• The Journal of Korean Obstetrics and Gynecology
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• v.24 no.3
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• pp.28-47
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• 2011

Objectives: This study was performed to investigate the effects of Angelicae gigantis Radix (AGR) which is one of the most useful herbal-drug to treat patients with Polycystic Ovary Syndrome (PCOS) in Oriental medicine on gene expression of ovary tissue. Methods: The effects of AGR on gene expression of ovary tissue resected from PCOS induced rats using single injection of $\ss$-Estradiol 17-valerate (EV) was measured using microarray technique, and the functional analysis on these genes was conducted. Results: Total 2,812 genes were up-regulated or down-regulated, 1,421 genes were up-regulated, 1,391 genes were down-regulated by induction of PCOS. Up-regulated genes were mainly involved in biological function such as cell signalling pathways and inflammatory response. Expression levels of 1,442 genes were restored to those of naive animals by administration of AGR. 558 genes were restored to those of naive animals, which were lowered by induction of PCOS. 884 genes were lowered to naive levels, which were elevated by induction of PCOS. The functions of restored genes were partially involved in the restoration of expression levels, which were changed by induction of PCOS. Especially, up-regulated gene by induction of PCOS were mainly involved in these changes. These results mean restorative effects of AGR on damaged functions by induction of PCOS. The network of total protein interactions was measured using cytoscape program, and some key molecules, such as IRS2, MCM10, ORC2L related in up-regulated genes, CTBP2, CD44, RHOA, related in down-regulated genes that can be used for elucidation of therapeutical mechanism of medicine in future were identified. Conclusion: Restored genes by AGR were thought to have common pathways related in regulation of gene expressions. Especially, genes in restored expression levels by AGR, which were up-regulated by induction of PCOS, were regulated by 9 of common transcription factors, genes in restored expression levels by AGR, which were down-regulated by induction of PCOS, were involved in 25 of common transcription factors.

• Clinical and Experimental Reproductive Medicine
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• v.38 no.2
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• pp.103-108
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• 2011

Objective: To investigate adverse pregnancy outcomes in non-obese women with polycystic ovary syndrome (PCOS) compared with obese-PCOS and control groups. Methods: Women with PCOS who underwent assisted reproductive technology (ART) from August, 2003 to December, 2007, were considered. A total of 336 women with PCOS were included in the study group and 1,003 infertile women who had tubal factor as an indication for ART were collected as controls. They were divided into four groups: a non-obese PCOS group, obese-PCOS group, non-obese tubal factor group, and obese tubal factor group, with obesity defined by a body mass index over 25 kg/$m^2$, and reviewed focusing on the basal characteristics, ART outcomes, and adverse pregnancy outcomes. Results: There was no difference among the groups' the clinical pregnancy rate or live birth rate. Regarding adverse pregnancy outcomes, the miscarriage rate, multiple pregnancy rate, and prevalence of preterm delivery and pregnancy induced hypertension were not different among the four groups. The incidence of small for gestational age infant was higher in the PCOS groups than the tubal factor groups ($p$ <0.02). On the other hand, the morbidity of gestational diabetes mellitus (GDM) was not high in the non-obese PCOS group but was in the obese groups. And in the obese PCOS group, the newborns were heavier than in the other groups ($p$ <0.02). Conclusion: Non-obese PCOS presents many differences compared with obese PCOS, not only in the IVF-parameters but also in the morbidity of adverse pregnancy outcomes, especially in GDM and fetal macrosomia.

• The Journal of Korean Obstetrics and Gynecology
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• v.30 no.1
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• pp.68-84
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• 2017

Objectives: Polycystic Ovarian Syndrome (PCOS) is characterized by ovulatory disorder, polycystic ovaries and clinical or laboratory hyperandrogenemia, also associated with an increased risk of various other long-term complications. The purpose of this study is to develop a standard instrument of pattern identifications in Korean medicine for PCOS. Methods: We retrieved the patterns and symptoms from Korean and Chinese literatures which mentioned pattern identifications of PCOS. In order to develop the instrument, we took the consultation from the advisor committee based on the collected informations from literatures. Finally the questionnaire of pattern identification for PCOS was developed. Results: 1) 5 pattern identifications and 53 symptoms and signs were selected from 20 references. 2) We obtained the mean weights which reflected the standard deviations from each symptom of the pattern by 15 experts. 3) We designed the Korean medicine Instrument on pattern identification for PCOS. It was composed of 61 questions, 44 of patient-reported format and 17 of assessor-reported format. Conclusions: Instrument of pattern identification for PCOS was developed through experts' discussion. Further study is required to identify the validity and reliability of this pattern identification instrument for PCOS.

• The Journal of Korean Obstetrics and Gynecology
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• v.29 no.3
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• pp.47-56
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• 2016

Objectives: We evaluated the effect of Korean medical treatment in case of irregular menstruation (amenorrhea, oligomenorrhea) due to Polycystic ovarian syndrome (PCOS).Methods: 20 Amenorrhea or oligomenorrhea Patients with PCOS were treated with Korean medical treatment at least 3 months. We analyzed clinical data of 20 patients and checked effectiveness of treatment through the change of menstrual pattern.Results: After Korean medical treatment, Patients who complained menstrual irregularity due to PCOS were improved in menstrual condition. Among 14 amenorrhea patients, 12 patients (85.7%) started menstruation within 3 months. Among 6 Oligomenorrhea patients, 4 patients (66.7%) got better menstruation pattern than before.Conclusions: PCOS Patients who got Korean medical treatment showed better condition in menstruation pattern. Amenorrhea patients started menstruation without contraceptive pill and oligomenorrhea patients got better menstruation cycle.

• Clinical and Experimental Reproductive Medicine
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• v.48 no.3
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• pp.194-197
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• 2021

Polycystic ovary syndrome (PCOS) is a common disorder in reproductive-age women. In 2018, an international evidence-based guideline announced recommendations spanning a wide range of issues on the assessment and management of PCOS. From the 166 recommendations, the present study reviews those that are of particular clinical relevance for daily practice and introduces other relevant studies that have been published since the global guideline. The 2018 guideline increased the antral follicle count cutoff for the diagnosis of PCOS from 12 to 20 when using a high-frequency probe. Hirsutism was defined as having a score of ≥4-6 based on a lower percentile of 85%-90% or cluster analysis, which was lower than the traditionally used 95th percentile-based cutoff. The diagnosis of PCOS in adolescents is challenging, and irregular menstruation was defined carefully according to years from menarche. The use of ultrasonography for the diagnosis of PCOS was restricted to those 8 years after menarche. As medication for non-fertility indications, combined oral contraceptives are the first-line drug. Metformin, in addition to lifestyle modifications, should be considered for adult patients with a body mass index ≥25 kg/m² for the management of weight and metabolic outcomes. An aromatase inhibitor is the recommended first-line medication for ovulation induction, a subsequent individual patient data meta-analysis also reported the same conclusion. Whether the new global guideline will be fully adopted by many specialists and change clinical practice is open to question. Further studies are needed to better understand and manage PCOS patients well.

• The Journal of Pediatrics of Korean Medicine
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• v.38 no.2
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• pp.53-67
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• 2024

Objective This study aimed to assess the trend of randomized clinical trials conducted in China involving oral herbal medicine for treating adolescent polycystic ovary syndrome (PCOS). Methods We used the China National Knowledge Infrastructure as our primary resource and conducted a search using keywords such as "PCOS", "多囊卵巢" and "多囊卵巢综合征". We identified and analyzed seven RCTs. Results 1. The group receiving herbal medicine treatment demonstrated significant improvements in total efficiency, sex hormone levels, and ultrasound-measurable values compared to the control group. 2. Epimedii Herba (淫羊藿), Alviae Miltiorrhizae Radix (丹參), and Angelicae Gigantis et Acutilobae Radix (當歸) were among the most used herbs in Traditional Chinese medicine decoctions for treating PCOS. Conclusions The findings suggest that oral herbal medicine is an effective treatment for patients with PCOS. This study provides a foundation for future research on the use of oral herbal medicine in PCOS treatment.

• Korean Journal of Radiology
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• v.25 no.5
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• pp.414-425
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• 2024

Objective: This study aims to explore the opinions on the insurance coverage of artificial intelligence (AI), as categorized based on the distinct value elements offered by AI, with a specific focus on patient-centered outcomes (PCOs). PCOs are distinguished from traditional clinical outcomes and focus on patient-reported experiences and values such as quality of life, functionality, well-being, physical or emotional status, and convenience. Materials and Methods: We classified the value elements provided by AI into four dimensions: clinical outcomes, economic aspects, organizational aspects, and non-clinical PCOs. The survey comprised three sections: 1) experiences with PCOs in evaluating AI, 2) opinions on the coverage of AI by the National Health Insurance of the Republic of Korea when AI demonstrated benefits across the four value elements, and 3) respondent characteristics. The opinions regarding AI insurance coverage were assessed dichotomously and semi-quantitatively: non-approval (0) vs. approval (on a 1-10 weight scale, with 10 indicating the strongest approval). The survey was conducted from July 4 to 26, 2023, using a web-based method. Responses to PCOs and other value elements were compared. Results: Among 200 respondents, 44 (22%) were patients/patient representatives, 64 (32%) were industry/developers, 60 (30%) were medical practitioners/doctors, and 32 (16%) were government health personnel. The level of experience with PCOs regarding AI was low, with only 7% (14/200) having direct experience and 10% (20/200) having any experience (either direct or indirect). The approval rate for insurance coverage for PCOs was 74% (148/200), significantly lower than the corresponding rates for other value elements (82.5%-93.5%; P ≤ 0.034). The approval strength was significantly lower for PCOs, with a mean weight ± standard deviation of 5.1 ± 3.5, compared to other value elements (P ≤ 0.036). Conclusion: There is currently limited demand for insurance coverage for AI that demonstrates benefits in terms of non-clinical PCOs.

• The Journal of Korean Obstetrics and Gynecology
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• v.30 no.4
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• pp.59-76
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• 2017

Objectives: The purpose of this study is to investigate the effect on both herbal medicine periodic therapy and western medicine for polycystic ovary syndrome subfertility. Methods: We searched 8 electronic databases and search keywords were 'PCOS' and 'periodic therapy' or 'cyclic treatment'. We included randomized controlled clinical trials (RCTs) using the periodic therapy combined western medicine for PCOS patients. Results: We selected 8 studies. In studies, there were three studies in which the menstrual cycle was divided into 2 periods, one study divided into 3 periods, and four study divided into 4 periods. The meta-analysis of the 7 trials indicated that pregnancy rates integrated clomiphene and periodic therapy were higher than clomiphene alone. Conclusions: The periodic therapy combined western medicine for PCOS subfertility patients seems to improve pregnancy rates from this research. However, this result should be taken cautiously by unclear risk of bias. It would be necessary to fulfill further clinical study with herbal medicine periodic therapy on PCOS in Korean medicine to establish standard evidence of them.

• Clinical and Experimental Reproductive Medicine
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• v.48 no.2
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• pp.156-162
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• 2021

Objective: The aim of the present study was to evaluate the predictive capability of fasting-state measurements of glucose and insulin levels alone for abnormal glucose tolerance in women with polycystic ovary syndrome (PCOS). Methods: In total, 153 Korean women with PCOS were included in this study. The correlations between the 2-hour postload glucose (2-hr PG) level during the 75-g oral glucose tolerance test (OGTT) and other parameters were evaluated using Pearson correlation coefficients and linear regression analysis. The predictive accuracy of fasting glucose and insulin levels and other fasting-state indices for assessing insulin sensitivity derived from glucose and insulin levels for abnormal glucose tolerance was evaluated using receiver operating characteristic (ROC) curve analysis. Results: Significant correlations were observed between the 2-hr PG level and most fasting-state parameters in women with PCOS. However, the area under the ROC curve values for each fasting-state parameter for predicting abnormal glucose tolerance were all between 0.5 and 0.7 in the study participants, which falls into the "less accurate" category for prediction. Conclusion: Fasting-state measurements of glucose and insulin alone are not enough to predict abnormal glucose tolerance in women with PCOS. A standard OGTT is needed to screen for impaired glucose tolerance and type 2 diabetes mellitus in women with PCOS.

• Korean Journal of Acupuncture
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• v.28 no.3
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• pp.165-175
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• 2011

Objectives : The purpose of this study is to review and summarize the research on Polycystic ovarian syndrome (PCOS). Methods : We searched the clinical studies with keywords of Polycystic ovarian syndrome and acupuncture therapy through the search site called CAJ (china academic journal) from 2000 to 2011. Results and Conclusions : We reviewed 22 studies about PCOS which were relative to acupuncture therapy. We investigated the frequency of Acupuncture point for PCOS in this article exclusive Auricular acupuncture treatment. SP6 (Sam$\={u}$mgyo), CV4 (Kwanwon), CA111 (Chagung), SP10 (Hy$\={o}$lhae), CV6 (Kihae), B23 (Shinsu) and S40 (P'ungnyung) were used frequently. Acupuncture therapy was effective method to improve Polycystic ovarian syndrome. Further studies needed for Polycystic ovarian syndrome.