It appears that a major determinant of the success of in vitro fertilization is the selection of the optimal follicle containing an oocyte capable of being fertilized and producing a normal pregnancy. However, the hormonal basis of oocyte maturation is not well substantiated by the as yet available informations. It has been suggested that prolactin(PRL) may stimulate the formation of an oocyte maturation inhibitor and thus inhibit the maturation of oocyte. During the hyperstimulated menstrual cycles serum estradiol($E_2$) levels are markedly elevated, and it seems justified to assume that serum prolactin levels may be elevated since estrogens are potent stimulators of prolactin secretion. This study was carried out to ascertain the effect of the elevated serum estradiol levels on the serum prolactin levels in women undergoing ovarian hyperstimulation with either hMG and/or clomiphene citrate. Serum estradiol and prolactin profiles were measured from third menatrual cycle day to ovulation or ovum aspiration day in 11 normal menstruating women and 30 women who underwent an in vitro fertilization procedure with ovarian hyperstimulation by hMG, clomiphene citrate/hMG, clomiphene citrate. Ovum aspiration was performed 36 hours after hCG administration. The day of ovum aspiration or ovulation was designated Day 0. Serum estradiol levels increased progressively during the follicular phase and this rise peaked on Day-1 at a mean concentration of 1,204${\pm}$189.0pg/ml in Group II(hMG), 1,194${\pm}$167.9pg/ml in Group III(clomiphene citrate/hMG), 1,035${\pm}$195.1pg/ml in Group IV(clomiphene citrate) respectively and on Day -2 of 336${\pm}$34.5pg/ml in Group I(normal control). The elevated estradiol levels fen rapidly after ovulation or ovum aspiration. Serum estradiol values of hyperstimulated groups(Group II, III, IV) were significantly higher than that of control group(Group I) from Day -6 to Day +1, but there was no significant difference of estradiol values among the hyperstimulated groups. Serum prolactin levels increased and peaked on Day +1 at a mean concentration of 60.8${\pm}$14.4ng/ml in Group II, 34.2${\pm}$7.0ng/ml in Group III, 30.1${\pm}$5.7ng/ml in Group IV respectively, but no significant elevation was observed in Group I. Levels of estradiol and prolactin can be positively and significantly correlated in the hyperstimulated groups. However, the increase of serum prolactin levels in hMG group was significantly higher than those in clomiphene citrate/hMG or clomiphene citrate group.
Objectives: The purpose of this study is to analysis the Clinical Study Trends on Korean Medicine Treatment for Polycystic Ovary Syndrome. Methods: The key words such as 'polycystic ovary syndrome', 'polycystic ovarian syndrome', 'korean medicine', 'herbal medicine', 'acupuncture' are used for the research through 'OASIS', 'KCI', 'KISS', 'RISS'. Results: Ten clinical studies with 73 patients were selected. All studies were the noncomparative studies, and 8 case reports, 1 case series, 1 retrospective chart review. Symptoms accompanied by PCOS were oligomenorrhea, amenorrhea, irregular menstruation, hirsutism, acne, obesity etc. The most used treatment was herbal medicine in all studies with 72 patients (98.6%). The most frequently used acupuncture and moxibustion point was respectively 合谷 (LI4) and 關元 (CV4). The duration of treatment was between 3 months and 10 months, the average 159 days. Outcome measurements were Recovery of menstrual cycle (97.6%), Hormone test (23.8%), Sonogram (61.9%), Indexes of obesity (23.8%). In terms of menstrual recovery, 35 patients (85.4%) have recovered from menstruation in 8 studies with 41 patients. In hormone tests, all 10 patients have decrease of LH/FSH ratio and LH in 3 studies with 10 patients. Through sonogram, Ovulation menstruation was confirmed in all 6 patients. In all 10 patients of 3 studies evaluating weight before and after treatment, weight was reduced. Conclusions: The effect on Korean Medicine treatment for Polycystic Ovary Syndrome had mostly positive results. However, Further large, well-designed clinical trials are needed to establish the foundation of Korean Medicine treatment for Polycystic Ovary Syndrome.
Objective : The purpose of this study was to assess the relationship between the premenstrual changes and stress perception in women with premenstrual changes($PMC^+$)(n=32) and those without premenstrual changes($PMC^-$)(n=62) by using prospective method. Method : The women who were older than 30 years of age and healthy were asked to complete a daily rating form based on DSM-IV diagnostic criteria for one menstrual cycle to assess the changes of psychological and physical symptoms across the menstrual cycle. They also completed 5-point likert scale to assess the perception of stress. Percent changes method was used to assess changes between follicular phase and luteal phase. Results : 1) No significant differences were found in demographic factors(age, education, marriage, employment) and risk factors(onset ages of menarche, regularities of premenstrual changes, duration of menstruation, cycle length, amount of menstruation, dysmenorrhea) between women with and without premenstrual changes. 2) There was a significant difference in mean luteal phase stress score between women with($1.92\pm0.63$) and without premenstrual changes($1.51\pm0.42$)(p<0.05). However no difference was found in mean follicular phase stress score between two groups($PMC^+$ : $1.67\pm0.43$, $PMC^-$ : $1.33\pm0.39$). 3) We divided women having premenstrual changes into two groups, higher stress group(stress score > 1.75(median)) and the lower stress group(stress score <1.75(median)). The higher stress group reported more luteal psychological symptoms than did the lower stress group(df=1, F=13.362, p<0.001). However, the groups did not differ in physical symptoms. Conclusion : In women with premenstrual changes, luteal stress score was higher than follicular stress score and this result suggested tha the perception of stress was related to psychological symptoms but not physical symptoms. These findings suggested that premenstrual change is associated with the stress level, and that it is important to manage the stress which is focused on the management of psychological symptom in the treamtment of prementrual syndrome.
Objectives : A large of studies have found an association between premenstrual syndrome and affective disorder, in particular, depression. Some studies have reported that women with depressive disorders may experience menstrual cycle-associated changes in the severity of their symptoms. This study was designed to compare the characteristics of premenstrual changes between control group and affective patient group, and to assess possible risk factors for premenstrual changes in patients. Methods : Eighty normal controls and eighty outpatients given maintenance therapy with fixed dose for at least more than four weeks were asked to complete questionnaires on menstrual history, obstetric-gynecological history, and functional impairment. In addition, to compare the characteristics of premenstrual changes, 16 items based on DSM-IV criteria A for premenstrual dysphoric disorder were rated on the following scale : 0(no change), 1(mild), 2(moderate), 3(severe). Moderate or severe change in each item was considered as premenstrual change and the subjects who reported more than one premenstrual change were defined as premenstrual change group. Results : The results were as follows : 1) The percentage of premenstrual change group was 32.6% in patient group and 50% in control group. 2) Frequently reported premenstrual changes were as follows in control group : breast tenderness; anger ; affective liability ; lethargy, easy fatigability, or marked lack of energy ; abdominal pain or discomfort. In patients, the mood or behavioral changes were frequently reported. The changes were as follows : lethargy, easy fatigability, or marked lack of energy ; change in appetite; affective liability ; sense of difficulty in concentrating : hypersomnia or insomnia. 3) In the premenstrual change group, the patients with only mood or behavioral changes were significantly more than those with only physical changes or both changes. 4) The severity of functional impairment was significantly correlated with the frequency of mood or behavioral changes in patients. 5) There were no significant differences in menstrual characteristics between patients with premenstrual changes and patients without them except the severity of dysmenorrhea. And the severity of dysmenorrhea was correlated with the frequency of premenstrual change. Conclusion : The proportion of patients with affective disorder, who reported moderate-to-severe premenstrual changes, experiencing mood or behavioral changes larger than those experiencing physical changes during premenstrual period. It is possible that some patients with affective disorder, who reported premenstrual mood or behavioral changes, suffer from coexisting premenstrual syndrome with affective disorder or premenstrual exacerbation of affective disorder. Since the more premenstrual changes, the severer functional impairment, the patients reporting mood or behavioral disturbance in premenstrual period should be carefully evaluated, and appropriate therapeutic stategies might be considered.
As the cytogenetic developed, cytogenetic study has also developed progressively. This study is a systematical cytogenetic and clinico-hormonal analysis of 20 cases Wp.ere gonadal dysgenesis was diagnosed and deferred to the Dept. of obstetrics and Gynecology, Yonsei University, Medical School from Jan. 1974 to Aug. 1983. Twenty patients with the diagnosis of gonada dysgenesis have been assesed as to possible correlations between clinical, homonal and cytogenic findings. The desults were as follows; l. Gonadal dysgenesis were found in 20 cases, consisting of 15 cases (75%) of turnurs syndrome, 4 case of pure gonadal dysgenesis (20%), 46. XX and 1 case of mixed gonadal dysgenesis, 45,XO/46,XY. 2. Patients with XO karyotype, turner's ryndorme, have a resonably constant clinical picture of sexual infantilism with streak gonads, short status and webbed neck. 3. 17 cases were found primary amenorhea and two cases were noted with 2 ndary amenorrhea. one case has been presented with menstruation. 4. The rudimentary streak gonads were found in 7 cases of 8 cases and one case has a rudimentary streak gonad on one side and a testis on the contralateral side. 5. The study showed that potients with gonadal dysgenesis had an average of about 4-8 times higher basal FSH and about 3-7 times higher basal LH than that of the early follicular phase of normal menstrual cycle. 6. Two cases of three gonadal dysgenesis patieats, who performed LH-RH challage test, showed that the serum FSH levels reached the maximal level at 30 min after injection of CHRH and the serum LH level reached the maximal level at 60 min ofter injection of LHRH one case showed no significant response to LH-RH injection. Thus, bu studying simultoneously the clinical, cytogenic, hormonal aspects and visualization of gonads, we have gained some practical insight into the requirements for proper disgnosis and treatment.
Purpose: The aim of this study was to examine the effect of oriental diagnosis and treatment for dysmenorrhea patients on lower abdominal temperature and Skin Resistance Variability(SRV). Methods: We studied twenty-five dysmenorrhea patients, who visited Oriental Medicine Hospital of ${\bigcirc}{\bigcirc}$ University for 10 months(Sep. 2011~Jun. 2012). Patients with organic disease such as endometriosis, uterine myoma and pelvic inflammatory disease were excluded from this study. We prescribed 3 types of treatments, herbal medicine, acupuncture, and moxibustion, for one menstrual cycle. Digital Infrared Thermographic Imaging(DITI), 7-Zone-Diagnostic System(CP-6000A), VAS(Visual analog scale) and MVRS(Multidimensional verbal rating scale) were conducted before and after the treatment. The result of DITI, 7-Zone-Diagnostic System, VAS and MVRS before and after treatment were compared in order to objectively assess the therapeutic effect. Results: When we compared the results of DITI, CV4 temperature after treatment was increased compared with that of before, and temperature difference between CV12 and CV4 after treatment was decreased compared with that of before. But there was no significant difference. When we compared the results of 7-Zone-Diagnostic System at 1st and 2nd trial, the height of 1~5 area was lower than that of before. And at 1st and 2nd trial, the height of 6, 7 area was higher than that of before, but there were no significant difference in most. When we compared the results of VAS and MVRS, VAS and MVRS after treatment was significantly decreased compared with that of before(p<0.01). Conclusions: This study shows that oriental diagnosis and treatment for dysmenorrhea patients affects the results of DITI. Further study will be needed.
Purpose: Although premsnstrual syndromes(PMS) have long been recognized, there has been difficulty to evaluate the symtoms. Usually the questionnaire has been used to dignose the PMS. Objective is to investigate the relationship of body temperature between women with PMS and without PMS. Methods: We studied 23 patients visiting OO hospital from 26th December 2005 to 26th April 2006. The Questionnaire for PMS was used to evaluate physical, emotional, and behavioral symptoms accompanying the menstrual cycle of the subjects. The subjects were categorized in two groups, non-PMS(11) and PMS group(12). Body temperature was assessed by Dorex spectrum 9000MB (DOREX Inc., USA). We measured CV4, CV3, CV12 and CV17 to evaluate the distribution of body temperature, compared the difference of temperature(${\Delta}T$) between CV17-CV4, CV17-CV3, CV17-CV12 and CV12-CV3. We investigated the of temperature and ${\Delta}T$ between two groups by Mann-Whitney U-test. Results: The temperature of CV3 and CV4 of PMS located in low abdomen were lower than those of non-PMS located in chest. But there was no statistical significance of temperature between two groups. There was lower temperature of low abdomen in PMS group than non-PMS group without statistical significance. Conclusion: The results suggest that DITI could be useful to assess the PMS objectively. But more research should be needed.
여성의 난소기능은 뇨중 Oestrone-3-glucuronide를 간편한 solid-phase 의 화학발광성 면역학적 측정법 (Chemiluminescence Imrnunoassay(CIA) 에 의하여 그 기능이 탐지될 수 있다. Oestrone-3-g1ucuronyl-6-bovine serum albumine에 대한 antiserum의 IgG fraction은 polystyrene 실험관벽에 흡착시켰으며, 항원으로서는 est r one-3- gl ucuronyI-6-aminoethyl-ethyl-isoluminol 을 항원 (antigen) 에 labeI 시킨 것이다. 시험 대상물인 뇨는 매일아침뇨(early morning urine) 을 희석 (1:1000 V/V)한 후 100mcl 를 취하여 이를 각기 이중분석액으로 택하였다. 시험관 내에서 결합반응 (1 hour at $4^{\circ}C)이 일어난 후에는 시험관내의 액체를 전부 흡입 폐기시켰으며, 항체반응이 일어난 후 ( antibody-bound fraction )에는 완충액 (400mcl)으로 한번 세척시켰다. 그후 염화수산화물(2N , 200mcl)을 가지고 $22^{\circ}C$에 60 분간 방치 혼합케 한 후 효소(microperoxidase) 와 과산화수소를 가하면서 산화작용에서 발생되는 발광양을 10초동안 측정하여 그 결과를 분석하였다. 위에 기술한 분석방법을 평가하면 다음과 같은 결론을 얻었다. Calibration curve sensitivity$3.12{\pm}0.75$ PG/tube ($mean{\pm}SD$)였고, lntra-assay precision(CV%) 9.52 (20 replicates;$38.4{\pm}3.66$nmol/1) 와 8.81 (15 replicates; $102.4{\pm}8.82$nmol/1)였다. Inter-assay precision(CV%) 은 11.9 (mean of 4 pools-7.03, 23.16, 52.11 과 117.53 nmol/1)로 2개월 동안에 걸쳐 시행되었고, 평균 비이어스(mean bias)는 -0.78 로 28에서 448 nmol 범위로서 매일아침 "뇨"의 차이분(different aliquots)은 좋은 결과를 얻었다. 건강한 여성으로부터 채취된 뇨중 Oestrone-3-glucuronide 의 농도(nmol/1)를 보면 월경주기의 여포기와 배난기 및 황체기에 있어서 각기 $40.2{\pm}9.9$ , $102.3{\pm}39.4$와 $84.3{\pm}13.3$nmol/1였다. 이와같은 결과는 동일한 검사뇨를 방사면역학적 방법(RIA)으로 측정 (6 menstrual cycle)한 결과와 유사한 측정치를 얻으므로서 간편하고 진보된 좋은 방법중의 하나라고 사료되는바이다.
Purpose : To investigate and compare the characteristics of menstruation in the shift workers and the day workers, and present guidelines for health promotion of the shift-working women. Methods : Questionnaires including general health condition and QSCC II were distributed to shift-working women and day-working women in one university hospital in Gyeonggi-do and 36 questionnaires of shift-working women and 33 of day-working women were analyzed. Results : Day workers were about 5 years older than shift workers on average. There was more irregularity of menstrual cycle and period in day-working group but it is thought to incorrect because of the age problem. There were more women who have dysmenorrhea in day-working group, but the proportion of dysmenorrhea which continues more than 72 hours -which is very suggestive of secondary dysmenorrhea- was higher in shift-working group. Average VAS of dysmenorrhea was nearly the same in two groups. The life of shift-working group was lesser satisfactory than that of day-working group. There were more sleep disturbances in the shift-working group. Sasang constitution was analyzed in both group using QSCC II, and Taeumin were more in shift-working group. Conclusion : As the number of shift-working women increases, needs for oriental medical treatments would increase because it is more natural and lesser invasive managements which women are very interested in. So it is thought to be necessary to understand health problems of shift-working women, and prepare guidelines for managements and treatments to promote the health of shift-working women.
The natural growth rate of the Korean population has decreased from 3.0% in 1960 to 1.0% in 1990. This was done with family planning program which was introduced by the government in 1961. The family planning program focused on birth control rather than the characteristics of the individuals and motivations of contraception. People were simply forced to use the method. Whereas, Natural Contraceptive is a method of family planning based solely on the timing of intercourse with the naturally occurring' physiological manifestation of fertilization and in fertilization during the menstrual cycle. This is the combination of self fertility awareness with periodic abstinence. Natural family .planning(NFP) programs in Korea were first started in the Chun-Chen diocese of catholic church by Bishop Thomas Stewart in 1970 In 1975, the Bishops conference launched the Korea Happy Family Movement in the Catholic Hospital Association, to promote the natural family planning. An average of 70,000 people, including adolescents, college students, unmarried and married persons, arid the clergies were trained during a six-year period (1986-1991). 61.5%(24,542 people) of those who completed 3 cycles during 6 year period (1986-1991) became autonomous users and the range was from 48.1% to 78.2%. In 1986, 22.7% of NFP individuals who drooped out of the program because of the desire for conception (23.4%), the difficulty of the method used(25.8%), and the loss of interest(22.8%). During the six-year period the unplanned pregnancy rate at the NFP was 2.9%. The range of the pregnancy rate was at 1.2-9.8%. The rate was decreased as years passed. The major reason for the failure of contraceptive was error by the individuals(61.1%). The percentage of the success of conception was 18.1% of 2.979 for achieving pregnancy. The highest percentage was 58.2% (99 users) in Kwang-Joo diocese and next was 37.1% (10 users) in Chong Joo diocese.
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