• 제목/요약/키워드: Gynecology Surgery

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A Clinical Report of an Anemia Patient Received Hospital Treatment after Hysterectomy (자궁적출술 이후 발생한 중증 빈혈 환자 1례 증례보고)

  • Kwon, Na-Yoen;Lee, Dong-Nyung
    • The Journal of Korean Obstetrics and Gynecology
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    • v.31 no.3
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    • pp.131-140
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    • 2018
  • Objectives: The posthysterectomy syndrome is sequela which occurred after hysterectomy. Even though hysterectomy is one of common surgery in gynecologic operation, the complications of surgery easily occurred. The purpose of this study is to report the effect of traditional Korean medicine on posthysterectomy syndrome, especially anemia. Methods: The patient having treated with hospital management, from January 19th in 2018 until Feburary 8th in 2018, participated. Her chief complaint was dizziness which occurred after hysterectomy. We diagnosed her as anemia based on symptoms and blood test result. We treated the patient with herbal medicine, moxibustion and iron pills. The efficacy of treatment was evaluated with visual analogue scale (VAS) and complete blood cell count. Results: During hospitalization period, the symptoms including dizziness, fatigue, headache, neck pain, abdominal pain were reduced. After discharging, we identified that the level of hemoglobin was normalized. Conclusions: To recover from posthysterectomy syndrome, Korean medicine treatment is considered to be effective.

mRNA Expression of Thrombospondin-1 and -2 in Severe Endometriosis Patients in Korean Women (중증 자궁내막증 환자의 내막에서 thrombospondin-1과 -2의 mRNA의 발현에 관한 연구)

  • Hur, Sung Eun;Lee, Ji Young;Moon, Hye-Sung;Chung, Hye Won
    • Clinical and Experimental Reproductive Medicine
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    • v.32 no.3
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    • pp.253-259
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    • 2005
  • Objective: We investigated the expression of TSP-1 and -2 in eutopic endometrium of advanced 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 III and IV and 32 controls without endometriosis confirmed by laparoscopic surgery. The mRNA expression from eutopic endometrium for TSP-1 and -2 were analyzed by RT-QC PCR. Results: The mRNAs of TSP-1 and -2 were expressed in eutopic endometrium from endometriosis and normal controls throughout the menstrual cycle. There were no significant differences in expression of TSP-1 and TSP-2 in eutopic endometrium between controls and endometriosis patients. Conclusion: Our results indicated that TSP-1 and -2 had no crucial role compared to other molecules in the regulation of angiogenesis. These findings also suggest that dysregulation of other angiogenic regulators would be concerned in pathophysiologic role in endometriosis development.

Two Cases of Combined Pregnancy Following IVF-ET (체외수정 시술 후 발생된 병합임신 2례)

  • Lee, Kyung-Ah;Kwak, Yang-Soo;Han, Kuk-Sun;Koh, Min-Whan;Lee, Tae-Hyung
    • Journal of Yeungnam Medical Science
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    • v.14 no.1
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    • pp.262-268
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    • 1997
  • Combined intrauterine and ectopic (heterotopic) pregnancy occurs in approximately 1 in 30,000 spontaneous gestations. Heterotopic gestations are increased in women who have had reconstructive pelvic surgery, pelvic inflammatory disease and artificial ovarian hyperstimulation. Patients who require assisted reproductive technologies, such as in vitro fertilization / embryo transfer and gamete intrafallopian transfer, also have an increased risk of a heterotopic pregnancy. We experienced two cases of combined pregnancy following IVF-ET. Following is a report of these cases with a brief review of references.

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Three Cases of Sequela following Thyroid Lobectomy for Thyroid Cancer (갑상선 유두암 환자의 갑상선엽절제술 후유증에 대한 증례 보고 3례)

  • Cho, Su-Yun;An, Tteul-E-Bom;Kim, Dong-Chul
    • The Journal of Korean Obstetrics and Gynecology
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    • v.31 no.3
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    • pp.141-151
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    • 2018
  • Objectives: This paper aims to report the effects of Korean medical treatment on three patients who underwent thyroid lobectomy for thyroid cancer. Methods: Three patients were hospitalized at hospital to treat pain and general weakness after thyroid lobectomy. The patients took Korean medical treatment including herbal medicine and acupuncture. Numerical Rating Scale (NRS) of symptoms was measured every morning. Results: After the treatment, the pain and general weakness following surgery decreased, and general conditions improved. Conclusions: This cases show that Korean medical treatment is effective for a patients who underwent thyroid lobectomy for thyroid cancer.

Pulsatile GnRH Therapy in Male Patients with Hypogonadotropic Hyprogonadism (GnRH의 맥동성 투여에 의한 남성 성선기능저하증의 치료)

  • Park, Ki-Hyun;Jee, Yong-Seok;Lee, Byung-Seok;Lee, Bo-Yun;Cho, Dong-Jae;Song, Chan-Ho;Lee, Moo-Sang;Choi, Hyung-Ki;Lee, Hyun-Chul;Heo, Kab-Beom
    • Clinical and Experimental Reproductive Medicine
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    • v.19 no.1
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    • pp.81-85
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    • 1992
  • The effects of pulsatile GnRH therapy have been studied for the treatment of different forms of hypogonadotropic hypogonadism, including idiopathic hypogonadotropic hypogonadism and hypogonadism developed as a result of treatment with combination of surgery and irradiation for pituitary or hypothalamic tumor. GnRH was administered subcutaneously in a dose of $10{\mu}g$ every 2 hours with the pulsatile infusion pump. With GnRH therapy, all patients improved secretion of LH, FSH and testosterone. Testicular volumes increased. Spermatogenesis was induced in 8 patients. Pulsatile GnRH therapy is an effective treatment for idiopathic hypogonadotropic hypogonadism and can have a role in hypogonadism previously treated with combination of surgery and irradiation for pituitary or hypothalamic tumor.

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IOTA Simple Rules in Differentiating between Benign and Malignant Adnexal Masses by Non-expert Examiners

  • Tinnangwattana, Dangcheewan;Vichak-ururote, Linlada;Tontivuthikul, Paponrad;Charoenratana, Cholaros;Lerthiranwong, Thitikarn;Tongsong, Theera
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3835-3838
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    • 2015
  • Objective: To evaluate the diagnostic performance of IOTA simple rules in predicting malignant adnexal tumors by non-expert examiners. Materials and Methods: Five obstetric/gynecologic residents, who had never performed gynecologic ultrasound examination by themselves before, were trained for IOTA simple rules by an experienced examiner. One trained resident performed ultrasound examinations including IOTA simple rules on 100 women, who were scheduled for surgery due to ovarian masses, within 24 hours of surgery. The gold standard diagnosis was based on pathological or operative findings. The five-trained residents performed IOTA simple rules on 30 patients for evaluation of inter-observer variability. Results: A total of 100 patients underwent ultrasound examination for the IOTA simple rules. Of them, IOTA simple rules could be applied in 94 (94%) masses including 71 (71.0%) benign masses and 29 (29.0%) malignant masses. The diagnostic performance of IOTA simple rules showed sensitivity of 89.3% (95%CI, 77.8%; 100.7%), specificity 83.3% (95%CI, 74.3%; 92.3%). Inter-observer variability was analyzed using Cohen's kappa coefficient. Kappa indices of the four pairs of raters are 0.713-0.884 (0.722, 0.827, 0.713, and 0.884). Conclusions: IOTA simple rules have high diagnostic performance in discriminating adnexal masses even when are applied by non-expert sonographers, though a training course may be required. Nevertheless, they should be further tested by a greater number of general practitioners before widely use.

Comparison of Effectiveness in Differentiating Benign from Malignant Ovarian Masses between IOTA Simple Rules and Subjective Sonographic Assessment

  • Tongsong, Theera;Tinnangwattana, Dangcheewan;Vichak-ururote, Linlada;Tontivuthikul, Paponrad;Charoenratana, Cholaros;Lerthiranwong, Thitikarn
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.9
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    • pp.4377-4380
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    • 2016
  • Background: To compare diagnostic performance in differentiating benign from malignant ovarian masses between IOTA (the International Ovarian Tumor Analysis) simple rules and subjective sonographic assessment. Materials and Methods: Women scheduled for elective surgery because of ovarian masses were recruited into the study and underwent ultrasound examination within 24 hours of surgery to apply the IOTA simple rules by general gynecologists and to record video clips for subjective assessment by an experienced sonographer. The diagnostic performance of the IOTA rules and subjective assessment for differentiation between benign and malignant masses was compared. The gold standard diagnosis was pathological or operative findings. Results: A total of 150 ovarian masses were covered, comprising 105 (70%) benign and 45 (30%) malignant. Of them, the IOTA simple rules could be applied in 119 (79.3%) and were inconclusive in 31 (20.7%) whereas subjective assessment could be applied in all cases (100%). The sensitivity and the specificity of the IOTA simple rules and subjective assessment were not significantly different, 82.9% vs 86.7% and 94.0% vs 94.3% respectively. The agreement of the two methods in prediction was high with a Kappa index of 0.835. Conclusions: Both techniques had a high diagnostic performance in differentiation between benign and malignant ovarian masses but the IOTA rules had a relatively high rate of inconclusive results. The IOTA rules can be used as an effective screening technique by general gynecologists but when the results are inconclusive they should consult experienced sonographers.

Risk of Down syndrome in duodenal atresia and atrioventricular septal defect: Is there an ethnic difference?

  • Lee, Seung Mi;Jun, Jong Kwan;Kim, Hyun-Young;Shin, Seung Han;Park, Jeong Woo;Kim, Min Kyoung;Park, Chan-Wook;Park, Joong Shin
    • Journal of Genetic Medicine
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    • v.17 no.1
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    • pp.16-20
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    • 2020
  • Purpose: Duodenal atresia (DA) and atrioventricular septal defect (AVSD) are well known ultrasonographic findings associated with Down syndrome. The risk of Down syndrome in fetuses with these anomalies has been reported as 30% to 40%. However, on the basis of our clinical experience, the risk of Down syndrome of DA may be lower in Korean population. To clarify this issue, we compared the risk of Down syndrome between cases with DA and AVSD. Materials and Methods: The study population consisted of neonates who were confirmed as DA or AVSD by postnatal diagnosis. Postnatal diagnosis was made by surgery, postnatal echocardiography, or autopsy. Medical record was reviewed retrospectively. Results: A total of 213 neonates with DA or AVSD were included: 67 cases with DA and 146 cases with AVSD. The risk of Down syndrome was 4.5% (3/67) in DA vs. 29.5% (43/146) in AVSD. When confining analysis to those whose karyotyping were not performed during antenatal period, the risk of Down syndrome were 7.9% (3/38) in DA and 35.4% (35/99) in AVSD. Conclusion: The risk of Down syndrome in cases with DA was much lower in Korean population than previously reported risk in the literature. The significance of some antenatal sonographic markers for Down syndrome may be different according to ethnicity.

Successful pregnancy following transmyometrial embryo transfer after robot-assisted radical trachelectomy

  • Hue, Hye Jeong;Choi, Hyun Ji;Park, Jee Yoon;Suh, Dong Hoon;Lee, Jung Ryeol;Jee, Byung Chul;Kim, Seul Ki
    • Clinical and Experimental Reproductive Medicine
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    • v.48 no.2
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    • pp.184-187
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    • 2021
  • Radical trachelectomy is a fertility-preserving alternative to radical hysterectomy in carefully selected young women with early-stage cervical cancer. However, in cases with subsequent severe cervical stenosis, assisted reproductive techniques can be difficult. This is a case report of a 34-year-old patient who underwent robot-assisted radical trachelectomy and cerclage for early-stage (IB2) adenosquamous carcinoma. Three months after surgery, the patient underwent ovarian stimulation using a gonadotropin-releasing hormone antagonist protocol. As it was impossible to perform transcervical embryo transfer due to the almost complete absence of the cervical opening, transmyometrial embryo transfer under ultrasound guidance was performed. This resulted in a successful singleton pregnancy. This is the first case of successful pregnancy conceived by in vitro fertilization with transmyometrial embryo transfer in a patient who had previously undergone robot-assisted radical trachelectomy.

Quarantine and Appendicitis: A Macro-Area Experience

  • Nicola, Zampieri;Virginia, Murri;Mauro, Cinquetti;Amedeo, Elio;Saverio, Camoglio Francesco
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.1
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    • pp.75-80
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    • 2021
  • Purpose: Appendicitis is the most frequent urgency in pediatric age; the aim of this study was to investigate the association of quarantine for severe acute respiratory syndrome coronavirus 2 pandemic and the incidence of pediatric appendicitis in a specific macro area. Methods: We retrospectively analyzed the medical records of consecutive patients who underwent surgical exploration for acute appendicitis in the period March-April since 2014. This specific quarantine period was divided into two phases as indicated by National government. Patient data, demographics, characteristics and outcomes were studied and evaluated comparing patients treated during quarantine especially phase 1 vs. phase 2 (March-April 2020). Results: After reviewing medical charts following the inclusion and exclusion criteria, 155 patients were studied; focusing on the final outcome, it is possible to show a decreased amount of appendicitis during phase 1 and a progressive increase during phase 2; respect to previous years, there was a statistical increase in severity of appendicitis during quarantine (gangrenous vs. phlegmonous appendicitis). Conclusion: During this specific quarantine there was a reduction in appendicitis and a progressive increase during phase 2. These results offer new perspective among disease incidences during lockdown.