No abstract available.
Cell Culture Techniques* ; Chorionic Gonadotropin* ; Epidermal Growth Factor* ; Humans* ; Trophoblasts*

The surgical construction of vagina could certainlty be done by skin grafting or flaps, but it involves hospitalization, discomfort,scarring of donor area and vaginal tract, hygiene problem. The tissues of the vagina are soft and distensible and it is reasonable to assume that these same tissues could be stretched, elongated or dilated with gradual external pressure. So, we performed the expansion of vaginal lining by self designed set of graduated dilators. The patients was a 27-years-old female whose chief complaint is amenorrhea and incapability to engage in sexual intercourse. On physical examination, this patients had a feminine figure with a normal vulva but only a vaginal dimple was observed. The patient was educated to carry out the mechanical dilation of this dimply by pressure 15 minutes twice a day. In the evening, with insertion of a dilator, the patient was asked to sit on a bicycle chair for 10 minutes. After 8 weeks, the overall outcome of vaginoplasty was successful. The vaginal tract was 8 cm in length and the largest vaginal speculum could be passed into vagina. The patient was able to engage in sexual intercourse without lubrication. The progressive dilatation of vaginal lining is non-invasive and probably the simplest way to treat the patients with congential vaginal atresia. So we recommend this method as the first treatment strategy before surgery.
Amenorrhea ; Coitus ; Dilatation* ; Female ; Hospitalization ; Humans ; Hygiene ; Lubrication ; Physical Examination ; Skin Transplantation ; Surgical Instruments ; Tissue Donors ; Vagina ; Vulva

PURPOSE: This study was done to identify the experience of health care services by foreign residents in Korea. METHOD: Participants were 12 foreigners from China, North America, and Japan. Qualitative data were collected using three focus group interviews and analyzed with qualitative content analysis. RESULTS: The participants' experience of health services was categorized as 21 sub-categories, 11 categories and three main categories. The main categories were 'Quality of health care', 'Health care personnel', and 'Health care system and infrastructure'. The main category of 'Quality of health care' included three categories, 'Health care personnel' included another four categories, and 'Health care system and infrastructure' included the remaining four categories. The participants reported positive experiences such as favorable feelings and satisfaction particularly, with the high quality of health care but also negative experiences such as apprehension, distrust, difficulties, and inconvenience in the health care service in Korea. CONCLUSIONS: The results of this study can be helpful in the development of strategies to improve health care services for foreigners by providing fundamental information about the foreign residents' experience of health care services in Korea from their perspectives.
China ; Delivery of Health Care ; Emigrants and Immigrants ; Focus Groups ; Health Services ; Humans ; Japan ; Korea ; North America ; Quality of Health Care

Plasma renin activity (ORA) was determined by radioimmunoassay in 55 normal controls and 121 hypertensive patients in basal state and after double stimulation with furosemide administration and upright posture of 4 hrs. The results were obtained as follows, 1) Mean value of PRA of normal control was 2.2+/-1.41ng/ml/hr in basal state and 2.9+/-1.39ng/ml/hr after double stimulation, respectively. The latter was elevated significantly as compaired to the former. 2) PRA in males was significantly higher than in females, and PRA tend to be decreased as age become old. 3) Normal value of PRA after double stimulation was ranged from 1.0 to 5.0 ng/ml/hr. Of total 121 hypertensive patients(55 males and 66 females), PRA was low in 33 cases(27.3%), normal in 77 cases (63.6%), and high in 11 cases(9.1%). 4) Of 55 male hypertensive patients, PRA was low in 13 cases(23.6%), normal in 35 cases (63.7%), and high in 7 cases(12.7%). Of 66 female hypertensive patients,, PRA was low in 20 cases (30.3%), normal in 42 cases(63.6%), and high in 4 cases(6.1%). High renin group was observed more frequently in male hypertensive patients than in female hypertensive patients, while low renin group more frequently in famale than in male patients. 5) Low renin group was observed more frequently in older age group than in younger age group, while high renin group more frequently in younger age than in older age group.
Female ; Furosemide ; Humans ; Hypertension* ; Korea* ; Male ; Plasma* ; Posture ; Radioimmunoassay ; Reference Values ; Renin*

Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a rare congenital disorder characterized by the congenital absence or hypoplasia of the uterus and the upper two thirds of the vagina due to mullerian duct malformation during embryogenesis. MRKH syndrome usually presents as primary amenorrhea in adolescence in females showing normal development of secondary sexual characteristics and a normal 46, XX karyotype. For this reason, MRKH syndrome usually remains undiagnosed until primary amenorrhea or difficulty in sexual intercourse occurs. In this study, a case of MRKH syndrome diagnosed in a child with idiopathic precocious puberty is reported.
Abnormalities, Multiple ; Adolescent ; Amenorrhea ; Child ; Coitus ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Embryonic Development ; Female ; Humans ; Karyotype ; Kidney ; Mullerian Ducts ; Pregnancy ; Puberty, Precocious ; Somites ; Spine ; Uterus ; Vagina

Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a rare congenital disorder characterized by the congenital absence or hypoplasia of the uterus and the upper two thirds of the vagina due to mullerian duct malformation during embryogenesis. MRKH syndrome usually presents as primary amenorrhea in adolescence in females showing normal development of secondary sexual characteristics and a normal 46, XX karyotype. For this reason, MRKH syndrome usually remains undiagnosed until primary amenorrhea or difficulty in sexual intercourse occurs. In this study, a case of MRKH syndrome diagnosed in a child with idiopathic precocious puberty is reported.
Abnormalities, Multiple ; Adolescent ; Amenorrhea ; Child ; Coitus ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Embryonic Development ; Female ; Humans ; Karyotype ; Kidney ; Mullerian Ducts ; Pregnancy ; Puberty, Precocious ; Somites ; Spine ; Uterus ; Vagina

Prolapse of the fallopian tube into the vaginal vault after hysterectomy is a rare phenomenon and it occurs more frequently after vaginal hysterectomy than abdominal hysterectomy. The exact incidence of tubal prolapse is unknown, because most of cases remain undiagnosed and may resolve before detection. The tubal prolapse may be suspected when granulation tissue or tender friable tissue are detected in vaginal cuff in women complaining lower abdominal pain, dysparenunia, vaginal discharge, or postcoital spotting. The definitive diagnosis of fallopian tube prolapse is made only by histologic confirmation. Reported methods of treatment have included transvaginal excision or transabdominal excision, cautery, and combined vaginal and laparoscopic salpingectomy. We experienced a case of fallopian tube prolapse after abdominal hysterectomy in a 40-year-old woman. We present this case with a brief review of the literature.
Abdominal Pain ; Adult ; Cautery ; Diagnosis ; Fallopian Tubes* ; Female ; Granulation Tissue ; Humans ; Hysterectomy* ; Hysterectomy, Vaginal ; Incidence ; Metrorrhagia ; Prolapse* ; Salpingectomy ; Vaginal Discharge

OBJECTIVE: Reduced tumor cell adhesion is associated with invasive growth and unfavorable prognosis. In endometrial carcinoma, the prognostic impact of adhesion marker such as E-cadherin is partly known. The purpose of this study is to investigate the correlation of the expression and the mutation of E-cadherin in endometrioid endometrial adenocarcinomas and endometrial hyperplasias and to correlate their results with various clinicopathological factors. METHODS: The expression of E-cadherin by using immunohistochemical staining (IHC) and the mutation of E-cadherin gene by using polymerase chain reaction-single stranded conformational polymorphism (PCR-SSCP) and sequencing were performed in tissues of 20 endometrial adenocarcinomas and 30 endometrial hyperplasias. The results were compared with previously known prognostic factors such as the stage, tumor grade and lymph node metastasis. RESULTS: Decreased expression of E-cadherin was detected in 13 of 30 (43.3%) endometrial carcinomas and in 1 of 20 (5%) endometrial hyperplasias (P=0.009). There was no statistical significance of the mutation of E-cadherin gene in between the endometrial carcinomas and endometrial hyperplasias (6.7%: 0%) (P=0.06). The incidence of the expression loss of E-cadherin in endometrial carcinomas also showed significantly higher with tumor grade 3, tumor stage above Ic or lymph nodal metastasis (P=0.01, P=0.02, P=0.03). CONCLUSION: Decreased expression of E-cadherin was detected significantly higher in endometrial carcinomas than endometrial hyperplasias. And the incidence of decreased expression of E-cadherin was more frequent in advanced stage, high histopathologic grade, and lymph nodal metasis. The mutation of E-cadherin gene was detected in only 2 cases. These results suggests that the expression of E-cadherin seems to be important in endometrial carcinomas and associated with aggressive subgroups. But the mutation of E-cadherin gene would not be related to endometrial carcinomas.
Adenocarcinoma ; Cadherins ; Cell Adhesion ; Endometrial Hyperplasia ; Endometrial Neoplasms ; Female ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis

OBJECTIVES: To evaluate the spectrum of hysteroscopic surgery to be extended. METHODS: Forty-three women who underwent hysteroscopic procedures with Urione(R) solution or normal saline as distension media between March 2001 and March 2009 were randomized. The clinical characteristics, laboratory data, and post-operative results were retrospectively analyzed. RESULTS: The following hysteroscopic procedures were performed: endometrial biopsy, 26; endometrial polypectomy, 8; myomectomy, 7; ablation for dysfunctional uterine bleeding and endometrial hyperplasia, 1; and excision of an endometrial mass, 1. The mean size of the myomas was 3.2 cm. The average duration of hospitalization was 2 days. The average change in hemoglobin was 1.1 g/dl. The mean operative time was 36 minutes. CONCLUSION: The indications for hysteroscopic procedures can be extended. Pure intramural myomas, submucosal myomas, endometrial polyps, adenomyosis, endometrial hyperplasia, hydrometra, and abnormal uterine bleeding can be treated via a hysteroscope. Intra-operative transabdominal ultrasonographic guidance can be helpful during hysteroscopic procedures, and reduces the complication and morbidity rates.
Adenomyosis ; Biopsy ; Endometrial Hyperplasia ; Female ; Hemoglobins ; Hospitalization ; Humans ; Hysteroscopes ; Hysteroscopy ; Menopause ; Metrorrhagia ; Myoma ; Operative Time ; Polyps ; Retrospective Studies ; Uterine Hemorrhage

OBJECTIVE: The incidence of endometrial cancer is increasing. We would like to report our institution's clinical data of endometrioid adenocarcinoma (EC) which is the most frequent type. METHODS: From 1998 to 2009, patients' clinical data were reviewed through medical records, retrospectively. RESULTS: For 11 years, there were 96 patients with EC. The average age was 51.1 years old and mean follow duration was 36.6 months. There were 73 patients with stage I, 10 patients with stage II, and 12 patients with stage III. 42 patients were treated by operation only and 46 patients were treated by operation and adjuvant radiotherapy. Among 95 patients who underwent operations, 32 patients did not get lymph node removal and 63 did, and 10 patients had malignant cells at the lymph nodes removed. 6 patients died of EC, 1 with stage I, 3 with stage II and 1 with stage III. CONCLUSION: This study had retrospective limitation but could show the profile of 96 patients with EC.
Adenocarcinoma ; Carcinoma, Endometrioid ; Endometrial Neoplasms ; Female ; Humans ; Incidence ; Lymph Nodes ; Medical Records ; Radiotherapy, Adjuvant ; Retrospective Studies