• The Journal of Korean Obstetrics and Gynecology
• /
• v.37 no.3
• /
• pp.33-48
• /
• 2024

Objectives: The purpose of this study is to analyze the effect of Korean-Western medicine integrative care for patients on hospitalized with gynecologic and breast cancer. Methods: The records were searched for integrative medical treatment the Department of Obstetrics and Gynecology in a Korean medical hospital between January 1st, 2021 and April 30, 2024, based on the Electronic Medical Record system (EMR). The records were reviewed and analyzed based on the patient's characteristics, the chief symptom, Korean medical treatment which patients received, and follow-up observation Results: 61 cases were screened, the patient's age is the highest in their 50s with 16 cases (26.23%). The average hospitalization period for patients with integrative care is 7.64 days. Among the patients with integrative care, 60 patients (98.36%) underwent surgery. Gastro-intestinal symptoms (nausea/vomiting, constipation /diarrhea etc.) showed the largest proportion in total symptoms (40.72%). After Korean-medicine integrative treatment, 62.30% of patients improved their symptoms, and 19.67% of cases were not improved because follow-up was not performed. Acupuncture is the most frequently performed Korean-medicine treatment (90.16%), followed by moxibustion (55.74%) and herbal medicine (37.70%). Among the herbal medicines, Gamisipjeon-tang and Geonchil-dan were the two most used herbal medicines. Conclusions: Included cases showed that treatments used in Korean medicine hospitals for integrative care with gynecologic and breast cancer are safe and effective based on several evidence. In the future, further high-quality large-scale study is needed to prove effectiveness of Korean-Western integrative care for patients with gynecologic and breast cancer.

• Women's Health Nursing
• /
• v.20 no.2
• /
• pp.148-154
• /
• 2014

Purpose: This study was done to evaluate postoperative patient satisfaction, vaginal bleeding, and sexual function in women after laparoscopic supracervical hysterectomy (LSH). Methods: A retrospective study was conducted using a questionnaire mailed to 131 women who underwent LSH between 2008 and 2011at the Department of Obstetrics &Gynecology, D University Hospital in Chungnam province. Indication for LSH was uterine myoma. The questionnaire contained questions on overall postoperative satisfaction, influence on quality of life of vaginal bleeding, and sexual satisfaction following surgery. Data were collected from March to July 2013 and 109 (83.2%) patients returned the questionnaire. Results: Most women reported being very satisfied (90.8%) or satisfied (7.3%), but 2 women (1.8%) were not satisfied with LSH. Four patients (3.4%) reported experiencing vaginal bleeding but with no negative influence on quality of life. Of sexually active women, 82 patients (90.1%) reported improvements in sexual function, 8 patients (8.8%) reported "no change", and one patient (1.1%) reported a deterioration Conclusion: Results of this study indicate that LSH is associated with a high degree of patient satisfaction, no negative influence on quality of life from vaginal bleeding, and improvement in sexual function to a minimum 2 years after the procedure.

• The Journal of Korean Obstetrics and Gynecology
• /
• v.29 no.2
• /
• pp.47-66
• /
• 2016

Objectives : The purpose of this study was to present the clinical practice guidelines for breast cancer through the analysis of existing clinical practice guidelines in Western and Chinese medicine. Methods : The literature search was performed regarding conventional and integrative medical treatment of breast cancer using Google Scholar, KIOM OASIS, PUBMED and Jisan library of Daejeon university. Results : Breast cancer is the fifth most common cancer in Korea. Recent studies revealed that combining conventional and integrative medical treatment can reduce the sequela of surgical operation and improve survival rate. However there isn’t still a systemic clinical guideline for breast cancer in korean medicine. This study will be a preliminary study to establish clinical practice guidelines of Korean Medicine for breast cancer.Conclusions : Further objective and systemic clinical studies related to Korean Medicine are needed to develope more advanced clinical practice guidelines of breast cancer.

• The Journal of Korean Obstetrics and Gynecology
• /
• v.30 no.3
• /
• pp.136-145
• /
• 2017

Objectives: The aim of this study was to report a case of 43 year-old patient, diagnosed with missed abortion who previously failed to do spontaneous gestational sac expulsion in spite of 2 week-expectant-method, eventually succeeded with Traditional Korean Herb Medicine (TKHM) treatment only. Methods: In transabdominal sonography, gestational sac was not present at week 8. Due to the possibility of effect of medication on future pregnancy and post-surgery complications, D&C (Dilation & Curettage) as well as any other treatment was not done. Instead, she presented to our clinic. A combination of 2 main TKHMs was prescribed with 120-150 cc/dose (2 times per day for a week) : Gunggi-tang for helping expulsion of the dead fetus and placenta, and Wooseul-tang for treating retained placenta. Results: On day 6 of TKHM treatment, initiation of placenta expulsion was done. From day 8, hemorrhage started, lasting for 6 days. On day 10, placenta was expelled. On day 13, gestational sac and placenta were completely expelled. No infection, delayed bleeding, or pain was observed. After bleeding stopped, menorrhea started from week 7. Conclusions: This report implies a potential of TKHM as an optional and safe medication for the natural expulsion of conceptus in missed abortion.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.11
• /
• pp.5715-5719
• /
• 2012

The relation between cyclooxygenase enzymes and E-cadherin, along with the roles of these markers in the prediction of survival in optimally cytoreduced serous ovarian cancer patients was investigated. Individuals who underwent primary staging surgery and achieved optimal cytoreduction (largest residual tumor volume <1 cm) constituted the study population. Specimens of 32 cases were immunohistochemically examined for cyclooxygenase-1, cyclooxygenase-2, and E-cadherin. Two could not be evaluated for E-cadherin and cyclooxygenase-1. Overall, 14/30, 19/30, and 15/32 cases were positive for E-cadherin, cyclooxygenase-1, and cyclooxygenase-2, respectively. The expressions of E-cadherin and cyclooxygenase-2 were inversely correlated (p:0.02). E-cadherin expression was related with favorable survival (p<0.001). The relation between the expression of cyclooxygenase enzymes and poor survival did not reach statistical significance. On multivariate analysis, E-cadherin appeared as an independent prognostic factor for survival. In conclusion, E-cadherin expression is strongly linked with favorable survival. E-cadherin and cyclooxygenase 2 may interact with each other during the carcinogenesis-invasion process. Further studies clarifying the relation between E-cadherin and cyclooxygenase enzymes may lead to new preventive and therapeutic targets in ovarian cancer.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.5
• /
• pp.1817-1820
• /
• 2015

Background: Hemoglobin A1c(HgA1c) is a marker of poor gylcemic control and elevation HgA1c is associated with increased risk of many cancers. We aimed to determine the HgA1c levels in endometrial cancer cases and any relationship with stage and grade of disease. Materials and Methods: A retrospective data review was performed between June 2011 and October 2012 at a tertiary referral center in Turkey. The study included 35 surgically staged endometrial cancer patients and 40 healthy controls. Preoperative HgA1c levels drawn within 3 months before surgery were compared. Also the relationships between HgA1c levels and stage, grade and hystologic type of cancer cases were evaluated. Results: The mean HgA1c levels were statistically significantly higher at $6.19{\pm}1.44$ in endometrial cancer cases than the $5.61{\pm}0.58$ in controls (p=0.027). With endometrial cancer cases, the mean HgA1c level was found to be $6.62{\pm}1.40$ for stage I and $6.88{\pm}1.15$ for stages II-IV (p=0.07). The figures were $6.74{\pm}1.65$ for endometrioid and $6.63{\pm}1.41$ for non-endometrioid type tumors (p=0.56). Mean HgA1c levels of $6.72{\pm}1.14$ for grade 1 and $6.62{\pm}1.42$ for grade 2-3 were observed (p=0.57). Conclusions: HgA1c levels in endometrial cancer patients were statistically higher than healthy controls. However, HgA1c did not show any significant correlation with stage, grade and histologic type in endometrial cancer cases.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.3
• /
• pp.1489-1492
• /
• 2016

Background: Although there are no biomarkers that are routinely used in endometrial cancer (EC) management, many studies have found that serum human epididymis protein 4 (HE4) is superior to cancer antigen 125 (CA125) in the detection of EC. The correlation of HE4 with two prognostic factors for EC, primary tumor diameter (PTD) and depth of myometrial invasion (DMI) may be useful in identifying EC patients at high risk of lymphatic dissemination. Objective: To evaluate the correlation of serum HE4 with PTD and DMI in patients with EC. Materials and Methods: A cross-sectional study was conducted on 70 EC patients who were scheduled for elective surgery at Rajavithi Hospital between 1st September 2013 and 30th May 2014. Preoperative serum levels of HE4 and CA125 were investigated, and then gross measurement of PTD was taken and postoperative pathologic slides were reviewed for DMI including histologic types, grading and staging. Results: Preoperative serum HE4 levels were strongly correlated with PTD (r=0.65, p<0.001) and moderately correlated with DMI (r=0.46, p<0.001). Moreover, serum HE4 levels were significantly elevated in EC patients with PTD >2 cm (p<0.001) and DMI > 50% (p=0.004). The performance of serum HE4 in identifying EC patients at low risk and high risk of lymph node metastasis was significantly better than that of CA125 (AUC 0.88 vs. 0.65, p=0.003). At an optimal cut-off value of 70 pM/L, serum HE4 had a sensitivity of 83.3% and a specificity of 80.0%. Conclusions: In EC patients, preoperative serum HE4 is significantly correlated with PTD and DMI. Serum HE4 levels could be useful in identifying endometrial cancer patients at high risk of lymphatic spread who would benefit from systemic lymphadenectomy at the cut-off value of 70 pM/L.

• Korean Medical Education Review
• /
• v.20 no.2
• /
• pp.112-117
• /
• 2018

Attending the operation room is an essential part of surgical clerkships. Syncope or presyncopal attacks in the operation room may negatively affect students' learning and career development. This study set out to identify the prevalence of syncope and presyncopal attacks in the operation room during medical students' surgical clerkships. Data from 420 medical students (303 men and 117 women) in their 3rd year of clerkship were collected between 2014 and 2017. An anonymous questionnaire was distributed to assess the prevalence and degree of syncope and presyncopal symptoms. A total of 27% of the respondents had experienced syncope or presyncopal symptoms, 49.6% of the female students and 18.8% of the male students (p<0.001). Fifty students (43.5%) had been attending as observers at the time of the syncopal attack, while 65 students (56.5%) had been participating as assistants. Thirty-four students (29.6%) had recently eaten at the time of the syncopal attack, while 81 students (70.4%) had not recently eaten. Prodromal symptoms included the urge to sit down (21.2%), sweating (19.3%), nausea (16.9%), a feeling of warmth (13.3%), darkened vision (12.6%), yawning (11.7%), palpitation (11.0%), ear fullness (10.2%), black spots in one's vision (7.6%), and hyperventilation (7.1%). This study showed the prevalence of syncope and presyncopal symptoms in the operation room during surgical clerkships. For students' safety and effective clerkship learning, thorough proactive education on syncopal attacks is required.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.10
• /
• pp.5237-5240
• /
• 2012

Objective: This observational study was to identify risk factors for vulvar cancer recurrence. Materials and Methods: In the study 107 patients with primary vulvar cancer were analyzed. Surgical treatment consisted of radical excision of the primary tumor in combination with unilateral or bilateral superficial and deep inguinofemoral lymphadenectomy through separate incisions. Patients with deeper tumor invasion >1 mm or wider than 2 cm and/or groin lymphnode metastases were referred for adjuvant radiotherapy. Those with large privary vulvar tumors received neoadjuvant radiotherapy of 30Gy followed by surgical treatment and adjuvant radiotherapy. Results: Most of patients had only primary radiotherapy to the vulva and inguinal lymph nodes and only 34.5% of patients were eligible for surgical treatment. In 5 year follow-up period 25.2% (27) patients were alive without the disease, 15.0% (16) were alive with the disease and 59.8% (64) were dead. 60.7% (65) patients experienced local recurrence and 2.8% (3) patients had distant metastases. Median survival for patients without recurrent disease was $38.9{\pm}3.2$ months and $36.0{\pm}2.6$ months with no statistically significant difference. Patients with early stage vulvar cancer had longer mean survival rates-for stage I $53.1{\pm}3.4$ months, $38.4{\pm}4.4$ months for stage II and $33.4{\pm}2.6$ and $15.6{\pm}5.2$ months for patients with stage III and stage IV vulvar cancer, respectively. The only signifficant prognostic factor predicting vulvar cancer recurrence was involvement of the midline. Conclusions: Patients having midline involvement of vulvar cancer has lower recurrence risk, probably because of receiving more aggressive treatment. There is a tendency for lower vulvar cancer recurrence risk for patients over 70 years of age and patients who are receiving radiotherapy as an only treatment without surgery, but tendency for higher risk of recurrence in patients with multifocal vulvar cancer.

• Journal of Korean Academy of Nursing
• /
• v.3 no.2
• /
• pp.45-51
• /
• 1973

Bacterial cultures of the transfer forceps, 4"$\times$4"mesh gauze and polluted air of nursing units of general surgery, internal medicine, gynecology and pediatrics of S.N.U.H. were carried on for S consecutive days (from 17th to 21s1 August, 1972) to investigate the degree of contamination of such instruments which were used in dressing the patients. 1. The average hospitalized patients for each nursing unit were 24 persons. 2. The frequency of dressing, and using forceps and gauze in surgical nursing unit were 25,316 and 66 times respectively. Actually the forceps were used most frequently. There was no dressing in the nursing unit of internal median. 3. Most of dressing were carried on from 11 : 00 to 13 : 59 o′clock. 4. Averagely 121.5 persons passed through each nursing unit. 549 visitors dropped in the nursing unit of gynecology in maximum, and 219 visitors in the nursing of internal medicine in minimum. The visitors rushed in from 11 : 00 to 13 : 59 o′clock to he 142.5 persons for each nursing unit in average. 5. Colony counts after the bacterial cultures of the forceps and gauze disclosed 1098.44 and 704.51 per plate respectively. 6. The degree of contamination was parallel to the duration and frequency of dressings. 7. The degree of contamination of the instruments was severest in the nursing unit of internal medicine, and !east in the nursing unit of gynecology. On the matter of gauze, the contamination was most extreme in the pediatric nursing unit. 8. There was no significant daily differences in terms of contamination throughout the week. 9. It was disclosed that empty forceps jars were less contaminated than the jars with solution of any kind. 10. Bacterial cultures of the polluted air in corridor showed 73,88 colony counts per plate.