Effect of particulate matter on endometriosis

( Inha Lee ),( Heeyon Kim ),( Bo Hee Won ),( Hye In Kim ),( So Hyun Ahn ),( Yun Jeong Park ),( Hae Won Baek ),( Jae Hoon Lee ),( Bo Hyon Yun ),( Seok Kyo Seo ),( Young Sik Choi ),( Sihyun Cho ),( Byun 대한산부인과학회 2020 대한산부인과학회 학술대회 Vol.106 No.-

Objective: Endometriosis is a common gynecologic disorder that is characterized by chronic pelvic pain, dysmenorrhea, and infertility. Although the adverse effects of particulate matter on the human body and many diseases are proven, studies of the effects on endometriosis and related infertility are insignificant not only in Korea but around the world. The object of this study is to evaluate the effect of the particulate matter on the endometrium of the endometriosis compared to controls. Methods: During the surgery, endometrial tissues in patients with and without endometriosis were obtained under informed consent. Benign ovarian cysts without endometriosis were served as controls. Each endometrium of the endometriosis and control cells were treated with 400ug of the urban particulate matter(SRM 1648a). Cell Counting Kit-8 (CCK-8) was used to determinate the cell viability. After protein extractions, expression levels of four cell signaling molecules related to apoptosis, caspase3, BAX, Bcl-2, and p53 were evaluated by using western blot. Results: After treating the particulate matter, cell viability was decreased in endometrium of both endometriosis and controls, with significanlty higher decrease rate in endometriosis group. Also, Expression of Caspase3, BAX, p53 was lower in eutopic endometrium of endometriosis compared to controls while Bcl-2 was higher in endometriosis. When particulate matter was applied, all protein levels in eutopic endometrium of the controls were decreased, while the decrease tendency was not definite in the endometrium of the endometriosis group. Conclusion: Particulate matter affects the cell proliferation and apoptosis of the endometrium cells by altering the cell signaling molecules. The effect of particulate matter was different in endometriosis group compared with control group and endometriosis might have reseistance in particulate matter.

Changes in expression of Thioredoxin and Thioredoxin binding protein-2 according to Histone deacetylase inhibitor treatment in human endometrial cells from patients with endometriosis

( Inha Lee ),( Young Bin Won ),( Jisun Yun ),( Jae Hoon Lee ),( Seok Kyo Seo ),( Si Hyun Cho ),( Young Sik Choi ),( Byung Seok Lee ),( Bo-hyon Yun ) 대한산부인과학회 2018 대한산부인과학회 학술대회 Vol.104 No.-

Objective: Thioredoxin (TRX) is a redox regulating antioxidant protein that prevents cell damage from oxidative stress and TRX binding protein(TBP)-2 are regulatory protein of TRX. Altered TRX and TBP-2 expressions in endometrium are known to be associated with the development of endometriosis. The aim of the study was to identify a role of Histone deacetylase inhibitor (HDACi) in human endometrial cells, by modifying TRX and TBP-2 expression. Methods: From July, 2015 to June, 2016, eutopic and ectopic endometrium was obtained from the patients who had undergone hysterectomy and ovarian cyst enucleation due to endometriosis respectively. The cultured human endometrial stromal cells (HESCs) and ishikawa cells were treated with HDACi (suberoylanilide hydroxamic acid, SAHA). After inducing cell inflammation adding oxidative stress on the cells, SAHA treatment and following changes of cell proliferation, viability and TRX, TBP-2 expression were examined. Inflammatory cytokines including Interleukin (IL)-1, IL-6, IL-10 and Tumor necrosis factor- were measured from the supernatants of the cultured cell treated with SAHA. Results: Expression of TBP-2 was significantly increasing according to the increase of SAHA concentration in eutopic, ectopic endometrial stromal cell and ishikawa cell. Cell proliferation was shown according to the recombinant high mobility group box(rHMGB)-1 treatment in cultured ectopic, eutopic endometrial cells. Expression of TBP-2 was significantly decreased after inducing oxidative stress by rHMGB-1 on the endometrial cells, which recovery was shown by treating SAHA, resulting in TBP-2 increase and decreased TRX/TBP-2 ratio. Inflammatory cytokine secretion was decreased according to the SAHA treatment by concentration in endometrial cells. Conclusion: SAHA may affect the inflammation induced by oxidative stress in development of endometriosis, via resuming the TRX and TBP-2 expression, leading a potential treatment option in endometriosis. Acknowledgements: This study was supported by a faculty research grant of Yonsei University College of Medicine for 6-2015-0073.

Pretreatment neutrophil-to-lymphocyte ratio and its dynamic change during neoadjuvant chemotherapy as poor prognostic factors in advanced ovarian cancer

( Yun-ji Kim ),( Inha Lee ),( Young Shin Chung ),( Eunji Nam ),( Sunghoon Kim ),( Sang-wun Kim ),( Young Tae Kim ),( Jung-yun Lee ) 대한산부인과학회 2018 Obstetrics & Gynecology Science Vol.61 No.2

Objective The purpose of this study was to determine the prognostic implications of the pretreatment neutrophil-to-lymphocyte ratio (NLR) and its dynamic change during chemotherapy in patients with advanced epithelial ovarian cancer undergoing neoadjuvant chemotherapy. Methods We performed a retrospective analysis of 203 patients who underwent neoadjuvant chemotherapy prior to interval debulking surgery for advanced-stage ovarian cancer at Yonsei Cancer Hospital between 2007 and 2015. Pretreatment NLR was evaluated before starting neoadjuvant chemotherapy. Change in NLR was defined as the post-neoadjuvant NLR value divided by the initial value. The correlation of NLR and its dynamic change with chemotherapy response score, response rate, and recurrence was analyzed. Results The NLR ranged from 0.64 to 22.8. In univariate analyses, a higher pretreatment NLR (>3.81) was associated with poor overall survival (OS), but not progression-free survival (PFS). Through multivariate analysis, high pretreatment NLR was shown to be an independent parameter affecting OS, but not necessarily PFS. Changes in NLR during chemotherapy were better predictors of PFS than baseline NLR. Patients with increased NLR during chemotherapy showed significantly poor PFS, and this change was an independent predictor of PFS. Conclusion Pretreatment NLR and its dynamic change during chemotherapy may be important prognostic factors in patients who undergo neoadjuvant chemotherapy.

Cytokines in culture medium of preimplantation embryos during in vitro fertilization : impact on embryo quality

( Inha Lee ),( Young Bin Won ),( Heeyon Kim ),( Jae Hoon Lee ),( Bo Hyon Yun ),( Seok Kyo Seo ),( Sihyun Cho ),( Byung Seok Lee ),( Young Sik Choi ) 대한산부인과학회 2019 대한산부인과학회 학술대회 Vol.105 No.-

Objective: Emerging evidence suggests that several cytokines support embryonic development, protecting blastomeres from cell stress and apoptosis, promoting implantation. Therefore, possible correlations between embryo quality and the concentrations of specific cytokines in the culture medium of human embryos have been explored for many years. The aim of this study was to assess the levels of variety of cytokines in culture medium of preimplantation embryos and to investigate their relationship with embryo quality and in vitro fertilization (IVF) outcomes. Methods: A total of 75 samples were obtained from 31 infertile couples undergoing either IVF or ICSI treatment between August 2018 and May 2019. Each embryo was cultured separately, and embryo culture media was collected 72 hours after fertilization. The cytokine concentrations of each culture media were analyzed for 23 selected cytokines using Multiplex cytokine/chemokine panel II (Merck Millipore®). Prior to day 3 embryo transfer, morphological evaluation of each embryo was performed and categorized into two groups (top quality and non-top). Results: The median age of 31 patients was 34 years old (range:25-39). Thirteen cytokines resulted in out of range data due to small sample volume; therefore, 10 out of 23 cytokines were quantified and compared between top quality embryo group and non-top quality embryo group. Among 10 cytokines, Chemokine ligand (CCL)-8, CCL-13, CCL-15, CCL-27, and CXCL-12 were significantly elevated in top embryo group. Conclusion: Our results suggest that specific cytokines that are measured from human embryo culture medium can serve as a potential tool for predicting embryo quality and IVF outcomes.

Zoster-associated limb paresis presenting as femoral neuropathy

Inha Hwang,UnKyu Yun,Heewon Bae,Jeong Ho Han,Sang-Won Ha,Doo-eung Kim 대한임상신경생리학회 2019 Annals of Clinical Neurophysiology Vol.21 No.1

Zoster-associated limb paresis is a relatively uncommon complication of herpes zoster that is characterized by focal motor weakness. Awareness of this disorder is important to avoid unnecessary invasive investigations and to ensure appropriate treatment. We report a case of a herpes zoster involving the femoral nerve.

Zoster-associated limb paresis presenting as femoral neuropathy

Hwang, Inha,Yun, UnKyu,Bae, Heewon,Han, Jeong Ho,Ha, Sang-Won,Kim, Doo-eung The Korean Society of Clinical Neurophysiology 2019 Annals of Clinical Neurophysiology Vol.21 No.1

Zoster-associated limb paresis is a relatively uncommon complication of herpes zoster that is characterized by focal motor weakness. Awareness of this disorder is important to avoid unnecessary invasive investigations and to ensure appropriate treatment. We report a case of a herpes zoster involving the femoral nerve.

Case report: preimplantation genetic diagnosis in Alport syndrome

( Yunjeong Park ),( Inha Lee ),( Young Bin Won ),( Jisun Yun ),( Jae Hoon Lee ),( Sihyun Cho ),( Young Sik Choi ),( Byung Seok Lee ),( Seok Kyo Seo ),( Bo Hyon Yun ) 대한산부인과학회 2018 대한산부인과학회 학술대회 Vol.104 No.-

A 37-year old married woman with 1 child delivered vaginally in 2013 was referred to nephrology outpatient clinic in July 2016 for incidentally identified proteinuria. She had no medical history, but her aunt was on hemodialysis. Her 24-hour urine test showed proteinuria of 844 mg/day, but the serum creatinine level and APCT results were normal. To determine the cause of proteinuria, kidney biopsy was performed on July, 2016. The biopsy result showed thin basement membrane nephropathy with focal splitting of lamina densa, but surprisingly with no apparent basket weave pattern of basement membrane splitting: Alport syndrome could not be excluded. Therefore, further genetic testing for COL4A3, COL4A4, COL4A5 genes was performed using NGS (new generation sequencing). A heterozygote mutation of p.Gly640Arg was found, and the patient was diagnosed with Alport syndrome. In January 2017, her first son was also diagnosed with Alport syndrome via NGS. This patient with Alport syndrome visited our infertility clinic of obstetrics and gynecology department for pre-pregnancy counseling. Alport syndrome is one of the few genetic syndromes that can be pre-diagnosed and prevented using preimplantation genetic diagnosis (PGD), and we proceeded with IVF-ET (in-vitro fertilization-embryo transfer) with PGD. The embryo without mutated p.Gly640Arg gene was selected using NGS and ET was performed. Normal intrauterine pregnancy (IUP) was confirmed, and at IUP 12 weeks the patient underwent chorionic villi sampling with NGS which showed no mutation of p.Gly640Arg of COL4A3 gene. After uncomplicated pregnancy the patient delivered a living female baby weighing 4.00 kg at IUP 40 weeks, and NGS of the baby confirmed no mutation in p.Gly640Arg of COL4A3 gene.

Delayed postpartum regression of theca lutein cysts with maternal virilization: A case report

Sanghwa Kim,Inha Lee,Eunhyang Park,Yeo Jin Rhee,Kyeongmin Kim,Aminah Ibrahim Aljassim,Joo Hyun Park,Jae Hoon Lee,Bo Hyon Yun,Seok Kyo Seo,Sihyun Cho,Young Sik Choi,Byung Seok Lee 대한생식의학회 2021 Clinical and Experimental Reproductive Medicine Vol.48 No.4

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.

The risk of breast cancer and other side effects of hormone replacement therapy on postmenopausal women in Korea

( Hye In Kim ),( Inha Lee ),( Jisun Yun ),( Seok Kyo Seo ),( Eui Hyeok Kim ) 대한산부인과학회 2019 대한산부인과학회 학술대회 Vol.105 No.-

Objective: Because of the improvement in nutrition and medical environment in Korea, the average lifetime is increasing. About 50 years ago, the life expectancy after menoapause was only 15 years in average but the medical development increased the life expectancy longer than 35 years in average. Therefore the quality of life after menopause is one of the most important topics regarding postmenopausal women. The hormone replacement therapy improved the quality of life after menopause. However, the controversy on its safety still hold back many patients from the treatment. In this research, we studied the risk. Methods: We searched Korea National Health Insurance (KNHI) Claims Database and set the inclusion criteria as women who were older than 50 and diagnosed as postmenopausal from January 1st, 2004 to December 31st, 2007. We did 1:1 propensity score matching between HRT group consisting of the patients who received hormone replacement therapy and control group consisting of the patients who did not. Results: In the case of breast cancer, the hazard ratio for HRT group was significantly lower than that of control group (HR 0.886; 95% CI 0.793-0.989, p=0.0308). Comparing each hormone therapy used, only the Livial group showed significantly lower hazard ratio. The hazard ratio of colorectal were significantly lower in HRT group (HR = 0.788; 95% CI 0.682-0.933, p=0.0048). However, the risk for endometrial cancer was not significantly different between the HRT group and control group (HR =0.802; 95% CI 0.576-1.119, p=0.1942). The odd ratio for ischemic heart disease, stroke and sleep disorder was significantly higher in HRT group but that of thromboembolism was not significantly different between the two group. In last, the risk for spine and radius fracture was lower in HRT group. Conclusion: Hormone replacement therapy can be used in postmenopausal women in 50s without any serious side effect such as breast cancer and it can reduce the incidence for ischemic heart disease, stroke, and bone fracture.

Non-alcoholic fatty liver disease in young PCOS women

( Young Bin Won ),( Inha Lee ),( Jisun Yun ),( Jae Hoon Lee ),( Seok Kyo Seo ),( Sihyun Cho ),( Young Sik Choi ),( Byung Seok Lee ),( Bo-hyon Yun ) 대한산부인과학회 2018 대한산부인과학회 학술대회 Vol.104 No.-

Objective: To evaluate whether excessive hyperandrogenicity in relation to insulin resistance in adolescents with polycystic ovary syndrome (PCOS) contributes to the progression of metabolic disease and is associated with non-alcoholic fatty liver disease (NAFLD) compared to adults diagnosed with PCOS. Methods: This was a retrospective cohort study evaluating women with PCOS aged between 13 and 35 years at the point of PCOS diagnosis without any other health condition that could influence liver function. PCOS phenotype, BMI, waist circumference, fasting and 2 hours postprandial insulin and glucose, homeostasis model assessment of insulin resistance, fasting glucose insulin ratio, HDL, LDL, total cholesterol, triglycerides, DHEA-S, total testosterone, SHBG, free androgen index, Anti-mullerian hormone, Liver fibroscan, and abdominal ultrasound were assessed. Results: In PCOS women with NAFLD compared to those without, hypertension, metabolic syndrome, insulin resistance, SHBG, FAI, weight, BMI, waist circumference, total cholesterol, TG, HDL, LDL, HbA1c, fasting and 2 hours postprandial glucose, and AMH were statistically significantly higher. Interestingly, when adolescents and adults with PCOS were compared, there was no statistically significant difference in weight, BMI, waist circumference, HDL, insulin resistance, SHBG, FAI, obesity, metabolic syndrome, PCOS phenotype, and NAFLD occurrence. Conclusion: NAFLD frequently arises women with PCOS. Liver evaluation should be considered when patients present with elevated metabolic syndrome factors. Earlier diagnosis can lead to more timely treatment. Even though adolescents with PCOS have not been exposed to an insulin resistant environment for an extended period compared to adults, there were no statistically significant differences in the characteristics studied between adolescents and adults. Regardless of the age at which PCOS is diagnosed, comorbidities can lead to an increased metabolic risk so systematized investigation of NAFLD may be helpful.