Recent trends in contraceptive use among Korean adolescents: Results from a nationwide survey from year 2013 to 2015

OBJECTIVE: This study was aimed to evaluate the recent trends in contraceptive use among Korean adolescents. METHODS: Data reviewed were from the 2013–2015 Korean Youth Risk Behavior Web-based Survey, which is a stratified, multistage-sampling designed online-based research project performed annually by the Korean government to ensure a nationally representative sample of Korean adolescence. Eight questions related to the topic of contraception were reviewed for the outcome variables. RESULTS: A total of 212,538 adolescents attending middle school and high school participated in the survey, and 8,755 students among them who were sexually active were included in the study. The percentage of contraceptive use showed a steady increase from 39% in 2013 to 48.7% in 2015; however, the proportion of adolescents who have never used any kind of contraception still remains high. Highly effective methods such as oral contraceptives and intrauterine devices were used by only 10% to 15% of sexually active adolescents. CONCLUSION: The present study demonstrates the status of contraceptive use among Korean adolescents. Our data have the potential to help healthcare providers to formulate policies and develop interventions for encouraging effective contraceptive use among sexually active Korean adolescents.

Disease-specific Growth Charts of Marfan Syndrome Patients in Korea

Patients with Marfan syndrome (MFS) presents with primary skeletal manifestations such as tall stature, chest wall abnormality, and scoliosis. These primary skeletal manifestations affect the growth pattern in MFS. Therefore, it is not appropriate to use normal growth charts to evaluate the growth status of MFS. We aimed to develop disease-specific growth charts for Korean MFS patients and to use these growth charts for understanding the growth patterns in MFS and managing of patients with MFS. Anthropometric data were available from 187 males and 152 females with MFS through a retrospective review of medical records. Disease-specific growth charts were generated and 3, 25, 50, 75, and 97 percentiles were calculated using the LMS (refers to lambda, mu, and sigma, respectively) smoothing procedure for height and weight. Comparisons between MFS patients and the general population were performed using a one-sample t-test. With regard to the height, the 50th percentile of MFS is above the normative 97th percentile in both genders. With regard to the weight, the 50 percentile of MFS is above the normative 75th percentile in male and between the normative 50th percentile and the 75th percentile in female. The disease-specific growth charts for Korean patients with MFS can be useful for monitoring growth patterns, planning the timing of growth-reductive therapy, predicting adult height and recording responses to growth-reductive therapy.

Effects of Hormone Therapy on Serum Lipid Levels in Postmenopausal Korean Women

OBJECTIVES: This study was conducted to examine the effects of hormone therapy on serum lipid levels in postmenopausal Korean women. METHODS: This retrospective cohort study included 154 healthy postmenopausal Korean women. Seventy-nine women took oral estrogen (conjugated equine estrogen 0.625 mg/day or equivalent), and 75 applied estrogen transdermally using 0.1% 17beta-estradiol gel. Micronized progesterone (MP) was added to 40 women of oral group and 49 women in transdermal group. Serum levels of triglyceride, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and lipoprotein (a) were measured before, 3 and 6 month after hormone therapy. RESULTS: At baseline, mean body mass index (BMI) were lower (22.76 vs. 23.74 kg/m2) and proportion of family history of cardiovascular disease (CVD) (61 vs. 39%) were higher in oral group. In oral group, LDL-C and lipoprotein(a) levels decreased, and triglyceride and HDL-C levels increased significantly after 3 and 6 months. There was no significant change in lipoprotein levels compared to the baseline in transdermal group. There were also no differences with additional MP. Changing pattern of HDL-C during 6 months was significantly different by the route of estrogen administration. CONCLUSION: Oral estrogen therapy might be more beneficial than transdermal estrogen in terms of lipid in postmenopausal Korean women. The estrogen effects are not influenced by adding MP.

Efficacy and safety of a 24-day regimen of drospirenone-containing combined oral contraceptive in Korean women

This study assesses the efficacy and safety of a 24-day regimen of drospirenone-containing combined oral contraceptive, and demonstrates that it is an effective and safe option for contraception, releasing symptom of premenstrual dysphoric disorder and acne in Korean women.

Cytotoxic Effects of Lysophosphatidylcholine on Vascular Smooth Muscle Cells / 대한폐경학회지

OBJECTIVES: To investigate the cytotoxic effects of lysophosphatidylcholine (lysoPC), an active component of oxidized low-density lipoproteins (LDL), on vascular smooth muscle cells (VSMCs). METHODS: VSMCs were derived from rat aorta. Cell death was assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) assay, lactic dehydrogenase (LDH) assay, and DNA fragmentation assay. Apoptosis was quantified by propidium iodide staining and fluorescent activated cell sorting (FACS) analysis, and intracellular free radical production was determined using 2',7'-dichlorofluorescin diacetate (DCF-DA). In addition, the changes in caspases, bcl-2 and bax proteins were evaluated by western blot analysis. RESULTS: LysoPC over 25 microM induced more than 50% of the cell death at 10 hours on MTT assay with no change in the level of LDH. The DNA ladder pattern showed that cell death induced by lysoPC was caused by apoptosis, which was associated with increased free radical production. Vitamin E, a potent antioxidant and caffeic acid phenylethyl ester (CAPE), an inhibitor of nuclear factor-kappaB (NF-kappaB), blocked apoptosis. The casepase-3 precursor decreased and the active form of caspase-8 increased. Total bcl-2 and bax proteins did not change with lysoPC treatment, but translocation of bax from cytosole to the mitochondria membrane was observed. CONCLUSION: LysoPC induces apoptosis in VSMCs via an oxidant mechanism, dependent on NF-kappaB.

Effect of Korean Native Cimicifuga Species on Proliferation of Vascular Smooth Muscle Cells / 대한폐경학회지

OBJECTIVES: To examine the effect of extracts of Korean native Cimicifuge species on cell proliferation in vascular smooth muscle cells (VSMC). METHODS: VSMC were isolated from rat aorta. Cell proliferation was assessed by measure of bromodeoxyuridine incorporation into the cells. Differences in Reactive oxygen species (ROS) levels were examined after exposure to the extracts of Korean native Cimicifuge species using the detection reagents dichlorofluorecin diacetate. The rhizomes/roots were air-dried and milled with a commercial food mixer. Milled rhizomes/roots of each Cimicifuga species were separately extracted by 80% ethanol, absolute methanol, and 40% 2-propanol using homogenizer and evaporated under reduced pressure at low temperatures. Effects of extracts dissolved in phosphate-buffered saline (0.3 mg/mL) were examined. RESULTS: Ethanolic, methanolic or propanolic extracts of 4 Korean native Cimicifuge species (Cimicifuga [C] davurica, C. japonica, C. heracleifolia var. bifida Nakai, C. simplex) were screened. The addition of extracts of each Korean native Cimicifuge species to cells in the presence of 10% fetal bovine serum (FBS) potently inhibited cell proliferation. Significant decrease of 23%-30% was observed. Vitamin E, a potent antioxidant, inhibited 10% FBS-stimulated cell proliferation of VSMC. We also demonstrated that extracts of each Korean native Cimicifuge species decreased intracellular ROS generation induced with 10% FBS. The effect of Korean native Cimicifuge species was not species-specific and solvent-specific. CONCLUSION: TExtracts of Korean native Cimicifuge species inhibit VSMC proliferation via inhibition of intracellular ROS. These findings suggest that Cimicifuge species used for reducing menopause symptoms might be cardioprotective in women.

Impact of Medroxyprogesterone Acetate by Type of Combined Oral Estrogen on Mammographic Density in Korean Postmenopausal Women / 대한폐경학회지

OBJECTIVES: We determined if the impact of medroxyprogesterone acetate (MPA) co-administered with conjugated equine estrogen (CEE) or estropipate differed on mammographic density (MMGD) in Korean postmenopausal women. METHODS: In this retrospective study, 53 healthy postmenopausal women without prior hormone therapy (HT) use were included. Smokers, habitual drinkers, women with a body mass index > or = 27 kg/m2, and women with a history of mammoplasty or breast cancer were excluded. HT using MPA (n = 26) consisted of the following two groups: CEE (n = 10) and estropipate (n = 16). Twenty-seven untreated women served as the control group. Mammography was obtained at baseline and 1 year later, and MMGD was assessed based on the breast imaging reporting and data system (BI-RADS) by one radiologist who was blinded to treatment. In addition, the change in the proportion of the dense area after HT was assessed using the J-image program. Data were analyzed with analysis of variance and chi-square or Fisher's exact test. RESULTS: There were no significant differences in baseline clinical characteristics and MMGD among the three groups. After 1 year of HT, CEE (7/10 [70%]; P < 0.001) and estropipate (3/16 [18.8%]; P = 0.002) regimens significantly elevated the BI-RADS grade compared with controls (0%), and CEE induced a greater increase in MMGD than estropipate (P = 0.033). In addition, the proportion of dense areas assessed using the J-image program increased more with the CEE regimen (7.67%) than the estropipate regimen (1.48%), but there was no statistically significant difference. CONCLUSION: Estropipate + MPA had a less stimulating effect on MMGD than CEE + MPA in Korean postmenopausal women. The change in MMGD induced with MPA might depend on the oral estrogen preparation. A further study on breast cancer risk based on combination HT is warranted.

Impact of Medroxyprogesterone Acetate by Type of Combined Oral Estrogen on Mammographic Density in Korean Postmenopausal Women / 대한폐경학회지

OBJECTIVES: We determined if the impact of medroxyprogesterone acetate (MPA) co-administered with conjugated equine estrogen (CEE) or estropipate differed on mammographic density (MMGD) in Korean postmenopausal women. METHODS: In this retrospective study, 53 healthy postmenopausal women without prior hormone therapy (HT) use were included. Smokers, habitual drinkers, women with a body mass index > or = 27 kg/m2, and women with a history of mammoplasty or breast cancer were excluded. HT using MPA (n = 26) consisted of the following two groups: CEE (n = 10) and estropipate (n = 16). Twenty-seven untreated women served as the control group. Mammography was obtained at baseline and 1 year later, and MMGD was assessed based on the breast imaging reporting and data system (BI-RADS) by one radiologist who was blinded to treatment. In addition, the change in the proportion of the dense area after HT was assessed using the J-image program. Data were analyzed with analysis of variance and chi-square or Fisher's exact test. RESULTS: There were no significant differences in baseline clinical characteristics and MMGD among the three groups. After 1 year of HT, CEE (7/10 [70%]; P < 0.001) and estropipate (3/16 [18.8%]; P = 0.002) regimens significantly elevated the BI-RADS grade compared with controls (0%), and CEE induced a greater increase in MMGD than estropipate (P = 0.033). In addition, the proportion of dense areas assessed using the J-image program increased more with the CEE regimen (7.67%) than the estropipate regimen (1.48%), but there was no statistically significant difference. CONCLUSION: Estropipate + MPA had a less stimulating effect on MMGD than CEE + MPA in Korean postmenopausal women. The change in MMGD induced with MPA might depend on the oral estrogen preparation. A further study on breast cancer risk based on combination HT is warranted.

Effect of birth order on respiratory distress syndrome in preterm twin pregnancy / 대한산부인과학회지

OBJECTIVES: To determine the effect of birth order on development of respiratory distress syndrome (RDS) in twin pregnancy according to the cause of preterm birth. METHODS: A retrospective analysis of 163 live born twin pairs who delivered at 24-34 weeks of gestation from January 1997 to April 2005 was done. Intrauterine fetal deaths or cases with severe fetal malformations were excluded. Subjects were categorized into three groups according to the cause of preterm birth: a preterm labor (PTL) group, a preterm premature rupture of membrane (PPROM) group and other maternal-fetal indication group. One hundred forty four twin pairs (88.3%) were delivered by cesarean delivery. We analyzed the incidence of RDS and other morbidities such as bronchopulmonary dysplasia, intraventricular hemorrhage, necrotizing enterocolitis and early neonatal sepsis in above three groups. Each second-twin was compared for specific outcomes directly with its first-twin birth mate. RESULTS: Overall, the first-born twin had less RDS compared to the second-born twin (p=0.02). Specifically, a reduced incidence of RDS of the first-born twin was significant in the PPROM group, regardless of neonatal sex (p=0.001). In other groups, there was no correlation between birth order and RDS. Except for RDS in the PPROM group, neonatal mortality and other morbidities were not significantly different between the first- and second-born twins. CONCLUSIONS: There is a significant decreased risk of RDS in the first-born twins from PPROM, but not from PTL or other indications.

Guidelines for Clinical Management of Premenstrual Syndrome

Premenstrual syndrome(PMS) refers to a group of menstruation-related symptoms that impair daily activity and interpersonal relationship. The therapeutic modality for PMS consists of non-pharmacologic and pharmacologic treatment. Generally, after confirmation of PMS, a set of non-pharmacologic treatments is recommended before pharmacologic treatment. Patients can be benefited from non-pharmacological treatments such as patient education, cognitive therapy, behavioral therapy, and dietary supplementation. Pharmacologic therapy including psychotropic agents, diuretics, and prostaglandin inhibitors may be used, when PMS symptoms are not sufficiently improved after non-pharmacologic treatments, or when symptoms fit the diagnostic criteria of premenstrual dysphoric disorder(PMDD). When treatment fails, hormonal therapy to manipulate menstrual cycle may be considered, and several trials showed improvement of physical and mood symptoms.

Effects of HMGB-1 Overexpression on Cell-Cycle Progression in MCF-7 Cells

High mobility group-1 (HMGB-1) enhances the DNA interactions and possesses a transcriptional activation potential for several families of sequence-specific transcriptional activators. In order to examine the effect of HMGB-1 on the cell cycle progression in MCF-7 cells, the HMGB-1 expression vector was transfected into synchronized MCF-7 cells, and the effect of HMGB-1 overexpression on the cell cycle was examined. The HMGB-1 protein level in the transfected cells increased 4.87-fold compared to the non-transfected cells. There were few changes in the cell cycle phase distribution after HMGB-1 overexpression in the MCF-7 cells. Following the estrogen treatment, the cell cycle progressed in both the HMGB-1 overexpressed MCF-7 and the mock-treated cells. However, a larger proportion of HMGB-1 overexpressing MCF-7 cells progressed to the either S or G2 phase than the mock-treated cells. The mRNA levels of the cell cycle regulators changed after being treated with estrogen in both the HMGB-1 overexpressing MCF-7 and the mock-treated cells, but the changes in the expression level of the cell cycle regulator genes were more prominent in the HMGB-1 overexpressing MCF-7 cells than in the mock-treated cells. In conclusion, HMGB-1 overexpression itself does not alter the MCF-7 cell cycle progression, but the addition of estrogen to the HMGB-1 overexpressing MCF-7 cells appears to accelerate the cell cycle progression.

Clinical Characteristics of 2070 Korean Women Who Visited the Adolescent Gynecology Clinic / 대한산부인과학회잡지

OBJECTIVE: To analyze the clinical characteristics of Korean pediatric, adolescent and premarital women who visited the Adolescent Gynecology Clinic at Samsung Medical Center. METHODS: A retrospective study was performed on the 2070 women visiting the Adolescent Gynecology Clinic at Samsung Medical Center from Feb. 1995 to Sep. 2003. The patients were divided into 3 groups according to patients' age; group I (~9 years, 258 patients), group II (10-20 years, 911 patients), group III (21-30 years, 901 patients). Clinical characteristics were analyzed by chart review and compared among three groups. RESULTS: The mean patient age was 18.4 +/- 6.9 years (mean SD) and the mean age at menarche was 13.4 +/- 1.5 years. The most common disease entity and disorder according to age groups were infectious disease and vaginitis in group I, menstruation associated problems and abnormal uterine bleeding (AUB) in group II, and menstruation associated problems and amenorrhea in group III. Among gynecologic problems, AUB was cited as the most common problem for the patients visiting the Adolescent Gynecology Clinic (425 cases, 20.5%), followed by amenorrhea (393 patients, 19.0%). 51.0% of primary amenorrhea had a congenital defects. Among the patients with pelvic tumor (293 patients), 85.3% was due to ovarian tumor, and 166 patients (66.4%) with ovarian tumor underwent operation. The most common pathologic diagnosis for ovarian tumor was endometrioma (60 cases, 36.1%). In primary dysmenorrhea (214 patients, 76.2% of total dysmenorrhea), treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) resulted in symptomatic improvement in 82.6% of the patients. The most common infectious disease was vaginitis and the most commonly isolated organisms varied according to age group (group I, II: E. coli, group III: Candida albicans). CONCLUSION: The most common gynecologic problem in korean pediatric, adolescent and premarital women is menstruation related disorders, presenting in 58.8% of patients visiting the Adolescent Gynecology Clinic.

Effect of Metformin Treatment and Insulin Resistance in Patients with Polycystic Ovary Syndrome / 대한산부인과학회잡지

OBJECTIVE: This study was performed to investigate the effect of metformin treatment and insulin resistance in the patients with polycystic ovary syndrome. METHODS: Twenty three patients with polycystic ovary syndrome were included at Seoul National University Hospital from September 2001 to September 2003. Metformin was administered at daily 1,500 mg for 3 months to these patients. Then restoration of regular menstruation or recovery of ovulation was evaluated and insulin resistance was compared between the responder and the non-responder before and after metformin treatment. RESULTS: Eleven patients (47.8%) showed a significant improvement in menstrual or ovulation cyclicity whereas twelve patients had no change. There was no statistically significant difference in the insulin resistance between the responder and the non-responder before and after metformin treatment. CONCLUSION: In non-obese patients with polycystic ovary syndrome, metformin treatment seems to be effective to improvement of menstrual or ovulation cyclicity irrespective of insulin resistance expressed as glucose-to- insulin ratio and HOMA.

CYP11alpha (tttta)n Microsatellite Polymorphism in Korean Patients with Polycystic Ovary Syndrome / 대한불임학회지

OBJECTIVES: To investigate the distribution and functional significance of CYP11alpha (tttta)n microsatellite polymorphism in Korean patients with polycystic ovary syndrome MATERIALS AND METHODS: Analysis of CYP11alpha(tttta)n microsatellite polymorphism was carried out on DNA samples from 97 patients with polycystic ovary syndrome and 70 normal controls. Comparison were done between PCOS patients and controls concerning CYP11alpha (tttta)n microsatellite polymorphism genotype or allele frequencies. RESULTS: The most frequent allele observed in the controls was an allele with six repeats (60.7%). Significant difference in the frequency of genotype (4R (-) genotype) having no copy of four-repeat-allele were observed between PCOS patients and controls (66.0% vs 34.0%, p=0.038, OR=1.939). But no significant difference was observed in the serum levels of total testosterone or free testosterone between 4R (+) genotype and 4R (-) genotype among PCOS patients. However, hyperandrogenic PCOS patients with 4R (+) genotype showed a higher serum testosterone levels compared to controls (mean+/-S.D: 0.49+/-0.21 ng/ml vs 0.37+/-0.18 ng/ml, p=0.037). CONCLUSION: The alleleic distribution of CYP11alpha (tttta)n microsatellite polymorphism in Korean subjects were different from those reported in Caucasians. CYP11alpha (tttta)n microsatellite polymorphism was associated with polycystic ovary syndrome in the Korean population, and may play a role in the synthesis of androgens in patients with polycystic ovary syndrome.

Analysis of Androgen Receptor Gene in Korean Patients with Androgen Insensitivity Syndrome / 대한산부인과학회잡지

Androgen insensitivity syndrome (AIS) is a X-linked disorder of sexual differentiation resulting from defective androgen receptor (AR) function. Androgens are secreted by the testes of 46,XY individuals, but there is loss of target organ response to the hormone. The abnormalities of AR are due to defects in the AR gene, and many mutations causing AIS have been reported since the cloning of AR gene. In this study, we analyzed the AR genes in twelve Korean patients with androgen insensitivity syndrome: 9 patients with complete AIS and 3 patients with partial AIS DNAs were isolated from patients with AIS, and the coding region of AR gene was amplified by a polymerase chain reaction using 7 pairs of primers (exon B-H). Sequence analysis of the AR gene was performed using direct sequencing and single strand conformational polymorphism (SSCP). The AR gene mutations were identified in 7 out of 12 patients: 6 of 9 patients with complete AIS, and one of 3 patients with partial AIS. Mutations found were as follows: the point mutation (ATT->ACT) at position 680 of exon D, point mutation (TGG->TGC) at position 751 of exon E, point mutation (CAA->TAA) at position 792 of exon F, point mutations (CGC->TGC, GTG->ATG) at position 855 and 866 of exon G, and the deletion of 13 nucleotides (CGTATCATTGCAT) at position 840 of exon G, respectively. To the best of our knowledge, the point mutations found in exon D, exon E, and exon F, and the deletion in exon G have not been observed before. SSCP revealed bands with abnormal mobility in 10 out of 12 patients tested. Mutations were found 5 out of these 10 patients. The other two patients showed no abnormal band on SSCP, but showed mutations by direct sequencing. In conclusion, we have demonstrated the AR gene mutations, including three novel mutations, in Korean patients with AIS, and these abnormalities might be related to the pathogenesis of androgen insensitivity syndrome.

Clinical Significance of Serum Leptin Level in Adolescent Patients with Menstrual Abnormalities / 대한산부인과학회잡지

OBJECTIVES: Leptin is known as an endocrinologic mediator which acts on the hypothalamic- pituitary-ovarian axis. This study was undertaken to evaluate whether the serum leptin level affects the menstrual cycles of adolescents and to analyze the clinical features of adolescents with abnormal serum leptin levels. METHODS: Seventeen normal controls and 118 patients with menstrual abnormalities were included in this study. The ages of patients ranged from 15 to 25 years. Patients with menstrual abnormality were divided into five subgroups according to the etiologies: group I; premature ovarian failure(n=8), group II; primary amenorrhea without congenital structural abnormality(n=14), group III; oligomenorrhea(n=12), group IV; secondary amenorrhea(n=53), group V; dysfunctional uterine bleeding(n=31). After collection of blood samples, the serum leptin levels were measured with a radioimmunoassay kit. The serum leptin level and the corrected leptin level(leptin/body mass index(BMI)) were compared and the clinical features of those with abnormal leptin concentration (>mean+standard deviation,

Changes in biochemical bone markers during pregnancy and puerperium

To elucidate the changes in bone turnover during pregnancy and puerperium, we measured serially the levels of serum osteocalcin and urine deoxypyridinoline (Dpy) as markers of bone formation and bone resorption, respectively, in 22 healthy women with normal pregnancy. Nineteen non-pregnant women served as control. The Dpy levels increased significantly at 16 weeks of pregnancy and remained elevated thereafter. The levels of osteocalcin, however, were significantly decreased at 16 weeks of pregnancy and elevated later at 6 weeks postpartum. Bone turnover ratio (Dpy/osteocalcin) continued to rise during pregnancy, but returned to control levels 6 weeks after delivery. Dpy levels and bone turnover ratio during puerperium tended to be higher in 17 breast-feeding women than those of 5 exclusive bottle-feeders. In conclusion, bone resorption begins to increase from the second trimester of pregnancy and calcium release from bone tissue might play a major role in calcium homeostasis during the whole period of pregnancy as well as during lactation.

Intactness of zona pellucida does not affect the secretion of a trypsin-like protease from mouse blastocyst

Assisted hatching (AH), which is known to improve the hatching potential of mammalian embryos, has been used to increase the pregnancy rate in in vitro fertilization cycles. However, the effect of AH on a trypsin-like protease, which is known to be associated with the hatching process, has not been studied. In this study, we evaluate whether the intactness of zona pellucida affects the secretion of a trypsin-like protease from mouse blastocyst. Four- to 8-cell stage mouse embryos were collected at 66- to 68 hr after hCG injection and divided into 3 groups according to the manipulation of zona pellucida. The groups are no treatment (control), drilling of zona pellucida (ZD) and thinning of zona pellucida (ZT). The activity of a trypsin-like protease, blastocyst development and hatching rate were compared among the three groups at 110 and 135 hr after hCG injection, respectively. The protease activity and blastocyst development were not significantly different among control, ZD and ZT groups at 110 and 135 hr after hCG injection, respectively. However, the hatching rate of ZD and ZT groups was significantly higher than that of control group at each time, respectively (p>0.001). Even in the zona pellucida removed embryos, the protease activity did not differ from the control group. In conclusion, the secretion of a trypsin-like protease from mouse blastocyst does not seem to be affected by the intactness of zona pellucida.

Changing pattern of serum leptin concentration in women undergoing clomiphene citrate challenge test or controlled ovarian hyperstimulation / 대한산부인과학회잡지

OBJECTIVE: To evaluate the changing pattern of serum leptin level and the correlation between estradiol level during the clomiphene citrate challenge test(CCCT) or controlled ovarian hyperstimulation(COH) cycle. METHODS: Twenty-seven women who underwent CCCT and fourteen women who underwent controlled ovarian hyperstimulation were recruited to measure the serum leptin level. After correction of serum concentration with body mass index(BMI), changes of leptin level and correlation with serum estradiol level during CCCT and COH cycle were analyzed. RESULTS: Circulating leptin levels were significantly correlated with BMI at each time point in CCCT cycle(P<0.01). In CCCT cycle, leptin/BMI level was significantly increased at midluteal phase compared to that of menstrual cycle day 3 and 10(p<0.05). In women with regular menstruation, leptin/BMI level at midluteal phase was significantly higher than that of menstrual day 3 and 10, but this difference was not seen in women with irregular menstruation. The leptin/BMI level in COH cycle showed increasing tendency throughout ovarian stimulation. But there was no significant correlation between leptin/BMI and estradiol level in CCCT and COH cycle. CONCLUSION: There is a significant correlation between BMI and circulating leptin level. Midluteal leptin level is significantly higher than that of follicular phase in CCCT cycle, and there is an increasing tendency in leptin level after ovarian stimulation in CCCT and COH cycle without statistical significance. These findings suggest that circulating estradiol concentration has no major influence on circulating leptin level.

Induction of c-Jun mRNA without changes of estrogen and progesterone receptor expression in myometrium during human labor

To elucidate the endocrine mechanism of human parturition, the expression of c-Jun and c-Fos mRNA were examined in relation to estrogen receptor (ER) and progesterone receptor (PR) in human myometrium. c-Jun mRNA was detected in all myometrial tissues (n=5) during labor but not before labor (n=5) and in oxytocin-resistant postterm pregnancy (n=3). c-Fos mRNA was detected in only one myometrial tissue from a woman in labor. The distribution and intensity of immunostaining for ER and PR were semiquantitatively scored. During the late pregnancies, no significant difference was seen in the receptor scores for myometrial ER and PR between the patients who experienced labor and those who did not. Receptor scores for ER and PR were significantly lower in postterm pregnancy than in late pregnancy, regardless of the labor status. These data suggest that there are no changes in ER and PR in human myometrium during parturition. On the other hand, postterm pregnancy is associated with low ER and PR. c-Jun, induced during labor without changes in ER and PR, may play a role as a signaling mechanism in human myometrium.