Seoul Municipal Boramae Hospital

Seoul, South Korea

Seoul Municipal Boramae Hospital

Seoul, South Korea
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PubMed | Bundangcheil Womens Hospital, Catholic Kwandong University, Seoul Municipal Boramae Hospital, Seoul National University and 2 more.
Type: Journal Article | Journal: Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology | Year: 2015

Estrogen might play a key role in the maintenance of pregnancy. We investigated the role of the ER- gene +1730G/A, +1082G/A, and CA repeat polymorphisms in Korean patients with recurrent pregnancy loss (RPL). Genotyping was performed using the TaqMan assay in 305 patients with at least two unexplained consecutive spontaneous miscarriages before 20 weeks of gestation and 299 controls. The genotype distributions of the ER- gene +1082G/A and +1730G/A polymorphisms in the RPL group did not differ from those in the control group. When the analysis was restricted to patients with three or more consecutive spontaneous miscarriages, there were also no differences in the genotype distribution between this subgroup and controls. The number of CA repeats was distributed from 13 to 28 with two large peaks at 18 and 23 in patients with RPL and controls. Using the two major peaks as cut-offs, the allele distributions were compared between patients and controls. However, the distribution of ER- gene CA repeats did not differ between women with recurrent miscarriage and controls. Findings of the current study suggest that the ER- gene polymorphisms are not major determinants of the development of RPL in Korean women.

Kim J.J.,Seoul National University | Choi Y.M.,Seoul National University | Hwang S.S.,Inha University | Yoon S.H.,Dongguk University | And 4 more authors.
BJOG: An International Journal of Obstetrics and Gynaecology | Year: 2011

Objective To investigate whether the interferon-γ (IFN-γ) gene (CA)n repeat polymorphism is associated with susceptibility to endometriosis. Design Case-control study. Setting University Department of Obstetrics and Gynaecology. Population Women with (n = 622) and without (n = 442) endometriosis. Methods Genotyping was performed by fluorescent polymerase chain reaction (PCR) and gene-scan analysis. Main outcome measures Genotype distribution and allele frequency of the dinucleotide (CA)n repeat polymorphism in the IFN-γ gene. Results Seven alleles (12-18 repeats) of the IFN-γ gene (CA)n repeat polymorphism were found. In both patients with endometriosis and controls the most common allele was composed of 13 repeats, followed by an allele of 15 repeats, and then by an allele of 12 repeats. Patients with endometriosis had a significantly higher incidence of genotypes with alleles composed of fewer repeats (12-13 repeats), compared with the controls (92.0 versus 84.4%, respectively, P < 001). Conclusions Our results suggest that the (CA)n repeat polymorphism in the IFN-γ gene may be associated with a risk of endometriosis in the South Korean population. © 2011 RCOG.

Kim J.J.,Seoul National University | Chae S.J.,Maria Fertility Hospital | Choi Y.M.,Seoul National University | Hwang S.S.,Inha University | And 4 more authors.
Human Reproduction | Year: 2011

Background The objectives of this study were to define the distribution of the modified FerrimanGallwey (mF-G) score in a random group of Korean women and to study any association(s) between hirsutism and endocrine/metabolic markers. Methods A single investigator assessed the mF-G score prospectively in 1010 Korean women, who consulted a health-care center as part of a group check-up for employment. Logistic regression models were utilized to test the relationships between the presence of hirsutism and levels of endocrine/metabolic markers. Results Subjects had mF-G scores ranging from 0 to 19, and 505 subjects (50.0) had an mF-G score of zero. Of the 1010 subjects, 95.1 had a score at or below six; thus, a score of six or greater represented hirsute women in our population. The most frequently affected site was the upper back, but the most densely affected area was found to be the lower abdomen. Hirsutism was significantly and positively associated with serum levels of total testosterone (T) and hemoglobin A1c, but negatively associated with those of sex hormone binding globulin (SHBG). In addition, the odds of a woman developing hirsutism were higher for increased total T and HbA1c, and lower for decreased SHBG. Hirsutism and homeostatic model assessment for insulin resistance were positively associated, but the relationship was not significant after adjusting for age and BMI. Conclusions mF-G scores greater that six represent the appropriate diagnostic cutoff for the detection of hirsutism in Korean women. Increased serum total T and HbA1c, and decreased SHBG concentrations were associated with the presence of hirsutism. © 2010 The Author.

Kim J.J.,Seoul National University | Choi Y.M.,Seoul National University | Cho Y.M.,Seoul National University | Hong M.A.,Seoul National University | And 5 more authors.
Clinical Endocrinology | Year: 2012

Objective Insulin resistance is a core feature of polycystic ovary syndrome (PCOS). Recently, genome-wide association studies have reported a number of single-nucleotide polymorphisms (SNPs) with reproducible associations and susceptibilities to type 2 diabetes. We examined the potential association between the diabetogenic genes uncovered in the genome-wide association studies and PCOS in Korean women. Design Case-control study. Patients Women with or without PCOS. Measurements DNA samples from 377 patients with PCOS and 386 age-matched controls were genotyped. Results None of the 12 SNPs in the six genes (KCNJ11, TCF7L2, SLC30A8, HHEX, FTO and CDKAL1) uncovered in the genome-wide association studies were associated with PCOS. For further analysis, the patients with PCOS were divided into two or three subgroups according to genotype, and the associations between the genotypes and insulin resistance or insulin secretory capacity were assessed. No SNPs were significantly associated with HOMA-IR, HOMA βcell (%), or 2-h 75-g oral glucose tolerance test insulin levels in the patients with PCOS; there were no significant associations with other serum hormonal and metabolic markers, such as androgen or glucose levels. Conclusions Our results suggest that the six type 2 diabetes-associated genes identified in genome-wide association studies are not associated with PCOS. © 2012 Blackwell Publishing Ltd.

Kim J.J.,Seoul National University | Chae S.J.,Maria Fertility Hospital | Choi Y.M.,Seoul National University | Hwang K.R.,Seoul National University | And 8 more authors.
Human Reproduction | Year: 2013

Study Questio: NIs a preponderance of small dense low-density lipoprotein-cholesterol (LDL-C) observed in non-obese women with polycystic ovary syndrome (PCOS)? Summary Answer: Non-obese Korean women with PCOS have no quantitative or qualitative changes in LDL-C profiles. What Is Known Already: Small dense LDL particles (sd-LDL) are more atherogenic than large buoyant ones and are strongly associated with coronary artery disease independent of other risk factors. Many investigators have found an increased proportion of atherogenic sd-LDL or a decreased mean LDL particle size in women with PCOS, but all of these studies have been based primarily on obese or overweight women with PCOS.STUDY Design: , SIZE, DURATIONThis was a case-control study evaluating complete lipid and lipoprotein profiles in 64 PCOS patients and 64 age-and BMI-matched controls. All women with PCOS in our study population were not obese. To determine the differences in the LDL particle profiles between PCOS phenotypes, the patients with PCOS were divided into two subgroups according to the presence of clinical or biochemical hyperandrogenism. Participants/ Materials, Setting, Methods: Using the Rotterdam criteria, we recruited 64 women (18-40 years) with PCOS who were attending a tertiary university hospital. A total of 64 premenopausal control women were matched with patients based on exact age and BMI (±1.0 kg/m2). All the participants fell within the non-obese range of the BMI (<25 kg/m2) according to the definition of obesity for Asians. The LDL subfraction was analyzed by 3% polyacrylamide gel tube electrophoresis. Seven LDL subclasses were quantified and LDL subclasses 3-7 were small LDL subfractions. LDL subfraction scores were calculated based on the following weighted scoring system developed by the manufacturer: scores of <5.5 were categorized as phenotype A (large, buoyant LDLs), and those >5.5 were categorized as non-A phenotype (sd-LDLs). The system also determined the mean LDL particle size diameter. Main Results and the Role of Chance: There were no differences in the absolute level of LDL-C, mean LDL diameter or percentage of atherogenic sd-LDLs between PCOS patients and controls or between hyperandrogenic and non-hyperandrogenic PCOS subgroups. Also, none of the subjects showed a non-A LDL phenotype. The most notable finding of our study was the difference in the lipoprotein (a) levels and prevalence of its elevation in PCOS patients versus controls (P = 0.002 and P = 0.004, respectively), and between PCOS subgroups (P = 0.030 and P = 0.047, respectively).LIMITATIONS, REASONS FOR CAUTIONInclusion of only non-obese subjects, small sample size and lack of information on other potential confounding factors, such as differences in diet and/or exercise patterns. Wider Implications of the Findings: Although our findings suggest that non-obese women with PCOS have no significant quantitative or qualitative changes in LDL-C profile, data on obese Korean women with PCOS could offer complementary findings about the possible relationship between the magnitude of obesity and LDL phenotype. Further investigations are needed to determine whether a change in lipoprotein (a) in non-obese women with PCOS is also found in other ethnic groups. Study Funding/Competing Interest: (S)No conflict of interest exists. This study was supported by a grant of the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (A100624). Trial Registration Number: N/A. © 2013 The Author.

Lee J.-H.,Sungkyunkwan University | Bahk J.-H.,Seoul National University | Park S.-H.,Seoul National University | Huh J.,Seoul Municipal Boramae Hospital
Korean Journal of Anesthesiology | Year: 2011

Background: The aim of this study was to evaluate the effect of diabetes on the function and distribution of vascular α1-adrenoceptors in the abdominal aorta and distal mesenteric artery from streptozotocin (STZ)-induced diabetic rats at the level of the α1-adrenoceptor subtypes. Methods: Diabetes was induced by a single intravenous injection of STZ (60 mg/kg) in 8 week-old male Sprague-Dawley rats (n = 11). Age-matched normal rats (n = 14) were used as a control group. Four weeks after STZ injection, the tilting-induced change of the mean arterial pressure was recorded. The α1-adrenoceptor subtypes mediating the contractions of the distal mesenteric artery and abdominal aorta were investigated using the agonist phenylephrine and subtype-selective antagonists that included prazocin, 5-methylurapidil and BMY 7378. The expressions of the α1-adrenoceptor subtypes of each artery were examined by immunofluorescence staining using the subtype selective antibodies. Results: The recovery of the mean arterial pressure was delayed after positional change in the diabetic rats. Compared with that of the normal rats, the contractile response to phenylephrine was increased in the abdominal aortas and it was decreased in the distal mesenteric arteries in the diabetic rats. In addition, compared with the normal rats, the fluorescent intensity of all the α1-adrenoceptor subtypes was increased in the abdominal aortas and it was decreased in the mesenteric arteries of the diabetic rats. Conclusions: Diabetes increased the contractility of the abdominal aorta in response to phenylephrine, yet diabetes decreased that of the mesenteric arteries in the STZ-induced diabetic rats. Those results are mainly based on the overall change of the α1-adrenoceptor, and not on the change of the specific α1-adrenoceptor subtypes. © the Korean Society of Anesthesiologists, 2011.

Park Y.J.,Seoul National University | Kim Y.A.,Seoul Municipal Boramae Hospital | Lee Y.J.,National Cancer Center | Kim S.H.,Seoul National University | And 7 more authors.
Head and Neck | Year: 2010

Background. Papillary thyroid microcarcinoma (PMC; ≤1 cm) is thought to take a benign course during the lifetime. However, recent studies showed high recurrence rates for PMC. Methods. We analyzed the clinicopathological features, long-term prognosis, and some molecular characteristics including BRAF V600E mutation by retrospectively reviewing the records of 1150 patients with papillary thyroid carcinoma (PTC), 278 with PMC, and 868 with PTC >1 cm. Results. The prevalence of extrathyroidal invasion (52.2%) and initial nodal metastasis (34.9%) in patients with PMC was surprisingly high and almost as high as that for patients with PTC (72.4% and 51.8%, respectively). The rate of recurrent or persistent disease did not differ between patients with PMC and PTC (recurrent or persistent disease, 6.1% vs 14.1%; 53.4- vs 84.2-month follow-up; n = 98 vs 647; corrected p = .112). The frequency of BRAF V600E mutation was similar in patients with PMC and PTC (65.6% vs 67.2%). Immunohistochemical staining showed no different expression pattern according to the tumor size. Conclusion. These results suggest that PMC is not an occult cancer and it can act like larger PTC. Therefore, PMC should not be underestimated in practice. © 2009 Wiley Periodicals, Inc.

Kim J.J.,Seoul National University | Choi Y.M.,Seoul National University | Cho Y.M.,Seoul National University | Jung H.S.,Seoul National University | And 7 more authors.
Human Reproduction | Year: 2012

Background Recently, the American Diabetes Association (ADA) has included glycated hemoglobin A1c (A1C) level as a component of diagnostic criteria of 'diabetes' or 'increased risk for diabetes'. This study was conducted to examine the prevalence of and risk factors for 'elevated A1C' (<5.7) in women with polycystic ovary syndrome (PCOS). Methods A1C was measured using an immunoturbidimetric assay, and was evaluated in 154 patients with PCOS and 469 age-matched controls (match ratio of 13). All subjects were categorized by BMI (non-obese <25 kg/m2 and obese <25 kg/m2), and the prevalence of elevated A1C was also analyzed according to BMI.RESULTSOne-third (31.2) of the patients with PCOS had elevated A1C. The prevalence of elevated A1C (<5.7) was similar in obese women with PCOS and obese controls (23.5 and 20.0, respectively, P 1.0) but non-obese women with PCOS (mean age 29.8 ± 5.3 years) had a higher prevalence of elevated A1C than non-obese controls (31.2 versus 6.6, respectively, P< 0.001). Logistic regression analysis of all subjects showed that the odds that a woman has elevated A1C was 6.7 times higher if she has PCOS (adjusted odds ratio 6.67, 95 confidence interval 3.5012.70). Conclusions The high prevalence of elevated A1C in non-obese patients with PCOS and an increased risk of elevated A1C associated with PCOS suggest that PCOS itself may be associated with abnormal A1C status. Assessing A1C level in young, non-obese patients with PCOS may be a useful new approach to screening for diabetes. © 2012 The Autho.

Cho S.Y.,Seoul Municipal Boramae Hospital | Cho S.Y.,Seoul National University | Lee S.L.,Seoul Municipal Boramae Hospital | Lee S.L.,Seoul National University | And 4 more authors.
Neurourology and Urodynamics | Year: 2012

Aims This study is to investigate whether a repetitive education program for behavioral modification is necessary for the patients with nocturnal polyuria (NPU). Materials and Methods A prospective single-arm study was carried out and 82 patients with NPU were analyzed. We developed a 30-min systematized behavioral modification program (SBMP), which consisted of (1) watching videos about normal physiology of storing and emptying function of urine, (2) regulation of fluid intake, (3) explanation by giving specific examples, and (4) discussion with a specialized nurse practitioner. Patients received reinforcement SBMP if they still had NPU after the first SBMP. Results Mean age was 66 ± 8.3 years. Sixty-three males (77%) and 19 females (23%) were included. The results of all questionnaires showed significant improvement of nocturia after the first SBMP. Nocturnal voids, quality of life scores, nocturia index, and nocturnal bladder capacity index were significantly improved and the decrease of nocturnal urine volume was borderline significant. No additional significant improvement was demonstrated after the second SBMP. Overall, 62 patients (78.5%) were satisfied with the first SBMP and 6 patients (7.6%) became satisfied after reinforcement SBMP. Eleven patients (13.9%) were eventually dissatisfied with SBMP. Conclusions A single SBMP was sufficient for treating most of the patients with NPU and reinforcement SBMP was effective in some patients. Moving from two to one rises at night may significantly reduce bother and this may explain quality of life improvements rather than any decrease in amount voided. © 2011 Wiley Periodicals, Inc.

Cho S.Y.,Seoul Municipal Boramae Hospital | Kim I.S.,Seoul Municipal Boramae Hospital | Lee S.-B.,Seoul Municipal Boramae Hospital | Choi H.,Seoul Municipal Boramae Hospital | Park K.,Seoul Municipal Boramae Hospital
Urology | Year: 2013

Objective: To understand the nature and long-term fate of supranormal differential renal function (snDRF), analysis of a post-pyeloplasty database was performed. Materials and Methods: Preoperative diethylenetriaminepentaacetic acid (DTPA) diuretic renal scans (DRS) identified 33 children with snDRF (>55%). Postoperatively, all showed improved hydronephrosis in ultrasound imaging or normalized drainage pattern in DRS during more than 5 years of follow-up. The fate of snDRF was described, and the nature of snDRF was speculated by associating it with clinical and ultrasound-related variables. Results: Median age at operation was 22 months. Preoperative hydronephrosis was grade III in 27 patients (82%) and grade IV in 6 (18%). Hydronephrosis was normalized or improved, showing relief of obstruction. Overall fate of snDRF revealed significant reduction of DRF in 23 patients (70%), of whom 18 (81%) showed normalization during 5 years of follow-up. Stationary change of snDRF was seen in one-third of patients. Comparison of clinical and ultrasound-related variables revealed lower age, lower renal parenchyma thickness (RPT) increase, and higher preoperative DRF in the normalized group compared with the other group. The normalized group also showed a higher number in Society of Fetal Urology grade 4 hydronephrosis and lower RPT, although they reached borderline statistical significance. Conclusion: Long-term follow-up revealed that 70% of snDRF significantly decreased and normalized in most patients. The normalized group was younger and showed more hydronephrotic changes. Hydronephrotic change is suggested as a possible cause of snDRF. © 2013 Elsevier Inc. All Rights Reserved.

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