• Journal of Yeungnam Medical Science
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• 제26권2호
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• pp.102-107
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• 2009

변비는 우리나라나 서구국가에서 가장 흔한 질환중의 하나로서 생활 습관, 식이, 육체적 활동, 스트레스등과 밀접한 관련이 있다고 한다. 그리고 가임기의 여성에서 남성보다 빈도가 높으며 그 이유는 여성호르몬에 의한 대장운동성 저하때문이라고 한다. 본 연구는 로페라미드 투여에 의한 변비 쥐에서 프로바이오틱스가 장운동과 변비에 미치는 영향을 알아보기 위하여 시행되었다. 로페라미드 투여는 쥐에서 변량은 감소시킨 대신에 변 pellet수는 증가시켰다. 변의 수분함량은 로페라미드 투여에 의하여 감소하였으나 건조 변량은 실험군간의 유의한 차이는 없었다. 따라서 로페라미드는 장 운동 감소에 의하여 변비를 유발하는 것으로 생각되었다. 프로바이오틱스의 투여는 로페라미드에 의하여 발생한 장 운동 저하와 변비를 완화시켜 주는 것으로 나타났다. 이상의 결과로 미루어 보아 프로바이오틱은 로페라미드에 의한 장 운동 감소 및 변비발생을 예방 또는 치료해 줄수 있는 것으로 생각되었다.

• Clinical and Experimental Reproductive Medicine
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• 제26권3호
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• pp.419-432
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• 1999

Objective: To establish the evaluation system of the quality of oocytes on the basis of the incidence of cumulus cells apoptosis, to investigate the relationships beween the incidence of cumulus cells and the outcomes of IVF-ET. Method: Thirth-four cycles undergoing controlled ovarian hyperstimulation for IVF-ET with tubal infertility (23 cycles) or unexplained infertility (11 cycles) were included in this study. Cumulus cell masses surrounding mature oocyte and co-culture of embryos with autologous cumulus cells during IVF-ET process. The incidence of apoptosis in cumulus cells was assessed by apoptosis detection kit fluorescein. The effect of co-culture using cumulus cells and the incidence of cumulus cells apoptosis. Results: The results were as follows: 1. The incidence of apoptosis in cumulus cells markedly increased in patients aged 40 or over, while the fertilization rate was greatly decreased in those age group. 2. Apoptosis in cumulus cells was found in both the fertilized oocytes and unfertilized oocytes, but the incidence of apoptosis was higher in unfertilized oocytes. 3. There is no clear correlation between apoptosis in cumulus cells and the number of oocytes retrieved. However, the incidence of apoptosis was increased when the number of oocytes retrieved was 5 and fewer in comparison with $6{\sim}10$. 4. Embryo grade was significantly affected by the incidence of apoptosis in cumulus cells. 5. Pregnancy rate of IVF-ET per cycle was 29.4%, and the pregnant group had the higher fertilization rate and a significantly lower incidence of apoptosis in cumulus cells compared with the nonpregnant group. 6. When cumulus cells were used as helper cells in the co-culture of the embryo, in vitro activity of cumulus cells based on morphological change and proliferation did not influence the quality of embryo, but was closely associated with the implantation rate and pregnancy rate, which was enhanced when morphological changes and proliferation of cumulus cells was more active. 7. This difference in the outcome of IVF-ET according to in vitro activity of cumulus cells used for co-cultue was not associated with the incidence of apoptosis in cumulus cells; but rather had likely relations with the different secretion pattern of protein, which may be an embryo trophic factor by cumulus cells. Conclusion: These results suggest that the incidence of apoptosis in cumulus cells can be used in predicting oocyte qualities and the outcomes of IVF-ET. And the effect of co-culture largely depends on the in vitro activity of cumulus cells as well.

• Clinical and Experimental Reproductive Medicine
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• 제26권3호
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• pp.355-362
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• 1999

Objective: This study was performed to compare the clinical response to controlled ovarian hyperstimulation (COH) of in vitro fertilization and embryo transfer (IVF-ET) according to the size of baseline ovarian cyst. Method: From February 1992 to March 1999, a retrospective analysis was done of 272 cases who underwent COH using mid-luteal phase long protocol of gonadotropin-releasing hormone agonist (GnRH-a) for IVF-ET. These cases were divided into four group; group 1 (n=63) had cysts with mean diameters between 20.0 and 29.0 mm on their baseline ultrasound on cycle day 3, group 2 (n=57, $30.0{\sim}49.0mm$), group 3 (n=68, >50.0 mm) and control group (n=84). Cases were excluded according to the following criteria; pure male factor infertility, the presence of only one ovary, high CA-125 level and previous endometriosis. Results: There were no statistically significant differences between cases with baseline ovarian cyst <50.0 mm in diameter and control group in any of the parameters. However, cases with baseline ovarian cyst>50.0 mm in mean diameter needed more amount of human menopausal gonadotropin (hMG), showed significantly lower estradiol ($E_2$) level, the number of follicle >15.0 mm on the day of human chorionic gonadotropin (hCG) administration, the number of oocytes retrieved, the number of mature oocytes, and pregnancy rate compared with control group. Conclusion: This study suggests that cases with baseline ovarian cyst <50.0 mm in diameter do not adversely impact on IVF-ET outcome. However, cases with baseline ovarian cyst >50.0 mm in diameter had adverse effects on various parameters. Therefore, to improve the outcome of IVF-ET in these cases, ovarian cyst aspiration prior to initiating COH may be required.

• 대한한방부인과학회지
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• 제36권4호
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• pp.40-48
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• 2023

Objectives: The purpose of this study is to investigate safety of postpartum herbal medicine by assessing the effect of taking herbal medicine of postpartum period on liver function. Methods: A retrospective chart review was conducted on 167 mothers who underwent liver function tests (LFT) within 3 months before and after childbirth among mothers who gave birth at ○○ Hospital between January 1, 2016 and May 31, 2018. Mothers with abnormally elevated LFT during pregnancy were excluded. Among 167 women, 6 women are herbal-medicine-group took herbal medicine for 5-6 weeks during postpartum period, and 161 patients are general -group who did not take herbal medicine. LFT Variation of Subjects before and after childbirth were compared between the two groups. And subjects who had elevated liver levels above the normal range after delivery were classified separately, the characteristics and causes of changes in liver levels were analyzed, and the presence or absence of drug-induced liver damage was confirmed. Results: Among a total of 167 subjects, there were 5 women in the herbal-medicine-group and 150 women in the general-group who had changes in liver values within the normal range after childbirth. Aspartate transaminase (AST) change before and after childbirth in the herbal-medicine-group was 3.40±1.82, and AST change in the general-group was 2.92±8.59, showing no significant difference between the two groups (p=0.901). Increase of Alanine transaminase (ALT) before and after childbirth in the herbal-medicine-group was 5.60±3.65, and ALT change in the general-group was 8.01±11.81, showing no significant difference between the two groups (p=0.651). There were 12 subjects who had elevated AST, ALT above the normal range after delivery, including 1 in the herbal-medicine-group and 11 in the normal mothers group. Valuation of 1 Subject of the herbal-medicine-group before and after delivery was 17 IU/L of AST and 52 IU/L of ALT. Because results of AST, ALT is under the standard to diagnose to liver damage, she was observed without any treatment. However the cause of AST, ALT elevation was not found in the chart, she was receiving treatment for diabetes and hyperlipidemia. The general-group had an average increase of AST 35.64±22.67 IU/L and ALT 53.00±26.80 IU/L. As a result of analyzing the cause, there were direct causes such as autoimmune hepatitis, chronic hepatitis B, and acute pyelonephritis. Abnormal elevations in liver levels were also found in mothers with hypothyroidism, diabetes, and fever of unknown cause, although they were not direct causes. Conclusions: To investigate the safety of taking herbal medicines, we assess the variation in AST and ALT within 3 months before and after delivery in the herbal-medicine-group and general-group. There was no significant difference between two groups.

• Clinical and Experimental Reproductive Medicine
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• 제26권3호
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• pp.467-474
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• 1999

Objectives: Cytogenetic investigations were carried out on 770 women with primary (n=560) and secondary amenorrhea (n=210) to determine the frequency of chromosomal or genetic causes of amenorrhea. Materials and Methods: In 770 women with primary amenorrhea (n=560) and secondary amenorrhea (n=210), chromosomal analysis were performed. Results: 1) The most prevalent age group is 16-20 years of age group with primary amenorrhea and 26-30 years of age group with secondary amenorrhea. 2) Out of 560 cases of primary amenorrhea, 343 cases (61.3%) had the normal chromosome constitution and 217 cases (38.7%) had the abnormal chromosome constitution including 46,XY. 3) In 217 cases of abnormal chromosome of primary amenorrhea, 57 cases (26.3%) had 45,X and 34 cases (15.8%) had the 46,XY, 24 cases (11.0%) had 45,X/46,X,i (Xq), 23 cases (10.6%) had 45,X/46,X,+mar and 14 cases (6.6%) had 45,X/46,XY. 4) Out of 210 cases of secondary amenorrhea, 181 cases (86.2%) had the normal chromosome constitution and 29 cases (13.8%) had the abnormal chromosome. 5) In 29 cases of abnormal chromosome of secondary amenorrhea, 7 cases (24.1%) had 45,X/46, X,i (Xq), 4 cases (13.8%) had 45,X/46,XX. Conclusion: High percentage of chromosomal abnormalities was diagnosed in primary amenorrhea and most of them were sex chromosome anomalies. In secondary amenorrhea, the prevalence was lower than primary amenorrhea, so a preselection of patients with secondary amenorrhea for cytogenetic investigations seems to be necessary.

• 대한한방부인과학회지
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• 제27권2호
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• pp.46-58
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• 2014

Objectives: This study was designed to investigate intestinal immune system activation and anti-metastatic effect on cancer cells by orally administered extracts of Boyanghwano-tang. Methods: To observe immunomodulating effects of Boyanghwano-tang on Peyer's patch cells, we measured cytokines GM-CSF, IL-4. In addition to observing effects of Boyanghwano-tang on hematopoiesis, we measured proliferation of bone marrow cells mediated by Peyer's patch cells in vitro. IgA induction activated in intestinal content and serum was measured to observe the effect of orally administered Boyanghwano-tang on mucosal immune system. After administering ovalbumin (OVA) with Boyanghwano-tang, Proliferation of Peyer's patch cell was measured to investigate gut immunostimulatory effect. Anti-metastatic experiments were conducted in vivo mouse model by using colon 26-M3.1 carcinoma cell. Results: The amounts of GM-CSF and IL-4 in the culture supernatant of Peyer's patch cells were significantly increased compared to the control group. The proliferation of bone marrow cell was significantly up-regualted with Boyanghwano-tang. These results indicate that oral administration of Boyanghwano-tang enhances the secretion of hematopoietic growth factors such as GM-CSF and IL-4 from Peyer's patch cells, and these cytokines also act on modulator of bone marrow cell proliferation. After orally administering OVA with Boyanghwano-tang, IgA induction and Proliferation of peyer's patch cell was up-regulated with Boyanghwano-tang. These results means orally administered Boyanghwano-tang activates intestinal immune system and has an inhibitory effect on tumor metastasis. In addition, We found that orally administered Boyanghwano-tang significantly inhibited tumor metastasis in vivo. Conclusions: Orally administered Boyanghwano-tang appears to have considerable activity on the anti-metastasis by activation of immune system.

• 대한한방부인과학회지
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• 제27권4호
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• pp.1-14
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• 2014

Objectives: This study was designed to investigate the anti-tumor metastasis by anti-inflammatory and innate immunomodulating effects of extracts of Jipae-san on cancer cells. Methods: Antimetastatic experiments were conducted in vivo mouse model by using 4T1 mouse mammary carcinoma cells. Cell viability of Jipae-san was tested with 4T1 mouse mammary carcinoma cells, colon 26-M3.1 carcinoma cells and macrophage. In addition expression of $TNF-{\alpha}$ and NO induced by LPS was measured after treating with Jipae-san. To observe innate immunomodulating effects of Jipae-san on macrophage, we measured $TNF-{\alpha}$, IL-12, IL-6 and MCP-1, respectively. Cell cytotoxicity was tested with the macrophage stimulated with Jipae-san and we evaluated the activation of $TNF-{\alpha}$ and NO. And the effect of Jipae-san on metastasis was measured without NK-cell using GM1 serum. Results: Intravenous inoculation of Jipae-san significantly inhibited metastasis of 4T1 mouse mammary carcinoma cells. In an in vitro cytotoxicity analysis, cell growth are closer to 100% less than $1,000{\mu}g/ml$ concentration. The expression of $TNF-{\alpha}$ and NO induced by LPS after treating Jipae-san was down regulated in dose-dependent manner. Level of cytokines such as $TNF-{\alpha}$, IL-12, IL-6 and MCP-1 of Jipae-san group were up regulated in compared to the control group. The macrophage stimulated with Jipae-san significantly inhibits the cancer cell at ratio of 10:1, 20:1. The activation of NO was significantly up regualted in a group of 5:1, 10:1, 20:1. The depletion of NK-cells by anti-asialo GM1 serum partly abolished the inhibitory effect of Jipae-san on tumor metastasis. Conclusions: Jipae-san appears to have considerable activity on the anti-metastasis by inflammation control and activation of innate immune system.

• Radiation Oncology Journal
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• 제18권1호
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• pp.40-45
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• 2000

목적 : 수술 및 수술 후 보조적 방사선치료를 시행한 자궁내막암 환자의 예후인자, 재발 장소 및 생존율 등을 분석해 보고자 하였다. 대상 및 방법: 1991년 9월부터 1997년 12월까지 서을중앙병원에서 수술 및 방사선치료를 받은 27예의 자궁내막암환자를 대상으로 하였다. 수술은 단순자궁적출술이 6예, 단순자궁적출술 및 림프절 절제술이 8예, 근치적 자궁적출 술이 13예에서 시행되었다. 모든 환자에서 외부 방사선치료가 시행되었으며 이 중 16예에서 ovoid를 이용한 질내조사가 추가되었다. 조사선량은 외부 방사선치료는 총 50.4 Gy를 조사하는 것을 원칙으로 하였고, 질내조사는 1회 분할선량 4$\~$5 Gy씩 4내지 5회 시행하였다. 추적기간은 6개월에서 95개월로서 중앙추적기간은 30개월이었다. 결과:FIGO 병기는 I-18예(67$\%$), II-1(4$\%$), III-8예(29$\%$)이었고, 조직분화도는 1$\~$14예(52$\%$), 2$\~$6예(9$\%$), 3$\~$7예(26$\%$)이었다. 수술 후 조직 소견상 조직분화도가 나쁠수록, 자궁근층의 침범 정도가 심할수록, 자궁부속기의 침범이있는 경우, 림프-혈관 침범이 있는 경우 골반내 림프절이 양성을 보이는 경우가 많았으나 통계적인 의미는 없었다. 추적이 종료된 시점에서 사망한 환자가 한 예도 없어 전체 생존율은 100$\%$이었으나 3예에서 병이 재발되어 3년 및 5년 무병생존율이 각각 89.6$\%$,, 76.8$\%$이었다. 재발 장소는 골반내, 대동맥방림프절, 폐를 포함한 다발성 등이 각각 I예 이었고 질 재발은 관찰되지 않았다. FIGO 병기(p=0.01), 림프-혈관 침범(p=0.03), 골반내 림프절 침범(p=0.0001)등이 무병생존을에 영향을 미치는 것으로 나타났고 조직분화도가 나쁠수록 무병생존율이 저조한 경향을 보였다(p=0.1). 치료부작용으로는 1예에서만 Grade 1의 직장출혈이 나타났으나 중등도 이상의 합병증을 보인 경우는 없었다. 결론 : 수술후 조직학적 소견에 따른 외부방사선치료 및 추가 질내조사는 국소재발을 억제하는데 효과적인 것으로 판단되며 결과적으로 생존율을 향상시키는데 기여하는 것으로 생각된다. 다만, 병기 및 조직분화도에 따라 질내조사를 추가하지 않는 경우 질 재발이 호발하는 환자군에 대한 연구가 더 진행되어야 할 것으로 판단된다.

• Clinical and Experimental Reproductive Medicine
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• 제36권4호
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• pp.255-263
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• 2009

목 적: 한국 가임기 여성의 다낭난소증후군 진단시에 복식 초음파를 이용하는 방법의 유용성과 정확도를 분석하여 국내 다낭난소증후군의 진단 기준 마련에 도움이 되고자 하였다. 연구방법: 이화여자대학교 목동병원에서 선별설문조사를 받은 15~44세 여성 8,793명에서 복식 초음파를 시행한 총 701명 중, 정상 월경을 하면서 안드로겐 과다 및 초음파의 다낭난소 소견이 없는 정상 대조군에서 복식 초음파를 시행한 185명과 초음파 검사 소견을 제외하고 NIH 진단 기준으로 다낭난소증후군을 진단 받은 248명의 환자에서 복식 초음파를 시행한 소견을 ROC (receiver operating characteristic) 곡선 분석하였다. 결 과: 정상 대조군의 평균 연령은 $23.64{\pm}4.26$세로 복식 초음파로 측정된 평균 난소 부피는 $6.03{\pm}1.89\;cm^3$, 평균 난포 개수는 $6.49{\pm}1.93$개였다. 복식 초음파를 진단에 사용할 경우 난소 부피를 이용하면 AURC (area under the ROC curve)가 0.761로 난소 부피>$9\;cm^3$ 기준일 때, 민감도 51.0%, 특이도 91.4%였다. 난포 개수에 대한 AURC는 0.733으로 ${\geq}9$개 기준일 때, 민감도 54.9%, 특이도 87.0%였으며, 난포 개수 ${\geq}10$개 기준일 때, 민감도 53.2%, 특이도 90.4%였다. 복식 초음파로 난소 부피와 난포 개수를 검사하여 다낭난소증후군의 선별 진단에 이용하기에는 부적합하였다. 결 론: 복식 초음파를 이용하여 다낭난소증후군을 진단하는 방법은 유용성과 정확도에서 신뢰할만하지 못하다.

• Clinical and Experimental Reproductive Medicine
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• 제34권4호
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• pp.275-283
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• 2007

목 적: 본 연구에서는 생리혈에 존재하는 탈락된 자궁내막조직에서의 자궁내막증 관련 유전자들의 발현 양상과 자궁내막증 병태생리와의 관련성을 살펴보고자 하였다. 연구방법: 자궁내막증으로 확진된 환자 (n=16)와 정상 대조군 (n=26)에서 생리주기 2$\sim$3일째 Wallace catheter로 채취한 생리혈로부터 탈락된 자궁내막조직을 분리하였다. 기존의 연구들에서 보고된 12종류의 자궁내막증 관련 유전자들의 mRNA 발현 양상을 semi-quantitative RT-PCR 방법으로 비교, 분석하였다. 결 과: 생리혈에서 분리한 탈락된 자궁내막조직은 조직학적 관찰을 통해 자궁내막조직임을 확인하였다. 총 12가지 종류의 자궁내막증 관련 유전자에 대한 RT-PCR 분석에서 telomerase, c-kit, aromatase등의 mRNA 발현이 관찰되지 않았다. 세포사멸 (apoptosis)과 관련성이 있는 fas, fas ligand, bcl-2, bax 유전자와 stem cell factor, ER-$\alpha$/$\beta$, endometriosis protein-I, secretory leukocyte protease inhibitor 등의 mRNA 발현 양상은 자궁내막증으로 확진된 환자군과 대조군에서 통계적으로 유의한 차이를 나타내지 않았다. 결 론: 결론적으로 자궁내막증과 관련된 다양한 유전자들의 발현 양상을 생리혈에 존재하는 탈락된 자궁내막조직에서 분석하였지만 의미성이 있는 유전자를 동정하지는 못하였다. 이는 자궁내막조직의 생리학적 특징인 생리주기에 따른 유전자 발현의 역동적인 변화와 관련이 있을 것으로 생각된다.