• Title/Summary/Keyword: miscarriage

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Minimal Stimulation using rhFSH and GnRH Antagonist for IVF Treated Patients of Advanced Age (고령 불임여성의 체외수정술시 최소자극법의 효용성)

  • Kim, So-Ra;Kim, Chung-Hoon;Lee, Jin-Kyoung;Jeon, Gyun-Ho;Kim, Sung-Hoon;Chae, Hee-Dong;Kang, Byung-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.36 no.1
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    • pp.63-70
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    • 2009
  • Objective: This study was performed to investigate the effectiveness of minimal stimulation using rhFSH and GnRH antagonist compared with GnRH antagonist multidose protocol (MDP) in IVF treated patients with aged 40 and above. Methods: Seventy-five patients with aged 40 and above were equally randomized to minimal stimulation group (n=37) or GnRH antagonist MDP group (n=38). For minimal stimulation group, ultrasound monitoring was started on cycle day 7 or 8. Daily injections of 0.25 mg cetrorelix together with 150 IU rhFSH were started from the day at 13${\sim}$14 mm of a leading follicle diameter. For GnRH antagonist MDP group, daily injections of 225 IU rhFSH were initiated from cycle day 2 and GnRH antagonist was started at a dose of 0.25 mg/day on rhFSH stimulation day 6 or the day at 13${\sim}$14 mm of leading follicle diameter. In both groups, transvaginal ultrasound-guided oocyte retrieval was performed. According to cleavage and morphologic characteristics of embryos, embryos were transferred 3 to 5 days after oocyte retrieval. Results: There were no differences in patients' characteristics and cycle cancellation rate between the two groups. Total dose and duration of rhFSH used were significantly fewer and shorter in minimal stimulation group than those in GnRH antagonist MDP group. The numbers of oocytes retrieved, mature oocytes and transferred embryos were also lower in minimal stimulation group. However, there were no significant differences in the clinical pregnancy rate and miscarriage rate between the two groups. Conclusions: This study demonstrates that minimal stimulation protocol provides comparable pregnancy rates to GnRH antagonist MDP with fewer dose and days of rhFSH used, and thus can be a cost-effective alternative in women aged 40 and above.

Mammalian Cloning by Nuclear transfer, Stem Cell, and Enzyme Telomerase (핵치환에 의한 cloning, stem cell, 그리고 효소 telomerase)

  • 한창열
    • Korean Journal of Plant Tissue Culture
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    • v.27 no.6
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    • pp.423-428
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    • 2000
  • In 1997 when cloned sheep Dolly and soon after Polly were born, it had become head-line news because in the former the nucleus that gave rise to the lamb came from cells of six-year-old adult sheep and in the latter case a foreign gene was inserted into the donor nucleus to make the cloned sheep produce human protein, factor IX, in e milk. In the last few years, once the realm of science fiction, cloned mammals especially in livestock have become almost commonplace. What the press accounts often fail to convey, however, is that behind every success lie hundreds of failures. Many of the nuclear-transferred egg cells fail to undergo normal cell divisions. Even when an embryo does successfully implant in the womb, pregnancy often ends in miscarriage. A significant fraction of the animals that are born die shortly after birth and some of those that survived have serious developmental abnormalities. Efficiency remains at less than one % out of some hundred attempts to clone an animal. These facts show that something is fundamentally wrong and enormous hurdles must be overcome before cloning becomes practical. Cloning researchers now tent to put aside their effort to create live animals in order to probe the fundamental questions on cell biology including stem cells, the questions of whether the hereditary material in the nucleus of each cell remains intact throughout development, and how transferred nucleus is reprogrammed exactly like the zygotic nucleus. Stem cells are defined as those cells which can divide to produce a daughter cell like themselves (self-renewal) as well as a daughter cell that will give rise to specific differentiated cells (cell-differentiation). Multicellular organisms are formed from a single totipotent stem cell commonly called fertilized egg or zygote. As this cell and its progeny undergo cell divisions the potency of the stem cells in each tissue and organ become gradually restricted in the order of totipotent, pluripotent, and multipotent. The differentiation potential of multipotent stem cells in each tissue has been thought to be limited to cell lineages present in the organ from which they were derived. Recent studies, however, revealed that multipotent stem cells derived from adult tissues have much wider differentiation potential than was previously thought. These cells can differentiate into developmentally unrelated cell types, such as nerve stem cell into blood cells or muscle stem cell into brain cells. Neural stem cells isolated from the adult forebrain were recently shown to be capable of repopulating the hematopoietic system and produce blood cells in irradiated condition. In plants although the term$\boxDr$ stem cell$\boxUl$is not used, some cells in the second layer of tunica at the apical meristem of shoot, some nucellar cells surrounding the embryo sac, and initial cells of adventive buds are considered to be equivalent to the totipotent stem cells of mammals. The telomere ends of linear eukaryotic chromosomes cannot be replicated because the RNA primer at the end of a completed lagging strand cannot be replaced with DNA, causing 5' end gap. A chromosome would be shortened by the length of RNA primer with every cycle of DNA replication and cell division. Essential genes located near the ends of chromosomes would inevitably be deleted by end-shortening, thereby killing the descendants of the original cells. Telomeric DNA has an unusual sequence consisting of up to 1,000 or more tandem repeat of a simple sequence. For example, chromosome of mammal including human has the repeating telomeric sequence of TTAGGG and that of higher plant is TTTAGGG. This non-genic tandem repeat prevents the death of cell despite the continued shortening of chromosome length. In contrast with the somatic cells germ line cells have the mechanism to fill-up the 5' end gap of telomere, thus maintaining the original length of chromosome. Cem line cells exhibit active enzyme telomerase which functions to maintain the stable length of telomere. Some of the cloned animals are reported prematurely getting old. It has to be ascertained whether the multipotent stem cells in the tissues of adult mammals have the original telomeres or shortened telomeres.

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The effectiveness of earlier oocyte retrieval in the case of a premature luteinizing hormone surge on hCG day in in vitro fertilization-embryo transfer cycles

  • Choi, Min Hye;Cha, Sun Hwa;Park, Chan Woo;Kim, Jin Young;Yang, Kwang Moon;Song, In Ok;Koong, Mi Kyoung;Kang, Inn Soo;Kim, Hye Ok
    • Clinical and Experimental Reproductive Medicine
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    • v.40 no.2
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    • pp.90-94
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    • 2013
  • Objective: To evaluate the efficacy of earlier oocyte retrieval in IVF patients with a premature LH surge on hCG day. Methods: One hundred forty IVF patients (164 cycles) with premature LH surge on hCG day were included, retrospectively. We divided them into 2 study groups: LH surge with timed ovum pick-up (OPU) 36 hours after hCG injection (group B, 129 premature cycles), and LH surge with earlier OPU within 36 hours after hCG injection (group C, 35 cycles). Control groups were tubal factor infertility without premature LH surge (group A, 143 cycles). Results: The mean age (year) was statistically higher in group C than in groups A or B ($38.2{\pm}5.4$ vs. $36.2{\pm}4.2$ vs. $36.8{\pm}4.9$, respectively; p=0.012). The serum LH levels (mIU/mL) on hCG day were significantly higher in group B and C than in group A ($22.7{\pm}14.9$ vs. $30.3{\pm}15.9$ vs. $3.2{\pm}2.9$, respectively; p>0.001). Among groups A, B, and C, 4.9%, 31.7%, and 51.4% of the cycles, respectively, had no oocytes, and the overall rates of cycle cancellation (OPU cancellation, no oocyte, or no embryos transferrable) were 15.4%, 65.9%, and 74.3%, respectively. The fertilization rate (%) was significantly higher in group B than in group C ($73.2{\pm}38.9$ vs. $47.8{\pm}42.9$, p=0.024). The clinical pregnancy rate was significantly higher in group C than in groups A and B (44.4% vs. 27.3% vs. 9.1%, respectively, p=0.021). However, the miscarriage rate was also higher in group C than in group B (22% vs. 0%, respectively, p=0.026). Conclusion: Earlier OPU may not be effective in reducing the risk of cycle cancellation in patients with premature LH surge on hCG day. A larger scale study will be required to reveal the effectiveness of earlier ovum retrieval with premature LH surge.

Study on the Vitrification of Human Blastocysts: II. Effect of Vitrification on the Implantation and the Pregnancy of Human Blastocysts (인간 포배기 배아의 초자화 동결에 관한 연구: II. 초자화 동결이 포배기 배아의 착상 및 임신에 미치는 영향)

  • Kim, Su-Hee;Lee, Sang-Won;Lee, Ju-Hee;Kang, Sang-Min;Oh, Hee-Jeong;Lee, Seoung-Min;Lee, Seong-Goo;Yoon, Hye-Gyun;Yoon, San-Hyun;Park, Se-Pill;Song, Hai-Bum;Lim, Jin-Ho
    • Clinical and Experimental Reproductive Medicine
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    • v.27 no.1
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    • pp.67-74
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    • 2000
  • Objective: This study was conducted to investigate the effect of vitrification on the implantation and the pregnancy of human blastocysts. Method: The transfer of the frozen-thawed blastocysts by the slow freezing or vitrification was performed between January 1998 and July 1999. The zygotes derives from IVF were cocultured with cumulus cells in YS medium containing 20% hFF for 5days. Two or three of the best balstocysts produced on day 5 were transferred into the uterus, and then supernumerary blastocysts were randomly divided into two groups. One was frozen by slow freezing and the other was frozen by vitrification method. The slow freezing procedure was performed in two steps (5% glycerol and 9% glycerol + 0.2 M sucrose for 10 min, respectively) using programmed freezer ($-2^{\circ}C$/min to $-7^{\circ}C$, manual seeding at $-7^{\circ}C$, $-0.3^{\circ}C$/min to $-38^{\circ}C$ and plunged into $LN_{2}$). The blastocysts frozen by slow freezing were thawed at $36^{\circ}C$ then removed glycerol in 7 steps. The vitrification procedure was performed in three steps (10% glycerol for 5 min, 10% glycerol + 20% ethylene glycol for 5 min, 25% glycerol + 25% ethylene glycol and directly $LN_{2}$ within 1 min). The blastocysts frozen by vitrification were thawed at $20^{\circ}C$ water then removed cryoprotectant in 3 steps. In each group, thawed blastocysts were cocultured with cumulus cells in YS medium containing 20% hFF for 18h and transferred into the uterus. The implantation rate was evaluated per transferred blastocysts and the pregnancy rate was evaluated per transfers. Results: The survival rate of vitrified group (74.5%) was higher than slow freezing group (68.0%), but not significant. When 98 thawed blastocysts of vitrification were transferred in 40 cycles, 19 pregnancies (clinical pregnancy rate; 47.5%) were established. One miscarriage occurred in the eighth week of pregnancy (ongoing pregnancy rate; 45.0%). 7 pregnancies were ongoing, 11 pregnancies went to term, and 16 healthy infants were born. The Implantation rate was 31.6%. These results were higher than those obtained by the slow freezing (clinical pregnancy rate; 40.3%, ongoing pregnancy rate; 32.5% and implantation rate; 25.3%), but not significant. Conclusion: Vitrification is a simple, quick and economical method when compared to slow freezing. It will be chosen as a good method of human embryo freezing in IVF-ET programs.

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THE PREVALENCE OF CLEFT LIP AND/OR CLEFT PALATE IN KOREAN MALE ADULT (한국인 성인 남자에게 구순열 및 구개열의 유병률에 관한 연구)

  • Baik, Hyoung-Seon;Keem, Jae-Hoon;Kim, Dong-Jun
    • The korean journal of orthodontics
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    • v.31 no.1 s.84
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    • pp.63-69
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    • 2001
  • Cleft lip and/or palate(CLP) is the most common congenital deformity in the craniofacial region. For a practical public health system for these patients it is necessary to have an understanding on the prevalence of CLP. However, it was difficult to estimate the exact number of CLP patients due to problems in sample selection, higher miscarriage and still birth rate, difficulty in classification, and adoptions to foreign countries. Therefore this study was to estimate the prevalence of CLP and the rate of orthodontic treatment, which is usually necessary in cleft lip and/or palate patients. The samples consisted of 218,322 Korean male adults from Seoul, Kwangju, Taegu and Pusan, all born in 1979. The screening method for recognizing the CLP patients was proceeded in steps and the results are as follows. 1. The prevalence of cleft lip and/or palate in Korean male adults born in 1979 was 0.65 out of the 1000 samples. 2. In the anteroposterior aspect of the 1000 samples, the prevalence of cleft lip, cleft lip and palate, and cleft palate was 0.26, 0.36 and 0.03 respectively. 3. In the transverse aspect of the 1000 samples, the prevalence of left, right and bilateral cleft was 0.35, 0.16, 0.12 respectively. The cleft in the left showed a much higher prevalence than in the rirht, while bilateral cleft showed a lower prevalence than unilateral cleft. 4. The orthodontic treatment rate of Korean male adults among cleft lip and/or palate Patients was $35\%$, and it was in the order of cleft lip and Palate, cleft lip, and cleft Palate, being $67\%,\;29\%\;and\;29\%$ respectively. The orthodontic treatment rate in patients with the more severe cleft lip and palate was higher than in patients solely having cleft lip or cleft palate.

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Effects of Social Support, Sleep Quality, and Oral Health Impact Profile on Depression among Pregnant Women (일부 임신부의 사회적 지지, 수면의 질 및 구강건강영향지수가 우울수준에 미치는 영향)

  • Han, Se-Young;Han, Yang-Keum
    • Journal of dental hygiene science
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    • v.17 no.2
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    • pp.134-141
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    • 2017
  • This study examined 191 pregnant women before delivery in an obstetrics and gynecology clinic in North Gyeongsang Province from May to September 2016 by using a questionnaire after obtaining informed consent for voluntary participation in the study. The study was performed to investigate the association of depression with sociodemographic characteristics, pregnancy-related characteristics, social support, sleep quality and Oral Health Impact Profile (OHIP) in pregnant women. The prevalence of depression among the pregnant women was 25.1% in the healthy group and 74.9% in the depression group. The depression level was significantly higher in women in the depression group who were unsatisfied with their marriage life, had no occupation, had lower social support, had poor sleep quality and had higher OHIP scores. The results of the logistic regression analysis indicated that, the risk ratio for more severe depression was significantly higher in the group with no experience of miscarriage and induced childbirth than in the group with childbirth experience. Conversely, the risk ratio for more severe depression was significantly lower in the group with high social support than in the group with low social support. Depression in the respondents significantly positively correlated with sleep quality and OHIP score but significantly negatively correlated with social support. The multiple regression analysis revealed that the depression level was significantly higher by 22.3% among pregnant women with lower marital satisfaction, no childbirth experience, lower social support and higher OHIP scores. In summary, depression was related to marital satisfaction, childbirth experience, social support, and OHIP score, among others, in pregnant women in this study. Therefore, further investigation is warranted to construct programs and measures that will help build positive thinking by designing and verifying a three-dimensional study model by taking into consideration various variables to reduce the incidence of depression in pregnant women.

Study on the Recognition of Brucellosis for Rural Residents (일부 농촌지역 주민의 브루셀라증 인지도)

  • Lim, Hyun-Sul;Min, Young-Sun
    • Journal of agricultural medicine and community health
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    • v.30 no.1
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    • pp.51-62
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    • 2005
  • Objectives: This study was conducted to understand the recognition on brucellosis in rural communities and to apply the results to counterplan for brucellosis control and prevention. Methods: The authors conducted a questionnaire survey from September 8 to 13, 2004 among the residents in 2 rural communities: 507 people at Gigye-myeon and 521 people at Buk-myeon. The authors developed a questionnaire which investigated age, gender, general recognition of brucellosis, status of cattle breeding, compensation for loss due to brucellosis and so on. Results: The study group contained 195 (19.0%) stock breeders (veterinarians and cattle merchants were included) and 833 (81.0%) non-stock breeders. For the question, 'Have you ever heard about brucellosis or do you know about brucellosis?', 283 respondents (27.5%) replied affirmatively. For the question, 'Do you know that pregnant women who suffer brucellosis may have a miscarriage?', 98 respondents (35.1%) replied affirmatively. For the question, 'Have your cattle ever aborted or calved a premature calf?', 28 respondents (14.9%) replied affirmatively. For the question, 'Have you ever handled an abortus or a premature calf with your bare hands?', 10 respondents (5.3%) replied affirmatively. For the question, 'Do you know that the government compensates for slaughter loss due to brucellosis?', 46 respondents (25.0%) replied affirmatively. Conclusions: Many people were ignorant about brucellosis. Therefore, their ignorance must be corrected by a publicity campaign. Some stock breeders handled the cattle abortus with their bare hand. Stock breeders must wear protective equipment during working. The authors expect that this study will assist in establishing both a safe cattle breeding environment and preventive strategies for diminishing the incidence of brucellosis.

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Clinical Outcome of Transfer of Cryopreserved-Thawed Embryos Obtained after Intracytoplasmic Sperm Injection: Comparison with Conventional In Vitro Fertilization (난자 세포질내 정자 주입술 후 동결보존 배아이식: 고식적 체외수정시술과의 비교 연구)

  • Kim, S.H.;Jee, B.C.;Jung, B.J.;Kim, H.S.;Ryu, B.Y.;Pang, M.G.;Oh, S.K.;Shon, C.;Suh, C.S.;Choi, Y.M.;Kim, J.G.;Moon, S.Y.;Lee, J.Y.
    • Clinical and Experimental Reproductive Medicine
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    • v.24 no.3
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    • pp.281-292
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    • 1997
  • The objective of this study was to compare retrospectively the survival and pregnancy rates(PR) of cryopresered-thawed embryos obtained from intracytoplasmic sperm injection (ICSI) or conventional in vitro fertilization (IVF). Ninety-six cycles of cryopresered-thawed embryo transfer (ET) were performed in 79 patients from June, 1996 to September, 1997 and grouped as followings: 20 cycles (16 patients) inseminated by ICSI (ICSI Group) and 76 cycles (63 patients) by conventional IVF (IVF Group). Slow-freezing and rapid-thawing protocol was used with 1.5M propanediol (PROH) and 0.1M sucrose as cryoprotectant. All embryos were frozen-thawed at the two pronuclear (2 PN) stage excluding four cycles in which the early cleavage stage embryos were frozen, and allowed to cleave in vitro for one day before ET. The duration from freezing to thawing was comparable in both groups ($mean{\pm}SD$, $112.1{\pm}80.0$ vs. $124.8{\pm}140.1$ days). The age of female ($31.2{\pm}3.4$ vs. $32.6{\pm}3.3$ years) and the endometrial thickness prior to progesterone injection ($9.4{\pm}2.0$ vs. $9.3{\pm}1.8$ mm) were also comparable in both groups. There was no significant difference in the outcomes of cryopreserved-thawed ET between two groups: survival rate ($85.2{\pm}16.1%$ vs. $82.2{\pm}19.7%$), cleavage rate ($96.9{\pm}6.7%$ vs. $94.7{\pm}13.0%$), cumulative embryo score (CES, $54.5{\pm}31.1$ vs. $49.0{\pm}20.0$), preclinical loss rate (5.0% vs. 5.3%), clinical miscarriage rate (0% vs 29.4%), clinical PR per transfer (35.0% vs. 22.4%), implantation rate (9.9% vs. 5.6%), and multifetal PR (42.9% vs. 17.6%). In conclusion, human embryos resulting from ICSI can be cryopreserved-thawed and transferred successfully, and the survival rate and PR are comparable to conventional IVF.

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Expression of Decidual Natural Killer (NK) Cells in Recurrent Abortion Patients with Increased Peripheral NK Cells (말초혈액 자연살해세포가 증가된 반복유산 환자의 탈락막 자연살해세포의 발현)

  • Lee, Hyun-Joo;Kim, Sun-Haeng;Yang, Kwang-Moon;Park, Dong-Wook;Park, Chan-Woo;Hong, Sung-Ran;Cho, Dong-Hee;Song, In-Ok;Koong, Mi-Kyoung;Kang, Inn-Soo
    • Clinical and Experimental Reproductive Medicine
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    • v.36 no.3
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    • pp.199-207
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    • 2009
  • Objectives: The purpose of this study was to compare the decidual NK cell populations between increased pre-conceptional peripheral NK cell population and normal pre-conceptional peripheral NK cell population in women with a history of recurrent abortion. Methods: Fourteen women with history of recurrent abortion and elevated pre-conceptional peripheral NK cell, above 15% of peripheral lymphocyte population were included in this study. As a control, twelve women with history of recurrent abortion and their peripheral NK cell percentage showed below 15% were included. Distribution of $CD56^+$ and $CD16^+$ NK cells in paraffin embedded decidual tissues including implantation sites were examined by immunohistochemical staining using anti-CD56, 16 monoclonal antibodies. After immuohistochemical staining, the numbers of decidual NK cells were counted and compared these results between study and control groups. Results: There was significant difference in decidual $CD56^+$ NK cell count ($170.1{\pm}132.1$ vs. $68.3{\pm}66.1$, p=0.02) between increased peripheral $CD56^+$ NK cell group and control group. But, there showed no statistically significant correlation between decidual $CD56^+$ NK cell count and peripheral $CD56^+$ NK cell percentage (r=0.229, p=0.261). Also there was no statistically difference decidual $CD16^+$ NK cell count between study and control group ($25.70{\pm}11.72$ vs. $31.17{\pm}22.67$), and no correlation between decidual $CD16^+$ NK cell and peripheral $CD16^+$ NK cell percentage (r=-1.40, p=0.535). Conclusions: This study shows that decidual $CD56^+$ NK cell are significantly increased in decidua of women exhibiting a history of recurrent abortion with increased $CD56^+$ peripheral NK cell. This study suggests that the percentage of peripheral NK cell reflect the expression of decidual NK cell. Consequently, pre-conceptional peripheral blood NK cell population can be the useful marker for detecting the risk of subsequent miscarriage.

The analysis for attributes of OUV of the capital of Shilla Kingdom (세계유산 신라왕경의 탁월한 보편적 가치 속성 분석)

  • KIM, Euiyeon
    • Korean Journal of Heritage: History & Science
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    • v.55 no.1
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    • pp.151-174
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    • 2022
  • According to the "Special Act on the Restoration and Maintenance of the Core Relics of the Shilla Kingdom" enacted in 2019, the Shilla Kingdom refers to the capital of Shilla and Unified Shilla period, and refers to Gyeongju, where the king lived, and the nearby area. Shilla Wanggyeong is a heritage registered on the UNESCO World Heritage List in 2000 under the name of Gyeongju Historic Site and belongs to Wolseong District, Hwangnyongsa District, and Daeneungwon District among the five districts registered as Gyeongju Historic Site. Unlike the Namsan and Sanseong districts, the Shilla Kingdom is a heritage consisting mostly of archaeological sites without physical substance. Gyeongju City sought to promote local tourism while providing more direct experiences to visitors by restoring the heritage that constitutes the Shilla Kingdom. Starting with the restoration of Woljeonggyo Bridge in 2005, the Shilla Wanggyeong restoration project began in earnest. Gyeongju City tried to restore the building site on the west side of Donggung Palace and Wolji after Woljeonggyo Bridge, but it was canceled due to opposition from the UNESCO World Heritage Committee. The World Heritage Committee opposed the restoration and recommended a heritage impact assessment for similar projects in the future. During the miscarriage impact assessment procedure, there is an OUV attribute analysis process of the heritage to be evaluated. This study intends to preemptively derive OUV attributes for the Silla Kingdom through literature and overseas case analysis. In the case of literature research, domestic and foreign research data related to the UNESCO World Heritage Convention and World Heritage Management were examined, and in overseas cases, the architectural works of Krakow Historical District, Stonehenge and Abbury Geoseok Ruins in England, and Le Corbusier were analyzed. Through this, the outstanding universal value attributes of the Silla Kingdom were derived. This study is expected to be used as a reference in the process of restoration projects of other heritage constituting the Shilla Kingdom or construction plans in nearby areas in the future and serve as an indicator to improve the management system of the Shilla Kingdom more efficiently from the perspective of world heritage.