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1.
Article in English | WPRIM | ID: wpr-915715

ABSTRACT

Purpose@#This study aimed to identify the prevalence of sarcopenia, obesity, and sarcopenic obesity and their association to radiographic knee osteoarthritis (OA) and knee pain in Korean menopausal women. @*Methods@#This study cross-sectional study utilized the data obtained from Korean National Health and Nutrition Examination Surveys (KNHANES) 2009-2011 which included 4,362 menopausal women. The participants were categorized based on their body composition and the prevalence of radiographic knee OA and knee pain were calculated. The effect of hormone therapy (HT) was analyzed as subcohort analysis. @*Results@#The prevalence of radiographic knee OA, knee pain, and both radiographic knee OA and knee pain were all highest in sarcopenic obese group and lowest in non-sarcopenic non-obese group. Among the non-sarcopenic people, the obese people showed higher ratio of only radiographic knee OA (57.64% vs. 41.54%, p < 0.001). When sarcopenic, the coexistence of obesity presented significantly higher ratio of radiographic knee OA, knee pain, and both radiographic knee OA and knee pain compared to sarcopenic without obesity (61.49% vs. 41.82%, 39.11% vs. 27.61%, 32.04 vs. 17.60%, all p < 0.001).Regarding the use of HT for longer than 1 year was not associated with statistically different ratio of neither radiographic knee OA nor knee pain. @*Conclusion@#The obesity in terms of sarcopenia have greater effect on knee OA compared to the obesity without sarcopenia and HT use of longer than 1 year is not associated with the prevalence of knee OA. Therefore, more preventive effort to knee OA should be focused on reducing body fat and increasing muscle in the postmenopausal women.

2.
Article in English | WPRIM | ID: wpr-915710

ABSTRACT

Objective@#After Women's Health Initiative (WHI) trial, hormone replacement therapy (HRT) prescription rate dropped by 16% in Korea. We investigated the relationship between the type of HRT and incidence of breast cancer (BC) in postmenopausal women in Korea.Material & Methods: We compared the prevalence of BC in 356,160 women on HRT, who reached menopause between 2004 and 2007. We divided the type and duration of HRT into three categories, i.e., estrogen-progestogen therapy (EPT), estrogen-only therapy (ET), tibolone, and 1– 3 years, 3–5 years, and >5 years, respectively. @*Results@#Regarding the type of HRT among all age groups, BC risk (BCR) was lower in the tibolone group (P<0.01). Based on age group, BCR was lower in the 50–59 years group using EPT (P=0.03) and tibolone (P<0.01). HRT administration for <3 years showed a significant decrease in the tibolone group (P=0.04) and an increase in the ET group (P=0.03). In groups undergoing HRT for >5 years, BCR in all groups decreased (P<0.05). @*Conclusions@#The results suggest that tibolone reduces the risk of BC in women aged ≥50 years and HRT use for ≥5 years was related to significantly decreased BCR in Korea.

3.
Article in English | WPRIM | ID: wpr-915709

ABSTRACT

Purpose@#This study aimed to investigate whether the number of parity is associated with the prevalence of sarcopenia in postmenopausal women. @*Methods@#This study was performed using data from the 2010-2011 Korean National Health and Nutrition Examination Survey that included 1,338 postmenopausal women aged 46-70 years. The prevalence of sarcopenia was analyzed according to the number of births. Modifiable risk factors were evaluated to determine the association of parity with sarcopenia in susceptible population. @*Results@#The sarcopenia group (n=343) had lower number of parity, lower body mass index, more frequent previous history of diabetes mellitus, higher Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), and higher education level than the non-sarcopenia group (n=995). The sarcopenia risk was significantly lower in postmenopausal women with a higher number of parity (≥3 births) (model 1: odds ratio [OR]=0.308; 95% confidence interval [CI]=0.115–0.827, p=0.0194; model 2: OR=0.269; 95% CI=0.109–0.66, p=0.0042; model 3: OR=0.640; 95% CI=0.428–0.957, p=0.0295; model 4: OR=0.636; 95% CI=0.413–0.980, p=0.0403). In subgroup analysis of the lower parity group, moderate aerobic activity was associated with a lower sarcopenia prevalence (OR: 0.52; 95% CI: 0.317–0.852; p=0.0095). @*Conclusion@#A lower number of parity increases the risk of sarcopenia in postmenopausal Korean women. Moderate aerobic activity may be effective in preventing sarcopenia in postmenopausal women with lower parity who are more susceptible to sarcopenia.

4.
Article in English | WPRIM | ID: wpr-913932

ABSTRACT

Theca lutein cysts are rare, benign lesions responsible for gross cystic enlargement of both ovaries during pregnancy. This condition is also termed hyperreactio luteinalis. Elevated human chorionic gonadotropin (hCG) levels or states of hCG hypersensitivity seem to promote these changes, which in up to 30% of patients produce clinical signs of hyperandrogenism. Given the self-limiting course of theca lutein cysts, which are subject to spontaneous postpartum resolution, conservative treatment is the mainstay of patient management. Described herein is a rare case of theca lutein cysts with maternal virilization that failed to regress by 9 months after childbirth. Surgical intervention was eventually undertaken, necessitated by adnexal torsion.

6.
Article in English | WPRIM | ID: wpr-760662

ABSTRACT

OBJECTIVE: This study was aimed at identifying a correlation between polycystic ovarian morphology (PCOM) and the severity of primary dysmenorrhea in young Korean women. METHODS: A total of 592 patients who visited a tertiary hospital from March 2008 to March 2015 for dysmenorrhea were examined. After excluding those with secondary causes of menstrual pain (for example, myoma, adenomyosis, endometriosis, and pelvic inflammatory disease), 361 women were recruited and retrospectively analyzed. Severe dysmenorrhea was defined as a visual analog scale (VAS) score ≥6. RESULTS: The mean patient age was 23.0±4.0 years, the average menstrual cycle length was 34.4±23.7 days, and the average pain intensity was VAS 6.7±0.1 at baseline. PCOM was assessed by ultrasound in 54 women (15%). Patients with severe menstrual pain were more likely to have irregular menstrual cycles (P=0.03) and heavy menstrual flow (P=0.01) than those with mild menstrual pain. After adjusting for weight, height, menstrual cycle interval, and menstrual flow in the logistic regression analysis, PCOM (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.05–4.97; P=0.04) and heavy menstrual flow (OR, 1.85; 95% CI, 1.05–3.28; P=0.04) were found to be significant independent factors influencing pain. CONCLUSION: Our study shows that PCOM may have a correlation with the severity of primary dysmenorrhea. Since PCOM may play a role in the development of menstrual pain, patients with PCOM should be under active surveillance with resources for prompt pain management readily available. It may also be necessary to further investigate the molecular mechanisms of pain development in primary dysmenorrhea.


Subject(s)
Adenomyosis , Dysmenorrhea , Endometriosis , Female , Humans , Logistic Models , Menstrual Cycle , Menstruation Disturbances , Myoma , Pain Management , Polycystic Ovary Syndrome , Retrospective Studies , Tertiary Care Centers , Ultrasonography , Visual Analog Scale
7.
Yonsei Medical Journal ; : 533-539, 2017.
Article in English | WPRIM | ID: wpr-188816

ABSTRACT

PURPOSE: To investigate the perceptions of postmenopausal symptoms and treatment options among middle-aged Korean women. MATERIALS AND METHODS: This cross-sectional study included 2330 Korean women. The women were administered a structured questionnaire to collect sociodemographic data and information regarding menopause and its treatment. RESULTS: More than half (65%) of the participants perceived menopause as a disease, and 66.8% knew hormone therapy (HT) is available for menopausal symptom treatment. However, only 19.7% of participants visited clinics for HT. The most common reasons for having negative views about HT were its adverse reactions (47.3%) and concerns about developing cancer (41.1%). For symptom management, 36.5% of the participants tried lifestyle modification instead of HT. CONCLUSION: The majority of Korean women regarded menopause as a disease. They were aware of HT for menopausal symptom treatment, but the use of HT was relatively low. Education about the safety and positive effects of HT and the importance of professional healthcare should be provided.


Subject(s)
Cross-Sectional Studies , Delivery of Health Care , Education , Female , Hormone Replacement Therapy , Humans , Life Style , Menopause , Middle Aged , Postmenopause
8.
Article in English | WPRIM | ID: wpr-34447

ABSTRACT

OBJECTIVE: This study aimed to identify factors that affect in vitro fertilization (IVF) outcomes in women with diminished ovarian reserve (DOR). METHODS: We reviewed 99 IVF cycles in 52 women with DOR between September 2010 and January 2015. DOR was defined as serum anti-Müllerian hormone level of <1.1 ng/dL or serum follicle-stimulating hormone level of ≥20 mIU/mL. Total 96 cycles in 50 patients were evaluated after excluding fertility preservation cases. RESULTS: The clinical pregnancy rate was 11.5% per cycle, and the total cancellation rate was 34.4%. Clinical pregnancy rate was significantly associated with the antral follicle count and the cause of the DOR. Age, serum anti-Müllerian hormone and follicle-stimulating hormone levels, antral follicle count, peak estradiol level, and the cause of DOR were significantly associated with cycle cancellation. However, history of previous ovarian surgery remained as a significant factor of clinical pregnancy (model 1: odds ratio [OR] 10.17, 95% confidence interval [CI] 1.46 to 70.84, P=0.019; model 2: OR 10.85, 95% CI 1.05 to 111.71, P=0.045). In cancellation models, idiopathic or previous chemotherapy group showed borderline significance (model 1: OR 3.76, 95% CI 0.83 to 17.04, P=0.086; model 2: OR 3.15, 95% CI 0.84 to 11.84, P=0.09). CONCLUSION: DOR caused by previous ovarian surgery may show better pregnancy outcome, whereas that caused by chemotherapy could significantly increase the cycle cancellation rate. Furthermore, patients with DOR who previously received gonadotoxic agents may show reduced efficacy and increased risk of IVF cycle cancellation.


Subject(s)
Drug Therapy , Estradiol , Female , Fertility Preservation , Fertilization in Vitro , Follicle Stimulating Hormone , Humans , In Vitro Techniques , Odds Ratio , Ovarian Reserve , Pregnancy , Pregnancy Outcome , Pregnancy Rate
9.
Article in English | WPRIM | ID: wpr-34446

ABSTRACT

OBJECTIVE: We evaluated the combined effects of vitamin D and daily calcium intake on bone mineral density (BMD) and osteoporosis in Korean postmenopausal women. METHODS: This study is a cross-sectional study consisting of 1,921 Korean postmenopausal women aged 45 to 70 years without thyroid dysfunction, from the 2008–2011 Korean National Health and Nutrition Examination Survey. Participants were classified into six groups according to serum 25-hydroxyvitamin D (25(OH)D) levels and daily calcium intake. BMD was measured using dual-energy X-ray absorptiometry at femur and at lumbar spine, and the serum vitamin D levels were measured by radioimmunoassay. RESULTS: The BMD divided according to serum 25(OH)D and daily calcium intakes were not statistically different among the groups. However, when both daily calcium intake and serum 25(OH)D were not sufficient, risk of osteopenia and osteoporosis showed significant increase in both femur neck and lumbar spine (odds ratio [OR] 2.242, P=0.006; OR 3.044, P=0.001; respectively). Although daily calcium intake was sufficient, risks of osteopenia and osteoporosis significantly increased in lumbar spine group if serum 25(OH)D is <20 ng/mL (OR 2.993, P=0.006). CONCLUSION: The combined effects of insufficient daily calcium intake and vitamin D deficiency may cause low BMD and increase in prevalence of osteopenia and osteoporosis in Korean postmenopausal women aged 45 to 70 years.


Subject(s)
Absorptiometry, Photon , Bone Density , Bone Diseases, Metabolic , Calcium , Cross-Sectional Studies , Female , Femur , Femur Neck , Humans , Menopause , Nutrition Surveys , Osteoporosis , Prevalence , Radioimmunoassay , Spine , Thyroid Gland , Vitamin D Deficiency , Vitamin D , Vitamins
10.
Article in English | WPRIM | ID: wpr-156644

ABSTRACT

The common causes of postmenopausal bleeding (PMB), according to the data from the western world, are atrophy, hormone replacement therapy (HRT), endometrial cancer, etc. We conducted a retrospective study to assess whether the causes of PMB in Korean postmenopausal women are similar to those already known. This retrospective study used 10-year medical records (March 2005 to December 2014) of 792 PMB women in the Yonsei University Health System. The data were divided into 2 categories by 5-year intervals to compare the differences between the 2 periods. The most common cause of PMB in Korean women was atrophy (51.1%). Polyps and HRT were the second, followed by anticoagulant medications, cervical cancer, and endometrial cancer. The proportion of patients with cervical cancer significantly decreased during the second half of the decade (8.7% vs. 5.2%; P = 0.048). Although no significant change was noted for HRT, its rank was higher during the latter 5-year period. Only the most common cause of PMB was the same as the conventional data. Interestingly, the proportion of patients with cervical cancer decreased during the latter half of the decade, reflecting the changes in the nation's cancer prevalence rate, while the use of HRT increased.


Subject(s)
Atrophy , Endometrial Neoplasms , Female , Hemorrhage , Hormone Replacement Therapy , Humans , Medical Records , Polyps , Prevalence , Retrospective Studies , Uterine Cervical Neoplasms , Western World
11.
Yonsei Medical Journal ; : 33-40, 2016.
Article in English | WPRIM | ID: wpr-199916

ABSTRACT

PURPOSE: This study aimed to investigate whether Mullerian inhibiting substance (MIS) in combination with calcitriol modulates proliferation and apoptosis of human ovarian cancer (OCa) cell lines (SKOV3, OVCAR3, and OVCA433) and identify the signaling pathway by which MIS mediates apoptosis. MATERIALS AND METHODS: OCa cell lines were treated with MIS in the absence or presence of calcitriol. Cell viability and proliferation were evaluated using the Cell Counting Kit-8 assay and apoptosis was evaluated by DNA fragmentation assay. Western blot and enzyme-linked immunosorbent assay were used to determine the signaling pathway. RESULTS: The cells showed specific staining for the MIS type II receptor. Treatment of OCa cells with MIS and calcitriol led to dose- and time-dependent inhibition of cell growth and survival. The combination treatment significantly suppressed cell growth, down-regulated the expression of B-cell lymphoma 2 (Bcl-2), and up-regulated the expressions of Bcl-2 associated X protein, caspase-3, and caspase-9 through the extracellular signal-regulated kinase signaling pathway. CONCLUSION: These results, coupled with a much-needed decrease in the toxic side effects of currently employed therapeutic agents, provide a strong rationale for testing the therapeutic potential of MIS, alone or in combination with calcitriol, in the treatment of OCa.


Subject(s)
Anti-Mullerian Hormone/pharmacology , Apoptosis/drug effects , Calcitriol/pharmacology , Caspase 3/metabolism , Caspase 9/metabolism , Cell Cycle/drug effects , Cell Line, Tumor , Cell Proliferation/drug effects , Cell Survival/drug effects , DNA Fragmentation/drug effects , Enzyme-Linked Immunosorbent Assay , Extracellular Signal-Regulated MAP Kinases/metabolism , Female , Growth Inhibitors/metabolism , Humans , Ovarian Neoplasms/drug therapy , Receptors, Peptide , Receptors, Transforming Growth Factor beta , Signal Transduction/drug effects
12.
Article in English | WPRIM | ID: wpr-10054

ABSTRACT

OBJECTIVES: Menopause is a natural aging process causing estrogen deficiency, accelerating atherogenic processes including dyslipidemia. Prevalence of thyroid dysfunction is also high in postmenopausal women, and it is known to elevate the risk of cardiovascular disease (CVD). Therefore, we are to study on the associations in between serum thyroid stimulating hormone (TSH) and prevalence of CVD in postmenopausal women who have normal thyroid function. METHODS: We performed a retrospective review of 247 Korean postmenopausal women who visited the health promotion center from January, 2007 to December, 2009. Postmenopausal women with normal serum TSH were included in the study. Coronary atherosclerosis was assessed by 64-row multidetector computed tomography. RESULTS: In multiple linear regression analysis, serum TSH was associated with serum triglyceride (TG) (β = 0.146, P = 0.023). In multiple logistic regression analysis, increasing age and serum TSH were associated with an increased risk of coronary atherosclerosis in euthyroid postmenopausal women (odds ratio [OR] = 1.107 [1.024-1.197], P = 0.011 and OR = 1.303 [1.024-1.658], P = 0.031, respectively). CONCLUSIONS: It revealed that significant predictor of serum TSH was serum TG, and increasing age and TSH were found to have associations with an increased risk of coronary atherosclerosis in euthyroid postmenopausal women. Screening and assessing risks for CVD in healthy postmenopausal women would be helpful before atherosclerosis develops.


Subject(s)
Aging , Atherosclerosis , Cardiovascular Diseases , Coronary Artery Disease , Dyslipidemias , Estrogens , Female , Health Promotion , Humans , Linear Models , Logistic Models , Mass Screening , Menopause , Multidetector Computed Tomography , Postmenopause , Prevalence , Retrospective Studies , Thyroid Gland , Thyrotropin , Triglycerides
13.
Article in English | WPRIM | ID: wpr-10051

ABSTRACT

OBJECTIVES: Decreased renal function is associated with increased cardiovascular risk. Our study was planned to verify the association of decreased renal function and subclinical coronary atherosclerosis in postmenopausal women. METHODS: We performed a retrospective review of 251 Korean postmenopausal women who visited the health promotion center for a routine health checkup. Estimated glomerular filtration rate (eGFR) was used to show renal function, which was estimated by calculated using the Cockcroft-Gault (CG) and the modification of diet in renal disease (MDRD) formulas. Coronary atherosclerosis was assessed by 64-row multidetector computed tomography. RESULTS: Women with reduced eGFR (< 60 mL/minute/1.73 m²) had significantly higher brachial-ankle pulse wave velocity (baPWV) than women with normal eGFR (≥ 60 mL/minute/1.73 m²). The eGFR was negatively correlated with baPWV (r = -0.352, P < 0.001), significantly. The eGFR was lower in women with coronary atherosclerosis than in normal control women, markedly. Reduced eGFR was significantly associated with the presence of coronary atherosclerosis (odds ratio [OR] = 7.528, 95% confidence interval [CI] = 2.728-20.772, P < 0.001). CONCLUSIONS: Decreased eGFR was closely associated with increased arterial stiffness and coronary atherosclerosis in postmenopausal women. Evaluating subclinical atherosclerosis by screening the renal function in postmenopausal women may be helpful screening high risk group and considering starting menopausal hormone therapy before atherosclerosis development.


Subject(s)
Atherosclerosis , Coronary Artery Disease , Diet , Female , Glomerular Filtration Rate , Health Promotion , Humans , Kidney Function Tests , Mass Screening , Multidetector Computed Tomography , Postmenopause , Pulse Wave Analysis , Retrospective Studies , Risk Factors , Vascular Stiffness
14.
Yonsei Medical Journal ; : 1079-1086, 2015.
Article in English | WPRIM | ID: wpr-150475

ABSTRACT

PURPOSE: This study aimed to evaluate the prognostic value of each component of the revised American Fertility Society (rAFS) classification system for the first recurrence of endometriosis after conservative laparoscopy. MATERIALS AND METHODS: As this was a retrospective cohort study, data were collected by reviewing medical records. A total of 379 women ages 18 to 49 years were included. Women who underwent conservative laparoscopy with histologic confirmation of endometriosis at Gangnam Severance Hospital between March 2003 and May 2010 were included. Individual components of the rAFS classification system as well as preoperative serum CA-125 levels were retrospectively analyzed to assess their prognostic values for recurrence of endometriosis. RESULTS: Of 379 patients, 80 (21.2%) were found to have recurrence of endometriosis. The median duration of follow-up was 19.0 months, and the mean age at the time of surgery was 31.8+/-6.7 years. In endometriosis of advanced stage, younger age at the time of surgery, bilateral ovarian cysts at the time of diagnosis, a rAFS ovarian adhesion score >24, and complete cul-de-sac obliteration were independent risk factors of poor outcomes, and a rAFS ovarian adhesion score >24 had the highest risk of recurrence [hazard ratio=2.948 (95% CI: 1.116-7.789), p=0.029]. CONCLUSION: Our results suggest that of the rAFS adnexal adhesion scores, the ovarian adhesion score rather than the tubal adhesion score was associated with a significantly increased risk of recurrent endometriosis. The preoperative serum CA-125 level may be also a significant prognostic factor for recurrence, as known. However, it seemed to only have borderline significance in affecting recurrence in the current study.


Subject(s)
Adolescent , Adult , Cohort Studies , Endometriosis/classification , Female , Fertility , Follow-Up Studies , Humans , Kaplan-Meier Estimate , Laparoscopy/methods , Middle Aged , Prognosis , Recurrence , Retrospective Studies , Risk Factors , Tissue Adhesions , Treatment Outcome , United States
15.
Yonsei Medical Journal ; : 490-496, 2015.
Article in English | WPRIM | ID: wpr-141617

ABSTRACT

PURPOSE: To evaluate the efficacy of minimal stimulation using discretely administered gonadotropin combined with clomiphene citrate (CC) or letrozole (LTZ) for intrauterine insemination (IUI) cycles. MATERIALS AND METHODS: Total 257 IUI cycles from 158 infertile couples were assessed. A CC dose of 100 mg/day (n=126 cycles) or a LTZ dose of 5 mg/day (n=131 cycles) was administered on days 3-5 of the menstrual cycle for 5 days. Each group received human menopausal gonadotropin at a dose of 150 IU by two or three alternative day: CC combined with alternate-day regimen for 2 or 3 days (CC+300, n=37; CC+450, n=89) and LTZ combined with alternate-day regimen for 2 or 3 days (LTZ+300, n=36; LTZ+450, n=95). RESULTS: The clinical pregnancy rate was comparable between the CC and LTZ groups (18.3% vs. 13.0%, p=0.243). The clinical pregnancy rate also showed no significant difference among the 4 groups (21.6% vs. 16.9% vs. 11.1% vs. 12.6%, p=0.507). The multiple pregnancy rate was significantly higher in LTZ compared to CC group (37.5% vs. 8.7%, p=0.028) and in the LTZ+450 compared to CC+450 group (50% vs. 13.3%, p=0.038). Overall, there were 15 cases of ovarian hyperstimulation syndrome (OHSS), with the prevalence being significantly lower in the LTZ compared to CC group (1.5% vs. 10.3%, p=0.003). OHSS was more prevalent in the CC+450 compared to the LTZ+450 group (12.4% vs. 1.1%, p=0.002). CONCLUSION: Our findings suggest that minimal stimulation using two alternate-day gonadotropin with LTZ decreases the development of OHSS and multiple pregnancies, while maintaining comparable pregnancy rates in IUI cycles.


Subject(s)
Adult , Aromatase Inhibitors/administration & dosage , Clomiphene/administration & dosage , Drug Administration Schedule , Drug Combinations , Female , Fertility Agents, Female/administration & dosage , Fertilization in Vitro , Gonadotropins/administration & dosage , Humans , Infertility, Female/drug therapy , Insemination, Artificial/statistics & numerical data , Nitriles/administration & dosage , Ovulation Induction/methods , Pregnancy , Pregnancy Rate , Treatment Outcome , Triazoles/administration & dosage
16.
Yonsei Medical Journal ; : 490-496, 2015.
Article in English | WPRIM | ID: wpr-141616

ABSTRACT

PURPOSE: To evaluate the efficacy of minimal stimulation using discretely administered gonadotropin combined with clomiphene citrate (CC) or letrozole (LTZ) for intrauterine insemination (IUI) cycles. MATERIALS AND METHODS: Total 257 IUI cycles from 158 infertile couples were assessed. A CC dose of 100 mg/day (n=126 cycles) or a LTZ dose of 5 mg/day (n=131 cycles) was administered on days 3-5 of the menstrual cycle for 5 days. Each group received human menopausal gonadotropin at a dose of 150 IU by two or three alternative day: CC combined with alternate-day regimen for 2 or 3 days (CC+300, n=37; CC+450, n=89) and LTZ combined with alternate-day regimen for 2 or 3 days (LTZ+300, n=36; LTZ+450, n=95). RESULTS: The clinical pregnancy rate was comparable between the CC and LTZ groups (18.3% vs. 13.0%, p=0.243). The clinical pregnancy rate also showed no significant difference among the 4 groups (21.6% vs. 16.9% vs. 11.1% vs. 12.6%, p=0.507). The multiple pregnancy rate was significantly higher in LTZ compared to CC group (37.5% vs. 8.7%, p=0.028) and in the LTZ+450 compared to CC+450 group (50% vs. 13.3%, p=0.038). Overall, there were 15 cases of ovarian hyperstimulation syndrome (OHSS), with the prevalence being significantly lower in the LTZ compared to CC group (1.5% vs. 10.3%, p=0.003). OHSS was more prevalent in the CC+450 compared to the LTZ+450 group (12.4% vs. 1.1%, p=0.002). CONCLUSION: Our findings suggest that minimal stimulation using two alternate-day gonadotropin with LTZ decreases the development of OHSS and multiple pregnancies, while maintaining comparable pregnancy rates in IUI cycles.


Subject(s)
Adult , Aromatase Inhibitors/administration & dosage , Clomiphene/administration & dosage , Drug Administration Schedule , Drug Combinations , Female , Fertility Agents, Female/administration & dosage , Fertilization in Vitro , Gonadotropins/administration & dosage , Humans , Infertility, Female/drug therapy , Insemination, Artificial/statistics & numerical data , Nitriles/administration & dosage , Ovulation Induction/methods , Pregnancy , Pregnancy Rate , Treatment Outcome , Triazoles/administration & dosage
17.
Article in English | WPRIM | ID: wpr-36572

ABSTRACT

OBJECTIVE: This study aimed to assess the association between bone mineral density (BMD) and coronary atherosclerosis in healthy postmenopausal women. METHODS: We performed a retrospective review of 252 postmenopausal women who had visited a health promotion center for a routine checkup. BMD of the lumbar spine (L1-L4) and femoral neck was evaluated using dual-energy X-ray absorptiometry, and coronary atherosclerosis was assessed using 64-row multidetector computed tomography. Participants were divided into normal BMD and osteopenia-osteoporosis groups, according to the T-scores of their lumbar spine or femoral neck. RESULTS: Participants with osteopenia-osteoporosis had a significantly higher proportion of coronary atherosclerosis than did those with normal BMD at the lumbar spine (P=0.003) and femoral neck (P=0.004). Osteopenia-osteoporosis at the lumbar spine (odds ratio [OR], 2.86; 95% confidence interval [CI], 1.12 to 7.27) or femoral neck (OR, 3.35; 95% CI, 1.07 to 10.57) was associated with coronary atherosclerosis, after controlling for age and cardiovascular risk factors. CONCLUSION: Decreased BMD is associated with coronary atherosclerosis in healthy postmenopausal women, independent of age and cardiovascular risk factors. Postmenopausal women with decreased BMD may have a higher risk of developing coronary atherosclerosis.


Subject(s)
Absorptiometry, Photon , Bone Density , Coronary Artery Disease , Female , Femur Neck , Health Promotion , Humans , Menopause , Multidetector Computed Tomography , Retrospective Studies , Risk Factors , Spine
18.
Article in Korean | WPRIM | ID: wpr-141945

ABSTRACT

Endometriosis, which is the presence of endometrial glands and stroma in extrauterine locations, is a benign gynecologic disease that may cause dysmenorrhea, chronic pelvic pain and infertility. Endometriosis is a relatively common disease that is estimated to occur in 6~10% of reproductive-aged women. Various theories have been proposed regarding the pathogenesis of endometriosis, but a definitive theory remains obscure. Diagnosis of endometriosis in postmenopausal women is rare, but it has been reported in 2~5% of postmenopausal women receiving hormone therapy. However, endometriosis can also occur in postmenopausal women not receiving hormone therapy, altogether indicating the complex pathogenesis of endometriosis. We report left ovarian endometriosis in a postmenopausal woman who had a hysterectomy a uterine myoma 16 years ago and review the relevant literature.


Subject(s)
Dysmenorrhea , Endometriosis , Female , Genital Diseases, Female , Humans , Hysterectomy , Infertility , Menopause , Myoma , Pelvic Pain
19.
Article in Korean | WPRIM | ID: wpr-141944

ABSTRACT

Endometriosis, which is the presence of endometrial glands and stroma in extrauterine locations, is a benign gynecologic disease that may cause dysmenorrhea, chronic pelvic pain and infertility. Endometriosis is a relatively common disease that is estimated to occur in 6~10% of reproductive-aged women. Various theories have been proposed regarding the pathogenesis of endometriosis, but a definitive theory remains obscure. Diagnosis of endometriosis in postmenopausal women is rare, but it has been reported in 2~5% of postmenopausal women receiving hormone therapy. However, endometriosis can also occur in postmenopausal women not receiving hormone therapy, altogether indicating the complex pathogenesis of endometriosis. We report left ovarian endometriosis in a postmenopausal woman who had a hysterectomy a uterine myoma 16 years ago and review the relevant literature.


Subject(s)
Dysmenorrhea , Endometriosis , Female , Genital Diseases, Female , Humans , Hysterectomy , Infertility , Menopause , Myoma , Pelvic Pain
20.
Article in English | WPRIM | ID: wpr-73425

ABSTRACT

OBJECTIVE: We investigated the clinical value of using preoperative differential white blood cell (WBC) count to predict the potential for malignancy of adnexal masses in laparoscopic surgery. METHODS: The electronic medical records of 1325 patients who underwent laparoscopic surgery for adnexal masses between July 2005 and December 2008 were analyzed retrospectively. RESULTS: Of 1325 patients, 30 (2.3%) had adnexal masses with malignant potential. Analysis of differential WBC count, neutrophil to lymphocyte ratio (NLR), neutrophil to monocyte ratio (NMR), serum CA 125, mass size showed that only cyst size was significantly different between patients with potentially malignant adnexal masses, those with benign disease (averages of 9.45 cm vs. 6.23 cm, p=0.001). Further analysis was performed using a combination of various markers and multiplication of cyst size and NMR yielded the highest area under the curve, at 0.711(95% confidential interval 0.619~0.806, p<0.001), with a sensitivity and specificity of 86.7% and 48.3% respectively, at a cut off value of 67.23. These values were also significantly different between patients with potentially malignant adnexal masses, and dermoid cyst or endometrioma (p=0.038 and 0.002 respectively, by analysis of variance, post hoc test). CONCLUSION: Preoperative measurement of NMR in conjunction with cyst size may be used as a simple, non invasive marker for predicting the malignant potential of adnexal masses before laparoscopic surgery.


Subject(s)
Dermoid Cyst , Electronic Health Records , Endometriosis , Female , Humans , Laparoscopy , Leukocytes , Lymphocytes , Monocytes , Neutrophils , Sensitivity and Specificity
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