OBJECTIVE: According to an analysis of data from the Korean Red Cross in 2007, the blood deficiency rate in Korea is approximately 22%, which is the highest level worldwide. To overcome a deficiency in the blood supply, we performed education about directed blood donation and transfusion. METHODS: We provided education about direct blood donation and transfusion to 64 high-risk pregnancies of all deliveries in our hospital between March 2008 and September 2008. After providing education, we administered a questionnaire about the recognition of direct blood donation and transfusion. We surveyed 50 cases of our obstetricians, gynecologists, and nurses about satisfaction of directed blood donation. RESULTS: The mean age was 31.5+/-4.4 years (range, 24~42 years; median, 30 years), the mean gravidity was 2.3+/-1.5, and the mean gestational age was 37.4+/-2.9 weeks. Eleven gravidas performed direct blood donation, and six women received direct blood donations. Thirteen units of directed blood donations remained after transfer to other patients. After providing education, we administered a questionnaire to gravidas, doctors and nurses; 52.8% and 71.0% were generally satisfied based on questions about recognition of direct blood donation, respectively. CONCLUSION: Our data demonstrates that education about direct blood donation is cost effective and helpful in supplying blood in high-risk pregnancies.
Blood Donors ; Blood Transfusion ; Compliance ; Female ; Gestational Age ; Gravidity ; Humans ; Korea ; Pregnancy, High-Risk ; Surveys and Questionnaire ; Red Cross

Heavy menstrual bleeding (HMB) is a common problem in primary care clinic of gynecology. HMB could cause adverse effect on the quality of life of many women. This guideline will provide evidence based information concerning diagnosis and management of HMB. Constructive dialogue should allow patients to be able to trust the advice given by their practitioner as they will be confident that they have and will be able to use it to inform this decision-making process. This guideline has been developed with the aim of providing guidance on HMB. The effectiveness of the various treatments as well as their risks and benefits are discussed in relation to their use in the treatment of HMB. We wish the information contained in this guideline will help clinicians reach a reasonable and beneficial decision with the latest information.
Female ; Gynecology ; Hemorrhage ; Humans ; Menorrhagia ; Primary Health Care ; Quality of Life ; Risk Assessment

The ectopic ovary is a rarely reported gynecologic entity. A variety of synonymous terms have been used to describe this condition, such as supernumerary ovary, accessory ovary, and ovarian implant syndrome. The etiology of ectopic ovary is poorly understood. The ectopic ovaries may occur in two ways. First, in the embryonic theories, they are believed to result from abnormal separation of a small portion of the developing and migrating ovarian primordium. Second, the accessory ovary can occur from acquired conditions such as inflammation and operations. In this report, we describe a case of the ectopic ovary with a mature cystic teratoma autoamputated into the cul-de-sac and subsequently diagnosed by laparoscopy.
Female ; Inflammation ; Laparoscopy ; Ovary ; Teratoma

Iatrogenic endometriosis and leiomyoma are rare complication of laparoscopic subtotal hysterectomy. I experienced a case of pelvic endometriosis and leiomyoma concurrently arising after laparoscopic subtotal hysterectomy 2 years ago. The patient was a 43-year-old woman, and her chief complaint was palpable mass with pelvic pain in pelvis. Contrast-enhanced computed tomography image showed multiple well enhanced masses. She underwent laparoscopic surgery which revealed pelvic endometriosis and leiomyomas. The solid masses in cul-de-sac and on the surface of rectum were revealed endometriosis. The solid masses on the surface of anterior abdominal wall and descending colon were revealed leiomyoma. Implantation of viable endometrial and leiomyoma tissues could occur during uterine morcellation at time of laparoscopic subtotal hysterectomy in some patients. Vigorous irrigation and meticulous inspection should be performed.
Abdominal Wall ; Adult ; Colon, Descending ; Endometriosis ; Female ; Humans ; Hysterectomy ; Laparoscopy ; Leiomyoma ; Myoma ; Pelvic Pain ; Pelvis ; Rectum

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.
Diagnosis, Differential ; Female ; Fibroma ; Ovary ; Sex Cord-Gonadal Stromal Tumors ; Thecoma

About 20~30% of benign or malignant tumors of ovarian origin arise from embryonic cells, and only 3% represent malignancy. But under age of 20, 70% of ovarian tumors arise from embryonic cells, and over 1/3 of them are malignant tumors. Over all the ovarian tumors arising from embryonic cells, immature teratoma is germ cell tumor, components include immature tissues and cells derived from ectoderm, mesoderm, and endomermal origins. Most of the immature tissues are from neuroectodermal origins. The immature teratoma of the ovary is a rare tumor, representing less than 1% of all ovarian neoplasm. These tumors typically present in young age woman (mean age 10~20 years) with pelvic and abdominal pain. Nowadays newly developed combination chemotherapeutic agents such as bleomycin, etoposide, cisplatin give us great survival and disease free prognosis than before. We have experienced two cases of immature teratoma so we report them with a brief review of concerned literatures.
Abdominal Pain ; Bleomycin ; Cisplatin ; Ectoderm ; Etoposide ; Female ; Humans ; Mesoderm ; Neoplasms, Germ Cell and Embryonal ; Neural Plate ; Ovarian Neoplasms ; Ovary ; Prognosis ; Teratoma

OBJECTIVE: To compare the clinical results between laparoscopic assisted vaginal hysterectomy (LAVH) and laparoscopic supracervical hysterectomy (LSH) in women with uterine leiomyoma. METHODS: One hundred four women underwent laparoscopic hysterectomy for the treatment of uterine leiomyoma between July 2008 and December 2009. A total of 60 women decided to undergo complete hysterectomy with removal of uterine cervix (LAVH group) and 44 women wished to preserve the uterine cervix (LSH group). Outcome measures including patient's characteristics, operating time, blood loss, rate of complications, were assessed and compared between groups. RESULTS: The women in the LAVH group were significantly older as compared with the LSH group, 45.16+/-0.84 years versus 42.41+/-0.62 years respectively. There were no significant differences in patient's characteristics (body mass index, parity, prior surgery) between the two groups. The mean operating time was 64.07+/-2.37 min. for LAVH group and 69.76+/-2.01 min. for LSH group; the mean hemoglobin change was 1.62+/-0.13 g/dL for LAVH group, 1.83+/-0.14 g/dL for LSH group, no significant differences were noted between two groups respect to the mean operating time and the mean hemoglobin change. There is no post-operative complications in both LAVH and LSH group. CONCLUSION: Based on our results, in women with uterine leiomyoma, LAVH and LSH seem to be the preferred hysterectomy techniques. The mean age was younger in LSH group, but did not appear to offer any significant benefits over LAVH. LAVH proved to be a valid alternative to LSH, and appropriate method for laparoscopic hysterectomy.
Cervix Uteri ; Female ; Hemoglobins ; Humans ; Hysterectomy ; Hysterectomy, Vaginal ; Leiomyoma ; Outcome Assessment (Health Care) ; Parity

OBJECTIVE: This study aims to survey the change of comsumption of hormone therapy (HT) before and after publication of Women's Health Initiative Study(WHI) result in Korea from 2000 to 2009. METHODS: Data from Intercontinental Marketing Services were used to analyze and ten years of hormone consumption from 2000 to 2009 was expressed in terms of hormone sales amount (Korean won, KRW, 1 dollar=1,100 won). Total hormone consisted of Estrogen (ET), Estrogen/Progestogen (EPT), and Tibolone. To identify changes in total hormone consumption, the cumulative growth rate was based on the sales in 2002. RESULTS: After publication of WHI result in 2002, HT consumption had been continuously decreased by 39% from 51.1 billion (bn) KRW in 2002 to 31.4 bn KRW in 2006. From 2007 to 2009, HT consumption has been slightly increased to 3.56 bn KRW. The decreased consumption of HT is mainly due to decrease of ET/EPT comsumption by 49%. Tibolone consumption was decreased by 25% during next 2years after WHI publication, but thereafter gradually increased over pre-WHI publication level in 2009. The proportion of consumption of low dosage regimen was markedly increased from 3.5% in 2002 to 41.8% in 2009. CONCLUSION: The total hormone consumption was markedly decreased after WHI. Low dosage regimen consumption was increased, comprising 3.5~41.8% of total EPT consumption. Tibolone consumption was transiently decreased during 2 years after WHI publication, but thereafter increased gradually and reached over the level of pre-WHI publication in 2009. We expect that low-dosage regimen of HT and tibolone will be more widely used. An individual-based treatment approach is essential in assessing the appropriateness of initiating hormone replacement therapy.
Commerce ; Estrogens ; Female ; Hormone Replacement Therapy ; Humans ; Korea ; Marketing ; Menopause ; Norpregnenes ; Publications ; Women's Health

OBJECTIVE: The aim of this study is to comparing the prevalence and correlationships between human papillomavirus (HPV) and Chlamydia trachomatis (CT) infection in cervical samples among women with abnormal cervical cytology. METHODS: This study was included three hundred seventy four patients with a abnormal liquid-based cytology in Dankook University hospital. All of them underwent HPV DNA test and CT analysis with polymerase chain reaction. All patients also went through colposcopic directed cervical biopsies or Loop Electrosurgical Excision Procedure, conization. The histo-pathologic results were classified as normal, cervical intraepithelial neoplasia (CIN) 1, CIN 2, CIN 3 and carcinoma in situ (CIS). RESULTS: Abnormal liquid-based cytology patients were pathologically proven to have CIN. Among 374 patients, the number of within normal limits (chronic cervicitis) and koilocytosis was 186 cases (49.7%), CIN 1, 64 cases (17.1%), CIN 2, 16 cases (4.3%) CIN 3, 55 cases (14.7%), and CIS, 53 cases (14.2%). HPV DNA positive patients were 235 cases and HPV DNA negative patients were 139 cases. The impact of CT infection seems not to interfere with the development or even the progression of CIN. Thirty one patients had positive infection of CT (8.3%) and 343 patients were negative infection of CT (91.7%). Both HPV and CT positive infected patients were 25 cases (6.7%) in abnormal cytologic women. The correlation between HPV and CT DNA positive among women with abnormal cytology was statistically significant. (P=0.022) CONCLUSION: This study suggests that CT infection is associated with HPV infection, but the clinical significance of the association between CT and HPV infection remains to be elucidated.
Biopsy ; Carcinoma in Situ ; Cervical Intraepithelial Neoplasia ; Chlamydia ; Chlamydia trachomatis ; Conization ; DNA ; Female ; Human Papillomavirus DNA Tests ; Humans ; Polymerase Chain Reaction ; Prevalence

OBJECTIVE: The purpose of this study was to investigate the treatment effects of a topical application of 5-aminolevulinic acid (5-ALA) for photodynamic therapy (PDT) to treat cervical cancer. METHODS: We first investigated the effects of 5-ALA cream according to application time. And to find the effective 5-ALA concentration and the distribution times in vivo, 20% 5-ALA cream was topically applied to the tumor of the nude mouse. We then observed the distribution of 5-ALA via fluorescence measurement with using a 532 nm diode laser. 25 nude mice were divided into Control, ALA, Laser, and PDT group. To evaluate the PDT effect at cancer lesion, we applied 20% 5-ALA cream to the tumor by the same method, and the PDT was done by using a 632 nm diode laser at the time of the peak level of fluorescence. We checked the changes of the volume of cancer for 30 days, and then biopsy was done. RESULTS: The effective post-irradiation time after topical ALA application was 9 hours. In the PDT group, 40% (4/10) of the mice showed decreased tumor size. CONCLUSION: The maximum PpIX fluorescence at 9 hours after local applicationof 5-ALA cream was checked. And PDT group did not show any statistical difference than control group in the growth of tumor size than control group. However responding cases (4/10) of PDT group showed the meaningful decrease of tumor size than control group (P<0.05).
Animals ; Biopsy ; Fluorescence ; Lasers, Semiconductor ; Mice ; Mice, Nude ; Photochemotherapy ; Protoporphyrins ; Triazenes ; Uterine Cervical Neoplasms