• Journal of the Korean Society of Radiology
• /
• v.84 no.4
• /
• pp.958-963
• /
• 2023

Primary peritoneal psammocarcinoma is a rare type of serous carcinoma that is characterized by the massive formation of psammoma bodies and the invasion of adjacent organs. A 55-year-old female who previously underwent a hysterectomy presented to the emergency room with severe abdominal pain. Contrast-enhanced CT revealed an intra-abdominal calcific mass. Initially, it was thought to be a heterotopic ossification due to the previous pelvic surgery with intact ovaries. However, this was diagnosed as a primary peritoneal psammocarcinoma. Primary peritoneal psammocarcinoma is a very rare disease entity that should be considered a differential diagnosis in patients with normal ovaries, massive ossification in the pelvic cavity, and calcific peritoneal nodules.

• The Korean Journal of Pain
• /
• v.6 no.2
• /
• pp.265-269
• /
• 1993

Subdural block is a rare but well recognized complication of epidural anesthesia. The placement of local anesthetics into the subdural space can lead to potentially life-threatening conditions. A healthy 46-year-old women underwent total abdominal hysterectomy under continuous lumber epidural anesthesia. The technical procedure for continuous epidural catheterization went smoothly without a single problem. However, signs of high epidural block such as apnea, cranial nerve paralysis and pupil dilatation developed gradually, about 20 minutes after the epidural injection of 2% lidocaine 20 ml through the epidural catheter. Such extensive segmental block can only be explained as the result of injection into subdural space even if it was not confirmed radiologically.

• The Korean Journal of Pain
• /
• v.20 no.2
• /
• pp.251-254
• /
• 2007

Perineal pain is a significant diagnostic challenge to the pain practitioner, and accurate diagnosis and treatment is essential. We report a case of 42-years old female patient suffering from excruciating vulvodynia for 5 years. Her pain on the visual analogue scale was 10 out of 10 and her pain was associated with sleep disturbance, dyspareunia, and chronic fatigue. She was diagnosed with a bladder stone by imaging, and The pain was relieved by cystolitholapaxy.

• Archives of Plastic Surgery
• /
• v.47 no.1
• /
• pp.78-82
• /
• 2020

Basal cell carcinoma (BCC) is the most common skin cancer and its incidence is steadily increasing. Prior radiation therapy is one of the most important risk factors for BCC. Although the mechanism remains undefined, long-term studies have shown that people exposed to radiation have an increased risk of BCC. Despite the fact that BCC occurs most frequently in sun-exposed areas of the body, patients with a history of radiation therapy have an increased risk of BCC in areas previously exposed to radiation. Here, we report a case of adenoid BCC on the abdomen in a 67-year-old woman after radiation therapy post-hysterectomy.

• The Journal of Korean Obstetrics and Gynecology
• /
• v.34 no.4
• /
• pp.151-162
• /
• 2021

Objectives: The purpose of this study is to report the effect of Korean medicine on endometrial cancer patient after laparotomy. Methods: The patient with endometrial cancer who underwent Total Abdominal Hysterectomy (TAH), Bilateral Salpingo Oophorectomy (BSO), Bilateral Paraaortic Lymph Node Dissection (BPLND) was treated by Korean medicine such as herbal medicine, acupuncture, moxibustion. To evaluate the patient, symptoms were measured by Numeric Rating Scale (NRS) and Eastern Cooperative Oncology Group (ECOG). Blood tests including cancer biomarker were conducted during treatment. Results: After treatment, postoperative pain and general weakness were gradually relieved. Conclusions: This case provides us treatment with Korean medicine have substantial benefit on postoperative complications after laparotomy.

• Radiation Oncology Journal
• /
• v.12 no.3
• /
• pp.369-376
• /
• 1994

This is a retrospective analysis of 64 patients who was treated with postoperative radiation therapy after radical hysterectomy and bilateral pelvic lymphadenectomy (53 patients) or total abdominal hysterectomy(11 patients) for uterine cervix cancer between May 1980 and September 1991 at the Department of Radiation Oncology, Kyung Hee University Hospital. Most patients were FIGO IB (31 Patients) and IIA (25 patients), and median period of follow-up was 5.1 years. Of these patients,24 received adjuvant whole pelvis irradiation of 6000 cGy and 40 received 5000-5500 cGy whole pelvis irradiation and/or intracavitary radiation (7 Patients). The actuarial overall and relapse free 5 year survival rate were $71.0\%$, $68.3\%$ respectively. The survival rates by stage were $79.1\%$ in stage I, and $61.2\%$ in stage II. Treatment failure was noted in 18 of 64 patients ($28.1\%$), Iocoregional failure in 8 ($12.5\%$), distant metastasis in 8 ($12.5\%$), paraaortic node metastasis in 1 and one patient and concurrent locoregional and distant metastasis. The univariate analysis of prognostic factors affecting to overall survival rate represented lymph node status, the number and site of metastatic lymph node, parametrial invasion, the thichness of cervical wall invasion, and size of cancer mass. Histology, vessel invasion, endometrial extension, hemoglobin level. resection margin status, age, radiation dose were not significant prognostic factors. Complication relating to operation and postoperative radiation were variable according to radiation therapy method: 6000 cGy RT group 8/24($33.3\%$), 5000-5500 cGy+ICR 3/7 ($42.9\%$), 5000-5500 cGy external RT only group 3/33 ($9.1\%$). In conclusion, the results suggest that postoperative radiotherapy is necessary in high risk patients for locoregional control and improving survival rate, and higher dose does not improve results but only increases complication.

• Archives of Plastic Surgery
• /
• v.38 no.3
• /
• pp.329-332
• /
• 2011

Purpose: In developed countries, vesicovaginal fistula occur from various pelvic operations including total hysterectomy, leading to urinary leakage and incontinence. Although various methods have been proposed for adequate tissue coverage in fistula repair, the surgical treatment of is not simple and still controversial. We report a case of neobladder-vaginal fistula repair using modified Martius fat pad flap. Methods: A 62-year-old female patient underwent radical cystectomy with total abdominal hysterectomy and neobladder formation due to invasive bladder tumor 5 years ago. For 3 years following the operation, urine leakage was observed. Exploration demonstrated neobladder-vaginal fistula and primary repair including fistulectomy and direct closure was performed. Urinary incontinence relapsed 2 years after primary repair, and after demonstrating the recurrence of fistula on urography, repair of recurrent fistula was performed. After dissection of vagina and neobladder and closure of fistula by urologic surgeon, fibroadipose flap was elevated, rotated and advanced through the tunnel at vaginal sidewall, and interpositioned to the fistula site between neobladder and vagina. Results: There was no acute complication after the surgery and urethral catheter was extracted on the 8th day after the operation. During six month follow-up period after the operation, there is no clinical evidence of fistula recurrence. Conclusion: From our clinical experience and literature review, we think Martius fat pad flap is a useful technique in management of neobladder-vaginal fistula, for it provides enough vascularity, major epithelization surface and better lymphatic drainage, and also prevents overlapping of vesical, vaginal suture lines at the same time.

• Women's Health Nursing
• /
• v.10 no.4
• /
• pp.351-359
• /
• 2004

Purpose: A descriptive study was conducted to examine the levels of distress, state anxiety, and physiologic responses in postoperative patients under patient controlled analgesia (PCA), and to determine correlations among the variables. Method: The study sample included women who underwent an elective hysterectomy procedure or other gynecologic surgeries(N=100). Subjective distress was assessed by visual analog scales around 8 hours postoperatively. Trained nurses collected objective distress data through observation of subject's behavior and vital signs. Data were analyzed with frequencies, percentages, means, Pearson correlation coefficients, ANOVA, and the Scheffe post test using SPSS/PC 11.0. Result: Subjective distress, objective distress, and state anxiety scores were relatively low, except pain scores(5.31 out of 10.0) among sub-scales of subjective distress. Women who had a total abdominal hysterectomy showed significantly higher levels of both subjective distress and state anxiety than those after a minor gynecologic surgery. In relationships among variables, subjective distress correlated positively with postoperative state anxiety, but not with the amount of analgesic medication, verified by further analysis on sub-scales of subjective and objective distress. The higher the levels of state anxiety, the higher the levels of tension, dyspnea, facial change, and systolic blood pressure observed. Conclusion: Regardless of effective pain management, most postoperatively experienced distress in gynecological patients was derived from surgery associated anxiety and pain. Specific psychological strategies should be established as well for those with high levels of state anxiety to facilitate prompt recovery.

• The Journal of Korean Obstetrics and Gynecology
• /
• v.30 no.3
• /
• pp.40-53
• /
• 2017

Objectives: This study aims to analyze the current status of hospitalized patients and effects of Korean medical treatment after gynecological surgery. Methods: We analyzed the medical records of patients admitted to our hospital from January 2015 to May 2017 and categorized the pre-operative and post-operative contents. We performed statistical analysis using SPSS ver.20 for the patients' pains among symptoms. Results: Among total 87, patients 82.8% had hysterectomy. The most cause of the surgery were adenomyosis. The average duration of hospitalization was $10.4{\pm}5.7days$ and all patients were treated with acupuncture. Gami-sibjeon-tang was used most frequently. Among the symptoms that occurred after the operation, abdominal pain, low back pain, pelvic pain were in the order of pain and statistically significant decrease in the mean NRS score. In the symptoms of system, general weakness, insomnia, digestive disorder were in the order of the frequency and were improved respectively. Conclusion: We were able to find out the effectiveness of post-operative Korean medical treatment through hospitalized patients. More data collection and systematic research designs are needed.

• The Korean Journal of Pain
• /
• v.20 no.2
• /
• pp.169-173
• /
• 2007

Background: Although the use of intravenous patient controlled analgesia (IVPCA) has been compared to the use of patient conrolled epidural analgesia (PCEA), there is no optimal administration route of alfentanil for the treatment of postoperative pain. This randomized double-blind study compared the efficacy of the use of IVPCA and PCEA for postoperative pain and the side effects after a total abdominal hysterectomy (TAH). Methods: Sixty patients undergoing a TAH were randomly assigned to receive either IVPCA (Group I) or PCEA (Group E) for the infusion of alfentanil for postoperative pain control. In both groups, a loading dose of $750{\mu}g$ alfentanil was administered. All patients received the same continuous infusion rate (0.3 mg/h), bolus dose (0.15 mg), and lockout time (15 min). The incidence of side effects, the VAS (visual analog scale) of pain, blood pressure, and heart rate were checked for 20 hours after the loading dose injection. Results: The VAS of pain was not significantly different between the two groups of patients. The onset of the analgesic effect was significantly more rapid in the Group I patients than in the Group E patients. There was no difference in side effects for either group. Conclusions: When considering multiple factors such as the onset of analgesia, technical difficulties or infection after the procedure, IVPCA using alfentanil is more useful than PCEA for postoperative pain control after a TAH.