• Asian Oncology Nursing
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• v.6 no.2
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• pp.162-171
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• 2006

Purpose: This study was undertaken to obtain the basic data on the spouses‘ stress and adaptation caring their wives affected by gynecological cancer. In addition, moderating variables for adaptation, family resource and situational definition, were also investigated. Method: This study was descriptive survey research work by questionnaire on the 71 spouses hospitalized in an university hospital located on Gwangju from Sep. 2001 to Oct. 2002. Results: The mean score of stress was 2.27, and the mean score of adaptation was 3.12. The correlation between stress and adaptation was significant (r = -.692, p = .000). The adaptation score of high stress group with high family resource was higher (p = .041) than the group with low family resource. The adaptation score of high stress group with high situational definition was higher (p = .033) than the group with low situational definition. Conclusion: This study showed that the spouses experienced a similar level of stress compared with the level of families with other type of cancer. This study also showed that the stress and adaptation levels were different depending upon the family resource and situational definition. This aspect should be considered for the development of nursing intervention program for the spouse of patients with gynecological cancer.

• Korean Journal of Social Welfare
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• v.60 no.1
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• pp.5-27
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• 2008

Purpose: This study aims to better understand the quality of life (QOL) for Korean breast and gynecological cancer survivors by examining the differences in multi-dimensional QOL outcomes according to stage of cancer survivorship. Methods: To identify the multiple dimensions of health status and psychosocial outcomes, three standardized QOL and psychological distress measures were administered to 110 Korean breast and gynecological cancer survivors. These participants were divided into three groups based on the stage of cancer survivorship. Results: Analyses of covariance revealed that once important confounders were controlled for, QOL outcomes were partially different depending on the stage of cancer survivorship. Results for SF-36 measure showed significant differences between acute and long-term survival stages, indicating that QOL for cancer survivors had gradually improved in the physical domain. However, there were no significant group differences in the psychological domain of SF-36. Additionally, QOL-CS and BSI-18 measures did not show significant QOL differences according to the stage of cancer survivorship. Conclusions: Evidence that, for Korean survivors, QOL outcomes differ according to the stage of cancer survivorship serves as a rationale for developing discriminatory strategies and interventions that take into account survival stage.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.5753-5759
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• 2013

Curcumin and curcumin containing polyherbal preparations have demonstrated anti-microbial and antiviral properties in pre-clinical studies. Till date no therapeutic intervention has been proved to be effective and safe in clearing established cervical human papillomavirus (HPV) infection. The present study evaluated the efficacy of Basant polyherbal vaginal cream (containing extracts of curcumin, reetha, amla and aloe vera) and of curcumin vaginal capsules to eliminate HPV infection from cervix. Women were screened by Pap smear and HPV DNA test by PCR. HPV positive women without high grade cervical neoplasias (N=287) were randomized to four intervention arms to be treated with vaginal Basant cream, vaginal placebo cream, curcumin vaginal capsules and placebo vaginal capsules respectively. All subjects were instructed to use one application of the assigned formulation daily for 30 consecutive days except during menstruation and recalled within seven days of the last application for repeat HPV test, cytology and colposcopy. HPV clearance rate in Basant arm (87.7%) was significantly higher than the combined placebo arms (73.3%). Curcumin caused higher rate of clearance (81.3%) than placebo though the difference was not statistically significant. Vaginal irritation and itching, mostly mild to moderate, was significantly higher after Basant application. No serious adverse events were noted.

• Women's Health Nursing
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• v.12 no.2
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• pp.87-96
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• 2006

Purpose: This study was conducted to provide fundamental information for a system establishment of advanced practice nursing for gynecological cancer patients (APN-GCP). Method: Data was collected by focus group and individual interviews and analyzed in the framework of the Grounded theory method mapped by Strauss and Corbin (1990). There were 13 subjects in this study (nurses, doctors, patient and her family). Result: We identified 87 concepts, 22 sub-categories, and 10 categories. Categories for role expectation were arrangement of diagnosis and treatment process, giving information of treatment course, support of treatment process, patients' right toward making a decision of treatment, counseling and teaching after discharge from hospital, medical insurance and financial problems, counseling about sexual problems and use of family and community resources. All subjects perceived the necessity of an APN-GCP. An APN-GCP requires over 2$\sim$7 years clinical experience and a master's degree. Services would be performed from initial registration to termination of treatment or death, and accomplished on an outpatient clinic basis. Conclusion: The nursing delivery system and curriculum should be developed for a women's health nurse practitioner including APN-GCP. As a further step, cost-effectiveness and projected estimation of manpower of APN-GCP should be studied in the future.

• Korean Journal of Adult Nursing
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• v.24 no.1
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• pp.52-63
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• 2012

Purpose: The purpose of this study was to measure the quality of life (QOL) and to identify the factors influencing QOL in gynecological cancer patients. Methods: The subjects of this study were 242 people who were receiving medical therapy or follow-up after surgery from one general hospital in Daegu. Data were collected from August 1, 2010 to January 31, 2011. A questionnaire including questions on QOL, distress score, distress problem, depression, anxiety, insomnia, perceived health status and body image were completed by the subjects. Results: The mean score of QOL was $70.68{\pm}13.40$. Religion, job, presence of spouse, level of education, household income, financial compensation, disease stage and recurrence were the significant factors related to QOL. Distress score, distress problem, depression, anxiety, insomnia, perceived health status and body image were also significant factors influencing QOL. Sixty eight percent of the variance in subjective overall QOL can be explained by body image, distress problem, distress score, anxiety, level of education and perceived health status (Cum $R^2$=0.689, F=76.316, $p$ <.001). Body image was the most important factor related to QOL. Conclusion: An integrative care program which includes general, disease-related and psychosocial characteristics of patients is essential to improve QOL in gynecological cancer patients.

• Journal of Physiology & Pathology in Korean Medicine
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• v.28 no.5
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• pp.571-575
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• 2014

This study was aimed to obtain epidemiological information of cancer patients treated with Oriental medicine. 58 breast and gynecological cancer patients treated in Cancer Center of Daeguhanny Oriental Hospital from August 2012 to August 2013 were reviewed. Careful investigations were done by categorizing these patients by their origin, stage, treatment, conventional treatment type, chief complaint, etc. In tumor origin, breast cancer showed the largest proportion in total patients(74.1%) and inpatients(81.8%). 63.8% of the patients' tumors were stage III and IV. 48.3% of patients visited Oriental hospital for combination treatment with conventional medicine. 91.4% of the patients have under 5 years of cancer duration. Their cheif complaints are general weakness, postoperative pain and abdominal discomfort in general. This study presented the characteristics of breast and gynecological cancer patients treated by Oriental medical therapies, and thus would be valuable for futher studies of Oriental medical cancer treatments.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.5589-5597
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• 2013

The aim of this review article was to evaluate the relationship and the possible etiological mechanisms between endometriosis, leiomyoma (LM) and adenomyosis and gynecological cancers, such as ovarian and endometrial cancer and leiomyosarcoma (LMS). MEDLINE was searched for all articles written in the English literature from July 1966 to May 2013. Reports were collected systematically and all the references were also reviewed. Malignant transformation of gynecologic benign diseases such as endometriosis, adenomyosis and LM to ovarian and endometrial cancer remains unclear. Hormonal factors, inflammation, familial predisposition, genetic alterations, growth factors, diet, altered immune system, environmental factors and oxidative stress may be causative factors in carcinogenesis. Early menarche, low parity, late menopause and infertility have also been implicated in the pathogenesis of these cancers. Ovarian cancers and endometriosis have been shown to have common genetic alterations such as loss of heterozygosity (LOH), PTEN, p53, ARID1A mutations. MicroRNAs have also been implicated in malignant transformation. Inflammation releases proinflammatory cytokines, and activates tumor associated macrophages (TAMS) and nuclear factor kappa b (NF-KB) signaling pathways that promote genetic mutations and carcinogenesis. MED12 mutations in LM and smooth muscle tumors of undetermined malignant potential (STUMP) may contribute to malignant transformation to LMS. A hyperestrogenic state may be shared in common with pathogenesis of adenomyosis, LM and endometrial cancer. However, the effect of these benign gynecologic diseases on endometrial cancer should be studied in detail. This review study indicates that endometriosis, LM, adenomyosis may be associated with increased risk of gynecological cancers such as endometrial and ovarian cancers. The patients who have these gynecological benign diseases should be counseled about the future risks of developing cancer. Further studies are needed to investigate the relationship between STUMPs, LMS and LM and characteristics and outcome endometrial carcinoma in adenomyotic patients.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.2085-2089
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• 2013

Background: The purpose of this descriptive study was to investigate attitudes women of towards cervical cancer prevention applications and early diagnosis, and whether or not their hopelessness levels had any influence. Materials and Methods: The present study was carried out in Isparta with a descriptive design. A sample of 251 individuals was recruited from January 2011 through May 2011 in the largest tea garden (restaurant-cafe). The data collection tool consisted of two parts: a "Questionnaire Form" identifying women; and the "Beck Hopelessness Scale". Data were analyzed using the Statistical Package for the Social Sciences (SPSS version 16.0 for Windows for the numerical and percentage distribution, average, standard deviation with the ANOVA and Mann-Whitney tests. Results: Some 70.2 % of the woman indicated that they had not taken the Pap test. There was a significant relationship between the hopelessness level and women believing that they could protect themselves from getting cervical cancer (F=10.11 p=0.00). There was a significant relationship between hopelessness levels and believing whether or not early diagnosis tests are deterministic (F=8.781 p=0.00). Conclusion: Our study concluded that the hopelessness level of women had an effect on their thoughts about cervical cancer prevention and early diagnosis.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.10
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• pp.4203-4206
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• 2014

Purpose: The objective of this study was to assess the predictive role of the neutrophil/lymphocyte ratio (NLR) for invasion of gestational trophoblastic disease (GTD). Materials and Methods: A retrospective analysis was conducted on 127 women who were managed at our clinic for GTD. Of all patients, 8 showed invasion according to histological examination. The clinical parameters of patients with invasive GTD (Group 1; n=8) were compared with patients who showed no invasion (Group 2; n=119). All underwent a prior uterine evacuation and followed up by regular assessment of ${\beta}$-hCG titers. Results: Demographic and obstetric history and pre-evacuation hCG levels of the patients showed no statistically significantly difference between the groups (p>0.05). The mean gestational weeks (GW), size of the GTD and NLR levels were statistically significantly higher in the invasive GTD group (p<0.05). Correlations between invasion and gestational weeks, size of GTD, post-evacuation chemotherapy and NLR were evident. ROC curve analysis demonstrated that GW, size of GTD and NLR may be discriminative parameters in predicting invasion of GTD. Conclusions: To the best of our knowledge, this is the first study evaluating the predictive role of NLR in invasion of GTD. In conclusion, we think that pretreatment NLR can be used as a biomarker of invasion in GTD.

• Annals of Geriatric Medicine and Research
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• v.22 no.4
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• pp.189-193
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• 2018

Background: This study aimed to reveal the clinicopathologic features and causes of bleeding in older patients with postmenopausal bleeding (PMB) and to investigate the correlation between the ultrasonographic findings and etiology of PMB. Methods: We retrospectively analyzed the causes and clinical characteristics of PMB in 498 patients who were diagnosed between January 2007 and December 2017. The population with PMB was divided into 2 groups according to age: Group A (n=204) included individuals more than 65 years of age and group B (n=294) included those less than 65 years of age. Clinical characteristics such as age, parity, underlying conditions, previous surgical history, and previous menopausal hormone therapy were compared between the groups. Cervical cytology testing and transvaginal ultrasonography were performed in all patients with PMB. Endometrial biopsy was performed in all cases of endometrial thickness ${\geq}5mm$. Results: We examined 498 patients with PMB. In group A, atrophic endometrium (n=125, 61.27%) was the most common cause of PMB. Twenty-three patients had gynecological malignancy (cervical cancer: n=12, 5.88%; endometrial cancer: n=8, 3.42%; ovarian cancer: n=3, 1.46%), and 30 patients had benign gynecological disease (endometrial polyp: n=10, 4.90%; submucosal myoma: n=6, 2.94%; uterine prolapse: n=7, 3.42%; cervical dysplasia; n=5, 2.45%; cervical polyp: n=2, 0.98%). Forty patients had endometrial thickness ${\geq}5mm$. Eight patients were diagnosed with endometrial cancer. All cases of endometrial cancer were diagnosed with endometrial thickness >10 mm. Conclusion: Atrophic endometrium was the most common cause of PMB in both groups, and approximately 12% of cases were associated with gynecological malignancy in older patients.