A Case of Papulopustular Rosacea-Like Eruptions Following COVID-19 Vaccination / 대한피부과학회지

A few cases of rosacea-like eruptions associated with COVID-19 vaccination have been reported. Herein, we report a case of papulopustular rosacea-like eruption following COVID-19 vaccination in an Asian male. A 46-year-old male patient presented with pruritic and pricking erythematous papules, as well as pustules on the face for 6 months.The lesions developed 1 month after the second dose of the BNT162b2 COVID-19 vaccine and improved, but the lesion recurred 1 month after the third dose of vaccine. Histopathological examination revealed moderate perivascular lymphohistiocytic and a few eosinophilic infiltrates in the upper dermis. He was treated with oral triamcinolone and doxycycline, and the lesion improved gradually over 4 months. Although its exact etiology is unclear, the immune response after COVID-19 vaccination may play a role in the onset of rosacea-like eruption. Clinicians should be aware that rosacea-like eruption are a possible cutaneous reaction after COVID-19 vaccination.

Association between Allergic Diseases and the Number of Persons per Household Using Data from the National Health and Nutrition Examination Survey / 대한피부과학회지

Background@#Atopic dermatitis (AD) and asthma are chronic allergic diseases that affect quality of life. @*Objective@#In this study, we analyzed data from the Korea National Health and Nutrition Examination Survey (KNHANES) to determine the association between allergic diseases and number of household members living with the patient. @*Methods@#This study included 20,893 participants ＞19 years of age from the KNHANES (2010∼2013). Multiple logistic regression analysis was performed to evaluate the odds ratio (OR) for presence of AD or asthma according to number of household members. @*Results@#The OR of allergic diseases including AD and/or asthma increased as the number of household members decreased in the age ＜40 group after adjustments for age, sex, smoking status, drinking status, regular physical activity, education level, income level, and stress level (1 member: adjusted OR [aOR]=2.019, 95% confidence interval [CI]=1.256∼3.245; 2 or 3 members: aOR=1.3, 95% CI=1.031∼1.64; ≥4 members: reference). And those with an allergic disease were less likely to have a spouse and had a higher stress level compared to those without. @*Conclusion@#Based on a nationwide population-based survey, this study showed that the number of household members was significantly related to rates of AD and asthma. The prevalence of allergic diseases tended to be higher in households with fewer members.

Assessment of the effect of transobturator tape surgery on women's sexual function using a validated questionnaire

OBJECTIVE: Women with pelvic floor disorders and urinary incontinence (UI) are at an increased risk of sexual dysfunction. The purpose of this study was to investigate the effect of surgery for UI on sexual function. METHODS: We retrospectively reviewed the charts of 82 women who underwent mid-urethral transobturator tape (TOT) surgery between March 2010 and December 2014. The Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire-12 (PISQ-12) were administered pre- and postoperatively. RESULTS: We observed a significant increase in the total postoperative PISQ-12 scores compared to the preoperative scores (from 27.1±7.3 to 30.5±6.8, P < 0.001). Improved sexual function was confirmed in the physical (13.3±4.5 vs. 15.8±3.5, P < 0.001) and partner-related domains (6.7±2.6 vs. 7.4±2.4, P=0.001). Coital incontinence and preoperative urinary distress inventory score were significant factors influencing postoperative sexual function in women undergoing TOT surgery for UI after adjusting for age, body mass index, menopause, and preoperative PISQ-12 score in multivariate regression analysis. CONCLUSION: TOT surgery for UI correction resulted in significant improvement in sexual function.

Risk factors and factors affecting the severity of overactive bladder symptoms in Korean women who use public health centers

OBJECTIVE: To investigate the prevalence, risk factors of overactive bladder (OAB) and the factors affecting the severity of OAB symptoms. METHODS: A total 822 interviews with women aged 18–80 years who visited public health centers were conducted between April 2014 and April 2015. The questionnaire was composed of 16 questions about urinary symptoms, 14 questions about self-treatment and the use of complementary and alternative medicine, and 21 questions about socio-demographic characteristics. The diagnostic criterion for OAB is a total OAB symptom score of 3 and more, with an urgency score of 2 or more. To know the risk factors and factors affecting the severity of OAB, the multivariate logistic regression analysis was performed. RESULTS: One hundred fifty-seven participants (19.3%) were diagnosed with OAB, of whom 10.7%, 8.1%, and 0.7% had mild, moderate, and severe OAB symptoms, respectively. In addition, the prevalence of OAB increased with age. Among all the participants, 39.1% had stress incontinence, among them 32.7% had OAB as well. The significant risk factors of OAB were identified as age, current smoking, hyperlipidemia, cardiovascular and renal disease, whereas, the factors affecting the severity of OAB were age, current smoking, and hyperlipidemia. CONCLUSION: Those who have risk factors and factors affecting severity of OAB should be educated to increase OAB awareness and act of urinary health promotion.

Predictors of Acute Postoperative Urinary Retention after Transvaginal Uterosacral Suspension Surgery

OBJECTIVES: To investigate the rate of postoperative urinary retention (POUR) and identify the risk factors for this complication in women who underwent transvaginal uterosacral suspension surgery. METHODS: A retrospective chart review was conducted for 75 women who underwent transvaginal uterosacral suspension surgery with vaginal hysterectomy, repair of cystocele, and levator myorrhaphy with/without transobturator anti-incontinence surgery. POUR was defined as a need for continuous intermittent catheterization on the third day subsequent to removal of the urethral indwelling catheter. RESULTS: Acute POUR was reported in 18 women (24.0%). Thirty-six of the 75 patients (48.0%) had undergone anti-incontinence surgery. Crude analysis revealed significant association between the following variables and the risk of POUR: hypertension, the lower average flow rate in the pressure-flow study (PFS), greater post-void residual (PVR) urine volume in PFS, and PVR >30% of the total bladder capacity (TBC) in PFS. In the logistic regression analysis, PVR >30% of the TBC in PFS was identified as the only significant predictor of POUR (odds ratio, 15.4; 95% confidence interval, 2.5–90.9; P = 0.003). CONCLUSIONS: The PVR >30% of the TBC in PFS was identified as the only predictive factor of acute POUR in women who underwent transvaginal uterosacral suspension surgery.

Comparison of sexual function between sacrocolpopexy and sacrocervicopexy

OBJECTIVE: To compare sexual function before and 12 months after between sacrocolpopexy and sacrocervicopexy. METHODS: This retrospective study examined a cohort of 55 sexually active women who underwent either supracervical hysterectomy with sacrocervicopexy (n=28) or total abdominal hysterectomy with sacrocolpopexy (n=27) for stage II to IV pelvic organ prolapse. Pelvic floor support was measured with Pelvic Organ Prolapse-Quantification examination. Pelvic floor function was measured with the Pelvic Floor Distress Inventory-Short Form 20 and sexual function was measured with Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire-Short Form 12 (PISQ-12). RESULTS: Baseline pelvic floor symptoms, demographics and PISQ-12 questionnaire scores were similar between the two groups. Overall improvements in sexual function were seen based on PISQ-12 scores in both groups, but were not statistically significant. No differences were seen in PISQ-12 scores regardless of sparing the cervix or surgical route. Responses to the PISQ-12 question of avoiding sexual intercourse because of vaginal bulging showed significant improvement in both group. No recurrences of prolapse occurred. CONCLUSION: In women with pelvic organ prolapse, sexual function after either sacrocolpopexy or sacrocervicopexy was not different. Sexual dysfunction in terms of avoidance of sexual activity because of vaginal bulging was greatly improved in both groups with statistical significance.

Factors affecting medication discontinuation in patients with overactive bladder symptoms

OBJECTIVE: To find out the factors affecting medication discontinuation in patients with overactive bladder (OAB) symptoms. METHODS: The clinical data of 125 patients with OAB symptoms who had taken antimuscarinics and behavioral therapy were retrospectively reviewed. Antimuscarinics related outcomes were evaluated by an independent observer with telephone interview. All patients were asked about duration of medication and reason of continuation or discontinuation of antimuscarinics. To determine pre-treatment factors predicting self-report discontinuation of antimuscarinics, variables of only those with P-values <0.25 on the univariate analysis were included in the Cox proportional hazard modeling. RESULTS: Mean follow-up was 39.6 months and the proportion of discontinuation of antimuscarinics was 60.0% (75/125). The mean duration of medication was 21.2 months in the continuation group and 3.3 months in the discontinuation group. The reasons of discontinuation of antimuscarinics were improved OAB symptoms (46.7%), tolerable OAB symptoms (33.3%), no change of OAB symptoms (1.3%), side-effects (8.0%) and no desire to take long-term medication (10.7%). The variables affecting remaining cumulative probability of antimuscarinics were age, history of anti-incontinence surgery or vaginal surgery, and having stress predominant urinary incontinence on urodynamic study. CONCLUSION: The lower rate of cumulative continuation of antimuscarinics encourages us to give a more detailed counseling and education to the patients with OAB symptoms before prescription. And explorations about newer agent and non-pharmacologic treatment with good efficacy and lower side-effects are needed.

Translation and linguistic validation of Korean version of short form of pelvic floor distress inventory-20, pelvic floor impact questionnaire-7

The short forms of pelvic floor distress inventory (PFDI) and pelvic floor impact questionnaire (PFIQ) are useful disease specific questionnaires evaluating symptoms, quality of life for pelvic floor disorders. The purpose is to develop linguistic validation of the PFDI-20 and PFIQ-7 questionnaires. Three types of Korean version of questionnaires have been used in four locations of University Hospitals in Korea. Each version of questionnaires was developed by forward translation and back-translation by bilingual translators and was verified by the patients with pelvic floor disorder and healthy persons. For harmonization of 3 types of questionnaires, four authors reviewed, discussed all discrepancies, incorporated and produced a new version. The multi-step processes of translation and linguistic validation of the Korean version of PFDI-20 and PFIQ-7 questionnaire were completed. Further process of validation of Korean version of these questionnaires is required.

Obstetric outcomes after laparoscopic myomectomy / 대한산부인과학회지

OBJECTIVE: To evaluate the outcomes of pregnancy after laparosocpic myomectomy. METHODS: A total of 99 cases of pregnancies after 512 cases of laparoscopic myomectomy which was performed at different 6 hospitals between 1995 and 2004 was selected. Retrospective chart review and telephone survey were performed for identifying outcomes of pregnancies, ectopic pregnancy rate, abortion rate, preterm delivery, spontaneous or cesarean delivery and presence of dangerous outcomes of uterine rupture. RESULTS: There were 20 (20.2%) spontaneous abortion, 2 (2.0%) ectopic pregnancy. Among the delivery of 77 cases, 4 (5.2%) had vaginal deliveries and 73 (94.8%) had cesarean section. No case of uterine rupture was reported. CONCLUSIONS: Outcomes of pregnancy after laparoscopic myomectomy showed safe and successful outcomes

Clinical efficiency of 50 g oral glucose challenge test, 75 g and 100 g oral glucose tolerance test for screening and diagnosis of gestational diabetes / 대한주산의학회잡지

OBJECTIVE: The purpose of this study was to compare the clinical efficiency of 75 g oral glucose tolerance test (OGTT) with those of 100 g OGTT for diagnosing gestational diabetes mellitus (GDM) after abnormal 50 g oral glucose challenge test (OGCT). METHODS: Data of 616 pregnant women delivered at Ewha Womans University Dongdaemoon hospital from January, 2003 to June, 2007 was reviewed and analyzed retrospectively. The positive diagnostic rate of GDM for the group resulted in the range of 130 and 140 mg/dl and in 140 mg/dl and higher on the 50 g OGCT group was analyzed. Pregnancy and fetal outcomes were compared for the women who showed positive results in the 75 g and 100 g OGTT. RESULTS: Of the 28 pregnant women whose results were in the range of 130 and 140 mg/dL on the 50 g OGCT, three women (10.7%) were diagnosed as GDM. Among women who showed the results of 140 mg/dL and higher, positive rate of GDM by 75 g OGTT (51.6%) was significantly higher than those by 100 g OGTT (31.6%) (p=0.047). The positive result group of 75 g and 100 g OGTT did not show significant differences in pregnancy and fetal outcomes except that BMI of 100 g OGTT positive group was more increased at early pregnancy (25.2+/-3.53 kg/m2 vs 22.9+/-3.26 kg/m2, p=0.043). CONCLUSION: 75 g OGTT may be a more convenient and useful tool in the diagnosis of GDM to protect for adverse outcomes in untreated gravidas with minimal hyperglycemia.

Agenesis of the Gallbladder

Gallbladder agenesis is a rare congenital biliary anomaly that may be associated with other biliary and extrabiliary congenital anomalies. Awareness of this condition is important because many of these patients may have vague biliary symptoms that lead to unnecessary operations. We treated a 46-year-old woman who was diagnosed with gallbladder agenesis during performance of gynecologic laparoscopic surgery. The gallbladder was not visualized by the preoperative abdominal ultrasonography, the abdominal computed tomography and the MRCP. The hepatobiliary scan revealed non-visualization of the gallbladder. Based on these imaging studies, there was a high suspicion of a sclero-atrophic gallbladder or agenesis of the gallbladder. At surgery, we carefully examined the porta hepatis and found that the gallbladder was absent. The operation involved only examination with a laparoscope. The patient has remained well and asymptomatic. It is extremely difficult to diagnose gallbladder agenesis in clinical settings; the identification of gallbladder agenesis is often an incidental finding. For cases where the gallbladder is not visualized preoperatively, a diagnostic laparoscopy can be an alternative diagnostic tool prior to performing laparotomy.

Pelvic floor muscle rehabilitation / 대한산부인과학회지

Since Dr. Kegel first reported good outcomes for pelvic floor muscle training in women with urinary incontinence this therapy has become used for women with various pelvic floor disorders. The incidence of pelvic floor disorders such as urinary incontinence and pelvic organ prolapse has been steadily increasing. Although surgery or medications are commonly used, behavioral modification and pelvic floor rehabilitation are gaining in popularity both as primary treatment and as alternatives to surgery. The goal of this article is to review the pelvic floor rehabilitation with emphasis on biofeedback and electrical stimulation and examine the evidence of effectiveness and application of pelvic floor rehabilitation.

Clinical Guidelines for Methotrexate in Conservative Treatment for Ectopic Pregnancy / 대한산부인과학회지

OBJECTIVE: To provide more useful guidelines for methotrexate (MTX) treatment in ectopic pregnancy, including patient selection, therapeutic dose, and reproductive outcome. METHODS: Retrospectively, records of 54 patients treated for ectopic pregnancy with systemic MTX were reviewed. MTX was administered 1.0 mg/kg intramuscularly, alternatively with leucovorin 0.1 mg/kg intramuscularly for up to four daily doses of each drug. Samples for beta-hCG detection were obtained on days +3, +7 after beginning of the therapy and then weekly until values were undetectable. RESULTS: 50 patients (92.6%) were treated successfully. 4 patients (7.4%) for whom MTX therapy failed, were treated surgically. The endometrial thickness significantly increased in the failed group, compared to the successful group (14.3+/-4.0 mm vs 7.0+/-2.8 mm, P=0.0001). The serum hemoglobin levels significantly changed in the failed group, compared to the successful group (2.1+/-0.9 g/dL vs 1.0+/-0.8 g/dL, P=0.044). Patients were divided into increasing group and decreasing group according to beta-hCG levels on day 0, that were higher or lower than day -2 level. The resolution time of beta-hCG between increasing group and decreasing group was significantly different (27.6+/-14.0 days vs 17.7+/-8.6 days, p=0.016). In 8 patients (15.1%), an immediate rise of beta-hCG was recorded on day 3 after MTX treatment, but on day 7, a rapid decrease was recorded. Women were treated with significantly different therapeutic dose of MTX according to initial level of serum beta-hCG (p=0.021). There were mild complications (12%). MTX treatment preserved the fallopian tube and thus preserved fertility (70%). CONCLUSION: Systemic MTX use with the dose according to initial level of serum beta-hCG is a safe and highly effective treatment in clinically stable ectopic pregnancy.

The Application of Endoscopic Surgery to Gynecologic Conditions

The advancements in optics, video technologies and endoscopic instrumentations have led to the expansion of endoscopy into the current therapeutic surgical practice of benign and malignant gynecologic conditions. So, minimally invasive and organ-preserving surgery can be performed in terms of organ-specific difficulties in the field of gynecology instead of conventional surgical techniques that require laparotomy and uterotomy. Also, the recent introduction of computer-aided instruments seems to have the potential to revolutionize endoscopic surgery. Major advantages of an endoscopic surgery include minimization of patient discomfort and analgesics requirements, a short period of hospitalization, rapid recuperation, superior cosmetics, easier intra-operative access to the pelvic floor, cul-de sac and intrauterine cavity, less blood loss and less postoperative adhesion. Today every gynecologists should have the knowledge and skill of the endoscopic surgery in order to gain great benefits from endoscopic surgery. In this article, recent advancements in the endoscopic surgery of gynecological conditions are reviewed.

The Application of Endoscopic Surgery to Gynecologic Conditions

The advancements in optics, video technologies and endoscopic instrumentations have led to the expansion of endoscopy into the current therapeutic surgical practice of benign and malignant gynecologic conditions. So, minimally invasive and organ-preserving surgery can be performed in terms of organ-specific difficulties in the field of gynecology instead of conventional surgical techniques that require laparotomy and uterotomy. Also, the recent introduction of computer-aided instruments seems to have the potential to revolutionize endoscopic surgery. Major advantages of an endoscopic surgery include minimization of patient discomfort and analgesics requirements, a short period of hospitalization, rapid recuperation, superior cosmetics, easier intra-operative access to the pelvic floor, cul-de sac and intrauterine cavity, less blood loss and less postoperative adhesion. Today every gynecologists should have the knowledge and skill of the endoscopic surgery in order to gain great benefits from endoscopic surgery. In this article, recent advancements in the endoscopic surgery of gynecological conditions are reviewed.

Guidelines for Medical Treatment of Sexually Transmitted Diseases in Gynecologic Clinics

Sexually transmitted diseases(STD) are quite common and observed more frequently in teens. The adolescents represent a group at particular risk for STD due to biological, sociocultural and psychological factors. Undetected infections may lead to unwanted sequelae, including pelvic inflammatory disease, chronic abdominal pain, tubal scarring and increased risk of ectopic pregnancy. Recently, the guidelines for the treatment of sexually transmitted disease have been developed by the Centers for Disease Control and Prevention (CDC) after consultation to a group of professionals in Atlanta during September 26~28, 2000 and published on May 10, 2002. This paper deals with the modified and simplified guidelines for STD for primary general practitions referring recommendation and reports of CDC.

The Effect of Single Estrogen and Continuous Combined Estrogen + Progestin on Lipid Profile and Bone Mineral Density in Premenopausal Hysterectomised and Natural Menopausal Women / 대한산부인과학회잡지

No abstract available.

The expression of NCAM ( Neural Cell Adhesion Molecule) in myometrium and leiomyoma / 대한산부인과학회잡지

No abstract available.

The Differential expression of matrix metalloproteinase and their tissue inhibitors in myometrium and leiomyoma / 대한산부인과학회잡지

OBJECTIVES: To determine the level of mRNA expression of various members of the matrix metalloproteinase and tissue inhibitors in uterine leiomyoma compared with unaffected myometrium. Materials & Method: 30 cases of portions of leiomyoma and myometrium were collected immediately followimg hysterectomy. Thirteen cases were from proliferative phase and seventeen were from secretory phase of menstrual cycle. The mean age was 43.7years old. The level of expression of mRNAs of interstitial collagenase, gelatinase, stromelysin, TIMP-1,-2,-3 was determined by reverse transcriptase-polymerase chain reaction(RT-PCR) and normalized to GAPDH(glyceraldehyde-3-phosphate dehydrogenase) mRNA. RESULTS: Myometrium and leiomyoma expressed all the members of above mentioned matrix metalloproteinase family and tissue inhibitors. Leiomyoma expressed a significantly higher level of stromelysin-3 during secretory phase, an extremely lower level of 92kDa gelatinase and a significantly lower level of TIMP-3. The immunohistochemical localization of TIMP-3 was smooth muscle cell and arteriole wall of myometrium and leiomyoma. CONCLUSIONS: The increased expression of stromelysin-3 in uterine leiomyoma compared with myometrium suggests that this MMP may be involved in the formation of a more fibrous extracellular matrix in leiomyoma. The extremely lower expression of 92kDa gelatinase of leiomyoma means that leiomyoma do not invade myometrium and forms a separated mass. Decreased expression of TIMP-3 of leiomyoma suggests that TIMP-3 is required for differentiation and homeostasis of extracellular matrix of normal myometrium and function as a suppressive role of tumor development

significance of serum CA-125 concentrations as tumor markers in patients with ovarian tumors / 대한산부인과학회잡지

No abstract available.