• Title/Summary/Keyword: Gynecology Surgery

Search Result 337, Processing Time 0.031 seconds

The Effect of Follicle-Stimulating Hormone Receptor (FSHR) Polymorphism on Outcomes of Controlled Ovarian Hyperstimulation (COH) and In-vitro Fertilization and Embryo Transfer (IVF-ET) (체외수정시술시 난포자극호르몬 수용체 유전자 다형성이 과배란유도 및 임신 결과에 미치는 영향)

  • Yoon, Ji-Sung;Choi, Young-Min;Lim, Kyung-Sil;Hur, Chang-Young;Kang, Young-Je;Jung, Jae-Hoon;Lee, Won-Don;Lim, Jin-Ho;Hwang, Kyu-Ri;Jee, Byung-Chul;Ku, Seung-Yup;Suh, Chang-Suk;Kim, Seok-Hyun;Kim, Jung-Gu;Moon, Shin-Yong
    • Clinical and Experimental Reproductive Medicine
    • /
    • v.31 no.2
    • /
    • pp.133-139
    • /
    • 2004
  • Objective: To investigate the association of FSH receptor (FSHR) polymorphism at position 680 with outcomes of controlled ovarian hyper-stimulation for IVF-ET in Korean women. Design: Genetic polymorphism analysis. Materials and Methods: The FSHR polymorphism was analyzed by PCR-RFLP in 172 ovulatory women below the age of 40 year. Patients with polycystic ovary syndrome, endometriosis, or previous history of ovarian surgery were excluded. Results: Genotype distribution was 41.9% for the Asn/Asn, 47.7% for the Asn/Ser, and 10.5% for the Ser/Ser FSHR genotype group. There was no difference in age of subjects and infertility diagnosis between genotype groups. When the patients were grouped according to their FSHR genotype, the basal levels of FSH (day 3) were significantly different among the three groups ($6.0{\pm}0.3\;IU/L$ (mean $\pm$ SEM), $5.8{\pm}0.3\;IU/L$, and $8.6{\pm}1.2\;IU/L$ for the Asn/Asn, Asn/Ser, and Ser/Ser groups, respectively, p=0.002). The Ser/Ser group showed a higher total doses of gonadotropins required to achieve ovulation induction, and a lower serum estradiol levels at the time of hCG administration compared with other two groups, but the differences were of no statistical significance. The numbers of oocytes retrieved were significantly different among the three groups ($8.6{\pm}0.8$, $9.9{\pm}0.6$, and $6.3{\pm}0.9$, for the Asn/Asn, Asn/Ser, and Ser/Ser groups, respectively, p=0.049). Clinical pregnancy rates were 42.4%, 25.9%, and 29.4% for the Asn/Asn, Asn/Ser, and Ser/Ser groups, respectively. Conclusion: Homozygous Ser/Ser genotype of FSHR polymorphism at position 680 was associated with decreased ovarian response to gonadotropin stimulation for IVF-ET.

Novel Directions in Adjuvant Chemotherapy for Early Stage Epithelial Ovarian Cancer

  • Sakarya, Derya Kilic;Yetimalar, M Hakan;Ozbasar, Demir
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.16 no.10
    • /
    • pp.4157-4160
    • /
    • 2015
  • Treatment of early stage ovarian cancer remains controversial despite advances in chemotherapeutic options. Over the past 30 years, molecular and clinicopathologic studies accelerated and treatment of ovarian cancer has undoubtedly improved although there is a debate as to whether this impacts outcome or not. More recently, the introduction of targeted therapy started a new era. Probably it is because early stage disease comprises a small portion of the epithelial ovarian cancer, studies have mostly ignored this group and still there is no clear consensus regarding systemic treatment of early-stage lesions. However this group of patients has the best chance of cure. In this review, we focus on current developments in the treatment of early stage ovarian cancer and query the options.

Commentary on the new 2022 European Society of Human Reproduction and Embryology (ESHRE) endometriosis guidelines

  • Eun Hee Yu;Jong Kil Joo
    • Clinical and Experimental Reproductive Medicine
    • /
    • v.49 no.4
    • /
    • pp.219-224
    • /
    • 2022
  • Endometriosis is a prevalent benign illness defined by the presence of endometrial glands and stroma outside of the uterine cavity, primarily on the ovary, pelvic peritoneum, and rectovaginal septum, resulting in a variety of symptoms, including dysmenorrhea and infertility. Traditionally, prolonged medical therapy has been needed in most cases since a conservative approach to surgery has usually been taken, especially in young women. In 2022, new European Society of Human Reproduction and Embryology (ESHRE) guidelines were published that present different directions for diagnosis and treatment from the past. Furthermore, the guidelines for the diagnosis and management of endometriosis are more precise and applicable than in previous editions. Thus, referring to the representative changes in the new guidelines and important updates will be beneficial for the diagnosis and management of endometriosis. This paper provides a brief overview of these developments.

Unpredictable post-laparoscopic bleeding in essential thrombocytosis: a call for additional safety measures

  • Atef M.M. Darwish;Dina A.M. Darwish;Yasser Abdelaal
    • Journal of Medicine and Life Science
    • /
    • v.20 no.2
    • /
    • pp.99-102
    • /
    • 2023
  • Patients with essential thrombocythemia (ET) can undergo laparoscopy without international precautions. This case report describes an ET with a mild increase in the platelet count that developed after laparoscopic surgery and prolonged intraperitoneal bleeding. The patient underwent intensive postoperative medical and surgical treatments until cured. Patients with ET should provide informed consent for post-laparoscopic bleeding. Surgeons should perform optimal hemostasis. Further studies are required to provide clear guidelines for both medical and surgical interventions aimed at preventing thrombo-hemorrhagic complications associated with ET. A preoperative study of platelet function and the selection of the best cytotoxic drug for the perioperative period are mandatory.

Accidental Trichloroacetic Acid Burn Injuries on Genital Area during Gynecological Procedures (부인과적 시술 중 발생한 생식기 부위의 Trichloroacetic Acid 화학 화상)

  • Lee, Chong Kun;Yu, Sung Hoon;Kim, Dong Chul
    • Journal of the Korean Burn Society
    • /
    • v.24 no.1
    • /
    • pp.18-20
    • /
    • 2021
  • TCA is widely used in cosmetic treatments such as chemical peels, tattoo removal, and also in gynecological procedures for managing cervical intraepithelial neoplasia. However, storage of high concentration of TCA in a gynecology office is a potential hazard, as it may accidentally cause severe chemical burns. We report a case of deep dermal TCA chemical burn on genital area, which occured accidentally and resulted from misuse of high concentration (90%) of TCA coated vaginal gauze packing dressing during gynecological procedures.

Disappearance of Serum Methylated p16 Indicates Longer Survival in Patients with Gastric Cancer

  • Lim, Han-Ki;Park, Joong-Min;Chi, Kyong-Choun;Lee, Eun-Ju;Jeong, Eun-Mi
    • Journal of Gastric Cancer
    • /
    • v.13 no.3
    • /
    • pp.157-163
    • /
    • 2013
  • Purpose: The aim of this study was to assess clinical correlations with postoperative alteration of p16 DNA methylation, and to clarify whether postoperative changes in the serum DNA methylation status of p16 could be used as a reliable prognostic factor for gastric cancer. Materials and Methods: Fifty-three consecutive gastric adenocarcinoma patients who underwent gastric resection (Chung-Ang University Hospital, Seoul, Korea) were included. DNA methylation of p16 was evaluated by methylation-specific polymerase chain reaction using serum DNA preoperatively and at the 10th postoperative day. The correlation between changes in methylation status and patients' prognosis was analyzed. Results: p16 was methylated in 79.2% of preoperative serum DNA and in 54.7% of postoperative serum DNA, respectively. Methylation in p16 disappeared more frequently in patients who underwent standard D2 lymphadenectomy compared to those who underwent modified D1+ lymphadenectomy (P=0.016). Whereas methylation of preoperative serum DNA was not correlated with survival, patients with postoperative disappearance of p16 methylation showed longer survival than those without postoperative disappearance of p16 methylation in the patients who had gastric cancer with lymph node metastasis (P=0.042). Conclusions: Postoperative disappearance of p16 methylation could be an available prognostic factor for node-positive gastric cancer.

Efficacy of Korean Medicine Combination Treatments for Recurrent Back Pain after Medical Procedures: A Retrospective Study

  • Jeong, Wu-Jin;Noh, Je-Heon;Huh, Hyo-Seung;Lee, Sun-Ho;Kim, Sun-A;Kim, Min-Kyung;Roh, Ji-Ae;Lee, Ji-Won
    • Journal of Acupuncture Research
    • /
    • v.36 no.4
    • /
    • pp.230-237
    • /
    • 2019
  • Background: The purpose of this study was to investigate the clinical efficacy of Korean medicine combination treatments for recurring back pain after medical procedures. Methods: This was a retrospective study performed on 311 patients admitted to Daejoen Jaseng hospital who were diagnosed with lumbar spine herniated intervertebral discs. The patients were divided into 2 groups according to whether or not they had undergone at least one medical procedure on the lumbar spine. They were assessed with Numeric Rating Scale (NRS), Oswestry Disability Index (ODI) and EuroQol-5 Dimensions Index (EQ-5D) before and after treatment. Results: Patients who experienced a medical procedure on the lumbar spine in the prehospital phase (Group A), statistically significantly improved EQ-5D and ODI scores. The NRS scores also decreased however it was not statistically significant. Patients who had not undergone a medical procedure on the lumbar spine in the prehospital phase (Group B) had statistically significantly improved ODI and NRS scores. The average EQ-5D score decreased however, there was no statistically significant difference before and after scores in Group B. There was no statistically significant difference in variation in EQ-5D, ODI, and NRS scores before and after treatment between the groups. Conclusion: The results of this study indicated that even after a bilateral procedure and surgery, when pain in patients with lumbar spine herniated intervertebral disc did not decrease, (as in failed back surgery syndrome), Korean medicine combination treatment of postoperative pain was helpful and there was improvement in daily life.

Uterine Arterial Embolization for the Treatment of Leiomyomas Accompanying with Adenomyosis (자궁선종을 동반한 자궁근종에서 자궁동맥 색전술을 이용한 치료의 효과)

  • Jang, Jin-Beum;Bai, Sang-Wook;Lim, Jae-Hak;Lee, Do-Yeon;Kim, Jung-Yeon;Jeong, Kyung-Ah;Kim, Sei-Kwang;Park, Ki-Hyun
    • Clinical and Experimental Reproductive Medicine
    • /
    • v.28 no.3
    • /
    • pp.215-223
    • /
    • 2001
  • Objective: The purpose of this study was to make a guideline of uterine artery embolization for the treatment of uterine leiomyomas accompanying with adenomyosis in Korea. Materials and Methods : We performed the retrospective study for 37 women who had uterine leiomyomas accompanying with adenomyosis. Bilateral uterine artery embolization was performed in 37 patients (age range 25-65) during 17 months with pain, hypermenorrhea, urinary frequency etc due to leiomyomas. Ultrasound imaging was performed before the procedure and at mean 6.9 months after the procedure. Results: All procedures were technically successful. Mean clinical follow-up was 12.8 months. Minor complication occurred in 82% patients after the procedure. After imaging follow-up (mean, 6.9 months postprocedure), median uterine volume decreased 34.4%, and dominant myoma volume decreased 86%. There was no statistical difference in uterine volume reduction and dominant myoma size reduction whether occluding agents was polyvinyl alcohol, polyvinyl alcohol plus gelfoam, and gelfoam, and whether ultrasound measured Resistance Index value before the procedure was low or high. Conclusion: Primary candidates for uterine artery embolization include those with symptomatic uterine leiomyomas who no longer des ire fertility but wish to avoid surgery or are poor surgical risks. To our study, uterine volume reduction and dominant myoma size reduction in patients who had adenomyosis were similar to previous other studies in patients who had not adenomyosis. Therefore adenomyosis should not be considered as a contraindication for uterine artery embolization. Because there is little data about subsequent reproductive potential after this procedure, it should not be routinely advocated for infertile women. Further investigation is warranted for occluding agents and Resistance Index.

  • PDF

A Case of Tamoxifen-Associated Rapid Growing and Multiple Endometrial Polyps (타목시펜 사용과 연관되어 빠르게 진행하는 다발성 자궁내막폴립 1예)

  • Lee, Hee-Jun;Kim, Hoon;Ku, Seung-Yup;Han, Won-Shik;Kim, Seok-Hyun;Choi, Young-Min;Kim, Jung-Gu;Moon, Shin-Yong
    • Clinical and Experimental Reproductive Medicine
    • /
    • v.37 no.2
    • /
    • pp.173-179
    • /
    • 2010
  • The antiestrogen tamoxifen is currently the most commonly used adjuvant treatment of breast cancer with antiestrogenic effect on mammary tissue. However, it is also associated with endometrial abnormalities, including hyperplasia, polyps, carcinoma, mostly interpreted as evidence of estrogenic effect on the endometrium. Previously, tamoxifen-associated polyp in breast cancer has been reported in the literature. Most studies had a long follow-up period and tamoxifen-associated polyp developed more than 1 year after tamoxifen treatment. In this case, we report an unusual case of rapid growing and multiple endometrial polyps that were developed only after 3 months' tamoxifen treatment in a postmenopausal breast cancer patient who received quadrant mastectomy with a brief review of literature.

Assessment of Ovarian Volume and Hormonal Changes after Ovarian Cystectomy in the Different Ovarian Tumor (난소 낭종 제거술후 난소 용적 및 호르몬의 변화)

  • Park, Joon-Cheol;Bae, Jin-Gon;Kim, Jong-In;Rhee, Jeong-Ho
    • Clinical and Experimental Reproductive Medicine
    • /
    • v.35 no.2
    • /
    • pp.155-162
    • /
    • 2008
  • Objectives: The aim of this study was to assess the change of ovarian reserve after removal of ovarian tumor using basal FSH, $E_2$, clomiphene citrate challenge test and ovarian volume. Methods: Twenty two patients with unilateral ovarian tumor, ${\leq}35$ years old, regular menstrual cycle were collected prospectively and divided into endometrioma or non-endometrioma group. We measured the ovarian volume with transvaginal ultrasonography on the day 3 of menstrual cycle within one month before and 3 months after surgery. Basal (cycle day 3) FSH, $E_2$ and CCCT were checked before surgery and repeated at least 2 spontaneous cycles later after surgery. Three patients that had been pregnant within 3 months after surgery were excluded in analysis. Results: The ovarian volume was reduced significantly after surgery in endometrioma and non-endometrioma ${\geq}10\;cm$ group ($4.79{\pm}2.57\;cm^3$ and $5.21{\pm}1.33\;cm^3$, respectively), but not in the non-endometrioma <10 cm group ($6.18{\pm}2.85\;cm^3$). After surgery, basal FSH and cycle day 10 FSH on CCCT in endometrioma and non-endometrioma were $4.25{\pm}0.20\;mIU/ml$ and $3.79{\pm}0.80\;mIU/ml$, $4.24{\pm}0.85\;mIU/ml$ and $4.28{\pm}0.92\;mIU/ml$, respectively. There were neither significant difference in comparison with the preoperative results nor between two groups. Conclusions: Enucleation of ovarian mass was associated with a significant reduction in ovarian volume in endometrioma and non-endometrioma larger than 10cm in diameter. Hormonal markers for evaluation of ovarian reserve, such as basal and cycle day 10 FSH on CCCT, were not changed significantly in each group. In reproductive age women, conservative enucleation or cystectomy rather than oophorectomy should be considered even in a large benign tumor and ovarian function could be reserved by meticulous operative technique.