The Effect of Eqoul, a Metabolite of Isoflavone, on Endothelial Cell-independent Vasodilatation of Human Uterine Artery In Vitro

BACKGROUND: The purpose of this study is to investigate 1) whether equol has the direct modulation on vascular tone of endothelium-denuded human uterine artery, and 2) if present, whether this equol-induced modulation of vascular tone is mediated by intracellular calcium modulation through Ca2+ & K+ channels on vascular smooth muscle cell membrane. METHODS: The uterine arteries were obtained at the time of hysterectomy from 15 women. The uterine smooth muscles were pretreated with phenylephrine, 10(-5) M & high KCl solution 70 mM. The equol at 6 different concentrations from 10(-11) to 10(-6) M were used for the evaluation of modulatory action of equol on precontracted vascular smooth. The cumulative concentration-response for equol were determined on phenylephrine-induced contractions and compared with the results without pretreatment. RESULTS: Equol 10(-11) to 10(-6) M in concentration showed relaxation effect on vascular smooth muscle contraction which was induced by phenylephrine 10(-5) M. This relaxation effect of equol was dose-dependent. Equol in same concentrations showed no significant effects on vascular smooth muscle contraction induced by high KCI solution. Phenylephrine-induced contraction was markedly reduced from 10(-7) to 10(-4) M in concentration by pretreatment of equol, but high KCI-induced contraction was not affected by pretreatment of equol. CONCLUSIONS: This vasodilatation effect of equol may be induced by calcium antagonistic action, which was mediated through antagonistic action for receptor-dependent Ca2+ channel, but not for voltage-dependent Ca2+ channel. As far as we know, this is the first report of phytoestrogen equol on vascular reactivity of human vessels.

The change of hormone therapy in postmenopausal women in Korea before and after women's health initiative study: 2000~2009 / 대한산부인과학회지

OBJECTIVE: This study aims to survey the change of comsumption of hormone therapy (HT) before and after publication of Women's Health Initiative Study(WHI) result in Korea from 2000 to 2009. METHODS: Data from Intercontinental Marketing Services were used to analyze and ten years of hormone consumption from 2000 to 2009 was expressed in terms of hormone sales amount (Korean won, KRW, 1 dollar=1,100 won). Total hormone consisted of Estrogen (ET), Estrogen/Progestogen (EPT), and Tibolone. To identify changes in total hormone consumption, the cumulative growth rate was based on the sales in 2002. RESULTS: After publication of WHI result in 2002, HT consumption had been continuously decreased by 39% from 51.1 billion (bn) KRW in 2002 to 31.4 bn KRW in 2006. From 2007 to 2009, HT consumption has been slightly increased to 3.56 bn KRW. The decreased consumption of HT is mainly due to decrease of ET/EPT comsumption by 49%. Tibolone consumption was decreased by 25% during next 2years after WHI publication, but thereafter gradually increased over pre-WHI publication level in 2009. The proportion of consumption of low dosage regimen was markedly increased from 3.5% in 2002 to 41.8% in 2009. CONCLUSION: The total hormone consumption was markedly decreased after WHI. Low dosage regimen consumption was increased, comprising 3.5~41.8% of total EPT consumption. Tibolone consumption was transiently decreased during 2 years after WHI publication, but thereafter increased gradually and reached over the level of pre-WHI publication in 2009. We expect that low-dosage regimen of HT and tibolone will be more widely used. An individual-based treatment approach is essential in assessing the appropriateness of initiating hormone replacement therapy.

The effect of bisphenol A on cell apoptosis pattern in the spinal cord of chick embryos / 대한주산의학회잡지

OBJECTIVE: To investigate the effects of bisphenol A (BPA) on cell death pattern in neuronal development of chick embryos. MATERIALS AND METHODS: We planned to compare the cytokinetic features in the normal chick embryo and those with BPA. Fifteen eggs were divided into three GROUPS: the control group, BPA 50 microgram/g egg group and BPA 200 microgram/g egg group. Embryos were incubated for 56 hours (Hamburger & Hamilton stage 16) and then we injected BPA into embryos. The embryos were sectioned by 3 micrometer thickness at the level of wing buds and stained at 72 hours after incubation (HH stage 18). We observed cell death in the spinal cord using terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) method. RESULTS: The TUNEL-positivity markedly increased in proportion to the doses of BPA. The number of TUNEL-positive cells per section was 15.2+/-2.14 in the control group, 34.6+/-3.44 in the BPA 50 microgram/g egg group, 87.6+/-4.32 in the BPA 200 g/g egg group. Furthermore the contour of spinal cord was deformed as the doses of BPA raised. CONCLUSION: BPA causes neuronal cell death and exerts cytotoxic effect on early chick embryos. It suggests that BPA might have an effect on cytogenesis during neural tube development.

Update in Laparoscopic Hysterectomy and Laparoscopic Myomectomy / 한양의대학술지

The role of laparoscopic hysterectomy (LH) in current gynecological practice has yet to be defined. Randomized trials have demonstrated that, compared to abdominal hysterectomy, LH shortens hospital stay and induces less postoperative pain and quicker recovery. Some retrospective publications it seems that complication rates have increased in LH, especially those involving the urinary system. However, a recent analysis revealed a reasonable complication rate for the procedure, compared with abdominal hysterectomy, Laparoscopic supracervical hysterectomy (LSH) is a minimally invasive procedure that was developed during the 1990s as a treatment for abnormal uterine bleeding. The literature regarding this procedure, mainly case series and retrospective comparisons, suggests that LSH results in reduced operating time and blood loss and a quicker return to normal activity, compared with laparoscopic-assisted vaginal hysterectomy (LAVH). Given the lack of appropriate randomized, controlled trials and the limitations of the existing research, the LSH's true value and appropriate clinical indications remain unknown Uterine fibroids are the most common benign tumors of the uterus. Management depends on the symptoms, location and size of the fibroids, and the patient's desire to conceive. Surgical management of uterine fibroids has changed from laparotomy to minimally invasive surgery. Advances in surgical instruments and techniques are expanding the role of laparoscopic myomectomy in well-selected ndividuals. Meticulous repair of the myometrium is essential for women considering pregnancy after laparoscopic myomectomy to minimize the risk of uterine rupture. Laparoscopic myomectomy is an appropriate alternative to abdominal myomectomy or hysterectomy.

The Vitamin D perception survey on Korean postmenopausal women in the treatment of osteoporosis / 대한산부인과학회지

OBJECTIVE: The purpose of this study was to evaluate the vitamin D perception level in the treatment of osteoporosis of Korean postmenopausal women. METHODS: This study investigates the perception levels of 400 postmenopausal women aged 50 and over, vitamin D supplement administration, knowledge of vitamin D nutrition, consulting and information of vitamin D and the effect of media exposure during osteoporosis management. A descriptive survey design and a convenience sample of 400 female postmenopausal patients were used. Data were collected with a questionnaire and analysed. RESULTS: Sixty-two% of the patients took supplementary drugs in addition to prescribed main anti-osteoporotic medications. As supplementary drugs, most of them took calcium (57%) and this was twice the number of people taking vitamin D. For those who failed to take the recommended vitamin D or calcium regularly, seventy-eight% of them did not understand that it is important to take regularly. And this survey showed that people do not have enough knowledge on vitamin D compared to calcium. Patients thought that vitamin D is the third most important factor, next to calcium and exercise, for managing healthy and strong bones. Findings indicated that the women displayed a low level of perception and interests in vitamin D and the importance of vitamin D in the management of osteoporosis was assessed at lower than the truth. CONCLUSION: These findings suggested that the rates of vitamin D administration of Korean postmenopausal women in the management of osteoporosis is a low level because of a low level of perception of the importance of vitamin D. Therefore the education and the informations about vitamin D are contributable to the treatment of osteoporosis.

The technique and the safety of laparoscopic incidental appendectomy using single loop during gynecologic laparoscopic surgery / 대한산부인과학회지

OBJECTIVE: To introduce the technique of laparoscopic incidental appendectomy using single loop during gynecologic laparoscopic surgery and to demonstrate the safety of it. METHODS: This was a retrospective case-controlled study of patients who did (n=52) or did not (n=52) undergo laparoscopic incidental appendectomy at the time of the same gynecologic laparoscopic surgery between March 2003 and February 2007. There was no difference in age, body mass index, hypertension, diabetes mellitus, preoperative diagnosis. RESULTS: No significant differences were found between the two groups with respect to the duration of nothing per os (1.1 days vs 1.1 days), the duration of postoperative hospital stay (5.0 days vs 4.9 days), and the postoperative complications. 42.3% of the histologic specimens were abnormal and abnormal histologic results included fibrous obliteration(21.2%), endometriosis (9.6%), serositis (5.8%) and appendicitis (5.8%). CONCLUSION: Laparoscopic incidental appendectomy using single loop during laparoscopic gynecologic surgery was not found to influence the duration of nothing per os, the duration of postoperative hospital stay, and postoperative complications, so it thought to be the safe procedure.