Biomedical subjects

Chii-Ruey Tzeng

Publications and source records attributed to Chii-Ruey Tzeng.

32 records · Page 2Linked to original sources

PubMed2004

Ovarian stimulation by concomitant administration of cetrorelix acetate and HMG following Diane-35 pre-treatment for patients with polycystic ovary syndrome: a prospective randomized study.

BACKGROUND: Patients with polycystic ovary syndrome (PCOS) may need a longer period of pituitary downregulation to suppress the elevated serum LH and androgen levels effectively during IVF treatment using the GnRH agonist long protocol. We proposed a stimulation protocol incorporating Diane-35 and GnRH antagonist (Diane/cetrorelix protocol) and compared it with the GnRH agonist long protocol for PCOS patients. METHODS: Part I of the study was an observational pilot study to evaluate the hormonal change as a result of the Diane/cetrorelix protocol (n = 26). Part II of the study was a prospective randomized study comparing the Diane/cetrorelix protocol (n = 25) and the GnRH agonist long protocol (n = 24). In the Diane/cetrorelix protocol, patients were pre-treated with three cycles of Diane-35, followed by 0.25 mg of cetrorelix on cycle day 3. From day 4, cetrorelix and gonadotrophin were administered concomitantly until the day of HCG injection. RESULTS: Serum LH, estradiol and testosterone levels were suppressed comparably in both protocols at the start of gonadotrophin administration. Serum LH was suppressed at constant levels without a premature LH surge in the Diane/cetrorelix protocol. The clinical results for both protocols were comparable, with significantly fewer days of injection, lower amounts of gonadotrophin used and lower estradiol levels on the day of HCG injection following the Diane/cetrorelix protocol. Furthermore, there was no significant difference in clinical pregnancy outcome between the two stimulation protocols. CONCLUSIONS: The Diane/cetrorelix protocol has a similar pregnancy outcome to the GnRH agonist long protocol for women with PCOS undergoing IVF treatment.

Adult↗

PubMed2004

Serum and endometrial markers.

Endometriosis is a benign but aggressive disease. It occurs when shed endometrium from the female reproductive tract grows at a site outside the uterus. The physiological changes in endometriosis-abnormal tissue growth, invasion, and adhesion phenomena-are similar to those seen in tumorous tissues. Although the etiology of endometriosis is not well understood, the disease is widely accepted to result from the ectopic implantation of refluxed menstrual tissues. In addition, immunologic changes, genetic factors, and environmental factors might also affect a woman's susceptibility to develop endometriosis. Thus far, laparoscopic examination is required to confirm the presence of endometriosis; there is no reliable marker for its diagnosis. Many studies are therefore focusing on identifying markers for the diagnosis and follow-up of endometriosis. This chapter provides a systematic review of these studies, including recent findings from our group on the identification of molecules, in serum and/or endometrium, which are associated with the development of endometriosis at different stages. From this research, we hope to be able to suggest how to approach the potential markers. The identification of highly sensitive and specific markers of endometriosis should facilitate the development of accurate and non-invasive techniques for diagnosis and prognosis.

Autoantibodies↗

PubMed2004

Decreased expression of mitochondrial genes in human unfertilized oocytes and arrested embryos.

OBJECTIVE: To evaluate the relationship between mitochondrial gene expression of oocytes/embryos and their fertilizability in unfertilized oocytes, arrested embryos, and tripronucleate zygotes, because both nuclear and cytoplasmic factors contribute to oocyte activation, fertilization, and subsequent development. DESIGN: Prospective laboratory research. SETTING: In vitro fertilization (IVF) laboratory in a university hospital. PATIENT(S): Seventy-five unfertilized oocytes, 45 arrested embryos, and 24 tripronucleate (3PN) embryos from 45 female patients undergoing IVF. INTERVENTION(S): Analysis of mitochondrial gene expression by semiquantitative reverse transcription polymerase chain reaction (RT-PCR). MAIN OUTCOME MEASURE(S): Comparison of the expression levels of mitochondrial genes including ND2, CO I, CO II, ATPase 6, CO III, ND3, ND6, and Cyt b in three groups. RESULT(S): Significantly decreased transcription levels were expressed in unfertilized oocytes and arrested embryos. The average expression levels of the eight determined genes compared with the control (GAPDH) was 4.4 +/- 0.7, 6.4 +/- 1.1, and 13.2 +/- 1.1 in unfertilized oocytes, arrested embryos, and 3PN embryos, respectively. Significantly decreased expressions of the ATPase 6, CO III, and ND3 genes were detected from samples with 4977-bp common deletion in the mitochondrial DNA (mtDNA) compared with the non-deletion group. CONCLUSION(S): The present study is the first report to present globally decreased mitochondrial gene expression levels in human compromised oocytes and embryos. These data support the notion that the down-regulation of mitochondrial RNA by defective oxidative phosphorylation genes possibly affects oocyte quality including fertilization and further embryo development.

Base Sequence↗

PubMed2004

Combining the uterine depletion procedure and myomectomy may be useful for treating symptomatic fibroids.

OBJECTIVE: To evaluate the therapeutic results of premyomectomy uterine depletion for the treatment of symptomatic fibroids, compared with myomectomy only. DESIGN: Controlled, clinical study without randomization. SETTING: University-affiliated tertiary referral center. PATIENT(S): Four hundred eighty-six women with symptomatic fibroids warranting surgical treatment and who wished to retain their uteri. INTERVENTION(S): Ligation of the uterine arteries was performed by either an abdominal or a laparoscopic approach before myomectomy. MAIN OUTCOME MEASURE(S): Operation time, intraoperative blood loss, postoperative improvement of symptoms, and recurrence rates of fibroids. RESULT(S): Of 342 women with pathology-confirmed fibroids who were included in the study, 108 received myomectomy only (group I), and 234 underwent the uterine depletion procedure followed by myomectomy (group II). Average blood loss was 250 +/- 132.5 mL for group I and 50 +/- 26.9 mL for group II. For patients with menorrhagia, 79 (84%) of 94 women in group I experienced complete resolution; all of the 194 women (100%) in group II had resolution within 2 months of surgery. The recurrence rate of ultrasound-confirmed fibroids was 19.4% (21 of 108) in group I and 0% in group II. Of the sexually active patients who were not using contraception, 50% (49 of 98) in group I and 37.5% (15 of 40) in group II had a live birth. CONCLUSION(S): This study demonstrates the value of uterine depletion before myomectomy for the management of patients with symptomatic fibroids. The procedure reduced blood loss during the operation, resulted in complete resolution of fibroid-related menorrhagia, and has the potential to prevent fibroid recurrence. Fertility capacity was apparently not compromised by this new treatment approach.

Adult↗

PubMed2004

Polyacetylenic compounds and butanol fraction from Bidens pilosa can modulate the differentiation of helper T cells and prevent autoimmune diabetes in non-obese diabetic mice.

Compelling evidence suggests that infiltrating CD4+ type I helper T (Th1) cells in the pancreatic islets play a pivotal role in the progression of diabetes in non-obese diabetic (NOD) mice. We demonstrate in the present report that a butanol fraction of B. pilosa suppressed the development of diabetes, helped maintain levels of blood sugar and insulin in NOD mice in a dose-dependent manner and elevated the serum IgE levels regulated by Th2 cytokines in NOD mice. Moreover, the butanol fraction inhibited the differentiation of naive helper T (Th0) cells into Th1 cells but enhanced their transition into type II helper T (Th2) cells using an in vitro T cell differentiation assay. Two polyacetylenic compounds, 2-beta-D-glucopyranosyloxy-1-hydroxy-5(E)-tridecene-7,9,11-triyne and 3-beta-D-glucopyranosyloxy-1-hydroxy-6(E)-tetradecene-8,10,12-triyne, identified from the butanol fraction also prevented the onset of diabetes like the butanol fraction. The latter compound showed a stronger activity for T cell differentiation than the former. In summary, the butanol fraction of B. pilosa and its polyacetylenes can prevent diabetes plausibly via suppressing the differentiation of Th0 cells into Th1 cells and promoting that of Th0 cells into Th2 cells.

Acetylene↗

PubMed2004

Adenosine 5'-triphosphate activates nuclear translocation of mitogen-activated protein kinases leading to the induction of early growth response 1 and raf expression in human granulosa-luteal cells.

With the stimulation of many types of cell surface receptors, MAPKs are activated. We have previously demonstrated an effect of extracellular ATP on ERKs and gonadotropin- induced progesterone secretion, implicating the significance of ATP in the regulation of ovarian function. However, little is known about the specific role of ATP in the subsequent MAPK-induced signaling cascade in human granulosa-luteal cells (hGLCs). The present study was designed to examine the effect of ATP on the activation of the MAPK signaling pathway, including nuclear translocation and the expression of the immediate early genes in hGLCs. Western blot analysis, using a monoclonal antibody, which detected the total and phosphorylated forms of ERK1 and ERK2 (p42(mapk) and p44 (mapk), respectively), demonstrated that exogenous ATP evoked ERKs in a dose- and time-dependent manner. In contrast, p38 and JNK were not significantly activated after ATP treatment. To examine the translocation of activated ERKs, fluorescein isothiocyanate-conjugated secondary antibody was used to detect the distribution of total and phosphorylated ERKs. Immunofluorescent staining revealed that phosphorylated ERKs were translocated from cytoplasm into nucleus subsequent to 10 microm ATP treatment. To study the gene(s) induced by exogenous ATP, mRNA was extracted from hGLCs in the presence or absence of 10 microm ATP. Gene array for 23 genes associated with members of the mitogenic pathway cascade and immediate early genes revealed that the expression of early growth response 1 and c-raf-1 was increased. To our knowledge, this is the first demonstration of the ATP-induced nuclear translocation of MAPKs in the human ovary. These results suggest that the MAPK signaling pathway plays a role in mediating ATP actions in the human ovary.

Adenosine Triphosphate↗

PubMed2003

Adenosine triphosphate activates mitogen-activated protein kinase in pre-neoplastic and neoplastic ovarian surface epithelial cells.

To investigate the role of ATP in ovarian tumorigenesis, the present study examined the expression of the P2U purinoceptor (P2U-R) and effect of ATP on growth stimulation in pre-neoplastic and neoplastic ovarian surface epithelial (OSE) cells. The immortalized OSE (IOSE) cell lines, including IOSE-29 (pre-neoplastic), IOSE-29EC (neoplastic), and OVCAR-3 (ovarian adenocarcinoma cell line) were used. Our results indicated that P2U-R mRNA was expressed and that ATP exerted a growth-stimulatory effect in IOSE-29, IOSE-29EC, and OVCAR-3. To investigate the mechanism of the growth-stimulatory effect, the activation of mitogen-activated protein kinases (MAPKs) by ATP was examined. Treatment with ATP resulted in MAPK activation in IOSE-29 and IOSE-29EC cells, whereas the stimulatory effect of ATP in cellular proliferation and MAPK activation was completely abolished in the presence of PD98059 (an MAPK/ERK kinase inhibitor) and staurosporin (a protein kinase C inhibitor), suggesting that the growth stimulatory effect of ATP is mediated via protein kinase C-dependent MAPK activation in pre-neoplastic and neoplastic OSE cells. In a time-dependent study, ATP significantly increased MAPK activity at 5-20 min in IOSE-29 cells. Activated MAPK declined to control levels after 20 min in these cells. Treatment with ATP significantly induced MAPK activation after 5 min and was sustained for 60 min in IOSE-29EC cells. In addition, treatment with ATP resulted in substantial phosphorylation of Elk-1, the Ets family transcriptional factor, confirming that ATP action is mediated by activation of MAPK. In conclusion, we have demonstrated that P2U-R was expressed and that ATP induced growth stimulation in IOSE and OVCAR-3 cells. Furthermore, treatment with ATP resulted in the activation of an MAPK cascade and phosphorylation of Elk-1 in IOSE-29 and IOSE-29EC cells. These results suggest that the MAPK cascade may be involved in growth stimulation in response to ATP in pre-neoplastic and neoplastic OSE cells.

Adenosine Triphosphate↗

PubMed2003

First-trimester uterine rupture from a placenta percreta. A case report.

BACKGROUND: Cesarean scar pregnancy complicated by placenta percreta and uterine rupture is an uncommon gynecologic emergency. CASE: A woman presenting with abdominal pain and shock was found to have a cesarean scar pregnancy complicated by placenta percreta and uterine rupture. CONCLUSION: Implantation within a cesarean scar may cause placenta percreta, leading to uterine rupture in the first trimester and mimicking other gynecologic emergencies.

Adult↗

PubMed2002

Multiple rearrangements of mitochondrial DNA in unfertilized human oocytes.

OBJECTIVE: To determine the rearrangement of mitochondrial DNA (mtDNA) in unfertilized human oocytes and compromised embryos to evaluate the fertilization capacity of oocytes. DESIGN: Prospective laboratory research. SETTING: IVF laboratory in a university hospital. PATIENT(S): One hundred twenty-four unfertilized oocytes, 98 arrested embryos, and 45 tripronucleate (3PN) embryos from 65 female patients undergoing in vitro fertilization (IVF). INTERVENTION(S): Unfertilized oocytes and poor quality embryos were collected 48 hours after IVF. MAIN OUTCOME MEASURE(S): Comparison of the frequency of mtDNA deletions and fertilization rates of oocytes. RESULT(S): Multiple deletions of mtDNA were found in unfertilized oocytes and arrested embryos obtained from IVF patients. A 4977-bp deletion was the most frequent deletion in human oocytes and embryos. About 66.1% of the unfertilized oocytes, 34.8% of the arrested or fragmented embryos, and 21.1% of the 3PN embryos harbored the 4977-bp deletion of mtDNA. There was a significant increase in the proportion of deleted mtDNA in unfertilized oocytes. CONCLUSION(S): Accumulation of mtDNA deletions may contribute to mitochondrial dysfunction and impaired ATP production. We conclude that the accumulation of rearranged mtDNA may interfere with fertilization of human oocytes and further embryonic development.

DNA, Mitochondrial↗

PubMed2002

Assessment of uterine receptivity by the endometrial-subendometrial blood flow distribution pattern in women undergoing in vitro fertilization-embryo transfer.

OBJECTIVE: To investigate the correlation of blood flow detected by color Doppler sonography in the endometrial-subendometrial unit with pregnancy outcome of IVF-ET treatments. DESIGN: Prospective clinical study. SETTING: University setting. PATIENT(S): Six hundred twenty-three patients selected prospectively on the day of ET. INTERVENTION(S): Transvaginal ultrasound examination was performed before ET. MAIN OUTCOME MEASURE(S): Association between pregnancy outcome and distribution of endometrial-subendometrial blood flow (primary outcome measure) and between pregnancy rate and endometrial measurements as well as uterine arterial blood flow (secondary outcome measures). RESULT(S): The overall pregnancy rate was 28.4% (177/623) per ET. The pregnancy and implantation rates of patients with the presence of both endometrial and subendometrial flow were 47.8% (64/134) and 24.2% (94/388); for patients with subendometrial flow only, 29.7% (102/343) and 15.8% (153/967); and for patients with no detectable endometrial-subendometrial flow, 7.5% (11/146) and 3.5% (13/376), respectively. The presence of both endometrial and subendometrial blood flow is indicative of good endometrial receptivity, whereas the absence of both represents a poor uterine environment. Nondetectable endometrial-subendometrial flow was associated with women who were older, had a thinner endometrium, and had higher uterine arterial resistance compared with those women who had detectable flow. CONCLUSION(S): Endometrial-subendometrial blood flow distribution pattern assessed by transvaginal color Doppler before ET is correlated with the implantation and pregnancy rate of IVF treatment.

Adult↗

PubMed2002

Fluid accumulation within the uterine cavity reduces pregnancy rates in women undergoing IVF.

BACKGROUND: The occurrence of fluid accumulation within the uterine cavity was examined in women undergoing IVF to investigate its correlation with tubal disease and impact on the pregnancy outcome. METHODS: A registry of ultrasound procedures spanning 5 years was retrospectively studied. RESULTS: Thirty five out of 746 (4.7%) IVF cycles were identified as having uterine fluid accumulation, and 15 (2.0%) persisted until the day of embryo transfer. Two of the 20 cycles of women with transient fluid accumulation were pregnant, and none of those with fluid retention on the day of embryo transfer conceived. The pregnancy rate was only 5.7% (2/35) in women with uterine fluid accumulation detected during IVF cycles. In contrast, the pregnancy rate was 27.1% (193/711) among women in whose cycles no fluid accumulation was detected (P = 0.0048). Uterine fluid accumulation during IVF cycles was found in 8% (18/225) of women documented with tubal factor compared with 3.3% (17/521) with non-tubal factor (P = 0.005). CONCLUSIONS: Fluid accumulation within the uterine cavity during the IVF transfer treatment could be observed in patients with both tubal and non-tubal factors; however, it mainly occurred in women with tubal infertility. Although it is not a common complication of IVF cycles, excessive uterine fluid is detrimental to embryo implantation.

Adult↗

PubMed2002

Global analysis of differentially expressed genes in early gestational decidua and chorionic villi using a 9600 human cDNA microarray.

The global gene expression profiles of the decidua and chorionic villi of early human pregnancies were analysed by using cDNA microarray technology. Decidual and villous placental tissues were obtained from first trimester abortus and mRNA was extracted for cDNA microarray analysis. The human cDNA microarray [9600 clones, including known regulatory genes and expressed sequence tags (EST)] with colorimetric detection was used to identify differentially expressed genes between early gestational decidua and villi. According to cDNA microarray analysis, we have identified 641 genes with highly expressed mRNA in both decidua and villi, 49 genes with higher expressions in decidua, and 75 genes with higher expression in chorionic villi. These differentially expressed genes were further grouped into categories by their putative functions, including: cell growth-related factors, hormones/cytokines, cell adhesion molecules, signal transduction molecules, apoptosis-related factors, cytoskeleton/extracellular matrix proteins, and EST. Immunohistochemical stainings of cathepsin L, leukaemia inhibitory factor-receptor, and proliferative cell nuclear antigen showed results consistent with the microarray data. Identification of the differentially expressed genes between decidua and villi by microarray provide a global profiling of the gene expression pattern. This work adds to our understanding of placentation by reporting the gene expression profiles during first trimester human pregnancies using cDNA microarray.

Adult↗

PubMedDate not supplied

Management and outcome of primary vaginismus.

Our objective was to access the success rate, and the factors affecting it, of treatment based on Masters and Johnson's sex therapy. For this prospective study, we enrolled 120 couples with unconsummated coitus due to vaginismus. We made a clinical diagnosis after taking a detailed history taking and conducting a clinical examination. Participants completed a questionnaire regarding characteristics of vaginismus after participating in a face-to-face interview. Both of these were done prior to treatment, after 3 months, and after 12 months. We provided sex therapy based on Masters and Johnson's method. Treatment results were then analyzed. After therapy, 93.3% of vaginismic women were successfully penetrated, and 83.3% had regular intercourse with orgasm. The abilities to reach orgasm and sexual desire were not different than that among normal women. There was a correlation between duration of unconsummation and success rate and also between severity of vaginismus, treatment sessions, and success rate. Because of our high success rate, we encourage vaginismic women and their partners to accept aggressive management.

Adult↗

PubMedDate not supplied

Applications of microarray in reproductive medicine.

In the genomic era, cDNA microarray (DNA chip) technology has become a very important and powerful tool for high-throughput comprehensive analysis of gene expression, genotyping and re-sequencing applications in almost every field of biomedical research. Large-scale transcriptional profiling analyses using microarrays are frequently used to explore gene expression patterns in order to better understand the molecular mechanisms of physiology and pathogenesis: these are the basis for the development of new diagnostic and therapeutic strategies. Recently, this powerful technique has been used with laser capture microdissection (LCM) and linear aRNA amplification (in vitro transcription), and used in reproductive medical research. Recent studies of microarray-related techniques used to study oocyte fertilization, early embryo development, implantation and some infertility-related diseases (endometriosis and myoma) are discussed and summarized in this review.

Animals↗