The role of laparoscopic hysterectomy (LH) in current gynecological practice has yet to be defined. Randomized trials have demonstrated that, compared to abdominal hysterectomy, LH shortens hospital stay and induces less postoperative pain and quicker recovery. Some retrospective publications it seems that complication rates have increased in LH, especially those involving the urinary system. However, a recent analysis revealed a reasonable complication rate for the procedure, compared with abdominal hysterectomy, Laparoscopic supracervical hysterectomy (LSH) is a minimally invasive procedure that was developed during the 1990s as a treatment for abnormal uterine bleeding. The literature regarding this procedure, mainly case series and retrospective comparisons, suggests that LSH results in reduced operating time and blood loss and a quicker return to normal activity, compared with laparoscopic-assisted vaginal hysterectomy (LAVH). Given the lack of appropriate randomized, controlled trials and the limitations of the existing research, the LSH's true value and appropriate clinical indications remain unknown Uterine fibroids are the most common benign tumors of the uterus. Management depends on the symptoms, location and size of the fibroids, and the patient's desire to conceive. Surgical management of uterine fibroids has changed from laparotomy to minimally invasive surgery. Advances in surgical instruments and techniques are expanding the role of laparoscopic myomectomy in well-selected ndividuals. Meticulous repair of the myometrium is essential for women considering pregnancy after laparoscopic myomectomy to minimize the risk of uterine rupture. Laparoscopic myomectomy is an appropriate alternative to abdominal myomectomy or hysterectomy.
Animals ; Female ; Humans ; Hysterectomy ; Hysterectomy, Vaginal ; Laparotomy ; Leiomyoma ; Length of Stay ; Mice ; Myometrium ; Pain, Postoperative ; Pregnancy ; Retrospective Studies ; Surgical Instruments ; Uterine Hemorrhage ; Uterine Rupture ; Uterus

OBJECTIVE: To investigate the effects of bisphenol A (BPA) on cell death pattern in neuronal development of chick embryos. MATERIALS AND METHODS: We planned to compare the cytokinetic features in the normal chick embryo and those with BPA. Fifteen eggs were divided into three GROUPS: the control group, BPA 50 microgram/g egg group and BPA 200 microgram/g egg group. Embryos were incubated for 56 hours (Hamburger & Hamilton stage 16) and then we injected BPA into embryos. The embryos were sectioned by 3 micrometer thickness at the level of wing buds and stained at 72 hours after incubation (HH stage 18). We observed cell death in the spinal cord using terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) method. RESULTS: The TUNEL-positivity markedly increased in proportion to the doses of BPA. The number of TUNEL-positive cells per section was 15.2+/-2.14 in the control group, 34.6+/-3.44 in the BPA 50 microgram/g egg group, 87.6+/-4.32 in the BPA 200 g/g egg group. Furthermore the contour of spinal cord was deformed as the doses of BPA raised. CONCLUSION: BPA causes neuronal cell death and exerts cytotoxic effect on early chick embryos. It suggests that BPA might have an effect on cytogenesis during neural tube development.
Animals ; Apoptosis ; Benzhydryl Compounds ; Cell Death ; Chick Embryo ; Eggs ; Embryonic Structures ; Neural Tube ; Neurons ; Ovum ; Phenols ; Spinal Cord ; Wings, Animal

OBJECTIVE: The purpose of this study was to evaluate the vitamin D perception level in the treatment of osteoporosis of Korean postmenopausal women. METHODS: This study investigates the perception levels of 400 postmenopausal women aged 50 and over, vitamin D supplement administration, knowledge of vitamin D nutrition, consulting and information of vitamin D and the effect of media exposure during osteoporosis management. A descriptive survey design and a convenience sample of 400 female postmenopausal patients were used. Data were collected with a questionnaire and analysed. RESULTS: Sixty-two% of the patients took supplementary drugs in addition to prescribed main anti-osteoporotic medications. As supplementary drugs, most of them took calcium (57%) and this was twice the number of people taking vitamin D. For those who failed to take the recommended vitamin D or calcium regularly, seventy-eight% of them did not understand that it is important to take regularly. And this survey showed that people do not have enough knowledge on vitamin D compared to calcium. Patients thought that vitamin D is the third most important factor, next to calcium and exercise, for managing healthy and strong bones. Findings indicated that the women displayed a low level of perception and interests in vitamin D and the importance of vitamin D in the management of osteoporosis was assessed at lower than the truth. CONCLUSION: These findings suggested that the rates of vitamin D administration of Korean postmenopausal women in the management of osteoporosis is a low level because of a low level of perception of the importance of vitamin D. Therefore the education and the informations about vitamin D are contributable to the treatment of osteoporosis.
Calcium ; Education ; Female ; Humans ; Osteoporosis* ; Surveys and Questionnaire ; Vitamin D* ; Vitamins*

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

BACKGROUND: The purpose of this study is to investigate 1) whether equol has the direct modulation on vascular tone of endothelium-denuded human uterine artery, and 2) if present, whether this equol-induced modulation of vascular tone is mediated by intracellular calcium modulation through Ca2+ & K+ channels on vascular smooth muscle cell membrane. METHODS: The uterine arteries were obtained at the time of hysterectomy from 15 women. The uterine smooth muscles were pretreated with phenylephrine, 10(-5) M & high KCl solution 70 mM. The equol at 6 different concentrations from 10(-11) to 10(-6) M were used for the evaluation of modulatory action of equol on precontracted vascular smooth. The cumulative concentration-response for equol were determined on phenylephrine-induced contractions and compared with the results without pretreatment. RESULTS: Equol 10(-11) to 10(-6) M in concentration showed relaxation effect on vascular smooth muscle contraction which was induced by phenylephrine 10(-5) M. This relaxation effect of equol was dose-dependent. Equol in same concentrations showed no significant effects on vascular smooth muscle contraction induced by high KCI solution. Phenylephrine-induced contraction was markedly reduced from 10(-7) to 10(-4) M in concentration by pretreatment of equol, but high KCI-induced contraction was not affected by pretreatment of equol. CONCLUSIONS: This vasodilatation effect of equol may be induced by calcium antagonistic action, which was mediated through antagonistic action for receptor-dependent Ca2+ channel, but not for voltage-dependent Ca2+ channel. As far as we know, this is the first report of phytoestrogen equol on vascular reactivity of human vessels.
Calcium ; Cell Membrane ; Equol ; Female ; Humans ; Hysterectomy ; Muscle, Smooth ; Muscle, Smooth, Vascular ; Phenylephrine ; Phytoestrogens ; Relaxation ; Uterine Artery* ; Vasodilation*

OBJECTIVE: To introduce the technique of laparoscopic incidental appendectomy using single loop during gynecologic laparoscopic surgery and to demonstrate the safety of it. METHODS: This was a retrospective case-controlled study of patients who did (n=52) or did not (n=52) undergo laparoscopic incidental appendectomy at the time of the same gynecologic laparoscopic surgery between March 2003 and February 2007. There was no difference in age, body mass index, hypertension, diabetes mellitus, preoperative diagnosis. RESULTS: No significant differences were found between the two groups with respect to the duration of nothing per os (1.1 days vs 1.1 days), the duration of postoperative hospital stay (5.0 days vs 4.9 days), and the postoperative complications. 42.3% of the histologic specimens were abnormal and abnormal histologic results included fibrous obliteration(21.2%), endometriosis (9.6%), serositis (5.8%) and appendicitis (5.8%). CONCLUSION: Laparoscopic incidental appendectomy using single loop during laparoscopic gynecologic surgery was not found to influence the duration of nothing per os, the duration of postoperative hospital stay, and postoperative complications, so it thought to be the safe procedure.
Appendectomy* ; Appendicitis ; Body Mass Index ; Case-Control Studies ; Diabetes Mellitus ; Diagnosis ; Endometriosis ; Female ; Gynecologic Surgical Procedures ; Humans ; Hypertension ; Laparoscopy* ; Length of Stay ; Postoperative Complications ; Retrospective Studies ; Serositis

Multiple carcinoid tumors in stomach are very rare tumors and associated with pernicious anemia, chronic atrophic gastritis and Zollinger-Ellison syndrome. These are believed to be due to hypergastrinemia, resulting in chronic stimulation of enterochromaffine-like (ECL) cells, leading to hyperplasia, metaplasia and ultimately neoplasia. The carcinoid tumor is potentially malignant, even though it may grow slowly, so the treatment of choice must be endoscopic lumpectomy or surgical gastrectomy. The prognosis depends on the site of the tumor and its size. Most carcinoid tumors are less than 1 cm in size and metastasis is uncommon but metastasis in tumors with size over 2 cm is common. A case of multiple carcinoid tumors in stomach, which was successfully removed by endoscopy, is herein reported.
Anemia, Pernicious ; Carcinoid Tumor* ; Endoscopy ; Gastrectomy ; Gastrins ; Gastritis, Atrophic ; Hyperplasia ; Mastectomy, Segmental ; Metaplasia ; Neoplasm Metastasis ; Prognosis ; Stomach* ; Zollinger-Ellison Syndrome

BACKGROUND: Circulating apolipoprotein J (ApoJ) is closely associated with insulin resistance; however, the effect of exercise on circulating ApoJ levels and the association of ApoJ with metabolic indices remain unknown. Here, we investigated whether a combined exercise can alter the circulating ApoJ level, and whether these changes are associated with metabolic indices in patients with type 2 diabetes mellitus. METHODS: Postmenopausal women with type 2 diabetes mellitus were randomly assigned into either an exercise (EXE, n=30) or control (CON, n=15) group. Participants in the EXE group were enrolled in a 12-week program consisting of a combination of aerobic and resistance exercises. At baseline, 4, 8, and 12 weeks, body composition and metabolic parameters including homeostatic model assessment of insulin resistance (HOMA-IR) and serum ApoJ levels were assessed. RESULTS: In the EXE group, ApoJ levels decreased 26.3% and 19.4%, relative to baseline, at 8 and 12 weeks, respectively. Between-group differences were significant at 8 and 12 weeks (P<0.05 and P<0.001, respectively). In the EXE group, 12 weeks of exercise resulted in significant decreases in body weight, percent body fat, and HOMA-IR indices. Concurrently, weight-adjusted appendicular skeletal muscle mass (ASM/wt) was increased in the EXE group compared with the CON group. Importantly, changes in the ApoJ level were significantly correlated with changes in ASM/wt. CONCLUSION Exercise training resulted in a significant decrease in the circulating ApoJ level, with changes in ApoJ associated with an improvement in some insulin resistance indices. These data suggest that circulating ApoJ may be a useful metabolic marker for assessing the effects of exercise on insulin resistance.

The Asian Society of Gynecologic Oncology International Workshop 2014 on gynecologic oncology was held in Asan Medical Center, Seoul, Korea on the 23rd to 24th August 2014. A total of 179 participants from 17 countries participated in the workshop, and the up-to-date findings on the management of gynecologic cancers were presented and discussed. This meeting focused on the new trends in the management of cervical cancer, fertility-sparing management of gynecologic cancers, surgical management of gynecologic cancers, and recent advances in translational research on gynecologic cancers.
Female ; Fertility Preservation/methods ; Genital Neoplasms, Female/*therapy ; Humans ; Ovarian Neoplasms/therapy ; Translational Medical Research/methods ; Uterine Cervical Neoplasms/therapy