• The Journal of Korean Obstetrics and Gynecology
• /
• v.33 no.2
• /
• pp.112-123
• /
• 2020

Objectives: The purpose of this study is to review the research in the cyclic treatment of endometriosis in traditional Korean medicine. Methods: By October 2019, the relevant studies on the periodic therapy of endometriosis were searched using the Chinese National Knowledge Infrastructure Database (CNKI) and Oriental Medicine Advanced Searching Integrated System (OASIS). Results: Finally, three Randomized controlled trials, one case study, two clinical observational studies were selected. In all studies, herbal medicine periodic therapy has been effective in improving symptoms of endometriosis. Blood-activating and stasis-dispelling medicinal were the most commonly used before menstruation and during menstruation, and tonifying and replenishing medicinal were the most commonly used after menstruation. According to the one study, which reported safety, herbal medicine was safe. Conclusions: Although limited due to a lack of literature, periodic therapy is effective in improving endometriosis related symptoms and preventing recurrence. A well-designed study and experimental studies for the identification of the mechanism are needed.

• Journal of Yeungnam Medical Science
• /
• v.24 no.1
• /
• pp.91-96
• /
• 2007

Extrapelvic endometriosis is a rare disease. The majority of extrapelvic endometriosis cases involve scar tissue following obstetric and gynecologic procedures. We have treated two cases of extrapelvic incisional endometriosis. A 39 year old female patient with cyclic vaginal spotting after laparoscopic assisted vaginal hysterectomy due to uterine myoma and a 35 year old female patient with a painful palpable abdominal mass after cesarean section. Both underwent complete excision and were proven to have endometriosis by pathology. Here we report on both cases and review the medical literatures.

• Journal of Genetic Medicine
• /
• v.6 no.2
• /
• pp.121-130
• /
• 2009

Medical Research Center, Seoul National University College of Medicine, Seoul, Korea To analyze a wide variety of polymorphisms in patients with endometriosis is important since this disease has a strong genetic component. Until now, more than 30 Korean studies have been performed in order to elucidate the possible role of specific polymorphisms in the susceptibility to endometriosis. The most meaningful polymorphisms in Korean patients with endometriosis came from studies investigating GSTM1, AhRR, ER-alpha, VEGF, AHSG, and TNF-alpha. However, following studies should be made to confirm the consistency of the data to have some implications in the prediction of endometriosis. In this review, we also present the future direction of the association studies in complex trait disease such as endometriosis.

• Clinical and Experimental Reproductive Medicine
• /
• v.40 no.2
• /
• pp.55-59
• /
• 2013

Endometriosis is defined as the presence of functional endometrial tissue outside the uterus, causing diverse progressive symptoms such as infertility, pelvic pain, and dysmenorrhea. Although endometriosis has been described since the 1800s, the mechanisms responsible for its pathogenesis and progression remain poorly understood. It is well established that endometriosis grows and regresses in an estrogen-dependent fashion and the disease can be effectively cured by definitive surgery. However, prolonged medical therapy may be needed in most of the cases since conservative surgery is usually performed especially in young women. This treatment modality is often associated with only partial relief and/or recurrence of the disease. In the present review, up-to-date findings on the treatment of endometriosis will be briefly summarized. The outcomes of surgery in patients with endometriosis will be reviewed in terms of pelvic pain relief as well as infertility treatment largely based on recent Cochrane reviews and clinical reports. The efficacy of newer drugs including aromatase inhibitor, anti-tumor necrosis factor-alpha, and dienogest will be also reviewed based on recent clinical studies.

• The Journal of Korean Obstetrics and Gynecology
• /
• v.36 no.1
• /
• pp.35-53
• /
• 2023

Objectives: The aim of this study is to investigate the research trends of animal experiment on the herbal medicine treatment for endometriosis over the past 10 years. Methods: We searched the databases (Pubmed, Embase, Science-on) with terms as endometriosis, Korean medicine, herbal medicine and Chinese medicine. Among the results, we reviewed studies published from 2013 to 2022. Results: 26 studies were selected and analyzed. 8 single herbs and 18 complex formula were used in these studies. The most commonly used herbal medicine for endometriosis was Paeoniae Radix. Each studies showed that herbal medicine had significant effect on treating endometriosis. Conclusions: These results suggest that treating endometriosis with herbal material is effective in inhibiting ectopic lesion and angiogenesis, increasing pain threshold and apoptosis. Further research should be conducted to verify its therapeutic mechanisms and effectiveness.

• Development and Reproduction
• /
• v.3 no.1
• /
• pp.29-38
• /
• 1999

The pathogenesis of endometriosis is unknown, but retrograde menstruation is widely accepted as an etiology. Refluxed endometrium from endometriosis patients is more prone to implant and invade peritoneum possibly through the action of extracellular proteolysis. This proteolytic action may involve plasminogen activators and the collagenase system. Plasminogen activators (PAs) and matrix metalloproteinases (MMPs) play a critical role in the breakdown of extracellular matrix components and basement membrane in the processes of implantation and tumor invasion. PAs are inhibited by plasminogen activator inhibitor (PAI) and MMPs activity is inhibited by tissue inhibitor of metalloproteinase (TIMP). To test the hypothesis that lower expression of PAI-1 and TIMP-3 in endometrium from women with endometriosis, we investigated their PAI-1 and TIMP-3 expression by quantitative competitive RT PCR in endometrium from women with and without endometriosis. Endometrial tissues were obtained from 14 patients with severe endometriosis and 14 patients without endometriosis. Total RNA was extracted and reverse transcribed into cDNA, and quantitative competitive PCR (QC PCR) was performed to evaluate PAI-1 and TIMP-3 mRNA expression. Endometrium from patients with endometriosis showed decreased expression of PAI-1 and TIMP-3 mRNA compared to endometrium from control in luteal phase (p<0.05). Our results suggest that endometrium from women with endometriosis expresses lower levels of PAI-1 and TIMP-3 than endometrium from normal women. Endometrium from endometriosis patients may be more invasive and prone to peritoneal implantation than control because of higher PA and MMP enzymatic activity. Thus, increased proteolytic activity may be one of the reasons for the invasive properties of the endometrium resulting in the development of endometriosis.

• Clinical and Experimental Reproductive Medicine
• /
• v.27 no.1
• /
• pp.91-97
• /
• 2000

Objective: The presence of the various cytokines in human peritoneal fluid has been evaluated incompletely. Changes in cytokine levels may be related to activation of peritoneal macrophage and T-lymphocyte, development of endometriosis, and infertility. This study assesses peritoneal fluid levels of interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10) and tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) in infertile women with endometriosis and normal women without endometriosis. Design: Prospective and case-control study in university hospital. Materials and Methods: Cytokine levels in peritoneal fluid obtained during laparotomy or laparoscopy from 21 patients in infertile patients with endometriosis and 24 controls undergoing laparotomy or laparoscopy with no evidence of pelvic endometriosis were determined by enzyme-linked immunosorbent assay. Results: The mean levels of interleukin-6 in infertile patients with endometriosis and controls were $72.7{\pm}23.7$ pg/ml and $18.5{\pm}9.7$ pg/ml respectively (p=0.02). Similarly, the mean levels of interleukin-8 in infertile patients with endometriosis was significantly higher than that of controls ($445.0{\pm}89.6$, vs $45.1{\pm}48.4$, p=0.04). The mean concentration of interleukin-10 in infertile patients with endometriosis was significantly lower than that of controls ($1.09{\pm}0.04$ vs $2.19{\pm}0.03$, p=0.03). The level of tumor necrosis factor-${\alpha}$ was not significantly different between the two study groups. Conclusions: Increased IL-6 and IL-8 and decreased IL-10 levels in the peritoneal fluid may be related to pathogenesis in the endometriosis and infertility, suggesting that partially contribute to the disturbed immune regulation observed in infertili women with endometriosis.

• Archives of Plastic Surgery
• /
• v.39 no.5
• /
• pp.551-555
• /
• 2012

Endometriosis is defined as the presence of functioning endometrial tissue outside the uterine cavity, and the standard treatment is extensive surgical excision. Cesarean scar endometriosis is a type of cutaneous endometriosis arising on or near a Cesarean section scar. A 44-year-old woman presented with a $9{\times}6$ cm sized dark-brown, stony-hard, irregular, lower abdominal mass of four years duration. The patient had a history of two Cesarean deliveries, 14 and 16 years ago. Suspecting endometriosis, we excised the tumor conservatively rather than extensively to prevent incisional hernia considering the benign nature of the tumor and the low possibility of recurrence because the patient's age was near menopause, along with simultaneous bilateral salpingo-oophorectomy that was performed in this case. On reconstruction, mini-abdominoplasty was adopted to avoid possible wound complications and cosmetic deformities. The patient was satisfied with the cosmetic results, and neither recurrence nor functional problems occurred during the 1-year follow-up period. Plastic surgeons should keep in mind the possibility of cutaneous endometriosis in an abdominal mass of a female of reproductive age with a previous history of pelvic or intra-abdominal surgery. An optimal result from oncological, functional, and cosmetic standpoints can be achieved with conservative excision followed by mini-abdominoplasty of extensive Cesarean scar endometriosis.

• Clinical and Experimental Reproductive Medicine
• /
• v.40 no.2
• /
• pp.67-75
• /
• 2013

Objective: To investigate the effect of peroxisome proliferator activated receptor ${\gamma}$(PPAR${\gamma}$) agonist on the cell proliferation properties and expression of human telomerase reverse transcriptase (hTERT) and aromatase in cultured endometrial stromal cell (ESC) from patients with endometriosis. Methods: Human endometrial tissues were obtained from women with endometriosis and healthy women (controls) using endometrial biopsy. Isolated ESCs were cultured and the cell proliferation was measured by 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide assay and expression of hTERT, aromatase, and cyclooxygenase (COX)-2 by western blotting according to the addition of rosiglitazone (PPAR${\gamma}$ agonist). Results: We demonstrate that the cultured ESCs of endometriosis showed hTERT protein overexpression and increased cellular proliferation, which was inhibited by rosiglitazone, in a dose-dependent manner. At the same time, PPAR${\gamma}$ agonist also inhibited aromatase and COX-2 expression, resulting in decreased prostaglandin $E_2$ production in the ESCs of endometriosis. Conclusion: This study suggests that PPAR${\gamma}$ agonist plays an inhibitory role in the proliferative properties of eutopic endometrium with endometriosis by down-regulation of hTERT and COX-2 expression; this could be a new treatment target for endometriosis.

• Clinical and Experimental Reproductive Medicine
• /
• v.48 no.4
• /
• pp.337-346
• /
• 2021

Objective: Red ginseng (RG) exerts anti-inflammatory, anti-proliferative, and immunomodulatory effects on endometriosis through the regulation of microRNA (miRNA) expression. It may also ameliorate endometriosis by affecting the expression of multiple miRNAs simultaneously, rather than acting on a single miRNA at a given time. Since studies on the overall effects of RG on endometriosis via the regulation of miRNA expression are lacking, the current study aimed to explore the global effect of RG on miRNA expression in a mouse model of endometriosis. Methods: To establish the mouse model, the uterine horn of donor mice was implanted into the lateral side of the recipients' peritoneum, followed by vehicle or RG treatment for 8 weeks. Results: To confirm the effects of RG on the established mouse model, the size of the implanted uterus was measured; it was found to be lower in mice from the RG group than in mice from the control group. miRNA expression profiles in the implanted uterus of the mouse model of endometriosis after vehicle or RG administration were analyzed using microarray technology. Thereafter, seven candidate miRNAs and 125 candidate genes (miRNA targets) were identified through a bioinformatics analysis. Conclusion: The present findings suggest that RG regulates the expression of multiple miRNAs and mRNAs, thereby alleviating endometriosis in a mouse model of the disease.