• Journal of Yeungnam Medical Science
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• v.37 no.1
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• pp.59-62
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• 2020

Hemoptysis is a major reason for emergency department (ED) visits. Catamenial hemoptysis (CH), a rare condition of thoracic endometriosis, can cause recurrent hemoptysis but is difficult to diagnose in the ED due to the scarcity of cases and nonspecific clinical findings. We report a case of a 26-year-old woman who presented to the ED with recurrent hemoptysis since 2 years without a definite cause. Her vital signs and blood test findings were unremarkable. Chest computed tomography (CT) did not show any specific lesions other than a non-specific ground-glass opacity pattern in her right lung. She was on day 4 of her menstrual cycle and her hemoptysis frequently occurred during menstruation. Although there was no histological confirmation, based on her history of hemoptysis during menstruation and no other cause of the hemoptysis, the patient was tentatively diagnosed with CH and was administered gonadotropin-releasing hormone. She had no recurrence of hemoptysis for 3 months. While CH is difficult to diagnose in the ED, the patient's recurrent hemoptysis related to menstruation was a clue to the presence of CH. Therefore, physicians should determine the relationship between hemoptysis and menstruation for women of childbearing age presenting with repeated hemoptysis without a definite cause.

• The Journal of Pediatrics of Korean Medicine
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• v.30 no.4
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• pp.60-65
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• 2016

Objectives The purpose of this study is to emphasize the importance of preventing precocious puberty. This study assessed current number of the patients with early puberty and their medical expenses from 2010 to 2015. Methods Using the data from Korean Statistical Information Service and Heathcare Bigdata Hub, number of patients diagnosed with precocious puberty by gender, age, and year from 2010 to 2015 were reviewed. Also, annual medical insurance expenses and the incidence of leuprorelin use were reviewed. Results Number of the patients with precocious puberty has increased from 29,251 in 2010 to 75,945 in 2015. Total medical insurance expenses have increased from 25,716,431 won in 2010 to 56,367,981 won in 2015. The use of lueprorelin also has increased annually from 11,097,590,000 won in 2010 to 21,617,585,000 won in 2015. Conclusions As a result, the patients diagnosed with precocious puberty are increasing in number, and their medical costs have been rising as well. It may be necessary to control the environmental causes of precocious puberty to reduce not only the physical and psychosocial health problems, but also the social costs.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.19 no.2
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• pp.130-138
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• 2016

Purpose: This study was conducted to analyze the change in the obesity index in girls receiving a gonadotropin-releasing hormone agonist (GnRHa), based on treatment duration, and to aid in nutritional counseling by investigating dietary habits and lifestyle. Methods: Anthropometric examinations were conducted on 62 girls treated with GnRHa from January 2010 through July 2014. Parents were asked to fill out questionnaires on patient dietary habits and lifestyle. Results: The group taking GnRHa for over 1 year had a higher rate of obesity increase than the group taking GnRHa for less than 1 year, but they had common habits related to obesity, which should be corrected. In addition, 69.2% of the normal weight group taking GnRHa for over 1 year gained weight, and needed more intensive programs, which include physical exercise and nutritional education. Although girls with precocious puberty showed a decrease in the intake of high-calorie foods with nutritional intervention regardless of treatment duration, they still had problems that needed improvement, such as shorter meals and lack of exercise. Conclusion: Girls with precocious puberty and their parents should emphasize maintenance of proper body weight, especially when treatment for over 1 year is anticipated. Consistent education in nutrition, ways to increase intensity and duration of physical activity, and the need to slow down mealtimes are important in managing obesity; doctors need to perform regular checkups and provide nutritional counseling.

• Reproductive and Developmental Biology
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• v.36 no.2
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• pp.103-108
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• 2012

Anestrus is one of the most important production limiting disorders in dairy buffaloes and its underlying causes have been a current topic of studies. The objectives of this study were to explore the causes of anestrus in buffaloes with the application of ultrasonography. Two examinations were performed by transrectal ultrasonography at 12 days apart in buffalo cows that were not seen in oestrus at 60 or more days postpartum. As high as 54.5% buffaloes had silent ovulation and 45.5% suffered from the true anestrus with ovarian dysfunction. The duration of anestrus after calving was 60~90, 91~120, 121~180 and 181~365 days in 27%, 32%, 18% and 23% buffalo cows, respectively. Treatment with prostaglandin of cyclic buffalo cows with a corpus luteum (72.7%) resulted in higher estrous rate as compared with close observation of estrus (23.1%) by the farmer (p=0.021). Acyclic buffalo cows without any corpus luteum on ovaries were successfully treated with gonadotropin releasing hormone (70%), resulting in higher estrous detection rate than those treated with a vitamin-mineral mixture (20%) (p=0.035). In conclusion, poor heat detection due to silent ovulation is the most important cause of apparent anoestrus in buffaloes; however the percentage of the true anestrous is also quite high in postpartum buffaloes.

• Childhood Kidney Diseases
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• v.23 no.2
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• pp.124-127
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• 2019

Herlyn-Werner-Wunderlich (HWW) syndrome is a rare congenital anomaly of the genitourinary tract comprising uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. Patients with HWW syndrome usually present symptoms such as dysmenorrhea, abdominal pain, pelvic mass, and purulent vaginal discharge. If not treated at an appropriate time, complications such as infertility, endometriosis, pyosalpinx, and subsequent pelvic adhesions may occur. Here, we report a case of HWW syndrome in a 7-year-old-girl who was also diagnosed as having central precocious puberty. She was brought to the pediatric department with chief complaints of lump in her breast and vaginal discharge. When she was around 2 months old, she was confirmed to have a single kidney on ultrasonography. We checked her past medical history and diagnosed her as having HWW syndrome based on the results of imaging studies, including abdominal ultrasonography and pelvic magnetic resonance imaging. She underwent treatment with gonadotropin-releasing hormone analogue for 2 years. During 24 months of follow-up, she showed no serious problems or complications. If renal anomalies are identified immediately after birth or in infancy, further screening tests should be conducted prior to menstruation for determining congenital abnormalities of the reproductive tract and vice versa.

• Clinical and Experimental Reproductive Medicine
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• v.48 no.2
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• pp.184-187
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• 2021

Radical trachelectomy is a fertility-preserving alternative to radical hysterectomy in carefully selected young women with early-stage cervical cancer. However, in cases with subsequent severe cervical stenosis, assisted reproductive techniques can be difficult. This is a case report of a 34-year-old patient who underwent robot-assisted radical trachelectomy and cerclage for early-stage (IB2) adenosquamous carcinoma. Three months after surgery, the patient underwent ovarian stimulation using a gonadotropin-releasing hormone antagonist protocol. As it was impossible to perform transcervical embryo transfer due to the almost complete absence of the cervical opening, transmyometrial embryo transfer under ultrasound guidance was performed. This resulted in a successful singleton pregnancy. This is the first case of successful pregnancy conceived by in vitro fertilization with transmyometrial embryo transfer in a patient who had previously undergone robot-assisted radical trachelectomy.

• Clinical and Experimental Reproductive Medicine
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• v.48 no.1
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• pp.1-10
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• 2021

In Korean women, a westernized lifestyle is associated with an increased risk of breast cancer. Fertility preservation has become an increasingly important issue for women with breast cancer, in accordance with substantial improvements in survival rate after cancer treatment. The methods of controlled ovarian hyperstimulation (COH) for fertility preservation in breast cancer patients have been modified to include aromatase inhibitors to reduce the potential harm associated with increased estradiol levels. Random-start COH and dual ovarian stimulation are feasible options to reduce the total duration of fertility preservation treatment and to efficiently collect oocytes or embryos. Using a gonadotropin-releasing hormone agonist as a trigger may improve cycle outcomes in breast cancer patients undergoing COH for fertility preservation. In young breast cancer patients with BRCA mutations, especially BRCA1 mutations, the possibility of diminished ovarian reserve may be considered, although further studies are necessary. Herein, we review the current literature on the practical issues surrounding COH for fertility preservation in women with breast cancer.

• Development and Reproduction
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• v.26 no.3
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• pp.107-115
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• 2022

Kisspeptins, products of KISS1 gene, are ligands of the G-protein coupled receptor (GPR54), and the kisspeptin-GPR54 signaling has an important role as an upstream regulator of gonadotropin releasing hormone (GnRH) neurons. Interestingly, extrahypothalamic expressions of kisspeptin/GPR-54 in gonads have been found in primates and experimental rodents such as rats and mice. Hamsters, another potent experimental rodent, also have a kisspeptin-GPR54 system in their ovaries. The presence of testicular kisspeptin-GPR54 system, however, remains to be solved. The present study was undertaken to determine whether the kisspeptin is expressed in hamster testis. To do this, reverse transcription-polymerase chain reactions (RT-PCRs) and immunohistochemistry (IHC) were employed. After the nest PCR, two cDNA products (320 and 280 bp, respectively) were detected by 3% agarose gel electrophoresis, and sequencing analysis revealed that the 320 bp product was correctly amplified from hamster kisspeptin cDNA. Modest immunoreactive (IR) kisspeptins were detected in Leydig-interstitial cells, and the weak signals were detected in germ cells, mostly in round spermatids and residual bodies of elongated spermatids. In the present study, we found the kisspeptin expression in the testis of Syrian hamster. Further studies on the local role(s) of testicular kisspeptin are expected for a better understanding the physiology of hamster testis, including photoperiodic gonadal regression specifically occurred in hamster gonads.

• Clinical and Experimental Reproductive Medicine
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• v.21 no.3
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• pp.233-240
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• 1994

This study was conducted to compare the endocrine milieu, and pregnancy rates in In Vitro Fertilization and Embryo Transfer(IVF-ET) program employing combined with gonadotropin releasing hormone agonist(GnRH-a) and pergonal(LH 75lU+FSH 75lU) when either human chorionic gonadotropin(HCG) or progesterone were used for luteal phase support. A total number of 40 IVF-ET treatment cycles were prospectively studied. Ovarian hyperstimulation method was modified ultrashort protocol using GnRH-a. All patients started Decapeptyl at menstrual cycle day # 2, and HMG was started at # 3 days. When leading follicle was ${\geqq}$18mm or at least two follicles were ${\geqq}$14mm in diameter, HCG 10000lU intramuscularly was injected. After 36 hours HCG administration, oocytes were retrieved as usual guided by transvaginal ultrasound. Embryo were transfered 36-48 hours later. The patient's cycles were prospectively randomized to receive HCG(20cycles) or Progesterone (20cycles) for luteal support. The progesterone group received 25mg 1M starting from the day of ET. The HCG group received 1500IU 1M. on days 0, +2, +5 after ET. Estadiol($E_2$) and Progesterone($P_4$) were measured on the day of oocyte aspiration, ET day, and every 6 days thereafter. Results were follows as; 1. Estradiol, progesterone and LH levels on the day of HCG trigger, retrieved oocytes and number of transfered embryo were not significantly different in both groups. 2. On the day of aspiration and embryo transfered day, $E_2$, $P_4$ level were significantly higher in progesterone group than HCG group(p<0.01). 3. $E_2$, $P_4$ level on 6 days after ET were significantly higher in progesterone group than HCG group(p<0.01). But, $P_4/E_2$ ratio was not different in both groups. 4. $E_2$, $P_4$ level 12 days after ET were decreased abruptly in both groups and higher hormonal level appeared in HCG group(P<0.01). 5. The total pregnancy rate in the HCG group was 40% (8/20) and in the progesterone group 15%(3/20). 6. Comparing the pregnant and nonpregnant cases progesterone group was not different the hormonal status. In HCG group, pregnant cases appeared in higher $P_4$, $P_4/E_2$ ratio than nonpregnanct cases(P<0.01).

• Journal of Ginseng Research
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• v.32 no.1
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• pp.8-14
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• 2008

Stress activates hypothalamic-pituitary-adrenal (HPA) axis and subsequently increases the systemic levels of glucocorticoids. It also inhibits the release of gonadotropin-releasing hormone (GnRH) from hypothalamus. Korean ginseng (Panax ginseng CA Meyer) has been proven as an anti-stress agent. However, most of the anti-stress effects of ginseng on stresses such as immobilization, electronic foot shock, and cold swim, which subsequently cause oxidative damage in brain, were obtained by using ginseng extract or ginseng total saponin. Moreover, anti-stress and anti-oxidative effects of ginseng were demonstrated by determination of enzyme or hormone levels but not mRNA as well as transcriptome. Further studies on transcriptome, proteomics, and systems biology as well as signal transduction would be required to elucidate molecular action mechanisms of ginseng on stresses.