Objectives : Middle aged women with depression often experience hot flush symptoms. It is still unclear about the association between depression and hot flush symptoms. Therefore, we investigated hormonal profile, functional somatic symptoms, coping styles and attitude for menopause between depressed women with hot flush and those without hot flush. Methods : This study included 33 depressed patients with hot flush symptoms and 33 depressed patients without hot flush symptoms. Hot flush was confirmed through prospective daily symptom ratings for a week. Subjects' coping styles were assessed by the stress coping checklist. Somatic symptoms were assessed by the Patient Health Questionnaire-15(PHQ-15). Sex hormonal levels were assayed by a radioimmunoassay. The Brief World Health Organization Quality of Life Assessment Instrument(WHOQOL-BREF) was used to evaluate quality of life. Results : In coping style, depressed women with hot flush symptoms used less 'problem-centered coping'($13.15{\pm}3.17$) and 'search for social support'($11.83{\pm}2.84$) than those without hot flush symptoms($15.17{\pm}3.1$, p=0.028 ; $14.25{\pm}3.22$, p=0.009 ; respectively). Depressed women with hot flush symptoms showed more negative attitude toward post-menopause, but its statistical significance was marginally insufficient(p=0.059). We did not find any group differences in sex hormonal levels and somatic complaints assessed by the PHQ-15. The score of social relationship domain of WHOQOL-BREF was significantly lower in subjects with hot flush symptoms($8.62{\pm}2.04$) than subjects without hot flush symptoms($9.71{\pm}1.65$ ; p=0.044). Conclusions : Among middle aged women with depression, the manifestation of hot flush symptoms was associated with coping styles and attitude for menopausal transition. Hot flush symptoms in depressed women negatively influence quality of life, so clinicians actively perform therapeutic approach in case of depressed patients with hot flush symptoms. In case of depressed patients who present hot flushes, cognitive behavior therapy or stress management might be an effective treatment option in company with antidepressants or hormonal treatment. Later, longitudinal study will be needed to evaluate risk factor, cause and effect associated with hot flush and depression.
In order to evaluate the consistency of the serum estradiol pattern and response and to determine the influence of number of ovary on them in repeat cycles in the same patient, 57 cycles in 24 patients who underwent in Vitro Fertilization-Embryo Transfer or Gamete Intrafallopian Transfer in Seoul National University Hospital. The patients were stimulated by follicular stimulating hormone and human menopausal gonadotropin and classified as high(${\geqq}$400 pg/ml) and low(<400 pg/ml) response group according to preovulatory estradiol concentration and classified as three estradiol patterns (A,G.B) according to Jones criteria. Seventeen(89.5%) of 19 patients in when a high response to ovulation induction in their first cycle showed a high response. 40%(2/5) of the second ovulation induction cycle were low response in the patient whose first cycle resulted resulted in a low response. Serum estradiol pattern in the first ovulation induction cycle tended to be repeated in the second cycle. Women with high response tended to be more likely to have A and G patterns and less likely to have a cancellation than those with low response. One-ovary patients were at higher risk for inadequate ovulation induction response.
The purpose of this study was to identify the risk factors of osteoporosis. The data were collected from women who visited Physical Examination Center of a university hospital located in Taejon during the period of September 1997-August 1998. The sample was divided into two groups(the osteoporosis group of 44 cases and the control group of 66 cases). The results were summarized as follows ; 1. Sociodemographic characteristics(education and family income) and BMI showed no significant difference between the osteoporosis group and the control group. 2. There was no significant difference in coffee, unbalanced diet, diet method and meal habit between the osteoporosis group and the control group. 3. The osteoporosis group reported more incidence of operative menopause due to hysterectomy and oophorectomy, but this was not statistically significant. There was no significant difference in use of oral pill use, past disease and family history of fracture between the osteoporosis group and the control group, but the odds ratio(OR 3.11, 95% CI : 1.30-7.41) of present illness was statistically significant in the osteoporosis group. 4. There was no significant difference in the reproductive history including number of delivery and abortion and feeding method between the osteoporosis group and the control group. 5. The osteoporosis group showed significant results of lower menopausal age, shorter duration of menstruation and longer duration after menopause compared to the control group. 6. The osteoporosis group reported significantly lower level of physical activity in such variables as work activity and walking time. 7. A logistic analysis showed that shorter period of menstruation, lower level of physical activity, non-alcohol drinking group, and presence of disease were related to the possibility of occurring of osteoporosis.
As far as we know, there were no studies of the effect of L-arginine on bone metabolism in post-menopausal women or ovariectomized rats. The primary objective of the current study was to determine whether arginine supplementation was associated with alterations in femoral and spinal bone mineral density (BMD) and bone markers in ovariectomized (Ovx) rats. Forty female Sprague-Dawley rats were divided into two groups, Ovx and sham groups, which were each randomly divided into two subgroups that were fed control and arginine supplemented diet. All rats were fed on experimental diet and deionized water ad libitum for 9 weeks. Bone formation was measured by serum osteocalcin and alkaline phosphatase (ALP) concentrations. Bone resorption was measured by deoxypyridinoline (DPD) crosslinks immunoassay and corrected for creatinine. Serum osteocalcin, growth hormone, insulin-like growth factor-1 (IGF-1), parathyroid hormone (PTH) and calcitonin were analyzed using radioimmunoassay kits. Bone mineral density (BMD) and bone mineral content (BMC) were measured using PIXImus (GE Lunar Co, Wisconsin, USA) in spine and femur. The serum and urine concentrations of Ca and P were determined. The plasma was analyzed for arginine. Diet did not affect weight gain, mean food intake, and plasma arginine concentration. Urinary Ca excretion was decreased by arginine supplementation in Ovx rats, but statistically not significant. The Ovx rats fed arginine-supplemented diet were not significantly different in ALP, osteocalcin, crosslinks value, PTH, calcitonin and IGF-1 compared to those fed control diet. The arginine-supplemented group had significantly higher serum Ca and growth hormone than control group. Spine and femur BMD were significantly increased by arginine supplementation on 5th and 9th weeks after feeding. Our findings indicate that dietary L-arginine supplementation decreased bone mineral density loss in Ovx rats. Therefore, dietary arginine supplementation may represent a potentially useful strategy for the management of osteoporosis.
This study was performed to determine the effect of three different concentrations of soy-isoflavones on calcium and phosphorus balance in either sham-operated or ovariectomized female rats. Seventy-two 16-week old Sprague-Dawley rats underwent sham operation or bilateral ovariectomy. They were provided diets containing different levels of soy iso-flavones for 6 weeks: 50 ppm (Jow isoflavone intake; LI) , 250 ppm (medium isoflavone intake; MI) and 500 ppm (high isoflavone intake; HI). The subsequent fecal and urinary excretions of calcium and phosphorus were then measured. In the sham-operated rats, body weight gains and food efficiency ratio of the MI and HI groups were significantly lower than the control group while food intake was not different. However, there was no significant difference in the ovariectomized rats. The fecal excretion of calcium was significantly lower in the LI, MI and HI groups than the control group in sham operated rats, and significantly lower in the HI group than the control group in ovariectomized rats. Also, apparent ab-sorption rate of calcium and phosphorus did not show any significant difference among groups. Urinary excretion of calcium and phosphorus was significantly lower in the HI group than the LI group in the sham-operated rats. Urinary excretion of calcium was significantly higher in the control ovariectomized rats than in the control sham-operated rats. Retention of calcium and phosphorus did not show any significant difference in both groups. From the above result, we see that isoflavone intake increases calcium retention through an increase in calcium absorption and also suppresses the increase of calcium excretion in urine in ovariectomy. Therefore, it is suggested that isoflavone intake is recommended for menopausal women who experience sharp bone loss due to the decrease in estrogen honnone.
Osteoporosis is recognized as one of the major hormonal deficiency diseases, especially in menopausal women and the elderly. When the estrogen level is reduced in the body, local factors, which are known to be related with bone resorption, are increased and promote osteoclastogenesis. In our previous study, we validated the estrogenicity of silkworm pupa. In this study, we investigated the effect of silkworm pupa extract (SPE) on the function of osteoblastic MC3T3-E1 cells. SPE (10 and $50\;{\mu}g/mL$) significantly elevated cell viability, alkaline phosphatase (ALP) activity, and collagen content in the cells. The effect of SPE ($50\;{\mu}g/mL$) in increasing cell viability, ALP activity, and collagen content was completely inhibited by the presence of $10^{-6}\;M$ of cycloheximide and $10^{-6}\;M$ of tamoxifen, suggesting that SPE's effect results from a newly synthesized, protein component and that it might be partly involved in estrogen action. Furthermore, we examined the effect of SPE on the $H_2O_2-induced$ apoptosis and production of local factors in osteoblasts. Treatment with SPE ($50\;{\mu}g/mL$) decreased the 0.2 mM $H_2O_2-induced$ apoptosis and the production of tumor necrosis factor (TNF)-${\alpha}$, interleukin (IL)-6 and nitric oxide (NO) in osteoblasts. Our data indicate that the enhancement of osteoblast function by silkworm pupa may prevent osteoporosis and inflammatory bone diseases.
The prevalence of type-2 diabetes increases remarkably in post-menopausal women, possibly because insulin secretion fails to compensate for the insulin resistance induced in various tissues by estrogen insufficiency. However, this has not been fully defined. Therefore, the present study investigated whether an ovariectomy (OVX) would increase insulin resistance and decrease the $\beta$-cell function and mass in female rats with and without a $90\%$ pancreatectomy (Px). Female rats aged 15 weeks were divided into four groups: 1) OVX + Px, 2) SOVX (sham operation of OVX) + Px, 3) OVX + SPx (sham operation of Px), and 4) SOVX + SPx, and given a $30\%$ fat diet for 8 weeks. At the end of the experimental period, the islet function and insulin resistance were determined using a hyperglycemic clamp and a euglycemic hyperinsulinemic clamp, respectively. The OVX only increased the body weight in the SPx rats, which was partially related to the food intake. Yet, the OVX did increase the peripheral insulin resistance, while the Px increased this resistance further. The OVX and Px both exacerbated the islet function, as measured by the insulin secretion pattern, while delaying and decreasing the first-phase insulin secretion. The OVX only decreased the proliferation of $\beta$-cells in the Px rats, while increasing apoptosis in both the Px and SPx rats. As a result, the OVX decreased the $\beta$-cell mass in the Px rats, but increased the mass in the SPx rats. In conclusion, an OVX was found to accelerate the development and progression of diabetes by increasing the insulin resistance and decreasing the $\beta$-cell mass. Therefore, menopause can be a risk factor for type-2 diabetes, mainly due to a deceased proliferation of $\beta$-cells.
Objectives: This study was a methodological study to verify the reliability and validity and to make a diagnosis of a diagnostic tool for climacteric and postmenopausal syndrome pattern identification (CaPSPI). Methods: This study was conducted from June 1, 2018 to October 18, 2018 with ${{\bigcirc}{\bigcirc}}$ University Korean Medicine Hospital IRB's approval (2018-3). To make a diagnosis using CaPSPI, we decided the cut-points for the tool. Three professors of ${{\bigcirc}{\bigcirc}}$Korean Medical University conducted pattern identification diagnosis. The result is marked from 0 to 3, 0 is 'No', 1 is 'Slightly Yes', 2 is 'Yes' and 3 is 'Very Yes'. And if two or more professors' diagnoses are the same, we took the diagnoses as a diagnostic criteria. The decision of pattern by three experts converted to 0-1 scores in two ways. In "method 1", if the diagnosis was zero points, the score was 0 (have no such identification), and the rest was 1 (have such identification). In "method 2", if the diagnosis was zero or 1 point, the score was 0, and the rest was 1. After that, intraclass correlation was calculated for experts agreement. And logistic regression was conducted. A response variable was the results of the experts' diagnosis and an explanatory variable was the results of the pattern identification diagnostic tool. Results: The diagnosis of the three experts showed excellent concordance of more than 0.794 and showed a significant correlation with the diagnostic tool. Both 'Method 1' and 'Method 2' showed statistically significant effects with the diagnosis of 3 experts and the results of the diagnostic tool. The frequency of cumulative pattern identification diagnosis in 'Method 1' and 'Method 2' were found to be 578 occasions and 203 occasions, respectively. The average number of pattern held by participants in 'Method 1' and 'Method 2' were found to be 5.26 and 1.85, respectively. In both "Method 1" and "Method 2," the yield frequency of liver qi depression was the highest, and the frequency of kidney yin deficiency and liver-kidney yin deficiency was relatively high. Conclusions: Based on the above results, it is thought that, in diagnosis using CaPSPI of menopausal women, 'method 1' could be used for the health diagnosis and prevention, 'method 2' could be used for the pattern diagnosis. On the conclusion, CaPSPI is thought to be available for pattern diagnosis of menopause women.
Purpose : To evaluate the clinical use of the menopause-specific quality of life questionnaire(MENQOL) for scoring menopausal symptoms by comparison with the conventional Kupperman's index. Methods : A population sample of 66 women was randomly selected from the female patients(aged 45-55) who had visited two oriental medical clinic in Seoul or Woo-Shin-Hwang oriental hospital from 1st April to 15th May in 2006. They completed both the MENQOL and the Kupperman's index and were asked a few additional questions. Results : 1. A degree of the Climacteric symptoms were not significantly related to either an education level or an income level. 2. A comparison of the MENQOL with the Kupperman's index produced a high positive correlation. 3. 41 of subjects (62.1%) answered that the MENQOL was more efficient for explaining their symptoms than the Kupperman's index. 49 (74.2%) of subject thought that both questionnaires are equally not difficult to fill out and 44(66.7%) of subject found no difficult questions to answer in any of questionnaires. Conclusion : The MENQOL is a valuable modern tool for the assessment of climacteric symptoms in place of the Kupperman's index. The MENQOL was excellent in applicability. The MENQOL could serve as an adequate diagnostic instrument for climacteric symptoms.
Osteoporosis is one of the major health problem affecting postmenopausal women. Estrogen deficiency results in an increase in bone turnover, lead to bone resorption and an increase risk of fracture. The aim of this study was to evaluate the effects of Capsosiphon fulvecense extract (SCF) on the collagen content of the connective tissues and alkaline phosphatase activity of serum in ovariectomized estrogen-deficient rats. Three groups were surgically ovariectomized (OVX). The fourth group was sham operated. Sprague-Dawley female rats were randomly assigned to the following groups : sham-operated rats (Sham), ovariectomized control rats (OVX-control), ovariectomized rats supplemented with CsF at 50mg/kg body wt (OVX-CSF50) and ovariectomized rats supplemented with CsF at 200mg/kg body wt (OVX-CSF200). The Capsosiphon fulvecense extracts were orally administrated at 1mL per day. The ovariectomy caused a decreasing in the levels of collagen content in bone, cartilage, skin and lung tissues. However CSF groups, supplementation with Capsosiphon fulvecense extract, were increased the level of collagen content in bone, cartilage, skin and lung tissues than OVX-control group. Alkaline phosphatase activity also were increased and calcium levels were decreased than OVX-control on serum. These results suggest that Capsosiphon fulvecense supplementation prevents postmenopausal bone loss, thus it may be used possibly to improve the quality of life in menopausal women.
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