• Clinical and Experimental Reproductive Medicine
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• v.43 no.4
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• pp.240-246
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• 2016

Objective: The study aimed to investigate the efficacy of intrauterine instillation of granulocyte colony-stimulating factor (G-CSF) on the day of ovulation triggering or oocyte retrieval in infertile women with a thin endometrium. Methods: Fifty women whose endometrial thickness (EMT) was ${\leq}8mm$ at the time of triggering during at least one previous in vitro fertilization (IVF) cycle and an index IVF cycle were selected. On the day of triggering (n = 12) or oocyte retrieval (n = 38), $300{\mu}g$ of G-CSF was instilled into the uterine cavity. Results: In the 50 index IVF cycles, the mean EMT was $7.2{\pm}0.6mm$ on the triggering day and increased to $8.5{\pm}1.5mm$ on the embryo transfer day (p< 0.001). The overall clinical pregnancy rate was 22.0%, the implantation rate was 15.9%, and the ongoing pregnancy rate was 20%. The clinical pregnancy rate (41.7% vs. 15.8%), the implantation rate (26.7% vs. 11.7%), and the ongoing pregnancy rate (41.7% vs. 13.2%) were higher when G-CSF was instilled on the triggering day than when it was instilled on the retrieval day, although this tendency was likewise not statistically significant. Aspects of the stimulation process and mean changes in EMT were similar in women who became pregnant and women who did not. Conclusion: Intrauterine instillation of G-CSF enhanced endometrial development and resulted in an acceptable pregnancy rate. Instillation of G-CSF on the triggering day showed better outcomes. G-CSF instillation should be considered as a strategy for inducing endometrial growth and good pregnancy results in infertile women with a thin endometrium.

• Radiation Oncology Journal
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• v.35 no.4
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• pp.349-358
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• 2017

Purpose: This study aimed to evaluate whether prophylactic extended-field pelvic radiotherapy (EF-PRT) yields better results than standard whole pelvic radiotherapy (WPRT) in patients with pelvic lymph node-positive cervical cancer treated with concurrent chemoradiotherapy (CCRT). Materials and Methods: A total of 126 cases of stage IB-IVA cervical cancer that had pelvic lymph node involvement in magnetic resonance imaging and were treated with CCRT between 2000 and 2016 were reviewed. None of the patients had para-aortic lymph node (PALN) metastases. The patients were classified to two groups, namely, those treated with EF-PRT, including prophylactic para-aortic radiotherapy, and those treated only with WPRT. The median dose to the PALN area in patients treated with EF-PRT was 45 Gy. All patients received concurrent cisplatin-based chemotherapy. Results: Overall, 52 and 74 patients underwent EF-PRT and WPRT, respectively. Patient characteristics and irradiated dose were not significantly different, except the dose to the para-aortic area, between the two groups. The median follow-up period was 75.5 months (range, 5 to 195 months). The 10-year cumulative recurrence rate of PALN for EF-PRT vs. WPRT was 6.9% and 10.1% (p = 0.421), respectively. The 10-year disease-free survival and overall survival for EF-PRT vs. WPRT were 69.7% vs. 66.1% (p = 0.748) and 71.7% vs. 72.3% (p = 0.845), respectively. Acute gastrointestinal complications were significantly higher in EF-PRT (n = 21; 40.4%) than WPRT (n = 26; 35.1%) (p = 0.046). Late toxicities were not significantly different in both groups. Conclusion: In this study, prophylactic radiotherapy for PALN does not have an additional benefit in patients with pelvic lymph node-positive cervical cancer treated with CCRT.

• The Journal of Korean Obstetrics and Gynecology
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• v.30 no.3
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• pp.92-116
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• 2017

Objectives: The purpose of this study were to researched a Korean medicine doctors' recognition about coldness of hands and feet, and developing of korean medicine clinical practice guidelines (CPG) for coldness of hands and feet. Methods: We conducted a questionnaire survey targeting 399 Korean medicine doctors belonging to the Association of Korean Medicine by e-mail and analyzed the answers. Results: 1. 86.86% of the respondents agreed about the necessity of CPG for coldness of hands and feet. 2. 84.2% of respondents wanted coding of Korean Standard Classification of Diseases (KCD) on coldness of hands and feet. 3. To diagnosis a coldness of hands and feet, the respondents used a Subjective symptoms (98.5%), Infrared thermographic imaging device (DITI) (26.32%) Heart rate variablity test (HRV) (17.04%), Thermometer (9.77%), Cold stress test (2.76%) 4. Causing of coldness of hands and feet, the respondents considered a constitution or heredity (84.71%), stress (73.66%), lack of exercise (64.91%), irregular eating habits (51.63%), Cold meals (32.83%), depression (31.33%), etc. 5. Treating coldness of hands and feet, the respondents used a herbal medicine (66.85%), acupuncture (70.7%) Pharmacopuncture (23.85%) and moxibustion (60.08%) for $10.91{\pm}8.03week$. Conclusions: We researched a Korean Medicine doctors' recognition of CPG, clinical diagnosis, treatment on a coldness of hands and feet, and policy they required.

• The Journal of Korean Obstetrics and Gynecology
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• v.37 no.2
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• pp.75-108
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• 2024

Objectives: The purpose of this study is to review the acupuncture treatment for Polycystic ovary syndrome (PCOS) in women. Methods: We searched articles in 3 search engines with keywords related to 'Polycystic ovary syndrome', 'PCOS', and 'Stein-leventhal' in February 2024. Clinical researches and case reports that used acupuncture on PCOS were included. Animal studies and non clinical data were excluded. Data on acupuncture treatment such as methods, site, duration, frequency, and period were analyzed. Results: Of 60 selected articles, there were 51 randomized controlled trials, 5 clinical trials and 4 case reports. Studies were conducted using manual acupuncture, electro acupuncture, auricular acupuncture, thread embedding acupuncture, warm needling and laser acupuncture. Most studies used more than one acupoint, and there were 78 acupoints selected for acupuncture treatment for PCOS. The most commonly used acupoint was 三陰交 (SP6)(n=50). By analyzing the network of acupoints, 關元 (CV4), 氣海 (CV6), 中脘 (CV12), 三陰交 (SP6), 血海 (SP10), 天樞 (ST25), 足三里 (ST36) were located in center of the network. The mean treatment time, number of treatments, and duration were 28.63±4.48 minutes, 34.52±29.26 times, and 98.18±38.25 days. Conclusions: The results of this study could be useful in establishing the evidence for performing standardized acupuncture treatment for Polycystic ovary syndrome.

• Clinical and Experimental Reproductive Medicine
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• v.36 no.2
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• pp.111-119
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• 2009

Objective: The aim of this study was to compare the clinical efficacy of clomiphene citrate (CC) and letrozole combined with gonadotropins for controlled ovarian stimulation (COS) in patients with CC-induced thin endometrium Methods: Fifty-one intrauterine insemination cycles performed in patients who previously had a thin endometrium (<8 mm) to ovulation induction using CC were included in this study. A CC 100 mg/day (CC+gonadotropin group, n=26) or letrozole 2.5 or 5 mg/day (letrozole+gonadotropin group, n=25) was administered on day 3~7 of the menstrual cycle, combined with gonadotropins at dose 75~150 IU every other day starting on day 5~7. We compared total dose of gonadotropin used, endometrial thickness, endometrial pattern, number of follicles ${\geq}14\;mm$ on hCG day, pregnancy rate and multiple pregnancy rate between the two groups, which were statistically analyzed using Mann-Whitney U test or Fisher's exact test, where appropriate. Results: There were no significant differences in clinical characteristics such as age, duration of infertility, number of previous IUI cycles, basal serum hormone levels and cause of infertility between the two groups. In both groups, the endometrium was significantly thicker than that of previous ovulation induction cycles using CC. No significant differences were found in the total dose of gonadotropin used, day of hCG administration, the rate of triple endometrium and pregnancy rate. The number of follicles ${\geq}14\;mm$ was significantly lower ($3.7{\pm}1.7$ vs. $2.8{\pm}1.7$, p=0.03) and the endometrium on hCG day was significantly thicker ($7.7{\pm}1.5$ vs. $9.1{\pm}1.7$, p=0.001) in letrozole+gonadotropin group compared to CC+gonadotropin group. Conclusion: The clomiphene citrate and letrozole combined with gonadotropins appear to avoid the undesirable effects on the endometrium frequently seen with CC for ovulation induction. However, in terms of adequate endometrial development or optimal follicular growth, letrozole may be more beneficial than CC for gonadotropin-combined COS in patients with CC-induced thin endometrium. Further prospective randomized controlled studies in a larger scale will be necessary to confirm our findings.

• The Journal of Korean Obstetrics and Gynecology
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• v.23 no.1
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• pp.53-64
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• 2010

Purpose: This study was performed to observe the correlation between Hot flush and pulse wave velocity(PWV), ankle brachial index(ABI) in the Climacteric women. Methods: We studied 63 climacteric women visiting OO hospital from 8th January 2007 to 22nd April 2009. The subjects were categorized in two groups, the hot flush group(37) and normal group(26). For the study, the subjects were selected by excluding the patients who receive treatment affect hot flush or have disease affect arterial states. We assessed PWV and ABI of two groups by Oscillometric method using VS-1000(Form PWV/ABI; Fukuda Denshi, Co., Ltd., Japan). From these results, we studied the correlation between hot flush and PWV/ABI by Wilcoxon Mann Whitney Test. Results: 1. It is shown that hot flush group was no significant correlation with normal group. There is no significant factor among R-PWV, L-PWV, R-ABI, L-ABI. However, L-ABI have shown relatively higher correlation with comparison to the other factors.(p-value<0.05) 2. R-PWV, L-PWV significantly increased in menopause group than in premenopause group though there is no relation to the hot flush. (p-value<0.01) Conclusion: Though the results showed no correlations between Hot flush and PWV/ABI in the Climacteric women, L-ABI showed relatively higher correlation with hot flush than others. R-PWV, L-PWV showed significant correlation between premenopause and menopause.

• Radiation Oncology Journal
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• v.24 no.2
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• pp.116-122
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• 2006

Purpose: To determine treatment policy for early stage endometrial carcinoma, we analyzed the results of postoperative radiotherapy. Materials and Methods: From Oct. 1994 to Aug. 2002, 42 patients with FIGO stage I endometrial carcinoma received postoperative radiotherapy. All patients received curative surgery and pelvic lymph node dissection was done in 25 patients. Based on the FIGO staging system, 3 were at stage IA, 21 were at stage IB and 18 were at stage IC. Histologically, there were 14 grade 1, 16 grade 2, and 12 grade 3. Nineteen patients received intracavitary brachytherapy and 23 patients did whole pelvic radiotherapy. The median period of follow-up was 41 months (22 to 100 months). Results: Five-year overall survival, disease-free survival, local control, and regional control rates of all patients were 85.0%, 87.9%, 100%, and 97.5%, respectively. All failures were distant metastases in 5 patients and two patients had simultaneous regional recurrences. There was no intrapelvic failure in patients who received intracavitary radiotherapy. Grade 3 chronic complications were found in 1 patient (4.3%), who received whole pelvic radiotherapy. Conclusion: We achieved high rates of loco-regional control and survival by curative surgery and post-operative radiotherapy. However, we need to select the type of radiotherapy based on the risk factors for recurrence to reduce the treatment-related complication.

• Clinical and Experimental Reproductive Medicine
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• v.27 no.1
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• pp.47-57
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• 2000

Objective: The effects of cryopreservation with or without coculture on the in vitro development of blastomere-biopsied 8-cell mouse embryos were investigated. This experimental study was originally designed for the setup of a preclinical mouse model for the preimplantation genetic diagnosis (PGD) in human. Methods: Eight-cell embryos were obtained after in vitro fertilization (IVF) from F1 hybrid mice (C57BL(표현불가)/CBA(표현불가)). Using micromanipulation, one to four blastomeres were aspirated through a hole made in the zona pellucida by zona drilling (ZD) with acid Tyrode's solution (ATS). A slow-freezing and rapid-thawing protocol with 1.5M dimethyl sulfoxide (DMSO) and 0.1M sucrose as cryoprotectant was used for the cryopreservation of blastomere- biopsied 8-cell mouse embryos. After thawing, embryos were cultured for 110 hours in Ham's F-10 supplemented with 0.4% bovine serum albumin (BSA). In the coculture group, embryos were cultured for 110 hours on the monolayer of Vero cells in the same medium. The blastocyst formation was recorded, and the embryos developed beyond blastocyst stage were stained with 10% Giemsa to count the total number of nuclei in each embryo. Results: The survival rate of embryos after cryopreservation was significantly lower in the blastomere-biopsied (7/8, 6/8, 5/8, and 4/8 embryos) groups than in the non-biopsied, zona intact (ZI) group. Without the coculture, the blastocyst formation rate of embryos after cryopreservation was not significantly different among ZI, the zona drilling only (ZD), and the balstomere-biopsied groups, but it was significantly lower than in the non-cryopreserved control group. The mean number of cells in embryos beyond blastocyst stage was significantly higher in the control group ($50.2{\pm}14.0$) than in 6/8 ($26.5{\pm}6.2$), 5/8 ($25.0{\pm}5.5$), and 4/8 ($17.8{\pm}7.8$) groups. With the coculture using Vero cells, the blastocyst formation rate of embryos after cryopreservation was significantly lower in 5/8 and 4/8 groups, compared with the control, 7/8, and 6/8 groups. The mean number of cells in embryos beyond blastocyst stage was also significantly lower in 4/8 group ($25.9{\pm}10.2$), compared with the control ($50.2{\pm}14.0$), 7/8 ($56.0{\pm}22.2$), and 6/8 ($55.3{\pm}25.5$) groups. Conclusion: After cryopreservation, blastomere-biopsied mouse embryos have a significantly impaired developmental competence in vitro, but this detrimental effect might be prevented by the coculture with Vero cells in 8-cell mouse embryos biopsied one or two blastomeres. Biopsy of mouse embryos after ZD with ATS is a safe and highly efficient preclinical model for PGD of human embryos.

• Clinical and Experimental Reproductive Medicine
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• v.26 no.1
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• pp.9-20
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• 1999

The genetic defects in human gametes and embryos can cause adverse effects on overall reproductive events. Biopsy of embryos for preimplantation genetic diagnosis (PGD) offers a new possibility of having children free of the genetic disease. In addition, advanced embryo culture method may enhance the effectiveness of embryo biopsy for the practical application of PGD. This experimental study was undertaken to evaluate the effects of coculture on the development in vitro of biopsied mouse embryos as a preclinical model for PGD of human embryos. Embryos were obtained after in vitro fertilization (IVF) from F1 hybrid mice (C57BLfemale/CBAmale). Using micromanipulation, 1, 2, 3 or 4 blastomeres of 8-cell stage embryos were aspirated through a hole made in the zona pellucida by zona drilling (ZD) with acidic Tyrode's solution (ATS). After biopsy of blastomeres, embryos were cultured in vitro for 110 hours in Ham's F-10 supplemented with 0.4% BSA or cocultured on the monolayer of Vero cells in the same medium. The frequence of blastocyst formation were recorded, and the embryos beyond blastocyst stage were stained with 10% Giemsa to count the total number of nuclei in each embryo. There was no significant difference in the blastocyst formation between the zona intact control group and the zona drilling (ZD) only, or biopsied groups. The hatching rate of all the treatment groups except 4/8 group was significantly higher than that of control group. In all the treatment groups, there was a significant reduction in the mean cell number of embryos beyond blastocyst stage ($50.2{\pm}14.0$ in control group vs. $41.2{\pm}7.9$ in ZD, $39.3{\pm}8.8$ in 7/8, $29.7{\pm}6.4$ in 6/8, $25.1{\pm}5.7$ in 5/8, and $22.1{\pm}4.3$ in 4/8 groups, p<0.05). When the same treatments were followed by coculture with Vero cells, a similar pattern was seen in the blastocyst formation and the hatching rate. However, in all the treatment groups, there was a significant increase in the mean cell number of embryos beyond blastocyst stage with coculture, compared with the parallel groups without coculture. In the cleavage rate of biopsied blastomeres cultured for 110 hours after IVF, there was no significant difference between coculture and non-coculture groups (87.2% vs. 78.7%). However, the mean cell number of embryos developed from the biopsied blastomeres was significantly higher in coculture group ($11.5{\pm}4.7\;vs.\;5.9{\pm}1.9$, p<0.05). In conclusion, biopsy of mouse embryos after ZD with ATS is a safe and highly efficient method for PGD, and coculture with Vero cells showed a positive effect on the development in vitro of biopsied mouse embryos and blastomeres as a preclinical model for PGD of human embryos.

• The Journal of Korean Obstetrics and Gynecology
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• v.26 no.4
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• pp.191-203
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• 2013

Purpose: This review is to figure out evidence that suggest effectiveness of Korean Medicine treatments against cervical dysplasia. Methods: Studies on cervical cancer and cervical dysplasia were searched through 6 databases: Korean Studies Information Service System(KISS), National Discovery for Science Leaders (NDSL), Korea Institute of Science and Technology Information (Korean TK), Oriental Medicine Advanced Searching Integrated System (OASIS), the Journal of Korean Medicine, and the Journal of Korean Obstetrics & Gynecology. After that, the articles were extracted with reference point of Korean Traditional Medicine. Results: 37 articles were included lastly according to selection criteria. 3 of them were case reports on cervical dysplasia, and 34 were in-vitro studies on Human Papilloma Virus (HPV) positive cancer cell. In case reports, acupuncture, moxibustion, medical herbs and pharmacoacupuncture were used for treatments of cervical dysplasia with about 3 months. Experimental studies on cervical cancer cell showed that several herbs function with clear heat, eliminate stasis (淸熱解毒, 化瘀消腫) have anti-cancer effects inducing apoptosis. Conclusions: The results of articles are not enough to use in practice. Therefore, we indicates more advanced research methodology as follows: development of Korean Medicine treatment protocol with oral and external, in-vivo experimental study, and evaluation immunity index.