Background: This study analyzed common gynecologic problems among Korean patients younger than ten years. Methods: We performed a retrospective analysis of medical records of patients younger than ten years who visited the Pediatric and Adolescent Gynecology Clinic at Samsung Medical Center between 1995 and 2020. Results: Among the 6,605 patients who visited the Pediatric and Adolescent Gynecology Clinic, data from 642 patients younger than ten years were analyzed in this study. The most common chief complaint was genital anomalies, followed by increased vaginal discharge and abnormal findings on clinical examinations. The most common disease entity was agglutination of the labia minora, which was commonly discovered incidentally during routine screenings. Vulvovaginitis, the second most common disease, was identified by symptoms of vaginal discharge, pruritus, and vaginal spotting. Neoplasm, issues with vaginal bleeding, and “other causes” were additional categories of gynecologic problems.245 patients (38.2%) were referred from primary care sources, 175 patients (27.4%) sought care directly at the clinic, 169 patients (26.3%) were referrals from the institution’s pediatric department, and the remainder were referrals from other departments. Conclusion This study provides information about the gynecologic problems most frequently encountered in pediatric patients. The study provides helpful insight for primary care physicians into the proper management and timing of referrals for these gynecologic problems of pediatric patients.

Mature cystic teratomas of the ovary (MCT) are usually observed in women of reproductive age with the most dreadful complication being malignant transformation which occurs in approximately 1% to 3% of MCTs. In this case report, we present a patient with squamous cell carcinoma which developed from a MCT during pregnancy. The patient was treated conservatively without adjuvant chemotherapy and was followed without evidence of disease for more than 60 months using conventional tools as well as positron emission tomography-computed tomography following the initial surgery. We report this case along with the review of literature.
Carcinoma, Squamous Cell ; Chemotherapy, Adjuvant ; Dermoid Cyst ; Electrons ; Female ; Humans ; Ovary ; Pregnancy ; Teratoma

BACKGROUND: Intra-operative application of continuous hyperthermic peritoneal perfusion (CHPP) in advanced cancer has been introduced as an effective and safe method to lessen the complication and enhance the effectiveness of its treatment. But CHPP induced acute change of body temperature and intra-abdominal pressure would produce various abnormal physiologic response. Now, we investigated to evaluate and understand the trend of changes of cardiac and oxygen parameters during CHPP. METHODS: Closed peritoneal irrigation was done with perfusate at temperature 47oC for 90 min under general anesthesia. Cardiac and oxygen parameters were measured at 10 min before CHPP, 30, 60, 90 min after the initiation of CHPP, 30 min after the end of CHPP with Swan-Ganz catheter application. RESULTS: Hemodynamic parameters; Systemic vascular resistance index and mean arterial pressure were decreased trend during CHPP. Pulmonary capillary wedge pressure and cardiac index were increased during CHPP. Oxygen parameters; AaDO2 and shunt fraction were increased during CHPP and O2 index were decreased during CHPP. Oxygen balance; O2 consumption and delivery increased during CHPP. CONCLUSIONS: We confirmed that systemic oxygen consumption and delivery were increased during CHPP but AaDO2 and shunt fraction were increased which could decrease systemic oxygen delivery. We should need more careful monitoring and proper treatment for maintaining stable hemodynamics and systemic oxygen balance during and after CHPP.
Anesthesia, General ; Arterial Pressure ; Body Temperature ; Catheters ; Hemodynamics ; Oxygen Consumption ; Oxygen* ; Perfusion* ; Peritoneal Lavage ; Pulmonary Wedge Pressure ; Vascular Resistance

Loss of heterozygosity (LOH) has been used to detect deleted regions of a specific chromosome in cancer cells. LOH on chromosome 16q has been reported to occur frequently in progressed hepatocellular carcinoma (HCC). Liver tissues from 37 Korean HCC patients were analyzed for LOH by using 25 polymorphic microsatellite markers distributed along 16q. Out of the 37 HCC patients studied, 21 patients (56.8%) showed LOH in various regions of 16q with at least one polymorphic marker. Puring the analysis of these 21 LOH cases, 6 patients showed interstitial LOHs in which the boundary of the LOH region was defined. With two rounds of LOH analysis, five commonly occurring interstitial LOH regions were identified; 16q21-22.1, 16q22.2 - 22.3, 16q22.3, 16q23.2 and 16q23.3 - 24.1. Among the five LOH regions the 16q23.3 - 24.1 region has been reported to be related with chromosome instability. A complete physical map, which covers the 3.2 Mb region of 16q23.3 - 24.1 (D16S402 and D16S486), was constructed to identify novel candidate tumor suppressor genes. We provide the minimally tiling path map consisting of 28 BAC clones. There was one gap between NT_10422.11 and NT_019609.9 of the human genome sequence contig (NCBI sequence build 33, April 29, 2003). This gap can be filled by sequencing the R-1425M20 clone which bridges these sequence contigs.
Carcinoma, Hepatocellular ; Chromosomal Instability ; Clone Cells ; Genes, Tumor Suppressor ; Genome, Human ; Humans ; Liver ; Loss of Heterozygosity ; Microsatellite Repeats

Meralgia paresthetica (MP) is a painful mononeuropathy of the lateral femoral cutaneouse nerve (LFCN) characterized by localized symptoms of numbness, tingling, pain and paresthesia along the anterolateral thigh area. L4 and L5 radiculopathy is set of symptoms that include sharp, burning or shooting pain, which is usually localized to anterolateral leg area and along the dermatomal distribution. When symptoms of MP and lumbar disc disease occur together it is not easy to diagnose MP. We report a case of synchronous post-traumatic MP and radiculopathy due to intervertebral disc herniation at L3–4 and 4–5. A 59-year-old male patient was admitted to the emergency room with symptoms of low back pain with left severe L4, L5 radiculopathy. This patient also complained of numbness and paresthesia in the left anterolateral thigh. After detailed history taking and lateral femoral cutaneouse nerve block, he was diagnosed with MP.
Burns ; Emergency Service, Hospital ; Humans ; Hypesthesia ; Intervertebral Disc ; Leg* ; Low Back Pain ; Male ; Middle Aged ; Mononeuropathies ; Nerve Block ; Paresthesia ; Radiculopathy* ; Thigh

BACKGROUND: The therapeutic effect of morphine on neuropathic pain states was controversial, but there are some reports that systemic morphine reduced pain. Recently, many investigators have reported that locally administered morphine alleviated pain in local inflammatory pain model. Therefore, we designed this study to evaluate the peripheral effect of morphine and its antagonism by naloxone in rats experiencing neuropathic pain. METHODS: Neuropathic pain was produced by tightly ligating the left 5 th and 6 th lumbar spinal nerves of male Spraw-Dawley rats. To evaluate the systemic effect, morphine 200 microgram was injected into the unaffected right paw. Morphine 50, 100 and, 200 microgram were injected into the affected left paw. Naloxone 5, 10 and 20 microgram were injected into the affected left paw ten minutes before morphine 200 microgram was injected into the affected left paw. Before and after drug injection, mechanical allodynia was quantified by the foot withdrawal frequency to von Frey filaments of 5.50 g or 1.48 g, applied to the affected left paw. RESULTS: Morphine 200 g injected into the unaffected right paw did not affect the foot withdrawal frequency on the affected left paw. Morphine 100 and 200 microgram decreased the foot withdrawal frequency. In rats with morphine 200 microgram injected into the left paw, naloxone 5, 10, and 20 microgram increased foot withdrawal frequency. Conclusion: These data represented that morphine injected into the affected paw dose-relatedly reduced mechanical allodynia via peripheral effect and pretreatment of naloxone significantly antagonized the morphine effect.
Animals ; Foot ; Humans ; Hyperalgesia* ; Male ; Models, Animal* ; Morphine* ; Naloxone ; Neuralgia* ; Rats* ; Research Personnel ; Spinal Nerves

STUDY DESIGN: In vitro experimental study. OBJECTIVES: To examine the cellular proliferation, synthetic activity and phenotypical expression of intervertebral disc (IVD) cells seeded on types I and II atelocollagen scaffolds, with the stimulation of TGF-beta1 and BMP-2. SUMMARY OF LITERATURE REVIEW: Recently, tissue engineering is regarded as a new experimental technique for the biological treatment of degenerative IVD diseases, and has been highlighted as a promising technique for the regeneration of tissues and organs in the human body. Research on cell transplantation in artificial scaffolds has provided that the conditions for tissue engineering have to be equilibrated, including the cell viability and proliferation, maintenance of characteristic phenotype, suitable scaffolds in organisms and biologically stimulated growth factor. MATERIAL AND METHOD: Lumbar IVD cells were harvested from 10 New Zealand white rabbits, with the nucleus pulposus cells isolated by sequential enzymatic digestion. Each of 1% types I and II atelocollagen dispersions were poured into a 96-well plate (diameter 5 mm), frozen at -70 degrees C, and then lyophilized at -50 degrees C. Fabricated porous collagen matrices were made using the cross-linking method. Cell suspensions were imbibed by surface tension into a scaffold consisting of atelocollagen. The cell cultured scaffolds were then treated with TGF-beta1 (10 ng/ml) or BMP-2 (100 ng/ml) or both. After 1 and 2 week culture periods, the DNA synthesis was measured by [3H] thymidine incorporation, and newly synthesized proteoglycan by incorporation of [35S] sulphate. Reverse transcription-polymerase chain reactions for the mRNA expressions of type I and II collagen, aggrecan and osteocalcin were performed. The inner morphology of the scaffolds was determined by scanning electron microscopy (SEM). RESULTS: The IVD cultures in collagen type II with TGF-beta1 demonstrated an increase in proteoglycan synthesis and up regulation of aggrecan and types I and II collagen mRNA expressions compared to the control. IVD cultures in the type I atelocollagen scaffold with growth factors exhibited an increase in DNA synthesis and up regulation of the type II atelocollagen mRNA expression. With all combinations of growth factor, the IVD cultures in types I and II atelocollagen scaffolds showed no up regulation of the osteocalcin mRNA expression. Furthermore, there was no synergistic effect of TGF-beta1 and BMP-2 in the matrix synthesis or for the mRNA expression of the matrix components. CONCLUSIONS: Nucleus pulposus cells from rabbit were viable in atelocollagen types I and II atelocollagen scaffolds. The type I atelocollagen scaffold was suitable for cell proliferation, but the type II atelocollagen scaffold was more suitable for extracellular matrix synthesis. The IVD cells in both scaffolds were biologically responsive to growth factors. Taken together, nucleus pulposus cells in atelocollagen scaffolds, with anabolic growth factors, provide a mechanism for tissue engineering of IVD cells.
Aggrecans ; Cell Proliferation ; Cell Survival ; Cell Transplantation ; Collagen ; Collagen Type II ; Digestion ; DNA ; Extracellular Matrix ; Human Body ; Intercellular Signaling Peptides and Proteins* ; Intervertebral Disc* ; Microscopy, Electron, Scanning ; Osteocalcin ; Phenotype ; Proteoglycans ; Rabbits ; Regeneration ; RNA, Messenger ; Surface Tension ; Suspensions ; Thymidine ; Tissue Engineering ; Transforming Growth Factor beta1 ; Transplants ; Up-Regulation

STUDY DESIGN: In vitro experimental study. OBJECTIVES: To examine the cellular proliferation, synthetic activity and phenotypical expression of intervertebral disc (IVD) cells seeded on types I and II atelocollagen scaffolds, with the stimulation of TGF-beta1 and BMP-2. SUMMARY OF LITERATURE REVIEW: Recently, tissue engineering is regarded as a new experimental technique for the biological treatment of degenerative IVD diseases, and has been highlighted as a promising technique for the regeneration of tissues and organs in the human body. Research on cell transplantation in artificial scaffolds has provided that the conditions for tissue engineering have to be equilibrated, including the cell viability and proliferation, maintenance of characteristic phenotype, suitable scaffolds in organisms and biologically stimulated growth factor. MATERIAL AND METHOD: Lumbar IVD cells were harvested from 10 New Zealand white rabbits, with the nucleus pulposus cells isolated by sequential enzymatic digestion. Each of 1% types I and II atelocollagen dispersions were poured into a 96-well plate (diameter 5 mm), frozen at -70 degrees C, and then lyophilized at -50 degrees C. Fabricated porous collagen matrices were made using the cross-linking method. Cell suspensions were imbibed by surface tension into a scaffold consisting of atelocollagen. The cell cultured scaffolds were then treated with TGF-beta1 (10 ng/ml) or BMP-2 (100 ng/ml) or both. After 1 and 2 week culture periods, the DNA synthesis was measured by [3H] thymidine incorporation, and newly synthesized proteoglycan by incorporation of [35S] sulphate. Reverse transcription-polymerase chain reactions for the mRNA expressions of type I and II collagen, aggrecan and osteocalcin were performed. The inner morphology of the scaffolds was determined by scanning electron microscopy (SEM). RESULTS: The IVD cultures in collagen type II with TGF-beta1 demonstrated an increase in proteoglycan synthesis and up regulation of aggrecan and types I and II collagen mRNA expressions compared to the control. IVD cultures in the type I atelocollagen scaffold with growth factors exhibited an increase in DNA synthesis and up regulation of the type II atelocollagen mRNA expression. With all combinations of growth factor, the IVD cultures in types I and II atelocollagen scaffolds showed no up regulation of the osteocalcin mRNA expression. Furthermore, there was no synergistic effect of TGF-beta1 and BMP-2 in the matrix synthesis or for the mRNA expression of the matrix components. CONCLUSIONS: Nucleus pulposus cells from rabbit were viable in atelocollagen types I and II atelocollagen scaffolds. The type I atelocollagen scaffold was suitable for cell proliferation, but the type II atelocollagen scaffold was more suitable for extracellular matrix synthesis. The IVD cells in both scaffolds were biologically responsive to growth factors. Taken together, nucleus pulposus cells in atelocollagen scaffolds, with anabolic growth factors, provide a mechanism for tissue engineering of IVD cells.
Aggrecans ; Cell Proliferation ; Cell Survival ; Cell Transplantation ; Collagen ; Collagen Type II ; Digestion ; DNA ; Extracellular Matrix ; Human Body ; Intercellular Signaling Peptides and Proteins* ; Intervertebral Disc* ; Microscopy, Electron, Scanning ; Osteocalcin ; Phenotype ; Proteoglycans ; Rabbits ; Regeneration ; RNA, Messenger ; Surface Tension ; Suspensions ; Thymidine ; Tissue Engineering ; Transforming Growth Factor beta1 ; Transplants ; Up-Regulation

BACKGROUND: Previous reports have demonstrated the synergistic interaction of midazolam and propofol in the induction of hypnosis. But there haer been some different views expnrsscd as to whether the synergism extended to hemodynamic effects. So we studied the effect of the co-administration of midazolam on induction dose, hemodynamic response, and recovery with the use of continuous infusion of propofol for induction, and the maintenance of anesthesia. METHODS: Thirty-five patients undergoing elective surgery within 2 hours were randomly assigned to one of two groups formed according to the induction agents: Group P (continuous propofol infusion 1,200 mg/h), Group MP (midazolam 2 mg followed by continuous propofol infusion 1,200 mg/h). After induction, anesthesia was maintained with fentanyl (50 microgram), N2O (70%), andpropofol (5 15 mg/kg/h). Outcome measures were propofol doses (induction and maintenance), hemodynamic responses (heart rate, blood pressure) during the induction period, emergence time (eye-opening to command), postoperative nausea and dizziness. RESULTS: The induction dose of propofol was 29% less in Group MP compared to Group P but there was no significant difference in maintenance doses between the two groups. Heart rates showed no differences between the two groups, but the changes of mean arterial pressures from base line at 30 sec, 2 min and 5 min after intubation were greater and the emergence time was delayed in Group MP compared to Group P (P < 0.05). CONCLUSIONS: Midazolam potentiates the hypnotic action of propofol synergistically, but there was no evidence that the synergism extended to the blunting effect of propofol against the hypertensive response to intubation.
Anesthesia ; Arterial Pressure ; Dizziness ; Fentanyl ; Heart Rate ; Hemodynamics ; Humans ; Hypnosis ; Intubation ; Midazolam* ; Outcome Assessment (Health Care) ; Postoperative Nausea and Vomiting ; Propofol*

BACKGROUND: Previous reports have demonstrated the synergistic interaction of midazolam and propofol in the induction of hypnosis. But there haer been some different views expnrsscd as to whether the synergism extended to hemodynamic effects. So we studied the effect of the co-administration of midazolam on induction dose, hemodynamic response, and recovery with the use of continuous infusion of propofol for induction, and the maintenance of anesthesia. METHODS: Thirty-five patients undergoing elective surgery within 2 hours were randomly assigned to one of two groups formed according to the induction agents: Group P (continuous propofol infusion 1,200 mg/h), Group MP (midazolam 2 mg followed by continuous propofol infusion 1,200 mg/h). After induction, anesthesia was maintained with fentanyl (50 microgram), N2O (70%), andpropofol (5 15 mg/kg/h). Outcome measures were propofol doses (induction and maintenance), hemodynamic responses (heart rate, blood pressure) during the induction period, emergence time (eye-opening to command), postoperative nausea and dizziness. RESULTS: The induction dose of propofol was 29% less in Group MP compared to Group P but there was no significant difference in maintenance doses between the two groups. Heart rates showed no differences between the two groups, but the changes of mean arterial pressures from base line at 30 sec, 2 min and 5 min after intubation were greater and the emergence time was delayed in Group MP compared to Group P (P < 0.05). CONCLUSIONS: Midazolam potentiates the hypnotic action of propofol synergistically, but there was no evidence that the synergism extended to the blunting effect of propofol against the hypertensive response to intubation.
Anesthesia ; Arterial Pressure ; Dizziness ; Fentanyl ; Heart Rate ; Hemodynamics ; Humans ; Hypnosis ; Intubation ; Midazolam* ; Outcome Assessment (Health Care) ; Postoperative Nausea and Vomiting ; Propofol*