배란장애를 동반한 다낭성 난소인 여성에서 혈중 Inhibin 농도의 증가

노재숙,유중배,문형,황윤영,Roh, Jae-Sook,Yoo, Jung-Bae,Moon, Hyung,Hwang, Yoon-Yeong 대한생식의학회 1998 Clinical and Experimental Reproductive Medicine Vol.25 No.1

Normal and abnormal follicular growth and steroidogenesis depend on gonadotropins as well as intraovarian peptides, which may mediate or potentiate gonadotropin action. Inhibin also affect follicular development and steroidogenesis and may play a role in dominant follicle selection and follicular atresia. Therefore, we studied the differences of serum inhibin, gonadotropin and androgen levels in the women with only the ultrasound findings and no disorder, and polycystic ovary (PCO) with ovulatory disturbance. We prospectively analysed forty-three women with PCO. The diagnosis of PCO was based on typical appearance of the ovaries on TVS. Twelve women with regular menstrual cycle and normal ovarian morphology were selected as control. Basal levels of inhibin, luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol $(E_2)$, testosterone (T), androstenedione (ADD), dehydroepiandrosterone-sulfate (DS), prolactin and TSH in serum were determined. There were significant differences in basal LH levels and LH/FSH ratio between the control and the women with PCO. The basal levels of inhibin and $E_2$ in the oligo-amenorrheic PCO (N=34) were significantly higher than those in the control. There was higher negative correlation between the inhibin and T levels in the oligo-amenorrheic PCO, but, not in the regular cycling PCO. Also, there was higher positive correlation between the LH and T levels in the oligo-amenorrheic PCO, but not in the regular cycling PCO. These data presume that the initial event of PCO is elevated pituitary LH secretion. Elevated levels of LH may down-regulate LH receptors on granulosa cells and also cause hypertrophy of the thecal layer. High level of androgen secreted by the hypertrophied thecal layer may stimulate inhibin secretion from granulosa cells and can be converted to estrogen by extraovarian tissues and could serve to augment pituitary sensitivity to GnRH with a resultant secretion of more LH than FSH. Inhibin may inhibit FSH action on granulosa cell in the PCO follicle, impairing follicular development and dominant follicle selection resulted in ovulatory disturbance.

Actions of the TGF Superfamily Members in Ovarian Follicle Growth and Development

노재숙,Roh, Jae-Sook The Korean Society for Reproductive Medicine 2007 Clinical and Experimental Reproductive Medicine Vol.34 No.3

난소내 혈관상피성장인자 ( Vascular Endothelial Growth Factor ) 의 발현 양상

노재숙(Jae Sook Roh),강지연(Ji Yeon Kang),지일운(Ill Woon Ji),정은환(Eun Hwan Jeong),안치석(Chi Seok Ahn),김학순(Hak Soon Kim) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.12

N/A Objective: The ovarian cycle is characterized by repeating patterns of cellular proliferation and differentiation that accompany follicular development and the formation and regression of the corpus luteum (CL). That angiogenesis may play an important role in this process. Angiogenesis is supposed to be regulated by vascular endothelial growth factor (VEGF). The goal of the present investigation, therefore, was to determine whether the expression of VEGF was changed in the normally cycling human ovary. We also investigated VEGF expression in the regressed CL (ie, nonfunctiong CL) of normal term pregnancy to define the association with steroidogenic activity. To our knowledge there is no report available on VEGF expression in the CL of term pregnancy. Methods: We assessed VEGF expression in ovaries obtained from, 26-42 yr of age, and from patients undergoing hysterectomy and salpingo-oophorectomy for nonendocrinological or nonovarian disorders. Tissue samples from premenopausal women included specimens from follicular (n=4) and luteal (n 4) phases. In addition, we studied ovarian specimens from pregnant women (n=3). Immunohistochemical analysis for VEGF was performed using a rabbit polyclonal antibody directed against human VEGF. Results: These data demonstrate a development-related VEGF expression in the follicle and indirectly show that VEGF expression may be up to the existence of LH-receptor. And also, VEGF was overexpressed in the regressed CL of pregnant women compared with the functioning CL of nonpregnant cycles Conclusion: This study suggests that the intensity of VEGF expression is not correlated with steroidogenic activity, although both of them are stimulated by LH.

진행성 자궁경관무력증에 있어서 응급자궁경부봉축술의 임상적 유용성

노재숙(Jae Sook Roh),정은환(Eun Hwan Jeong),김학순(Hak Soon Kim) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.12

N/A To evaluate the clinical efficacy of emergency cervical cerclage in the treatment of advanced cervical incompetence, a prospective clinical trial was performed in 18 patients with advanced cervical incompetence at 20 to 25 weeks gestation. Modified McDonalds operation with or without transabdominal amniocentesis was used for cervical cerclage. Pregnancy was prolonged for a sufficient time to deliver viable fetuses in 56.3% of patients. The median procedure-to-delivery interval was 8.6 (range 0.1 to 20.5) weeks for the entire group, and 13.9 (range 6.5 to 20.5) weeks for 9 patients who achieved live birth. The median gestational age at delivery was 38.6 (range 28.3 to 41.0) weeks for the live infants. The median birthweight of the live infants was 3062 g (range 1050 to 3620 g). The lack of significant matemal morbidity combined with the results for the fetus-infant supports further efforts in this area.

사람의 난관 상피세포에서 인슐린유사 성장인자 - II 의 발현

노재숙(Jae Sook Roh),성노현(Ro Hyun Sung),신중식(Joong Sik Shin),유중배(Jung Bae Yoo),황윤영(Youn Yeung Hwang) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.9

연구목적 : 인슐린유사성장인자-II가 여성의 자궁이나 난소조직의 주기적인 변화에 관여하는 것은 잘 알려져 있으나, 난관 상피세포의 주기적인 변화와도 관련이 있는지는 명확치 않다. 본 연구는 난관 상피세포에서 IGF-II가 발현되는지를 알아보고, 발현되는 경우 생식주기에 따른 차이를 보이는지 비교하였다. 연구대상 및 방법 : 다양한 부인과 질환으로 개복수술을 받았던 월경주기가 규칙적인 16명의 가임기 여성과 4명의 폐경기 여성에서 난관조직을 얻어 IGF-II에 대한 면역조직염색을 시행하였다. 연구결과: IGF-II는 주로 난관 상피세포에서 강하게 발현되었고 기질세포와 근육층에서는 약하게 발현되었다. 상피세포 중에서 섬모가 있는 세포와 없는 세포간에 차이는 없었다. 난관 상피세포에서 IGF-II의 발현정도는 생식주기에 따른 차이를 보여, 증식기 중,후기와 분비기 초,중기가 증식기 초기 및 분비기 후기와 비교하여 강하게 발현되고 폐경기에서는 발현되지 않았다. 결 론 : 본 연구결과 가임기 여성의 난관 상피세포에 IGF-II가 발현된다는 것을 알 수 있었다. 이는 IGF-II가 직, 간접적으로 난관 기능에 관여한다는 것을 의미하며, 또한 주기에 따른 발현 정도의 차이는 IGF-II가 난소에서 분비되는 스테로이드 호르몬의 영향을 받는다는 것을 의미한다. Objective : The involvement of IGF-II in reproductive tissues, especially uterine and ovarian, there is very little information is available concerning their presence in human tubal epithelium. To elucidate this, the present study was undertaken to determine the pattern of expression and cyclic changes of IGF-II in human tubal epithelium during various reproductive stages including postmenopause. Methods : Tube samples from 16 normally cycling women, as well as from 4 postmenopausal women were obtained. The expression pattern of IGF-II was examined using immunohistochemistry. Results : The primary site of immunoreactivity for IGF-II in fallopian tube tissue was in the epithelial lining of the tubes, with substantially lower intensity in the stromal cells and smooth muscle layer. The immunostaining was associated with both cilicated and nonciliated tubal epithelial cells without substantial differences in their intensity. Immunostaining intensity of IGF-II in tubal epithelial cells was cycle-dependent and considerably higher in mid-late proliferative and early-mid secretory compared to early proliferative and late secretory phases of the menstrual cycle, with no immunostaining in the postmenopausal period. Conclusion : This study demonstrates the presence of IGF-II in the human fallopian tube during various stages of the menstrual cycle. These data suggest an autocrine or paracrine role for the IGF-II in fallopian tube function, and their cyclic dependency further implies ovarian steroidal regulation.

Implication of Oxygen Level on the regulation of follicle growth in cultured mice ovaries in vitro

노재숙 ( Jae Sook Roh ),Teresa K Woodruff 대한산부인과학회 2008 대한산부인과학회 학술대회 Vol.94 No.-

Regulation of Wilms` tumor suppressor gene, WT1, FSH and FSH receptor in the immature rat granulosa cells(초)

노재숙 ( Jae Sook Roh ),( Mi Hyeon Jeong ) 대한산부인과학회 2009 대한산부인과학회 학술대회 Vol.95 No.-

과배란유도에 의한 난소과자극증후군 발생 고위험군에 있어서 알부민 정맥투여요법의 효과에 관한 연구

문신용,노재숙,이경순,서창석,김석현,최영민,신창재,김정구,이진용,장윤석,Moon, Shin-Yong,Roh, Jae-Sook,Lee, Kyung-Soon,Suh, Chang-Suk,Kim, Seok-Hyun,Choi, Young-Min,Shin, Chang-Jae,Kim, Jung-Gu,Lee, Jin-Yong,Chang, Yoon-Seok 대한생식의학회 1995 Clinical and Experimental Reproductive Medicine Vol.22 No.2

Ovarian hyperstimulation syndrome(OHSS) is one of the well-known complication of controlled ovarian hyperstimulation(COH). Though there have been numerous measures to prevent the occurrence of OHS, it has not been completely preventable until now. The fluid shift from the intravascular space to the third space is due to decreased oncotic pressure of the serum. The objective of this study was to evaluate if IV administration of 20% albumin in those patients with OHSS risk can make prevention of severe OHSS. We retrospectively analysed 70 patients undergoing IVF-ET who had serum peak estradiol($E_2$) level of >2,500 pg/ml and/or the number of oocytes retrieved over 20. The treatment group(n=39) received albumin while the control group(n=31) did not. After 40 grams of human albumin diluted in 1,000 ml of 0.9% sodium chloride solution, the treatment group received half of the fluid during oocyte retrieval, the remainder in the recovery suite. The results were as follows; There were significant differences in the levels of serum peak $E_2$ and number of oocytes retrieved between the two groups(p<0.05). However, there were no significant differences in the incidence of OHSS and pregnancy rate or multifetal pregnancy rate. In conclusion, administration of albumin to OHSS risk patients did not reduce the rate of OHSS in IVF-ET. However, if we consider the fact that there were differences in the level of peak serum $E_2$ and oocyte numbers, further prospective study may be needed.

정상 및 자궁경부무력증의 임신중 경부 길이 비교

라명재 ( Myung Jae Ra ),유중배 ( Jung Bae Yoo ),박문일 ( Moon Il Park ),노재숙 ( Jae Sook Roh ),나도수 ( Do Soo Nah ),문형 ( Hyung Moon ),황윤영 ( Yoon Yeoung Hwang ) 대한주산의학회 1996 Perinatology Vol.7 No.2

자궁내막증과 동반된 불임환자의 보조생식술을 이용한 치료

문신용,이경순,노재숙,서창석,김석현,최영민,신창재,김정구,이진용,장윤석,Moon, Shin-Yong,Lee, Kyung-Soon,Roh, Jae-Sook,Suh, Chang-Suk,Kim, Seok-Hyun,Choi, Young-Min,Shin, Chang-Jae,Kim, Jung-Gu,Lee, Jin-Young,Chang, Yoon-Seok 대한생식의학회 1995 Clinical and Experimental Reproductive Medicine Vol.22 No.2

Though the endometriosis is not always related with infertility, endometriosis causes infertility in some patients. There are many treatment modalities of infertile patients who have endometriosis. In recent years, Assisted Reproductive Technology(ART) have been widely accepted as being a useful tool for the treatment of infertile endometriotic patients. The objective of this study was to evaluate the outcome of ART in infertile endometriotic patients who have been carried out IVF-ET from Jan, 1992 to Dec, 1994 and to compare the results between COH/IUI and IVF-ET in the patients with endometriosis stage I. Tubal disease only patients were grouped(308 patient, 956 cycles) as a control. Endometriosis group was subdivided into 4 groups according to American Fertility Society classification; endometriosis stage I (45 patients, 61 cycles), stage II (26 patients, 39 cycles), stage III (26 pateitns, 37 cycles), stage IV (33 patients, 50 cycles). The outcomes of IVF-ET in endometriosis patients were as follows; The oocyte recovery rates were significantly lower in stage III, IV endometriosis. In case of stage III endometriosis, the fertilization rate was significantly lower than other stages of endometriosis. Clinical pregnancy rates per cycle were not different between the tubal group(22%) and the endometriosis group(25%). According to endometriosis stage, the implantation rate and clinical pregnancy rate were significantly lower in stage IV (5.6%, 16%) compared with other stages (I; 10.0%, 26%, II;9.8%, 31%, III;12.6%, 32%). It suggests that some factor like autoantibodies may inhibit implantation of embryos in stage IV endometriosis. To evaluate the possibility that simply increasing the number of gametes at the site of fertilization might account for pregnancies attributed to IVF-ET, the authors retrospectively analyzed the outcome of couples undergoing IUI during hMG cycles and CC cycles between 1992 and 1994 in the women with endometriosis stage 1. In case of stage I endometriosis, though the COH/IUI group showed lower FSH level and lesser age profile than IVF-ET group, IUI group has resulted in lower pregnancy rates(19.2%) compared with the IVF-ET group(26.2%). In conclusion, endometriotic infertile patients can get comparable pregnancy rates with the tubal factor infertility patients during IVF-ET program. Moreover even in stage I endometriosis, IVF-ET may be an more effective treatment modality than COH/IUI.