• Title/Summary/Keyword: Gynecology Surgery

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The Importance of Multidisciplinary Management during Prenatal Care for Cleft Lip and Palate

  • Han, Hyun Ho;Choi, Eun Jeong;Kim, Ji Min;Shin, Jong Chul;Rhie, Jong Won
    • Archives of Plastic Surgery
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    • v.43 no.2
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    • pp.153-159
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    • 2016
  • Background The prenatal ultrasound detection of cleft lip with or without cleft palate (CL/P) and its continuous management in the prenatal, perinatal, and postnatal periods using a multidisciplinary team approach can be beneficial for parents and their infants. In this report, we share our experiences with the prenatal detection of CL/P and the multidisciplinary management of this malformation in our institution's Congenital Disease Center. Methods The multidisciplinary team of the Congenital Disease Center for mothers of children with CL/P is composed of obstetricians, plastic and reconstructive surgeons, pediatricians, and psychiatrists. A total of 11 fetuses were diagnosed with CL/P from March 2009 to December 2013, and their mothers were referred to the Congenital Disease Center of our hospital. When CL/P is suspected in the prenatal ultrasound screening examination, the pregnant woman is referred to our center for further evaluation. Results The abortion rate was 28% (3/11). The concordance rate of the sonographic and final diagnoses was 100%. Ten women (91%) reported that they were satisfied with the multidisciplinary management in our center. Conclusions Although a child with a birth defect is unlikely to be received well, the women whose fetuses were diagnosed with CL/P on prenatal ultrasound screening and who underwent multidisciplinary team management were more likely to decide to continue their pregnancy.

MicroRNAs as Promising Biomarkers for Tumor-staging: Evaluation of MiR21 MiR155 MiR29a and MiR92a in Predicting Tumor Stage of Rectal Cancer

  • Yang, Yun;Peng, Wei;Tang, Tian;Xia, Lin;Wang, Xiao-Dong;Duan, Bao-Feng;Shu, Ye
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5175-5180
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    • 2014
  • Objective: In this study, tumor-stage predictive abilities of miR21, miR155, miR29a and miR92a were evaluated in rectal cancer (RC). Methods: Expression of miR21, miR155, miR29a and miR92a was detected and quantitated in tumor tissue and in adjacent normal tissue from 40 patients by TaqMan MicroRNA assay. Results: Significant overexpression of miR21, miR155, miR29a and miR92a was observed in RC tissues. While high expression of miR21, miR155 and miR29a in N1-2 and C-D stages presented a potential correlation with N and Duke stages, partial correlation analysis suggested that only miR155 rather than miR21 and miR29a played a greater influencing role. Receiver operating characteristics (ROC) curve analysis showed that miR155 could discriminate N0 from N1-2 with 85.0% sensitivity and 85.0% specificity, N2 from N0-1 with 90.0% sensitivity and 96.7% specificity, and C-D stage from A-B stage with 81.0% sensitivity and 84.2% specificity. Conclusions: Increase in expression of miR155 might represent a novel predictor for RC N and Dukes staging.

Decreased Serum Immunoglobulin in Recurrent Otitis Media with Effusion (재발성 삼출성 중이염과 혈청 면역글로불린 농도의 저하)

  • Shin, Il-Ho;Park, Dong-Choon;Byun, Jae-Yong;Park, Moon-Seo;Cha, Chang-Il;Yeo, Seung-Geun
    • IMMUNE NETWORK
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    • v.7 no.2
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    • pp.75-79
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    • 2007
  • Background: Defective or immature antibody responses to pathogens in children may explain the increased susceptibility to acute otitis media. However, there is no study in Korea patients whether a correlation exists between otitis media with effusion and the levels of serum immunoglobulins, IgG subclasses, IgA, IgM and IgE. Methods: 45 children with otitis media with effusion more than 4 episodes in 12 months or 3 episodes in 6 months, 62 children with otitis media with effusion less than 3 episodes in 12 months and 102 children for control group took part in the study at the Department of Otorhinolaryngology of the KyungHee University from May 2004 to Feburary 2007. Serum immunoglobulin levels were determined by nephelometry. And then the relationship between otitis media with effusion and serum immunoglobulin level was evaluated. Results: In otitis media prone group, serum IgG1, IgG2, IgG4, and IgA level was lower than those level of control group, it was significantly decreased (p<0.05). In otitis media group, serum IgA, IgE, and IgG4 level was lower than those level of control. But it was not statistically significant (p>0.05). Conclusion: Lower immunoglobulins in children with otitis media with effusion suggest a generalized decreased antibody responses. Lower levels of serum IgG1, IgG2, IgG4, and IgA may be related with chronicity or intractability of otitis media with effusion.

Effects of Local Pancreatic Renin-Angiotensin System on the Microcirculation of Rat with Severe Acute Pancreatitis

  • Pan, Zhijian;Feng, Ling;Long, Haocheng;Wang, Hui;Feng, Jiarui;Chen, Feixiang
    • The Korean Journal of Physiology and Pharmacology
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    • v.19 no.4
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    • pp.299-307
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    • 2015
  • Severe acute pancreatitis (SAP) is normally related to multiorgan dysfunction and local complications. Studies have found that local pancreatic renin-angiotensin system (RAS) was significantly upregulated in drug-induced SAP. The present study aimed to investigate the effects of angiotensin II receptors inhibitor valsartan on dual role of RAS in SAP in a rat model and to elucidate the underlying mechanisms. 3.8% sodium taurocholate (1 ml/kg) was injected to the pancreatic capsule in order for pancreatitis induction. Rats in the sham group were injected with normal saline in identical locations. We also investigated the regulation of experimentally induced SAP on local RAS expression in the pancreas through determination of the activities of serum amylase, lipase and myeloperoxidase, histological and biochemical analysis, radioimmunoassay, fluorescence quantitative PCR and Western blot analysis. The results indicated that valsartan could effectively suppress the local RAS to protect against experimental acute pancreatitis through inhibition of microcirculation disturbances and inflammation. The results suggest that pancreatic RAS plays a critical role in the regulation of pancreatic functions and demonstrates application potential as AT1 receptor antagonists. Moreover, other RAS inhibitors could be a new therapeutic target in acute pancreatitis.

An Algorithm for Labia Minora Reduction Based on a Review of Anatomical, Configurational, and Individual Considerations

  • Maurits Lange;J. Joris Hage;Refaat B. Karim;Frederic Amant
    • Archives of Plastic Surgery
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    • v.50 no.1
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    • pp.17-25
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    • 2023
  • A variety of reduction labiaplasty techniques have been introduced to date, but no single technique will offer the optimal solution for every patient. Rather, the technique should be chosen based on anatomical, configurational, and technical considerations, as well as on patients' personal preferences regarded maintenance of the labial rim, maintenance of labial sensitivity, and prevention of iatrogenic thickening of the labium. We reviewed, defined, and assessed labial configurational variety, neurovascular supply, reduction techniques, and patient's preferences as the considerations relevant to the choice of labiaplasty technique. Based on this review, an algorithm was constructed that leads to a choice of reduction technique through five decisions to be made regarding (1) resection or (partial) retention of the labial free rim, (2) the measure of required labial width reduction, (3) labial vascular status, (4) prevention of iatrogenic labial thickening, and (5) preservation of labial sensibility. The choice of techniques includes edge trimming, central spindle form de-epithelialization or full-thickness resection, and three modifications of the wedge resection or de-epithelialization technique. These three modifications comprised a modified anterior resection or de-epithelialization combined with posterior flap transposition, a custom flask resection or de-epithelialization, and a modified posterior wedge resection or de-epithelialization combined with anterior flap transposition. Use of the five decisional steps and the inclusion of modifications of all three conventional reduction techniques offer an improved algorithm for the choice of labioplasty technique.

Conceptus-related measurements at early pregnancy in Black Bengal goat: an abattoir study

  • Talukder, Anup K.;Rahman, Mohammad A.;Hoque, Mohammad N.;Islam, Mohammad T.;Rahman, Abu N.M.A.;Das, Ziban C.
    • Journal of Animal Reproduction and Biotechnology
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    • v.35 no.2
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    • pp.177-182
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    • 2020
  • The present study aimed to investigate the conceptus-related changes during early pregnancy in the Black Bengal breed of goat. A total of 22 gravid genitalia of the Black Bengal goats were collected from local slaughterhouses. The crown-rump lengths (CRL) of the conceptuses were determined to estimate the gestational age (GA). The length and diameter of uterine horn and amniotic sac were measured, and volume of amniotic and allantoic fluid formed by individual conceptus were recorded. The results reveal that the CRL is positively correlated with GA of the conceptus (R2 = 0.89, p < 0.05); however, CRL was not influenced by number of conceptus. Both the left and the right uterine horn gradually increased in size with the advancement of pregnancy irrespective of conceptus number present in the horn. The size of the amniotic sac of conceptus gradually increased with the conceptus age but maintained spherical shape from 5 to 7 weeks of pregnancy. The amniotic fluid formed by individual conceptus rapidly increased from 5 weeks (3.4 ± 0.3 mL) to 7 weeks (21.0 ± 2.0 mL) and 9 weeks (111.5 ± 4.0 mL). The volume of allantoic fluid formed by individual conceptus was steadily increased until 7 weeks (60.0 ± 5.0 mL) and began to decline slowly thereafter (50.0 ± 5.0 mL at 9 weeks). Notably, there was no effect of conceptus number per pregnancy on individual amniotic and allantoic fluid volume. The cotyledons have first appeared on the allanto-chorionic surface from 4 to 5 weeks of pregnancy. The closed eye, nostril and hooves of the conceptus became visible at 7 weeks of pregnancy. The present study has shown the basic information on conceptus-related developmental changes during early pregnancy up to 9 weeks in Black Bengal goat.

mRNA Expression Differences of uPA, uPAR in Eutopic Endometrium of Advanced Stage Endometriosis Patients (중증 자궁내막증 환자의 자궁내막과 정상인 자궁내막에서 uPA, uPAR mRNA 발현의 차이에 관한 연구)

  • Hur, Sung Eun;Lee, Ji Young;Lee, Woon Jung;Chung, Hye-Sung;Chung, Hye Won
    • Clinical and Experimental Reproductive Medicine
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    • v.33 no.4
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    • pp.229-236
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    • 2006
  • Objective: We investigated the expression of uPA and uPAR in eutopic endometrium of advanced stage endometriosis and control patients. Methods: The 33 endometriosis patients and 32 controls were enrolled. Endometrial samples were obtained from 65 premenopausal women aged 29-44 years, undergoing laparoscopic surgery or hysterectomy for non-malignant lesions. Sufficient samples were collected from 33 patients with endometriosis stage Ill and IV and 32 controls without endometriosis confirmed by laparoscopic surgery. The mRNA expression of uPA and uPAR from eutopic endometrium were analyzed by RT-QC PCR. Results: The mRNAs of uPA and uPAR were expressed in eutopic endometrium from endometriosis and normal controls throughout the menstrual cycle. Uterine endometrium from women with endometriosis expresses significantly (p<0.05) higher levels of u-PA mRNA than endometrium from normal women without endometriosis in the proliferative phase. There were no significant differences in expression of uPAR in eutopic endometrium between controls and endometriosis patients. Conclusion: These results suggest that eutopic endometrium from endometriosis patients may be more invasive and prone to peritoneal implantation because of greater u-PA mRNA expression than endometrium from women without endometriosis. Thus, increased proteolytic activity may be one etiology for the invasive properties of the endometrium resulting in the development of endometriosis.

Good Outcomes of Patients with Stage IB Endometrial Cancer with Surgery Alone

  • Rahatli, Samed;Dizdar, Omer;Kucukoztas, Nadire;Oguz, Arzu;Yalcin, Selim;Ozen, Ozlem;Reyhan, Nihan Haberal;Tarhan, Cagla;Yildiz, Ferah;Dursun, Polat;Altundag, Ozden;Ayhan, Ali
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.9
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    • pp.3891-3893
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    • 2014
  • Background: Most patients with endometrial cancer have stage I disease. Adjuvant therapy in stage IB (formerly IC) endometrial cancer is controversial, treatment options including observation or brachytherapy/radiotherapy in grade 1-3 patients with or without chemotherapy. The purpose of this study was to assess the outcomes of our patients with stage IB endometrioid endometrial cancer. Materials and Methods: Sixty two patients with stage IB endometrial cancer and endometrioid histology were retrospectively evaluated. All patients were initially treated surgically by the same surgeon with comprehensive staging, i.e. total abdominal hysterectomy, bilateral salphingooopherectomy, bilateral pelvic and paraaortic lymph node dissection and omentectomy. Adjuvant radiotherapy was discussed with patients and utilized by those who accepted. Adjuvant chemotherapy was not given to any of the patients. Results: Median age was 62 (range, 42-95). Ninety percent of the patients had grade 1-2 disease. Thirteen patients (21%) received intra vaginal brachytherapy (IVBT) and one received whole pelvic radiotherapy (WPRT). Median follow-up time was 46 months (range, 9-77 months). Three patients experienced recurrence (4.8%), two of them died on follow-up and one was still alive at last visit. Two patients with recurrence had FIGO grade 2 tumors and one had a grade 3 tumor. Two patients (3.2%) died without evidence of recurrent disease. Relapse free survival at 5 years was 94.4% and overall survival was 93.1%. Conclusions: Patients with stage IB disease in our study demonstrated relatively low recurrence rates although the majority of them received no adjuvant treatment. Surgery alone may be sufficient for most patients with this stage of endometrial cancer.

Effect of intravenous ascorbic acid administration on fatigue after laparoscopic myomectomy: A randomized, double-blind, placebo-controlled trial (복강경 자궁근종절제술을 받은 여성에서 정맥 내 아스코르브산 투여가 피로에 미치는 영향: 무작위 배정 양측맹검 위약대조 임상시험)

  • Hwang, Woo Yeon;Kim, Kidong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.2
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    • pp.434-439
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    • 2021
  • We assessed the effects of intravenous (IV) ascorbic acid administration on fatigue in women undergoing laparoscopic myomectomy. We analyzed the secondary endpoint results of a randomized, double-blind, placebo-controlled trial. Fifty patients undergoing laparoscopic myomectomy received IV ascorbic acid (2g) or placebo (randomly 1:1 ratio) intravenously during surgery. On day 2 post-surgery, we measured the level of fatigue using the Brief Fatigue Inventory-Korean version. Forty-five women (experimental arm 23, control arm 22) were eligible for analysis after 5 women (experimental arm 2, control arm 3) were excluded due to withdrawal of consent, cancellation of surgery or non-measurement of the endpoints. The baseline and operative characteristics were similar between arms and the global fatigue score of the experimental arm (4.56 ± 2.63) was not significantly different from that of the control arm (5.21 ± 2.02, P = 0.351). However, the fatigue score of the experimental arm tended to be lower than that of the control arm in most domains. IV ascorbic acid administration did not significantly reduce the level of fatigue in women undergoing laparoscopic myomectomy as compared to placebo. More research is needed to better understand the effects of ascorbic acid on fatigue in surgical patients.

Role of $Na^+\;-K^+$ Pump on Endothelium-dependent Relaxation

  • Sung, Sang-Hyun;Roh, Joon-Ryang;Park, Tae-Sic;Suh, Suk-Hyo;Hwang, Sang-Ik;Kim, Ki-Whan
    • The Korean Journal of Physiology
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    • v.27 no.2
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    • pp.199-207
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    • 1993
  • To study the underlying mechanism through which the endothelium-dependent relaxation is inhibited by blocking the $Na^+\;-K^+$ pump, the effects of $Na^+\;-K^+$ pump blockade on the release of EDRF and its relaxing activity were examined, using organ bath study, bioassay technique, and cGMP measurement. Endothelium-dependent relaxation was attenuated by blocking the $Na^+\;-K^+$ pump in the vascular ring with intact endothelium. In bioassay experiment EDRF release was decreased with the blockade of the $Na^+\;-K^+$ pump in the EDRF donor strip. Endothelium-dependent increase of cGMP level was suppressed by inhibiting the $Na^+\;-K^+$ pump in the test strips. The magnitude of relaxation of test strip which was induced by the perfusate that had passed through the EDRF donor strip was decreased with the blockade of the $Na^+\;-K^+$ pump in the test strip. Therefore, it could be suggested that the attenuation of endothelium-dependent relaxation caused by inhibiting $Na^+\;-K^+$ pump activity is due to both the decreased release of EDRF from endothelial cells and the decreased sensitivity of the smooth muscle cells to EDRF.

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