Fractional CO2 Laser Treatment Is Safe and Effective for the Management of Genitourinary Syndrome of Menopause in Korean Women.

This study evaluates the efficacy and safety of fractional CO2 lasers for treating genitourinary syndrome of menopause (GSM) in Korean women. The patients received three laser applications at an interval of 4 weeks each. The severity of GSM symptoms was assessed using a visual analog scale (VAS) at baseline and at every visit. The objective scale was measured using the vaginal health index score (VHIS) and Vaginal Maturation Index (VMI) after completion of the laser procedure. During each procedure, the patients' pain in the VAS score was recorded. In the last visit, patients evaluated their satisfaction with the laser therapy using a 5-point Likert scale. Thirty women completed all the study protocols. After two sessions of laser therapy, some GSM symptoms (vaginal dryness and urgency) and VHIS improved significantly. After completion of the treatment, all GSM symptoms improved (p < 0.05), and the VHIS further increased significantly (VHIS at baseline, 8.86 ± 3.2 vs. V3, 16.83 ± 3.15, p < 0.001). The average satisfaction was 4.3. This study shows that fractional CO2 laser treatment is effective and safe for Korean women with GSM. Further studies are needed to confirm these results and assess the long-term effects of laser therapy.

Electrochemical Impedance-Based Biosensors for the Label-Free Detection of the Nucleocapsid Protein from SARS-CoV-2.

Diagnosis of coronavirus disease (COVID-19) is important because of the emergence and global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Real-time polymerase chain reaction (PCR) is widely used to diagnose COVID-19, but it is time-consuming and requires sending samples to test centers. Thus, the need to detect antigens for rapid on-site diagnosis rather than PCR is increasing. We quantified the nucleocapsid (N) protein in SARS-CoV-2 using an electro-immunosorbent assay (El-ISA) and a multichannel impedance analyzer with a 96-interdigitated microelectrode sensor (ToAD). The El-ISA measures impedance signals from residual detection antibodies after sandwich assays and thus offers highly specific, label-free detection of the N protein with low cross-reactivity. The ToAD sensor enables the real-time electrochemical detection of multiple samples in conventional 96-well plates. The limit of detection for the N protein was 0.1 ng/mL with a detection range up to 10 ng/mL. This system did not detect signals for the S protein. While this study focused on detecting the N protein in SARS-CoV-2, our system can also be widely applicable to detecting various biomolecules involved in antigen-antibody interactions.

Updates on Therapeutic Alternatives for Genitourinary Syndrome of Menopause: Hormonal and Non-Hormonal Managements.

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.

Intravenous leiomyomatosis misdiagnosed with large thrombosis in inferior vena cava.

OBJECTIVE: The aim of this report is to highlight the importance of a comprehensive preoperative evaluation in the case of intravenous leiomyomatosis. CASE REPORT: A 49-year-old women was presented with dyspnea and abdominal distension. Imaging studies revealed a large leiomyoma with intravenous leiomyomatosis from this mass to the right parauterine veins, right ovarian vein reaching the inferior vena cava. Complete resection was performed by a two-stage operation by a multidisciplinary team. Final pathology confirmed it to be intravenous leiomyomatosis and uterine leiomyomas. CONCLUSION: Intravenous leiomyomatosis is a benign and rare disease that can be a fatal condition. Precise diagnosis and appropriate treatment are important for the best outcome. Gynecologists should consider this rare disease when a patient with a uterine tumor shows symptoms such as chest pain and dyspnea.

Exposure to occupational noise and periodontitis in Korean workers.

BACKGROUND: Chronic exposure to occupational noise is reported to cause a wide range of health problems. But, there are no reports on studies investigating the association between noise exposure and periodontitis. The purpose of this study was to examine the relationship between occupational noise exposure and periodontitis in a nationally representative sample of Korean workers. METHODS: This cross-sectional study used data from the 4th Korean National Health and Nutrition Examination Survey. The study sample included 8,927 workers aged 19 to 54 years. Noise exposure assessment was performed by using self-report questionnaires. The dependent variable was periodontitis. Age, sex, perceived stress level, place of residence, income, education, health behaviors (frequency of daily toothbrushing, binge drinking, smoking status, regular dental checkup), diabetes, obesity, and white blood cell count were included as covariates. Logistic regression analyses estimated the association between noise exposure and periodontitis after sequential adjustment. RESULTS: Compared with never-exposed individuals, participants exposed to occupational noise had an increased prevalence of periodontitis. The association remained significant after full adjustment of covariates (odds ratio [OR] 1.34; 95% confidence interval [CI] 1.06 to 1.70). Association of noise exposure with periodontitis was particularly strong for individuals aged < 45 years (OR 1.65; 95% CI 1.22 to 2.23). CONCLUSIONS: Our study shows that there is an association between occupational noise exposure and periodontitis in a representative sample of Korean workers. Policy efforts to improve workplace noise environments might have an effect on improving periodontal health status among Korean workers.

Is robot-assisted laparoscopic myomectomy limited in multiple myomas?: a feasibility for ten or more myomas.

OBJECTIVE: 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.

Association between Dental Caries and Delayed Growth in Korean Children.

The purpose of this study was to assess the relationship of dental caries with anthropometric outcomes in 4- to 6-year-old children participating in the Korean National Health and Nutrition Examination Survey (KNHANES). The sample size was 1,910 children from the 4th and 5th KNHANES. The caries status was assessed with the decayed and filled teeth index in primary dentition (dft score). We employed height for age, body weight for age, and body mass index for age as outcome variables. Age, gender, region, and income were confounders. Nutritional deficiency as a mediator in the association between dental caries and delayed growth was also examined. A series of logistic regression analyses estimated the magnitude of association between dental caries and unfavorable growth after adjustment of the confounders and the mediator. Those with a high dft score were more likely to be deficient in nutrition (OR 1.77, 95% CI 1.14-2.74). After adjusting for sociodemographic factors and nutritional deficiency, we also found that a high dft score was associated with low weight (OR 1.70, 95% CI 1.15-2.51). The influence of dental caries on delayed growth was found in Korean representative children.