Expression of FSHR mRNA in female genital organs / 대한산부인과학회잡지

FSH is the pivotal hormone in the regulation of ovarian function and acts by binding to specific receptor, FSH receptor (FSHR), which is belong to the family of G-protein coupled receptor. It have been considered that ovary is the only target organ of FSH because FSHR mRNA was first detected in ovarian follicles. However expression of FSHR mRNA was also detected on fallopian tube in experimental animal study and it is related wih tumorigenesis in postmenopausal women.In this study, in order to understand the FSH function in female genital organs, the ontogeny of the production profile of FSHR and the pattern of its localization in female genital organs were studied. We obtained the fresh tissues of ovary, fallopian tube, uterine body and uterine cervix with blood samples during proliferative phase in women with regular menstrual cycle. To establish FSHR mRNA expression of human internal genital organ, we studied by using in situ hybridization and quantitative competitive reverse transcription polymerase chain reaction (QC RT-PCR). To localize FSHR transcripts by in situ hybridization, we synthesized digoxigenin-labelled ssRNA probe (about 800 bp) from the cloned FSHR cDNA. For QC RT-PCR, we designed oligonucleotide primers (antisense: 5'-GGCCCTGCTCCTGGTCTCTTTG-3', sense: 3'-AACAGCGGGAGTACCTTCGG-5') which produced 799 bp sized PCR products. Simultaneously we synthesized 149 bp deleted DNA competitor by site-directed mutagenesis to quantify target FSHR mRNA expression comparing as internal control.In situ hybridization with digoxigenin-labelled ssRNA probe showed no signal above the background in primordial follicles. FSHR mRNA was first detected in the single layer of cuboidal granulosa cells surrounding primary follicles. As follicular growth progressed, FSHR mRNA expression increased gradually in antral and graafian follicles. Similary, in fallopian tube, the epithelium stained intensly. But FSHR mRNA expression was absent in uterine body including endometrium and myometrium and uterine cervix. Total RNA was extracted and quantitated by QC RT-PCR. The amounts of FSHR transcript measured were 840.00+/-516.29 in the ovarian tissue, 240.00+/-154.91 in the fallopian tube, 6.06+/-4.13 in the uterine body, 5.48+/-5.00 fg in the uterine cervix. These experiments demonstrated that FSHR mRNA is expressed in the ovary and fallopian tube, albeit only small amount was expressed in uterine body and cervix.In conclusion, the presence of FSHR mRNA in female internal genital organ with site specific pattern suggested that FSH may have some role in female genital organs during the adult reproductive cycle and may act as an factor in the tumorigenesis. Further study about the functional role and tumorigenesis of FSH should be performed in human internal genital organ.

Influence of aging on expression of FSHR mRNA in human ovary / 대한산부인과학회잡지

FSH is the central hormone for the regulation of ovarian function and acts by binding with specific receptor, FSHR, which is one of the G-protein coupled receptor family. The aging of ovary decreases the number and the activity of follicle, which results in the increase of FSH by reduction of inhibin and estrogen. The study on FSH level and FSHR mRNA expression in the ovary of perimenopausal women is the crucial step for the understanding of the menopausal mechanism.We studied FSHR mRNA expression of ovarian follicle by using in situ hybridization and QC RT-PCR. The fresh ovarian tissues and blood samples were obtained from premenopausal women in mid-follicular stage and postmenopausal women. The experimental samples were grouped as below 40 years old women, 40-44 years old ones, 45-49 years old ones, 50-54 years old ones, and postmenopausal women as negative control. To localize FSHR transcripts by in situ hybridization, we synthesized digoxigenin-labelled ssRNA probe (about 800 bp) and measured the degree of staining as 0, 1+, 2+ in the primary follicles which were independent to FSH effect. To do QC RT-PCR, we synthesized oligonucleotide primers (antisense: 5-GGCCCTGCTCCTGG- TCTCTTTG-3, sense: 3-AACAGCGGGAGTACCTTCGG-5) to form the 799 bp sized PCR products. We also synthesized 149 bp deleted DNA competitor by site-directed mutagenesis and then calculated the relative amount of target FSHR mRNA by comparing with competitor after PCR.There were significant reverse relationships between follicular number and aging (r=-0.934, P=0.01), and FSH level (r=-0.713, P<0.001). The similar amount of FSHR mRNA was expressed in the group of below 40 years by in situ hybridization. In the groups of above 40 years, the FSHR mRNA expression decreased progressively according to aging (r=-0.744, P<0.001) and FSH level (r=-0.771, P<0.001). But we could not find FSHR mRNA expression in menopausal ovaries. The amount of follicular FSHR mRNA was measured as 840.00+/-516.29 for the below 40 years group, 240.00+/-154.91 for the 40-44 years group, 40.00+/-21.90 for the 45-49 years group, 6.06+/-4.13 for the 50-54 years group, and 0.48+/-0.00 fg in the postmenopausal ovary. The amount of FSHR mRNA decreased with ovarian aging (r=-0.857, P<0.001) and FSH level (r=-0.771, P<0.001).These results demonstrate that the gradual increase of FSH and the decrease of FSHR mRNA expression in older than 40 years women are related to the changes of sex hormones. However the gradual decrease of the FSHR mRNA expression in the primary follicle may be due to the follicular aging itself. Therefore the menopausal transition already starts at the beginning of 40 years and one of the major cause of the menopause may be the reduction of FSHR mRNA expression followed the decrease of ovarian response to gonadotropins. The further studies should be required to elucidate the underlying mechanism and the associated factors of menopause.

Comparison of tubal patency and pregnancy rate in microsurgical reanastomosis of rabbit fallopian tube using contact Nd-YAG Laser and suture materials / 대한산부인과학회잡지

OBJECTIVE: Many different methods have been undertaken to increase the success rate of tuboplasty. Ttubal reanastomosis, Nd-YAG laser, splint he development of a new generation of surgical lasers has offered a possibility for the practical use of the laser technique in microsurgical fields. In gynecology, the laser beam has been reported to be a precise instrument for successful tubal surgery with minimal bleeding and postoperative reaction. The authors studied the effect of the infrared laser beam in the area of tubal reanastomosis. METHODS: To compare tubal patency, pregnancy rate, and histologic difference in site of anastomosis, total 120 tubes of 60 rabbits were used for experimental tuboplasty. The study groups were divided according to the kinds of reanastomosis methods. Group I : 1 layer(right tube) and 2 layer(left tube) anastomosis without using splint, group II : 1 layer(right tube) and 2 layer(left tube) anastomosis with using splint, group III : reanastomosis using laser with splint(III-b) and without splint(III-a). RESULTS: 1. The infiltration of inflammatory cell were observed in all group by optical microscopic examination. Group II revealed more fibrotic change and inflammatory cell without significant statistical difference and there was no significant difference between left and right tubes in each group. 2. The tubes of group II were significantly more patent(75%) than that of group I(50%). Especially the patency of group III performed Nd-YAG laser with splint was the highest(90%). 3. The pregnancy rates in groups without splint were 40%(one layer without splint, group I-right tube), 60%(two layer without splint, group I-left tube), 30%(Nd-YAG laser without splint, group III-a), were significantly lower than that of group with splint, 60%(one layer with splint, Group II-right tube), 60%(two layer with splint, Group II-left tube), 80%(Nd-YAG laser with splint, Group III-b). Especially the group IIIb showed the hightest pregnancy rate(80%). CONCLUSIONS: From the above results, it is considered that the tubal reanastomosis using splint and Nd-YAG laser will improve the pregnancy rate and could be the procedure of choice in the future.

Assessment of Pelvic Floor Muscle Exercise using Vaginal Cone in Stress Urinary Incontinence of Korea Women / 대한산부인과학회잡지

Defective or inadequate pelvic floor function is important etiologic factor for urinary stress incontinence and uterine prolapse. Pelvic floor muscle exercise is the mainstream of the nonoperative treatment for female stress urinary incontinence. Especially Vaginal cones have been known as a simple and practical means of improving both pelvic floor muscle strength and genuine stress incontinence using biofeedback mechanism. Forty adult women suffering from mild and moderate stress incontincnce were instructed to exercise their pelvic muscles using vaginal cones. They retained cones of increasing weight in the vagina by contracting pelvic floor muscles for 15 minutes twice a day for 4 weeks. The comparison of pelvic floor muscle function before and after the exercise were assessed by the frequency of incontinence, vaginal digital palpation, vaginal pressure measurement and speculm lift test. The results were as follows; 1. The frequency of incontinence was significantly reduced after the exercise using vaginal cone (P<0.001). 2. Vaginal digital palpation score (strength of vaginal levator muscle) was significantly increased after the exercise using vaginal cone (P<0.001). 3. The vaginal pressure by perineometer was significantly increased after the exercise using vaginal cones (P<0.001). 4. The vaginal lumen during contraction was significantly narrower after the exercise using vaginal cones (P<0.001). 5. The maximal cone weight which patients could hold over 1 minute was significantly increased after the exercise using vaginal cones (P<0.001).

Change of serum sex hormone levels in hysterectomized patients according to type of adnexal surgery / 대한산부인과학회잡지

OBJECTIVE: To describe the change of serum estradiol, follicul-stimulating hormone and testosterone after hysterectomy, and its difference according to the type of adnexal surgery in pre, and postmenopausal women. MATERIALS AND METHOD: Three hundred twenty four women presenting for hysterectomies for nononcologic reasons. We divide the women into four groups, who only hysterectomized, who with both adnexectomized, who with unilateral adnexectomized, and who with both salpingectomized. We collect the blood samples for serum estradiol and testosterone in preoperative day, 1 day after, 3 day after, 6 day after and 1 month after operation. And check FSH in a day before operation and 1month after operation. RESULT: Estradiol shows significant decrease in both adnectomy group compared to the unilateral adnexectomized and only hysterectomized. The both salpingectomized shows no difference with the both adnectomized. Testosterone shows no difference between groups in premenopausal women. In postmenopausal women, testosterone decreased 3 days after both adnexectomy compared to the only hysterectomized and the unilateral adnexectomized. The both salpingectomized shows no difference with the both adnexectomized. CONCLUSION: Testosterone decreases significantly in postmenopausal women after hysterectomy with both adnexectomy or both salpingectomy. So we think it was appropriate treatment to replace estrogen and testosterone in postmenopausal women who both adnexectomized or both salpingectomized.

Change of serum sex hormone levels in hysterectomized patients according to type of adnexal surgery / 대한산부인과학회잡지

OBJECTIVE: To describe the change of serum estradiol, follicul-stimulating hormone and testosterone after hysterectomy, and its difference according to the type of adnexal surgery in pre, and postmenopausal women. MATERIALS AND METHOD: Three hundred twenty four women presenting for hysterectomies for nononcologic reasons. We divide the women into four groups, who only hysterectomized, who with both adnexectomized, who with unilateral adnexectomized, and who with both salpingectomized. We collect the blood samples for serum estradiol and testosterone in preoperative day, 1 day after, 3 day after, 6 day after and 1 month after operation. And check FSH in a day before operation and 1month after operation. RESULT: Estradiol shows significant decrease in both adnectomy group compared to the unilateral adnexectomized and only hysterectomized. The both salpingectomized shows no difference with the both adnectomized. Testosterone shows no difference between groups in premenopausal women. In postmenopausal women, testosterone decreased 3 days after both adnexectomy compared to the only hysterectomized and the unilateral adnexectomized. The both salpingectomized shows no difference with the both adnexectomized. CONCLUSION: Testosterone decreases significantly in postmenopausal women after hysterectomy with both adnexectomy or both salpingectomy. So we think it was appropriate treatment to replace estrogen and testosterone in postmenopausal women who both adnexectomized or both salpingectomized.

A Case for Treatment of Precocious Pseudopuberty Associated with Follicular cyst / 대한산부인과학회잡지

Small follicular cysts are common findings in the ovaries of prepubertal girls, and in most cases, they are of no clinical importance. Ocassionally these cysts may enlarge and continue to produce estrogen, resulting in signs of precocious sexual development and vaginal bleeding. We have experienced a case of a precocious pseudopuberty causing ovarian follicular cyst which was treated by exploratory laparotomy. we present this case with a brief review of literatures

A Case of Hypogonadotrophic Hypogonadism due to Intrasellar Arachnoid Cyst / 대한산부인과학회잡지

Primary amenorrhea due to intrasella arachnoid cyst is a very rare disease and require careful and frequent evaluation because may produce intracranial hemorrhage, elevated intracranial pressure and rapid expansion. Surgical intervention is needed only when visual disturbance, hypopituitarism or enlarging lesion is shown. Thus, we present a case of primary amenorrhea due to intrasella arachnoid cyst which was resected through the transsphenoidal approach.

The effect of Vitamin D(3)addition on bone mineral density in postmenopausal hormone replacement / 대한산부인과학회잡지

OBJECTIVE: To determine the effect of the addition of Vit. D3 (1,25-Dihydroxychole calciferol D3) to the conventional postmenopausal hormone replacement therapy on bone mineral density(BMD) DESIGN: A 2-year retrospective , randomized study Setting : Department of Obstetrics and Gynecology of Catholic university hospital Patients : 388 postmenopausal women were recruited and divided into 5 groups according to treatment regimen; A: conjugated estrogens only treated group(n=146), B : conjugated estrogens and progesterone treated group(n=103), C : conjugated estrogens and Vit.D3 treated group (n=36), D : conjugated estrogens, progesterone and Vit.D3 treated group (n=41), E : control group (n=60). METHODS: The bone mineral density of the lumbar spines and femoral neck were determined by dual-energy X-ray absorptiometry(DEXA) every 2 years. STATISTICS: The difference between before and after treatment was determined by paired t-test. The comparison among the groups were determined by one way ANOVA test and student's t-test. RESULTS: The addition of progesterone to estrogen showed insignificant increase in the lumbar and femoral neck BMD. The addition of Vit. D3 compared with conventional hormone replacement therapy insignificantly influened bone density in women with initially normal BMD, but definitely increase in women with initially osteopenic and osteoporotic BMD of femoral neck rather than lumar spine(p<0.05). CONCLUSIONS: The use of Vit. D3 combined with postmenopausal estrogen replacement effects the increase of BMD in low bone density than normal bone density, especially femoral neck.

Ovarian Recovery after Bone Marrow Transplantation in Aplastic Anemia / 대한산부인과학회잡지

OBJECTIVE: Ovarian failure is often common complication by the conditioning protocol used for bone marrow transplantation (BMT). To determine the frequency of recovery of ovarian function after allo-BMT and the major factor that predict recovery, we monitored ovarian function in 24 premenopausal women METHOD: Twenty-four women met the inclusion criteria, which were (1) moderate to severe aplastic anemia before BMT, (2) disease-free at least 18 month after transplantation, (3) age younger than 40 years and more than 3 years after menarche at transplantation and (4) regular menstrual periods before transplantation. Recovery of ovarian function was determined by regular menses without menopausal symptom and sign. we divided conditioning regimen to two groups, Group I : cytoxan alone(n=17), Group II : cytoxan plus total body irradiation (TBI)(n=7). RESULTS: All women became amenorrhea after BMT and the clinical characteristics were not significant between two groups. 17 patients who received only cytoxan all recovered ovarian function between 1 to 14 months(median : 7.28) after BMT. The median age at BMT of women with regained ovarian function was 26 years (range, 21 to 33) versus 30 (range, 21 to 37) for those who did not. The age at transplantation was not significant between two groups in our study and the most predictive independent factor in ovarian recovery is the presence of total body irradiation. None of women who received TBI regained ovarian function during 19-49 month follow up. CONCLUSION: Gonadal insufficiency due to pre-BMT conditioning is more severe in radiation based regimen than cytoxan alone. therefore, we recommend early hormone replacement therapy in radiation treated women to prevent the complication of premature menopause.

Expression of Epidermal Growth Factor, Transforming Growth Factor-alphaand Epidermal Growth Factor Receptor in Human Trophoblast and Decidua / 대한산부인과학회잡지

OBJECTIVE: We studied the expression of epidermal growh factor(EGF) and transforming growth factor(TGF)-a and epidermal growth factor receptor(EGFR) in human trophoblast and decidua at the first and third trimester. METHODS: To confirm the expression of EGF, TGF-a and EGFR immunohisochemically in human trophoblast and decidua, we used monoclonal antibodies to EGF, TGF-a and EGFR. RESULTS: Immunohistochemical stainings using anti-EGF, anti-TGF- a and anti-EGFR antibodies showed a specific stainings in human trophoblast and decidua at the first and third trimester. The staining intensity of EGF in the trophoblast was light to moderate at the first trimester and moderate at the third trimester, and that in the decidua was light to moderate at the first trimester and light at the third trimester. The patterns of expression of TGF- a in the trophoblast and decidua were similar to that seen with EGF in the trophoblast and that of EGFR in trophoblast and decidua were similar to that seen with EGF in decidua. CONCLUSION: These findings suggest that EGF, TGF-a and EGFR may play an important role in human trophoblast and decidua during gestation.

p16INK4A and p15 INK4B Gene Alterations in Primary Uterine Cervical Carcinoma Tissues and Cervical Carcinoma Cell Lines / 대한암학회지

PURPOSE: Alterations of the p15(INK4B) and p16(INK4A) gene which are separated by 25 kb on chromosome 9p21 have been reported in various tumor derived cell lines and primary tumors, but the role of these genes in cervical cancer is unknown. MATERIAL AND METHOD: To determine the frequency of deletions and point mutations of these genes in human cervical cancer, we examined 57 primary tumors and matched normal tissues, and 3 cervical cancer derived cell lines. All the tumor tissues and cell lines were human papil- INK48 lomavirus (HPV)-positive. Deletions or point mutations of exon 2 of the pl5 gene and exons 1, 2, and 3 of the p16(INK4A) gene were examined by polymerase chain reaction (PCR) and direct sequencing, respectively. RESULT: Our data indicate no evidence for intragenic homozygous deletion or point mutation in the cervical cancer or cervical cancer derived cell lines. INK48 INK4A CONCLUSION: Deletions or point mutations in the p15 or p16 gene may not be required for the development of HPV-positive cervical cancer or for establishment of cervical cancer cell lines.

A Case of Stage III c Borderline Malignant Ovarian Surface Papilloma with Invasive Peritoneal Implant / 대한산부인과학회잡지

The serous borderline tumors(SBTs) are divided into 3 groups, typical SBT with nonin-vasive implants, SBTs with invasive implants, and a recently described tumor, desinated mic-ropapillary serous carcinoma(MPSC). These tumors are associated with extraovarian implants, espicially peritoneum. Invasiveness of implants has prognostic significance in disease progre-ssion and recurrence. Micropapillary serous carcinoma and SBTs with invasive implants sho-uld be classified as carcinoma and treated accordingly. We report a case of borderline malign-ant ovarian surface papilloma with invasive peritoneal implant.

Exression of p53, Proliferating Cell Nuclear Antigen(PCNA), c-myc, and Epidermal Growth Factor Receptor(EGFR) in Cervical Neoplasia / 대한산부인과학회잡지

No abstract available.