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Causes of amenorrhea in Korea: Experience of a single large center

  • Kwon, Su-Kyoung;Chae, Hee-Dong;Lee, Kyung-Hee;Kim, Sung-Hoon;Kim, Chung-Hoon;Kang, Byung-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.41 no.1
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    • pp.29-32
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    • 2014
  • Objective: To investigate the causes of amenorrhea in Korean women. Methods: Medical records from 1,212 women with amenorrhea who visited the Department of Obstetrics and Gynecology, Asan Medical Center, between January 1989 and December 2011 were retrospectively reviewed. Amenorrhea was categorized as either primary or secondary. Results: Primary amenorrhea was identified in 132 of the patients (10.9%) and secondary amenorrhea in 1,080 (89.1%). The most frequent causes of primary amenorrhea were gonadal dysgenesis (28.0%, 37/132); Mayer-Rokitansky-K$\ddot{u}$ster-Hauser syndrome (20.0%, 27/132); and constitutional delay and androgen insensitivity syndrome (8.3%, 11/132; 8.3%, 11/132, respectively). Secondary amenorrhea was due to polycystic ovary syndrome (48.4%, 523/1,080); premature ovarian insufficiency (14.0%, 151/1,080); and nutrition-related hypogonadotropic hypogonadism (8.3%, 90/1,080). Conclusion: In this retrospective study, gonadal dysgenesis was the most common cause of primary amenorrhea and polycystic ovary syndrome was the most common cause of secondary amenorrhea in Korean women.

Socio-economic Factors Influencing Tumor Presentation and Treatment Options in Chinese Breast Cancer Patients

  • Wang, Ke;Li, Xiao;Zhou, Can;Ren, Yu;Wang, Xian-Bing;He, Jian-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.267-274
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    • 2013
  • The impact of income and education level on the clinical and pathologic characteristics, implementation of clinical breast examination (CBE), and treatment patterns of a small population of Chinese female breast cancer patients was studeied in order to provide a theoretical basis and statistical reference for further nationwide research. We included 484 pathologically confirmed female primary breast cancer inpatients of the First Affiliated Hospital of Medical College of Xi'an Jiaotong University from February 2003 to January 2004. All cases were reviewed and relevant information was collected using a designed case report form (CRF). Chisquare tests, rank-sum tests, and Fisher's exact tests were used in the analysis. Our analysis showed that: (1) women in different occupation groups had significant differences in tumor size, pre-operative mammography, surgical options, post-operative estrogen receptor (ER), progestin receptor (PR) and human epidermal growth factor receptor 2 (Her2) status, and post-operative radiotherapy and chemotherapy (P < 0.05); and (2) women with different education levels had statistically significant differences in tumor size, post-operative ER, PR and Her2 status, and post-operative chemotherapy, radiotherapy, and endocrine therapy (P < 0.05). In Xi'an, China, women in low-income occupations or with low education levels are more likely to have advanced tumor stages at presentation, lower implementation rate of clinical breast examination, and less treatment.

Medical Care Utilization During 1 Year Prior to Death in Suicides Motivated by Physical Illnesses

  • Cho, Jaelim;Lee, Won Joon;Moon, Ki Tae;Suh, Mina;Sohn, Jungwoo;Ha, Kyoung Hwa;Kim, Changsoo;Shin, Dong Chun;Jung, Sang Hyuk
    • Journal of Preventive Medicine and Public Health
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    • v.46 no.3
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    • pp.147-154
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    • 2013
  • Objectives: Many epidemiological studies have suggested that a variety of medical illnesses are associated with suicide. Investigating the time-varying pattern of medical care utilization prior to death in suicides motivated by physical illnesses would be helpful for developing suicide prevention programs for patients with physical illnesses. Methods: Suicides motivated by physical illnesses were identified by the investigator's note from the National Police Agency, which was linked to the data from the Health Insurance Review and Assessment. We investigated the time-varying patterns of medical care utilization during 1 year prior to suicide using repeated-measures data analysis after adjustment for age, gender, area of residence, and socioeconomic status. Results: Among 1994 suicides for physical illness, 1893 (94.9%) suicides contacted any medical care services and 445 (22.3%) suicides contacted mental health care during 1 year prior to suicide. The number of medical care visits and individual medical expenditures increased as the date of suicide approached (p<0.001). The number of medical care visits for psychiatric disorders prior to suicide significantly increased only in 40- to 64-year-old men (p=0.002), women <40 years old (p=0.011) and women 40 to 64 years old (p= 0.021) after adjustment for residence, socioeconomic status, and morbidity. Conclusions: Most of the suicides motivated by physical illnesses contacted medical care during 1 year prior to suicide, but many of them did not undergo psychiatric evaluation. This underscores the need for programs to provide psychosocial support to patients with physical illnesses.

Preliminary Report of Use-Effectiveness of Ovulation Method in Korea (자연피임법으로서의 배란법의 피임효과)

  • Bae, S.C.;Chung, Y.J.;Rha, J.G.;Oh, W.S.;Kim, S.J.
    • Clinical and Experimental Reproductive Medicine
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    • v.3 no.1
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    • pp.27-32
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    • 1976
  • In recent years, explosive increase in population has been damaging mankind in terms of deprivation of natural resources and more of economical demands. Therefore, we have thought about problems as to counter-balance the increasing population, and reached a resolution of artificial methods of controlling birth. In the past, though now used in some of contraceptive methods, extravaginal ejaculation, condom were commonly used. But recently, pills, IUD and several kinds of operative procedures are quite popular. Though the recent methods are known to be effective compared with the traditional methods, a certain unwanted side effects as well as limited value of usages now must be discussed. On this aspect, we are trying to research for a ideal methods such as symptom free, more of natural way of family planning and try to zero the failure rate. And also it has been suggested that only if those scientific methods of controlling birth can be base on religious concepts of moral being, it will be enlightened. At the Happy Family Planning Clinic of St. Mary's Hospital, we apply Billing's ovulation method to out-patients who want contraception and usually advise them to use it on a self-care basis. For a retrospective study of the presurvey data analysis and use-effectiveness of the ovulation method from April 1, 1975 to Nov., 30, 1975, we have dealt with a total of 1,383 women (urban areas 465, rural areas 918). The results of preliminary survey were as follows; 1) Among 465 women in Seoul areas, the failure rate was 10.3, which signified unplanned pregnancies of 32 women. 27 of the 32 women were pregnant due to the users own failure and the remaing 5 due to the failure of the method. Therefore, the failure of the method accounted for 1.6. 2) Among 918 women in rural areas, the failure rate was 15.2 signifing unplanned pregnancies in 93 women. The cause of the failure in 81 of the 93 women was attributable to the user's own mistake and that in the remaing 12 to the default of the method. Therefore, the failure attributable to the method accounted for 2.0.

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Sex Differences in Cerebellar Structure of Healthy Adults (정상 성인에서 남녀의 소뇌 구조 차이)

  • Kim, Ji-Hyun H.;Bae, Su-Jin;Ryu, Keun-Taik;Kang, Min-Seong;Lim, Soo-Mee;Lee, Sun-Ho;Lee, So-Jin;Ko, Eun;Jeong, Do-Un
    • Korean Journal of Biological Psychiatry
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    • v.19 no.2
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    • pp.77-83
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    • 2012
  • Objectives : Although there have been studies that examine sex differences of the brain structures using magnetic resonance imaging, studies that specifically investigate cerebellar structural differences between men and women are scarce. The purpose of current study was to examine sex differences in structures of the cerebellum using cerebellar template and cerebellum analysis methods. Methods : Sixteen men and twenty women were included in the study. A MATLAB based program (MathWorks, Natick, MA, USA), Statistical Parametric Mapping 5 (SPM5) using the spatially unbiased infra-tentorial atlas template (SUIT) as the cerebellum template, was used to analyze the brain imaging data. Results : There was no significant difference in age between men (mean age=28.1) and women (mean age=27.2). Men showed higher gray matter density than women in two left cerebellar areas including the clusters in the lobules IV and V (a cluster located across the lobules IV and V), and the lobule VIIIb (lobules IV and V, t=4.75, p<0.001 ; lobule VIIIb, t=3.08, p=0.004). Conclusions : The current study found differences in cerebellar gray matter density between men and women. The current study holds its significance for applying the template specifically developed for the analysis of cerebellum.

The frequency of chromosomal abnormalities and the prenatal cytogenetic analyses for couples with recurrent abortions

  • Choi, Soo-Kyung;Park, So-Yeon;Han, Jung-Yeol;Ryu, Hyun-Mee;Jun, Jong-Young
    • Journal of Genetic Medicine
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    • v.2 no.2
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    • pp.59-63
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    • 1998
  • Between 1988-1998, cytogenetic analyses were performed for 1,476 couples and 162 women with recurrent abortions. We applied GTG-banding, high resolution-banding and FISH (fluorescent in situ hybridization) techniques in this study. The frequency of balanced translocations was 3.6% (112/3114). Of them, 74 cases (2.38%) were reciprocal translocations and 38 (1.22%) were robertsonian translocations. Chromosome aberrations were more frequent in women (80 cases) than in men (32 cases). No phenotypical abnormalities were found in all carriers who had experienced recurrent spontaneous abortions or experienced giving birth to malformed offsprings. Prenatal cytogenetic analyses were carried out on 40 subsequent pregnancies for carrier couples with balanced translocation. The fetal karyotypes showed that 13 cases (32.5%) were normal, 25 (62.5%) were balanced translocations, and two (6%) were unbalanced translocations. It is believed that the frequency of chromosomal abnormalities in patients with recurrent spontaneous abortion is higher than that of the normal population. Most of the fetal samples showed normal karyotypes or balanced translocations matching that of one of their parents. Although the incidence of chromosomal imbalance in the fetuses was relatively low in prenatal cytogenetic analysis, individuals with balanced translocations are predisposed to giving birth to malformed offsprings with partial trisomy or monosomy. Therefore, we recommend the cytogenetic and the prenatal cytogenetic analysis for those who experiences recurrent abortion as well as in case they become pregnant, to prevent the birth of offsprings with chromosomal abnormalities.

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Determinants of Participation in a Breast Cancer Screening Trial in Trivandrum District, India

  • Frie, Kirstin Grosse;Ramadas, Kunnambath;Anju, Gopan;Mathew, Beela Sara;Muwonge, Richard;Sauvaget, Catherine;Thara, Somanathan;Sankaranarayanan, Rengaswamy
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7301-7307
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    • 2013
  • Background: Conspicuous differences in participation rates for breast self-examination (BSE), clinical breast examination (CBE), and referral for further investigations have been observed indicating involvement of a number of different factors. This study analysed determinants for participation in different levels of the breast cancer screening process in Indian females. Materials and Methods: An intervention group of 52,011 women was interviewed in a breast cancer screening trial in Trivandrum district, India. In order to assess demographic, socio-economic, reproductive, and cancer-related determinants of participation in BSE, CBE, and referral, uni- and multi-variate logistic regression was employed. Results: Of the interviewed women, 23.2% reported practicing BSE, 96.8% had attended CBE, and 49.1% of 2,880 screen-positives attended referral. Results showed an influence of various determinants on participation; women who were currently not married or who had no family history of cancer were significantly less likely to attend the screening process at any level. Conclusions: Increasing awareness about breast cancer, early detection methods, and the advantages of early diagnoses among women, and their families, as well as health care workers offering social support, could help to increase participation over the entire screening process in India.

Prenatal diagnosis of interchromosomal insertion of Y chromosome heterochromatin in a family

  • Lee, Bom-Yi;Park, Ju-Yeon;Lee, Yeon-Woo;Oh, Ah-Rum;Lee, Shin-Young;Park, So-Yeon;Ryu, Hyun-Mee;Lee, Si-Won
    • Journal of Genetic Medicine
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    • v.14 no.2
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    • pp.62-66
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    • 2017
  • Interchromosomal insertion of Y chromosome heterochromatin in an autosome was identified in a fetus and a family. A fetal karyotype was analyzed as 46,XX,dup(7)(?q22q21.1) in a referred amniocentesis at 16 weeks of gestation for advanced maternal age. In the familial karyotype analyses for identification of der(7), the mother, the first daughter and the maternal grandmother showed the same der(7) as the fetus's. CBG-banding was positive at 7q22 region of der(7) that indicated inserted material was originated from heterochromatin. The origin of heterochromatic insertion region in der(7) of the fetus and the mother was found in Yq12 region by fluorescent in situ hybridization with a DYZ1 probe. In the specific analysis of Y chromosomal heterochromatic region of ins(7;Y) of the mother, 15 sequence tagged sites from Yp11.3 region including SRY to Yq11.223 region was not detected. Final karyotypes of the mother, the first daughter and the maternal grandmother were reported as 46,XX,der(7)ins(7;Y)(q21.3;q12q12). All female carriers of ins(7;Y) in the family showed normal phenotype and the mother and the maternal grandmother were fertile. A healthy girl was born at term. We report a rare case of familial interchromosomal insertion of Y chromosome heterochromatin detected only in female family members with normal phenotype that was diagnosed prenatally.

Selection of Reference Equations for Lung Volumes and Diffusing Capacity in Korea (우리나라 성인 폐용적 및 폐확산능 정상예측식의 선정)

  • Song, Eun Hee;Oh, Yeon Mok;Hong, Sang Bum;Shim, Tae Sun;Lim, Chae Man;Lee, Sang Do;Koh, Youn Suck;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Kim, Tae Hyung
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.3
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    • pp.218-226
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    • 2006
  • Background: The lung volume and diffusing capacity are influenced by ethnicity. However, there are no equations for predicting the normal lung volume in the adult Korean population, and there is only one equation for diffusing capacity. The aim of this study is to select the most suitable reference equation for the Korean population. Method: 30 men and 33 women at Hanyang University Guri Hospital, and 27 men and 34 women at Asan Medical Center in healthy nonsmoking adults were enrolled in this study. The subject's age, gender, height, weight, lung volume by plethysmography, and diffusing capacity by a single breathing method were obtained. The most suitable equation with the lowest sum of residuals between the observed and predicted values for lung volume and diffusing capacity was selected. Result: At Hanyang University Guri Hospital, the equations with the lowest sum of residuals in the total lung capacity were ECSC's equation in males (sum of residual: 0.04 L) and Crapo/Morris's equation (-1.04) in women. At the Asan Medical Center, the equations with the lowest sum of residuals in the total lung capacity were Goldman/Becklake's equation in males (sum of residual: -2.35) and the ECSC's equation -4.49) in women. The equations with the lowest sum of residuals in the Diffusing capacity were Roca's equation in males (sum of residual: -13.66 ml/min/mmHg) and Park's in women (25.08) in Hanyang University Guri hospital and Park's equation in all cases in the Asan Medical Center (male: -1.65, female: -6.46). Conclusions: Until a reference equstion can be made for healthy Koreans by sampling, ECSC's equation can be used for estimating the lung volume and Park's can be used for estimating the diffusing capacity.