• Clinical and Experimental Reproductive Medicine
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• v.50 no.3
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• pp.170-176
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• 2023

Objective: Autophagy is highly active in ovariectomized mice experiencing hormone deprivation, especially in the uterine mesenchyme. Autophagy is responsible for the turnover of vasoactive factors in the uterus, which was demonstrated in anti-Müllerian hormone receptor type 2 receptor (Amhr2)-Cre-driven autophagy-related gene 7 (Atg7) knockout (Amhr-Cre/Atg7^f/f mice). In that study, we uncovered a striking difference in the amount of sequestosome 1 (SQSTM1) accumulation between virgin mice and breeder mice with the same genotype. Herein, we aimed to determine whether repeated breeding changed the composition of mesenchymal cell populations in the uterine stroma. Methods: All female mice used in this study were of the same genotype. Atg7 was deleted by Amhr2 promoter-driven Cre recombinase in the uterine stroma and myometrium, except for a triangular stromal region on the mesometrial side. Amhr-Cre/Atg7^f/f female mice were divided into two groups: virgin mice with no mating history and aged between 11 and 12 months, and breeder mice with at least 6-month breeding cycles with multiple pregnancies and aged around 12 months. The uteri were used for Western blotting and immunofluorescence staining. Results: SQSTM1 accumulation, representing Atg7 deletion and halted autophagy, was much higher in virgin mice than in breeders. Breeders showed reduced accumulation of several vasoconstrictive factors, which are potential autophagy targets, in the uterus, suggesting that the uterine stroma was repopulated with autophagy-intact cells during repeated pregnancies. Conclusion: Multiple pregnancies seem to have improved the uterine environment by replacing autophagy-deficient cells with autophagy-intact cells, providing evidence of cell mixing.

• Journal of Preventive Medicine and Public Health
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• v.37 no.2
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• pp.166-173
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• 2004

Objectives : Cervical cancer is the second most frequent cancer among women in Busan. The Pap smear test could have a significant effect on detecting cervical cancer, and enhancing their rate of use is an important strategy for reducing the incidence and mortality of cervical cancer. This study aimed to evaluate the factors associated with the past use of the Pap smear test in Korean women. Methods : A population-based survey was carried out in Busan between November 1999 and March 2000. 1,673 participants were randomly selected from 2,684 women in Busan, using a 2-stage cluster sampling method, and interviewed in their homes. Their socio-demographic characteristics, smoking, drinking, familial cancer history, Pap smear screening history, reproductive and menstrual factors, sexual habits and use of contraceptive methods data were collected by a trained interviewer using a questionnaire. The use of the screening test was defined by a self-report from the participants on how many times they had had a Pap smear test in their lifetime, and when they had received their latest examination. Results : Of the 1,673 respondents (62.3% response rate), 57.6% had had a Pap smear test during her life (mean number, 2.3). Among the health examination participants(1,064), 961(90.3%) reported having sexual experience and 70.9% of these had had a Pap smear test. In a multiple logistic regression analysis, statistically significant relationships were observed for age groups and the Pap smear test rate (odds ratio, OR for 35-44 years=2.45; OR for 45-54 years=3.41; OR for 55 years=2.60; reference, under 34 years). The married or cohabiting women were more likely to have used the Pap smear test than those separated or widowed (OR=1.73). Among the reproductive behavioral measures, the number of births (OR for 3 births=4.22; OR for 2 births=3.95; OR for 1 births=3.38; reference, 0 births) and husband's extra-marital affairs (OR=1.50) were associated with the rates of use of Pap smear tests. Conclusion : It appears that the most important contributing factors to cervical cancer screening were age, marital status and number of births. A positive association was also observed for the husband's extra-marital affairs. This study enabled us to systematically assess the relationship between Pap smear rates and risk factors for cervical cancer. It is hoped that this study will make a significant contribution to the accumulating scientific evidence on the identification of factors associated with cervical cancer screening in Korea.

• Clinical and Experimental Reproductive Medicine
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• v.4 no.2
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• pp.23-34
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• 1977

A study was carried out for the evaluation on family situation of 900 homemakers those who had received tubal sterilization operation (laparoscopic and minilaparotomy) at family planning clinic, Seoul Red Cross Hospital from October 1974 to September 1977. The results obtained are as follows: 1) In age distribution, predominant age group consisted of those $31{\sim}35$ years frequency of 43.2% and average age was 33.3 years. 2) Educational level showed that homemakers who finished primary school accounted for 37.3% of the total and those having middle school education comprised 28.7%, and 24.3% of them were high school graduates, 8.3% of them were college graduates. On the other hand, husband's education level showed that, 37.6% of them were high school graduates, 29.7% were college graduates and 19.9% were middle school graduates, therefor, educational level of husbands was one step higher than wives. 3) In the gravidity at the tubal sterilization, the highest incidence(18.4%) among 853cases was the group of gravida 5, and 16.2% gravida 4, and the gravidity ranged $1{\sim}23$. Average gravidity of clients was 6.0. 4) Among the total number of 900 clients, 778cases (91.3%) had no experience of spontanous abortion, history of 1 abortion in 5.9%, 2 abortions in 1.8%, and it showed the decresed incidence of spontanous abortion recently. Average was 0.15. As regarding induced abortion, in spite of only 142 homemakers (16.7%) had no history of induced abortion, 20.5% had experienced 1 induced abortion before sterilization, 17.7% had 2 induced abortions, 14.6% had 3 abortions, 10.3% had 4 abortions, and 0.2% (2cases) had over 20 abortions. Average was 2.7. 5) In regarding to the number of living children, the greatest number (45.0%) of clients had 3 children, and 26.5% 2 children, 19.7% 4 children. Average number of their living children was 3.03. 6) Sex ratio of living children, among 18 clients those had 1 child, 17 homemakers had 1 boy and no girl, 1 homemaker had no boy and 1 girl only. Sex ratio showed that woman who had 2 boys and no girl accounted for 46.3%, however, those having no boy and 2 girls ocmprised only 1. 8% among 229 clients who had 2 children. Among 389 clients who had 3 children, in spite of woman who had 3 boys and no girl comprised 16.5%, but no boy and 3 girls only 1.5%. Among 170 clients who had 4 children, homemakers with 4 boys and no girl accounted for 4.1%, however, no boy and 4 girls 1.8% of the total. Among 52 clients, who had 5 children, woman with 5 boys and no girl comprised 3.9%, no boy and 5 girls 0%. Among 7 cases who had 6 children, there were 3 cases who had 3 boys and 3 girls, but only 1 cases had 1 boy and 5 girls and so on. These results showed a strong trend of male preference in Korea and this could be one of the inhibit factors for family planning.

• Korean Journal of Psychosomatic Medicine
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• v.30 no.2
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• pp.99-111
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• 2022

Akey factor in evolution is reproduction, which is also a major concern in medicine. Evolutionists have proposed many theories and hypotheses to explain the low fertility rates of modern industrial societies, which are contrary to maximization of biological fitness. Given that childbirth is the most significant factor affecting reproductive fitness, it is likely that a variety of psychological modules related to childbirth behavior and intention evolved over time. Several evolutionary psychological modules have been proposed in relation to reproduction, including sexual desire, status-seeking, a need for nurturing, and the desire for children. Previously adaptive psychological modules may now be expressed maladaptively due to the discrepancy between the Environment of Evolutionary Adaptedness (EEA) and the environment of modern industrial society. Several evolutionary ecological factors influence childbirth intention in modern society, including individual personality factors, childhood life history experiences, and socioecological factors throughout reproductive life. By focusing on mental, social, and ecological factors, this review examines several hypothetical models relating to evolutionary psychological factors and childbirth decisions in modern industrial society, as well as a possible explanation for the low birth rate.

• Journal of Nutrition and Health
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• v.40 no.4
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• pp.334-346
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• 2007

The present study examined the reproductive factors and food intake pattern which influence on the breast cancer risk in Daegu${\cdot}$Gyungbuk area. The case subjects were 103 patients newly diagnosed as breast cancer at Kyungpook National University Hospital. The control subjects were 159 healthy women selected by frequency matching of age and menopausal status in the same community. The survey was conducted by individual interviews using questionnaires which include general and reproductive characteristics, dietary habits, and food frequency. The odds ratios were calculated by using unconditional logistic regression after adjusting for confounding variables. The mean age of the subjects was 50 yrs, and mean body mass index was significantly high in the patient group than in the control. The patient group had a significantly higher familial history of breast cancer and a significantly shorter breast-feeding period compared to the control group. It has been found no significant relationship between extrinsic hormone use such as oral contraceptives or estrogen replacement therapy and breast cancer risk. In regard of food habits, a high preference for the cooking method of steaming rather than frying, panbroiling or roasting was significantly associated with lower relative risk of breast cancer. The higher intake frequencies of fruits for all subjects, and seaweeds only for postmenopausal subjects were related with a significantly lower relative risk of breast cancer. The results of the study suggest that the possible risk factors for the breast cancer occurrence include high BMI, family history, less breast feeding experience, preference for the cooking method of frying, and less consumption of fruits and seaweeds. This study provides an useful data for nutrition education to prevent breast cancer for the residents in Daegu${\cdot}$Gyungbuk area.

• Clinical and Experimental Reproductive Medicine
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• v.29 no.4
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• pp.269-278
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• 2002

Objective s: Chromosome aneuploidy is associated with recurrent abortion and congenital anomaly and genetic diseases occur repeatedly in the specific families. Preimplantation genetic diagnosis (PGD) can prevent aneuploidy or genetic disease by selecting normal embryos before implantation and is an alternative to prenatal diagnosis. The aim of this study is to assess the outcome of PGD cycles by using FISH or PCR, and to determine the clinical usefulness and values in patients with risk of chromosomal aneuploidy or genetic disease. Materials and Methods: From 1995 to Apr. 2001, a total of 108 PGD cycles in 65 patients with poor reproductive outcome were analyzed. The indications of PGD were translocation (n=49), inversion (n=2), aneuploidy screening (n=7), Duchenne muscular dystrophy (n=5) and spinal muscular atrophy (n=2). PGD was applied due to the history of recurrent abortion, previous birth of affected child or risk of aneuploidy related to sex chromosome aneuploidy or old age. Blastomere biopsy was performed in 6$\sim$10 cell stage embryo after IVF with ICSI. In the single blastomere, chromosome aneuploidy was diagnosed by using FISH and PCR was performed for the diagnosis of exon deletion in DMD or SMA. Results: The FISH or PCR amplification was successful in 94.3% of biopsied blastomeres. The rate of transferable balanced emb ryos was 24.0% in the chromosome translocation and inversion, 57.1% for the DMD and SMA, and 28.8% for the aneuploidy screening. Overall hCG positive rate per transfer was 17.8% (18/101) and clinical pregnancy rate was 13.9% (14/101) (11 term pregnancy, 3 abortion, and 4 biochemical pregnancy). The clinical pregnancy rate of translocation and inversion was 12.9% (11/85) and abortion rate was 27.3% (3/11). In the DMD and SMA, the clinical pregnancy rate was 33.3% (3/9) and all delivered at term. The PGD results were confirmed by amniocentesis and were correct. When the embryos developed to compaction or morula, the pregnancy rate was higher (32%) than that of the cases without compaction (7.2%, p<0.01). Conclusions: PGD by using FISH or PCR is useful to get n ormal pregnancy by reducing spontaneous abortion associated with chromosome aneuploidy in the patients with structural chromosome aberration or risk of aneuploidy and can prevent genetic disease prior to implantation.

• Clinical and Experimental Reproductive Medicine
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• v.35 no.1
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• pp.83-88
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• 2008

Thromboembolic disease associated with assisted reproductive techniques is considered to be extremely rare but most serious complication. The reasons for this are thought to hypercoagulable state characteristic of OHSS due to high serum levels of estrogen, hemoconcentration and reduced circulating blood volume, but is still unclear. The risk is increased those with rare hypercoagulable conditions such as antiphospholipid antibody syndrome, protein C deficiency, protein S deficiency, antithrombin III deficiency, and those with a personal or family history of thromboembolic disease. The majority of thrombosis reported were venous site but arterial thrombosis mostly intracerebral was reported 5 cases in Korea so far. We present a case of basilar a. thrombosis at 11 days after hCG injection. The patient developed the right hemiparesis, and recovered after intraarterial thrombolysis and transluminal angioplasty. Protein S activity was decreased and vWF antigen was increased. Decreased protein S activity was also found in previous reported 4 cases, so we suggest screening test for protein S in OHSS patients.

• Clinical and Experimental Reproductive Medicine
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• v.25 no.2
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• pp.115-122
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• 1998

The maintenance of a viable pregnancy has long been viewed as an immunological paradox. The deveolping embryo and trophoblast are immunologically foreign to the maternal immune system due to their maternally inherited genes products and tissue-specific differentiation antigens (Hill & Anderson, 1988). Therefore, speculation has arisen that spontaneous abortion may be caused by impaired maternal immune tolerance to the semiallogenic conceptus (Hill, 1990). Loss of recall antigen has been reported in immunosuppressed transplant recipients and is associated with graft survival (Muluk et al., 1991; Schulik et al., 1994). Progesterone $(10^{-5}M)$ has immunosuppressive capabilities (Szekeres-Bartho et al., 1985). Previous study showed that fertile women, but not women with unexplained recurrent abortion (URA), lose their immune response to recall antigens when pregnant (Bermas & Hill, 1997). Therefore, we hypothesized that immunosuppressive doses of progesterone may affect proliferative response of lymphocytes to trophoblast antigen and alloantigen. Proliferative responses using $^3H$-thymidine ($^3H$-TdR) incorporation of peripheral blood mononuclear cells (PBMCs) to the irradiated allogeneic periperal blood mononuclear cells as alloantigen, trophoblast extract and Flu as recall antigen, and PHA as mitogen were serially checked in 9 women who had experienced unexplained recurrent miscarriage. Progesterone vaginal suppositories (100mg b.i.d; Utrogestan, Organon) beginning 3 days after ovulation were given to 9 women with unexplained RSA who had prior evidence of Th1 immunity to trophoblast. We checked proliferation responses to conception cycle before and after progesterone supplementation once a week through the first 7 weeks of pregnancy. All patients of alloantigen and PHA had a positive proliferation response that occmed in the baseline phase. But 4 out of 9 patients (44.4%) of trophoblast antigen and Flu antigen had a positive proliferative response. The suppression of proliferation response to each antigen were started after proliferative phase and during pregnancy cycles. Our data demonstrated that since in vivo progesterone treated PBMCs suppressed more T-lymphocyte activation and $^3H$-TdR incorporation compare to PBMCs, which are not influenced by progesterone. This data suggested that it might be influenced by immunosuppressive effect of progesterone. In conclusion, progesterone may play an important immunological role in regulating local immune response in the fetal-placental unit. Furthermore, in the 9 women given progesterone during a conception cycle, Only two (22%) repeat pregnancy losses occured in these 9 women despite loss of antigen responsiveness (one chemical pregnancy loss and one loss at 8 weeks of growth which was karyotyped as a Trisomy 4). These finding suggested that pregnancy loss due to fetal aneuploidy is not associated with immunological phenomena.

• Journal of muscle and joint health
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• v.6 no.1
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• pp.37-50
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• 1999

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.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.7023-7027
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• 2013

To evaluate the relationship between obesity, diet, physical activity and breast cancer in Thai women, we conducted a case control study with 1,130 cases and 1,142 controls. Informed consent was obtained from all participants and a structured questionnaire was performed by trained interviewers to collect information on demographic and anthropometric data, reproductive and medical history, residential history, physical activity and occupation as well as dietary habits. A significant positive association with an increased risk of breast cancer was observed in women body mass index (BMI) of ${\geq}25mg/m^2$ (OR=1.33, 95%CI 1.07-1.65), the risk being higher in postmenopausal women (OR=1.67, 95%CI 1.24-2.25). In addition, underweight BMI at ages 10 and 20 years showed an inverse association in all women (OR=0.70, 95%CI 0.56-0.88 and OR=0.74, 95%CI 0.59-0.93, respectively) and in those with a premenopausal status (OR=0.69, 95%CI 0.51-0.93 and OR=0.76, 95%CI 0.56-0.99, respectively). Regular exercise was associated with a decreased risk of breast cancer (OR=0.78, 95%CI 0.68-0.98). Interestingly, analysis by type of activity revealed significant protective effects for women who reported the highest levels of walking for shopping (OR=0.58, 95%CI 0.38-0.88). High consumption of vegetables and fruit were associated with a decreased risk of breast cancer, while high consumption of animal fat showed an increased risk in postmenopausal women. In conclusion, our results indicate that obesity and high consumption of animal fat are associated with breast cancer risk, particularly in postmenopausal women, while recreational physical activity has protective effects. It seems that primary prevention of breast cancer should be promoted in an integrated manner. Effective strategies need to be identified to engage women in healthy lifestyles.