Randomized, Double-Blind, Placebo-Controlled Trial on the Efficacy of Hyaluronidase in Preventing Perineal Trauma in Nulliparous Women

Gender affirmative care of transgender people: a single center's experience in Korea

OBJECTIVE: To investigate the clinical characteristics and medical management of transgender people in South Korea. METHODS: The electronic medical records of 54 transgender persons who had visited Soonchunhyang University Hospital from January 2016 to December 2017 for medical care were retrospectively reviewed. We identified patient demographics and gender identity-related characteristics. Moreover, we compared our hospital protocol with official guidelines. RESULTS: At the time of the medical record search, the average age of these 52 transgender persons was 27 years, and 46 (88.5%) were Korean. Ten (19.2%) persons had a mental disorder other than gender dysphoria. Gonadotropin-releasing hormone agonist, estrogen, antiandrogen agents, and testosterone were used according to the guidelines issued by the World Professional Association for Transgender Health and the Endocrine Society. Ten (19.2%) transgender persons, including 6 (22.2%) male-to-females (MTFs) and 4 (16.0%) female-to-males (FTMs), had a mental disorder other than gender dysphoria. Among persons who were administered testosterone, 3 had high triglyceride and lipoprotein cholesterol levels. Nine patients, including 6 (66.7%) MTFs and 3 (33.3%) FTMs, underwent both gonadectomy and gender affirmative surgery. Seven (43.8%) persons, including 1 (14.3%) MTF and 6 (85.7%) FTMs, underwent only gonadectomy. There was a significant difference (P=0.040) between MTFs and FTMs. CONCLUSION: Medical providers should have adequate knowledge of and experience in managing transgender persons and be familiar with the relevant guidelines and literature. Long-term follow-up examinations should also be performed.

Multiple Factors in the Second Trimester of Pregnancy on Preterm Labor Symptoms and Preterm Birth

PURPOSE: The aim of this study was to determine the influence of various factors on preterm labor symptoms (PLS) and preterm birth (PB). METHODS: This prospective cohort study included 193 women in the second stage of pregnancy. Multiple characteristics including body mass index (BMI), smoking, and pregnancy complications were collected through a self-report questionnaire. Pregnancy stress and PLS were each measured with a related scale. Cervical length and birth outcome were evaluated from medical charts. Multiple regression was used to predict PLS and logistic regression was used to predict PB. RESULTS: Multiple regression showed smoking experience, pregnancy complications and pregnancy specific stress were predictors of PLS and accounted for 19.2% of the total variation. Logistic regression showed predictors of PB to be twins (OR=13.68, CI=3.72~50.33, p25 (kg/m²) (OR=3.50, CI=1.35~9.04, p<.01) and a previous PB (OR=4.15, CI=1.07~16.03, p<.05). CONCLUSION: The results of this study show that the multiple factors affect stage II pregnant women can result in PLS or PB. And preterm labor may predict PB. These findings highlight differences in predicting variables for pretrm labor and for PB. Future research is needed to develop a screening tool to predict the risk of preterm birth in pregnant women.

Efficacy and safety of drospirenone 2 mg/17β-estradiol 1 mg hormone therapy in Korean postmenopausal women

This regulatory post-marketing surveillance study aimed to evaluate the therapeutic efficacy and safety of drospirenone (DRSP) 2 mg/estradiol (E₂) 1 mg tablet in Korean postmenopausal women. A total of 4,149 patients were enrolled and the study was conducted at 207 clinical research centers. The patients' source data was collected between November 2006 and November 2012. More than 85% of patients experienced improvement of menopausal symptoms. The most frequently reported adverse events were vaginal bleeding and breast pain; most of the women suffering from these symptoms fully recovered. The incidence of adverse event was higher in patients of younger age (20 to 39 years), in patients with concomitant diseases, previous hormone replacement therapy in medical history, those treated with DRSP 2 mg/E₂ 1 mg for shorter duration (3 years or less) and in patients using concomitant medication. In conclusion, the results from this large post-marketing surveillance study confirm the efficacy and safety of DRSP 2 mg/E₂ 1 mg tablet in Korean postmenopausal women.

Practice patterns in the management of threatened preterm labor in Korea: A multicenter retrospective study

OBJECTIVE: This study aimed to examine clinical practice patterns in the management of pregnant women admitted with threatened preterm labor (TPL) in Korea. METHODS: Data from women admitted with a diagnosis of TPL were collected from 22 hospitals. TPL was defined as regular uterine contractions with or without other symptoms such as pelvic pressure, backache, increased vaginal discharge, menstrual-like cramps, bleeding/show and cervical changes. Data on general patient information, clinical characteristics at admission, use of tocolytics, antibiotics, and corticosteroids, and pregnancy outcomes were collected using an online data collections system. RESULTS: A total of 947 women with TPL were enrolled. First-line tocolysis was administered to 822 (86.8%) patients. As a first-line tocolysis, beta-agonists were used most frequently (510/822, 62.0%), followed by magnesium sulfate (183/822, 22.3%), calcium channel blockers (91/822, 11.1%), and atosiban (38/822, 4.6%). Of the 822 women with first-line tocolysis, second-line tocolysis were required in 364 (44.3%). Of 364 with second-line, 199 had third-line tocolysis (37.4%). Antibiotics were administered to 29.9% of patients (284/947) with single (215, 22.7%), dual (26, 2.7%), and triple combinations (43, 4.5%). Corticosteroids were administered to 420 (44.4%) patients. Betamethasone was administered to 298 patients (71.0%), and dexamethasone was administered to 122 patients (29.0%). CONCLUSION: Practice patterns in the management of TPL in Korea were quite various. It is needed to develop standardized practice guidelines for TPL management.

Sclerosing stromal tumors of the ovary occurred in various ages / 대한산부인과학회지

Sclerosing stromal tumor (SST) of the ovary is a rare, benign tumor. The most common clinical symptom is menstrual irregularity. Diagnosis of SST is often made by postoperative pathologic examination. The important differential diagnoses are other sex cord stromal tumors including fibroma, thecoma and etc. We present four cases of SST of the ovary during 10 years with a brief review of the literature.

Fetal origins of adult disease / 대한산부인과학회지

Human epidemiological and animal studies show that many chronic adult disease have their antecedents in compromised fetal and early postnatal development. Developmental programming is defined as the response by the developing mammalian organism to a specific challenge during a critical time window that alters the trajectory of development with resulting persistent effects on phenotype. Each individual's phenotype is influenced by the developmental environment as much as their genes. Also, the term 'fetal origins of adult disease' was coined on the basis of the inverse association between low birth weight and blood pressure, adult-onset diabetes, coronary heart disease, and stroke seen in numerous epidemiological studies. However, it seems unlikely that birth weight is involved in causal pathways underlying theses observations, and if it were then the significance to public health of these findings is very limited because of our inability to modify birth weight to a relevant extent in humans. There has been a major focus on maternal nutrition. Important targets for future research include distinction between the effects of different pregnancy conditions, such as maternal malnutrition, preeclampsia, and maternal infection, which may have dissimilar late-life consequences. This will be a crucial step when the associations that are currently emerging will be translated into disease prevention.

A survey on the sexual behavior of adolescents in South Korea: The third survey in 2007 / 대한산부인과학회지

OBJECTIVE: The survey was conducted to improve the health of Korean adolescents and to prepare adequate teaching programs by investigating their sexual behavior. METHODS: The participants of the survey was 80,000 middle and high school students aged 13 to 18. The survey was conducted from September 1st, 2007 to September 22nd, 2007. RESULTS: 78,834 students were surveyed and 74,698 (94.8%) students responded the survey. 35,232 (47.2%) of respondents were male students and 39,466 (52.8%) of respondents were female students. 38,820 (52.0%) of respondents were middle school students, 25,051 (33.5%) of respondents were high school students and 10,827 (14.5%) of respondents were technical high school students. 5.2% of respondents experienced sexual intercourse. The average age of the first sexual intercourse was 14.2 years old. 1.0% of respondents had a sexual intercourse before they enter the middle school. The pregnancy rate was 0.3%. Among respondents who experienced sexual intercourse, the rate of the use of contraceptive methods was 38.2%. The rate of using inappropriate contraceptive methods was 21.6%. The average age of a first wet dream for boys was 13.2 years old. The average age of menarche for girls was 12.4 year old. The rate of respondents who had a sex education was 72.2%. CONCLUSION: The average age of the first wet dream and menarche had been decreased. The average age of the first sex experience among adolescents had been decreased. The rate of adolescents who experienced a sexual intercourse was increased. However, the rate of using reliable contraceptive methods was very low. Therefore, adequate sex educations including effective contraceptive methods needs to be conducted to prevent unwanted pregnancy of adolescents.

Torsion of the paratubal cyst in an adolescent female: A case report / 대한산부인과학회지

Torsion of the paratubal cyst is a rare but significant cause of acute or recurrent lower abdominal pain in adolescent females that is difficult to recognize preoperatively. Early diagnosis is very important in adolescent because of the risk of decreased fertility if it is not treated at an early stage. We report a case of torsion of the paratubal cyst that has resulted in hemorrhagic infarction of the paratubal cyst and fallopian tube in an adolescent female with brief review of literatures.

A survey of sexual behavior of teenagers in South Korea: 2006 / 대한산부인과학회지

OBJECTIVE: This research was performed to improve the health of Korean adolescents and to prepare adequate teaching programs by investigating their sexual cognition and behavior and preparing for adequate programs. METHODS: We conducted a survey of eighty thousand middle and high school students whose ages range from 13 to 18, during the period of September 1st, 2006 to October 30th, 2006. RESULTS: 78,593 people are polled and 71,404 people responded. Accordingly, the response rate was 90.0%: 52.1% (37,204) of the respondents were boys and 47.9% (34,200) were girls; 52.4% (37,420) of respondents were middle school students, 32.9% (23,500) of them were high school students, and 14.7% (10,479) of them were technical high school students. The rate of respondents who had experienced sexual relationship was 5.1%. The average age of starting sexual relationship was 14.2 year old. The rate of respondents who had experienced sexual relationship before they go to the middle school was 1.0%. The rate of pregnancy experience was 0.5%. The rate of respondents who were using a contraceptive method was 38.1%. The average boys age of having the first wet dream was 13.1 years old and girls of starting menstruation was 12.5 year old. The rate of using inappropriate contraception was 24.3%. The rate of having a sex education per a year was 62.0%. CONCLUSION: This research shows that the rate of adolescents who are experiencing sexual relationship is increasing. Besides, the age of adolescents starting sexual relationship is decreasing as their age of starting wet dream and menstruation decreases. As a result, it is strongly asserted that adequate sex education programs are indispensable to adolescents.

One case of adenomatoid tumor of uterus / 대한산부인과학회지

Adenomatoid tumor of uterus is described by Golden and Ash as a tumor that similar to adenoma but found obscured histogenesis. Adenomatoid tumor is a rare benign disease that originated from mesothelium and mostly occurred in male and rarely in female, and can be treated by simple excision of tumor because there is no recurrence or malignant change. We describe the clinical and histologic findings with references to other reported cases. We herein report a case of adenomatoid tumor of the uterus that gets an operation under clinical impression of myoma uteri.

A case of pelvic desmoplastic small round cell tumor in a old aged woman / 대한산부인과학회지

Peritoneal desmoplastic small round cell tumor is a very rare and highly aggressive neoplasm that predominantly strikes male children and young adults. It frequently presents as a large abdominal mass with widespread peritoneal involvement at diagnosis. We report one case of desmoplastic small round cell tumors in the pelvis in a old aged woman with a brief review of literature.