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Large, Multilocular Cystic Mass in the Uterine Cervix Mimicking Adenoma Malignum.

Tae Hee KIM ; Hae Hyeog LEE ; Soo Ho CHUNG

The Journal of Korean Society of Menopause.2011;17(2):114-117.

Multilocular cystic lesions in the uterine cervix can vary widely from benign to malignant. Pseudoneoplastic glandular lesions are benign lesions that are often histologically and radiographically confused with adenoma malignum, which is a rare variant of mucinous adenocarcinoma of the uterine cervix. The benign lesions include uterine cervicitis, tunnel cluster, deep endocervical glands, deep nabothian cysts, endocervical hyperplasia, infectious and reactive atypias. It is crucial but difficult to differentiate between an adenoma malignum and the benign cystic lesions. We report two cases of large nabothian cysts mimicking adenoma malignum. Radiologic findings, signs, and symptoms of these cases are described.
Adenocarcinoma, Mucinous ; Adenoma ; Cervix Uteri ; Female ; Hyperplasia ; Uterine Cervicitis

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Fibroepithelial Polyps on an Unusual Genital Site during Menopausal Transition.

Tae Hee KIM ; Hae Hyeog LEE ; Soo Ho CHUNG ; In Chul HWANG ; Hyo Sang HAN

The Journal of Korean Society of Menopause.2011;17(2):110-113.

Fibroepithelial polyps (FEPs) on the vulvovaginal region are rare lesions of the lower genital track and differential diagnosis can be wide. When faced with FEPs, gynecologists and pathologists have to consider a wide range of diagnoses, because overlapping morphologic features and management of these lesions has been observed. We report a case of fibroepithelial polyps that developed on an unusual genital site, and provide a brief review of the literature.
Diagnosis, Differential ; Polyps ; Polytetrafluoroethylene ; Track and Field

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Effects of Drospirenone (2 mg) with 17beta-estradiol (1 mg) on Blood Pressure, Body Weight, and Lipid Profiles in Postmenopausal Korean Woman.

You Jung SHIN ; Sun joo LEE ; Su Kyeong KWON ; Rae Mi YU ; Hyuk Jae KANG ; Sung Hoon KIM ; Hee Dong CHAE ; Chung Hoon KIM ; Byung Moon KANG

The Journal of Korean Society of Menopause.2011;17(2):102-109.

OBJECTIVES: The objective of the present study was to determine the effects of the widely used combination hormone therapy, drospirenone and 17beta-estradiol on the blood pressure, body weight, lipid profiles, and major side effects in postmenopausal Korean women. METHODS: Four hundred seventeen menopausal patients who were being treated with drospirenone/17beta-estradiol at the Asan Medical Center between December 2007 and October 2010 underwent a retrospective chart review. One hundred twenty-five patients were divided into 2 groups based on blood pressure, as follows: group 1 (normal blood pressure, n = 76); and group 2 (stage 1 hypertension and pre-hypertension, n = 49). The systolic and diastolic blood pressure and the body weight were checked before the treatment, and 1, 2, 3, 6, 9, 12, 18 and 24 months after taking the medication. RESULTS: The median days of administration were 279. The combination of drospirenone and 17beta-estradiol had a blood pressure-lowering effect in groups 1 and 2. However, the body weight did not show a statistically significant change. Only the level of triglycerides decreased with time and the change was statistically significant. The low density lipoprotein (LDL)-cholesterol and triglycerides levels had a statistically significant decrease 18 months after the medication. The most common reasons for discontinuouing medication were vaginal spotting (28%), fear of side effects (27%), and ineffectiveness (26%). CONCLUSION: The combination of drospirenone/17beta-estradiol caused a decrease in systolic and diastolic blood pressure and the body weight showed no statistically significant decrease. Furthermore, triglycerides showed statistically significant decrease and there were no severe side effects of the medication reported.
Androstenes ; Blood Pressure ; Body Weight ; Female ; Hormone Replacement Therapy ; Humans ; Hypertension ; Lipoproteins ; Menopause ; Metrorrhagia ; Prehypertension ; Retrospective Studies ; Triglycerides

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Effects of 3 Years of Hormone Therapy, Raloxifene, and Alendronate on Mammographic Breast Density in Postmenopausal Korean Women.

Myounghwan KIM ; Hoon CHOI

The Journal of Korean Society of Menopause.2011;17(2):94-101.

OBJECTIVES: Breast density is an independent risk factor for the development of invasive breast cancer. We conducted this study to evaluate the effects of 3 years of hormone therapy, raloxifene, and alendronate on mammographic breast density in postmenopausal Korean women. METHODS: We studied 127 postmenopausal women who had visited the Department of Obstetrics and Gynecology of Inje University Sanggye Paik Hospital between January 2000 and June 2010. These patients were divided into the following 5 groups: alendronate (n = 26); raloxifene (n = 18); estrogen therapy (ET; n = 43); continuous estrogen-progesterone therapy (EPT; n = 20); and cyclic EPT (n = 20). The Breast Image Reporting and Data System (BI-RADS) composition grade 1, 2, and 3 years after treatment was compared with the BI-RADS composition grade at baseline. RESULTS: The BI-RADS grade decreased significantly in the raloxifene group at 1 year (P = 0.04). The BI-RADS grade increased significantly in the ET group at 3 years (P = 0.03), in the continuous EPT at 1, 2, and 3 years (P = 0.01, < 0.001, < 0.001, respectively), and in the cyclic EPT group at 2 and 3 years (P = 0.04 and 0.02, respectively). Although not statistically significant, a decrease in the BI-RADS grade occurred in the alendronate group at 1, 2, and 3 years (P = 0.08, 0.1, and 0.1, respectively). CONCLUSION: This study showed that there was significant decrease in mammographic breast density at 1 year in the raloxifene group and a decreasing trend in the alendronate group, whereas there was significant increase in the ET and EPT groups. To determine the effect of raloxifene and alendronate on breast density, larger prospective studies are needed.
Alendronate ; Breast ; Breast Neoplasms ; Estrogens ; Female ; Gynecology ; Humans ; Information Systems ; Menopause ; Obstetrics ; Raloxifene Hydrochloride ; Risk Factors

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Association between Seasonal Changes in Vitamin D and Bone Mineral Density.

Seung Hwa CHOI ; Duk Joo LEE ; Kwang Min KIM ; Bom Taeck KIM

The Journal of Korean Society of Menopause.2011;17(2):88-93.

OBJECTIVES: Vitamin D deficiency, which causes secondary hyperparathyroidism, is considered to be a major contributor to osteoporosis. Because the serum 25-hydroxyvitamin D (25-OHD) level depend on sun exposure and, varies by season, the level of serum 25-OHD in each season at which vitamin D status can lead to changes in bone mineral density (BMD) is not known. METHODS: A total of 2,878 women who underwent periodic health examinations at Ajou University Hospital were included in this study. We measured the serum 25-OHD concentrations using radioimmunoassay and BMDs using dual energy x-ray absorptiometry (DXA). The differences in serum 25-OHD levels among groups as a function of age, season, and BMD were tested by one-way ANOVA. RESULTS: The serum 25-OHD level was not different based on age, but by season, with higher levels in the summer and autumn than in the winter and spring. However, the 25-OHD level did not have a significant relationship with BMD in any season. CONCLUSION: The serum 25-OHD level represents vitamin D status at the time of testing, which is not associated with long-term changes in BMD. When the 25-OHD levels are used to make clinical decisions related to the treatment of osteoporosis, careful interpretation is required.
Absorptiometry, Photon ; Bone Density ; Female ; Humans ; Hyperparathyroidism, Secondary ; Osteoporosis ; Radioimmunoassay ; Seasons ; Solar System ; Vitamin D ; Vitamin D Deficiency ; Vitamins

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Barium Stimulates the Expression of Osteogenic Genes in Human Mesenchymal Stem Cells into Osteoblasts in vitro.

Ki Hoon AHN ; So Eun JUNG ; Kyong Wook YI ; Hyun Tae PARK ; Jung Ho SHIN ; Young Tae KIM ; Jun Young HUR ; Sun Haeng KIM ; Tak KIM

The Journal of Korean Society of Menopause.2011;17(2):81-87.

OBJECTIVES: The purpose of this study was to determine the effect of barium on gene expression in differentiation of human mesenchymal stem cells into osteoblasts in vitro. METHODS: Human bone marrow stem cells were cultured for 0~14 days in osteogenic differentiation medium with strontium chloride (SrCl2) and barium chloride (BaCl2). Alkaline phosphatase (ALP) activity staining was the method selected for measuring osteoblast differentiation. Total ribonucleic acid (RNA) was extracted after 1, 3, 7, and 14 days, and analysis of runt-related transcription factor 2/core-binding factor alpha 1 (Runx2/Cbfa1), bone morphogenetic protein-2 (BMP-2), and bone sialoprotein (BSP) gene expression was performed by real-time reverse transcriptase (RT)-polymerase chain reaction (PCR). RESULTS: Barium and strontium had a superior enhancing effect on cell proliferation when compared to cells cultured in media without strontium or barium. BaCl2 produced a 2-fold increase in the expression of Runx2/Cbfa1 at 14 days. SrCl2 (0.1~0.3 mM) produced a 2-fold increase in the expression of Runx2/Cbfa1 at 14 days. Barium produced a 1.5-fold increase in the expression of BMP-2 on days 1 or 3. Expression of BSP was increased 1.5~1.7- and 2-fold on days 1 and 14 by barium and strontium, respectively. CONCLUSION: Barium-like strontium is considered one of the important factors in inducing mesenchymal stem cells to differentiate into osteoblasts with further enhancement on bone formation.
Alkaline Phosphatase ; Barium ; Barium Compounds ; Bone Marrow ; Cell Proliferation ; Chlorides ; Durapatite ; Gene Expression ; Humans ; Integrin-Binding Sialoprotein ; Mesenchymal Stromal Cells ; Osteoblasts ; Osteogenesis ; RNA ; RNA-Directed DNA Polymerase ; Stem Cells ; Strontium ; Transcription Factors

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Serum Concentration of Estradiol and Estrone Following Oral Administration of Low-dose Hormone Therapy in Postmenopausal Korean Women.

Eun Ju LEE ; Byung Seok LEE ; Byung Moon KANG ; Byung Koo YOON ; Hoon CHOI ; Jung Gu KIM ; Hyoung Moo PARK

The Journal of Korean Society of Menopause.2011;17(2):75-80.

OBJECTIVES: To determine the baseline serum concentrations of estradiol and estrone in postmenopausal Korean women and the serum concentrations of estradiol and estrone after 4 and 16 weeks of treatment using 1 mg of estradiol and 2 mg of drospirenone. METHODS: This was a multicenter study. Thirty-six subjects were screened. Serum estradiol, estrone and drospirenone levels were determined by gas chromatography-mass spectrometry and radioimmunoassay. RESULTS: The mean estradiol concentration was 8.37 +/- 12.1 pg/mL at baseline and increased to 53.7 +/- 52.1 and 41.4 +/- 26.1 pg/mL after 4 and 16 weeks of treatment, respectively. The mean estrone concentrations were 28.7 +/- 26.8, 266.1 +/- 182.9, and 256.1 +/- 179.1 pg/mL at baseline, and after 4 and 16 weeks of treatment, respectively. When women were stratified according to the basal estradiol level, the level after 4 weeks of treatment was significantly higher in the women with a detectable level (> or = 5 pg/mL) than in women with an undetectable level (< 5 pg/mL; 65.2 +/- 21.5 vs. 37.4 +/- 25.8 pg/mL, P = 0.008). After 16 weeks of treatment, the estradiol level was still higher in the detectable group (51.6 +/- 28.6 vs. 38.7 +/- 21.7 pg/mL, P = 0.09). CONCLUSION: This study showed that 1 mg of estradiol and 2 mg of drospirenone is an appropriate regimen to achieve the desired serum estradiol level. The difference in serum hormonal levels after 4 weeks of treatment could be caused by different basal levels.
Administration, Oral ; Androstenes ; Estradiol ; Estrogen Replacement Therapy ; Estrone ; Female ; Gas Chromatography-Mass Spectrometry ; Humans ; Postmenopause

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SSRIs and SNRIs for Management of Hot Flushing.

Jae Yen SONG ; Mee Ran KIM ; Jang Heub KIM

The Journal of Korean Society of Menopause.2011;17(2):68-74.

For postmenopausal women who fear hormone therapy, women 60 years of age with continuous, severe hot flushing or women with a history of breast cancer, we should consider selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs) as therapeutic agents. Base on the results from a meta-analysis and clinical trials regarding hot flushing, paroxetine and the conetrolled-release formultation of paroxetine have been shown to effectively reduce hot flushing by 30~40% and 60~70%, respectively, and 13~41% more reductions as compared to placebo. Venlafaxine reduced hot flushes by 30~60% (133% reductions compared to placebo), and desvenlafaxine reduced hot flushes by 30~70%. Fluoxetine and citalopram were shown to be less effective than paroxetine and venlafaxine, by 20% (113% reductions compared to placebo) and 40~50%, respectively. Sertraline reduced hot flushes 3~18% compared to the placebo group, but was considered ineffective. Citalopram (20 mg), paroxetine (10 mg), venlafaxine (37.5~150 mg), and desvenlafaxine (100~200 mg) not only reduced vasomotor symptoms, but demonstrated additional beneficial outcomes with respect to sleep disturbances, mood, the vigor index, and improved quality of life. Citalopram (20 mg), fluoxetine (20 mg), paroxetine (10 mg), venlafaxine (75~150 mg), and desvenlafaxine (150 mg) are recommended at the corresponding doses after weighing the risks and benefits of these medications. SSRIs and SNRIs were shown to interrupt the conversion of tamoxifen into the active metabolite, endoxifen, and thus SSRIs and SNRIs must not be used in breast cancer patients who are taking tamoxifen. Paroxetine suppressed vasomotor symptoms most potently, followed by fluoxetine, sertraline, citalopram, and venlafaxine.
Breast Neoplasms ; Citalopram ; Cyclohexanols ; Female ; Fluoxetine ; Flushing ; Humans ; Menopause ; Norepinephrine ; Paroxetine ; Quality of Life ; Risk Assessment ; Serotonin ; Serotonin Uptake Inhibitors ; Sertraline ; Tamoxifen ; Desvenlafaxine Succinate ; Venlafaxine Hydrochloride

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Menopause and Skin.

Kye Hyun KIM

The Journal of Korean Society of Menopause.2011;17(2):63-67.

Aging is associated with declining levels of several hormones, including estrogen. Although the effects of estrogen on the skin are still not fully understood, it is known that, in women, declining estrogen levels are associated with a variety of cutaneous changes. In aged skin, skin is thinning, more and more dry, decreased in vascularity. The effects of estrogen deprivation on skin may include wrinkling, dryness, atrophy, laxity and poor wound healing. Hormone replacement therapy (HRT) studies have not generally been scientifically vigorous but indicate mixed clinical effects regarding improvements in dry skin, stratum corneum hydration, and barrier preservation. HRT helps to maintain or restore collagen and skin thickness, possibly dampening of the pace of development of fine wrinkles, increasing skin strength, improving acute wound healing rates, and perhaps preventing skin breakdown in elderly postmenopausal women. The maintenance of skin function and appearance is important and plays an influential role in the quality of life for women who can spend up to one-third of their lives in a hypoestrogenic state. Ideally, a safe and effective topical hormone replacement preparation without systemic adverse effects would be a highly desirable treatment for hypoestrogenic skin.
Aged ; Aging ; Atrophy ; Collagen ; Estrogens ; Female ; Hormone Replacement Therapy ; Humans ; Menopause ; Quality of Life ; Skin ; Wound Healing

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The Association between Subclinical Hypothyroidism and Cardiovascular Risk Factors in Post-menopausal Women.

Oh Sung KWON ; Jin Hee KIM ; Soo Hyun CHO ; Hyoung Moo PARK ; Eun Ju SUNG

The Journal of Korean Society of Menopause.2012;18(3):193-198. doi:10.6118/jksm.2012.18.3.193

OBJECTIVES: The relationship between subclinical hypothyroidism and cardiovascular disease has not yet been clearly defined. This study will investigate whether or not there is a difference in the prevalence of subclinical hypothyroidism in menopausal women with respect to cardiovascular risk factors, and will furthermore analyze the relationship between cardiovascular diseases and subclinical hypothyroidism, in order to establish a foundation for subclinical hypothyroidism research. METHODS: The study subjects consisted of 713 post-menopausal women, who visited the hospital for a health check-up in 2006-2010. They were divided into a subclinical hypothyroidism group and a normal group. This study analyzed the difference in blood pressure, serum lipid, body mass index (BMI) and blood glucose level between the two groups. The data was analyzed using a two-sample t-test. RESULTS: The prevalence of subclinical hypothyroidism for menopausal women was 6.7%. The results showed no significant differences between the normal and subclinical hypothyroidism patient groups, in regards to blood pressure, BMI, and blood glucose levels (P > 0.05). However the triglyceride of serum lipid was significantly higher in the subclinical hypothyroidism group (P = 0.003). CONCLUSION: It has been confirmed that the triglyceride of the subclinical hypothyroidism group was higher than that of the normal group, and so serum lipid maintenance and caution towards cardiovascular disease is necessary for the subclinical hypothyroidism group.
Blood Glucose ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Female ; Humans ; Hypothyroidism ; Middle Aged ; Postmenopause ; Prevalence ; Risk Factors ; Triglycerides

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