Joon Cheol Park

Plasma Components Affect Accuracy of Circulating Cancer-Related MicroRNA Quantitation

Circulating microRNAs (miRNAs) have emerged as candidate biomarkers of various diseases and conditions including malignancy and pregnancy. This approach requires sensitive and accurate quantitation of miRNA concentrations in body fluids. Herein we report that enzyme-based miRNA quantitation, which is currently the mainstream approach for identifying differences in miRNA abundance among samples, is skewed by endogenous serum factors that co-purify with miRNAs and anticoagulant agents used during collection. Of importance, different miRNAs were affected to varying extent among patient samples. By developing measures to overcome these interfering activities, we increased the accuracy, and improved the sensitivity of miRNA detection up to 30-fold. Overall, the present study outlines key factors that prevent accurate miRNA quantitation in body fluids and provides approaches that enable faithful quantitation of miRNA abundance in body fluids.

Immunological Modes of Pregnancy Loss

Citation Kwak‐Kim J, Park JC, Ahn HK, Kim JW, Gilman‐Sachs A. Immunological modes of pregnancy loss. Am J Reprod Immunol 2010

REVIEW ARTICLE: Immunological Modes of Pregnancy Loss

Citation Kwak‐Kim J, Park JC, Ahn HK, Kim JW, Gilman‐Sachs A. Immunological modes of pregnancy loss. Am J Reprod Immunol 2010

Thyroid autoimmunity and its association with cellular and humoral immunity in women with reproductive failures.

Citation Kim NY, Cho HJ, Kim HY, Yang KM, Ahn HK, Thornton S, Park JC, Beaman K, Gilman‐Sachs A, Kwak‐Kim J. Thyroid autoimmunity and its association with cellular and humoral immunity in women with reproductive failures. Am J Reprod Immunol 2011; 65: 78–87

Endometrial histology and predictable clinical factors for endometrial disease in women with polycystic ovary syndrome

Objective This study was aimed to investigate endometrial histology and to find predictable clinical factors for endometrial disease (hyperplasia or cancer) in women with polycystic ovary syndrome (PCOS). Methods We investigated the endometrial histology and analyzed the relationship between endometrial histology and clinical parameters, such as LH, FSH, estradiol, testosterone, fasting and 2 hours postprandial glucose and insulin, insulin resistance, body mass index, endometrial thickness, menstrual status from 117 women with PCOS. Statistical analysis was performed with chi square and t-test, p-value<0.05 was considered as statistically significant. And receiver operating characteristic curve was used to find predictable clinical factors for endometrial disease and to decide the cuff off values. Results In 117 women with PCOS, endometrial histologic profiles are as follows: proliferative phase in 90 women (76.9%), endometrial hyperplasia in 25 women (21.4%), and endometrial cancer in 2 women (1.7%). Of 25 women with endometrial hyperplasia, simple hyperplasia without atypia, complex hyperplasia without atypia and complex hyperplasia with atypia were diagnosed in 15 (12.8%), 6 (5.1%), 4 (3.4%) women, respectively. Age and endometrial thickness were significantly related with endometrial disease, p=0.013 and p=0.001, respectively. At the cut off level of 25.5 years in age, sensitivity and specificity predicting for endometrial disease were 70.4% and 55.6%, respectively (p=0.023). At the cut off level of 8.5 mm in endometrial thickness, sensitivity and specificity were 77.8% and 56.7%, respectively (p=0.000). Conclusion In women with PCOS, the incidence of endometrial hyperplasia and cancer were 21.4% and 1.7%. The age and endometrial thickness may be used as clinical determining factors for endometrial biopsy.

Surgical impact on serum anti-Müllerian hormone in women with benign ovarian cyst: A prospective study

Objective The aim of this study was to evaluate the surgical impact of benign ovarian mass on ovarian reserve as measured by serum follicle stimulating hormone (FSH), estradiol (E2) and anti-Müllerian hormone (AMH) levels, antral follicle count (AFC) and ovarian volumes. In addition, the differences in ovarian reserve impairment between endometrioma cystectomy and non-endometrioma cystectomy were investigated. Methods In this prospective study, 22 patients of reproductive age (range, 18.35 years) with benign ovarian masses were enrolled to undergo laparoscopic cystectomy. Of whom 12 had endometriomas and 10 had non-endometriomas. On early follicular phase (day 3) of the cycle preceding the operation and three months after the laparoscopic cystectomy, serum levels of FSH, E2 and AMH, AFC and ovarian volumes were measured in all patients. Data were analyzed with Mann-Whitney U-test and Wilcoxon rank test using SPSS ver. 12.0 for statistic analysis. Results Median level of serum AMH was significantly decreased from 5.48 ng/mL (interquartile range [IQR], 2.80-7.47) before cystectomy to 2.56 ng/mL (IQR, 1.74-4.32) 3 months postoperation (P<0.05). On the other hand, no significant differences in FSH, E2, AFC and ovarian volumes were found between the preoperative and three months postoperative levels. In a subgroup analysis of the pathologic type of the ovarian cyst, postoperative serum AMH levels were significantly decreased in the endometrioma group, but not in the non-endometrioma group. Conclusion Serum AMH levels were significantly decreased after laparoscopic cystectomy without any changes of other ovarian reserve tests.

Obstetrical Outcome of Anti‐Inflammatory and Anticoagulation Therapy in Women with Recurrent Pregnancy Loss or Unexplained Infertility

Women with a history of recurrent pregnancy losses (RPL) and unexplained infertility (UI) have a high incidence of preeclampsia (PE) and other obstetrical complications. We aimed to investigate the incidence of PE and other obstetrical complications in women with RPL or UI who were treated with anti‐inflammatory and anticoagulant treatment.

Pulmonary and retroperitoneal benign metastasizing leiomyoma.

Benign metastasizing leiomyoma (BML) is a rare disease, which usually occurs in women with a history of a prior hysterectomy or myomectomy for benign uterine leiomyoma, and has the potential to metastasize to distant sites, such as the lung, lymph nodes, muscular tissue, heart, or retroperitoneum. These lesions are slow-growing, asymptomatic, and usually found incidentally. The prognosis of BML is also excellent. However, there has been debate on the origin and the correct classification of BML, and there are no guidelines for the treatment of BML. We report here on a rare case of BML in both the retroperitoneal cavity and lung in a 48-year-old woman with a history of hysterectomy due to histologically benign uterine leiomyoma. The patient underwent retroperitoneal mass excision and bilateral salpingo-oophorectomy, and then wedge biopsy of two pulmonary nodules was performed additionally 9 days later. Until now, there has been no sign of recurrence and the patient remains asymptomatic. To our knowledge, pulmonary BML is rare and the co-existence of the retroperitoneal metastases after previous hysterectomy is even rarer.

Intravenous immunoglobulin G in women with reproductive failure: The Korean Society for Reproductive Immunology practice guidelines

The task force of the Korean Society for Reproductive Immunology recommends intravenous immunoglobulin G treatment in women with reproductive failure, including recurrent pregnancy loss and/or repeated implantation failure, who show cellular immune factors such as abnormal natural killer cell levels, natural killer cell cytotoxicity, and/or type 1 T helper immunity.

Isolated torsion of bilateral fallopian tubes combined with tubal endometriosis: A case report

Torsion of the fallopian tube is less frequent. Indeed, isolated bilateral fallopian tube torsion is rare and often diffi cult t o diagnose. The etiology of fallopian tube torsion is still uncertain, especially when this is not associated with torsion of the ovary. We present a case of the torsion of isolated bilateral fallopian tube combined with tubal endometriosis. A 30-year-old woman presented with chronic abdominal pain of 5-month duration and severe dysmenorrhea. Presumptive diagnosis by ultrasound and magnetic resonance imaging was both adnexal endometriosis. At laparoscopy, the fi mbrial ends of both tubes were dilated, twisted and necrotic changes with adhesion to omentum, which subsequently led to terminal obstruction of that tube. However, both ovaries and uterus were normal. Laparoscopic bilateral salpingectomy was performed. The postoperative histological report confi rmed hematosalpinx with tubal endometriosis. To our knowledge, this is the fi case of isolated and bilateral fallopian tubes tors ion combined with tubal endometriosis.