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Comparative Analysis of Pregnancy Outcomes after In Vitro Fertilization with Intracytoplasmic Sperm Injection (IVF-ICSI) between Obstructive and Non-obstructive Azoospermia (폐쇄성 무정자증과 비폐쇄성 무정자증에서 체외수정시술 후의 임신 결과 비교)

  • Park, Chan-Woo;Koong, Mi-Kyoung;Yang, Kwang-Moon;Kim, Jin-Young;Yoo, Keun-Jai;Seo, Ju-Tae;Song, Sang-Jin;Park, Yong-Seog;Kang, Inn-Soo;Jun, Jin-Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.30 no.3
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    • pp.207-215
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    • 2003
  • Objective: To compare the pregnancy outcomes after in vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI) between obstrucvtive and non-obstrucvtive azoospermia. Methods: From January 1994 to December 2002, 524 patients with obstructive azoospermia (886 cycles) and 163 patients with non-obstructive azoospermia (277 cycles) were included in this study. Microsurgical epididymal sperm aspiration (MESA) or testicular sperm extraction (TESE) in obstructive azoospermia and TESE in non-obstructive azoospermia were perfomed to retrieve sperm, which was used for ICSI and then fertilized embryos were transferred. The results of ICSI - fertlization rate (FR), clinical pregnancy rate (CPR), clinical abortion rate (CAR) and delivery rate (DR) - were statistically analysed in obstructive versus non-obstructive azoospermia. Results: There were no differences in the number of retrieved oocytes, injected oocytes for ICSI and oocyte maturation rate. FR was significantly higher in obstructive than non-obstructive azoospermia (71.7% vs. 61.1%, p<0.001). There was no difference in CPR per embryo transfer cycle. After pregnancy was established, however, CAR was significantly higher in non-obstructive than obstructive azoospermia (25.6% vs. 12.5%, p=0.004). DR per clinical pregnancy cycle was significantly higher in obstructive than non-obstructive azoospermia (78.0% vs. 64.4%, p=0.012). In the karyotype ananlysis of abortus, abnormal karyotypes were found in 75.0% (6/8) of obstructive and 55.6% (5/9) of non-obstructive azoospermia. Conclusion: Our data show significantly higher FR in obstructive than non-obstructive azoospermia. Though there was no differrence in CPR, CAR was significantly higher in non-obstructive than obstructive azoospermia. The abortion may be related to the abnormal karyotype of embryo, but further investigations are necessary to elucidate the cause of clinical abortion in azoospermia.

Implantation Rate and Clinical Pregnancy Rate According to Dosage and Timing of Progesterone Administration for Secretory Endometrial Preparation in Frozen-Thawed Embryo Transfer Cycles (동결보존 배아이식에서 분비기 자궁내막 유도시 프로게스테론 투여 방법에 따른 착상율과 임신율의 비교)

  • Park, Chan-Woo;Hur, Kuol;Kim, Moon-Young;Song, Hyun-Jung;Kim, Hye-Ok;Yang, Kwang-Moon;Kim, Jin-Yeong;Song, In-Ok;Yoo, Keun-Jae;Cheon, Kang-Woo;Byun, Hye-Kyung;Koong, Mi-Kyoung;Kang, Inn-Soo
    • Clinical and Experimental Reproductive Medicine
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    • v.30 no.3
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    • pp.193-202
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    • 2003
  • Objective: To evaluate the difference of implantation rate (IR) and clinical pregnancy rate (CPR) between two protocols of endometrial preperation in women undergoing frozen-thawed embryo transfer (FET) cycles. Methods: This study was performed during the different time periods: A retrospective study from January 2000 to June 2001 (phase I) and a prospective study from July 2001 to March 2002 (phase II). All the patients received estradiol valerate (6 mg p.o. daily) starting from day 1 or 2 of the menstrual cycle without pituitary down regulation. Progesterone was administered around day 14 after sonographic confirmation of endometrial thickness $\geq$7 mm and no growing follicle. In Group A (n=88, 99 cycles) of phase I, progesterone was administered i.m. at a dose of 50 mg daily from one day prior to thawing of pronuclear (PN) stage frozen embryo or three days prior to thawing of 6-8 cell stage frozen embryo and then each stage embryos were trasnsferred 2 days or 1 day later after thawing. In Group B (n=246, 299 cycles) of phase I, patients recieved progesterone 100 mg i.m. from one day earlier than group A; two days prior to PN embryo thawing, four days prior to of 6-8 cell embryo thawing. During the phase II, to exclude any differences in embryo transfer procedures, in Group 1 (n=23, 28 cycles) of phase II embryo was transfered by one who have used the progesterone protocol since the phase I. In Group 2 (n=122, 139 cycles) of phase II embryo was transfered by one who use the progesterone protocol from the phase II. Results: When compared across the phase and group, there were no significant differences in the characteristics. During the phase I, there were significant increase in IR (14.4% vs 5.9%, p=0.001) and CPR (28.3% vs 14.5%, p=0.000) in group A. During the phases II, IR (11.8% vs 10.6%) and CPR (27.6% vs 27.3%) show no differences between two groups. Conclusions: In FET cycles, IR and CPR are increased significantly by the change of dosage and timing of progesterone administraton. And the timing is considered to be more important factor because the dosage of progesterone did not affect implantation window in previous studies. Therefore, we suggest that progesterone administration in FET cycle should begin from one day prior to PN stage embryo thawing and three days prior to 6-8 cell stage embryo thawing.

Effect of Testicular Histopathology on Pregnancy Outcomes in Non-Obstructive Azoospermia (비폐쇄성 무정자증 환자에서 고환의 조직병리학적 진단에 따른 체외수정시술 결과의 비교)

  • Park, Chan-Woo;Seo, Ju-Tae;Park, Yong-Seog;Kim, Hye-Ok;Yang, Kwang-Moon;Kim, Jin-Young;Koong, Mi-Kyoung;Kang, Inn-Soo;Song, In-Ok
    • Clinical and Experimental Reproductive Medicine
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    • v.35 no.4
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    • pp.293-301
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    • 2008
  • Objective: To evaluate outcomes of patients with non-obstructive azoospermia (NOA) undergoing the testicular sperm extraction (TESE) combined with intracytoplasmic sperm injection (ICSI) with different histopathologic subgroups. Method: A total of 122 embryo-transferred TESE/ICSI cycles were compared among NOA subgroups; Germ-cell aplasia (GA, 40 cycles), Maturation arrest (MA, 32 cycles) and severe hypospermatogenesis (S-HS, 50 cycles). Obstructive azoospermia (OA, 667 cycles) patients were served as a control. TESE/ICSI outcomes such as fertilization rate (FR), clinical pregnancy rate (CPR) and live birth rate (LBR) were evaluated. Results: The 2PN FR of embryo-transferred TESE/ICSI cycle was 58.1% in GA, 42.2% in MA and 48.0% in S-HS, which was significantly lower than that of OA (72.9 %, p<0.001). For ICSI-spermatozoa cycles, there were no significant differences in CPR (22.6%, 29.4% and 26.1%) and LBR (16.1%, 29.4% and 19.6%) among NOA subgroups. The CPR of ICSI-spermatid cycles was 0.0%, 9.1% and 0.0% without a live birth. For ICSI-spermatocyte cycles, no clinical pregnancies occurred in any group. Conclusion: There was no significant difference in the FR of embryo-transferred TESE/ICSI cycles among NOA subgroups. The FR among all NOA subgroups was significantly lower than that of OA. Testicular histopathology in NOA did not affect successful pregnancy if spermatozoa extraction from the testis is successful and embryo transfer is possible.

Development of Benthic Macroinvertebrates Index (BMI) for Biological Assessment on Stream Environment (하천환경의 생물학적 평가를 위한 저서동물지수(BMI)의 개발)

  • Kong, Dongsoo;Son, Se-Hwan;Hwang, Soon-Jin;Won, Doo Hee;Kim, Myoung Chul;Park, Jung Ho;Jeon, Te Su;Lee, Jong Eun;Kim, Jong Hyun;Kim, Jong Sun;Park, Jaeheung;Kwak, Inn Sil;Ham, Sun Ah;Jun, Yung-Chul;Park, Young-Seuk;Lee, Jae-Kwan;Lee, Su-Woong;Park, Chang-Hee;Moon, Jeong-Suk;Kim, Jin-Young;Park, Hae Kyung;Park, Sun Jin;Kwon, Yongju;Kim, Piljae;Kim, Ah Reum
    • Journal of Korean Society on Water Environment
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    • v.34 no.2
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    • pp.183-201
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    • 2018
  • The tolerance of Korean benthic macroinvertebrates to organic pollution has been analyzed since the early 1990s. However, considering the fact that there have been related studies carried out in some European countries since the early 20th century, the history of the research in Korea is very short and there is still much knowledge to supplement. We revised the saprobic valency, the saprobic value and the indicator weight value of 190 benthic macroinvertebrates taxa through the data of water quality and individual abundance collected from 7,086 sampling units in Korea from 2008 to 2014. The individual abundance of Uracanthella (Ephemeroptera) as a representative, one of the most common and abundant taxa in Korea, showed a typical lognormal distribution to 5-day biochemical oxygen demand (BOD5) concentration, and a normal distribution to the class interval of BOD5 concentration according to saprobic series. The value combining the mean individual abundance and the relative frequency of occurrence was a more efficient indicator value than that of each property alone. Benthic Macroinertebrates Index (BMI) was newly proposed as a modification of the saprobic index of Zelinka and Marvan (1961). BMI showed extremely significant correlation (determination coefficient $r^2$ > 0.6, n = 569 sites) with the concentration of BOD5, and the coefficient was a little higher than those of the previous indices. Until now, there has been very little research on the assessment of biological integrity of benthic macroinvertebrates community in Korea. While continuing researches into improve the reliability of BMI, it is necessary to develop multimetric indices for evaluating the integrity, including the composition of species and functional guilds, and the richness and diversity of the community.

An Alternative Method for a Rapid Urease Test Using Back-table Gastric Mucosal Biopsies from Gastrectomy Specimen for Making the Diagnosis of Helicobacter pylori Infection in Patients with Gastric Cancer (위암 환자의 헬리코박터 파이로리 감염 진단에 있어서 위절제술 직후 생검된 위점막 조직을 이용한 신속 요소 분해 효소 검사법 도입의 의의)

  • Kim, Sin-Ill;Jin, Sung-Ho;Lee, Jae-Hwan;Min, Jae-Seok;Bang, Ho-Yoon;Lee, Jong-Inn
    • Journal of Gastric Cancer
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    • v.9 no.4
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    • pp.172-176
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    • 2009
  • Purpose: The rapid urease test is a rapid and reliable method for diagnosing Helicobacter pylori infection. However it requires gastric mucosal biopsies during endoscopy, and the test is not covered by national health insurance for patients with gastric cancer. So, we introduced an alternative method for a rapid urease test using back-table gastric mucosal biopsies from gastrectomy specimen. Materials and Methods: Ninety gastric cancer patients underwent an anti H. pylori IgG ELISA test and gastrectomy. Just after gastrectomy, two gastric mucosal biopsies from the prepyloric antrum and lower body of the gastrectomy specimen were taken from the back table in the operative room, and these were fixed immediately with the rapid urease test kit, and the color change was monitored for up to 24 hours. In this study, H. pylori infection was defined as positive when the serology or rapid urease test showed positive results. Results: The positive rate of the rapid urease test and serology was 91.1% and 77.8%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of the rapid urease test and serology were 94.3 and 80.5%, 100 and 100%, 100 and 100%, and 37.5 and 15%, respectively. The accuracy of the rapid urease test was higher than that of serology (94.4 vs. 81.1%, respectively). The rapid urease test showed a higher rate of detecting H. pylori infection than that of serology (McNemar's test, P=0.019). Conclusion: The result of the rapid urease test using back-table gastric mucosal biopsies from a gastrectomy specimen is comparable to the reference data of the conventional rapid urease test using gastric mucosal endoscopic biopsies. Therefore, it can be an alternative diagnostic method for H. pylori infection.

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Survival Rates after Operation for Gastric Cancer: Fifteen-year Experience at a Korea Cancer Center Hospital (위암 수술 후 생존율 분석: 원자력병원의 15년간 경험)

  • Park, Jong-Ik;Jin, Sung-Ho;Bang, Ho-Yoon;Paik, Nam-Sun;Moon, Nan-Mo;Lee, Jong-Inn
    • Journal of Gastric Cancer
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    • v.8 no.1
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    • pp.9-19
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    • 2008
  • Purpose: Gastric cancer is the most common malignant tumor in Korea. We reviewed the cases at our institution to identify the survival rates and clarify the prognostic factors of patients with gastric cancer. Materials and Methods: We conducted a retrospective study of 6,918 patients who had received a diagnosis of gastric cancer, and they underwent surgery at Korea Cancer Center Hospital during a 15-year period from 1991 to 2005. Results: The overall 5-year survival rate was 66.8%. The univariate analysis revealed that age, location of tumor, gross type of tumor, the histology according to the WHO classification, the Lauren classification, depth of invasion (T stage), lymph node metastasis (N stage), distant metastasis (M stage), the type of surgery, the UICC TNM stage, postoperative complications, adjuvant chemotherapy, lymphatic invasion, venous invasion and perineural invasion were the significantly different factors of the survival rates. The multivariate analysis revealed that age, Borrmann type 4, the histology according to the WHO classification, depth of invasion (T stage), lymph node metastasis (N stage), distant metastasis (M stage), the type of surgery, UICC TNM stage, postoperative complications, adjuvant chemotherapy and lymphatic invasion were the independent prognostic factors. Conclusion: We have shown a statistically significant association between the survival rates after operation for gastric cancer and the clinicopathologic factors. Early diagnosis of gastric cancer, appropriate surgeryand adjuvant therapy might improve the quality of life and the survival rates of gastric cancer patients.

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A Study on Seismic Liquefaction Risk Map of Electric Power Utility Tunnel in South-East Korea (국내 동남권 지역의 전력구 지반에 대한 지진시 액상화 위험도 작성 연구)

  • Choi, Jae-soon;Park, Inn-Joon;Hwang, Kyengmin;Jang, Jungbum
    • Journal of the Korean GEO-environmental Society
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    • v.19 no.10
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    • pp.13-19
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    • 2018
  • Following the 2016 Gyeongju earthquake, the Pohang Earthquake occurred in 2017, and the south-east region in Korea is under the threat of an earthquake. Especially, in the Pohang Earthquake, the liquefaction phenomenon occurred in the sedimentation area of the coast, and preparation of countermeasures is very important. The soil liquefaction can affect the underground facilities directly as well as various structures on the ground. Therefore, it is necessary to identify the liquefaction risk of facilities and the structures against the possible earthquakes and to prepare countermeasures to minimize them. In this study, we investigated the seismic liquefaction risk about the electric power utility tunnels in the southeast area where the earthquake occurred in Korea recently. In the analysis of seismic liquefaction risk, the earthquake with return period 1000 years and liquefaction potential index are used. The liquefaction risk analysis was conducted in two stages. In the first stage, the liquefaction risk was analyzed by calculating the liquefaction potential index using the ground survey data of the location of electric power utility tunnels in the southeast region. At that time, the seismic amplification in soil layer was considered by soil amplification factor according to the soil classification. In the second stage, the liquefaction risk analysis based on the site response analyses inputted 3 earthquake records were performed for the locations determined to be dangerous from the first step analysis, and the final liquefaction potential index was recalculated. In the analysis, the site investigation data were used from the National Geotechnical Information DB Center. Finally, it can be found that the proposed two stage assessments for liquefaction risk that the macro assessment of liquefaction risk for the underground facilities including the electric power utility tunnel in Korea is carried out at the first stage, and the second risk assessment is performed again with site response analysis for the dangerous regions of the first stage assessment is reasonable and effective.

Spatial problems of Korea -A delphi survey- (國土管理의 方向定立을 위한 國土診斷 -專門家 集團의 問題意識을 中心으로-)

  • Kim, Inn;Yu, Woo-Ik;Huh, Woo-Kung;Park, Young-Han;Park, Sam-Ock;Yu, Keun-bae;Choi, Byung-Seon
    • Journal of the Korean Geographical Society
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    • v.29 no.1
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    • pp.16-38
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    • 1994
  • The spatial structure of Korea has been changed drastically during the second half of this century. The events such as the Korean War and the resultant division of the Korean Peninsular into two Koreas, rapid industrialization and urbanization are the major causes among others for the spatial changes of the nation. The changes in turn have spawned a number of spatial problems. It is time, we argue, to diagnose how much the nation is now ill-structured, and to discuss of which directions the long-term spatial management be reoriented. A delphi survey was conducted during the early 1993 to fulfill such research needs. Questionnaires were distributed among geographers, planners, and high governmental officials throughout the nation. These 'experts of spatial problems' were requested to evaluate the past spatial policies and strategies, and to identify spatial and environmental problems at the national, regional and local levels. The survey included questions with regard to the spatial problems in North Korea too. A complementary literature survey in the fields of spatial sciences was accomplished as well in order to identify the major research interests and issues with regard to the nations's spatial structure. The delphi survey results indicatee that the present spatial structure: in relation to consumption, housing and economic activities is satisfactory in overall, while rather poor in terms of education, leisure and community activities. Most of the experts consider infrastructural improvements are urgent in the areas of roads, waste disposal facilitles, railroads, harbors, water supply and drainage systems. The over-concentration of economic, social and political function in the Seoul Metropolitan Region is perceived to be the most serious spatial problem in Korea. The long-term solutions suggested are strategies toward a more balanced regional development as well as toward a cleaner environment. The concensus among the experts for the short-term solution is the redistribution of population and industries from the Seoul Metropolitan Region to the intermediate and small cities. The land use policies and concurrent large-scale infrastructural projects are evaluated largely pertinent and desirable in general. It is, however, suggested that development projects be conducted in a more harmonious way with environment. The survey respondents suggest that the present environmental management policies should be reexamined critically. With regard to regional and local problems, transportation and pollutions are thought to be most serious in the Seoul Metropolitan Region, while employment opportunities, and information, education and health care services are most deprived in small cities and rural areas. The majority of the experts consider a city size of 250, 000-500, 000 population is desirable to live within. Respondents beileve that North Korea's physical environment is still not aggravated much whereas its infrastructural provisions are largely pool. The co-authors of this research figure a "environmentaly sound and spatially balanced Korean Penninsular" as the ideal type of spatial structure in Korea. The basic guidelines toward this ideal prototype are suggested: the recovery of spetial integrity, progressive restructuring of the nation, land uses geared to public welfare rather than private interests, and eco-humanistic approach in spatial policies.

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The Study of Prevalence Rate of Refractive Error among the Primary Students in Jeollanamdo (전남지역 초등학생의 굴절이상 유병률에 관한 연구)

  • Jang, Jung Un;Park, Inn-Jee
    • Journal of Korean Ophthalmic Optics Society
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    • v.20 no.3
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    • pp.311-318
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    • 2015
  • Purpose: This study was designed to investigate the prevalence rate of refractive error with gender and age presenting visual acuity of primary student in Jeonnam. Methods: Subjective refraction, objective refraction and visual acuity test were examined on 735 primary school children who ages of 8~13 years lived in Jenman. Presenting visual acuity test was using Han's visual acuity chart and objective refraction was carried out using auto-refractometer. Results: The presenting visual acuity was 0.1 worse in the eye of 54(7.3%) students and 49(7.3%) of them wearing the glasses. The rate of the wearing glasses were 79.3% in 0.125~0.25 visual acuity, 64.2% in 0.3~0.5 visual acuity and 61.6% in 0.6~0.8 visual acuity. It was appeared that 269(36.6%) of them were emmetropia, 321(43.7%) of them were myopia and 56(7.6%) of them were hyperopia, and 89(12.1%) of them were astigmatism. The prevalence rate of myopia was the highest and followed by the prevalence rate of astigmatism. The low degree of myopia occupied the most and the medium degree of myopia showed the tendency of increase as the students get olds. The prevalence rate of the hyperopia showed the tendency of decrease as the students get olds. The prevalence rate of with the rule astigmatism were 50.6% students and against the rule astigmatism were 48.3% of students. Conclusions: The present study reveals the considerable prevalence rates, 466(63.4%) of included subjects, of refractive errors among primary students in Jeonnam province. The rate of the wearing glasses were 313(42.6%). The prevalence of myopia increases as the students get older. Therefore students of visual management is considered necessary through the visual acuity test and refractive examination.

GnRH Agonist Stimulation Test (GAST) for Prediction of Ovarian Response in Controlled Ovarian Stimulation (COH) (난소기능평가를 위한 Gonadotropin Releasing Hormone Agonist Stimulation Test (GAST)의 효용성에 관한 연구)

  • Kim, Mee-Ran;Song, In-Ok;Yeon, Hye-Jeong;Choi, Bum-Chae;Paik, Eun-Chan;Koong, Mi-Kyoung;Song, Il-Pyo;Lee, Jin-Woo;Kang, Inn-Soo
    • Clinical and Experimental Reproductive Medicine
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    • v.26 no.2
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    • pp.163-170
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    • 1999
  • Objectives: The aims of this study are 1) to determine if GAST is a better indicator in predicting ovarian response to COH compared with patient's age or basal FSH level and 2) to evaluate its role in detecting abnormal ovarian response. Design: Prospective study in 118 patients undergoing IVF-ET using GnRH-a short protocol during May-September 1995. Materials and Methods: After blood sampling for basal FSH and estradiol $(E_2)$ on cycle day two, 0.5ml (0.525mg) GnRH agonist ($Suprefact^{(r)}$, Hoechst) was injected subcutaneously. Serum $E_2$ was measured 24 hours later. Initial $E_2$ difference $({\Delta}E_2)$ was defined as the change in $E_2$ on day 3 over the baseline day 2 value. Sixteen patients with ovarian cyst or single ovary or incorrect blood collection time were excluded from the analysis. The patients were divided into three groups by ${\Delta}E_2$; group A (n=30):${\Delta}E_2$<40 pg/ml, group B (n=52): 40 pg/ml${\leq}{\Delta}E_2$<100 pg/ml, group C (n=20): ${\Delta}E_2{\leq}100$ pg/ml. COH was done by GnRH agonist/HMG/hCG and IVF-ET was followed. Ratio of $E_2$ on day of hCG injection over the number of ampules of gonadotropins used ($E_2hCGday$/Amp) was regarded as ovarian responsiveness. Poor ovarian response and overstimulation were defined as $E_2$ hCGday less than 600 pg/ml and greater than 5000 pg/ml, respectively. Results: Mean age $({\pm}SEM)$ in group A, B and C were $33.7{\pm}0.8^*,\;31.5{\pm}0.6\;and\;30.6{\pm}0.5^*$, respectively ($^*$: p<0.05). Mean basal FSH level of group $A(11.1{\pm}1.1mlU/ml)$ was significantly higher than those of $B(7.4{\pm}0.2mIU/ml)$ and C $(6.8{\pm}0.4mIU/ml)$ (p<0.001). Mean $E_2hCGday$ of group A was significantly lower than those of group B or C, i.e., $1402.1{\pm}187.7pg/ml,\;3153.2{\pm}240.0pg/ml,\;4078.8{\pm}306.4pg/ml$ respectively (p<0.0001). The number of ampules of gonadotropins used in group A was significantly greater than those in group B or C: $38.6{\pm}2.3,\;24.2{\pm}1.1\;and\;18.5{\pm}1.0$ (p<0.0001). The number of oocytes retrieved in group A was significantly smaller than those in group B or C: $6.4{\pm}1.1,\;15.5{\pm}1.1\;and\;18.6{\pm}1.6$, respectively (p<0.0001). By stepwise multiple regression, only ${\Delta}E_2$ showed a significant correlation (r=0.68, p<0.0001) with $E_2HCGday$/Amp, while age or basal FSH level were not significant. Likewise, only ${\Delta}E_2$ correlated significantly with the number of oocytes retrieved (r=0.57, p<0.001). All four patients whose COH was canceled due to poor ovarian response belonged to group A only (Fisher's exact test, p<0.01). Whereas none of 30 patients in group A (0%) had overstimulation, 14 patients among 72 patients (19.4%) in group B and C had overstimulation (Fisher's exact test, p<0.01). Conclusions: These data suggest that initial $E_2$ difference after GAST may be a better prognostic indicator of ovarian response to COH than age or basal FSH level. Since initial $E_2$ difference demonstrates significant association with abnormal ovarian response such as poor ovarian response necessitating cycle cancellation or overstimulation, GAST may be helpful in monitoring and consultation of patients during COH in IVF-ET cycle.

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