• Clinical and Experimental Reproductive Medicine
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• 제40권2호
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• pp.100-105
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• 2013

Objective: The aim of this study was to investigate the effect of insulin sensitizing agents on hormonal and metabolic parameters as well as menstrual patterns in women with polycystic ovary syndrome (PCOS). Methods: One hundred and twenty-three patients with PCOS were included. Metformin was administered to patients at 1,500 mg or 1,700 mg daily for 3 months. If the patients had no improvement of the menstrual cycle or metformin-related adverse effects developed, the patients changed medication to a daily dose of either 15 mg pioglitazone or up to 45 mg. Then resumption of a regular menstrual cycle or recovery of ovulation was evaluated. Hormonal and metabolic profiles were compared between the response and non-response group to insulin sensitizing agents. Results: One hundred and five patients with PCOS were treated with metformin for 3 months. Forty-eight patients (45.7%) showed improvement of menstrual cycle regularity after 3 months of metformin use, whereas 57 patients (54.3%) had no change. The mean free testosterone measured after 3 months of treatment was significantly lower in metformin responders than in non-responders. The other parameters did not differ between the groups. Of the 23 patients who used pioglitazone for 3 to 6 months, 19 patients (82.6%) showed improvement in their menstrual cycles. Conclusion: Metformin treatment seems to be effective for the improvement of menstrual cyclicity irrespective of insulin resistance in women with PCOS. When metformin related adverse effect occurred, pioglitazone would be effective for aiding the resumption of the menstrual cycle.

• Clinical and Experimental Reproductive Medicine
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• 제26권3호
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• pp.483-490
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• 1999

Objectives: Polycystic ovary syndrome (PCOS) has the feature of excessive LH, hyperandrogenism and disturbance of folliculogenesis. Also, insulin, IGF-I and IGFBP-l are involved in the pathogenesis of PCOS. Various surgical and medical therapies have been used and the action mechanisms are related to the endocrine effect. Laparoscopic ovarian electrocautery or laser vaporization is effective in the restoration of ovulation and normal menstrual cycle with minimal invasive procedure especially in the patients resistant to medical therapy. Clomiphen citrate (CC) is used for the ovulation induction in pcas and the resistance is known to be related to insulin, IGF-I, IGFBP-l levels. This study was performed to evaluate the effect of the laparoscopic laser vaporization on the levels of LH, FSH, testosterone, IGF-I and IGFBP-l and on the ovarian response to clomiphen citrate in patients with CC-resistant PCOS. Materials and Methods: The fasting basal serum LH, FSH, testosterone, IGF-I and IGFBP-l level were measured in 10 PCOS patients with CC-resistance and 7 normal controls with regular menstrual cycle. In PCOS, after laparoscopic $CO_2$ laser vaporization, endocrine levels were measured in 1 week interval for 4 weeks and then compared with preoperative levels. Results: In PCOS group, mean serum LH/FSH ratio, testosterone, IGF-I levels were higher and IGFBP-l level was lower than control. LH/FSH ratio decreased from $2.51{\pm}0.67$ to $1.7{\pm}0.6$ (p<0.05) in 2 weeks, to $0.56{\pm}0.2$ (p<0.01) in 3 weeks and to $1.41{\pm}0.3$ (p<0.01) in 4 weeks after operation. Testosterone level decreased from $1.51{\pm}0.82ng/ml$ to $0.65{\pm}0.34ng/ml$ (p<0.05) in 2 weeks, to $0.56{\pm}0.67ng/ml $(p<0.01) in 3 weeks after operation. IGF-I level also decreased from $436{\pm}47.5{\mu}g/l$ to $187{\pm}38{\mu}g/l$ (p<0.0l) in 1 week, to $167{\pm}42{\mu}g/l$ (p<0.01) in 2 weeks, $179{\pm}55{\mu}g/l$ (p<0.01) in 3 weeks and to $120{\pm}43{\mu}g/l$ (p<0.01) in 4 weeks after operation. IGFBP-l level showed no significant change. In 8 of 10 PCOS patients, ovulation was induced with low dose clomiphen citrate. Conclusion: Laparoscopic $CO_2$ laser vaporization restores normal menstrual cycle and ovulation through endocrine effect of decreasing LH/FSH ratio, testosterone and IGF-I level and increases the response to CC. Therefore it is useful for restoration of normal menstruation and induction of ovulation in CC resistant PCOS patients.

• Clinical and Experimental Reproductive Medicine
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• 제38권2호
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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.

• 대한한방부인과학회지
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• 제32권1호
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• pp.37-47
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• 2019

Objectives: The purpose of this study was to analyze the current characteristics and prescriptions of outpatients with Polycystic Ovary Syndrome (PCOS). Methods: We searched medical records from January 1, 2017 to December 31, 2017 and found out 31 patients who first visited with PCOS. Results: The average age of PCOS patients was $26.48{\pm}5.15years$ old, average height was $162.16{\pm}5.56cm$, average weight was $55.27{\pm}9.34kg$, and average BMI was $21.01{\pm}3.48kg/m^2$ A total of 24 patients who had received western treatment for PCOS in the past, 13 people received oral contraceptions, 4 hormones, 2 metformin, one hormone and metformin, also 4 people were treated for assisted reproductive technologies due to infertility. There were only two patients who combined Korean and Western treatments. The most common menstrual-related symptoms of PCOS patients were oligomenorrhea (48.4%) and dysmenorrhea (22.6%). Other symptoms were the highest in the cold symptoms (54.8%), followed by infertility (9.7%). The average number of patients visiting the hospital was $6.26{\pm}7.2$, with 22 (71.0%) coming from 1 to 5. The average treatment period for patients was $10.1{\pm}10.8weeks$, with 41.9% the largest for 1 to 4 weeks. Acupuncture (93.5%), moxibustion (96.8%) herbmed (96.8%) was treated to most PCOS patients. The most commonly used herbal medicines were Ongyeong-tang (35.5%), Ijin-tang-gami (19.4%), Dodam-tang-gami (12.9%), and Jogyeongjongok-tang-gami (12.9%). Conclusions: These results could be helpful to treat PCOS patients in Korean gynecologic clinical fields.

• 한국융합학회논문지
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• 제13권3호
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• pp.337-343
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• 2022

본 연구는 다낭난소증후군 여성의 불안, 우울, 스트레스를 평가하고, 발병 위험인자에 대하여 살펴보고자, 다낭난소증후군 여성을 대상으로 Beck's 우울증(BDI) 및 우울 불안 스트레스 척도(DASS) 설문을 시행하였고, 항뮐러리안호르몬(AMH), 총 테스토스테론, 황체형성호르몬(LH), 난포자극호르몬(FSH), 에스트라디올(E2), 지질대사검사 및 당부하검사(OGTT)를 시행 후 분석하였다. 설문지를 완전히 작성하여 회수된 52명의 환자군과 29명의 건강한 가임기 여성 대조군을 분석하였다. 다낭난소증후군 환자 중 BDI>13점, DASS>10점인 우울증 38.5 %, DASS>8점인 불안 23.1 %, DASS>15점인 스트레스 30.8 %로 대조군에 비해 유의하게 높았다. 총 테스토스테론, LH 및 AMH는 우울증 및 스트레스와 유의한 상관관계를 보였고, 체중 및 체질량지수도 우울증과 유의한 상관관계를 보였다. 당뇨병과 고지혈증으로 진단된 여성에서 우울증과 스트레스가 높았다. 다낭난소증후군 여성은 우울증, 불안 및 스트레스에 더 취약한 것으로 나타나, 조기진단과 치료가 중요하다.

• 대한한방부인과학회지
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• 제34권3호
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• pp.175-191
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• 2021

Objectives: This study aims to analyze the medical record of eight cases of polycystic ovary syndrome (PCOS) in a local Korean medicine clinic, in order to provide evidence on Korean medicine treatment of PCOS and to suggest the direction of future studies. Methods: The medical records of eight cases diagnosed with PCOS based on 2003 Rotterdam Criteria and whose total testosterone level was 0.53 ng/ml and over were retrospectively analyzed. The primary outcome was total testosterone level, and the secondary outcomes included luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels, LH/FSH ratio, weight, last mentrual period (LMP), numerical rating scale (NRS) score of dysmenorrhea, and other associated symptoms pre- and post-treatment. Korean medicine treatment consists of the complex herbal prescription consisting of Yukmijihwang-tang, Baekho-tang, Daesiho-tang, and Gyejibokryeong-hwan, modified according to symptoms; acupuncture and electroacupuncture on 中脘 (CV12), 下脘 (CV10), 關元 (CV4), 石門 (CV5), 合谷 (LI4), 太衝 (LR3), 三陰交 (SP6), and 懸鍾 (GB39); and indirect moxibustion on 神闕 (CV8). Results: The average total testosterone level lowered statistically significantly after the treatment. The average FSH and LH levels lowered with insignificance, while the average LH/FSH ratio and weight lowered statistically significantly. During the treatment period of three to six months, every patient had the menstrual cycle shortened except for one case; and two cases with infertility problem succeeded in being pregnant. There was no adverse event. Conclusions: The Korean medicine treatment was found effective in treating PCOS, especially regarding hyperandrogenism, amenorrhea or oligomenorrhea, and infertility.

• Applied Microscopy
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• 제41권2호
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• pp.109-116
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• 2011

다낭성 난소증후군(polycystic ovary syndrome, PCOS)은 내분비 및 대사장애로 호르몬 불균형 상태를 야기하여 가임기 여성의 불임 및 여러 합병증을 유발한다. 폐경기 여성의 호르몬대체 치료에 사용되는 estradiol valerate (EV)는 과다 투여 시 PCOS를 유발하는 것으로 알려졌다. 신경성장인자(nerve growth factor, NGF)는 발생 중인 신경세포의 생존과 성숙을 조절하는 인자로 난소에서도 합성되고, EV 처리에 의해 유도된 다낭성난소(polycystic ovary, PCO)에서 발현이 크게 증가하는 것으로 보고됐다. 따라서 본 연구에서는 난소유래 세포인 CHO 세포주와 다낭성 난소를 이용해 호르몬 불균형 상태인 PCOS 진단 시 NGF가 생물학적 표지인자로서 사용될 수 있는 가능성을 규명하고자 하였다. CHO 세포에 EV 2 mg과 3 mg 처리는 초기에 세포증식을 억제했으나 1 mg 처리는 영향을 미치지 않음으로써 실험 시 최적농도로 사용하였다. 하지만 농도별 EV 처리에 따른 CHO 세포의 형태학적 차이는 관찰되지 않았다. CHO 세포에 EV 처리 후 NGF mRNA 및 단백질 발현은 대조군에 비해 30분 후 크게 증가하였고, 다수의 난포낭이 관찰된 PCOS 조직에서도 정상군에 비해 크게 증가하였다. 따라서 이상의 결과들을 종합하면 EV 처리 후 난소에서 유도되는 NGF 과발현은 비정상적 난포발달을 유도하는 인자로 작용할 것으로 보이며, 다낭성난소 진단 시 표지인자로서 사용될 수 있을 것으로 생각된다.

• Clinical and Experimental Pediatrics
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• 제49권12호
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• pp.1257-1262
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• 2006

The age of puberty represents a very critical time in the life history of every young woman. The menarche stands as primary indicator of the onset of sexual maturation in females. By late adolescence, 75% of girls experience some problem associated with menstruation. Delayed, irregular, painful, and heavy menstrual bleeding are leading reasons for physician office visits by adolescents, and dysmenorrhea is the leading reason for school absenteeism among girls. This article discusses normal menstrual function during adolescence, then reviews the clinical presentation, evaluation, and management of adolescent dysmenorrhea, dysfunctional uterine bleeding, amenorrhea, and polycystic ovary syndrome.

• 대한생식의학회:학술대회논문집
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• 대한불임학회 2006년도 제51차 추계학술대회
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• pp.136-137
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• 2006

• 대한생식의학회:학술대회논문집
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• 대한불임학회 2006년도 제51차 추계학술대회
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• pp.117-117
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• 2006