The Survey on Korean Menopausal Women's Behavior and Perception of Hormone Therapy / 대한폐경학회지

OBJECTIVES: After Women's Health Initiative (WHI) study had been published, the use of hormone therapy (HT) have been decreasing even though it is the most effective therapy for menopausal symptom. The survey was conducted to investigate Korean menopausal women's perception of HT and behavior when they are treated by HT. METHODS: During 4 weeks from September 2009 to October 2009, total 600 women aged 45~64 participated in the survey by face to face interview. Out of answering women, women who have visited clinic/hospital at least 1 time to treat their menopausal symptom during last 1 year were included. One hundred fifty women for each age group, 45~49, 50~54, 55~59 and 60~64, were recruited in consecutive order. RESULTS: Eighty percent women who have visited clinic/hospital to treat menopausal symptom, visited obstetrics and gynecology. Only 16% of these women were current user, and other 84% of these women had no experience of HT (53%) or stopped therapy (31%). Among current user, only 9% of women have used HT more than 5 years. Eighty percent of current user had used HT less than 2 years. Most distressing menopausal symptom is 'hot flush' regardless HT experience. When doctor recommend HT, 72% of patients accept HT in overall. Among women who had no experience of HT, the most common reason of not to take HT was concern of side effects (51%). And 67% of women who had concern of side effects worried about cancer incidence. CONCLUSION: Many women with menopausal symptom do not take HT even though it is the most effective therapy. Most of women who take HT stop treatment within 1 year. Most common reason of not to take HT is concern about side effect, increasing incidence of cancer related to HT. Therefore, HT should be considered to short-term relief of menopausal symptoms and at the minimal dose, if possible.

Ectopic ovary with a mature cystic teratoma diagnosed by laparoscopy: A case report / 대한산부인과학회지

The ectopic ovary is a rarely reported gynecologic entity. A variety of synonymous terms have been used to describe this condition, such as supernumerary ovary, accessory ovary, and ovarian implant syndrome. The etiology of ectopic ovary is poorly understood. The ectopic ovaries may occur in two ways. First, in the embryonic theories, they are believed to result from abnormal separation of a small portion of the developing and migrating ovarian primordium. Second, the accessory ovary can occur from acquired conditions such as inflammation and operations. In this report, we describe a case of the ectopic ovary with a mature cystic teratoma autoamputated into the cul-de-sac and subsequently diagnosed by laparoscopy.

Comparison of the Effects of Hormone Replacement Therapy on Bone Mineral Density, Lipid Profiles, and Biochemical Markers of Bone Metabolism / 대한폐경학회지

OBJECTIVES: To assess the effects of hormone replacement therapy on bone mineral density (BMD), biochemical markers of bone turnover, and lipid profiles in postmenopausal women. METHODS: We retrospectively reviewed the medical records of 199 postmenopausal women who had received care at the Department of Obstetrics and Gynecology of Catholic University Seoul St. Mary's Hospital between January 1994 and December 2008. The patients were divided into the following three groups: group 1 received combined estrogen and progesterone therapy (n = 91); group 2 received estrogen only (n = 65); and group 3 received tibolone (n = 43). We compared the changes in biochemical markers of bone turnover, lipid profiles, and BMD during therapy. RESULTS: The BMD of the lumbar spine increased in groups 1 and 3 by 2.0% and 1.2%, respectively, and the BMD of the total femur increased in groups 1 and 2 by 2.3% and 0.5% from the initial values after 3 years, respectively. However, the BMD of the femoral neck and total femur decreased significantly in group 3 by 4.8% and 1.9%, respectively, 3 years after treatment initiation (P < 0.05). Serum osteocalcin and urinary deoxypyridinoline decreased in all groups 1 year after treatment. In groups 1 and 3, the total cholesterol level decreased and the triglycerides level increased. However, there were no definite changes in the total cholesterol and triglycerides levels in group 2. The high density lipoprotein cholesterol (HDL)-cholesterol level increased in groups 1 and 2, but decreased in group 3. As a result, the BMD of the lumbar spine increased and the total cholesterol level decreased in the combined therapy and tibolone groups. Tibolone had no beneficial effect on the BMD of the femoral neck. CONCLUSION: Our results suggest that each therapy has different effects on BMD, biochemical markers of bone metabolism, and lipid profiles. A prospective study involving a larger group, and considering multiple factors, will be required to obtain more clinically meaningful conclusions.

Comparison of the Effects of Hormone Replacement Therapy on Bone Mineral Density, Lipid Profiles, and Biochemical Markers of Bone Metabolism / 대한폐경학회지

OBJECTIVES: To assess the effects of hormone replacement therapy on bone mineral density (BMD), biochemical markers of bone turnover, and lipid profiles in postmenopausal women. METHODS: We retrospectively reviewed the medical records of 199 postmenopausal women who had received care at the Department of Obstetrics and Gynecology of Catholic University Seoul St. Mary's Hospital between January 1994 and December 2008. The patients were divided into the following three groups: group 1 received combined estrogen and progesterone therapy (n = 91); group 2 received estrogen only (n = 65); and group 3 received tibolone (n = 43). We compared the changes in biochemical markers of bone turnover, lipid profiles, and BMD during therapy. RESULTS: The BMD of the lumbar spine increased in groups 1 and 3 by 2.0% and 1.2%, respectively, and the BMD of the total femur increased in groups 1 and 2 by 2.3% and 0.5% from the initial values after 3 years, respectively. However, the BMD of the femoral neck and total femur decreased significantly in group 3 by 4.8% and 1.9%, respectively, 3 years after treatment initiation (P < 0.05). Serum osteocalcin and urinary deoxypyridinoline decreased in all groups 1 year after treatment. In groups 1 and 3, the total cholesterol level decreased and the triglycerides level increased. However, there were no definite changes in the total cholesterol and triglycerides levels in group 2. The high density lipoprotein cholesterol (HDL)-cholesterol level increased in groups 1 and 2, but decreased in group 3. As a result, the BMD of the lumbar spine increased and the total cholesterol level decreased in the combined therapy and tibolone groups. Tibolone had no beneficial effect on the BMD of the femoral neck. CONCLUSION: Our results suggest that each therapy has different effects on BMD, biochemical markers of bone metabolism, and lipid profiles. A prospective study involving a larger group, and considering multiple factors, will be required to obtain more clinically meaningful conclusions.

Clinical characteristics of 110 women with uterine anomalies / 대한산부인과학회지

OBJECTIVE: To investigate the clinical characteristics of symptoms, diagnostic procedures, infertility, obstetrical complications, and surgical corrections in women with congenital uterine anomalies. METHODS: Between January 1990 and December 2007, 110 patients diagnosed with uterine anomalies from Kangnam St. Mary's Hospital, the Catholic University of Korea were included in this study. The charts of patients were reviewed retrospectively for uterine anomaly type, clinical symptom, diagnostic workup, fertility, fetal presentation, and uteroplasty. Congenital anomaly was categorized according to classification by the American Fertility Society (1988). RESULTS: Uterine anomaly was noticed in 1 in 752 patients (0.13%) who visited the inpatient department. The diagnosis was made by pelvic ultrasonography and manual examination (45.5%), incidental discovery during Cesarean section (24.5%), and other surgical procedures and salpingography. Most common types of uterine anomaly were bicornuate uterus (42 cases, 38.2%) and uterine didelphys (39 cases, 35.5%). Renal anomaly was accompanied in 21 patients (19.1%), frequently associated with bicornuate uterus and uterine didelphys. Uteroplasty was performed in 26 patients with 9 cases of bicornuate uterus (34.6%) and 8 cases of septate uterus (30.8%). The cases diagnosed incidentally during prenatal ultrasound examination were 35.5%. Other initial symptoms were dysmenorrhea, pelvic pain and habitual abortion. Primary infertility was reported in 3 cases (2.7%) which was fewer than abortion. Primary dysmenorrhea was observed in 2 cases (1.8%). One case of PID (0.9%) and one asymptomatic case were noted. Among 241 pregnancies, there were 46.9% full term birth, 24.34% abortion, 9.5% preterm birth, and 0.83% ectopic pregnancy. Fetal presentations were 16.67% breech and 1.51% transverse lie. Cesarean section rate was 81.3%. CONCLUSIONS: Women with uterine anomaly complain symptoms such as dysmenorrhea and pelvic pain, but most are aymptomatic and diagnosed incidentally. They are frequently accompanied with urologic anomalies and complicated with obstetrical challenges such as preterm labor, habitual abortion, malpresentation, intrauterine growth retardation and uterine atony. Thus, when diagnosis of uterine anomaly is made, it is crucial to discuss sufficiently with patients about their expected prognosis on fertility and possible obstetrical outcomes and complications and to provide appropriate therapy accordingly.

Characteristics of dietary pattern and tissue mineral in premenstrual syndrome patients / 대한산부인과학회지

About 80% of premenopausal women experience premenstrual syndrome (PMS), but the definite etiology or effective treatment is still under the investigation. In this study, serum and tissue mineral analysis, which are essential for biosynthesis and secretory regulation of neurotransmitters, We evaluate what kind of changes in mineral levels is correlated to the presence of PMS. This study also include the approaches that entail changes to diet and lifestyle so that symptoms of premenstrual disorders can be alleviated. 61 women who were recruited on volunteer basis and completed Modified Moss Menstrual Distress Questionnaire (MMDQ) and devided into 2 groups, scored less than 10 points, as control group, and women scored higher than 11 points, as PMS group. They were asked to fill out questionnaires about their diet patterns and submitted to tissue mineral and serum analysis to evaluate the levels of Ca, Mg, Na, K, Cu, and Zn. In the control group, serum Mg and Zn were relatively high but within normal reference range, but showed high level of Mg and Zn in tissue. For Mini Dietary Assessment Index (MDAI), the score of control group was 33.8 and that of PMS group 19.7, showed statistical significance (P<0.05). The score of daily calcium-taking group was 21.6+/-3.7 whereas that of seldom calcium-taking group was 39.6+/-6.2 (P<0.05). The score of daily magnesium-taking group was 9.75+/-2.7 whereas that of seldom magnesium-taking group was 26.0+/-4.9 (P<0.05). In this study, we conclude the importance of dietary and lifestyle modifications could prevent and treat symptoms of PMS and minerals had significant roles of regulating PMS especially Ca, Mg and Zn. Further studies about roles of these minerals and possible therapeutic applications using minerals in PMS are needed.

The significance of maternal serum and umbilical cord blood leptin concentration with intrauterine fetal growth restriction and/or preeclampsia / 대한산부인과학회지

OBJECTIVE: To ascertain whether fetal growth restriction with or without preeclampsia is associated with alteration of leptin concentration in maternal and umbilical cord serum. METHODS: Maternal serum and umbilical cord blood leptin concentrations were determined by ELISA assay in 25 women with singletone pregnancies complicated by fetal growth restriction without preeclampsia (IUGR), in 11 women with singletone pregnancies complicated by fetal growth restriction with preeclampsia (IUGR+PE), in 9 women with singletone pregnancies complicated by preeclampsia without fetal growth restriction (PE), and in 13 women with uncomplicated singletone pregnancies (Control). RESULTS: Maternal weight and BMI before pregnancy and in delivery were significantly different among groups. The lowest weight and BMI before pregnancy and in delivery was group IUGR. Neonatal birth weight was significantly different among groups. The lowest birth weight was group IUGR+PE. Maternal serum leptin concentration and umbilical cord leptin concentration were not significantly different among groups. Maternal serum leptin levels were not significantly correlated with maternal BMI or with neonatal birth weight. Umbilical cord blood leptin levels were significantly correlated with neonatal birth weight. CONCLUSION: Maternal serum leptin concentration and umbilical cord blood leptin levels were independent of presence of preeclampsia and/or IUGR. Umbilical cord blood leptin reflects neonatal birth weight.

A case of ovarian pregnancy with focal adenomyosis mimicking cornual pregnancy that managed by laparoscopy / 대한산부인과학회지

Ovarian pregnancy is rare form of ectopic pregnancy occurring in 0.5-1% of all ectopic pregnancies. But the presenting symptom is very similar and difficult to distinguish with other forms of ectopic pregnancy. We report a case of ovarian pregnancy mimicking cornual pregnancy managed with laparoscopy. Early detection is important role in preserving fertility to avoid the ablation of functional ovarian tissue. The diagnostic criteria, etiology, and management are discussed.

Correlation between the duration of labor and leptin concentration in cord blood / 대한산부인과학회지

OBJECTIVE: To evaluate the correlation of level of leptin in cord blood and duration of labor. METHODS: Eighty-four pregnant women who had delivered during Jan. 2004-Jun. 2004. at the delivery unit of St. Mary's Hospital of Catholic University Medical College. We checked the level of leptin in cord blood, total duration of labor (cervix 3 cm-delivery of placenta), age of pregnant women, body weight before pregnancy, body weight before delivery, weight of the baby and placenta, head circumference, abdominal circumference, and height of the baby. Leptin was checked by ELISA. RESULTS: Cord blood leptin was in proportion to one's pregnancy duration (umbilical vein p<0.01, umbilical artery p<0.05), change of body weight (p<0.05), weight of placenta (p<0.01), weight of newborn (umbilical artery p<0.01, umbilical vein p<0.05), baby's abdominal circumference (umbilical vein p<0.01, umbilical artery p<0.05). Leptin was in inverse proportion to head circumference of new born infant in umbilical artery (p<0.01) and in umbilical vein (p<0.05). Level of leptin in umbilical vein was in proportion to duration of labor (p<0.05). When the labor duration exceeded 8 hours, leptin in cord blood decreased suddenly, but within 8 hours, their correlation coefficient showed a strong relationship (p<0.01) between the labor duration and leptin level in cord blood. CONCLUSION: Duration of labor affects the level of leptin in cord blood.

Expression of Mullerian Inhibiting Substance Type II Receptor during Follicular Development in the Human Ovary / 대한산부인과학회잡지

OBJECTIVES: This study was aimed to obtain information on the ontogeny of the production profile of MIS type II receptor (MISR II) and the pattern of its localization according to follicular development METHODS: Expression of MISR II were studied in 21 ovarian specimens from adult normal cycling women by RT-PCR and in situ hybridization of the MISR II mRNA and immunohistochemical staining of the MISR II. RESULTS: The first staining for MISR II and MISR II mRNA were detected in the granulosa cells in primary follicles. The granulosa cells of multiple layered growing follicles showed strong specific staining for MISR II and MISR II mRNA. Among the growing follicles, large follicle stained more intensely than small one. Expression of the MISR II and MISR II mRNA were also seen in the granulosa cells and theca cells of antral follicles. The expression levels of MISR II and MISR II mRNA in mature follicles were lower than those in growing follicles and were even further reduced, but still detectable, in corpus luteum. There was a decreased level of MISR II and MISR II mRNA expression when follicles become atretic. Both expressions were eventually lost from atretic follicles. And the MISR II and MISR II mRNA staining were not found in primordial follicles, oocytes, interstitial cells, ovarian epithelium, and corpus albicans. CONCLUSION: The production and localization of MISR II in granulosa cells, theca cells, and corpus luteum in normal reproductive ovary indicate that actions of MIS via MISR II are autocrine and paracrine in nature. The pattern of MISR II and MISR II mRNA expression according to follicular development indicate that MIS function in the ovary is turned on in primary follicles, increases to maximal levels in large growing follicles, and decreases just before ovulation. These experiments suggest that MIS may play an important role in follicle maturation and follicle selection during the adult reproductive cycle. And this study may yield important information to direct the development of newer contraceptive strategies.

Prevalence of Chlamydia Trachomatis and Relation with Human Papilloma Virus / 대한산부인과학회잡지

OBJECTIVE: One of the most common causative microorganisms in pelvic inflammatory disease (PID) is the chlamydia trachomatis. In many cases chlamydia trachomatis infection has weak and nearly absent symptom, but it's endocervical infection usually disseminates into upper genital tract. In this infection tubal obstruction, infertility, tubal pregnancy, and recurrent pelvic infection has involved. In this study, we investigated the prevalance of chlamydia trochoma infections in symptomatic and asymptomatic women and its relation with Human Papilloma infection. METHODS: From Jan, 1999 to July, 2003, in St. Vincet's Hospital, The Catholic University of Korea, endocervial swabs were obtained in 3416 patients (1137 in Heath Promotion Center, 2226 in OPD) by Amplicor Chlamydia Trahomatis Kits (STD swab specimen collection transprt kits). Chlamydia trachomatis DNA was extracted and amplified by PCR assays to investigate the prevalence. Also in this study we investigated the prevalence of human papilloma virus by hybrid capture method. Women who visted Hospital were received routine gynecologic examination, history taking, and physical examination and information on potential risk factors was obtained by questionnaire. RESULTS: The prevalence rate of Chlamydia trachomatis in symptomatic women was 12.6% and there was a high peak prevalence among the early twenties (66%). The prevalence rate of Chlamydia in asymtomatic women was 8.2% but there was no peak in early twenties. In asymptomatic woman, asymptomatic chlamydia infection can be statistically anticipated by 1) Economic status, 2) Occupation status, 3) Alcohol intake, 4) History of Gynecologic disease, 5) History of STD. Women with chlamydia infection was 1.5 times greater risk of coincidal HPV infection and was statistically significant. CONCLUSION: The prevalence rate of chlamydia infection is higher than any other developed country, especially in asymptomatic women. Although symptoms are weak, the rate of prevalence and complications can be reduced by the screening of chlamydial infection.

A Study on the Leptin Concentrations in Maternal and Cord Blood / 대한산부인과학회잡지

OBJECTIVE: In this study, We investigated the circulating level of leptin in the maternal and cord serum to estimate the effect of leptin on the fetal growth. METHODS: In full-term pregnancy, right after delivery, we calculated the concentration of leptin in the maternal and cord serum by using an immunoassay. we studied the relation between these value, the maternal BMI at the time of delivery, the neonatal body weight. RESULTS: At the time of delivery, mean concentration of maternal leptin and cord leptin showed 335.7 pg/ml and 118.3 pg/ml and there was no statistical significance between them. Mean concentration of matenal leptin has positive relation with maternal body weight. but not to neonatal weight. Mean concentration of cord serum leptin has a positive relation with neonatal weight. There was a correlation between the maternal BMI and the neonatal weight at the time of delivery. We evaluated the mean leptin level of neonates of two different sexes, that difference did not show a statistically significant level. CONCLUSION: In this study, no correlation was found between concentration of maternal leptin and cord leptin. These data suggested that the cord serum leptin has a positive relation with fetal growth independantly, regardless of maternal leptin and maternal BMI.

Development of Trans Attack Anticancer Gene Vaccine Interact in HPV Oncoprotein Expression Inhibition / 대한산부인과학회잡지

OBJECTIVE: Adeno-associated virus Rep 78 protein is known to inhibit the promoter site of several onco-genes and viral gene, including the human papillomavirus type 16 E6 transforming genes. In this study, we investigated AAV Rep 78 mediated inhibition of HPV 16 E6 promotor activity. METHODS: pcDNA3.1/V5/His-Topo vector, cloned by AAV mediated Rep 78, is transfected into cervical cancer cell line (Caski). After that, we confirmed HPV16 derived E6 expression and cell growth inhibition. RESULTS: Transfection rate of Rep78 GFP-vector, approximately from 30 to 60 per-cent, is highly expressed at first day. But E6 expression is lower at this day. The growth of CaSki and HeLa cervical cancer cell lines was inhibited by Rep78 (p<0.05). But, the other cervical cancer cells were unaffected by Rep78 transfection. CONCLUSION: In spite of the high Rep78 transfection efficiency and expression rate, we could not show the cervical cancer cell growth inhibition. In our data, long term expression of Rep78 strategy is needed for cervical carcinoma gene therapy using adeno-associated virus vector.

Umbilical Cord Arterial Blood pH Analysis at Term Pregnancy / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to assess the gestational age adjusted values of umbilical cord arterial blood pH in term pregnancy with normal Apgar score. METHODS: We performed in attempt to compare umbilical arterial blood pH values for in term 757 singleton pregnancy, immediately after delivery of live-born infants delivery, with normal 1 and 5 minutes Apgar score. They were divided into 380 cases of normal full term vaginal delivery without any complication and 377 cases of elective cesarean section with normal fetal heart rate tracing. We determined gestational age, parity, Apgar score. RESULTS: There was a significant decline correlation between gestational age and umbilical artery pH (P=0.018). In acidemia, the odds ratio was increasing from 37 weeks to 41 weeks but there was no association between normal Apgar score and pH less than 7.10 with increasing gestational age. We evaluated the umbilical artery pH level in different delivery mode. In uncomplicated normal vaginal delivery, negative significant correlation was found (P=0.022), and elective cesarean section case did not show a statistically significant level. CONCLUSION: Our data suggested that umbilical artery pH has a negative relation with gestational age during term period.

Effects of Isoflavone on Surgically Menopaused Women / 대한산부인과학회잡지

OBJECTIVE: To evaluate the effects of isoflavone intake on estrogen deprivated symptoms in surgically menopaused women. METHODS: Premenopausal women who took total hysterectomy with both adnexectomy were randomized into three groups. One group took conjugated equine estrogen 0.625 mg daily for 12 weeks after surgery, the second group took isoflavone 100 mg #3 daily for 12 weeks after surgery, and the third group took no medication for controlled group. Questionnaires about the acute menopausal symptoms, incontinence score, blood lipid profile, bone turnover marker were checked before and 12 weeks after surgery. RESULTS: Kupperman's index and insentience score were showed less increased rate than control group. Total cholesterol and triglyceride were increased in all groups and HDL cholesterol was increased in estrogen and isoflavone groups. Osteocalcin was decreased in estrogen and isoflavone groups, ICTP was decreased in estrogen group, and increased in the other groups. CONCLUSION: Isoflavone was effective to acute postmenopusal symptoms, urogenital atrophy and bone turnover.

A Case of Ruptured Cornual Pregnancy in Adenomyosis Uterus at 29 Weeks' Gestation / 대한산부인과학회잡지

A case of ruptured cornual pregnancy in adenomyosis uterus at 29 weeks' gestation is presented here. A cornual pregnancy occurs when the conceptus implants at the junction between the tube and the uterus rather than in main part of uterine cavity. It is relatively rare entity, but the rich vascularity of the uterus in this location makes rupture particularly dangerous. resulting in higher maternal mortality. The presented case was unique in continuing till the third trimester of pregnancy. We present a case of a ruptured cornual pregnancy in adenomyosis uterus at the third trimester of pregnancy with a brief review of literatures.

A Case of Fetal Skin Bullae after Amnioinfusion / 대한산부인과학회잡지

Premature rupture of membrane generally leads to a poor perinatal outcome. For better perinatal survival, transabdominal prophylatic amnioinfusion and active expectant management was performed. We experienced a case of fetal right arm multiple skin bullae and stomach perforation after amnioinfusion. Underskin bullae was to disappear within a few days and stomach perforation site was treated by primary closure.

The role of ceramidase in murine ovarian granulosa cell death / 대한산부인과학회잡지

OBJECTIVE: One of the models we study is the ovarian granulosa cell (GC), a somatic cell lineage that is critically important for maintenance of the female germ line and many endocrine functions of the ovaries. The objective of this study is to clarify the significance of ceramide and the role of ceramide metabolism in dictating the fate of cells exposed to stress. METHODS: We first treated GC with a C8-ceramide analog or an amine derivative of ceramide that cannot be metabolized by ceramidase (C8-ceramine). Northern blot analysis was performed to evaluate mRNA of acid ceramidease expression regualted by gonadotropin and in situ hybridization was done to identify the mRNA expression of acid ceramidase in ovaries. RESULTS: After 6 hours, C8-ceramide (50 micro M) triggered apoptosis in only 28 +/- 6% of the cells, whereas C8-ceramine (50 micro M) induced apoptosis in all cells (LD50=1 micro M). These data suggested that ceramidase activity is a critical determinant of GC survival. In situ hybridization showed that mRNA of acid ceramidase was highly expressed in GC in growing follicle. mRNA of acid ceramidase was expressed abundantly in granulosa cells and ovaries and its expression was significantly increased by gonadotropin in granulosa cells in in situ hybridization. Forty two hour after gonadotropin treatment, mRNA expression of acid ceramidase in granulosa cells was two fold increased cells comparing with no treatment control in northern blot analysis (P<0.05). In copora lutea, elevated mRNA expression of acid ceramidase was decreased. CONCLUSION: We concluded that GC possess inherently high levels of ceramidase activity, and that ceramidase has important for metabolizing ceramind to maintain GC survival in the ovary.

Serum Levels and Expressions of Inhibin A and Inhibin B in the Ovaries of Perimenopausal Women / 대한산부인과학회잡지

OBJECTIVE: To understand the physiologic effects and secretion pattern of inhibin A and inhibin B during menstrual cycle and menopausal transition, inhibin A and inhibin B levels were measured. And to detect any changes in expression of inhibins in human ovary with age, we examined immunohistochemical staining of alpha, beta A, and beta B subunits of inhibin in ovarian tissues. This study was also designed to investigate whether or not inhibin is an early marker for menopausal transition. METHODS: Inhibin A and inhibin B levels were measured in 320 samples from normal reproductive women, in 60 from perimenopausal women, and in 20 from menopausal women by ELISA. And we examined the immunohistochemical staining of alpha, beta A, and beta B subunits of inhibin in ovarian tissues of 35 normal reproductive, 20 perimenopausal, and 5 menopausal women, respectively. RESULTS: In the normal reproductive women, inhibin A begins to increase in the late proliferative phase (16.53 +/- 1.57 pg/ml), reaches the peak in the mid-secretory phase (45.85 +/- 2.08 pg/ml), and subsequently decreases. Inhibin B begins to increase in the early proliferative phase (65.40 +/- 4.08 pg/ml), reaches the peak in the ovulatory phase (110.74 +/- 9.83 pg/ml), and thereafter declines rapidly. In the perimenopausal women, mean inhibin A serum concentration was 6.68 +/- 0.53 pg/ml during proliferative phase and 21.78 +/- 3.61 pg/ml during secretory phase, which were significantly lower than that of the same phase in the normal reproductive women (P<0.01). Mean inhibin B serum concentration was 52.16 +/- 7.46 pg/ml during proliferative phase and 22.41 +/- 6.73 pg/ml during secretory phase, which were significantly lower than that of the same phase in the normal reproductive women (P<0.01, P=0.025). In the menopausal women, both inhibin A and inhibin B were not detected. In the normal reproductive women, we observed strong immunostaining for alpha subunit in granulosa cells, theca cells, and corpus luteum. Immunostaining for beta A subunit was observed in corpus luteum, but not in growing follicles. Immunostaining for beta B subunit was observed in primary follicle, granulosa and theca cells of growing follicle, and mature follicle, but less strong than immunostaining for alpha subunit. No staining for beta B subunit was observed in the corpus luteum. In the perimenopausal women, immunostaining for inhibin subunits were observed in the same pattern as that of the normal reproductive women, but weaker. Stronger immunostaining was observed in theca cells than in granulosa cells. In the menopausal women, none of the immunostaining of inhibin subunits were observed. CONCLUSION: It is concluded that inhibin A is associated with the luteal function and inhibin B, the follicular function. The secretion of inhibins decreased rapidly in the perimenopausal transition period and were not detected in the menopausal period. Inhibin A and inhibin B are associated with the follicular maturation and development. It suggests that the inhibin A and inhibin B are good candidates as markers for perimenopausal transition.

The Cytotoxic and Radiosensitizing Effects of Taxol in Uterine Sarcoma Cell Lines / 대한산부인과학회잡지

OBJECTIVE: The cytotoxic and radiosensitizing effects of Taxol in uterine sarcoma cell lines were investigated. METHODS: Two uterine sarcoma cell lines with different Taxol responses were used, namely, Taxol- sensitive and MDR gene negative MES-SA, and Taxol-resistant and MDR gene positive MES-SA/MX2 cells. These cells were treated with Taxol, radiation, or both, and cytotoxicities were compared by XTT assay and TUNEL staining. The cytotoxic mechanism was also studied by flow cytometry and by RT-PCR of the MDR gene expression. RESULTS: In Taxol-sensitive MES-SA cell lines, Taxol showed highly cytotoxic activity than radiation or the Taxol-radiation combined treatment. On the contrary, in Taxol-resistant MDR positive MES-SA/MX2 cell lines, Taxol significantly increased the sensitivity to radiation therapy, and increased cytotoxicity and apoptosis. Flow cytometry showed that treatment with Taxol alone produced the highest rate of cell cycle shifting to the G0/G1 phase in the MES-SA cell line. However, in the MES-SA/MX2 cell line, Taxol only treatment did not show significant cell cycle shifting compared to the control group. However, in cases of combined Taxolradiation treatment, the rate of cell cycle shifting was higher than for radiation treatment only. CONCLUSION: Taxol has cytotoxic and radiosensitizing effects on uterine sarcoma cell lines.