• Clinical and Experimental Reproductive Medicine
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• 제26권3호
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• pp.389-398
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• 1999

Objective: This study was designed to evaluate the effects of endogenous LH surge, GnRH agonist (GnRH-a) or human chorionic gonadotropin (hCG) as ovulation trigger on pregnancy rate by intrauterine insemination (IUI). Method: Patients received daily 100 mg of clomiphene citrate (CC) for 5 days starting on the third day of the menstrual cycle followed by human menopausal gonadotropin (hMG) for ovulation induction. Follicles larger than >16 mm in diameter were present in the ovary, frequent LH tests in urine were introduced to detect an endogenous LH surge. Final follicular maturation and ovulation were induced by GnRH-a 0.1 mg (s.c.) or hCG $5,000{\sim}10,000$ IU (i.m.) administration except natural ovulation. Pregnancy was classified as clinical if a gestational sac or fetal cardiac activity was seen on ultrasound. Results: There were no differences in age, duration of infertility and follicle size, but more ampules of hMG were used in GnRH-a group compared to hCG 10,000 IU treated group (p<0.05). Lower level of estradiol ($E_2$) on the day of hCG or GnRH-a injection was observed in hCG 10,000 IU group than other treatment groups (p<0.01). The overall clinical pregnancy rate was 19.8% per cycle (32/162) and 22.2% per patient (32/144). Pregnancy rate was higher in natural-endogenous LH surge group (37.5%, 9/24) than GnRH-a (18.8%) or hCG treated group (20.9% & 13.9%), but this difference was not statistically significant. No patient developed ovarian hyperstimulation. Abortion rate was 22.2% (2/9) in hCG 5,000 IU group. Delivery or ongoing pregnancy rate was 37.5% (9/24), 18.8% (3/16), 16.3% (7/43) and 13.9% (11/79) in endogenous LH surge, GnRH-a, hCG 5,000 IU and hCG 10,000 IU treatment groups, respectively. Conclusion: These results support the concept that use of natural-endogenous LH surge in stimulated cycles may be more effective to obtain pregnancies by IUI than GnRH-a or hCG administration.

• Clinical and Experimental Reproductive Medicine
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• 제17권1호
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• pp.29-44
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• 1990

In 105 patients with the past history of poor response to the previous controlled ovarian hyperstimulation(COH) due to poor follicular growth or premature LH surge, the effectiveness of pituitary suppression with gonadotropin-releasing hormone agonist(GnRH agonist) in IVF/GIFT program was evaluated in 112 cycles of COH using a combination regimen of Leuprolide acetate (Lupron TAP Pharmaceuticals, USA) and FSH/hMG or pure FSH from May to December, 1989 at SNUH. Starting on day 21 of the menstrual cycle(MCD #21, Day 1), Lupron (1.0mg/day, subcutaneous) was administered once a day till next MCD #3(suppression phase). After the confirmation of pituitary suppression, ovarian follicular growth was stimulated with FSH/hMG or pure FSH from MCD #3(Day + 1), and Lupron was continued with hMG or FSH until hCG administration (D 0) (stimulation phase). After suppression phase, serum E2 level decreased from 183.7${\pm}$95.1(Day 1) to 17.4${\pm}$12.3pg/ml (Day +1), and serum progesterone level from 19.17${\pm}$8.67 to 0.12${\pm}$0.05ng/ml. But there was no decresas in serum LH and FSH levels; LH from 12.74${\pm}$6.21 to 15.49${\pm}$4.93mIU/ml,FSH from 7.60${\pm}$3.84 to 8.58${\pm}$3.15 rnlU/ml. There was no occurrence of premature LH surge during COH. Eleven cycles(9.8%) were cancelled due to poor follicular growth during stimulation phase, and 3 cycles (3.0%) failed in the transvaginal oocytes fretrieval. Serum E2 level was 1366.8${\pm}$642.4 on D 0 and 1492.3${\pm}$906.9pg/ml on D+1. 7.00${\pm}$3.32 follicles(FD${\geq}$12mm) were observed on D 0, and 6.11${\pm}$4.15 oocytes were retrieved, with the oocyte retrieval rate per follicle of 95.0%. 3.59${\pm}$2.57 oocytes were fertilized and cleaved with the oocyte cleavage rate of 55.7%. In 83 IVF patients, 4.08${\pm}$2.39 embryos were transferred, and 16 pregnancies were obtained with the pregnancy rate per ET 2.39 mebryos were transferred, and 16 pregnancies were obtained with the pregnancy rate per ET of 19.3%. In 6 GIFT patients, 7.83${\pm}$3.31 oocytes were retrieved and transferred with maximum number of 6, but no pregnancy was obtained. When compared with the previous 108 cycles of COH using FSH/hMG or pure FSH regimen, the cancellation rate during COH was significantly decreased, and all the parameters of the outcome of COH including the pregnancy rate were increased. These data suggest that GnRH agonist therapy for pituitary suppression is an effective adjunct to the current gonadotropin regimens for COH in IVF/GIFT and can increase the probability of oocytes retrieval and pregnancy, especially in the previous poor responders.

• 동의생리병리학회지
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• 제21권1호
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• pp.158-164
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• 2007

Uterine leiomyoma is the most common tumor in the female genital tract. Although the tumor is benign, it is a matter of paramount importance since it often causes profuse menstrual bleeding, pressure symptoms and infertility. Nevertheless, the etiology and pathophysiology of this abnormality remain poorly understood. The traditional definitive treatment for uterine leiomyomas is hysterectomy and, even today, symptomatic leiomyomas are the leading cause of hysterectomy in Korea. Clearly, the development of a safe, effective, and nonsurgical method of treatment for leiomyoma would be of great benefit to many women. This study demonstrated growth inhibition of uterine leiomyoma cells using Haeohyultang (HT). When human leiomyoma cells were treated with Haeohyultang, cells showed dose-dependent growth inhibitory effect. Cell growth was inhibited by over 40% as determined by both cell counts and MTS assay. Reduction of cellular viability as a consequence of exposure to Haeohyultang resulted from induction of apoptosis, as assessed by DNA fragmentation, PARP cleavage, caspase 9 and caspase 3 assay. Flow cytometry analysis with uterine leiomyoma cells demonstrated sub G1 cell cycle arrest after treatment with drug Haeohyultang. But, the expression levels of p27 and p21 were not changed in Haeohyultang treated cells compared with control. However, the expression levels of clAP1 were reduced by Haeohyultang compared with control. This reduction of clAP1 data means activation of the caspase family, and then induction of PARP cleavage and apoptosis. These results suggest that Haeohyultang may be potential therapeutic approach in the clinical management of uterine leiomyoma.

• 대한불안의학회지
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• 제12권2호
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• pp.113-118
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• 2016

Objective : Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) is known to reduce the quality of sleep and is associated with various psychiatric disorders. The aim of this study was to investigate the relationship of PMS with depression, sleep qulity and sleep pattern in Korean female adolescents. Methods : Out of 867 high school female students, 400 female subjects were included in this study. All participants completed self-report questionnaires that included demographic variables, shortened premenstrual assessment form (SPAF), patient health questionnaire-9 (PHQ-9), Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), insomnia severity index (ISI) and Korean translation of composite scale (CS). A total of 394 individuals who completed the questionnaires were analyzed. Results : As score of SPAF, 143 subjects was defined PMDD group. They had more prevalence of eveningness, more depressive symptom, poorer sleep quality, and more excessive sleepiness than non-PMDD groups. Although the PMDD groups showed more menstrual dysmenorrhea, no difference was found in bleeding duration and cycle. PMS symptom had correlations with depression, poorer sleep quality and excessive sleepiness during the daytime. There was no difference in sleep duration between two groups, but PMS might have a relationship with eveningness of chronotype. Conclusions : Among Korean female high school students, the PMS might have an association with depression and poor sleep quality, and it might lead to daytime impairment due to excessive sleepiness. An appropriate evaluation of PMS could be helpful in determining the mental health condition of adolescents.

• 한국학교보건학회지
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• 제14권1호
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• pp.115-130
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• 2001

Dieting behaviors prevail among most women and are highly increasing among female adolescents who don't have to lose weight. The dieting behaviors of normal or low weight groups are highly related to the negative impact of health risk behaviors. We need a strategy for intervening in the dieting behaviors of relevant groups. With this background, a study was conducted to examine the current situation of dieting behaviors and related factors in middle school girls, and to provide guidelines for the relevant dieting group. This survey was carried out by self-questionnaires passed out to 901 middle school girls from 3 middle schools in Seoul. Data were collected from April 10th, 2000 to April 17th, 2000 and 794 respondents' data were finally selected for analysis. The instruments of this study were Shin's scale for effects of mass-media, Birleson's depression self-rating scale translated by shim, Rosenberg's self-esteem scale, Smilkstein's Family APGAR score translated by Yoon, Kim's school-related adjustment scale. The credibility of instruments was 0.41~0.83 in the pilot study and 0.70~0.86 in the main study. The summary of results was as follows: 1. The general characteristics of respondents were analyzed. In comparison of grade and dieting behaviors, the subjects of the group perceived that their body image was obeser than their real body image and their ideal body image was slenderer than their current body image. A dieter's body image was seriously distorted. 2. The dieting behaviors were analyzed. The Subjects' BMI was within the normal to low range -- they didn't have to lose weight. But actually 47.3% of the respondents were dieters. Their main dieting methods were exercise(71.8%), computer games(64.9%) such as DDR and pump, and intake reduction(64.1%). Most dieters were using desirable methods such as exercise and intake control. But unhealthy methods such as saunax, smoking and harmful drug-use were also used by a few dieters. The main reason for dieting was attractiveness. The chief resources of dieting methods were mass-media(67.8%), friends(64.3%), and parents & relatives(35.1%). Only a few subjects obtained the information from health professionals. While they were trying to lose weight, 42.1% of the subjects experienced side effects such as dizziness(45.0%), apathy(20.5%), appetite loss(18.5%), amenorrhea and the irregularity of the menstrual cycle(16.6%). 3. The relationship between dieting behaviors and factors was analyzed. Dieting behaviors were significantly related to the experience of menarche, the experience of dating with heterosexuals, perceived body image, self-esteem, depression, family's relationship, school instruction-related adjustment, school life-related adjustment, and the effect of mass-media. After that, the multiple logistic regression was used. The analysis revealed that dating, perceived body image, the experience of menarche and the effect of mass media were significant factors. In conclusion, strategies for preventing irrelevant dieting behaviors are urgently required to enhance female adolescents' ability to choose the right information from countless others and to recognize their optimum body image.

• 지역사회간호학회지
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• 제13권2호
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• pp.354-362
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• 2002

Objectives: This study was conducted to examine the relationships among perceived life stress, self-esteem, and depression in middle-aged women. Methods: Data were collected from March 30 to May 25, 2000. The study subjects were 123 middle-aged women living in Pusan. The instruments used for this study were the Perceived Life Stress scale developed by Lee (1984), based on the original scale designed by Yu, et al. (1994), Self-esteem scale developed by Rho, et al. (1997), and the Depression scale developed by Ahn (1988). For data analysis, the SPSS PC+ was utilized, by which frequency and percentage, mean and standard deviation, t-test, ANOVA, Sheffe's test and Pearson's correlation coefficients were examined. The reliability of the instruments were tested by Cronbach's $\alpha$, showing the internal consistency of 0.7328 for the self-esteem scale. and 0.8987 for the depression scale. Results: 1) The results showed a relatively low perceived life stress score in the middle-aged women with a mean and standard deviation of 363.18 and 72.92 (range: .00 - 1877.38). 2) The results showed a relatively high self-esteem score in the middle-aged women with a mean and standard deviation of 29.77 and 5.06 (range: 10 - 40). 3) The results showed a relatively high depression score in the middle-aged women with a mean and standard deviation of 39.46 and 9.38 (range: 0 - 61). 4) There were no statistically significant differences in perceived life stress by demographic related factors. 5) There were statistically significant differences in self-esteem by health status (F=8.930, p= .000) and economic status (t=4.792, p= .010). 6) There were statistically significant differences in depression by age (F=3.770, p= .0261). education (F=4.850, p= .003) and regularity of menstrual cycle (F=13.180, p= .000). 7) There was no statistically significant correlation between perceived life stress, and self-esteem in the middle-aged women (r=-.077, p= .399). 8) There was no significant correlation between perceived life stress. and depression in the middle-aged women (r= .010, p= .916). 9) There was a significant negative correlation between self-esteem, and depression in the middle-aged women (r=- .359, p= .000). Conclusion: Higher self-esteem was related to a lower depression status. Therefore, it is necessary to elevate the level of self-esteem in order to reduce the level of depression in middle-aged Korean women.

• 동의생리병리학회지
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• 제18권2호
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• pp.528-533
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• 2004

The immune system acts to protect the host from infectious agents that exist in the environment and from other noxious insults. The immune system has two functional divisions: the innate and the acquired. Both components involve various factors such as cytokines. A number of methodologies exist to assess aspects of immune function. There are large inter-individual variations in many immune functions even among the healthy. Genetics, age, gender, smoking habits, habitual levels of exercise, alcohol consumption, diet, stage in the female menstrual cycle, stress, history of infections and vaccinations, and early life experiences are likely to be important contributors to the observed variation. While it is clear that individuals with immune responses significantly below 'normal' are more susceptible to infectious agents and exhibit increased infectious morbidity and mortality, it is not clear how the variation in immune function among healthy individuals relates to variation in susceptibility to infection. Oriental medicine is an important factor contributing to immune competence. The author investigated the immune enhancement effects of Bojungikkitanggami-bang (BITB). The forced swimming test (FST) has been used as a screening model for new immune enhancement agents. In the present study, the author investigated the effects of BITB on FST and blood biochemical parameters related to fatigue, glucose (Glc); blood urea nitrogen (BUN); lactate dehydrogenase (LDH); creatinine; and total protein (TP). The author found that BITB (1 g/kg) significantly reduced the immobility time in the FST compared to the control. In addition, the contents of Glc, LDH, BUN, TP in the blood serum were increased in BITB (1g/kg)-fed group. Also, the author investigated the effects of BITB on the production of cytokines in human T-cell line, MOLT-4 cells. BITB (1 mg/ml) significantly increased the interferon (IFN)-vproduction compared with media control (about 2.2-fold for IFN-γ) at 24 h. However, BITB has not affect the production of IL-2 and IL-4. In addition, BITB increased the protein expression level of IFN-γ in MOLT-4 cells. Thus, BITB may have therapeutic value in generating or enhancing immune function in a clinical setting.

• 대한약침학회지
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• 제18권4호
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• pp.26-31
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• 2015

Objectives: This study used semiology based on traditional Chinese medicine (TCM) to investigate vital energy (Qi) behavior in women with abdominal myofascial pain syndrome (AMPS). Methods: Fifty women diagnosed with chronic pelvic pain (CPP) secondary to AMPS were evaluated by using a questionnaire based on the theories of "yin-yang," "zang-fu", and "five elements". We assessed the following aspects of the illness: symptomatology; specific location of myofascial trigger points (MTrPs); onset, cause, duration and frequency of symptoms; and patient and family history. The patients tongues, lips, skin colors, and tones of speech were examined. Patients were questioned on various aspects related to breathing, sweating, sleep quality, emotions, and preferences related to color, food, flavors, and weather or seasons. Thirst, gastrointestinal dysfunction, excreta (feces and urine), menstrual cycle, the five senses, and characteristic pain symptoms related to headache, musculoskeletal pain, abdomen, and chest were also investigated. Results: Patients were between 22 and 56 years old, and most were married (78%), possessed a elementary school (66%), and had one or two children (76%). The mean body mass index and body fat were 26.86 kg/cm2 (range: 17.7 - 39.0) and 32.4% (range: 10.7 - 45.7), respectively. A large majority of women (96%) exhibited alterations in the kidney meridian, and 98% had an altered gallbladder meridian. We observed major changes in the kidney and the gallbladder Qi meridians in 76% and 62% of patients, respectively. Five of the twelve meridians analyzed exhibited Qi patterns similar to pelvic innervation Qi and meridians, indicating that the paths of some of these meridians were directly related to innervation of the pelvic floor and abdominal region. Conclusion: The women in this study showed changes in the behavior of the energy meridians, and the paths of some of the meridians were directly related to innervation of the pelvic floor and abdominal region.

• 대한약리학회지
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• 제23권2호
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• pp.57-75
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• 1987

Two modalities of gonadotropin secretion, pulsatile gonadotropin and preovulatory gonadotropin surge, have been identified in the mammals. Pulsatile gonadotropin secretion is modulated by the pulsatile pattern of GnRH release and complex ovarian steroid feedback actions. The neural mechansim that regulates the pulsatile release of GnRH in the hypothalamus is called "GnRH pulse generator". Ovarian steroids, estradiol and progesterone, appear to exert thier feedback effects both directly on the pituitary to modulate gonadotropin release and on a hypothalamic site to modulate GnRH release; estradiol primarily affects the amplitude while progesterone decreases the frequency of the pulsatile GnRH. Steroid hormones are known to affect catecholamine transmission in brain. MBH-POA is richly innervated by NE systems and close apposition of NE terminals and GnRH cell bodies occurs in the MBH as well as in the POA. NE normally facilitates pulsatile LH release by acting through ${\alpha}-receptor$ mechanism. However, precise nature of facilitative role of NE transmission in maintaining pulsatile LH has not been clearly understood. Close apposition of DA and GnRH terminals in ME might permit DA to influence GnRH release. Action of DA transmission probably is mediated by axo-axonic contacts between GnRH and DA fibers in the ME. Dopamine transmission does not normally regulate pulsatile LH release, but under certain conditions, increased DA transmission inhibit LH pulse. Endogenous opioid acts to suppress the secretion of GnRH into hypophysial portal circulation, thereby inhibiting gonadotropin secretion. However, an interaction between endogenenous opioid peptides and gonadotropin release is a complex one which involves ovarian hormones as well. LH secretion appears to be most suppressed by endogenenous opioids during the luteal phase, at a time of elevated progesterone secretion. The arcuate nucleus contains not only cell bodies for GnRH and ${\beta}-endorphin$ but also a dense aborization of fibers suggesting that GnRH release is changed by the interactions between GnRH and ${\beta}-endorphin$ cell bodies within the arcuate nucleus. The frequency and amplitude of pulsatile LH release seem to be increased during the preovulatory gonadotropin surge. Estradiol exerts positive feedback action on the hypothalamo-pituitary axis to trigger preovulatory LH surge. GnRH is also crucial hormonal stimulus for preovulatory LH surge. It is unlikely, however, that increased secretion of GnRH during the preovulatory gonadotropin surge represents an obligatory neural signal for generation of the LH discharge in primates including human. Modulation of preovulatory LH surge by catecholamines has been studied almost exclusively in rats. NE and E may be involved in distinct way to accumulate GnRH in the MBH and its release into the hypophysial portal system during the critical period for LH surge on proestrus in rats. However, the mechanisms whereby augmented adrenergic transmission may facilitate the formation and accumulation of GnRH in the ME-ARC nerve terminals before the LH surge have not been clearly understood.

• 대한방사선기술학회지:방사선기술과학
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• 제39권3호
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• pp.429-434
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• 2016

본 연구는 일부 한국 대학생들의 골밀도와 생활습관간의 관련성을 규명하고자 수행되었다. 먼저 이중에너지 방사선흡수법(DEXA)을 이용하여 총 121명의 대학생들의 요추와 대퇴골두의 골밀도(BMD)를 측정하였고, 생활습관에 관련된 설문은 자기기입식 질문지법을 이용하여 2014년 9월부터 동년 10월까지 실시하였다. 연구대상자의 일반적인 특성과 골밀도는 빈도분석을 통해 분포를 파악하였고, 연구대상자의 신체적 특성, 식이습관, 운동습관, 생활습관에 따른 골밀도(T-Score)의 차이를 검정하기 위하여 교차분석(Chi-square test)을 하였다. 수집한 자료는 SPSS 18.0을 이용하여 분석하였다. 대퇴골과 요추의 골밀도는 평균 $0.993{\pm}0.14g/cm^2$이었고, 골다공증은 없었으며, 골감소증은 30명(24.8%), 정상은 91명(75.2%)이었다. 체질량지수(BMI)가 높을수록, 생리주기가 규칙적인 여대생이, 주 150시간 이상 걷기를 시행한 군이, 청소년기에 규칙적으로 운동을 한 경험이 있는 군이 골감소증의 비율이 상대적으로 낮았고, 일 기준 전자기기를 6시간 이상 사용한 군이 골감소증의 비율이 상대적으로 높았는데, 이는 통계적으로 유의한 관계를 보이는 것으로 나타났다. 대학생의 신체적인 특성과 식이 운동 생활습관, 특히 청소년기의 운동습관은 골건강과 관련성이 있다. 추후 청소년과 대학생에 대한 식이 운동 생활습관에 관한 가이드라인을 제시하고, 이를 정규 교육과정과 연계하는 방안을 마련하는 것이 필요할 것으로 생각한다.