Hyun Ju Lee

MEDIPOST Biomedical Research Institute, Sŏul, Seoul, South Korea

Are you Hyun Ju Lee?

Claim your profile

Publications (317)666.78 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Brain abscesses are an uncommon and devastating complication of bacteremia in extremely low birth weight infants (<1 kg). We report a 25-week preterm neonate who developed a brain abscess 4 weeks following methicillin-resistant Staphyloccocus aureus (MRSA) sepsis. A huge brain abscess was seen with routine brain sonography on day 19 of life. Despite intravenous vancomycin treatment, the brain abscess increased in size and was associated with increased intracranial pressure on day 49 of life. The brain abscess was accompanied by mild meningeal inflammation with negative blood and cerebrospinal fluid cultures. Diagnosis of abscess was confirmed by bedside ultrasound-guided aspiration, and MRSA was isolated from the pus culture. The MRSA brain abscess refractory to vancomycin was successfully treated by surgical ultrasound-guided percutaneous needle aspiration of brain abscess and prolonged courses of antibiotic administration. At the time of this report, the infant was 9 months old (corrected age was 6 months) and had normal neurodevelopment for her corrected age on the Bayley Infant Neurodevelopmental Screener. © 2015 S. Karger AG, Basel.
    Pediatric Neurosurgery 07/2015; DOI:10.1159/000381749 · 0.50 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Thymic carcinomas are uncommon malignant tumors, and thymic adenocarcinomas are extremely rare. Here, we describe a case of primary thymic adenocarcinoma in a 59-year-old woman. Histological examination of the tumor revealed tubular morphology with expression of cytokeratin 20 and caudal-type homeobox 2 according to immunohistochemistry, suggesting enteric features. Extensive clinical and radiological studies excluded the possibility of an extrathymic primary tumor. A review of the literature revealed only two global cases of primary tubular adenocarcinomas of the thymus with enteric immunophenotype.
    06/2015; DOI:10.4132/jptm.2015.04.16
  • [Show abstract] [Hide abstract]
    ABSTRACT: To report the histopathological findings of the cornea with fulminant Mooren ulcer, an idiopathic autoimmune keratitis. A 54-year-old woman was diagnosed with Mooren ulcer. Despite intensive immunosuppression, corneal perforation developed, and penetrating keratoplasty with a limbal tectonic graft was performed. The removed cornea was histopathologically evaluated for the phenotype of the cells infiltrating the lesion. Hematoxylin-eosin staining showed massive infiltration of inflammatory cells in the anterior corneal stroma and epithelial hyperplasia in the adjacent conjunctiva. Further analysis with immunohistochemistry indicated that the cells infiltrating the lesion included a number of CD4 and CD8 T lymphocytes, CD19CD45 B lymphocytes, and CD14CD68 macrophages. There were a few neutrophils and no CD56 NK cells. Our findings suggest that multiple types of immune cells including T cells, B cells, and macrophages are involved in the pathogenesis of Mooren ulcer.
    Cornea 05/2015; DOI:10.1097/ICO.0000000000000471 · 2.36 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Exogenously administered mesenchymal stem/stromal cells (MSCs) suppress autoimmunity despite transient engraftment. However, the mechanism is unclear. In this study, we report a novel mechanism by which MSCs modulate the immune system by recruiting myeloid-derived suppressor cells in a mouse model of experimental autoimmune uveitis (EAU). Intravenous infusion of MSCs blocked EAU development and reduced Th1 and Th17 responses. Time course analysis revealed an increase of MHC class II(lo)Ly6G(-)Ly6C(hi)CD11b(+) cells in draining lymph nodes by MSCs. These Ly6C(hi)CD11b(+) cells suppressed CD4(+) cell proliferation and Th1/Th17 differentiation and induced CD4(+) cell apoptosis. Adoptive transfer of Ly6C(hi)CD11b(+) cells ameliorated EAU, whereas depletion of Ly6C(hi)CD11b(+) cells abrogated the effects of MSCs. 1.8% of MSCs were present in draining lymph nodes 1 d after infusion, and MSCs with CCL2 knockdown did not increase MHC class II(lo)Ly6G(-)Ly6C(hi)CD11b(+) cells and failed to attenuate EAU. Therefore, our findings demonstrate that MSCs suppress autoimmunity by recruiting myeloid-derived suppressor cells into sites of inflammation in a CCL2-dependent manner. Copyright © 2015 by The American Association of Immunologists, Inc.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Recent studies have revealed recurrent alterations in the cell adhesion gene FAT4, a candidate tumor suppressor gene, in cancer. FAT atypical cadherin 4 (FAT4) is a transmembrane receptor involved in the Hippo signaling pathway, which is involved in the control of organ size. Here, we investigated the loss of FAT4 expression and its association with clinicopathological risk factors in gastric cancer. We assessed the expression of FAT4 by using immunohistochemistry on three tissue microarrays containing samples from 136 gastric cancer cases, radically resected in the Soonchunhyang University Cheonan Hospital between July 2006 and June 2008. Cytoplasmic immunoexpression of FAT4 was semi-quantitatively scored using the H-score system. An H-score of ≥10 was considered positive for FAT4 expression. Variable cytoplasmic expressions of FAT4 were observed in gastric cancers, with 33 cases (24.3%) showing loss of expression (H-score <10). Loss of FAT4 expression was associated with an increased rate of perineural invasion (H-score <10 vs. ≥10, 36.4% vs. 16.5%, P=0.015), high pathologic T stage (P=0.015), high tumor-node-metastasis stage (P=0.017), and reduced disease-free survival time (H-score <10 vs. ≥10, mean survival 62.7±7.3 months vs. 79.1±3.1 months, P=0.025). However, no association was found between the loss of FAT4 expression and tumor size, gross type, histologic subtype, Lauren classification, lymphovascular invasion, or overall survival. Loss of FAT4 expression appears to be associated with invasiveness in gastric cancer.
    03/2015; 15(1):39-45. DOI:10.5230/jgc.2015.15.1.39
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To report the various anatomic locations of surgically and pathologically proven endometriosis. Pathologic reports (n=1,376) of women who underwent surgeries at a single center between April 2005 and March 2013 were retrieved from the electronic medical record system of the hospital. Pathologic reports were included after performing a search by using the key-words "endometrial cyst," "endometriotic cyst," "endometriosis," or "endometrioma." Only reports dealing with female patients were selected, and the pathologic reports of 1,350 women (1,374 surgery cases) were included in the analysis. The predominant location of endometriosis was the ovaries (96.4%), followed by the soft tissue (2.8%), gastrointestinal tract (0.3%) and urinary tract (0.2%). Laparoscopic surgery was the major surgical technique used for the pelvic endometriosis (89.2%). Adrenal gland endometriosis was found in a 55-year-old woman. We established the various anatomic locations of surgically and pathologically proven endometriosis in Korean women.
    01/2015; 58(1):53-8. DOI:10.5468/ogs.2015.58.1.53
  • Hwan Jun Choi, Eun Taik Son, Hyun Ju Lee
    [Show abstract] [Hide abstract]
    ABSTRACT: Chondroid syringoma (CS) is an uncommon cutaneous tumor in the head and neck, with reported incidence rate from 0.01% to 0.1%. The CS of skin is a rare type of soft tissue tumor originating from the sweat glands. We report a documented case of CS occurring in the nasal dorsum in a 58-year-old man, which developed during the course of 1 year. The clinical, gross pathologic, and histologic findings of the tumor are described. The lesion was totally excised via transcutaneous approach and showed no evidence of recurrence after excision.
    Journal of Craniofacial Surgery 01/2015; 26(1):e12-4. DOI:10.1097/SCS.0000000000001222 · 0.68 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Choroidal neovascularization (CNV) is the hallmark of wet age-related macular degeneration (AMD), one of the leading causes of blindness in the elderly. Although the pathogenesis of CNV is not clear, a number of studies show that ocular-infiltrating macrophages and inflammation play a critical role in the development of CNV. TNFα-stimulated gene/protein (TSG)-6 is a multifunctional endogenous protein that has anti-inflammatory activities partly by regulating macrophage activation. Therefore, we here investigated the therapeutic potential of TSG-6 in a rat model of CNV induced by laser photocoagulation. Time course analysis showed that the expression of VEGF and pro-inflammatory cytokines in the choroid was up-regulated early after laser injury, and gradually decreased to baseline over 14 days. An intravitreal injection of TSG-6 suppressed the expression of VEGF and pro-inflammatory cytokines including CCL2, and reduced the size of CNV. Also, the number of Iba(+) and CCR2(+) cells including infiltrating macrophages was markedly lower in the CNV lesion of TSG-6-treated eyes. Further analysis identified CCR2(+) CD11b(+) CD11c(+) cells and CCR2(+) CD11b(-)CD11c(+) cells as the cell populations that were increased by laser injury and reduced by TSG-6 treatment. Together, the results demonstrate that TSG-6 inhibits inflammation and CCR2(+) monocyte recruitment into the choroid, and suppresses the development of CNV.
    Scientific Reports 01/2015; 5:11872. DOI:10.1038/srep11872 · 5.58 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to report the characteristics of biomaterial-free sheets cultured from human oral mucosal epithelial cells without fibrin support, in vitro and after transplantation to limbal-deficient models. Human oral mucosal epithelial cells and limbal epithelial cells were cultured for 2 weeks, and the colony-forming efficiency (CFE) rates were compared. Markers of stem cells (p63), cell proliferation (Ki-67) and epithelial differentiation (cytokeratin; K1, K3, K4, K13) were observed in colonies and in biomaterial-free sheets. Biomaterial-free sheets which had been detached with 1% dispase or biomaterial-free sheets generated by fibrin support were transplanted to 12 limbal-deficient rabbit models. In vitro cell viability, in vivo stability and cytokeratin characteristics of biomaterial-free sheets were compared with those of sheets formed by fibrin-coated culture 1 week after transplantation. Mean CFE rate was significantly higher in human oral mucosal epithelial cells (44.8%) than in human limbal epithelial cells(17.7%). K3 and K4 were well expressed in both colonies and sheets. Biomaterial-free sheets had two to six layers of stratified cells and showed an average of 79.8% viable cells in the sheets after detachment. Cytokeratin expressions of biomaterial-free sheets were comparable to those of sheets cultured by fibrin support, in limbal-deficient models. Both p63 and Ki-67 were well expressed in colonies, isolated sheets and sheets transplanted to limbal-deficient models. Our results suggest that biomaterial-free sheets cultured from human oral mucosal epithelial cells without fibrin support can be an alternative option for cell therapy in use for the treatment of limbal-deficient diseases. Copyright © 2014 John Wiley & Sons, Ltd.
    Journal of Tissue Engineering and Regenerative Medicine 11/2014; DOI:10.1002/term.1971 · 4.43 Impact Factor
  • Hwan Jun Choi, Kyu Hwa Jung, Hyun Ju Lee
    [Show abstract] [Hide abstract]
    ABSTRACT: Nodular fasciitis (NF) is a pseudosarcomatous reactive proliferative lesion that commonly occurs as a solitary, well-circumscribed, painful, rapidly growing soft tissue mass. It appears at any age, but incidence peaks in the third decade, with a slight predilection for women. It is most commonly located on the extremities, followed by the chest and trunk. Although a common site in the pediatric population, NF is found on the head and neck only in 7% to 20% in the adult population and includes the cheek, parotid region, zygoma, periorbital area, eyelid, forehead, and intraoral sites. The cause of NF is unknown, but an association with trauma may be present. A case of NF over the temple area in a 28-year-old man who has no trauma history but has surgical incisional biopsy history and tenderness on palpation is reported.
    Journal of Craniofacial Surgery 10/2014; 25(6). DOI:10.1097/SCS.0000000000001049 · 0.68 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background We aimed to evaluate the efficacy and safety of early surgical ligation (within 15 days of age) over late surgical ligation (after 15 days of age) by a comparative analysis of very low birth weight (VLBW) infants undergoing surgical correction for symptomatic patent ductus arteriosus (PDA) over the course of 6 years in our hospital. Methods We retrospectively reviewed all the medical records in the neonatal intensive care unit at Hanyang University Seoul Hospital, from March 2007 to May 2013, to identify VLBW infants (< 1,500 g) who underwent surgical PDA ligation. Results The gestational age (GA) in the late ligation (LL) group was significantly younger than in the early ligation (EL) group (p=0.010). The other baseline characteristics and preoperative conditions did not differ significantly between the two groups. The intubation period before surgery (p < 0.001) and the age at surgery (p < 0.001) were significantly different. The postoperative clinical outcomes of the study patients, including major morbidity and mortality, are summarized. There were no significant differences in bronchopulmonary dysplasia, sepsis, or mortality between the EL and the LL groups. However, the LL group was significantly associated with an increased risk of necrotizing enterocolitis (p=0.037) and with a prolonged duration of the total parenteral nutrition (p=0.046) after adjusting for GA. Conclusion Early surgical ligation for the treatment of PDA that failed to close after medical treatment or in cases contraindicated for medical treatment might be desirable to reduce the incidence of necrotizing enterocolitis and to alleviate feeding intolerance in preterm infants.
    10/2014; 47(5):444-50. DOI:10.5090/kjtcs.2014.47.5.444
  • Source
    Hyun Ju Lee
    [Show abstract] [Hide abstract]
    ABSTRACT: Alveolar soft part sarcoma (ASPS) of the uterine cervix is a rare malignancy, and 21 cases have been reported the literature from every language (including our case). Herein, we describe a 17-yearold female patient who presented with active vaginal bleeding. Pelvic examination revealed a 1.6 ×1.0×0.5-cm-sized soft mass protruding from the uterine cervix. The final pathological diagnosis was ASPS of the uterine cervix. Immunohistochemically, tumor cells were strongly nuclear positive for transcription factor E3. The patient remained disease free for 24 months without adjuvant therapy. The prognosis of ASPS in the cervix is considerably better than that of ASPS in soft tissues due to early clinical detection, small size, and resectability. ASPS should be considered in the differential diagnosis of an unusual epithelioid neoplasm showing organoid appearance with mild cytologic atypia and no/rare mitotic figures, particularly in young women. Pathologists should be aware of those unusual locations where ASPS may originate.
    The Korean Journal of Pathology 10/2014; 48(5):361-5. DOI:10.4132/KoreanJPathol.2014.48.5.361 · 0.17 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: An efficient stereoselective synthesis of various 3-(3-dimethylaminoprop-2-enylidene)oxindoles has been disclosed. The compounds were synthesized via a vinylogous N,N-dimethylaminomethylenation at the gamma-position of 3-[(1-substituted)ethylidene]oxindoles with DMF-DMA.
    Tetrahedron Letters 09/2014; 45(38). DOI:10.1002/chin.201438113 · 2.39 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective To evaluate the dose effect of recombinant mouse granulocyte-macrophage colony-stimulating factor (rmGM-CSF) or brain-derived neurotrophic factor (BDNF) in culture medium on the development of in vitro fertilized mouse embryos. Methods Mature oocytes were retrieved from superovulated female BDF1 mice and inseminated by sperm from male BDF1 mice. On day 1, two-cell stage embryos were divided and cultured until day 5 in the embryo maintenance medium supplemented with 0, 1, 2, 5, or 10 ng/mL of rmGM-CSF or supplemented with 0, 5, 10, or 20 ng/mL of BDNF. Blastocyst formation rate and their cell numbers were assessed. Results The blastocyst formation rate and the total cell count in blastocyst was similar in all the rmGM-CSF treatment groups when compared with the control. However, the blastocyst formation rate and the total cell count was significantly higher in the group supplemented with 10 ng/mL of BDNF compared with the control (63.9%, 45.8±11.5 vs. 52.3%, 38.0±6.8; P<0.05, respectively). Conclusion Supplementation of 10 ng/mL of BDNF enhanced the developmental potential of mouse preimplantation embryos, but supplementation of rmGM-CSF did not.
    09/2014; 57(5):373-8. DOI:10.5468/ogs.2014.57.5.373
  • [Show abstract] [Hide abstract]
    ABSTRACT: Dry eye syndrome (DES) is one of the most common ocular diseases affecting nearly 10% of the U.S. population. Most of the currently-available treatments are palliative, and few therapeutic agents target biological pathway of DES. Although DES is a multifactorial disease, it is well-known that inflammation in the ocular surface plays an important role in the pathogenesis of DES. Mesenchymal stem/stromal cells (MSCs) have been shown to repair tissues by modulating excessive immune responses in various diseases. Therefore, we here investigated the therapeutic potential of MSCs in a murine model of an inflammation-mediated dry eye that was induced by an intraorbital injection of concanavalin A. We found that a periorbital administration of MSCs reduced the infiltration of CD4(+) T cells and the levels of inflammatory cytokines in the intraorbital gland and ocular surface. Also, MSCs significantly increased aqueous tear production and the number of conjunctival goblet cells. Subsequently, corneal epithelial integrity was well-preserved by MSCs. Together, the results demonstrate that MSCs protect the ocular surface by suppressing inflammation in DES, and suggest that MSCs may offer a therapy for a number of ocular surface diseases where inflammation plays a key role.Molecular Therapy (2014); doi:10.1038/mt.2014.159.
    Molecular Therapy 08/2014; 23(1). DOI:10.1038/mt.2014.159 · 6.43 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: To investigate the effect of an anti-inflammatory protein, TNF-α stimulated gene/protein (TSG)-6 and an anti-apoptotic protein, stanniocalcin (STC)-1 on corneal endothelium in rabbits with transcorneal cryoinjury. Methods: Transcorneal freezing (-80°C) was applied to rabbit corneas for 30 sec. Immediately post-injury, either TSG-6 (10 μg/100 μl), STC-1 (10 μg/100 μl), or the same volume of balanced salt solution (BSS) was injected into the anterior chamber. Each eye was examined for corneal opacity, corneal thickness, endothelial cell density, and endothelial hexagonality every 2 to 6 h for 48 h post-injury. The concentrations of myeloperoxidase (MPO) and IL-1β were measured in the aqueous humor every 6 h. At 48 h post-injury, each cornea was assayed for TNF-α, IL-1β, IL-6, and MPO, and histologically evaluated with alizarin red-trypan blue staining, hematoxylin-eosin staining, and immunostaining for neutrophils. Results: TSG-6 significantly decreased the development of corneal opacity and edema after cryoinjury compared to STC-1 or BSS. The corneal endothelial cell density and hexagonality were markedly preserved by TSG-6. The mRNA levels of TNF-α, IL-1β, and IL-6 in the cornea and the protein levels of MPO and IL-1β in the aqueous humor and cornea were significantly lower in TSG-6-treated eyes than BSS-treated controls. Similarly, the expression of fibroblast growth factor-2 was reduced by TSG-6 treatment. Histologic evaluation demonstrated that neutrophil infiltration of the cornea was decreased in TSG-6-treated eyes. Conclusions: TSG-6 protected corneal endothelial cells from transcorneal cryoinjury through suppression of inflammation.
    Investigative Ophthalmology &amp Visual Science 07/2014; 55(8). DOI:10.1167/iovs.14-14538 · 3.66 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Autoimmune uveitis is one of the leading causes of blindness. We here investigated whether intraperitoneal administration of human mesenchymal stem/stromal cells (hMSCs) might prevent development of experimental autoimmune uveitis (EAU) in mice. Time course study showed that the number of IFN-γ- or IL-17-expressing CD4(+) T cells was increased in draining lymph nodes (DLNs) on the postimmunization day 7 and decreased thereafter. The retinal structure was severely disrupted on day 21. An intraperitoneal injection of hMSCs at the time of immunization protected the retina from damage and suppressed the levels of proinflammatory cytokines in the eye. Analysis of DLNs on day 7 showed that hMSCs decreased the number of Th1 and Th17 cells. The hMSCs did not reduce the levels of IL-1β, IL-6, IL-12, and IL-23 which are the cytokines that drive Th1/Th17 differentiation. Also, hMSCs did not induce CD4(+)CD25(+)Foxp3(+) cells. However, hMSCs increased the level of an immunoregulatory cytokine IL-10 and the population of IL-10-expressing B220(+)CD19(+) cells. Together, data demonstrate that hMSCs attenuate EAU by suppressing Th1/Th17 cells and induce IL-10-expressing B220(+)CD19(+) cells. Our results support suggestions that hMSCs may offer a therapy for autoimmune diseases mediated by Th1/Th17 responses.
    Mediators of Inflammation 07/2014; 2014:624640. DOI:10.1155/2014/624640 · 3.24 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Mesenchymal stem/stromal cells (MSCs) control excessive inflammatory responses by modulating a variety of immune cells including monocytes/macrophages. However, the mechanisms by which MSCs regulate monocytes/macrophages are unclear. Inflammasomes in macrophages are activated upon cellular 'danger' signals, and initiate inflammatory responses through the maturation and secretion of pro-inflammatory cytokines such as interleukin 1β. Here we demonstrate that human MSCs (hMSCs) negatively regulate NLRP3 inflammasome activation in human or mouse macrophages stimulated with LPS and ATP. Caspase-1 activation and subsequent IL-1β release were decreased in macrophages by direct or transwell co-culture with hMSCs. Addition of hMSCs to macrophages either at a LPS priming or at a subsequent ATP step similarly inhibited the inflammasome activation. The hMSCs had no effect on NLRP3 and IL-1β expression at mRNA levels during LPS priming. However, MSCs markedly suppressed the generation of mitochondrial reactive oxygen species (ROS) in macrophages. Further analysis showed that NLRP3-activated macrophages stimulated hMSCs to increase the expression and secretion of stanniocalcin (STC)-1, an anti-apoptotic protein. Addition of recombinant protein STC-1 reproduced the effects of hMSCs in inhibiting NLRP3 inflammasome activation and ROS production in macrophages. Conversely, the effects of hMSCs on macrophages were largely abrogated by an siRNA knockdown of STC-1. Together, our results reveal that hMSCs inhibit NLRP3 inflammasome activation in macrophages primarily by secreting STC-1 in response to activated macrophages and thus by decreasing mitochondrial ROS. Stem Cells 2013.
    Stem Cells 06/2014; 32(6). DOI:10.1002/stem.1608 · 7.70 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Alteration of retinal angiogenesis during development leads to retinopathy of prematurity (ROP) in preterm infants, which is a leading cause of visual impairment in children. A number of clinical studies have reported higher rates of ROP in infants who had perinatal infections or inflammation, suggesting that exposure of the developing retina to inflammation may disturb retinal vessel development. Thus, we investigated the effects of systemic inflammation on retinal vessel development and retinal inflammation in neonatal rats. Methods To induce systemic inflammation, we intraperitoneally injected 100 μl lipopolysaccharide (LPS, 0.25 mg/ml) or the same volume of normal saline in rat pups on postnatal days 1, 3, and 5. The retinas were extracted on postnatal days 7 and 14, and subjected to assays for retinal vessels, inflammatory cells and molecules, and apoptosis. Results We found that intraperitoneal injection of LPS impaired retinal vessel development by decreasing vessel extension, reducing capillary density, and inducing localized overgrowth of abnormal retinal vessels and dilated peripheral vascular ridge, all of which are characteristic findings of ROP. Also, a large number of CD11c+ inflammatory cells and astrocytes were localized in the lesion of abnormal vessels. Further analysis revealed that the number of major histocompatibility complex (MHC) class IIloCD68loCD11bloCD11chi cells in the retina was higher in LPS-treated rats compared to controls. Similarly, the levels of TNF-α, IL-1β, and IL-12a were increased in LPS-treated retina. Also, apoptosis was increased in the inner retinal layer where retinal vessels are located. Conclusions Our data demonstrate that systemic LPS-induced inflammation elicits retinal inflammation and impairs retinal angiogenesis in neonatal rats, implicating perinatal inflammation in the pathogenesis of ROP.
    Journal of Neuroinflammation 05/2014; 11(1):87. DOI:10.1186/1742-2094-11-87 · 4.90 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To estimate the incidence of, and identify risk factors for, spontaneous expulsion of the levonorgestrel-releasing intrauterine system (LNG-IUS). Pre-insertion characteristics for 481 women who received the LNG-IUS at a single institution in the Republic of Korea between 2003 and 2011 were analyzed retrospectively. The median duration of follow-up was 13.4months. Kaplan-Meier plots were constructed to estimate the time to occurrence of spontaneous expulsion in multiple subgroups. The overall crude incidence of spontaneous LNG-IUS expulsion was 9.6%. The cumulative incidence was 7.9%, 9.1%, and 9.6% at 1, 2, and 3years, respectively. It was significantly higher in women with adenomyosis (9.1%, 10.6%, and 11.1%) or uterine leiomyoma (14.5%, 15.8%, and 15.8%) than in those with a normal uterus (3.6%, 4.1%, and 4.6%) (P=0.008). Women with heavy menstrual bleeding (11.0%, 12.7%, and 13.4%), dysmenorrhea (8.1%, 9.0%, and 10.0%), or pre-insertion receipt of gonadotropin-releasing hormone agonists (13.3%, 16.0%, and 17.3%) also had higher cumulative incidences than those without these conditions (P<0.05). Most (84.5%) women with a spontaneous expulsion chose to discontinue the device. Clinicians need to be aware of the risk factors for spontaneous LNG-IUS expulsion because this can lead to a discontinuation of its use.
    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 04/2014; 126(2). DOI:10.1016/j.ijgo.2014.02.017 · 1.56 Impact Factor

Publication Stats

3k Citations
666.78 Total Impact Points

Institutions

  • 2013–2015
    • MEDIPOST Biomedical Research Institute
      Sŏul, Seoul, South Korea
  • 2012–2015
    • Soonchunhyang University
      • College of Medicine
      Onyang, Chungcheongnam-do, South Korea
  • 2000–2015
    • Seoul National University Hospital
      • • Department of Obstetrics and Gynecology
      • • Department of Ophthalmology
      • • Department of Radiology
      Sŏul, Seoul, South Korea
  • 2014
    • Hanyang University Medical Center
      Sŏul, Seoul, South Korea
  • 2003–2014
    • Seoul National University
      • • Cancer Research Institute
      • • Department of Pediatrics
      • • Department of Ophthalmology
      • • Inter-University Semiconductor Research Center
      • • Department of Medicine
      Sŏul, Seoul, South Korea
    • Chungbuk National University
      • Department of Computer Science
      Chinsen, North Chungcheong, South Korea
  • 2002–2014
    • Chonnam National University
      • • Department of Chemistry
      • • Hormone Research Center
      Gwangju, Gwangju, South Korea
    • University of Oslo
      • Institute of Theoretical Astrophysics
      Kristiania (historical), Oslo County, Norway
  • 2011–2013
    • Hanyang University
      Sŏul, Seoul, South Korea
    • Seoul National University Bundang Hospital
      • • Department of Pathology
      • • Department of Pediatrics
      Seoul, Seoul, South Korea
    • Ewha Womans University
      • • Medical Research Institute
      • • Department of Pediatrics
      Sŏul, Seoul, South Korea
    • Korea Research Institute of Bioscience and Biotechnology KRIBB
      Anzan, Gyeonggi Province, South Korea
    • Daegu Gyeongbuk Institute of Science and Technology
      Daikyū, Daegu, South Korea
    • Korea University
      Sŏul, Seoul, South Korea
  • 2011–2012
    • Chonnam National University Hospital
      Sŏul, Seoul, South Korea
  • 2008–2012
    • Chung-Ang University
      • School of Chemical Engineering and Materials Science
      Sŏul, Seoul, South Korea
    • Pusan National University
      • • Department of Chemistry
      • • Department of Pharmacology
      • • Division of Materials Science and Engineering
      Tsau-liang-hai, Busan, South Korea
  • 2008–2011
    • Pai Chai University
      • Department of Biology and Medicinal Sciences
      Sŏul, Seoul, South Korea
  • 2010
    • Kyungpook National University
      Daikyū, Daegu, South Korea
  • 2002–2010
    • University of Ulsan
      • College of Medicine
      Urusan, Ulsan, South Korea
  • 1994–2010
    • Sogang University
      • Department of Chemistry
      Sŏul, Seoul, South Korea
  • 2007
    • University of Seoul
      Sŏul, Seoul, South Korea
    • Pohang University of Science and Technology
      • Division of Molecular and Life Sciences
      Antō, North Gyeongsang, South Korea
    • Asan Medical Center
      • Health Promotion Center
      Sŏul, Seoul, South Korea
    • Yeungnam University
      • Division of Internal Medicine
      Onyang, South Chungcheong, South Korea