Effects of black cohosh on the plasminogen activator system in vascular smooth muscle cells.

OBJECTIVE: The rhizome of the Cimicifuga racemosa plant (commonly known as black cohosh) has been used for menopausal complaints. Studies regarding the cardiovascular effects of black cohosh are lacking. We investigated the effect of black cohosh on the plasminogen activator system in cultured vascular smooth muscle cells (VSMCs). METHODS: VSMCs were isolated from rat aortae. Expression of plasminogen activator inhibitor type 1 (PAI-1) and tissue-type plasminogen activator (t-PA) proteins were evaluated by Western blot analysis and enzyme-linked immunosorbent assay, respectively. The activities of PAI-1 and t-PA in the conditioned media were assessed by fibrin overlay zymography. A 40% 2-propanol extract of black cohosh was used. RESULTS: Black cohosh extract (BcEx) stimulated the protein expression of PAI-1, but it did not affect that of t-PA. Vitamin E, a potent antioxidant, inhibited the BcEx-induced increase in PAI-1 expression, while ICI 182,780, an estrogen receptor antagonist, had no effect. Fibrin overlay zymography revealed that BcEx increased the activity of PAI-1 in the conditioned media, while concurrently decreasing that of free t-PA by inducing a binding to PAI-1. CONCLUSIONS: BcEx induces PAI-1 protein expression in the VSMCs likely via an oxidant mechanism. It also stimulates the enzyme activity of PAI-1 and reduces that of free t-PA. These findings suggest that black cohosh might exert a negative influence on fibrinolysis.

Reproductive health characteristics of urban South Korean women.

AIMS: To characterize the reproductive health of urban South Korean women of reproductive age. METHODS: A cross-sectional online survey on menstrual patterns, sexual behavior, utilization of contraception, and perception of gynecological diseases was administered to 500 women from 15 to 39 years of age in five major cities of South Korea. RESULTS: Among the respondents, 76.8 and 25% experienced dysmenorrhea and abnormal uterine bleeding, respectively. Two-thirds of the respondents with dysmenorrhea used analgesics. After analgesics, herbal medicine was the next most commonly used treatment. The mean age of first sexual intercourse was 24.3 years, and 68.8% of the sexually active women used contraception. The most commonly used contraceptive method was the condom (79.7%), and many women (up to 62.2%) demonstrated a distorted understanding of oral contraceptives. Although many women were aware of general gynecological diseases such as cervical cancer (77%), endometriosis (64.4%), and leiomyoma (62.6%), only 22.2% of the respondents had visited a clinic for a gynecological examination, and among those who had visited a clinic, the main reason for the visit was pregnancy (44.1%). CONCLUSION: The results of this survey provide insight into and allow us to characterize the reproductive health status of urban South Korean women.

Altered vascular endothelial growth factor expression during GnRH antagonist protocol in women of reproductive age with normal baseline hormone profiles.

OBJECTIVE: To explain the unexpected low response to GnRH antagonist protocol in reproductive women with normal baseline hormone profiles. DESIGN: Retrospective study. SETTING: University hospital. PATIENT(S): Twenty-five women undergoing their first IVF cycle. INTERVENTION(S): Follicular fluid (FF) from large follicles (>15 mm) was obtained during oocyte retrieval from unexpected low responders (n = 13, group A) and 12 age-matched normal responders (n = 12, group B). MAIN OUTCOME MEASURE(S): The FF markers known to reflect follicle environment (insulin-like growth factor [IGF] II, IGF-binding protein 4, müllerian-inhibiting substance, pregnancy-associated plasma protein A, soluble Fas, and vascular endothelial growth factor [VEGF]) were analyzed by ELISA. RESULT(S): The baseline characteristics (age, day 3 serum LH, FSH, E(2), duration and dose of r-FSH, GnRH antagonist) were not different between the two groups. The number of large follicles, oocytes retrieved, and serum E(2) levels on the day of hCG injection were significantly higher in group B. Whereas the other follicular markers did not differ between the two groups, VEGF was significantly higher in group A. In addition, the VEGF concentration showed an inverse correlation with the total number of oocytes retrieved. CONCLUSION(S): The unexpected low response in women with normal basal hormone profiles, during GnRH antagonist protocol, was associated with altered follicular VEGF expression.