Nonpersistent endocrine disrupting chemicals and reproductive health of women

( Yeon Jean Cho ),( Jeong Hye Yun ),( Su Jin Kim ),( Hyun Young Kwon ) 대한산부인과학회 2020 Obstetrics & Gynecology Science Vol.63 No.1

Nonpersistent endocrine disrupting chemicals (npEDCs) are exogenous chemicals or mixtures of industrial agents that can interfere with the normal action of hormone with a shorter half-life and lower liposolubility. These are commonly found in plastics, medical equipment, detergents, and cosmetics. Recently, role of npEDCs on the changes of ovary and/or uterus development and alterations in hormonal signaling has been emphasized. However, many controversial results exist on the effects of npEDCs and reproductive health of women. Thus, we have focused to review the scientific evidence of a causal relationship between exposure to npEDCs and representative female reproductive issues such as menstrual cycle, endometriosis, uterine fibroids, polycystic ovarian syndrome and infertility/subfertility. Though not all studies indicated a positive correlation of npEDCs with female reproductive issues, the reviewed data illustrated that the majority of the available data strengthen the evidence of reproductive health-related actions of npEDCs. In future, recommendations should be made in order to reduce human exposure to npEDCs and to protect from steadily increasing reproductive health risks.

Effect of Di (2-ethylhexyl) phthalate on human endometrial stromal cells, on the repsect of oxidative stress

( Yeon Jean Cho ),( Seung Bin Park ),( Jong Woon Bae ),( Jung Woo Park ),( Hee Suk Lee ),( Myoung Seok Han ) 대한산부인과학회 2014 대한산부인과학회 학술대회 Vol.100 No.-

목적: Di-(2-ethylhexyl)-phthalate (DEHP), one of the most commonly used phthalate diesters, and is considered to be a reproductive and development toxicants in humans and animals. It may induce oxidative stress in other human cells. We aimed to see if DEHP induce oxidative stress in human endometrial stromal cell in vitro, which could be one of the background of explaining the pathogenesis endocrine-related diseases related with the endometrium. 방법: For endometrial stromal cell (ESC) cultures, endometrial samples were obtained from disease free premenopausal women. We treated a human endometrial stromal cell with DEHP and measured reactive oxygen species (ROS) generation using the dichlorofluorescein diacetate (DCF-DA) assay. Quantitative real time PCR (qPCR) for antioxidant enzymes, hormonal receptors and proinflammatory cytokines. Western blot analysis for nuclear protein was done. 결과: We showed that DEHP increases reactive oxygen species (ROS) and decreases antioxidant enzymes such as superoxide dismutase (SOD), glutathione peroxidase (GPX), heme oxygenase (HO) and catalase (CAT). Increased ROS activates the MAPK/NF-κB signaling pathway and subsequently increased production of nitric oxide (NO). Increased production of proinflammatory cytokines such as IL-6 and TNF-a were noted. We also found that the mRNA and protein expression levels of ER-α were up-regulated in DEHP treated human endometrial stromal cells. In contrast, there was a decrease in ER-β (statistically significant) and PR expression (statistically non-signifcant). 결론: In conclusion, we found that DEHP induce oxidative stress in human endometrial stromal cells, with alterations of intracellular mechansism. It may contribute to endocrine-related disease such as endometriosis or adenomyosis.

Recurrence of ovarian endometrioma in adolescents after conservative surgical treatment

( Yeon Jean Cho ),( Soo Yoon Lee ),( Mi La Kim ),( Joo Myoung Kim ),( Seok Joo Song ),( Jong Woon Bae ),( Jung Woo Park1,),( Hee Suk Lee ),( Myoung Seok Han1 ) 대한산부인과학회 2014 대한산부인과학회 학술대회 Vol.100 No.-

목적: To evaluate the cumulative recurrence rate of endometriomas after a laparoscopic endometriotic cyst enucleation in adolescents and to find the factors associated with recurrence. 방법: A multicenter retrospective cohort study was performed at 3 gynecologic surgery centers between January 2000 and December 2010. Patients surgically treated by laparoscopic enucleation of endometriotic cysts younger than 20 years old were selected. We excluded patients who had reproductive tract anomalies. Endometrioma recurrence was considered when transvaginal or transrectal sonography indicated a cystic mass with a diameter of ≥ 20 mm. 결과: In total, 105 patients were followed up for 47.3 ± 44.3 months (range, 3 - 161 months). Seventeen patients (16.2 %) experienced recurrence after the first-line surgery and 8 patients (7.6 %) underwent a second surgery. The median time to recurrence was 51.1 ± 9.1 months (SEM) (range, 8 - 111 months). The cumulative recurrence rates of endometrioma per patient at 24, 36, 60 and 96 months after the first-line surgery were 6.4 %, 10 %, 19.9 % and 30.9 %, respectively. Surgical characteristics such as the diameter of the cyst, rAFS stage, unilateral or bilateral involvement, co-existence of deep endometriosis were not associated with the recurrence in this age group. 결론: The short-term recurrence rate in adolescent after the first-line surgery is relatively low but is appears to be higher according to the follow- up duration. Long-term and strict follow up is needed who have undergone surgical treatment for endometriosis in adolescent period.

Does blastomere biopsy in preimplantation genetic diagnosis affect early serum ${\beta}$-hCG levels?

Cho, Yeon-Jean,Kim, Jin-Yeong,Song, In-Ok,Lee, Hyung-Song,Lim, Chun-Kyu,Koong, Mi-Kyoung,Kang, Inn-Soo The Korean Society for Reproductive Medicine 2011 Clinical and Experimental Reproductive Medicine Vol.38 No.1

Objective: To determine whether the serum ${\beta}$-human chorionic gonadotropin (hCG) profile following preimplantation genetic diagnosis (PGD) is lower than that of intracytoplasmic sperm injection (ICSI) cycles. Methods: A total of 129 PGD cycles and 1,161 age-matched ICSI cycles, which resulted in pregnancy (serum ${\beta}-hCG{\geq}5$ mIU/mL) on post-ovulation day (POD) 12 were included. We compared the mean serum ${\beta}$-hCG levels on POD 12, 14, 21, and 28, doubling time of serum hCG, and created a cut-off value for predicting a singleton pregnancy in each group. Results: The mean serum ${\beta}$-hCG concentration of the PGD group was significantly lower than that of the control group on POD 12, 14, and 21. The doubling time of serum ${\beta}$-hCG at each time interval showed no significant difference. The cut-off-value of serum ${\beta}$-hCG for predicting a single viable pregnancy was 32.5 mIU/mL on POD 12 and 113.5 mIU/mL on POD 14 for the PGD group, which was lower than that for the control group. Conclusion: Blastomere biopsy may decrease the ${\beta}$-hCG-producing activity of the trophoblasts, especially in early pregnancy. Setting a lower cut-off value of serum ${\beta}$-hCG for predicting pregnancy outcomes in PGD may be needed.

The long term recurrence rate after conservative surgical treatment of endometriosis in adolescents

( Yeon Jean Cho ),( Mi La Kim ),( Seok Joo Seoung ),( Myoung Seok Han ),( Jong Woon Bae ),( Jung Woo Park ),( Soo Yoon Lee ) 대한산부인과학회 2015 대한산부인과학회 학술대회 Vol.101 No.-

Environment and women's gynecologic health

( Yeon Jean Cho ) 대한산부인과학회 2018 서울심포지움 Vol.23 No.-

Bisphenol A modulates inflammation and proliferation pathway in human endometrial stromal cells by inducing oxidative stress

Cho, Yeon Jean,Park, Seung Bin,Park, Jung Woo,Oh, So Ra,Han, Myoungseok Elsevier 2018 Reproductive toxicology Vol.81 No.-

<P><B>Abstract</B></P> <P>Bisphenol A (BPA) has been implicated in altered human reproductive function. The oxidative stress or change of inflammatory signaling may appear a key factor in the biological changes of the human endometrium. Using MTT assay we assessed BPA mediated modulation of oxidative stress and inflammation responses in human endometrial stromal cells (ESCs). According to the results, reactive oxygen species (ROS) generation was highest upon exposure to 1000 pmol BPA. Increased mitogen-activated protein kinase (MAPK) and nuclear factor-κB (NF-κB) were demonstrated. Gene expression and release of inflammatory cytokines were increased. Upon BPA exposure, elevated estrogen receptor (ER)-α expression levels in ESCs correlated with changes in oxidative stress, inflammatory gene expression and signal changes in cellular proliferation signaling. These findings support that BPA induces oxidative stress and activates inflammatory signals in cultured ESCs via ER-α. Together, this result may provide insight into the association between BPA exposure and endometrium-related disorders.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Bisphenol A (BPA) increases oxidative stress in human endometrial cells. </LI> <LI> BPA activates cell proliferation through ERK/AKT/NF-κB pathway. </LI> <LI> BPA induces inflammatory response in human endometrial cells. </LI> </UL> </P> <P><B>Graphical abstract</B></P> <P>[DISPLAY OMISSION]</P>

Dysfunctional signaling underlying endometriosis: current state of knowledge

Cho, Yeon Jean,Lee, Seung Hyun,Park, Jung Woo,Han, Myoungseok,Park, Mi Jin,Han, Sang Jun Journal of Endocrinology (Ltd. by Guarantee) 2018 Journal of molecular endocrinology Vol.60 No.3

<P>Endometriosis is defined as the presence of endometrial tissue outside the uterine cavity. It affects approximately 5-10% of women of reproductive age. Endometriosis is associated with dysmenorrhea, dyspareunia and, often, severe pelvic pain. In addition to pain, women with endometriosis often experience infertility. Defining the molecular etiology of endometriosis is a significant challenge for improving the quality of women's lives. Unfortunately, the pathophysiology of endometriosis is not well understood. Here, we summarize the potential causative factors of endometriosis in the following three categories: (1) dysregulation of immune cells in the peritoneal fluid and endometriotic lesions; (2) alteration of apoptotic signaling in retrograde menstrual tissue and cytotoxic T cells involved in endometriosis progression and (3) dysregulation of oxidative stress. Determining the molecular etiology of these dysregulated cellular signaling pathways should provide crucial clues for understanding initiation and progression of endometriosis. Moreover, improved understanding should suggest new molecular therapeutic targets that could improve the specificity of endometriosis treatments and reduce the side effects associated with current approaches.</P>

Recurrence of ovarian endometrioma after the second-line, conservative, laparoscopic cyst enucleation

( Yeon Jean Cho ),( Hee Suk Lee ),( Joo Myoung Kim ),( Soo Yoon Lee ),( Mi La Kim ),( Seok Joo Sung ),( Myoung Seok Han ),( Jong Woon Bae ),( Jung Woo Park ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-

We aimed to evaluate the recurrence rate of endometriomas after a second-line conservative laparoscopic endometriotic cyst enucleation and to analyze the preoperative, intraoperative, and postoperative factors that influence the recurrence of endometriomas. One hundred and eighty three patients with endometriosis who were surgically treated by laparoscopy on 2 previous occasions were considered for inclusion in the present study between January 2000 and December 2010 at three gynecologic surgery center. The patients` characteristics and time to recurrence were recorded; time to recurrence was defined as the time in months from the second-line surgery detection of a new endometrioma. Patients were followed up for to 33.2 ± 27.7 months. According to the definition of recurrence, 20.8% of patients experienced recurrence after the second-line surgery and 13.1% underwent a third surgery. The median time to recurrence was 24 ± 3.36 months (SEM). The cumulative recurrence rates per patient at 12, 24, 36, and 60 months after the surgery were 7.7%, 13.7%, 21.3%, and 37.5%, respectively. After second- line surgery, the ipsilateral cyst, contralateral cyst, and repeated bilateral cyst recurrence rates were 17.5%, 4.7%, and 12.3%, respectively. After multivariate analysis and analysis of covariance, we noted that rAFS score and disease stage were significantly higher in patients who experienced a third recurrence of endometrioma The cumulative recurrence rate of ovarian endometrioma after the second-line surgery appeared to be dependent on the number of that had elapsed since treatment and this value increased over time. Advanced rAFS stage and score may be risk factors for a third recurrence. Physicians should account for when explaining the benefits and potential limitations of a second-line surgery for the treatment of endometriomas.

자궁내막폴립의 악성화 빈도와 관련 인자

조연진 ( Yeon Jean Cho ),김미라 ( Mi La Kim ),김주명 ( Joo Myung Kim ),주관영 ( Kwan Young Joo ),이인국 ( In Kook Lee ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.1

Objective: To determine the incidence of benign, hyperplastic, and malignant endometrial polyps and whether particular clinical parameters are associated with malignancy in the polyps. Methods: Four hundred and forty nine patients who were suspected as endometrial polyps by hysteroscopy underwent hysteroscopic guided removal over 12 months period were retrieved. The medical records and histopathological findings were reviewed. Statistical analysis was performed. Results: Histologically, among 360 (80.1%) polypoid lesions, 353 polyps (75.1%) were benign; 16 polyps (3.5%) had simple or complex hyperplasia, only 1 polyp (0.2%) had hyperplasia with atypia (considered as premalignant lesions), and 6 polyps (1.3%) were cancerous. Non polypoid lesions were found in 89 (19.9%) cases. Older age, postmenopausal status were associated with pre-malignant or malignant changes significantly, but presence of abnormal uterine bleeding, multiplicity, larger sizes (>1.5cm) were not a predictor of malignancy in the polyp. Conclusions: Age and menopausal status may increase the risk of premalignant and malignant polyps. Although the risk of malignancy is low, we should pay attention to postmenopausal women with endometrial polyps regardless of the symptoms, and we prefer hysteroscopic resection for the exact diagnosis.