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Summary Introduction It is believed that Rhodiola rosea is able to reduce various stressors caused by chemical and biological factors. Studies have demonstrated that Rhodiola rosea is able to retard muscle damage caused by intense exercise; however, whether this effect is related to inflammatory cytokines remains unknown. The purpose of this study is to examine the impact of Rhodiola rosea administration after continuous endurance exercise on the inflammatory responses. Summary of facts and results Twelve healthy subjects were recruited. The study was a randomized, double-blind, crossover study, composed of two 8-day trials, each separated by a 2-week washout phase. Each trial included a 3-day exercise period consisting of a 30-min run at 75% VO2max per day followed by a 5-day recovery period. The subjects were given two orally administered capsules of placebo (P) or Rhodiola rosea (Rh) per day during the recovery period and immediately after continuous exercise. At 24 and 48 h after the exercise, the blood creatine kinase (CK) levels were higher than those before exercise in both groups. The blood variables had returned to the baseline level at 24 h after exercise except the CK level. The CK levels were lower in the Rh group than that in the P group 72 h after continuous exercise (208.2 ± 32.7 vs 136.7 ± 13.8 U/L, P Conclusion The main finding of this study is that supplementation of Rhodiola rosea after continuous endurance exercise has a trend to decrease blood CK levels moderately, but it is unable to reduce inflammatory reactions.

OBJECTIVES The objective of the study is to evaluate the therapeutic effect of hyoscine N-butylbromide (HBB) in active phase of labor and its safety to mother and fetus. METHODS A systematic literature search was conducted on Cochrane Library, Pubmed, EMBASE, CINAHL, ClinicalTrials.gov and three databases in Chinese up to March 31, 2020. Randomized controlled trials (RCTs) of HBB administration during the active phase for shortening of spontaneous labor at term compared with placebo were included. Two reviewers assessed the methodological quality and data extraction independently. We calculated pooled risk ratios (RRs), mean differences (MDs) and 95% confidence intervals (CIs) using Review Manager 5.3 software. Intention-to-treat principles and random-effects model were adopted for analysis and pool results. RESULTS In total, 1448 women from 9 RCTs were included in the meta-analysis. The HBB group exhibited significantly decreased durations of active phase (MD -61.1 min; 95% CI: -87.7 to -34.4, I2 : 96%), the second stage (MD -2.0 min; 95% CI: -3.4 to -0.5, I2 : 62%), and third stage (MD -0.7 min; 95% CI: -1.1 to -0.3, I2 : 51%). Intravenous (IV) HBB group and intramuscularly (IM) HBB group were compared to the control group (MD -60.9 min; 95% CI -87.7 to -34.1, I2 : 96%). No significant differences were observed in Cesarean section, post-partum hemorrhage, instrumental labor, Apgar scores or any adverse effects. CONCLUSION Hyoscine N-butylbromide had a significant effect of shortening the duration of the active phase of labor without adverse effects. We recommend a single dose of intravenous administrated HBB when a woman undergoes labor augmentation.

Wharton’s jelly-derived mesenchymal stromal cells (WJ-MSCs) have distinct immunomodulatory and protective effects against kidney, liver, or heart injury. Limited studies have shown that WJ-MSCs attenuates oxygen–glucose deprivation-mediated inflammation in hippocampal slices. The neuroprotective effect of intracerebral WJ-MSC transplantation against stroke has not been well characterized. The purpose of this study was to examine the neuroprotective effect of human WJ-MSC (hWJ-MSC) transplants in an animal model of stroke. Adult male Sprague–Dawley rats were anesthetized and placed in a stereotaxic frame. hWJ-MSCs, pre-labeled with chloromethyl benzamide 1,1’-dioctadecyl-3,3,3’3’- tetramethylindocarbocyanine perchlorate (CM-Dil), were transplanted to the right cerebral cortex at 10 min before a transient (60 min) right middle cerebral artery occlusion (MCAo). Transplantation of hWJ-MSCs significantly reduced neurological deficits at 3 and 5 days after MCAo. hWJ-MSC transplants also significantly reduced brain infarction and microglia activation in the penumbra. Grafted cells carrying CM-Dil fluorescence were identified at the grafted site in the ischemic core; these cells were mostly incorporated into ionized calcium-binding adaptor molecule (+) cells, suggesting these xenograft cells were immuno-rejected by the host. In another set of animals, hWJ-MSCs were transplanted in cyclosporine (CsA)-treated rats. hWJ-MSC transplants significantly reduced brain infarction, improved neurological function, and reduced neuroinflammation. Less phagocytosis of CM-dil-labeled grafted cells was found in the host brain after CsA treatment. Transplantation of hWJ-MSC significantly increased glia cell line-derived neurotrophic factor expression in the host brain. Taken together, our data support that intracerebral transplantation of hWJ-MSCs reduced neurodegeneration and inflammation in the stroke brain. The protective effect did not depend on the survival of grafted cells but may be indirectly mediated through the production of protective trophic factors from the transplants.

Objective Menstrual irregularity is one of the major complaints in women of reproductive age. The aim of this study was to evaluate the complications in women with different menstrual disturbances. Materials and methods This is a retrospective study. A total of 576 women were screened first, and 470 women were included later [257 women with oligo/amenorrhea (149 hyperandrogenic and 108 nonhyperandrogenic women) and 213 normocyclic controls]. Endocrine and metabolic parameters and insulin resistance were compared among different menstrual patterns. Results The average duration of menstrual cycle length was positively correlated with age, levels of androgens and prolactin, lipid profiles, and the parameters of insulin resistance. Hyperandrogenic women with amenorrhea had higher levels of androgens and more lipid profiles disorders than hyperandrogenic women with oligomenorrhea. However, nonhyperandrogenic women with amenorrhea had a degree of insulin resistance and metabolic disturbance similar to that of nonhyperandrogenic women with oligomenorrhea. Interestingly, for women with normal prolactin levels, serum prolactin levels were significantly lower in amenorrhea than oligomenorrhea in both hyperandrogenic and nonhyperandrogenic groups. Conclusion The degree of menstrual disturbances does not correlate with the severity of insulin resistance and metabolic disturbances in women without excess levels of androgen. For women with normal prolactin levels, amenorrheic patients had significantly lower serum prolactin levels than oligomenorrheic patients.

Objective Hyperhomocysteinaemia is a well-established risk factor for cardiovascular disease. This study investigated the relationship between hyperhomocysteinaemia and factors related to polycystic ovary syndrome (PCOS). Study design Case–control study. Three hundred and thirty-nine women were included; of these, 84 had hyperhomocysteinaemia (homocysteine >12.4 μmol/l) and 255 had normal homocysteine levels. Homocysteine, high-sensitivity C-reactive protein, insulin resistance, metabolic disturbance and PCOS-related disturbance were evaluated. The clinical and biochemical characteristics of women with hyperhomocysteinaemia and normal homocysteine levels, including insulin resistance, metabolic disturbance and PCOS-related disturbance, were compared. Results Correlation was found between serum homocysteine level and serum total testosterone level and diastolic blood pressure. No correlation was found between serum homocysteine level and age, body mass index, insulin resistance and lipid profile. Women with hyperhomocysteinaemia had a significantly higher risk for biochemical hyperandrogenaemia and higher serum total testosterone levels than women with normal homocysteine levels. The prevalence rates of PCOS, oligo-amenorrhoea, polycystic ovary morphology and metabolic disturbance did not differ between the two groups. The parameters of insulin resistance and lipid profiles were similar between the two groups, and signs of clinical hyperandrogenism (hirsutism and the modified Ferriman–Gallwey score) did not differ between the two groups. Logistic regression analysis found a significant association between hyperandrogenaemia and hyperhomocysteinaemia (odds ratio 2.24, 95% confidence interval 1.26–4.01). Conclusions For women with PCOS, an elevated serum total testosterone level is the main factor associated with hyperhomocysteinaemia. The association between biochemical hyperandrogenism and hyperhomocysteinaemia may contribute to cardiovascular risk for women with PCOS.

We aimed to investigate the clinicopathologic features, immunohistochemical studies, and prognosis in patients with endometrial stromal sarcoma (ESS). Clinical information was reviewed retrospectively for cases of ESS (1985-2009). A histologic review and immunohistochemical staining for the estrogen receptor, progesterone receptor, c-Kit, CD-10, Ki-67, and m-TOR were performed. Sixty-one patients (median age, 44 y; range, 22-71) were eligible for analysis (1988 International Federation of Gynecology and Obstetrics Stage I, 43; Stage II, 2; Stage III, 11; Sage IV, 4; unstaged, 1). The median follow-up period for survivors was 73 mo. Of those, the patients who underwent an adnexectomy and a pelvic lymphadenectomy, 15% and 13%, respectively, revealed metastasis. There were 20 relapses/persistence, including 13 (65%) in the pelvis and abdomen and 7 (35%) in distant sites. Eight patients died from ESS at a median duration of 14.5 mo (range, 2-50 mo) after relapse. Five- and 10-yr cancer-specific survival (CSS) rates were 88% and 85%, respectively; and 5- and 10-yr progression-free survival rates were 69% and 57%, respectively. Stage, residual disease, and high proliferative index of Ki-67 were significant prognostic factors for both progression-free survival and CSS in a univariate analysis, in addition to mitotic index for CSS. Multivariate analysis selected only residual disease as an independent variable for progression-free survival and stage and residual disease for CSS. Our results support using clinical Stage I, no residual disease, low proliferative index of Ki-67, and estrogen receptor/progesterone receptor overexpression as potential biomarkers to select patients with ESS for fertility-preservation surgery (5 such patients were alive and free).

This study is designed to evaluate the relationship between endometrial thickness and clinical/biochemical parameters in women with chronic anovulation. One hundred and twenty women with ovulatory dysfunction were prospective included, endometrial thickness and endocrine and metabolic parameters were measured. The interval between the examination day and the day of the most recent menstrual bleeding (the anovulatory interval) for the studied subject was an average of 145 ± 186 days. The endometrial thickness averaged 7.1 ± 3.2 mm. Correlation analyses revealed that the endometrial thickness was positively correlated with body mass index but was not correlated with age, serum androgens, or estradiol (E2) levels. We further classified the subjects into two groups based on endometrial thickness: Group A, endometrial thickness

Objective To evaluate the contribution to glucose intolerance and metabolic syndrome of obesity combined with the diagnostic criteria of polycystic ovary syndrome (PCOS). Design Prospective study. Setting University teaching hospital from 31 August 2010 to 31 August 2011. Population Two hundred and twenty women with PCOS and seventy normal control women. Methods The clinical and biochemical characteristics of women with PCOS and control women were evaluated. Main outcome measures. The impact of obesity, hyperandrogenism, oligo-anovulation and polycystic ovary morphology on impaired glucose tolerance and metabolic disturbances. Results Obese women with PCOS had significantly higher insulin resistance than obese normal control women. Logistic regression analysis showed that obesity was the only factor that predicted impaired glucose tolerance and metabolic syndrome. Use of the area under the receiver operating characteristic curve (AUROC) for the body mass index to predict impaired glucose tolerance and metabolic syndrome was more accurate than AUROCs for serum total testosterone level and the average menstrual interval. Conclusions Body weight status was the major factor determining the risk of impaired glucose tolerance and metabolic syndrome in women with PCOS. Obesity should be treated as the major factor determining long-term health consequences associated with PCOS.

Objective Sonographic gray-scale histogram is used to assess the endometrial changes in the different phases of the menstrual cycle. The objective was to examine the usefulness of a gray-scale histogram and computer-assisted image analysis software in assessing normal physiologic states of the endometrium with sonography. Materials and Methods Thirty-eight patients, who visited the Taipei Medical University-Wan Fang Hospital and matched the eligibility criteria, were categorized into one of three groups: (1) menstrual phase; (2) follicular phase; and (3) luteal phase of the menstrual cycle. Ultrasonography of the uterus was performed on each patient and the endometrium was analyzed with ImageJ image analysis software. Results A statistically significant difference in signal intensity scores of the gray-level histogram, represented as mj, was found among the three groups. Conclusion Sonographic images analyzed by using computer-assisted image analysis software and gray-level histogram are proven to be useful in assessing the physiological state of the endometrium.

The purpose of this prospective study was to evaluate Kruger strict morphology and conventional semen analysis in predicting cryosurvival and the progressive motility recovery rate of frozen spermatozoa. Our study included 56 semen samples with >10 million spermatozoa per ejaculate. The main outcome measures were conventional semen analysis, strict morphology analysis by the Kruger method, cryosurvival rate and post-thaw sperm motility. A significant reduction in sperm motility after cryopreservation was demonstrated. The freeze-thawing process caused a 66% reduction in rapid progressive motile spermatozoa, a 45% reduction in slow progressive motile spermatozoa and a 2% reduction in nonprogressive motile spermatozoa. The cryosurvival and progressive motility recovery rates were not correlated with parameters of conventional semen analysis, such as sperm concentration, motility, WHO morphology and total motile count, but the progressive motility recovery rate was significantly correlated with the percentage of spermatozoa exhibiting Kruger normal morphology (P = 0.028). The recovery rate of rapidly progressive motility was profoundly decreased compared with slow progressive motility following the frozen-thaw procedure of semen. Kruger strict morphology assessment was a better predictor of the progressive motility recovery rate following the freezing-thaw procedure than parameters of conventional semen analysis.

Objective To assess the relationship between antimullerian hormone (AMH) and parameters related to polycystic ovary syndrome (PCOS). Design Prospective study. Setting Academic tertiary care center. Patient(s) A total of 290 women. Intervention(s) None. Main Outcome Measure(s) Parameters related to insulin resistance and metabolic syndrome. Result(s) Women with polycystic ovary morphology had significantly higher AMH levels than women in the control group. The prevalence of PCOS increased from 21% in the low-AMH ( 11 ng/mL) group. However, significant differences in insulin resistance parameters were not observed among groups. The results of the correlation analysis revealed that AMH levels were positively correlated with LH, total T, A, and total cholesterol content; however, AMH levels were negatively correlated with age, body mass index, and the number of menstrual cycles per year. AMH levels were not correlated with insulin resistance parameters. Conclusion(s) Elevated serum AMH levels increase the risk of PCOS but do not affect the risk of insulin resistance or metabolic syndrome.

Polycystic ovary syndrome (PCOS) is an extremely common disorder in women of reproductive age. Diagnosis of PCOS is principally based on clinical and physical findings. Diagnostic criteria and PCOS definitions used by clinicians and researchers are almost as heterogeneous as the syndrome. Of those diagnosed with PCOS using the 2003 Rotterdam criteria, 61% fulfilled the 1990 National Institutes of Health criteria for unexplained hyperandrogenic chronic anovulation. Patient populations with the new phenotypes have less severe ovulatory dysfunction and less androgen excess than patients diagnosed using the 1990 National Institutes of Health criteria. These findings might be common across all female populations with PCOS, in Asian or Western countries. Data for clinical hyperandrogenism indicates that the prevalence of hirsutism in Taiwanese PCOS women is lower than that for Caucasian/Western women. The extent of metabolic abnormalities in women with PCOS may vary with phenotype, age and ethnicity. Obesity represents a major risk factor for metabolic syndrome and insulin resistance. Approximately 40–50% of all women with PCOS are overweight or obese. Obese subjects with PCOS have a higher risk of developing oligomenorrhea, amenorrhea and biochemical hyperandrogenemia than non-obese women with PCOS. Moreover, obese women with PCOS have significantly more severe insulin resistance, lower serum luteinizing hormone levels, and lower luteinizing hormone to follicle-stimulating hormone ratios than those of non-obese women with PCOS. PCOS women in Taiwan have a higher luteinizing hormone to follicle-stimulating hormone ratio and lower insulin resistance than those in PCOS women in Western countries. However, the average body mass index is significantly lower in Taiwanese PCOS women than in Western women, which might partially explain the difference between these two populations in terms of clinical and biochemical presentations. To further document the ethnic variation between women with PCOS in Taiwan and Western countries, future studies should pay attention to the effect of obesity on the diagnosis and clinical presentations of PCOS-related syndromes.

Aim: To examine the usefulness of a gray scale histogram and computer assisted image analysis software in assessing physiologic states of the endometrium with ultrasonography. Methods: Seventy patients at the Taipei Medical University-Wan Fang Hospital who matched eligibility criteria were categorized into one of three groups: (i) normal menstrual cycle, (ii) postmenopausal, and (iii) post incomplete abortion. Ultrasonography of the uterus was performed on each patient and the endometrium was analyzed with ImageJ image analysis software. Results: A statistically significant difference in signal intensity scores of the gray level histogram, represented as mj, was found between the groups. Conclusion: Ultrasonographic images analyzed using computer assisted image analysis software and gray level histogram are useful in assessing the physiological state of the endometrium.

Polycystic ovary syndrome (PCOS) and hyperprolactinaemia are both common causes of secondary amenorrhoea in reproductive women. The relationship between PCOS and hyperprolactinaemia has been reported with controversial results. To evaluate the clinical and laboratory features of women with mild hyperprolactinaemia and PCOS, we studied 474 Taiwan Chinese women: 101 had mild hyperprolactinaemia, 266 had PCOS and 107 were the control group. In this study, we found that 64% of the women with mild hyperprolactinaemia fulfilled the PCOS diagnostic criteria, regardless of their prolactin levels. Obese women with PCOS had significantly lower luteinising hormone (LH) and LH-to-FSH ratios than non-obese women with PCOS. Obese hyperprolactinaemic women had significantly lower follicle-stimulating hormone (FSH), but higher LH-to-FSH ratios than the non-obese hyperprolactinaemic women. For women with PCOS, the BMIs were significantly negative with LH (γ = -0.253, p 0.001), but not with FSH (γ = -0.061, p = 0.319). For the hyperprolactinaemic women, the BMIs were significantly negative with FSH (γ = -0.353, p 0.001), but not with LH (γ = -0.021, p = 0.837). Although PCOS-related syndrome was very prevalent in women with hyperprolactinaemia, the patterns of disturbance in gonadotropin secretion were different between the PCOS and the hyperprolactinaemia patients.

Increasing evidence have supported that Wharton's jelly mesenchymal stem cell (WJ-MSCs) have immunomodulatory and protective effects against several diseases including kidney, liver pathologies, and heart injury. Few in vitro studies have reported that WJ-MSCs reduced inflammation in hippocampal slices after oxygen–glucose deprivation. We recently reported the neuroprotective effects of human WJ-MSCs (hWJ-MSCs) in rats exposed to a transient right middle cerebral artery occlusion. hWJ-MSCs transplantation significantly reduced brain infarction and microglia activation in the penumbra leading with a significant reduction of neurological deficits. Interestingly, the grafted hWJ-MSCs in the ischemic core were mostly incorporated into IBA1 (+) cells, suggesting that hWJ-MSCs were immunorejected by the host. The immune rejection of hWJ-MSCs was reduced in after cyclosporine A treatment. Moreover, the glia cell line-derived neurotrophic factor expression was significantly increased in the host brain after hWJ-MSCs transplantation. In conclusion, these results suggest that the protective effect of hWJ-MSCs may be due to the secretion of trophic factors rather than to the survival of grafted cells. This paper is a review article. Referred literature in this paper has been listed in the references section. The data sets supporting the conclusions of this article are available online by searching various databases, including PubMed. Some original points in this article come from the laboratory practice in our research center and the authors’ experiences.

Objective To evaluate inappropriate gonadotropin secretion in women with polycystic ovary syndrome (PCOS). Design Retrospective study. Setting Academic tertiary center. Patient(s) A total of 373 women were classified into three groups: [1] healthy control women (n = 48); [2] women who were positive for PCOS risk factor; and [3] women with PCOS (n = 251). Intervention(s) None. Main Outcome Measure(s) Gonadotropin levels, LH-FSH ratio, body mass index, and clinical and/or biochemical presentations of PCOS. Result(s) The area under the receiver operating characteristic curve, used to predict PCOS for the LH-FSH ratio, showed similar diagnostic performance to total T and average ovarian volume. The LH-FSH ratio exhibits greater observed accuracy than total T and average ovarian volume for evaluation of women with oligomenorrhea or anovulation. An LH-FSH ratio of >1 presented the best combination of sensitivity and specificity. Body mass index was positively correlated with total T in non-PCOS and PCOS groups; however, body mass index was negatively correlated with LH in PCOS but showed no correlation in non-PCOS subjects. Conclusion(s) The LH-FSH ratio is a valuable diagnostic tool in evaluating women with PCOS and oligomenorrhea or anovulation, and an LH-FSH ratio of >1 may be used as a decision threshold. The link between body mass index and LH may provide clues for further understanding the pathological milieu of PCOS.

Background: From a public health point of view, it is important to evaluate the prevalence of nocturia and to identify the associated factors for nocturia among the elderly that might impair the quality of life of sufferers. However, those among the Taiwanese female population aged 60 or older are still unclear. Aims: To estimate the prevalence of nocturia in Taiwanese women aged 60 or older and to assess its associated factors. Methods: Nocturia, defined by the International Continence Society, and its associated problems were evaluated, and medical history and sociodemographic variables were recorded. A sample of 2410 female was selected by a multistage random sampling method. Results: Six hundred and twenty-one women who were selected had been deceased. Face-to-face interviews with 1523 women were completed, producing a response rate of 85.1% (1523 of 1789) and 73.5% (1120 of 1523) of the interviewees reported having had nocturia. Age, diabetes mellitus, hypertension, prior drug allergy and urinary incontinence significantly increased the risk of nocturia. Conclusions: Although the pathophysiologies of nocturia are still not all known, it is a common condition among Taiwanese women. Multiple approaches are necessary to treat the patients with nocturia. Treatment of nocturia in this patient population can both improve their quality of life and reduce the risk of deterioration in their general state of health.

Objective: To assess the risk factors for urinary incontinence among Taiwanese women. Materials and Methods: A sample of 4,549 women was selected using a multistage random sampling protoco The women selected were interviewed face-to-face by well-trained interviewers. The usual risk factors, which included marital status, age, body mass index, menstrual status, alcohol intake, drug allergy, diabetes mellitus, hypertensio and gynecologic events, were evaluated. The factors were assessed by frequency analysis and logistic regressio analysis using a significance level of less than 0.05. Results: A total of 3,537 women were successfully interviewed, producing a response rate of 77.8% (3,735/4,549’ The prevalence of urinary incontinence increased significantly with marriage (21.7%; 95% confidence interva Cl, 20.2-23.2), alcohol intake (24.9%; 95% Cl, 1 9.3-30.5), drug allergy (24.5%; 95% Cl, 1 9.9-29.2), diabete mellitus (40.3%; 95% Cl, 29.3-51.2), hypertension (30.1%; 95% Cl, 23.8-36.4), body mass index (odds ratic 1.05 per unit increase; 95% Cl, 1.02-1.09) and a previous gynecologic operation (25.5%; 95% Cl, 1 9.9-31.2). Ag was also a risk factor for urinary incontinence (odds ratio, 1.04; 95% Cl, 1.03-1.05), but there was no relationshi between urinary incontinence and parity, route of delivery, smoking or menstrual status. Conclusion: There is a high prevalence of urinary incontinence among women who suffer from diabetes o hypertension, or who have undergone a gynecologic operation, in particular hysterectomy. From a public healt viewpoint, it is important to promote better health education in order to improve understanding of urinar incontinence and its risk factors and to increase the awareness of the availability of mainstream treatment; [Taiwan J Obstet Cynecol 2008;47(2):1 97-202]

Objective: To assess the risk factors for nocturia among Taiwanese women aged 20–59 years. Materials and Methods: A random sample of 4,549 women aged 20–59 years was selected by multistage sampling. A total of 3,537 women were interviewed face-to-face by well-trained interviewers and local public health nurses. The definition of lower urinary tract symptoms used is that as defined by the International Continence Society. Variables of sociodemography, medical histories, obstetric and gynecologic histories, and lower urinary tract symptoms were recorded. The factors were assessed by frequency and logistic regression analyses using a significance level of less than 0.05. Results: The prevalence of nocturia increased significantly with age (p < 0.001), body mass index (p < 0.001), diabetes mellitus (p = 0.024), hypertension (p = 0.001), previous gynecologic operation (p = 0.003), drug allergy (p = 0.036), and marital status (p = 0.000). However, there was no relationship between nocturia and smoking, alcohol consumption, parity, hysterectomy, menopause or hormone therapy. Conclusion: Although the answers to the etiology of nocturia are still not all known, nocturia has been associated with various factors, suggesting that multiple approaches are necessary in the treatment of patients with nocturia.

Summary Objective To estimate the prevalence of nocturia in Taiwanese women aged 20–59 years. Materials and Methods A random sample of 4,549 women within the age range was selected by a multistage sampling design. Face-to-face visits with 3,537 women were completed by well-trained professional interviewers. Nocturia, according to the definition of the International Continence Society, and its associated problems were evaluated and, concurrently, variables of medical histories and sociodemography were recorded. Results The response rate was 77.8%, and a total of 930 of 3,521 women reported having had nocturia, producing a prevalence of nocturia of 26.4%, with 16 not answering the question about nocturia. For those who had nocturia, 88.9% of the interviewees reported ≤ 2 voids per night and 1.6% of these women reported having to void ≥ 5 times per night. Conclusion Nocturia is a common condition among Taiwanese women, especially among the elderly. Its prevalence is significantly related to age. Treatment of this condition in this patient population can both improve their quality of life and reduce the risk of deterioration in their general state of health.

Cnidium monnieri (L.) Cusson is a Chinese medicine which is used widely by traditional medicine doctors. Osthol is a major bio-activity compound of the herb. In this study, osthol was isolated from C. monnieri and its in vitro and in vivo antitumor effects studied. The results of the in vitro study showed: that osthol inhibited the growth of HeLa, in a time- and concentration-dependent manner, with IC(50) values of 77.96 and 64.94 microm for 24 and 48 h, respectively; that osthol had lower cytotoxic effects in primary cultured normal cervical fibroblasts; and that increased DNA fragmentation and activated PARP in HeLa after treatment with osthol which could induce apoptosis. The results of the in vivo model showed that the survival days of the P-388 D1 tumor-bearing CDF(1) mice were prolonged (ILS% = 37) after osthol (30 mg/kg) was given once a day for 9 days. Based on these results, it is suggested that osthol could inhibit P-388 D1 cells in vivo and induce apoptosis in HeLa cells in vitro, and that osthol is good lead compound for developing antitumor drugs. However, C. formosanum Yabe of Taiwan's endemic plants contained little osthol, with no imperatorin, and its major components were different from that of C. monnieri. Therefore, it is suggested that C. formosanum also may possess economic worth.

Objective The aim of this study was to assess the relationship between fish consumption and total mercury concentration in maternal blood, umbilical cord blood, and placenta tissue of pregnant women in Taiwan. Design Cross-sectional study. Setting A medical centre in Taipei, Taiwan. Sample Sixty-five pregnant women delivered between July 2004 and March 2005. Methods We administered a questionnaire to each woman in the third trimester and collected blood samples and placenta tissue after delivery. Mercury concentrations in the maternal blood, cord blood and placenta tissue were measured using mercury analyser (Hiranuma HG-310, Hitachi, Japan). A dietitian calculated the quantity of fish consumed from the questionnaire. Main outcome measures The total mercury concentration in maternal blood, cord blood and placenta tissue. Results The mean total mercury concentration in maternal blood, cord blood and placenta tissue was 9.1 ± 0.40 microgram/l, 10.0 ± 0.55 microgram/l and 19.2 ± 1.8 ng/g, respectively. Eighty-nine percent of the maternal blood mercury concentrations exceeded the US National Research Council recommended value of 5.8 microgram/l. Fish consumption while pregnant correlated significantly with maternal blood and cord blood mercury concentrations. Conclusions Total mercury concentrations of maternal blood, cord blood and placenta tissue commonly exceeded recommended values, and were higher in women who ate fish more than three times a week while pregnant.

Our previous study based on the results of polymerase chain reaction and Southern hybridization for the detection of Human papilloma virus (HPV), Cytomegalovirus (CMV), Epstein-Barr virus (EBV), Herpes simplex virus (HSV)-1, HSV-2, and Human herpesvirus (HHV)-8 DNA in non-familial breast cancer patients suggest that the viruses associated with breast cancer are HHV-8EBV (P0.01). Therefore, efforts were made to further investigate the association between breast cancer with nodal status and viral infections.Sixty-two breast cancer patients and their mammary specimens were enrolled in this retrospective study. The presence of these six potential oncogenic viruses was analyzed to establish the relationship between nodal status and treatment outcome. Statistical analyses were used for the assessment of variables, including viral positivity and clinical feature.Viral positivity was not significantly different comparing node-positive and node-negative patients (P0.05). When the viral factors were not entered for statistical analyses, no variable was significantly related to overall survival. However, tumor stage, tumor size, nodal status , and estrogen receptor were significantly related to relapse-free survival (P0.05). For viral factors, the number of infecting viruses is related to the overall and relapse-free survivals. Only when V0 or V(0, 1) was grouped for comparison with other multiply virus-infected subgroups, were the overall and relapse-free survivals significantly different (P0.005 or P0.001). The results suggest that HSV-1, HHV-8, EBV, CMV, and HPV were related to overall survival, however, only HHV-8 and CMV were related to relapse-free survival (P0.05 or P0.01).Virus factor is significantly related to human breast cancer, not only in terms of the oncogenetic process, but also in overall and relapse-free survivals.

Pulmonary hemorrhage is a rare but sometimes fatal complication of hysteroscopy. We present the first case report in which a healthy patient developed lung collapse induced by pulmonary hemorrhage after operative hysteroscopy. The possible etiologies of this rare complication are also discussed.

Summary Objective The oral mifepristone/misoprostol combination (MMC) is safe for medical abortion in early pregnancy. The abortion status in MMC-treated pregnancies at Taipei Medical University-Wan Fang Medical Center was determined by ultrasonography, serum β-human chorionic gonadotropin (β-HCG), and histopathology. Methods All women at less than 49 days since the last menstruation who asked for legal abortion were evaluated by ultrasonography. They then received 600 mg of oral mifepristone followed 48 hours later by 600 μg of misoprostol. Women who had vaginal spotting or bleeding after 14 days were included in this study and underwent transvaginal ultrasonography, serum β-HCG measurement and vacuum aspiration or therapeutic dilatation and curettage (D&C) on day 14. Specimens were identified by histopathology. Abortion status was determined from linear regression of serum β-HCG and endometrial thickness. Results Of 35 women who underwent vacuum aspiration or therapeutic D&C, histopathology showed that 20 had decidual tissue and 15 had gestational tissue. Logistic regression showed that the distance measurement to the logistic regression line differed significantly between complete and incomplete abortion ( p Conclusion In this study, serum β-HCG assays in addition to ultrasonographic evaluation helped to discriminate abortion status after oral MMC.

Dysmenorrhea is directly related to elevated level of prostaglandin F(2)alpha (PGF(2)alpha), and is treated with nonsteroid anti-inflammatory drugs. Though efficacy of the latter is rapid, the effect is temporary, and they cause many side effects to the liver, kidney and digestive system. Because of this, Chinese medicinal therapy is being considered as a feasible alternative medicine. In this study, Dang-Qui-Shao-Yao-San (DQSYS), one of Chinese medicinal prescriptions was selected. A 50% alcohol solution was used to extract the active ingredients and create a freeze-dried product. Using rat uterine smooth muscle in vitro, DQSYS was used to suppress spontaneous contractions and PGF(2)alpha induced contractions. Then acetylcholine, ergonovine, propranolol, oxytocin and KCl were used to analyze the physiological mechanisms. The results show that DQSYS has the antagonistic action on both PGF(2)alpha and Ach induced uterine contraction. Furthermore, it has the antagonistic effect on contraction caused by KCl-depolarization. These actions may be the major mechanism of the beneficial effect of Chinese prescription in treating dysmenorrhea.