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Objective: The aim of the present study was to determine whether polycystic ovarian morphology (PCOM) is related to insulin resistance in women with polycystic ovary syndrome (PCOS).Methods: A total of 147 Korean women aged 18 to 35 years and diagnosed with PCOS were included in this study. Fasting blood tests and standard 2-hour 75-g oral glucose tolerance tests were performed for all participants. PCOM-related parameters including total antral follicle count (TFC) and total ovarian volume (TOV) were assessed using transvaginal or transrectal ultrasonography. Correlation analysis was conducted to assess the relationships of TFC and TOV with insulin resistance-related clinical and biochemical parameters using Spearman rank correlation coefficients and linear regression analysis, with partial correlations used to control for the effects of confounding covariates.Results: Fasting insulin levels, low-density lipoprotein levels, and insulin sensitivity assessment indices (ISAIs) were significantly correlated with TFC, but neither postprandial blood glucose levels nor insulin levels were significantly associated with TFC. No insulin resistance-related parameter was significantly correlated with TOV. These results did not change after adjustments for other anthropometric covariates. Fasting insulin and some ISAIs differed significantly between groups categorized by the median TFC value (TFC ≤54 and TFC >54).Conclusion: TFC, but not TOV, was found to be related to fasting insulin resistance-related parameters in women with PCOS.

Objective: The aim of the present study was to evaluate the associations between hematologic parameters related to systemic inflammation and insulin resistance-associated metabolic parameters in women with polycystic ovary syndrome (PCOS). Methods: Eighty-two women between the ages of 18 and 35 years who were diagnosed with PCOS were included in this study. A 2-hour 75-g oral glucose tolerance test (OGTT) was administered to all study participants; fasting and postprandial glucose and insulin levels were measured simultaneously during the 2-hour OGTT. Hematologic parameters were derived from a standard complete blood count and a differential count of fasting-state blood samples. The correlations between hematologic parameters and insulin resistance-associated clinical and metabolic parameters were evaluated using the Spearman rank correlation and partial correlation coefficients. Hematologic parameters related to systemic inflammation were compared between the two groups, categorized by the presence or absence of insulin resistance.Results: Significant differences in the absolute neutrophil count, absolute monocyte count, platelet count, and neutrophil-lymphocyte ratio were found between the insulin-resistant group and insulin-nonresistant group. Correlation analysis found that all hematological parameters, except for the platelet-lymphocyte ratio, were associated with at least one insulin resistance-associated metabolic parameter. However, these significant correlations between hematological and metabolic parameters were attenuated after controlling for the effects of other covariates using partial correlation analysis.Conclusion: The association between hematologic parameters indicative of systemic inflammation and insulin resistance-associated metabolic parameters seems to be strongly influenced by other anthropometric covariates in women with PCOS.

Objective This study aimed to assess the effect of combined oral contraceptives (COCs) on polycystic ovarian morphology (PCOM) and serum anti-Mullerian hormone (AMH) levels in Korean women with polycystic ovary syndrome (PCOS). Methods This university hospital study enrolled 36 Korean women who were newly diagnosed with PCOS based on the Rotterdam criteria and were treated with COCs for at least 1 year. We retrospectively evaluated the ovarian volume and number of antral follicles using ultrasonography and assessed serum AMH levels at baseline and after 1 year of COC treatment. Results Significant decreases in ovarian volume and antral follicle count were observed after 1 year of COC treatment. Compared to baseline, serum AMH levels were significantly decreased after 1 year. Conclusion COC treatment significantly affects ultrasound-assessed PCOM and serum AMH levels of patients with PCOS.

Objective The aim of this study was to establish whether differences in ovarian size exist between the right and the left ovary of the same individual in women with polycystic ovary syndrome. Methods In total, 206 Korean women with polycystic ovary syndrome were included in this study. In all participants, a transvaginal or transrectal ultrasound examination was conducted in the early follicular phase of the menstrual cycle. Results A significant linear correlation was found between the two ovaries with regard to antral follicle count and ovarian volume. The mean antral follicle count in the right ovary (26.75±11.72) was significantly higher than that in the left ovary (23.98±10.85), and the mean volume of the right ovary (11.06±5.17 cm3) was significantly different from that of the left ovary (9.12±4.89 cm3). Conclusion Ovarian size is different between the right and the left ovary in women with polycystic ovary syndrome.

Thymosin β4 (Tβ4) is a highly conserved actin binding protein associated with the metastatic potential of tumor cells by stimulating cell migration. The role of Tβ4 and its derived fragment peptides in migration of ovarian cancer cells has not been studied. To analyze the effects of Tβ4 and its derived fragment peptides on ovarian cancer cell migration and invasion, we applied Tβ4 and three Tβ4-derived synthetic peptides to SKOV3 ovarian cancer cells. The migration and invasion of SKOV3 cells treated with Tβ4(1–43), Tβ4(1–15), Tβ4(12–26), Tβ4(23–), and untreated control were analyzed by in vitro migration and invasion assay with transwell plate. Cell proliferation assay was conducted to identify the effect of Tβ4 and its derived peptide on SKOV3 cell proliferation. The expression of Tβ4 related proteins related with cell proliferation was analyzed by Western blot after treatment with Tβ4 and its derived peptides. Cell migration and invasion were significantly increased in Tβ4 peptide-treated SKOV3 cells compared with untreated control. All three Tβ4-derived fragment peptides including those without an actin binding site significantly stimulated migration and invasion of SKOV3 cells. Tβ4 and its derived peptide significantly stimulated SKOV3 cell proliferation and up-regulated the expression of RACK-1 protein. The Tβ4 peptide and all of its derived fragment peptides including those without an actin binding motif stimulate migration and invasion of SKOV3 ovarian cancer cells. All peptides significantly increased RACK-1 expression and cell proliferation of SKOV3 cells. These results suggest that Tβ4 stimulates migration and invasion of SKOV3 cells by stimulation of cell proliferation through up-regulation of RACK-1 protein.

Objective: The aim of the present study was to evaluate the predictive capability of fasting-state measurements of glucose and insulin levels alone for abnormal glucose tolerance in women with polycystic ovary syndrome (PCOS).Methods: In total, 153 Korean women with PCOS were included in this study. The correlations between the 2-hour postload glucose (2-hr PG) level during the 75-g oral glucose tolerance test (OGTT) and other parameters were evaluated using Pearson correlation coefficients and linear regression analysis. The predictive accuracy of fasting glucose and insulin levels and other fasting-state indices for assessing insulin sensitivity derived from glucose and insulin levels for abnormal glucose tolerance was evaluated using receiver operating characteristic (ROC) curve analysis.Results: Significant correlations were observed between the 2-hr PG level and most fasting-state parameters in women with PCOS. However, the area under the ROC curve values for each fasting-state parameter for predicting abnormal glucose tolerance were all between 0.5 and 0.7 in the study participants, which falls into the “less accurate” category for prediction.Conclusion: Fasting-state measurements of glucose and insulin alone are not enough to predict abnormal glucose tolerance in women with PCOS. A standard OGTT is needed to screen for impaired glucose tolerance and type 2 diabetes mellitus in women with PCOS.

Objectives This study aimed to evaluate the influence of simple hysterectomy on the ovarian reserve based on the type of surgery. Methods Eighty-six premenopausal women between 31 and 48 years who underwent hysterectomy for benign gynecologic disease without additional adnexal surgery at a university hospital participated in this study. Seventy-one patients underwent laparoscopy-assisted vaginal hysterectomy (LAVH), and 15 patients underwent abdominal hysterectomy (AH). Blood samples were obtained from all study participants on preoperative day and 3 days after the operation to determine the anti-Mullerian hormone (AMH) levels. Results The postoperative reduction of the mean serum AMH level in the LAVH group (0.42 ± 0.76 ng/mL) was greater than that in the AH group, although the difference was not statistically significant (0.01 ± 0.60 ng/mL) (P = 0.053). The mean baseline AMH level (2.59 ± 2.33 ng/mL) was significantly reduced to 2.24 ± 2.08 ng/mL at 3 days after hysterectomy, and the mean rate of decline of AMH levels after surgery was 13.61% ± 30.81%. In subgroup analysis based on the type of surgery, the mean serum AMH level decreased significantly after surgery in the LAVH group, but no significant changes were found in serum AMH levels before and after the surgery in the AH group. Conclusions These preliminary results suggest that simple hysterectomy affects the early postoperative decline of ovarian reserve, and these results might vary depending on the type of surgery.

The aim of this study was to investigate the relationship between serum estrone (E1) level and other cardinal features in women with polycystic ovary syndrome (PCOS). 133 Korean women aged 18-35 years who were newly diagnosed with PCOS at a university hospital were included in the present study. Blood samples were collected from all participants during the early follicular phase to determine the serum E1 level and other biochemical hormonal parameters. The total antral follicle count (TFC) and the total ovarian volume (TOV) were assessed using transvaginal or transrectal ultrasound. A significant correlation was found between serum E1 and luteinizing hormone (LH) levels in women with PCOS. In addition, statistically significant correlations were observed between serum E1 level and other hormonal parameters, including testosterone, free testosterone, dehydroepiandrosterone sulfate, and 17α-hydroxyprogesterone. With respect to the ultrasound features, serum E1 levels were significantly correlated with TFC and TOV. All results did not change after adjusting for body mass index (BMI). In conclusion, serum E1 level is significantly correlated with serum LH and androgen levels, and it may be a useful marker for representing the status of the ovarian volume in women with PCOS.

The aim of this study was to evaluate the relationship between the serum anti-Müllerian hormone (AMH) level and parameters related to insulin resistance in Korean women with polycystic ovary syndrome (PCOS). A total of 95 Korean women aged 18-33 years who were newly diagnosed with PCOS according to the Rotterdam Consensus at a university hospital were included in this study. Blood samples were collected from all participants during the early follicular phase using tubes without anticoagulants after an overnight fasting to determine the serum AMH level and other biochemical parameters, and then a standard 2-h 75-g oral glucose tolerance test (OGTT) was performed for all participants. All patients with PCOS were divided into two groups based on the serum AMH level: group 1 (AMH 10.0 ng/ml) and group 2 (AMH ≥ 10.0 ng/ml). The clinical variables were not significantly different between the two groups. The mean postprandial glucose level at 1 h (PPG1) in group 1 (111.70 ± 4.9 mg/dl) was significantly lower than that in group 2 (136.76 ± 9.86 mg/dl). No significant differences between the two groups were found in the other insulin resistance-related parameters. In conclusion, the serum AMH level may be related to PPG1 in women with PCOS.

OBJECTIVE: This study aimed to evaluate the impact of cancer treatment on bone mineral density (BMD) in the lumbar spine (LS) and femur in the postmenopausal women with cervical or endometrial cancer without bone metastasis compared to normal control postmenopausal women. METHODS: We retrospectively evaluated the BMD data in the LS, femur neck (FN) and trochanter (FT) by dual-energy X-ray absorptiometry and laboratory data of bone turnover markers at baseline and after one year in 130 patients with cervical cancer, 68 patients with endometrial cancer, and 225 healthy controls. RESULTS: There were no significant differences in the T-scores of basal BMD in LS and femur between patients with endometrial cancer and controls, and only T-score of basal BMD at the fourth lumbar vertebra (L4) was significantly lower in patients with cervical cancer compared to controls. One year later, T-scores of BMD at all LS sites and FN in patients with cervical cancer and T-scores of BMD at L3, L4, FN, and FT in those with endometrial cancer after cancer treatment were significantly lower compared to controls. Lower proportions of normal BMD at all skeletal sites except L2 in patients with endometrial cancer and those at L1, L4, and FN in patients with cervical cancer were observed compared to controls after cancer treatment. CONCLUSIONS: Our results suggest that cancer treatment increase bone loss in postmenopausal women with cervical and endometrial cancer.

Objective: To measure hematologic parameters derived from the white blood cell (WBC) count and differential count (DC) as prognostic factors for survival in patients with stage IB and IIA cervical cancer. Methods: We retrospectively examined demographic, clinicopathologic, and laboratory parameters in a cohort of 233 patients with International Federation of Gynecology and Obstetrics stage IB and IIA cervical cancer who underwent surgical resection. We further assessed the effects of the WBC count and DC-derived hematologic parameters on progression-free survival (PFS) and overall survival (OS) after controlling for other parameters. Results: Patients were followed up for a median of 46.6 months (range, 9-142 months). The Kaplan-Meier estimates of PFS and OS at 5 years were 88.5% and 92.3%, respectively. In a multivariate analysis, we identified the absolute monocyte count (AMC) (hazard ratio [HR], 11.78; P

Primary ovarian insufficiency (POI) is defined as the presence of amenorrhea for ≥ 4 months accompanied by evidence of two serum follicle-stimulating hormone levels in the menopausal range in women aged < 40 years. Anti-Müllerian hormone (AMH) has been recognized as the most reliable marker of ovarian reserve status, and its serum level is very low or undetectable in women with POI. Here we report two cases of patients who were diagnosed with POI despite high serum AMH levels and preservation of ovarian follicles, as revealed by ultrasound. In addition, we have presented a review of the current literature regarding this condition.

Based on the analysis conducted by the World Health Organization regarding the life expectancy in 35 Organisation for Economic Co-operation and Development (OECD) countries, South Korea’s life expectancy is predicted to rank first in the world by 2030, with the life expectancy for women reaching 90.82 years. In other words, the importance of women’s health and the quality of life (QoL) after menopause is increasing. The most effective treatment for vasomotor symptoms (VMS) and genitourinary syndrome of menopause (GSM) is menopausal hormone therapy (MHT), which is also effective in preventing osteoporosis. MHT is an effective therapy that offers more advantages than disadvantages for women aged less than 60 years or who have had menopause for less than 10 years. Therefore, the purpose of these guidelines is to provide help by sharing accurate knowledge and treatment methods regarding MHT based on recent research findings.

Impaired angiogenesis of the developing placenta in the early pregnancy is one etiology of preterm delivery. Vascular endothelial growth factor (VEGF) is a key regulator of normal angiogenesis. Leptin stimulates other angiogenic factors, including VEGF. In this study, we aimed to investigate whether levels of VEGF and leptin in amniotic fluid during the second trimester could serve as markers for preterm delivery. This study was conducted on second trimester amniotic fluid samples obtained from women undergoing genetic amniocentesis at 16–20 weeks of gestation. VEGF and leptin levels were measured by enzyme-linked immunosorbent assay in every case of delivery at

Mayer-Rokitansky-Kuster-Hauser syndrome (MRKHS) is characterized by vaginal agenesis with variable Mullerian duct abnormalities. We report here a case of uterine adenomyosis which developed from a hypoplastic uterus in a patient with MRKHS. A 55-year-old postmenopausal woman visited a university hospital for pelvic mass. She had underwent vaginoplasty via the McIndoe procedure for MRKHS at 15 years of age. Pelvic magnetic resonance imaging showed a 5.4 × 4.8 × 4.7 cm mass suspicious for a uterine myoma. She received total abdominal hysterectomy with bilateral salpingo-oophorectomy, and neither the cervix nor endometrium was found grossly in the surgical specimen. The final histologic diagnosis was uterine adenomyosis.

OBJECTIVE: The purpose of the present study was to determine the prognostic significance of the neutrophil-lymphocyte ratio (NLR) in recurrence of cervical intraepithelial neoplasia (CIN). METHODS: We evaluated the NLR as a prognostic marker in the entire cohort of 230 patients who had undergone surgical resection and were diagnosed with CIN. Subjects were categorized into two different groups based on the NLR (NLR-high and NLR-low) using cutoff values determined by receiver operating characteristic (ROC) analysis. The primary research objective for this study was to validate the impact of the NLR on recurrence-free survival (RFS) in patients with CIN. The secondary objective was to evaluate the impact of other hematologic parameters on RFS in CIN patients. RESULTS: Using the entire cohort, the most appropriate NLR cut-off value for CIN recurrence selected on the ROC curve was 2.1. The NLR-low and NLR-high groups included 167 (72.6%) and 63 patients (27.4%), respectively. According to Kaplan-Meier analysis, RFS rates during the entire follow-up period were considerably lower in the NLR-high group than in the NLR-low group (P = 0.0125). In multivariate survival analysis using Cox proportional hazard model, we identified the NLR, absolute eosinophil count (AEC), hemoglobin concentration, and mean corpuscular volume (MCV) as valuable prognostic factors that impact RFS. CONCLUSIONS: The NLR is an independent prognosticator for RFS following surgical resection in CIN patients. We also found that the AEC, hemoglobin level, and MCV were strongly associated with RFS, as determined by multivariate analysis using a Cox model. These hematological parameters might provide additional prognostic value beyond that offered by standard clinicopathologic parameters.

Problem To investigate the association between polymorphisms of the interleukin-1 (IL-1) family genes and endometriosis in Korean women. Method of study In this case–control study, the IL-1α −889C>T, IL-1 receptor antagonist (IL-1RA) 86-bp microsatellite, IL-1 receptor 1 (IL-1R1) 52C>A, 294C>T, 1498T>C, 1632A>G,IL-1R2 rs2072472 C>T and rs7561460 C>T polymorphisms were analyzed in women with (n = 138) and without (n = 214) endometriosis using restriction fragment length polymorphism (RFLP) analysis, TaqMan assay, or DNA sequencing. Serum IL-1α, soluble IL-1RA (sIL-1RA), and sIL-1R2 levels were measured by enzyme-linked immunosorbent assay (ELISA). Results Among the polymorphisms measured, the 1498T>C polymorphisms in the IL-1R1 gene were found to be related with early-stage endometriosis but not with advanced-stage endometriosis. The genotypes with at least one T allele (CT + TT) were less frequently observed in early-stage endometriosis compared with normal controls (OR = 0.44, 95% CI = 0.22–0.87, P = 0.02). Serum sIL-1R2 levels were significantly lower (P C polymorphism is associated with early-stage endometriosis in Korean women.

OBJECTIVES Cervical length assessment is helpful to predict and prevent preterm birth. However, transvaginal sonography is not easy to perform. The aim of this study was to investigate the relationship and discrepancies between cervical lengths measured by transabdominal and transvaginal sonography in midpregnancy. METHODS Transabdominal and transvaginal cervical lengths were measured in 255 pregnant women between 20 and 29 gestational weeks. The discrepancies in cervical lengths between the two methods were analyzed for the following maternal and fetal conditions: (1) vertex versus breech fetal presentation, (2) whether the fetal presenting part overlay the cervical internal os, (3) whether both the internal os and external os were visible or only the internal os was clearly visible, (4) maternal bladder filling status, (5) maternal age, (6) parity, and (7) gestational age. RESULTS The mean cervical lengths were not significantly different (mean ± SD, 3.88 ± 0.73 cm on transabdominal sonography and 3.93 ± 0.72 cm on transvaginal sonography; P = .129; Pearson r = 0.75). The 5th-percentile transabdominal cervical length was 26.0 mm, and the transvaginal length was 27.8 mm. There were significant discrepancies between the two methods in the cases in which a fetal presenting part overlay the internal os, in the cases in which the external os was not clearly visible, and in primiparous women. Transabdominal cervical measurements were consistently shorter than transvaginal measurements in the cases with discrepancies. CONCLUSIONS Transabdominal cervical length measurements are correlated with transvaginal measurements overall, and the transabdominal length is consistently shorter than the transvaginal length in cases with discrepancies. Transabdominal sonography could be used as a cervical length screening tool.

Objective: To evaluate the bone mineral density (BMD) in the lumbar spine and femur in postmenopausal women with cervical cancer and endometrial cancer without bone metastasis in comparison with that in healthy control postmenopausal women, and to assess the loss of BMD according to the cancer stage. Materials and methods: We analyzed the BMD of the lumbar spine and femur using dual-energy X-ray absorptiometry (DXA) in 218 patients with cervical cancer, 85 patients with endometrial cancer, and 259 healthy controls. The serum levels of calcium (Ca), phosphorus (P), osteocalcin (OSC), and total alkaline phosphatase (ALP), and urine deoxypyridinoline(DPL) were measured in all participants. Results: Age, body mass index, parity, and time since menopause were not significantly different between the three groups. Serum Ca level was higher in the cervical cancer group (p = 0.000), however, urine DPL was lower in endometrial cancer group (p = 0.000). The T-scores of basal BMD at the second and fourth lumbar vertebra (L2, L4) were significantly lower in patients with cervical cancer (p = 0.038, 0.000, respectively) compared to those in the healthy control groups. Additionally, the incidence of osteoporosis and osteopenia basal status of bone mass was significantly higher in patients with cervical cancer compared to that in controls (p = 0.016). No differences in basal BMD of the lumbar spine and femur were observed between patients with cervical cancer according to their stages. Conclusion: Our results suggest that postmenopausal women with cervical cancer have a lower BMD and are at increased risk of osteoporosis in the lumbar spine before receiving anticancer treatment compared with postmenopausal women with endometrial cancer.

OBJECTIVE The aim of the present study was to investigate the relationship of polymorphisms in the tumor necrosis factor (TNF)-alpha, TNF-beta, and TNF receptor (TNFR) genes to circulating TNF, soluble TNFR (sTNFR) levels, and bone mineral density (BMD) in women. METHODS The TNF-alpha G(-308)A, C(-857)T, C(-863)A, T(-1031)C, TNF-beta A252G, TNFRI A36G, TNFRII T676G, A1663G, A1668G, and C1690T polymorphisms were analyzed in 377 postmenopausal Korean women. The levels of serum TNF-alpha, TNF-beta, sTNFRI, sTNFRII, and bone turnover markers were measured. BMD was examined by dual energy x-ray absorptiometry. RESULTS After adjustment for age, body mass index, and years since menopause, no significant differences in BMD of the lumbar spine and femoral neck and serum levels of bone turnover markers were detected, according to single polymorphisms in TNF and TNFR genes and combined polymorphisms. However, the frequencies of the TT genotype of TNF-alpha T(-1031)C polymorphism, the non-AA genotype of TNF-beta A252G polymorphism, and the GG genotype of TNFRII A1663G polymorphism were significantly higher in osteoporotic women than in women with normal BMD, respectively (P < 0.05). The TNFRII T676G polymorphism affected the serum sTNFRI and sTNFRII levels. The serum sTNFRII levels in the CC genotype of TNFRII C1690T polymorphism were the highest, with a G or C allele dose effect, and the TNFRII G676C/C1690T haplotype genotype also affected serum sTNFRII levels. CONCLUSIONS TNF-alpha T(-1031)C, TNF-beta A252G, and TNFRII A1663G polymorphisms may be genetic factors for osteoporosis in Korean postmenopausal women, and the TNFRII T676G and C1690T polymorphisms and their combined polymorphism affected serum sTNFRII levels. The TNFRII T676G polymorphism also affected the serum sTNFRI levels.

Objective To evaluate the relationship between serum gonadotropin level and parameters related to insulin resistance in Korean women with polycystic ovary syndrome (PCOS). Methods This retrospective study included 138 women aged 18 to 35 years who were newly diagnosed with PCOS according to the Rotterdam consensus. Participants were divided into three groups based on the serum luteinizing hormone to follicle-stimulating hormone (LH/FSH) ratio in the early follicular phase: group 1 (LH/FSH 2.0), and group 3 (LH/FSH ≥2.0). The correlations between the LH/FSH ratio and various metabolic parameters were evaluated using Pearson correlation coefficients. Results Patients with higher LH/FSH ratios showed higher total antral follicle counts and higher total ovarian volume. In the comparison of anthropometric and biochemical parameters among the three groups, the waist to hip ratio was the only parameter that differed significantly among the groups (P=0.003). Correlation analysis revealed no significant correlations between serum LH/FSH ratios and biochemical parameters related to insulin resistance. However, after adjustments for age and body mass index, a significant correlation between total cholesterol level and serum LH/FSH ratio was observed (r=0.221, P=0.018). Conclusion Most parameters related to insulin resistance, with the exception of total cholesterol level, are unrelated to the inappropriate pattern of serum gonadotropin secretion in Korean women with PCOS.

Objective: The aim of the present study was to investigate the relationship between ovarian follicle count and volume on ultrasonography and serum hormone levels including the levels of the anti-Mullerian hormone (AMH) and gonadotropin in women with the polycystic ovary syndrome (PCOS). Methods: A total of 118 Korean women aged 18–35 years who were newly diagnosed with PCOS at a university hospital were included in this study. Serum LH, FSH, and AMH levels were measured in the early follicular phase, and the total antral follicle count (TFC) and the total ovarian volume (TOV) were assessed by ultrasonography. The correlations between serum hormonal parameters and ultrasonography characteristics in women with PCOS were evaluated using Pearson’s correlation coefficients and a linear regression analysis. Results: Serum AMH levels were significantly correlated with serum LH levels and LH/FSH ratios, and TFC and TOV were significantly correlated with each other on ultrasonography. Serum AMH and LH levels and the LH/FSH ratio were significantly correlated with TFC. Statistically signifi cant correlations between TOV and the LH level (r = 0.208, p = 0.024) and the LH/FSH ratio (r = 0.237, p = 0.010) were observed. However, the serum AMH level was not significantly correlated with the ovarian volume, and this result did not change after adjusting for age and body mass index. Conclusion: Serum AMH is not related to the ovarian volume in women with PCOS. My results suggest that serum LH level and the LH/FSH ratio may be more useful than the serum AMH level for representing the status of the ovarian volume in women with PCOS.

1. 열성 홍조란? 열성 홍조 (hot flush, or hot flash)는 가장 흔한 갱년기 급 성 증상으로, 야간 발한 (night sweat)과 함께 대표적인 폐경 기 혈관운동성증상 (vasomotor symptom, VMS)이며, 폐경 기 여성의 삶에 있어 가장 영향을 미치는 증상으로 알려져 있다. 열성 홍조는 대부분 얼굴과 목, 가슴 상부로부터 불 쾌한 발열감이 시작되어 빠르게 전신으로 전파되며, 특히 안면의 적색 피부 변화가 특징적으로 나타난다. 또한 발한 과 맥박상승을 동반하여 수분 가량 지속되다가 오한으로 이 어지기도 하는데, 심계항진, 현기증을 거쳐 심할 경우 실신 까지 동반될 수 있다. 증상이 있는 동안에는 말단부 혈관 확 장에 의해 피부 온도가 상승하고, 심박수 및 대사율 역시 상 승하는데, 피부 온도는 보통 30분 정도가 지나면 회복되는 것으로 알려져 있다. 지속시간은 개인에 따라 수 초에서 길게는 한 시간에 이르기까지 다양하게 나타나며, 일반적 으로는 1-5분간 지속된다. 열성 홍조의 빈도는 개인차가 커 서 한 시간에 수 회에서부터 수 일에 1회 정도에 이르기까지 매우 다양하게 나타난다. 주로 이른 저녁 시간에 많이 발생 하며, 불안, 흥분, 더운 날씨, 매운 음식이나 뜨거운 음료 섭 취, 그리고 스트레스를 많이 받는 상황에서 자주 나타난다. Kronenberg에 따르면 열성홍조의 증상이 있는 여성 중 매 일 증상을 경험하는 여성의 빈도는 87%에 달하며, 이 중 1/3 은 하루에 10번 이상 증상을 보인다고 하였다. 열성 홍조와 발한은 크롬친화세포종 (pheochromocytoma), 갑상샘기능항진증 (hyperthyroidism), 췌장종양, 카 르시노이드증후군, 결핵, 백혈병과 같은 질환이나 선택 적 에스트로겐 수용체 조절제 (selective estrogen receptor ISSN 1226-8704 http://dx.doi.org/10.6118/jksm.2013.19.2.54 J Korean Soc Menopause 2013;19:54-63

Objectives: To investigate the occurrence of glaucoma and association with the serum estradiol (E2) level in postmenopausal women. Methods: We evaluated the serum E2 level, female reproductive factors and glaucoma related risk factors including intraocular pressure and optical coherence tomography (OCT) findings in 30 postmenopausal women who visited Obstetrics and Gynecology outpatient clinic. Patients who showed abnormal findings on the glaucoma screening test were classified to the glaucoma suspect group (group-G), and underwent a glaucoma confirmatory test. Serum E2 level, female reproductive and other menopausal healthrelated factors such as lipid profiles and bone mineral densities were analyzed in the group-G and non glaucomatous group (group-N). Results: Eight out of thirty participants (26.7%) were classified to the group-G. One of them was diagnosed as having glaucoma that required treatment, and the other two were found to have early glaucomatous changes. Compared to the group-G, the group-N had a higher level of serum E2 (19.40 ± 4.79 vs. 13.95 ± 4.55 pg/mL) The difference, however, was not statistically significant (P = 0.525). The proportion of glaucoma suspect patients in the groups with a higher serum E2 level (≥ 20 pg/mL) and a lower serum E2 level (< 20 pg/mL) was similar (25.0 and 27.3%, P = 0.645). Multiple logistic regression analysis showed that no female reproductive factors were associated with the risk of glaucoma. Conclusion: Comprehensive glaucoma screening using an OCT in postmenopausal women could detect more glaucoma patients than prevalence in the similar age group. Statistical significance was not found in the association between serum E2 level and the risk of glaucoma. (J Korean Soc Menopause 2013;19:106-111)

Methods We retrospectively reviewed the medical records and laboratory data of patients aged 30-50 years with regular menstruation before hysterectomy, and 31 patients were included in this study. All patients enrolled underwent scheduled hysterectomy with conservation of both ovaries (laparoscopy-assisted vaginal hysterectomy, n = 21; and total abdominal hysterectomy, n = 10), and received serum anti-Mullerian hormone (AMH) tests preoperatively and 3 days after operation. Changes between preoperative and postoperative AMH levels of each patient were calculated.

The Klippel-Trenaunay syndrome is rare congenital disease characterized by a triad of cutaneous vascular malformations, varicose veins, and hypertrophy of bone and soft tissue. Although several cases of pregnancy in women with Klippel-Trenaunay syndrome were reported as there may be increased risk of pregnancyand/or delivery-associated complications such as varicosities, thromboembolism and hemorrhage, there is little general information regarding how to deal with pregnancy in patients with Klippel-Trenaunay syndrome and their obstetric outcome. We describe the case of a woman suffering from Klippel-Trenaunay syndrome delivering a healthy child with a brief review of concerned literature.