• Title/Summary/Keyword: Gynecology Surgery

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Sonographic Pattern Recognition of Endometriomas Mimicking Ovarian Cancer

  • Saeng-Anan, Ubol;Pantasri, Tawiwan;Neeyalavira, Vithida;Tongsong, Theera
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5409-5413
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    • 2013
  • Background: To assess the accuracy of ultrasound in differentiating endometrioma from ovarian cancer and to describe pattern recognition for atypical endometriomas mimicking ovarian cancers. Materials and Methods: Patients scheduled for elective surgery for adnexal masses were sonographically evaluated for endometrioma within 24 hours of surgery. All examinations were performed by the same experienced sonographer, who had no any information of the patients, to differentiate between endometriomas and non-endometriomas using a simple rule (classic ground-glass appearance) and subjective impression (pattern recognition). The final diagnosis as a gold standard relied on either pathological or post-operative findings. Results: Of 638 patients available for analysis, 146 were proven to be endometriomas. Of them, the simple rule and subjective impression could sonographically detect endometriomas with sensitivities of 64.4% (94/146) and 89.7% (131/146), respectively. Of 52 endometriomas with false negative tests by the simple rule, 13 were predicted as benign masses and 39 were mistaken for malignancy. Solid masses and papillary projections were the most common forms mimicking ovarian cancer, consisting of 38.5% of the missed diagnoses. However, with pattern recognition (subjective impression), 32 from 39 cases mimicking ovarian cancer were correctly predicted for endometriomas. All endometriomas subjectively predicted for ovarian malignancy were associated with high vascularization in the solid masses. Conclusions: Pattern recognition of endometriomas by subjective assessment had a higher sensitivity than the simple rule in characterization of endometriomas. Most endometriomas mimicking ovarian malignancy could be correctly predicted by subjective impression based on familiarity of pattern recognition.

Systemic Review on Complementary and Alternative Medicine for Breast Cancer (유방암의 보완대체의학적 치료에 관한 연구)

  • Park, Young-Ae;Kim, Dong-Chul
    • The Journal of Korean Obstetrics and Gynecology
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    • v.22 no.3
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    • pp.205-222
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    • 2009
  • Purpose: The aim of this study was to review systemically journals on the studies for Complementary and Alternative Medicine in the treatment of breast cancer. Methods: Through medical websites, foreign clinical literatures about complementary and alternative medicines of breast cancer were searched. The cite used was http://www.Pubmed.gov. And then they were divided into three groups. Medication, Non-medication therapies and questionnaire reports. Results: 1. We researched 23 papers about herb medicines. Most of papers were about single herb and there were rarely about mixed composition. And there were papers about Ocimum gratissimum, elliptilimba, seeds of Livistona chinensis, golden feverfew which were not commonly used in Korea. 2. We researched 16 papers about acupuncture. Acupuncture had a possitive effect on such symptoms like flushing, nausea and vomitting and pain on upper limb caused by anticancer therapy or tamoxifen or surgery. 3. We researched 36 papers about questionnaire study. Most were about research for women who diagnosed as breast cancer or women after breast cancer surgery. Subjects were about proportion of using CAM, purpose of using it, most popular CAM therapy, satisfaction degree, and relation with age, aducation and social position. And most conclusion were that patient-doctor communication was needed. Conclusion: Afterwards we have to focus on realisitic clinical studies about breast cancer patients, especially postsurgery and people who takes anticancer therapy. And we have to be interest in acupuncture therapy on breast cancer patients.

Therapeutic Results of Surgery and Radiation Therapy in Younger Patients with Stage IB Cervical Cancer (젊은 연령에서 발생한 자궁경부암 병기 IB의 수술 및 방사선치료 결과)

  • Huh Gil Cha;Yang Kwang Mo;Suh Hyun Suk;Kim Yong Bong;Lee Eung Soo;Park Sung Kwan
    • Radiation Oncology Journal
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    • v.13 no.1
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    • pp.49-54
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    • 1995
  • Purpose : To evaluate the prognostic importance of age in patients with Stage IB cervical cancer, we examined the relationship between age and survival in patients. Methods and Materials: Retrospective analysis was performed on 107 patients with Stage IB cervical cancer: 79 patients were treated with surgery followed by postoperative radiotherapy or radiation alone between October 1983 and August 1993 and 28 patients with Stage IB cervical cancer treated with surgery alone between January 1989 and August 1993 at Inje University Seoul Paik Hospital. Patients ranged in age from 26 to 74 (median 48) and were followed for a modian period of 39 months. Patients were divided into two groups; Group A comprising 32 Patients $with{\geq}$age 40 and Group B comprising 75 patients with>age 40. Both Group A and Group B patients were comparable with respect to all covariables studied. Results : The overall 5-year survival and the disease free 5-year survival for the 107 patients studied were $85.2\%$ and $82.1\%$, respectively. The overall survival for Group A and Group B was $92\%$ and $83\%$, respectively(p>0.05). The disease free 5-year survival for Group A and Group B was $82.3\%$ and $82.6\%$, respectively(p>0.05). There was no difference in both local and distant failure in Group A and Group B. Conclusion: On the basis of the this analysis it is concluded that age alone is a poor indicator of prognosis and should not be used as an indication for adjuvant treatment.

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Oncology Nurses Knowledge and Attitudes Regarding Cancer Pain Management

  • Shahriary, Shahdad;Shiryazdi, Seyed Mostafa;Shiryazdi, Seyed Ali;Arjomandi, Amir;Haghighi, Fatemeh;Vakili, Fariba Mir;Mostafaie, Naiemeh
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7501-7506
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    • 2015
  • Background: Oncology nurses play a crucial role in cancer pain management and must be highly informed to ensure their effective practice in the cancer setting. The aim of this study was to determine the baseline level of knowledge and attitudes of oncology nurses regarding cancer pain management. Materials and Methods: A cross-sectional survey research design was employed. The sample comprised 58 cancer nurses working in Shahid Sadoughi hospital, Yazd, Iran. The "Nurses Knowledge and Attitudes Survey Regarding Pain" (NKAS) tool and a demographic form were utilized to ascertain the knowledge and attitudes of oncology nurses working in oncology settings. Results: The average correct response rate for oncology nurses was 66.6%, ranging from 12.1% to 94.8%. The nurses mean score on the knowledge and attitudes survey regarding pain management was 28.5%. Results revealed that the mean percentage score overall was 65.7%. Only 8.6% of nurse participants obtained a passing score of 75% or greater. Widespread knowledge deficits and poor attitudes were noted in this study, particularly regard pharmacological management of pain. Conclusions: The present study provides important information about knowledge deficits in pain management among oncology nurses and limited training regarding pain management. Our results support the universal concern of inadequate knowledge and attitudes of nurses regarding cancer pain. It is suggested educational and quality improvement initiatives in pain management could enhance nurses knowledge in the area of pain and possibly improve practice.

Korean Medical Treatment’s Report about a Spontaneous Pregnancy with Low Anti-Müllerian Hormone (AMH) Level and Thin Endometrium Infertility after Anorectal Cancer Surgery (항문암 수술 후 혈중 항뮬러관 호르몬 저하 및 자궁내막이 얇은 난임 환자의 한약치료 자연임신 1례)

  • Koh, Ji-Eun;Lyou, Myung-Sook
    • The Journal of Korean Obstetrics and Gynecology
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    • v.29 no.3
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    • pp.68-77
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    • 2016
  • Objectives: This paper is to report a spontaneous pregnancy with low AMH level and thin endometrium infertility after Korean medical treatments.Methods: A 38-year old patient who had low AMH level, thin endometrium, sleep disturbance and anxiety happened after anorectal cancer surgery was treated by korean medicine such as herb medications per day for 6 months. And we observed the effects of treatments by improvement of symptoms checking endometrium ultrasonography.Results: After treatments, Symptoms of anxiety and sleep disturbance were improved. The number of ovarian follicle and endometrium thickness were upgraded during artificial pregnancy trials. Finally the patient was a spontaneous pregnancy after failures of one intrauterine insemination and one in vitro fertilization trial.Conclusions: This case shows that the korean medicine has effective option for a patient with low AMH level and thin endometrium infertility. Further ultrasonography would be valid measurements to check the effectiveness of oriental treatments as well as symptoms.

Serous tubal intraepithelial carcinoma detected during benign gynecologic surgery: a case report

  • Eun Seo Shin;Sung Yob Kim
    • Journal of Medicine and Life Science
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    • v.20 no.1
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    • pp.48-52
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    • 2023
  • High-grade serous carcinoma (HGSC) is the most common type of pelvic cancer among women. Serous tubal intraepithelial carcinoma (STIC) is a precursor lesion of HGSC. Herein, we report a rare occurrence of STIC in patients undergoing surgery for benign indications without a family history of ovarian cancer. A 77-year-old woman underwent total laparoscopic hysterectomy and bilateral salpingo-oophorectomy for uterine prolapse. Pathological examination revealed bilateral STIC without ovarian abnormalities, and no other abnormal findings were noted. Another patient, a 49-year-old woman, underwent laparoscopic total hysterectomy and bilateral salpingectomy for uterine fibroids. STIC lesions were observed in both fallopian tubes. Subsequently, a staging was performed. No additional lesions were found, and the patient was followedup through imaging and blood tests. As reports of STIC lesions are rare, data on their clinical outcomes and management strategies are limited. In this report, we present cases of incidental STIC in benign surgery and discuss its proper interpretation and management. Through the early detection of STIC lesions, patients with risk factors can be identified in advance, which will allow prevention and early detection of ovarian cancer. Opportunistic salpingectomy was also actively discussed in this regard.

Efficacy of methotrexate therapy in patients with tubal pregnancy and a serum human chorionic gonadotropin level above 10,000 IU/L

  • Kim, Kidong;Suh, Dong Hoon;Cheong, Hyun Hoon;Yoon, Sang Ho;Lee, Taek-Sang;No, Jae Hong;Kim, Yong-Beom
    • Clinical and Experimental Reproductive Medicine
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    • v.41 no.1
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    • pp.33-36
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    • 2014
  • Objective: To estimate the failure rate of medical treatment and to identify variables associated with treatment failure in patients with tubal pregnancy and an initial serum level of human chorionic gonadotropin (HCG) over 10,000 IU/L. Methods: The inclusion criteria were tubal pregnancy diagnosed using ultrasonography, primary treatment of intramuscular methotrexate injection at one of the four institutions between January 2003 and December 2011, a serum HCG level within two days before treatment >10,000 IU/L, and follow-up data to determine treatment success or failure. Exclusion criteria were other primary treatments besides intramuscular methotrexate injection. The clinicopathologic data of 36 patients were collected and analyzed. Results: Medical treatment failed and surgery was performed in 19 (53%) patients. In univariable analysis, age, parity, and size of the gestational sac were associated with treatment failure, but none of the variables were associated with treatment failure in multivariable analysis. The failure rate in the subgroup with age<33 years and size of gestational sac ${\geq}1.1cm$ was significantly higher than those of the other subgroups (82% vs. 41% [mean of the other subgroups], respectively). Conclusion: Patients with a serum HCG level >10,000 IU/L who received medical treatment had a high failure rate. Among them, patients aged<33 year and with a gestational sac ${\geq}1.1cm$ had an extremely high failure rate.

A Case Report of Heterotopic Pregnancy after IVF-ET (체외 수정후 발생한 병합임신 1예)

  • Park, Chul-Min;Kim, Sung-Yop;Son, Young-Soo
    • Clinical and Experimental Reproductive Medicine
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    • v.32 no.4
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    • pp.353-359
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    • 2005
  • Heterotopic pregnancy is named when an extrauterine (ectopic) pregnancy coexists with an intrauterine pregnancy simultaneously by many causes such as PID (pelvic inflammatory disease), endometriosis, IUD (intrauterine device), previous pelvic surgery and others. This is very rare in general population, with a range of occurrence estimated between 1:7963 and 1:30000. But recently the incidence has increased as the uses of ARTs (assisted reproductive technologies) including ovulation induction, IVF-ET (in-vitro fertilization and embryo transfer) and GIFT (gamete intrafallopian transfer) increase. Because this has high maternal morbidity, mortality and fetal loss, early diagnosis and proper management is very important. We report a case of heterotopic pregnancy following IVF-ET with a brief review.

Identification of Serum MicroRNA-21 as a Biomarker for Early Detection and Prognosis in Human Epithelial Ovarian Cancer

  • Xu, Yun-Zhao;Xi, Qing-Hua;Ge, Wen-Liang;Zhang, Xiao-Qian
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.1057-1060
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    • 2013
  • Recent investigations have confirmed up-regulation of serum miR-21 and its diagnostic and prognostic value in several human malignancies. In this study, we examined serum miR-21 levels in epithelial ovarian cancer (EOC) patients, and explored its association with clinicopathological factors and prognosis. The results showed significantly higher serum miR-21 levels in EOC patients than in healthy controls. In addition, increased serum miR-21 expression was correlated with advanced FIGO stage, high tumor grade, and shortened overall survival. These findings indicate that serum miR-21 may serve as a novel diagnostic and prognostic marker, and be used as a therapeutic target for the treatment of EOC.