• Clinical and Experimental Reproductive Medicine
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• v.45 no.1
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• pp.38-43
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• 2018

Objective: To survey knowledge about the factors that influence fertility in a reproductive-age population living in an urban area. Methods: A cross-sectional study was conducted using a questionnaire-based survey among both males and females aged 18-45 years living in the Bangkok metropolitan area. Results: The mean age of the participants was $26.8{\pm}7.2years$ (male, 41.9%; female, 58.1%). Of the participants, 53.1% had an undergraduate degree and 57.1% were single. Only one-fifth of the participants correctly identified the age when fecundity declines in male and female, the definition of infertility, and the period during the menstrual cycle with the highest chance of pregnancy. Approximately three-fourths of the participants correctly identified that cigarette smoking, alcohol consumption, and sexually transmitted infections affect fertility. Conclusion: A considerable knowledge gap about the factors that influence fertility was identified in reproductive-age individuals in an urban area of Thailand. This issue should be urgently addressed by promoting fertility awareness through education, discussions about social perceptions regarding fertility, and reliable sources of knowledge.

• The Journal of Korean Obstetrics and Gynecology
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• v.31 no.3
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• pp.121-130
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• 2018

Objectives: The purpose of this study is to report the effects of Korean medical treatment in ovarian disorder patients resistant to controlled ovarian hyperstimulation. There are some case-reports about effectiveness of the Korean medical treatment to treat ovulation disorder and become pregnant, but cases are still deficient. Methods: The patient was diagnosed possibility of premature ovarian failure by serum hormone assay and underwent hyperstimulation to freeze oocyte. But ovary had no response to hyperstimulation. She was treated by Korean medical treatment, such as herbal medicine, acupuncture and moxibustion. Results: After the treatment, the patient recovered from irregular ovulation & menstrual cycle and became pregnant and gave birth. Conclusions: This case shows the Korean medical treatment might be effective in ovarian disorder patients resistant to hyperstimulation.

• Clinical and Experimental Reproductive Medicine
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• v.26 no.3
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• pp.377-381
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• 1999

Objectives: Recent studies, including our own, demonstrated that the novel expression of LH gene in rat gonads and uterus, indicating that the local production and action of the LH-like molecule. In the present study, we investigated whether human uterus also expresses the LH gene. Design: Reverse transcription-polymerase chain reaction (RT-PCR) amplified the cDNA fragments coding $LH_{\beta}$ polypeptide from human endometrium but not from myometrium. Presence of the transcripts for the ${\alpha}$-subunit in human endometrium was also confirmed by RT-PCR. Results: Transcripts for $LH_{\beta}$ subunit were detected in endometrial samples from women with endometriosis. The gene for LH/hCG receptor was expressed in both endometrium and myometrium, showing good agreement with previous studies. Increased level of $LH_{\beta}$ transcript was determined in the endometrium from follicular phase compared to that from luteal phase. Conclusion: Taken together, our findings demonstrated that 1) the genes for LH subunits and LH/hCG receptor are expressed in human uterus, 2) the uterine LH expression was changed during menstrual cycle, suggesting that the uterine LH may playa local role in the control of uterine physiology and function(s).

• Clinical and Experimental Reproductive Medicine
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• v.38 no.3
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• pp.119-125
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• 2011

Implantation of an embryo occurs during the mid-secretory phase of the menstrual cycle, known as the "implantation window." During this implantation period, there are significant morphologic and functional changes in the endometrium, which is followed by decidualization. Many immune cells, such as dendritic and natural killer (NK) cells, increase in number in this period and early pregnancy. Recent works have revealed that antigen-presenting cells (APCs) and NK cells are involved in vascular remodeling of spiral arteries in the decidua and lack of APCs leads to failure of pregnancy. Paternal and fetal antigens may play a role in the induction of immune tolerance during pregnancy. A balance between effectors (i.e., innate immunity and helper T [Th] 1 and Th17 immunity) and regulators (Th2 cells, regulatory T cells, etc.) is essential for establishment and maintenance of pregnancy. The highly complicated endocrine-immune network works in decidualization of the endometrium and at the fetomaternal interface. We will discuss the role of immune cells in the implantation period and during early pregnancy.

• The Journal of Korean Obstetrics and Gynecology
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• v.25 no.2
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• pp.142-153
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• 2012

Objectives: The purpose of this study is to identify the clinical effects of korean medicine treatment of dysmenorrhea patients. Methods: We studied twenty-six patients who visited Oriental Hospital of ${\bigcirc}{\bigcirc}$ University from September 2011 to December 2011. Women with organic disease such as endometriosis, uterine myoma and pelvic inflammatory disease were excluded from this study. We treated them with herb, acupuncture and moxibustion for one menstrual cycle. The severity of dysmenorrhea was measured by VAS(Visual analog scale) and MVRS(Multidimensional Verbal Rating scale). Results: The mean${\pm}$Standard Error of mean(S.E) of VAS on after treatment was decreased significantly compared with that of before(p=0.00). The mean${\pm}$S.E of MVRS on after treatment was decreased significantly compared with that of before(p=0.00). Conclusions: This study shows that korean medicine treatment such as herb, acupuncture and moxibustion has remarkable effects on dysmenorrhea patients. Further study will be needed.

• The Journal of Korean Obstetrics and Gynecology
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• v.30 no.4
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• pp.59-76
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• 2017

Objectives: The purpose of this study is to investigate the effect on both herbal medicine periodic therapy and western medicine for polycystic ovary syndrome subfertility. Methods: We searched 8 electronic databases and search keywords were 'PCOS' and 'periodic therapy' or 'cyclic treatment'. We included randomized controlled clinical trials (RCTs) using the periodic therapy combined western medicine for PCOS patients. Results: We selected 8 studies. In studies, there were three studies in which the menstrual cycle was divided into 2 periods, one study divided into 3 periods, and four study divided into 4 periods. The meta-analysis of the 7 trials indicated that pregnancy rates integrated clomiphene and periodic therapy were higher than clomiphene alone. Conclusions: The periodic therapy combined western medicine for PCOS subfertility patients seems to improve pregnancy rates from this research. However, this result should be taken cautiously by unclear risk of bias. It would be necessary to fulfill further clinical study with herbal medicine periodic therapy on PCOS in Korean medicine to establish standard evidence of them.

• Archives of Plastic Surgery
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• v.37 no.6
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• pp.843-846
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• 2010

Purpose: Plastic surgeon can easily misdiagnose the mass on the postoperative scar as hypertrophic scar. We present a case of endometrioma at abdominal scar after cesarean section. Methods: A 36 year-old female visited with a protruding, rubbery hard mass on her abdominal scar. The mass grew slowly after cesarean section performed 7 years ago. She has felt intermittent pain, not with menstrual cycle, for 2 months. The ultrasonography showed a solid irregular, ill defined mass with heterogenous echogenicity. The MRI finding is suggestive of malignant soft tissue tumor with deep fascial invasion. Incisional biopsy showed acanthosis, melanophage, lymphoplasmacytic infiltration. So we excised mass elliptically, we could see chocolatelike discharge from the mass, adhering to external oblique muscle fascia. The mass confirmed histologically as an endometrioma. Results: The mass was completely removed and did not recurr. The patient does not complain more about pain or any discomfort. Conclusion: Plastic surgeons should be aware of the possibility of endometrioma when the patient present with mass on her abdominal scar after surgery of the pelvis and abdomen.

• Clinical and Experimental Reproductive Medicine
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• v.32 no.3
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• pp.253-259
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• 2005

Objective: We investigated the expression of TSP-1 and -2 in eutopic endometrium of advanced endometriosis and control patients. Methods: The 33 endometriosis patients and 32 controls were enrolled. Endometrial samples were obtained from 65 premenopausal women aged 29-44 years, undergoing laparoscopic surgery or hysterectomy for non-malignant lesions. Sufficient samples were collected from 33 patients with endometriosis stage III and IV and 32 controls without endometriosis confirmed by laparoscopic surgery. The mRNA expression from eutopic endometrium for TSP-1 and -2 were analyzed by RT-QC PCR. Results: The mRNAs of TSP-1 and -2 were expressed in eutopic endometrium from endometriosis and normal controls throughout the menstrual cycle. There were no significant differences in expression of TSP-1 and TSP-2 in eutopic endometrium between controls and endometriosis patients. Conclusion: Our results indicated that TSP-1 and -2 had no crucial role compared to other molecules in the regulation of angiogenesis. These findings also suggest that dysregulation of other angiogenic regulators would be concerned in pathophysiologic role in endometriosis development.

• The Journal of Korean Obstetrics and Gynecology
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• v.27 no.3
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• pp.135-142
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• 2014

Objectives: The purpose of this study is to report the effects of herbal medicine on infertility caused by premature ovarian failure. Methods: The patient in this case was 38-year-old female. The patient was diagnosed premature ovarian failure by serum hormone assay. The chief complain is amenorrhea and infertility. She was treated by traditional treatment, such as herbal medicine (Buickjihwang-hwan), acupuncture and moxibustion. Results: After the treatment, the patient recovered the menstrual cycle and became pregnancy and delivery. Conclusions: This case shows that traditional Korean treatment might be effective in infertility caused by premature ovarian failure.

• Clinical and Experimental Reproductive Medicine
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• v.27 no.2
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• pp.117-131
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• 2000

Objectives: To develop a new immunohistochemical marker system for supplementation of the Noyes histological classification of the endometrium in women of child bearing age with regular menstrual cycles, and to employ this system to evaluate pathologic factors involved in endometriosis, and thus to ascertain if it is useful in diagnosis. Materials and Methods: Endometrial biopsies were sampled from the posterior fundus of 41 (24 proliferative phases, 17 secretory phases) women with regular menstrual cycles (28-32 days), and each sample was immunohistochemically stained according to Noyes et al (1975) for determination of expression for estrogen receptor (ER), progesterone receptor (PR), integrin ${\alpha}_1$, ${\alpha}_4$, ${\beta}_3$, COX-1 and COX-2. Then, the PR, integrin ${\beta}_3$ and COX-2 which were clearly expressed in the luteal phase was with endometrial samples were obtained from 20 cases of normal patients (group 1) and 25 cases with endometriosis (group 2) after confirming the day of ovulation by sex steroid level measurements 7-8 days after ovulation Results: In the regular menstruation group the expression of ER showed a tendency to be increased in the proliferative phase and decreased in the secretory phase, and was the highest in the proliferative phase. However, PR in the stromal cells showed no change in the entire menstrual cycle while in the epithelial cells, PR reached a peak in the late proliferative phase and was almost absent in the secretory phase. Integrin (${\alpha}_1$, ${\alpha}_4$, and ${\beta}_3$ expression in the epithelial cells was absent in the proliferative phase but ${\alpha}_1$ was strongly expressed starting from the early secretory phase into the entire secretory phase. ${\alpha}_4$ was expressed strongly in the early and mid secretory phases and disappeared in the late proliferative phase, while ${\beta}_3$ appeared after the mid secretory phase and continued to be expressed until the late secretory phase. Expression in the stromal cells was weak overall and did not show any cyclic pattern. COX-1 expression was shown as a cyclic pattern in the stromal and epithelial cells and was particularly strongly expressed in the mid secretory phase of epithelial cells, and in the mid secretory and menstruation phase of stromal cells. In the endometrial epithelial cells there was strong expression during the entire cycle with stronger expression in the secretory phase compared to the prolferative phase. COX-2 was clearly expressed in the late proliferative, early and mid secretory phases in the stromal cells. No expression was observed in the proliferative phase of the epithelial cells, but which began to appear in the early secretory phase reaching a significant pattern from the mid secretory phase onwards. There was almost no expression in the stromal cells. In the cases with endometriosis showing normal endometrial maturation according to the Noyes classification, PR expression was increased while Integrin-${\beta}_3$의 expression was significantly decreased compared to the normal group. Also, COX-2 expression was slightly decreased in the stromal cells of patients with endometriosis while it was significantly increased in the stromal cells. Conclusion: Immunohistochemical markers can supplement the original Noyes classification of histological endometrial dating and therefore ascertain existing pathologic conditions. Particularly for patients with endometriosis with normally mature endometrial cells, changes in COX-2 and integrin expression patterns may assist in elucidating pathophysiologic mechanisms and therefore aid in the diagnosis of abnormal implantation conditions, and consequently determine a treatment modality.