• Journal of Genetic Medicine
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• v.18 no.2
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• pp.142-146
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• 2021

Alagille syndrome (AGS) is a rare autosomal dominant inherited disorder, with major clinical manifestations of bile duct paucity, cholestasis, cardiovascular anomaly, ophthalmic abnormalities, butterfly vertebrae, and dysmorphic facial appearance. It is caused by heterozygous mutations in JAG1 or NOTCH of the Notch signaling pathway presenting with variable phenotypic penetrance and involving multiple organ systems. The following case report describes a unique case of a 16-year-old female with AGS who presented with the primary complaint of renovascular hypertension. She had a medical history of ventricular septal defect and polycystic ovary syndrome. The patient had a dysmorphic facial appearance including frontal bossing, bulbous tip of the nose, a pointed chin with prognathism, and deeply set eyes with mild hypertelorism. Stenoocclusive changes of both renal arteries, celiac artery, lower part of the abdominal aorta, and left intracranial artery, along with absence of the left internal carotid artery were found on examination. Whole exome sequencing was performed and revealed a pathologic mutation of JAG1, leading to the diagnosis of AGS. Reverse phenotyping detected butterfly vertebrae and normal structure and function of the liver and gallbladder. While the representative symptom of AGS in most scenarios is a hepatic problem, in this case, the presenting clinical features were the vascular anomalies. Clinical manifestations of AGS are diverse, and this case demonstrates that renovascular hypertension might be in some cases a presenting symptom of AGS.

• Applied Microscopy
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• v.39 no.1
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• pp.1-7
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• 2009

Experimental induction of polycystic ovary (PCO) resembling some aspects of human PCO syndrome was produced using the long-acting compound estradiol valerate (EV). Our previous study on the role of Korean red ginseng total saponins (GTS) in a steroid-induced PCO rat model demonstrated that electro-acupuncture modulates nerve growth factor (NGF) concentration in the ovaries. In fact, the involvement of a neurogenic component in the pathology of PCO-related ovarian dysfunction is preceded by an increase in sympathetic outflow to the ovaries. In the present study, we tested the hypothesis that therapeutic GTS administration modulates sympathetic nerve activity in rats with PCO. This was done by analyzing NGF protein and NGF mRNA expression involved in the pathophysiological process underlying steroid-induced PCO. EV injection resulted in significantly higher ovarian NGF mRNA expression in PCO rats compared to control rats, and PCO ovaries were counteracted by GTS administration with significantly lower expression of NGF mRNA compared to EV treated ovaries. However, NGF protein was unaffected in both EV and GTS treated ovaries compared to control rats. These results indicate that EV modulates the neurotrophic state of the ovaries, which may be a component of the pathological process by which EV induces cyst formation and anovulation in rodents.

• Natural Product Sciences
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• v.28 no.3
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• pp.130-137
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• 2022

This study was conducted to characterise phytochemicals and to explore the biological activities of Vitex negundo leaves. The washed, course powder of V. negundo leaves were extracted with different solvents of increasing polarity. All the extracts were characterized and biological activities were compared. The results revealed that the ethanolic and cold water extracts showed the presence of all phytochemicals studied except protein compared to other extracts. Further, the quantitative estimation of phytochemicals showed that the ethanolic extract had highest yield and maximum amount of total polyphenols, flavonoids, and alkaloids with the least amount of tannins compared to other extracts studied. Furthermore, the highest total polyphenol content corresponds with the potent biological activities. Indeed, in vitro antioxidant and antisteroidogenic activities were highest in the ethanolic extract than others. To conclude, the present study is the first to report the characterization and antiandrogenic property of V. negundo leaf extracts. The ethanolic extract of V. negundo leaves can be used as an antioxidant and antiandrogenic agent. Hence, it can be considered for the treatment of hyperandrogenic conditions like polycystic ovary syndrome, etc.

• Development and Reproduction
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• v.27 no.3
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• pp.117-126
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• 2023

Bariatric surgery is an effective treatment option for obesity, but its effects on reproductive hormones are not well understood. This study aimed to investigate the impact of bariatric surgery on estrogen and progesterone levels in women with obesity. This was a prospective study that included 87 women with obesity who underwent bariatric surgery and 87 control women with obesity who did not. Blood samples were collected at baseline and at 3-month and 6-month follow-up periods to measure reproductive hormones and Adiponectin as well as medical history and physical examination for endometriosis and polycystic ovary syndrome (PCOS). The study found that sleeve gastrectomy significantly increased follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels in the bariatric surgery group compared to the control group at 3 and 6-month follow-up. There was no significant difference in the mean levels of estrogen and progesterone between the two groups at the 3-month follow-up period. Bariatric surgery leads to significant weight loss in women with obesity, but it does not seem to have a significant impact on estrogen and progesterone levels in the short-term. Future studies with longer follow-up periods are needed to investigate the long-term effects of bariatric surgery on reproductive hormones.

• The Journal of Korean Obstetrics and Gynecology
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• v.33 no.3
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• pp.80-94
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• 2020

Objectives: The purpose of this review is to analyze the domestic study trends of clinical use of Digital Infrared Thermal Imaging (DITI) as a diagnosis instrument on obstetrics and gynecological diseases in Korean literature. Methods: We searched for clinical studies using DITI in the journal of Korean obstetrics & gynecology, National Digital Science Library, Research Information Sharing Service, Korean Medical Database up to May 2020. After searching studies, we selected studies and analyzed according to disease. Results: 18 clinical studies were published in two kinds of academic journals. There were 4 studies about dysmenorrhea and menopausal symptoms, 2 studies about postpartum disease and hypercryalgesia, 1 study about amenorrhea, premenstrual syndrome, leukorrhea, infertility, polycystic ovary syndrome and hot flush. Conception vessel was frequently used for DITI measurement, followed by stomach meridian. The temperatures of abdomen (CV4, CV12), face (HN3), upper and lower limb (PC8, LU4, LR3, ST32) were commonly measured. Conclusions: This study shows that DITI could be one of effective diagnosis instrument for obstetrics and gynecological diseases. More well-designed clinical studies using DITI will be needed.

• The Journal of Korean Medicine
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• v.41 no.1
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• pp.84-92
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• 2020

Objectives: To observe the effects on liver and kidney of gynecology patients' during long term Korean Medicine. Methods: This research was conducted as a panel study on 29 female gynecology patients at Korean medicine clinic and compares their conditions before, 3 months after, and 6 months after Intake of Korean medicine. This analysis was conducted to frequency(%), repeated measure ANOVA and significantly statistics was p<0.05, confidence interval. Results: The most common conditions among the subjects were polycystic ovary syndrome, endometriosis, adenomyosis, and uterine myoma. Except in a few instances, liver functions (AST, ALT, γ-GTP) were within the normal range before and after the intake of Korean medicine. Further, while there was a slight change in liver functions when three months and six months after the intake, but there was no statistical significance (p>0.05). As for the kidney functions (BUN, Creatinine, BUN/Creatinine), they were within the normal range before and after the intake of Korean medicine. Further, while there was a slight change in kidney functions three months and six months after the intake, there was no statistical significance(p>0.05) either. Conclusions: Based on these results, it can be concluded that Korean medicine does not have a negative impact on the gynecology patients' liver and kidney.

• Clinical and Experimental Reproductive Medicine
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• v.27 no.3
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• pp.291-294
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• 2000

연구목적: 본 연구는 자궁내막증과 다낭성 난포증후군 불임환자들을 대상으로 $LH{\beta}$ exon 3 (Gly102Ser) 유전자의 돌연변이를 탐색하고자 시도하였다. 연구재료 및 방법: 그 대상으로 26명의 자궁내막증 환자와 52명의 다낭성 난포증후군 환자 그리고, 50명의 출산 경험이 있는 건강한 여성을 대조군으로 사용하였다. 이들을 대상으로 한 돌연변이 탐색은 PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) 방법으로 수행되었다. 결과 : 그 결과 자궁내막증과 다낭성 난포증후군 환자 및 출산 경험이 있는 건강한 여성에서 그 변이형이 나타나지 않았다. 결론: 따라서, 자궁내막증과 다낭성 난포증후군 불임환자의 $LH{\beta}$ exon 3 돌연변이형은 중국인 집단에만 존재할 가능성이 높으며, 더 많은 불임환자들을 대상으로 한 연구가 요구된다.

• Clinical and Experimental Reproductive Medicine
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• v.32 no.1
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• pp.27-32
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• 2005

Objective: To evaluate the effectiveness of aromatase inhibitor (AI) for ovulation induction in polycystic ovary syndrome (PCOS) patients with thin endometrium, hyper-responsiveness after clomiphene citrate (CC) treatment. Material and Methods: A prospective study was performed in 43 PCOS patients (50 cycles) with ovulatory dysfunction between March 2004 and September 2004. AI group (total 36 cycles) included the patients 1) with thin endometrium below 6 mm on hCG day after CC (n=17), 2) with more than 5 ovulatory follicles after 50mg of CC (n=4), 3) who do not want multiple pregnancy (n=14). Patients were treated with Letrozole 2.5mg for days 3 to 7 of the menstrual cycle. CC group (total 14 cycles) were treated with CC 50~100 mg. Results: In PCOS patients, ovulation was occurred 97.2% after AI use. Between AI group and CC group, there was no significant difference in the mean age, duration of infertility, interval of menstruation, basal FSH, prior treatment cycles, and the day of hCG administration. But, the number of mature follicles (${\geq}15mm$) was lower in the AI group ($1.08{\pm}0.45$ vs. $1.64{\pm}0.75$) (p=0.018), and the thickness of endometrium (mm) was significantly thicker in the AI group ($10.35{\pm}1.74$ vs. $9.23{\pm}1.61$) (p=0.044), and E2 (pg/ml) concentration on hCG day was lower in the AI group ($116.9{\pm}75.8$ vs. $479.5{\pm}300.8$) (p=0.001). Among the AI group, patients with prior thin endometrium (below 6 mm) during CC treatment showed $10.6{\pm}1.6mm$ in the endometrial thickness and $106.6{\pm}66.8pg/ml$ in $E_2$ concentration. Patients with more than 5 ovulatory follicles after CC showed decreased follicle number ($1.25{\pm}0.5$) compared to prior CC cycle. Conclusions: In PCOS patients, AI group showed significantly thicker endometrium, lesser number of mature follicles, and lower E2 concentration on hCG day than CC group. AI might be useful alternative treatment for ovulation induction in PCOS patients with thin endometrium and hyper-responsiveness after CC treatment.

• Clinical and Experimental Reproductive Medicine
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• v.29 no.1
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• pp.67-76
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• 2002

Objective: To assess the difference of baseline hormonal status and pathophysio logy, and confirm the risk factors for long term complication according to Body Mass Index in women with polycystic ovary syndrome. Materials and Methods: Serum level of LH, FSH, Estradiol, Prolactin, Testosterone, DHEA-S, fasting insulin were measured and 100 gm oral glucose tolerance test and endometrial biopsy were performed in total 75 chronic anovulation patients and 20 normal cycling infertility patients. 95 evaluated patients were divided into 3 groups including patients with chronic anovulation having BMI below 25, BMI beyond 25.1, normal cycling infertility patients, Group 1 (n=39), Group 2 (n=36), Group 3 (n=20), respectively. Statistical analysis was performed respect to relationship between BMI and measured hormone level, sum of glucose level during 100 gm OGTT, insulin resistance using t-test, ANOVA test, Post Hoc test, Mann-Whitney test. p<0.05 was considered as statistically significant. Results: Serum LH level and LH/FSH ratio was significantly higher in Group 1, compared than Group 2 or 3 (p<0.05), BMI and LH, LH/FSH ratio was negatively correlated (r=-0.351, r=-0.318). There was no significant difference according to BMI in FSH, testosterone, estradiol, prolactin, DHEA-S level. Fasting insulin and sum of glucose level during 100 gm OGTT were significantly higher in Group 2 compared than Group 1 or Group 3 (p<0.05), there was no significant difference between Group 1 and Group 3. Insulin resistance was more frequently identified in Group 2 compared than Group 1 (p=0.001). Conclusions: BMI and LH, LH/FSH ratio were negatively correlated, so clinical significance of LH, LH/FSH ratio in diagnosis of PCOS may be attenuated by increasing body weight. Overweight patients with chronic anovulation may be the risk group for developing insulin resistance, hyperinsulinemia, glucose intolerance, later type 2 DM. Hyperinsulinemia may operate mainly in overweight chronic anovulation patients in development of hyperandrogenism.

• Clinical and Experimental Reproductive Medicine
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• v.33 no.2
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• pp.97-104
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• 2006

Objective: To investigate whether polymorphism of Catechol-O-methyltransferase(COMT) gene is associated with the risk of polycystic ovary syndrome (PCOS) in Korean women. Methods: One hundred and thirty-six PCOS patients and eighty four controls were enrolled. Blood samples were collected from the patients diagnosed according to the 2003 revised criteria of the Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group. Age matched women with regular menstruation from same geographic region were recruited as control subject. Polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) of PCR products were done to determine all individuals' genotype. Results: In women with $COMT^{LL}$ genotype, there was decreased PCOS risk and this difference was statistically significant (OR 0.24, 95% CI 0.11~0.51). Conclusion: The results suggest that the $COMT^{LL}$ genetic polymorphism might be associated with PCOS risk in Korean women.