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( Suhyun Shim ),( Kyung-min Park ),( Youn-jee Chung ),( Mee-ran Kim ) 대한폐경학회 2021 대한폐경학회지 Vol.27 No.1
Postmenopausal atrophic vaginitis, along with vasomotor symptoms and sleep disorders, is one of the most troublesome symptoms of menopause. However, many women do not manage this symptom properly due to insufficient knowledge of the symptoms or sexual embarrassment. With appropriate treatment, many postmenopausal women can experience relief from discomforts, including burning sensation or dryness of the vagina and dyspareunia. Topical lubricants and moisturizers, systemic and local estrogens, testosterones, intravaginal dehydroepiandrosterones (DHEAs), selective estrogen receptor modulators, and energy-based therapies are possible treatment modalities. Systemic and local estrogen therapies effectively treat genitourinary syndrome of menopause (GSM), but they are contraindicated in patients with breast cancer, for whom lubricants and moisturizers must be considered as the primary treatment. Intravaginal DHEA and ospemifene can be recommended for moderate to severe GSM; however, there is insufficient data on the use of intravaginal DHEA or ospemifene in patients with breast cancer, and further studies are needed. Energy-based devices such as vaginal laser therapy reportedly alleviate GSM symptoms; however, the U.S. Food and Drug Administration warning has recently been issued because of complications such as chronic pain and burning sensations of the vagina. To summarize, clinicians should provide appropriate individualized treatment options depending on women’s past history, symptom severity, and chief complaints.
( Suhyun Shim ),( Mee-ran Kim ),( Hyejin Hwang ),( Youngsin Han ),( Youn-jee Chung ),( Hyun-hee Cho ),( Hyun-kyung Kim ),( Minkyoung Lee ),( Mira Kim ),( Chai-young Jung ),( Kyung-hee Chae ),( Sukil K 대한산부인과학회 2018 대한산부인과학회 학술대회 Vol.104 No.-
Objective: The prevalence and incidence of endometriosis are estimated highly varied according to several study. Until now, the overall prevalence is known about 10% in reproductive-age women and up to 50% of symptomatic women with infertility or pain in high-risk population. in addition, there are few studies about nationwide epidemiological data in korea. Therefore reliable estimation of prevalence and incidence of endometriosis in korea remain unclear. Methods: This study is using administrative data provided by the Korean National Health Insurance Service (NHIS). These data from overall Korean population, totaling 45 million people, with national claims data for the period from January 1, 2002, to December 31, 2016. We selected patients with endometriosis as primary or secondary diagnosis code from the NHIS database and estimated prevalence and incidence rate of endometriosis according to time and age group. The diagnoses of endometriosis were identified by ICD-10 codes N80, except adenomyosis (N80.0). Results: Among women aged 11- 55 selected from the NHIS database from 2002 to 2016, 212,509 women were diagnosed as endometriosis. The incidence of endometriosis was increased 1.94 per 1000 person in 2002 to 1.82 per 1000 person in 2016. The overall prevalence of endometriosis was increased from 1.9 per 1000 person in 2002 to 4.0 per 1000 women in 2016. The prevalence increased gradually except 2007 to 2008. Conclusion: We found a significant trend of increase in diagnosing endometriosis in Korean women with time, although prevalence was decline in 2007 to 2008. We presume that this declination was a result of restructuring the diagnostic code at that time. Considering that endometriosis is associated with subfertility and has high incidence rate in young age in Korean women, it is very important to detect and treat endometriosis earlier.
( Hyunkyung Kim ),( Suhyun Shim ),( Youngbin Hwang ),( Minkyoung Kim ),( Hyejin Hwang ),( Younjee Chung ),( Hyun-Hee Cho ),( Mee-Ran Kim ) 대한산부인과학회 2018 Obstetrics & Gynecology Science Vol.61 No.1
Objectives To evaluate the feasibility of robot-assisted laparoscopic myomectomy in multiple myomas over 10. Methods A retrospective study was conducted for 662 patients who underwent robot-assisted laparoscopic myomectomy and open myomectomy by a single operator in a tertiary university hospital. Results A total of 30 women underwent removal of 10 or more uterine myomas by robotics and 13 patients were selected for this study. The average number of myomas removed was 13.7 (range 10-20). The maximum diameter of the myomas was 6.8 cm (range 5.0-10.0 cm). The sum of the diameters of each myoma was 34.7 cm (range 20.0-54.5 cm) and the mass of resected myomas for each case was 229.1 g (range 106.8-437.9 g). In no case was the robotic procedure converted into conventional laparoscopy or laparotomy, and all patients recovered without any major complications. In comparison with 13 cases of open myomectomy during the same period, robotic surgery took longer time than open surgery (360.5 vs. 183.8 minutes; P=0.001) but had shorter postoperative hospital days after surgery (mean 2.5 vs. 3.5 days; P=0.003). Conclusion Robot-assisted laparoscopic myomectomy could be an alternative to laparotomic myomectomy for numerous myomas over 10 in number.
Prevalence, incidence and birth rate of endometriosis in Korea using big data
( Oyoung Kim ),( Suhyun Shim ),( Youngsin Han ),( Hye Jin Hwang ),( Youn-jee Chung ),( Hyun-hee Cho ),( Mee-ran Kim ),( Mira Kim ),( Chai-young Jung ),( Kyung-hee Chae ),( Sukil Kim ) 대한산부인과학회 2019 대한산부인과학회 학술대회 Vol.105 No.-
Objective: The aim of this study is to estimate the prevalence, incidence and birth rate of endometriosis in Korea using big data. Methods: This study is using administrative data provided by the Korean National Health Insurance Service (NHIS). These data from overall Korean population, totaling 45 million people, with national claims data for the period from January 1, 2002, to December 31, 2016. We selected patients with endometriosis as primary or secondary diagnosis code from the NHIS database and estimated prevalence and incidence rate and birth rate of endometriosis according to time and age group. Results: 433,422 women were diagnosed as endometriosis from January 1, 2002 to December 31, 2016. The overall prevalence of endometriosis is 2.7 per 1000 women. The prevalence increased gradually except a few periods, especially from 2007 to 2008. The estimated incidence is 1.4 per 1000 women. It also increase gradually, especially in the last five years. 39658 patients out of 211884 gave birth after diagnosis. The peak age was 29 in this group. A one year difference between the time of diagnosis and the time of birth was most common. On the other hand, for those who were treated before giving a birth, 2 years of time difference was most common. Among patients who gave birth, 56% of them gave birth without treatment. Conclusion: The prevalence and incidence of endometriosis in Korean women were lower than previous reports in high-risk populations studies. We found a significant trend of increase in diagnosing endometriosis in Korean women with time, especially in young age group.