.1% (123/279) in EG group and 62.1% (198/319), 45.1% (123/279) in PROH group, respectively. However, in EG group, partially damaged embryos after thawing were decreased compared to PROH group. In combination group, when the exposure time during dehydration and rehydration were reduced, the survival and embryonic developments were increased slightly, but not significant. Conclusion: Cryopreservation of mouse and human embryos at cleavage stage by using EG or PROH exhibited no statistical difference in the survival rate and/or developmental rate to blastocyst. However, the use of EG for cryopreservation of embryos might reduce the exposure time of the cryoprotectant because of a high permeation of EG and result in lessen its toxic effects.

자기공명영상을 이용한 간경변 단계별 분류에 관한 연구 (Classification of Fall in Sick Times of Liver Cirrhosis using Magnetic Resonance Image)

  • 박병래;전계록
    • 대한방사선기술학회지:방사선기술과학
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    • 제26권1호
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    • pp.71-82
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    • 2003
  • T1강조 자기공명영상과 계층적 신경회로망을 이용하여 간경변증을 단계별로 분류하고자 제안한다. 데이터는 2001년 6월부터 12월까지 부산대학교병원에서 얻었으며, 각 단계별 분류는 정상, 1, 2, 3단계별로 분류하였다. 그리고 46명의 데이터를 분석하였다. T1강조 자기공명 간영상으로부터 정상간 실질과 간경변 결절을 추출하였다. 그 다음에 T1강조 자기공명 간 영상에서 간 경화증의 단계를 객관적으로 해석 분류하였다. 간경변 분류기 구현은 계층적 신경회로망을 이용하였고, 명암도 분석과 간 결절 특성을 통하여 정상간과 3단계의 간경변으로 구분하였다. 제안한 신경회로망 분류기는 오류 역전과 알고리즘을 이용하였다. 분류결과 인식율이 정상군은 100%, 1 단계는 82.3%, 2 단계는 86.7%, 3 단계는 83.7%의 분류율을 나타내었다. 신경회로망 분류 결과와 전문의 판독 결과를 서로 비교한 결과 인식률은 매우 높게 나타났다. 만일 더욱더 충분한 데이터나 파라미터를 가지고 지속적으로 수행한다면 간경변 환자들에게 임상적으로 지원하는 도구뿐만 아니라 의료전문 신경회로망으로도 기대된다.

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Enhanced Recovery after Surgery for Gastric Cancer Patients Improves Clinical Outcomes at a US Cancer Center

  • Desiderio, Jacopo;Stewart, Camille L.;Sun, Virginia;Melstrom, Laleh;Warner, Susanne;Lee, Byrne;Schoellhammer, Hans F.;Trisal, Vijay;Paz, Benjamin;Fong, Yuman;Woo, Yanghee
    • Journal of Gastric Cancer
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    • 제18권3호
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    • pp.230-241
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    • 2018
  • Purpose: Enhanced recovery after surgery (ERAS) protocols for gastric cancer patients have shown improved outcomes in Asia. However, data on gastric cancer ERAS (GCERAS) programs in the United States are sparse. The purpose of this study was to compare perioperative outcomes before and after implementation of an GC-ERAS protocol at a National Comprehensive Cancer Center in the United States. Materials and Methods: We reviewed medical records of patients surgically treated for gastric cancer with curative intent from January 2012 to October 2016 and compared the GC-ERAS group (November 1, 2015-October 1, 2016) with the historical control (HC) group (January 1, 2012-October 31, 2015). Propensity score matching was used to adjust for age, sex, number of comorbidities, body mass index, stage of disease, and distal versus total gastrectomy. Results: Of a total of 95 identified patients, matching analysis resulted in 20 and 40 patients in the GC-ERAS and HC groups, respectively. Lower rates of nasogastric tube (35% vs. 100%, P<0.001) and intraabdominal drain placement (25% vs. 85%, P<0.001), faster advancement of diet (P<0.001), and shorter length of hospital stay (5.5 vs. 7.8 days, P=0.01) were observed in the GC-ERAS group than in the HC group. The GC-ERAS group showed a trend toward increased use of minimally invasive surgery (P=0.06). There were similar complication and 30-day readmission rates between the two groups (P=0.57 and P=0.66, respectively). Conclusions: The implementation of a GC-ERAS protocol significantly improved perioperative outcomes in a western cancer center. This finding warrants further prospective investigation.

원주기독병원 응급실로 내원한 치과 응급환자에 관한 임상적 연구 (THE CHARACTERISTICS ON THE DENTAL EMERGENCY PATIENTS OF WONJU CHRISTIAN HOSPITAL FOR LAST 10 YEARS)

  • 문원규;정영수;이의웅;권호근;유재하
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제30권1호
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    • pp.34-42
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    • 2004
  • The appropriate care to the dental emergency patients is much important in the aspect of community dental service. To attain such a purpose, the sacred duty of the training of oral and maxillofacial surgeons is required. So, a retrospective study on the characteristics of dental injuries and diseases in emergency care unit will be very meaningful. This study was carried by reviewing the charts and radiographic films of 3,394 patients, treated for dental emergency at Wonju Christian Hospital, Republic of Korea, from January 1, 1993 to December 31, 2002. All patients were classified to 6 groups including trauma, toothache, infection, hemorrhage, TMJ disorder and the others. The clinical characteristics of diseases and treatment modalities according to each group were analyzed. The trauma (73.9%) was the most frequent cause in dental emergency patients, and acute toothache, odontogenic infection, oral hemorrhage, and TMJ disorder were next in order. Gender prediction was male (68%), there were many patients on May and December in the monthly frequency, and the most frequent age group was from 0 to 9 years. In the trauma group, male (68.6%) was predominant, and soft tissue injuries and primary closures were the most frequent type of injury and treatment. In jaw fractures, traffic accidents were the most cause and the weakest site was mandibular symphysis area, and mandibular angle, condyle, and body area were next in order. In the acute toothache group, the cause was dental pulpitis mostly and treatment for that was drug administration mainly. Buccal space abscess in infection group had the largest incidence (24.5%), and common treatments were incision and drainage and medications. In the hemorrhage group, a major cause was postoperative bleeding (60.3%) and hemostasis was obtained by pressure dressing, curettage and suture. For the TMJ disorder group, the peak incidence (63.8%) was shown in the post-traumatic myofascial pain dysfunction syndrome and its primary care was medication such as analgesics and sedatives. In the other group, the various specific symptoms were complained due to acute sialadenitis, trigeminal neuralgia, acute stomatitis, chemical burn, terminal stage neuritis of head and neck cancer, and foreign body aspiration. In conclusion, for the rapid and proper care of the emergency dental diseases, well-trained education should be presented to the intern and resident course of oral and maxillofacial surgery. And it is demanded that oral and maxillofacial surgeons must be prepared in knowledge and skill for such emergency care.

기능성 반대교합을 가진 초기 혼합치열기 어린이에서 FR III를 단기간 장착했을 때의 효과 (SHORT-TERM EFFECTS OF THE FUNCTIONAL REGULATOR III APPLIED TO ANTERIOR CROSSBITE PATIENTS IN EARLY MIXED DENTITION)

  • 우세은;남순현;김영진;김현정
    • 대한소아치과학회지
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    • 제39권3호
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    • pp.293-300
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    • 2012
  • 기능성 전치부 반대교합을 가진 성장기 환자의 경우, 조기에 원인을 제거함으로써 골격성으로 이행하는 것을 방지하고 성장 조절로 악골 관계를 개선함으로써 정상적인 기능과 안모를 유도할 수 있다. 1966년 R$\ddot{o}$lf Fr$\ddot{a}$nkel에 의해 소개된 Functional regulator(FR)의 한 종류인 FR III는 기능성 전치부 반대교합 및 상악의 열성장을 동반한 반대교합을 치료하기 위해 유치열기, 혼합치열기 초기, 및 영구치열기에 사용되고 있다. 이 장치는 비정상적인 근육력을 차단하여 구강 내 치열 및 악골에 대한 힘의 불균형 상태를 개선하여 정상적인 성장 발육을 할 수 있게 하는 악정형 장치이다. 이번 증례에서는 초기 혼합치열기에서 기능성 반대교합을 가진 환자의 임상 케이스를 선별하여 FR III 장치를 사용하여 다음과 같은 양호한 결과를 얻었다. 1. 초기 혼합치열기 환아에서 FR III 장치를 5~6개월 정도 단기간 장착하여 전치부 반대교합을 치료하였으며, 협측 차폐판에 의해 발생할 수 있는 상악의 횡적인 악골 변화는 나타나지 않았다. 2. 상, 하악 전치의 치성 변화와 하악의 후하방 회전의 효과를 통해 정상적인 치열관계의 회복과 심미적인 안모를 얻을 수 있었다.

Effect of Pioglitazone on Production of Regulated upon Activation Normal T-cell Expressed and Secreted (RANTES) and IVF Outcomes in Infertile Women with Endometriosis

  • Kim, Chung-Hoon;Lee, You-Jeong;Kim, Jun-Bum;Lee, Kyung-Hee;Kwon, Su-Kyung;Ahn, Jun-Woo;Kim, Sung-Hoon;Chae, Hee-Dong;Kang, Byung-Moon
    • 한국발생생물학회지:발생과생식
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    • 제17권3호
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    • pp.207-213
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    • 2013
  • This study was performed to investigate the effect of peroxisome proliferators activated receptor-${\gamma}$ (PPAR-${\gamma}$) ligand, pioglitazone, on production of regulated upon activation normal T-cell expressed and secreted (RANTES) and in vitro fertilization (IVF) outcome in infertile patients with endometriosis. Sixty-four infertile patients with stage III or IV endometriosis undergoing IVF were randomly allocated to the study or the control group. The long protocol of GnRH agonist (GnRH-a) was used for controlled ovarian stimulation (COS) in all patients. Patients in the study group were treated with pioglitazone at a dose of 15 mg/day orally from the starting day of GnRH-a treatment to the day of hCG injection. Blood samples were drawn for serologic assay of RANTES on the first day of GnRH-a treatment and the day of hCG injection. There were no differences between the study and control groups in patient characteristics. There were also no differences between the two groups in COS duration, and the numbers of retrieved oocytes, fertilized oocytes and embryos transferred. The clinical pregnancy rate per cycle was higher in the study group, but this difference was not statistically significant. However, embryo implantation rate was significantly higher in the study group of 12.5% compared with 8.6% in the control group (P<0.05). The serum RANTES levels after pioglitazone treatment were significantly lower than those before pioglitazone treatmen in the study group (P<0.05). Our data suggest that pioglitazone treatment can suppress RANTES production and improve the embryo implantation rate in patients with endometriosis undergoing IVF.

원형탈모증(alopecia areata)의 최신 이해와 치료 (Advance Understanding and New Treatment of Alopecia Areata)

  • 강경화
    • 생명과학회지
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    • 제26권11호
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    • pp.1345-1354
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    • 2016
  • 원형탈모증은 흔하게 발병하고 두피와 전신에 모발의 탈락을 일으키는 모낭조직 특이 자가면역질환이다. 모낭은 자체적으로 면역체계와 내분비 환경을 가지고 각 모발주기 단계에 따라 다른 면역 상태를 나타내는 특이한 기관이다. 성장기 모낭의 면역특권의 파괴는 모낭상피 MHC class I 발현과 자가반응성 CD8+T세포에 대한 자가항원 발현을 유도하는 자가면역의 공격을 일으키고 원형탈모증을 유발한다. 임상적 실험적 연구에 의하면, 심리적 스트레스도 모낭 면역/호르몬 체계에 영향을 미쳐 원형탈모증의 유도에 관여할 수 있다고 지적한다. 원형탈모증의 핵심적인 병리기전은 면역특권 수호자(ACTH, ${\alpha}-MSH$$TGF-{\beta}$ 등), 자연살해세포그룹 2D-양성(NKG2D+) 세포(NK 세포와 CD8+T 세포 등)와 스트레스 호르몬(CRH와 substance P)과 관련되어 있다. 효과적인 치료법은 여전히 요구되고 있다. 앞으로 치료목표 중의 하나는 스트레스를 포함한 모낭 면역특권을 개선하는 것일 것이다. 최근 연구는 건선, 아토피피부염, 류마티스 관절염 같은 다른 자가면역질환에서 사용되는 JAK억제제와 면역조절제, Tregs, 혈소판풍부혈장요법, 스타틴과 프로스타글란딘 유사제가 원형탈모증에 효과적이라고 보고하였다. 본 논문은 모낭주위 내분비/면역과 관련된 발병기전에 대한 새로운 이해와 원형탈모증의 새로운 치료법에 대해 고찰하였다.

상지로봇치료가 아급성기 뇌졸중 환자의 팔뻗기 움직임에 미치는 단기 효과 (Short-term Effect of Robot-assisted Therapy on Arm Reaching in Subacute Stroke Patients)

  • 홍원진;김용욱;김종배;박지혁
    • 재활치료과학
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    • 제7권4호
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    • pp.79-91
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    • 2018
  • 목적 : 본 연구에서는 상지 로봇 치료가 아급성기 뇌졸중 환자의 상지기능에 단기적으로 미치는 영향을 알아보는 것이었다. 연구방법 : 본 연구는 뇌졸중 편마비 진단을 받고 1회 1시간씩 상지 로봇 치료와 과제 지향적 훈련(task-oriented training)를 받았던 환자 20명의 의무기록을 이용한 후향적 연구로서, 중재 전/후의 3차원 동작분석검사 결과 값을 토대로 두 중재간의 변화량을 비교 하였다. 결과 분석은 기술 통계와 대응표본 t검정을 사용하여 결과 값을 파악 하였다. 결과 : 연구 결과 상지 로봇 치료를 한 경우 팔 뻗기를 하는 동안 팔굽관절 움직임의 순발력, 효율성, 부드러움에서 향상을 보였으며, 과제 지향적 훈련(task-oriented training)과 비교 하였을 때 팔굽관절의 부드러움에서 유의한 차이를 보였다(p<.05). 결론 : 단기적 상지 로봇 치료는 아급성기 뇌졸중 환자의 팔뻗기 시 팔굽관절 움직임에 효과를 보였으며, 추후 장기적인 연구를 통해 상지 기능의 움직임 개선에 대한 효과 입증이 필요하다.