• Clinical and Experimental Reproductive Medicine
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• v.48 no.3
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• pp.268-272
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• 2021

Bone marrow-derived cell (BMDC) therapy has numerous applications as potential biological cells for use in regenerative medicine. Here, we present an original case of endometrial atrophy associated with genital tuberculosis in a woman who achieved a live birth with BMDC. This 27-year-old woman came to our center with endometrial atrophy and primary infertility. She had a past history of genital tuberculosis and amenorrhea. Her husband's semen quality was normal. The patient was counseled for hysteroscopy due to thin endometrium and advised in vitro fertilization (IVF) with donor eggs in lieu of poor ovarian reserve. Several attempts of IVF with hormone replacement therapy (HRT) were made, but the desired thickness of the endometrium was not achieved. Uterine artery injection of BMDC through interventional radiology was given, followed by HRT for three months, which resulted in improved endometrium. This was subsequently followed by IVF with donor egg. The treatment resulted in the conception and delivery of a 3.1-kg baby boy through lower segment caesarean section with no antenatal, intranatal or postnatal complications. Recently, there has been massive interest in stem cells as a novel treatment method for regenerative medicine, and more specifically for the regeneration of human endometrium disorders like Asherman syndrome and thin endometrium, which was the reason behind using this strategy for treatment.

• The Journal of Korean Academic Society of Nursing Education
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• v.7 no.2
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• pp.308-322
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• 2001

The purpose of this study was to investigate the relationship between climacteric symptoms and management of menopause of middle -aged women. The subjects of this study were 261 women(40 to 60 years old). Data were collected from Jun. 1 to Jul. 15, 2001 by a structured questionnaire. The instruments employed were : 1) The Climacteric Symptoms Scale developed by Aeri Song and Eun soon Chung(1998). 2) The Management of Menopause Scale developed by Aeri Song(1997). The data were analyzed by the SPSS p.c. program using t-test, ANOVA and Pearson correlation coefficient. The results of the study were as follows : 1. Mean score of climacteric symptoms was $2.18{\pm}0.39$(Maximum 4, Minimum 1). The mean scores among the categories of climacteric symptoms, in descending order, were : a) physical and physiological reactions ($2.62{\pm}0.53$), b) social and family relationships ($2.23{\pm}0.50$), c) psychiatric and psychological reactions ($2.08{\pm}0.49$), d) relationship with sexual partner($1.73{\pm}0.54$), e) genitourinary reactions ($1.72{\pm}0.55$). 2. Mean score of management of menopause was $1.79{\pm}0.45$ (Maximum 4, Minimum 1). The mean scores among the categories of management of menopause, in descending order, were : a) dietary management($2.57{\pm}0.52$), b) self control ($2.24{\pm}0.57$), c) management of exercise and physical activity($2.14{\pm}0.75$), d) management of sex life($1.71{\pm}0.47$), e) management of professional health maintenance($1.61{\pm}0.59$). 3. There were statistically significant differences in the score of middle-aged women's self reported climacteric symptoms according to : a) occupation (t=-2.79, p<0.001) b) marriage state (t=-2.29, p<0.05) c) age of menarche (F=4.66, p<0.001) d) method of Sanhujori (post natal care & treatment) (F=4.22, p<0.001) e) hormone replacement therapy (t=-3.09, p<0.05). From the above statistics, several significant findings were noted : a) There were more climacteric symptoms from those who were unemployed, those who had no partner or were divorced and those who started a menarche earlier. b) There were less climacteric symptoms reported from those on hormone replacement therapy and those who followed their parents or parents-in-law advice regarding Sanhujori (postnatal care) 4. There were statistically significant differences in the score of middle-aged women's self reported management of menopause according to : The educational background (F=7.63, p<0.001), religion (F=3.74, p<0.001), income (F=3.65, p<0.001), number of parity (F=4.87, p<0.001), method of Sanhujori(postnatal care) (F=5.73, p<0.001), period of Sanhujori (postnatal care) (F=2.81, p<0.05), hormone replacement therapy (t=3.81, p<0.001). Women with higher educational background, strong religion, higher income, large number of parity, managed their post natal care well, were on HRT, managed their menopause significantly better than the others who took part in the survey. 5. It will be noted from the above that women's degree of climacteric symptoms showed a negative correlation to the management of menopause(r=-0.2146, p<0.001). The findings shown above suggest the need to develop a variable management of menopause, in order to improve climacteric symptoms of middle-aged women. It is hoped that the above findings will stimulate more detailed research into this matter, and thereby enable guidance to be given to women going through the menopause to cope with it in a less stressful way.

• Clinical and Experimental Reproductive Medicine
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• v.46 no.4
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• pp.173-177
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• 2019

Objective: We investigated the clinical characteristics of men with testosterone replacement therapy (TRT)-induced hypogonadism and its effect on assisted reproductive technology (ART) in infertile couples. Methods: This study examined the records of 20 consecutive male patients diagnosed with azoospermia or severe oligozoospermia (< 5 × 10⁶/mL) who visited a single infertility center from January 2008 to July 2018. All patients were treated at a primary clinic for erectile dysfunction or androgen deficiency symptoms combined with low serum testosterone. All men received a phosphodiesterase 5 inhibitor and TRT with testosterone undecanoate (Nebido^®) or testosterone enanthate (Jenasteron^®). Patients older than 50 years or with a chronic medical disease such as diabetes were excluded. Results: The mean age of patients was 37 years and the mean duration of infertility was 16.3 ± 11.6 months. At the initial presentation, eight patients had azoospermia, nine had cryptozoospermia, and three had severe oligozoospermia. Serum follicle-stimulating hormone levels were below 1.0 mIU/mL in most patients. Three ongoing ART programs with female factor infertility were cancelled due to male spermatogenic dysfunction; two of these men had normal semen parameters in the previous cycle. After withholding TRT, serum hormone levels and sperm concentrations returned to normal range after a median duration of 8 months. Conclusion: TRT with high-dose testosterone can cause spermatogenic dysfunction due to suppression of the hypothalamic-pituitary-testicular axis, with adverse effects on infertility treatment programs. TRT is therefore contraindicated for infertile couples attempting to conceive, and the patient's desire for fertility must be considered before initiation of TRT in a hypogonadal man.

• Molecules and Cells
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• v.40 no.9
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• pp.677-684
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• 2017

Postmenopausal atrophic vagina (PAV) is the thinning of the walls of the vagina and decreased lugae of the vagina. PAV is caused by decreased estrogen levels in postmenopausal women. However, the harmful effects of hormone replacement therapy (HRT) have resulted in considerable caution in its use. Various estrogen agonist treatment options are available. Vitamin D is influences the regulation of differentiation and proliferation of various cells, especially tissues lining stratified squamous epithelium, such as the vaginal epithelium. In this study, we hypothesized that vitamin D could provide an alternative and a safe treatment option for PAV by promoting the proliferation and differentiation of the vaginal epithelium. Thirty six patients were enrolled in this case-control study. Vitamin D associated proteins in a vitamin D and sex hormone treated vaginal epithelial cell line as well as normal and PAV tissues were measured. To confirm of cell-to-cell junction protein expression, cell line and tissue studies included RT-PCR, immunohistochemistry staining, and immunoblot analyses. The expression of cell-to-cell junction proteins was higher in women with symptoms of atrophic vagina tissue compared to women without the symptoms. Vitamin D stimulated the proliferation of the vaginal epithelium by activating p-RhoA and Erzin through the vitamin D receptor (VDR). The results suggest that vitamin D positively regulates cell-to-cell junction by increasing the VDR/p-RhoA/p-Ezrin pathway. This is the first study to verify the relationship of the expression of RhoA and Ezrin proteins in vaginal tissue of PAV.

• Journal of Korean Neurosurgical Society
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• v.42 no.2
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• pp.83-88
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• 2007

Objective : Pituitary apoplexy, resulting from an acute infarction or hemorrhage mainly in pituitary adenomas, is a rare yet major clinical event with neurological, ophthalmological and hormonal emergent consequences. The authors review our surgical experience with a series of 16 cases of pituitary apoplexy. Methods : The cases of pituitary apoplexy, operated via trans-sphenoidal approach in our hospital between 1998-2005, were retrospectively analyzed in terms of their clinicoradiological features, pathological findings and surgical outcomes. Results : The mean age of patients (9 male and 7 female) was 47.1 years. The average time of presentation after onset of symptom was 8.9 days. Pituitary apoplexy occurred as an initial manifestation of pituitary adenoma in all patients. Headache was the most common presenting symptom (94%). Visual disturbance was found in 56% of patients. Thirty-one percent of the patients had hypopituitarism. On magnetic resonance imaging, this entire catastrophic event accompanied with macroadenoma in a mean size of 22.5 mm. Only four patients needed postoperative hormone replacement therapy. Three of them showed preoperative hypopituitary function, and one patient in normal pituitary function. There was no specific complication in any of these patients. Conclusion : Early trans-sphenoidal decompression with high-dose corticosteroid replacement showed good outcomes of pituitary apoplexy.

• Women's Health Nursing
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• v.14 no.4
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• pp.257-269
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• 2008

Purpose: The purpose of this study was to investigate educational needs, knowledge and attitude towards menopause in middle-aged women Method: The research design was a descriptive study. The subjects of this study were 231 middle-aged women. Data was collected from a structured questionnaire from October 2 to November 30, 2007. Result: The score of educational needs towards menopause was relatively high at 3.83/5. The score of educational needs related to 'Osteoporosis'(3.99 score), 'Cardiovascular disease'(3.91 score), and 'Hormone replacement therapy'(3.87 score) was relatively high. The score of know ledge towards menopause was relatively low at 17.28/30. The score of attitude towards menopause was neutral at 2.3/4. The relationship between knowledge and attitude towards menopause revealed a negative significant correlation(r=-.194, p=.003). The relationship between knowledge and educational needs towards menopause revealed a positive significant correlation(r=0.275, p<.0001). The degree of educational needs of women before menopause is higher than in menopausal women. Conclusion: There is a need to develop a continuing educational program according to age and menopause condition. Specialists(Nurses) must give information about menopause for a positive attitude toward menopause.

• Korean Journal of Psychosomatic Medicine
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• v.4 no.1
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• pp.109-119
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• 1996

Hormone replacement therapy in menopausal women has recently been a hot issue in medical fields. The author reviewed the physiology of menopause and discussed the physiological mechanism and biological management of vascular flushing and menopausal depression. The above symptoms are hard to distinguish from those of psychiatric disorders.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6839-6844
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• 2013

This study was conducted to analyze the prevalence of non-performance of mammography, and associated factors, among postmenopausal women. This analytical, exploratory, cross-sectional study, of a domicile population inquiry type, was performed in the municipality of Maringa, Parana, Brazil. A total of 456 women were interviewed, aged 45 to 69 years, who presented with natural menopause and cessation of menstruation for at least twelve months. Statistical associations were found between the non-performance of mammography and schooling of less than seven years, paid employment, sedentary lifestyle, smoking, the non-use of hormone replacement therapy, not having consulted a doctor in the previous year, not having consulted a gynecologist, lacking a family history of breast cancer, not having performed the Papanicolaou test, not having performed clinical breast examination, and not having difficult access to health services. After logistic regression analysis, not performing mammography was associated with reports of a fair or bad health status. The study data revealed factors "responsible" for the non-performance of mammography, and the results should contributing to improvement/enhancement of healthy behaviour of Brazilian women in the post-menopausal phase.

• Women's Health Nursing
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• v.12 no.4
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• pp.308-315
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• 2006

Purpose: This study was conducted to identify sexual functioning in women with gynecologic cancer. Method: Sexually active women with gynecologic cancer without evidence of distant metastasis were recruited in Seoul, Korea from a university medical center. Subjects were asked to complete an anonymous mail-back survey on their sexual functioning. Result: One hundred eighty four women completed questionnaires. Their mean age was 51.0 years and 96.2% lived with their husbands. Subjects were diagnosed with cervical cancer(53.8%), ovarian cancer (27.7%), or endometrial cancer(18.5%). Sexual functioning for women with gynecologic cancer was relatively low, 15.4, in comparison to Rosen's cutoff scores of 26.6. Univariate analyses indicated that age, employment status, and their monthly income were significantly associated with sexual functioning. Tumor staging, treatment modality, and hormone replacement therapy were also significantly associated factors with women's sexual functioning. Sexual arousal, orgasm, and pain were affected by time since last treatment. Conclusion: Sexual counselling or education for women with gynecologic cancer should be considered by medical professionals in order to improve their quality of life including sexual functioning.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3091-3096
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• 2015

Worldwide, breast cancer is the most common malignant neoplasm and the second most common cause of cancer death in women. This malignancy is recognized to be estrogen-dependent and due to this feature, hormone replacement therapy is regarded as potentially dangerous in breast cancer survivors who seek relief of their menopausal symptoms. Whereas hot flashes are detected in nearly half of postmenopausal women with a relatively high frequency and severity, botanic sources of estrogens have been proposed as an alternative treatment. Nevertheless, estrogenic properties of these compounds suggest possibility of stimulating cancer recurrence or worsening prognosis in survivors. As well, effects in improving vasomotor climacteric changes is controversial. Many studies have considered the subject, some focusing on efficacy of phytoestrogens for control of menopausal symptoms, and others discussing effects of these compounds on breast cancer outcome in terms of survival or recurrence. The present article is a concise review of the effects of consumption of phytoestrogens on menopausal symptoms, namely hot flashes, and breast cancer recurrence and mortality in survivors of the disease. Overall, the major part of the current existing literature is in favor of positive effects of phytoestrogens on breast cancer prognosis, but the efficacy on menopausal symptoms is probably minimal at the best.