The Effect of Manual Physical Therapy on Improvement in the Range of Motion of Frozen Shoulder Patients: A Meta-Analysis of Cases in South Korea

Purpose@#The main purpose of this meta-analysis was to identify the degree of effect size and variables for the impact of manual physical therapy on the improvement in the range of motion of frozen shoulder patients. @*Methods@#This study collected 8 studies published between 1st January 2010 and 31st December 2020. The analysis of the results verified 49 effect size data and the random effect model was chosen. @*Results@#First, the full case showed the largest mean effect size of 2.485 (p 0.737). The number of intervention periods showed 4 weeks 20 or more effect size of 2.782 (p > 0.294). Finally, the ‘Trim and Fill’ result confirmed that the calibration effect size was 1.471 (p < 0.001). @*Conclusion@#This study verified that manual physical therapy had a substantial effect on the improvement of the range of motion of patients with frozen shoulders and that the effects were dependent on the methods of outcomes.

The incidence of urologic complications requiring urologic procedure in radical hysterectomy and difference between abdominal radical hysterectomy and laparoscopic radical hysterectomy / 부인종양

Objective@#To evaluate the incidence of urologic complications requiring a urologic procedure during the perioperative period and compare the differences between abdominal radical hysterectomy (ARH) and laparoscopic radical hysterectomy (LRH). @*Methods@#We identified all Korean women who underwent radical hysterectomy (RH) between January 2006 and December 2019 using the National Health Insurance Service database. Complications requiring surgical intervention-based urologic procedures between ARH and LRH were investigated. @*Results@#A total of 12,068 patients were classified into the ARH group and 8,837 patients were classified into the LRH group. Urologic complications requiring urologic procedures occurred in 1,546 of 20,905 patients (7.40%) who underwent RH. The most common urologic procedure was double-J insertion (R326, 5.18%), followed by bladder repair (R3550, 0.90%). There was no significant difference in urologic complications requiring urologic procedures between the ARH and LRH groups (odds ratio [OR]=1.027; 95% confidence interval [CI]=0.925–1.141; p=0.612). The incidence of bladder repair (R3550) was significantly higher in patients who underwent LRH (OR=1.620; 95% CI=1.220–2.171; p<0.001). Urologic complications requiring urologic procedures were statistically higher in the LRH group during the first half (OR=1.446; 95% CI=1.240–1.685; p<0.001), but more in the ARH group during the second half (OR=0.696; 95% CI=0.602–0.804; p<0.001) of the study period. @*Conclusion@#There was no difference of urologic complications between ARH and LRH with regard to urologic procedures. The incidence of urologic procedures decreases with time in patients who underwent LRH.

Comparison of Cytokine Expression in Mesenchymal Stem Cells from Human Placenta, Cord Blood, and Bone Marrow

Mesenchymal stem cells (MSCs) are capable of self-renewal and differentiation into lineages of mesenchymal tissues that are currently under investigation for a variety of therapeutic applications. The purpose of this study was to compare cytokine gene expression in MSCs from human placenta, cord blood (CB) and bone marrow (BM). The cytokine expression profiles of MSCs from BM, CB and placenta (amnion, decidua) were compared by proteome profiler array analysis. The cytokines that were expressed differently, in each type of MSC, were analyzed by real-time PCR. We evaluated 36 cytokines. Most types of MSCs had a common expression pattern including MIF (GIF, DER6), IL-8 (CXCL8), Serpin E1 (PAI-1), GROalpha(CXCL1), and IL-6. MCP-1, however, was expressed in both the MSCs from the BM and the amnion. sICAM-1 was expressed in both the amnion and decidua MSCs. SDF-1 was expressed only in the BM MSCs. Real-time PCR demonstrated the expression of the cytokines in each of the MSCs. The MSCs from bone marrow, placenta (amnion and decidua) and cord blood expressed the cytokines differently. These results suggest that cytokine induction and signal transduction are different in MSCs from different tissues.

The utility of the human papillomavirus DNA load for the diagnosis and prediction of persistent vaginal intraepithelial neoplasia / 부인종양

OBJECTIVE: We evaluated the human papillomavirus (HPV) DNA load for the diagnosis and prediction of persistent vaginal intraepithelial neoplasia (VAIN). METHODS: A retrospective review of the medical records of patients with a pathological diagnosis of VAIN was performed. Eligible women (N=48) were followed for cytology and HPV DNA test, and colposcopic biopsies were taken at 3- to 6-month intervals. Thirty-seven patients were followed for more than 6 months; their HPV DNA test results were compared to the cytology results for the prediction of disease prognosis. RESULTS: The degree of VAIN was more severe in patients with a high initial HPV DNA load (p=0.009). Patients with VAIN 2 and VAIN 3 were older than those with VAIN 1 (p=0.005 and 0.008, respectively). In 26 out of 37 patients (70.3%), the VAIN resolved. The other patients had persistent lesions with no progression to invasive vaginal carcinoma. The last follow-up HPV DNA load was significantly higher in the group with persistent VAIN compared to the group with resolved VAIN (p<0.0001). Negative cytology was observed in 25 out of 26 patients in the VAIN resolved group and in nine out of 11 patients in the VAIN persistent group (p=0.205). CONCLUSION: These results suggest that the HPV DNA test, especially for viral load, was more effective for the diagnosis and prediction of persistent VAIN than cytology.

Isolation and characterization of mesenchymal stem cells from human amnion and decidua / 대한산부인과학회지

OBJECTIVES: The purpose of this study is to isolate a population of multipotent cells from human amnion and decidua, respectively. METHODS: Human placentas (gestational age, 30~42 weeks) were obtained after vaginal or cesarean deliveries. Amnions and deciduas were divided mechanically. The collected cells from the amnion and decidua were cultured. Cultured cells were immunophenotypically characterized. The adipogenic, osteogenic and neurogenic differentiation capacities were tested, and their growth kinetics were analyzed. RESULTS: We successfully isolated MSCs from both the amnion and decidua. The phenotype of MSCs cultured from different fetal and maternal parts of the placenta was comparable. The growth kinetics of MSCs derived from amnions and deciduas were similar. Isolated MSCs were differentiated into various cell lines such as adipogenic, osteogenic, myogenic and neurogenic cells. CONCLUSIONS: The human amnion and decidua could be an excellent source of MSC because they are easily obtainable after delivery and showed a higher expansion capacity than that of MSCs from adult bone marrow.

A Case of Papillary Serous Carcinoma of Endometrium / 대한산부인과학회잡지

Uterine papillary serous carcinoma (UPSC) has been recognized as an aggresive tumor with early and deep myometrial invasion, frequent lympho-vascular space involvement, and a high relapse rate. It has also been shown that deep myometrial invasion cannot predict the risk of extrauterine disease. UPSC accounts for 2-10% of all endometrial cancer and generally occurs in postmenopausal women (mean age 66 years) who usually present with abnormal vaginal bleeding. Obesity, diabetes, hypertension, or a history of previous hormone replacement treatment, known as risk factors of endometrial cancer, are not usually seen in women with UPSC. In this paper, we present a case of uterine papillary serous carcinoma with obesity, hypertension, diabetes. The initial endometrial biopsy showed an endometrioid adenocarcinoma but the result of postoperative pathologic finding revealed UPSC with extension to less than half thickness of the muscle layer and involvement of pelvic lymph node.

A Case of Pelvic Lymph Node Metastases in Cervical Carcinoma with Early Stromal Invasion / 대한산부인과학회잡지

The definition and management of microinvasive cervical cancer varies from time to time depending on the organization involved and is a persistent focus of controversy. The purpose of defining microinvasion is to identify a group of patients who are not at risk of lymph node metastases or recurrence and who therefore may be treated with less than radical therapy. Microinvasive cervical cancer with

A case of Laparoscopic Removal of Perforated Intrauteirne device / 대한산부인과학회잡지

Intrauterine devices (IUDs) have a low complication rate and minimal side effects and are pervaded contraceptive method. Perforation of the uterus by an IUD is very rare. But perforation of the uterus is one of the most serious complications associated with insertion of IUD. During the puerperium when the uterus is small and the uterine wall is thin the risk of perforation increase. The frequency has been estimated between 0.05 and 13 per 1000 insertions. When the IUD strings are not visible during pelvic examination, physicians make efforts to locate the IUD. We experienced a laparosopic removal of perforated intrauterine device, which had been inserted on postpartum 5 th week, at posterior lower segment of uterus with intrauterine pregnancy. So we report a case with a brief review of the literature.

A case of successful treatment of an ectopic pregnancy embedded in the myometrium of previous cesarean section scar with systemic methotrexate injection / 대한산부인과학회잡지

Intramural pregnancy implanting in the previous cesarean section scar is one of the rarest form of an ectopic pregnancy and probably the most dangerous form because of its risk of rupture and hemorrhage. Pathologically, the location of the gestational sac is completely isolated from the uterine cavity and entirely surrounded by myometrium without any contact of endometrium. For young patients who wish to maintain their fertility, an earlier diagnosis and more conservative treatment are highly desirable. We have recently experienced a case of intramural pregnancy implanting in the scar of cesarean section, treated completely with systemic methotrexate injection. So, we report this case with a brief review of the literature.

A Case of Hemorrhagic Huge Bartholin Abscess / 대한산부인과학회잡지

A bartholin gland cysts and abscesses are common problems in women of reproductive age. Although the cysts are usually asymptomatic, they may become enlarged or infected and cause significant pain. Bartholin gland abscesses usually develop over two to four days and can become larger than 8 cm by literature but huge bartholin abscess is very rare. A number of vulvar and vaginal lesions can mimic bartholin gland cysts or abscesses and should be included in the differential diagnosis. So we report a case of hemorrhagic huge bartholin abscess with a brief review of the literatures.

Combined intrauterine and cervical pregnancy / 대한산부인과학회잡지

Although recently the incidence of heterotopic pregnancies are increasing because of assisted reproduction, heterotopyic pregnancies were rare with an incidence of 1 per 30,000 pregnancies. In this presentation, we describe a case of combined intrauterine and cervical pregnancy after artificial abortion. The patient was treated by local injection of methotrexate directly into gestational sac under the guidance of sonogram after systemic methotrexate treatment. The gestational products were removed by dilatation & currettage due to persistent vaginal bleeding on the next day. So we report a case with a brief review of the literatures.