• The Journal of Korean Obstetrics and Gynecology
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• v.33 no.2
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• pp.44-62
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• 2020

Objectives: The purpose of this study is to evaluate the effectiveness of herbal medicine for recovery and treatment of cervical intraepithelial neoplasia (CIN) after loop electrosurgical excision procedure (LEEP). Methods: We searched two english, one chinese and four korean database up to November 4, 2019. Randomised controlled trials (RCTs) were eligible. Primary outcome included Human papilloma virus (HPV) clearance rate and the effective ratio of treatment. And vaginal bleeding time and volume, improvement of symptoms, and recovery of wound were regarded as secondary outcomes. The risk of bias was assessed by two independent authors using the Cochrane risk of bias tool. Results: Of 47 screened, 10 RCTs were included. Number of participants per study ranged from 58 to 360. The studies which used HPV clearance rate as primary outcome were considered as low risk of bias. Most of the studies had considerable heterogeneity in terms of type of intervention, comparison and time-points for outcome measurement. Compared to LEEP alone, herbal vaginal suppository combined group showed favorable results for HPV clearance in patients (5 studies, n=627, 95% CI 1.26 to 1.55, I²=75%). And compared to LEEP alone, herbal external application also showed favorable results for HPV clearance in patients (2 studies, n=252, 95% CI 1.19 to 1.61, I²=86%). Three studies reported mild and temporary adverse events, and no serious adverse events were reported. Conclusions: The studies showed that herbal medicine can significantly effective on recovery of CIN after LEEP. However, included studies suffered from incomplete reporting, high or unclear risk of bias and substantial heterogeneity between studies. In the Future, further high-quality RCTs are needed to prove effectiveness of herbal medicine for CIN after LEEP and reduce the risk of bias.

• The Journal of Korean Obstetrics and Gynecology
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• v.19 no.2
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• pp.162-185
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• 2006

Purpose : This study was carried out to investigate the effects of Gamigwichulpajing-Tang(GGT) on the development of experimentally-induced endometriosis in rats. Materials and Methods : Endometriosis was induced in rats by auotransplanting uterine tissue to the peritoneum and devided them into three groups: (1) sham-operated group(n=8), (2) surgically induced endometriosis and untreated control group(n=8), (3)surgically induced endometriosis and GGT treated group. GGT(700mg/head) was orally administrated for 15days after operation. Then we measured the body weight, the volumes of endometriotic implants, the weight of uterus and ovary, and investigated the content of cytokines(MCP-1, $TNF-{\alpha}$, $IL-l{\beta}$) in serum and ascites. Histopathology, immunohistochemistry for COX-2, and histochemistry for mast cell in transplanted uterine tissue were performed. Results :- The $volume(mm^3)$ of endometriotic implants in GGT-treated group$(53.50\;{\pm}18.63)$ was significantly decreased(p<<0.01) compared with control group$(404.50{\pm}317.68)$. - The content(pg/ml) of MCP-1 in ascites in GGT-treated group$(4265{\pm}108)$ was significantly decreased(p<<0.001) compared with control group$(8632{\pm}1245)$. - The content(pg/ml) of $TNF-{\alpha}$ in serum in GGT-treated group$(64.5{\pm}21.6)$ was significantly decreased(p<<0.05) compared with control group$(147.1{\pm}78.2)$. - The content(pg/ml)- of $TNF-{\alpha}$ in ascites in GGT-treated group$(738.3{\pm}502.4)$ was significantly decreased(p<<0.05) compared with control group$(1245.2{\pm}362.2)$. - The percentage(%) of positive epithelial layers for COX-2 in GGT-treated group$(22.9{\pm}9.3)$ was significantly decreased(p<<0.001) compared with control group$(50.2{\pm}8.2)$. - The number of mast cells in adjacent tissue of transplanted uterine tissue in GGT-treated group$(61.4{\pm}13.9)$ was significantly decreased(p<<0.001) compared with control group$(109.3{\pm}30.2)$. - The number of mast cells in stroma of transplanted uterine tissue in GGT-treated group$(9.4{\pm}2.7)$ was significantly decreased(p<<0.001) compared with control group$(26.0{\pm}7.7)$. - Histopathologically, proliferation of endomeuiotic epithelia and stroma, and infiltration of inflammatory cells in transplanted uterine tissue of GGT-treated group were weakly observed than those of control group. Conclusion :On the basis of these results, we concluded that Gamigwichulpajing-Tang have inhibiting effects on the development of transplanted uterine tissue. And these effects may be related with decreased Production of MCP-1 and $TNF-{\alpha}$, decreased expression of COX-2, and decreased infiltration of mast cells by administration of Gamigwichulpajing-Tang.

• The Journal of Korean Obstetrics and Gynecology
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• v.19 no.2
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• pp.141-161
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• 2006

Purpose : This study was performed to investigate the effects of Sobokchukeo- Tang(SCT) on the experimentally-induced endometriosis in rats. Materials and Methods : Endometriosis was induced via the surgical autotransplantation technique in rats. A laparotomy was performed and a $4\;{\times}\;4\;mm$ of the right uterine horn was resected incised and sutured to the peritoneum. And the animals divided into control(n=8) and SCT-treated group(n=8). SCT(1,000 mg/head) was administered orally for 15 days after operation. The weights(body, left uterus, and ovaries) and concentrations of cytokines(MCP-1,$TNF-{\alpha}$, $IL-l{\beta}$) were measured. Histopathology, immunohistochemistry for COX-2, and histochemistry for mast cells of the transplanted uterine tissues were performed. Results : - The $volume(mm^3)$ of transplanted uterine tissues of SCT-treated group$(92.88{\pm}41.89)$ was significantly(p<<0.01) decreased than the control group $(404.50{\pm}317.68)$. The concentration(pg/ml) of MCP-1 in ascites of SCT-treated group$(5,256{\pm}1,209)$ was significantly(p<<0.001) decreased than the control group$(8,632{\pm}1,245)$. - The concentration(pg/ml) of $TNF-{\alpha}$ in ascites of SCT-treated group$(521.8{\pm}306.1)$ was significantly(p<<0.01) decreased than the control group$(1,245.2{\pm}362.2)$. - The percentage of COX-2 positive epithelial layer in transplanted uterine tissues of SCT-treated group$(25.0{\pm}7.3)$ was significantly(p<<0.001) decreased than the control group$(50.2{\pm}8.2)$. - The number of mast cells in the stroma of transplanted uterine tissues of SCT-treated group$(16.5{\pm}6.8)$ was significantly(p<<0.05) decreased than the control group$(26.0{\pm}7.7)$. - The number of mast cells in the periphery of transplanted uterine tissues of control group$(71.3{\pm}18.5)$ was significantly(p<<0.01) decreased than the control group$(109.3{\pm}30.2)$. - Proliferation of epithelia, infiltration of inflammatory cells, and microanglogenesis in transplanted uterine tissues of treated group were weakly observed than the control group. Conclusion : From the above results, Sobokchukeo-Tang(SCT) has an inhibitory effect on the development of transplanted uterine tissue in rats and it is related to the decreased concentration of MCP-1 and $TNF-{\alpha}$, and decreased expression of COX-2, and decreased infiltration of mast cells by administration of Sobokchukeo-Tang.

• The Journal of Korean Obstetrics and Gynecology
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• v.20 no.1
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• pp.61-83
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• 2007

Purpose: This study was performed to investigate the effects of Keukhachukeo-Tang (KCT) on the development of experimentally-induced endometriosis in rats. Methods : Endometriosis was induced in rats by autotransplanting uterine tissue to the peritoneum and devided them into three groups: (1) sham-operated group (n=8), (2) surgically induced endometriosis and untreated control group (n =8), (3) surgically induced endometriosis and KCT treated group. KCT (1,200 mg/head) was orally administrated for 15 days after operation. Then we measured the body weight, the volumes of endometriotic implants. The weight (body, left uterus and ovaries) and concentrations of cytokines (MCP-1, TNF-${\alpha}$, IL-l${\beta}$) in serum and peritoneal fluid were also measured. Histopathology, immunohistochemistry for COX-2, and histochemistry for mast cells in transplanted uterine tissue were performed. Results : - The volumes(mm$^3$) of endometriotic implants in KCT-treated group (107${\pm}$66) were significantly decreased (p<0.05) compared with control group (405${\pm}$318). - The contents(pg/ml) of MCP-1 in peritoneal fluid in KCT-treated group (6,940${\pm}$893) were significantly decreased (p<0.01) compared with control group (8,632${\pm}$1,245). - The contents(pg/ml) of TNF-${\alpha}$ in peritoneal fluid in KCT-treated group (847${\pm}$330) were significantly decreased (p<0.05) compared with control group (1,245${\pm}$362). - The percentages(%) of positive epithelial layers for COX-2 in KCT-treated group (31${\pm}$10) were significantly decreased (p<0.01) compared with control group (50${\pm}$8). - The numbers of mast cells in adjacent tissue of transplanted uterine tissue in KCT-treated group (69${\pm}$18) were significantly decreased (p<0.01) compared with control group (109${\pm}$30). - The numbers of mast cells in stroma of transplanted uterine tissue in KCT-treated group(16${\pm}$5) were significantly decreased (p<0.01) compared with control group (26${\pm}$8). - Histopathologically, proliferation of endometriotic epithelia and stroma, and infiltration of inflammatory cells in transplanted uterine tissue of KCT-treated group were weakly observed than those of control group. Conclusion : From the above results, Keukhachukeo-Tang (KCT) have inhibiting effects on the development of transplanted uterine tissue. And these effects are related to the decreased concentration of MCP-1 and TNF-${\alpha}$, decreased expression of COX-2, and decreased infiltration of mast cells by administration of Keukhachukeo-Tang.

• The Journal of Korean Obstetrics and Gynecology
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• v.32 no.1
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• pp.85-93
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• 2019

Objectives: The aim of this study was to demonstrate the benefit of Traditional Korean Medicine as an adjuvant therapy in management of mid-trimester oligohydramnios. Methods: It is a case report of a 31 year-old woman hospitalized for oligohydramnios at $24^{+4/7}$weeks of gestation. This patient diagnosed with special oligohydramnios had no abnormal findings such as fetal urinary abnormalities or other anomalies. Also, symptom of PPROM (preterm premature rupture of membrane) was not confirmed. The decoction, Gami-danggui-san (DG) was prescribed for the purpose of reducing unnecessary contraction of uterine muscle during pregnancy and promoting blood circulation and metabolism, thereby improving placental function and contributing to the increase of the fluid. DG decoction was administered twice a day until 19th of June, which was 10 days in total. During the treatment, level of amniotic fluid had been monitored by measuring AFI (amnioti fluid index). Results: After these conventional therapies, the amount of amniotic fluid increased steadily, and eventually reached the optimal level. AFI was found to be 3.2 on the $24^{+4/7}$ weeks, 8 on the $26^{+1/7}$ weeks, 11.5 on the $27^{+0/7}$ weeks of gestation. In the same periods, EFW (expected fetal weight) was also found to be increasing gradually: 545 g, 630, and 760 g. Conclusions: Our report implies the potential of herbal medicine as a effective therapy for oligohydramnios tratment. Further studies are needed to assess the efficacy of TKM herbal medicine and reveal the mechanisms of the decoction.

• The Journal of Korean Obstetrics and Gynecology
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• v.26 no.1
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• pp.25-40
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• 2013

Objectives: The object of this study was to observe the in vitro antibacterial effects of five single(Pulsatillae Radix, Patrinae Radix, Sanguisorbae Radix, Sophorae Flos, and Sophorae Radix) aqueous herbal extracts, traditionally used for treating various gynecological diseases including mastitis in Korea, against Staphylococcus aureus. Methods: Antibacterial activities against Staphylococcus aureus of aqueous extracts of Pulsatillae Radix, PatrinaeRadix, Sanguisorbae Radix, Sophorae Flos, and Sophorae Radix were detected using standard agar microdilution methods. In addition, the effects on the bacterial growth curve were also monitored at Minimal Incubation Concentration(MIC) and $MIC{\times}2$ levels. The effects on the intracellular killing and bacterial invasion of individual test materials were also observed using murine macrophage(Raw 264.7) and human mammary gland carcinoma cell(MCF-7). Results: MIC of aqueous extracts of Pulsatillae Radix, Patrinae Radix, Sanguisorbae Radix, Sophorae Flos, and Sophorae Radix against Staphylococcus aureus were detected as $0.215{\pm}0.107$ mg/ml, $0.273{\pm}0.107$ mg/ml, $0.469{\pm}0.297$ mg/ml, $11.850{\pm}8.406$ mg/ml, and $0.664{\pm}0.546$ mg/ml, respectively. MIC of Ciprofloxacin was detected as $0.469{\pm}0.297{\mu}g/ml$ at same conditions. In addition, all five single aqueous herbal extracts were also showed marked dosage-dependent inhibition of bacterial growth. The effects of intracellular killing with Raw 264.7 and inhibition of bacterial invasion with MCF-7 cells were detected, in the order of Sophorae Flos, Pulsatillae Radix, Patrinae Radix, Sanguisorbae Radix and Sophorae Radix aqueous extracts in the present study. Conclusions: The results obtained in this study suggest that all five single aqueous herbal extracts showed antibacterial effects against Staphylococcus aureus and they also showed dosage-dependent inhibitory effects on the bacterial growth. They showed the significant intracellular killing and inhibition of bacterial invasion effects. It means, all five single aqueous herbal extracts may show potent anti-infectious effects against Staphylococcus aureus for mastitis.

• The Journal of Korean Obstetrics and Gynecology
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• v.26 no.1
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• pp.41-58
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• 2013

Objectives: The object of this study was to observe the in vitro anti-bacterial and anti-inflammatory effects of three single aqueous herbal extracts(Trichosanthes Semen, Gardeniae Fructus, and Angelicae Dahuricae Radix), traditionally used for treating various gynecological diseases including mastitis in Korea, against Staphylococcus aureus and lipopolysaccharide(LPS)-activated Raw 264.7 cells. Methods: Anti-bacterial activities of three single aqueous herbal extracts against S. aureus were detected using standard agar microdilution methods. In addition, the effects on the cell viability, $PGE_2$, NO, TNF-${\alpha}$, IL-$1{\beta}$ and IL-6 productions of LPS activated Raw 264.7 cells. The anti-bacterial and anti-inflammatory effects were compared with lincomycin and piroxicam, respectively in the present study. Results: MIC of three single aqueous herbal extracts against S. aureus were detected as over 25, $4.063{\pm}2.096$ and $1.641{\pm}0.972$ mg/ml, respectively. MIC of lincomycin was detected as $0.469{\pm}0.297{\mu}g/ml$ at same conditions. In addition, $ED_{50}$ against LPS-induced cell viabilities and cytokine releases of three single aqueous herbal extracts were as follows - cell viability: 7.635, 13.761, 6.986 mg/ml, NO production : 4.808, 22.015, 2.949 mg/ml, $PGE_2$ production : 3.040, 4.312, 0.821 mg/ml, TNF-${\alpha}$ production : 9.563, 54.931, 1.240 mg/ml, IL-$1{\beta}$ production : 1.362, 1.801, 0.534 mg/ml, IL-6 production : 0.371, 0.797, 0.202 mg/ml, respectively. $ED_{50}$ of piroxicam against LPS-induced cell viabilities, NO, $PGE_2$, TNF-${\alpha}$, IL-$1{\beta}$ and IL-6 were detected as 35.179, 6.552, 1.162, 7.273, 7.101 and 5.044 ${\mu}g/ml$, respectively at same conditions. Conclusions: The results of the study showed anti-bacterial effects against S. aureus in the order of Gardeniae Fructus and Angelicae Dahuricae Radix aqueous extracts, except for Trichosanthes Semen. They also showed anti-inflammatory effects against LPS-activated Raw 264.7 cells in the order of Angelicae Dahuricae Radix, Trichosanthes Semen, and Gardeniae Fructus aqueous extracts. These three herbs are expected to be great substitutes to reduce side-effect of lincomycin and piroxicam, if the amount of those three single aqueous herbal extracts is adjusted appropriately.

• The Journal of Korean Obstetrics and Gynecology
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• v.26 no.4
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• pp.66-81
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• 2013

Purpose: This study was carried out to investigate the anti-inflammatory effects of Ligustri Lucidi Fructus water extract (LF) in the lipopolysaccharide (LPS)-induced mouse macrophages RAW 264.7 cell. Methods: Ligustri Lucidi Fructus was extracted with distilled water (2,000 ml) for 2 hours. In order to evaluate cytotoxicity of LF, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was performed. To investigate anti-inflammatory effects of LF, the concentration of nitric oxide (NO) was measured with NO assay, cytokine was measured by Bio-Plex cytokine assay, and intracellular calcium (Ca) was measured with Fluo-4 Ca assay in RAW 264.7 cell. And when p-value is below 0.05, it is judged to have the significant difference statistically (P<0.05). Results: 1. LF showed no cytotoxicity. 2. LF inhibited significantly the production of NO at the concentration of 25, 50 and $100{\mu}g/ml$. 3. LF inhibited significantly the production of interleukin (IL)-4, macrophage inflammatory protein (MIP)-$1{\alpha}$, granulocyte colony stimulating factor (G-CSF) at the concentration of 25, 50, 100 and $200{\mu}g/ml$. 4. LF inhibited significantly the production of granulocyte macrophage-colony stimulating factor (GM-CSF), vascular endothelial growth factor (VEGF) at the concentration of 50, 100 and $200{\mu}g/ml$, the interferon (IFN)-${\gamma}$ at 25, 50 and $100{\mu}g/ml$ respectively. 5. LF inhibited significantly the production of IL-$1{\beta}$ at the concentration of 50 and $200{\mu}g/ml$, the IL-5 at 25 and $100{\mu}g/ml$, the IL-12p70, MIP-$1{\beta}$ at 50 and $100{\mu}g/ml$, the regulated on activation, normal T cell expressed and secrete d (RANTES) at 100 and $200{\mu}g/ml$ respectively. 6. LF inhibited significantly the production of IL-10, interferon gamma-induced protein (IP)-10 at the concentration of $200{\mu}g/ml$. 7. LF inhibited significantly the production of intracellular Ca at the concentration of 25, 50, 100 and $200{\mu}g/ml$. Conclusions: These results suggest that LF has anti-inflammatory effect and immuno-modulating activity.

• The Journal of Korean Obstetrics and Gynecology
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• v.27 no.4
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• pp.69-87
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• 2014

Objectives: We analyzed retrospective clinical data of Korean medical institutes for infertility care and investigated current status and outcome of the Korean medical treatment of infertility as a part of foundational research for verifying validity of constructing national support system and developing appropriate policy on Korean medical treatment of infertility. Methods: We investigated data uploaded on the homepage of The Society of Korean Medicine for Subfertility (http://www.okinfertility.org) by Korean medical institutes for infertility care to get informations such as patients' age, body height, weight, methods of Korean medical treatment, cost and duration of treatment, success or failure of pregnancy and result of treatment. Results: The average age of patients was $33.1{\pm}3.8$ and the average body height was $161.2{\pm}5.3cm$ and the average body weight was $55.2{\pm}8.5kg$. The method of Korean medical treatment was Herbal medicine (97.5%), acupuncture (80.4%), moxibustion (57.7%), cupping (32.7%). The average cost of treatment was $1,160,625{\pm}882,499$ won, and the average medical cost per visit was $357,845{\pm}241,602$ won. The average duration of treatment was $11.26{\pm}10.58$ weeks, and the average number of visits per patient was $4.78{\pm}6.10$ times. The average duration of treatment was the longest in the group of infertile patients with the highest average medical cost per visit. The average pregnancy success rate was 30.9% overall, and that of the group of infertile patients was 25.8%. Conclusions: When we develop the standard project model with expectation for about 25% success rate of pregnancy and delivery in the group of patients who have idiopathic and ovulatory factors, it is desirable to perform acupuncture and moxibustion treatment 1-2 times a week with herbal medicine. The treatment period is set to at least 12 weeks. Average treatment fee maybe calculated by converting the averaged treatment cost of clinic's one month worth of daily treatment fee and medical hospital's ten day treatment fee into weekly treatment cost.

• Clinical and Experimental Reproductive Medicine
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• v.26 no.1
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• pp.89-96
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• 1999

Some of the information concerning sexual function in the male diabetes has been focused upon the problems of endocrine or semen parameters. However, the characteristics of acrosome reaction and spermatozoa concentration at the epididymis and vas deferens have scarcely been studied, and the causes of the infertility has not been critically identified. So, we designed to inspect the spermatozoa concentration and the characteristics of acrosome reaction at epididymis and vas deferens of diabetic Wistar rat induced by streptozotocin (STZ, 70 mg/kg, ip). Experimental animal was sacrificed at 3 days and 14 days after the STZ injection. In the diabetes-induced rat, the levels of insulin and glucose had a pattern of inverse proportion. The spermatozoa concentrations in caput and corpus epididymis were significantly decreased in all diabetic condition. In cauda epididymis, however, there was significant decrease in sperm concentration at 14 days onward. In diabetic rat, the spontaneous reaction rate of spermatozoa of cauda and vas deferens were significantly higher than the control group. The ARIC (acrosome reaction to ionophore challenge) value of caudal sperm was 28.7 at control, 22.1 at 3 days, and 8.3 at 14 days. In the present study the spermatozoa concentration was decreased and the spontaneous reaction rate was increased by diabetes. In ARIC-test, it is revealed that the fertility of spermatozoa of 14 days group was lower than control or 3 days group. Diabetes mellitus may be provoke the decreased fertilization rate and subsequent infertility and subsequent infertility.