• Title/Summary/Keyword: 임신거부증

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Borderline Personality Disorder with Infanticide and Denial of Pregnancy : A Case Report (영아살해와 임신거부증을 주소로 내원한 경계선 인격장애의 치료사례)

  • Jung, Semina;Paik, Ki Chung;Lee, Jun Hyung;Kim, Kyung Min;Doh, Jin Ah;Lim, Myung Ho
    • Anxiety and mood
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    • v.8 no.2
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    • pp.161-166
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    • 2012
  • Though infanticide, killing the baby after birth of the neonate and denial of pregnancy, are very rare psychiatric disorder, they have been receiving a lot of social concerns. We report and review infanticide and denial of pregnancy administration in a 19 year-old adolescent with bipolar disorder and borderline personality disorder. Patients with a young age, cognitive immaturity, an unwanted child, hid the pregnancy facts were consistent with the results of previous studies. In addition, the patient's impulsivity and emotional instability is affecting infanticide. After inpatient care with pharmacotherapy (escitalopram 20mg, alprazolam 1.5 mg, clonazepam 0.5 mg, valproate sodium 1,100-1,300 mg, and quetiapine 100-400 mg) and supportive psychotherapy, and there were significant improvement of clinical symptoms.

Roles of T Lymphocytes in Early Human Reproduction (착상과 임신 초기 면역반응에서 T 림프구의 역할)

  • Yang, Kwang-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.36 no.3
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    • pp.151-162
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    • 2009
  • 착상, 태반생성 및 임신 유지 등 생식과정에서 semi-allograft인 배아 및 태아가 생존하기 위해서는 모체 면역계의 면역관용이 요구된다. 면역관용은 분자 생물학적으로 염증반응과 항염증반응의 적절한 균형을 유지하는 인식되고 있으며, 생식과정에서 모체 면역계의 T 림프구, 자연살해세포, 수지상 세포, 대식세포 등 여러 면역세포의 유기적인 협조하에 이루어진다. 면역세포들은 특정 항원 및 사이토카인의 자극에 따라 정반대의 성질을 가진 사이토카인을 생산, 분비할 수 있는 특성을 가지고 있어 각각을 염증성 또는 항염증성 면역세포로 명확히 구분할 수 없으며 면역세포의 이러한 특성에 의해 생산 및 분비되는 사이토카인의 종류에 따라 Th0 형 (Th 0 cell, Tc 0 cell, NK 0 cell), Th1형 (Th 1 cell, Tc 1 cell, NK 1 cell), Th2 형 (Th 2 cell, Tc 2 cell, NK 2 cell), Th3 형 세포 (Th 3 cell, Tc 3 cell, NK 3 cell)로 분류하기도 한다. 즉, 착상 시기에 혈관신생 및 영양막의 자궁 내 침투를 위한 적절한 염증성 사이토카인(inflammatory cytokine)의 분비 및 임신의 지속을 위한 항염증성 (anti-inflammatory) 사이토카인의 분비 등 생식과정에서 수반되는 염증성과 항염증성 면역반응의 적절한 균형을 유지하는 기전은 특정 면역세포만의 작용으로 결론 지을 수 없으며 면역 세포간 network의 산물이라 할 수 있다 (Figure 5). 면역세포 중 최근 그 존재가 알려진 면역조절 T림프구 (T reg cell)는 여러 연구자들에 의해 면역관용에 관여함이 일관되게 보고되고 있어 자궁 내모체-태아간 접촉면에서 면역세포들 간의 network에 중추적인 역할을 할 것으로 인식되고 있으나 작용기전으로 제시되고 있는 가설들을 뒷받침 할 만한 객관적인 연구가 필요한 실정이다. 본 고찰에서는 착상과 임신 유지 등 생식과정에 수반되는 면역세포 및 그 세포들의 작용기전중 T 림프구의 역할에 중점을 두고 그 분류 및 기능에 대해 정리해 보았다. 결론적으로 착상과 임신의 유지 등 생식과정에서 T 림프구는 면역관용과 거부에 적극적으로 작용하며 착상부전, 습관성유산 등 면역학적 병인이 유사한 생식장애 (poor reproductive performance)들의 발병에 중요한 역할을 하는 것은 의심할 여지가 없다. 하지만 향후 T 림프구 및 그와 연관된 면역세포들의 작용에 대한 확실한 분자학적 규명이 요구된다.

OBSTETRICIAN'S VIEW OF TEENAGE PREGNANCY:PRESENT STATUS, PREVENTION AND PSYCHIATRIC CONSULTATION (산과 의사가 인지한 10대 임신의 현황, 예방, 정신과 자문)

  • Kim, Eun-Young;Kim, Boong-Nyun;Hong, Kang-E;Lee, Young-Sik
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.117-128
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    • 2002
  • Objectives:For the purpose of obtaining the more vivid present status and prevention program of teenage pregnancy, this survey was done by Obstetricians, as study subject, who manage the pregnant teenager in real clinical situation. Methods:Structured survey form about teenage pregnancy was sent to 2,800 obstetricians. That form contained frequency, characteristics, decision making processes, and psychiatric aspects of the teenage pregnancy. 349 obstetricians replied that survey form and we analysed these datas. Results:(1) The trend of teenage pregnancy was mildly increased. (2) The most common cases were unwanted pregnancy by continuing sexual relationship with boyfriends rather than by forced, accidental sexual relationship with multiple partners. (3) The most common reason of labor was loss the time of artificial abotion. (4) Problems of pregnant girls' were conduct behaviors and poor informations about contraception rather than sexual abuse or mental retardation. (5) Most obstetricians percepted the necessity of psychiatric consultation, however psychiatric consultation was rare due to parents refusal and abscense of available psychiatric facility. (6) For the prevention of teenage pregnancy, the most important thing was practical education about contraception. Conclusions:Based on the result of this study, further study using structured interview schedule with pregnant girl is needed for the detecting risk factor of teenage pregnancy and effective systematic approach to pregnant girl.

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Megakaryocyte Colony Formation of Fetal Liver Cells (태아 간세포의 거핵구 집락형성)

  • Kwon, Byung O;Ju, Hye Young;Kim, Chun Soo;Jeon, Dong Seok;Kim, Jong In;Kim, Heung Sik
    • Clinical and Experimental Pediatrics
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    • v.45 no.2
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    • pp.247-255
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    • 2002
  • Purpose : This study was undertaken to obtain basic data about the megakaryocyte colony formation of fetal liver cells by using immunocytochemical staining and ex vivo culture with growth factors. Methods : The mononuclear cells were isolated from fetal liver and bone marrow with idiopathic thrombocytopenic purpura(ITP) and pancytopenia. These mononuclear cells were cultured in $MegaCult^{TM}-C$(Stem Cell Tech, Canada) media in the presence of growth factors and CFU-Megakaryocyte( CFU-Mk) colonies were counted on day 12. The expansion of CD34+ and CD41+ cell was analyzed by flow cytometry after 5 days incubation using flask culture. Results : The numbers of CFU-Mk colonies of mononuclear cells obtained from fetal liver in the 11th week gestational age were more than those in the 19th week specimens; growth factors could not enhance the colony expansion in all cases. Total numbers of CFU-Mk colony of fetal liver cells were higher than bone marrow from ITP or pancytopenia groups. The numbers of pure or large CFU-Mk colonies of fetal liver cells were also higher than bone marrow specimens. The rate of CD34+ cell expression of fetal liver was increased after flask culture and the enhancement effect of epression was seen only in cases which added thrombopoietin. The rate of CD41+ cell expression of fetal liver was increased after incubation, but the enhancement effect of growth factors was unclear. Conclusion : This study revealed good results about the megakaryocyte colony assay of fetal liver mononuclear cells using $MegaCult^{TM}-C$ media. This study suggests that the fetal liver could be a good source of megakaryocytic progenitor cells for clinical application in hematopoietic stem cell transplantation.