• Title/Summary/Keyword: Uterine Fibroids

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A study of the Guidelines for Investigation and Management of Uterine Myomas with Korean Medicine Therapies in Korea (자궁근종의 한의학 연구 경향과 임상적 접근에 관한 연구)

  • Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.19 no.2
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    • pp.240-260
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    • 2006
  • Purpose : The objective of this study is to serve guidelines for the investigation and management of uterine myomas with KM therapies. Methods : English-language articles from PubMed and Korean-language articles from the database of the journal of oriental gynecology were reviewed from 2000 to 2005, using the key words 'uterine myoma', 'uterine leiomyoma', 'fibroid', 'uterine artery embolization', 'endometrial ablation', 'myomectomy', and jagungguenjong(子宮筋腫)'. Results and Limits : The areas of clinical practices considered in formulating this guideline are assessment, KM therapies, medical treatments, myolysis, selective artery occlusion, endometrial ablation and surgical therapies including myomectomy and hysterectomy. Implementation of this guideline would optimize the decision-making process of women with uterine myomas and further investigation or therapy of their KM doctors. But we don't have abundant evidences of clinical trials of uterine myoma treated with KM therapy, though we treat or manage that with every-day clinical practices. Moreover cultural gaps between Korea and other western countries make many differences in the attitude to surgical therapies, especially hysterectomy. So it is very difficult to compare W therapies with other therapies. Moreover it is much difficult to estimate cost-effectiveness and benefit of those therapies in QOL. Conclusions : The majority of uterine myoma is asymptomatic and will not require any intervention or further investigation. But unmarried women who wish to marry and get pregnant want to find safe therapy for their asymptomatic uterine myomas. In that case, most of the patients prefer non-surgical therapy to surgical therapy. So KM herbal medicinal therapy is a good alternative method for those patients. For the symptomatic myomas, hysterectomy offers a definitive solution. However, it is not the best solution for women who wish to preserve their uterus. So KM therapy is a good alternative for them. But the predicted benefits of alternative therapies including KM therapy must be carefully weighed against the Possible risks of these therapies. To improve the quality of life of both women with asymptomatic and symptomatic myomas, selecting and treating patients should be done carefully. Moreover, the effect of KM therapy has to evaluated, comparing the possible situation without treatment and the benefit of constant treatment as a health-care system.

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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.

Lack of Influence of the ACE1 Gene I/D Polymorphism on the Formation and Growth of Benign Uterine Leiomyoma in Turkish Patients

  • Gultekin, Guldal Inal;Yilmaz, Seda Gulec;Kahraman, Ozlem Timirci;Atasoy, Hande;Dalan, A. Burak;Attar, Rukset;Buyukoren, Ahmet;Ucunoglu, Nazli;Isbir, Turgay
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.1123-1127
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    • 2015
  • Uterine leiomyomas (ULM), are benign tumors of the smooth muscle cells of the myometrium. They represent a common health problem and are estimated to be present in 30-70% of clinically reproductive women. Abnormal angiogenesis and vascular-related growth factors have been suggested to be associated with ULM growth. The angiotensin-I converting enzyme (ACE) is related with several tumors. The aim of this study was to identify possible correlation between ULM and the ACE I/D polymorphism, to evaluate whether the ACE I/D polymorphism could be a marker for early diagnosis and prognosis. ACE I/D was amplified with specific primer sets recognizing genomic DNA from ULM (n=72) and control (n=83) volunteers and amplicons were separated on agarose gels. The observed genotype frequencies were in agreement with Hardy-Weinberg equilibrium ($x^2=2.162$, p=0.339). There was no association between allele frequencies and study groups ($x^2=0.623$; p=0.430 for ACE I allele, $x^2=0.995$; p=0.339 for ACE D allele). In addition, there were no significant differences between ACE I/D polymorphism genotype frequencies and ULM range in size and number ($X^2=1.760;$ p=0.415 for fibroid size, $X^2=0.342;$ p=0.843 for fibroid number). We conclude that the ACE gene I/D polymorphism is not related with the size or number of ULM fibroids in Turkish women. Thus it cannot be regarded as an early diagnostic parameter nor as a risk estimate for ULM predisposition.

A New Healthcare Policy in Korea Part 3: Ultrasound and MRI in Urogenital Disorders (새로운 건강보험 보장성 강화 대책 3부: 비뇨생식기 초음파 및 MRI 급여 확대)

  • Young Sup Shim;Kye Jin Park
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1083-1095
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    • 2020
  • Since 2019, ultrasound and magnetic resonance imaging for evaluation of urogenital disorders have been covered by the National Health Insurance (NHI) in Korea. Patients with urogenital malignancies were already insured by NHI for ultrasound and MRI. With the expansion of NHI coverage, patients with suspected prostate or gynecologic cancer, uterine fibroids before myomectomy and some other benign disease such as congenital anomaly can receive benefits of NHI. In consideration of these changes, radiologists and other clinicians should be aware of the indications and standard images of each examination and the required reporting forms. Clinical application based upon thorough understanding of the NHI guidelines will aid in improving the standard care of patients.