• The Journal of Korean Obstetrics and Gynecology
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• v.18 no.4
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• pp.242-252
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• 2005

Purpose : Dysfunctional uterine bleeding is an abnormal uterine bleeding without an organic disease. A hormone therapy or anti-depressant medicine is chosen to treat dysfunctional uterine bleeding. However sometimes it didn't work. Hysterectomy is recommended to stop bleeding but a lot of women are afraid of it. The purpose of this study is to show the possibility of oriental medical treatment for dysfunctional uterine bleeding in this case report. Methods : The 30-year-old female patient who had suffering from uterine bleeding was treated with hormone therapy and anti-depressant medicine. However she was bleeding again. She had no organic disease in some medical examination, finally she was recommended a hysterectomy. But she didn't want the operation. In addition, she started acute abdominal pain. She wanted a oriental medical treatment and we treated her from the May 14th 2005 to the June 4th 2005 in admission. We used Yikweseungyangtang(益胃升陽湯), Ojuksan(五積散), Kwibitang hap Gyoesamultang(歸婢湯合膠艾四物湯) for herb-medication. In acupuncture therapy,　ST36(Chok-Samni 足三里) SP1(Eunbek, 隱白) SP6(Samumgyo, 三陰交) SP10(Hyulhae, 血海) Liv1(Daedon, 大敦) Liv3(Taechung, 太衝) LI4(Hapgok, 合谷) was selected. In moxa therapy CV4(Kwanwon, 關元), CV6(Kihae, 氣海), CVl2(Chung-wan, 中脘) was used.　Results : After oriental medical treatment for 22 days, she stopped uterine bleeding　and recovered her health．　Conclusion ：　Oriental medical treatment is expected to have an effect on　dysfuctional uterine bleeding with abdominal pain.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.4971-4975
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• 2015

Background: Several methods have been presented for the evaluation of the endometrium in patients with abnormal uterine bleeding, which include minimal invasive and invasive approaches such as diagnostic curettage or endometrial biopsy by Pipelle. Many studies have been performed in order to compare two methods; diagnostic curettage and outpatient endometrial biopsy. This investigation compared sampling adequacy, endometrial histopathology, failure rates, duration and costs between diagnostic curettage in a hospital and endometrial biopsy. Materials and Methods: This single blind clinical trial was performed on 130 patients older than 35 years who was referred to Amir training hospital in 2013 for elective diagnostic curettage because of abnormal uterine bleeding. For all patients eligible for the study, an endometrial sample by Pipelle was taken without anesthesia or dilatation. Then under general anesthesia diagnostic curettage was performed by sharp curette. Sampling duration was calculated and both samples were sent to the same pathologist. The diagnostic values of two methods in the diagnosis of normal endometrium, endometrial hyperplasia and carcinoma were compared. The costs of these two methods were also compared. Data analysis was performed by SPSS (version 16.0) software. Chi-Square, Fisher, and Pearson tests were used and were considered statistically significant at P values less than 0.05. Results: Two methods were agreed upon 88% of sampling adequacy and 94% of pathological results. Specificity of 100% and sensitivity of 90% for detection of proliferative endometrium, secretory endometrium, simple hyperplasia without atypia and 100% for cancer were recorded. Pipelle diagnostic accuracy in comparison with curettage, have been reported over 97%, so the failure rate in this study was below 5%. Sensitivity of Pipelle for detection of atrophic endometrium was reported below 50%. Duration and cost was lower in Pipelle versus curettage. Conclusions: It is concluded that due to high agreement and cohesion coefficient between curettage and Pipelle on the issue of sampling adequacy, histopathology finding (except atrophic endometrium), low failure rate, duration of sampling and cost, Pipelle can be introduced as a suitable alternative of diagnostic curettage.

• The Korean Journal of Cytopathology
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• v.13 no.1
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• pp.1-7
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• 2002

The significance of endometrial cells on cervicovaginal smears is underestimated. The aim of this study is to evaluate the detection rate of endometrial cells on cervicovaginal smears. The materials consisted of two groups. Group I was 701 cervicovaginal smears from patients with no gynecological problems. Group II was 208 cervicovaginal smears from patients with abnormal uterine bleeding followed by endometrial curettage; 31 cases of endometrial adenocarclnoma(CA), 19 cases of endometrial hyperplasia(HP), 83 cases of dysfunctional uterine bleeding(DUB), and 75 cases of normal endometrium. Cervicovaginal smears were reviewed according to the criteria of The Bethesda System. Endometrial cells were identified in 15 of 701 cases(2.1%) in group I and 64 of 208 cases(30.8%) in group II. Among group II, detection rate of endometrial cells was the highest in CA (51.6%) compared to HP(26.3%), DUB(41.0%), and normal endometrium(12.0%) (p<0.05). Cytologic atypia of endometrial cells was not found In group I, but was more frequently identified in CA(87.5%) than in HP(10.5%) or DUB(14.7%) (p<0.05). Exfollatlon of endometrial cells might be related to abnormal endometrial lesion, and reporting of endometrial cells in the cervicovaginal smear may increase a chance to detect endometrial lesions especially in patients with abnormal uterine bleeding.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.8
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• pp.3737-3740
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• 2014

Background: Abnormal uterine bleeding (AUB) is the most important symptom of endometrial hyperplasia and endometrial curettage (EC) is the gold standard diagnostic procedure. We present the results of patients who underwent EC for AUB and the efficacy of progestin administration in those with endometrial hyperplasia. Materials and Methods: A total of 415 female patients who presented to Duzce Public Hospital in 2011-2012 for AUB and who underwent EC were included. We determined the reasons for AUB, and females with hyperplasia were treated with 10 mg/day medroxyprogesterone acetate for 14 days/month or 160 mg/day megestrol acetate continuously for 3 months. We evaluated the efficacy of progestins for periods of three and/or six cycles by repeating EC. A statistical analysis of specific endometrial causes according to age of presentation was conducted using the chi-square test. Results: Among the 415 females (average age, 53.5 years) followed for 6 months, 186 had physiological changes (44.8%), 89 had simple hyperplasia (21.44%), 1 had atypical hyperplasia (0.2%), 6 had (1.44%) complex hyperplasia, 3 had (0.72%) atypical complex hyperplasia, and 5 had adenocarcinoma (1.2%). Regression rates were 72.7-100%, and the optimum results were observed after 6 months of hormonal therapy. Conclusions: The main cause of AUB was physiological change. Progestin therapy resulted in significant regression even in females with atypical hyperplasia.

• Clinical and Experimental Reproductive Medicine
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• v.43 no.1
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• pp.51-53
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• 2016

Uterine fibroids are benign tumors of the myometrium with a diverse range of manifestations. Fibroids can dramatically increase in size during pregnancy due to the increase in estrogen levels. After delivery, the fibroids usually shrink back to their pre-pregnancy size. Uterine myomas may have many complications, including abnormal uterine bleeding, infertility, pressure on nearby organs, degeneration, and malignant transformation. No previous reports have indicated that a fistula may develop between a uterine fibroid and the bowel loops, although previous studies have documented the occurrence of fistulas from the uterus to the bowel following myomectomy or uterine artery embolization performed to treat a myoma. In our case report, we document the rare complication of a fistula occurring between a degenerated myoma in the posterior wall and the ileum 1 week postoperatively in a patient who underwent a Caesarean section but did not have a history of uterine artery embolization.

• Journal of Haehwa Medicine
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• v.13 no.1
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• pp.169-181
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• 2004

Uterine bleeding is a physiologic monthly event occuring during the reproductive period of the nonpregnant woman. As with any other physiologic event, normal women have different menstrual patterns and at times, it is difficult to define when normality ends and abnormality begins. Dysfunctional uterine bleeding is an all-inclusive term: its diagnosis usually bepends on the exclusion of local or systemic organic causes. The term dysfunctional refers to alterations in the physiologic mechanism controlling a multitude of cyclic events in the women's reproductive function. These mechanism are primarily neuroendocrine in nature. According to oriental medicine, the Metrorrhagia(崩漏) means an abnormal bleeding of femail genetalia, and is devided to bungjung and bungha. The etiological factors of metrorrhagia are heat of blood, asthenic coldness, asthenia of chong and ren channels, deficiency of blood, deficiency of vital energy, stagnated blood, and asthenia of spleen & stomach.

• Korean Journal of Acupuncture
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• v.25 no.4
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• pp.59-71
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• 2008

Objectives : The aim of this study was to show the rationale of point-selection for acupuncture and moxibustion in the Uterine section(in the Naegyeong Chapter) of the Dong-Ui-BO-Gam. Methods : We reviewed the causes of each disease in the Uterine section of the Dong-Ui-BO-Gam, and then explained the rationale of acupoint-selection for the treatment of those diseases referring to etiology and physiology of Oriental medicine, other applications of each acupoints in the Dong-Ui-BO-Gam, characteristic of each acupoints, flow of Gi (Qi) through meridian pathways and specific acupoints etc. Results : There are comments on acupuncture and moxibustion for abnormal menstruation, amenorrhea, metrorrhagia, leukorrhea, bleeding from uterus after menopause in the Uterine section of the Dong-Ui-BO-Gam. Conclusions : Acupoints of conception vessel, and three foot Yin meridians are preferably used for acupuncture and moxibustion in the Uterine section of the Dong-Ui-BO-Gam. Out of them, CV3 is most frequently used and SP6, CV6, BL23, LR2 are also used often.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.4
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• pp.1689-1692
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• 2014

Background: An easy, reproducible and simple marker is needed to estimate phase of endometrial pathologic lesions such as hyperplasia and endometrial cancer and distinguish from pathologically normal results. We here aimed to clarify associations among neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), endometrial hyperplasia and cancer in patients with abnormal uterine bleeding. Materials and Methods: Patients (n=161) who were admitted with abnormal uterine bleeding and the presence of endometrial cells on cervical cytology or thick endometrium were investigated. The study constituted of three groups according to pathologic diagnosis. Group 1 included endometrial precancerous lesions like hyperplasia (n=63), group 2 included endometrial cancerous lesions (n=38) and group 3 was a pathologically normal group (n=60). Blood samples were obtained just before the curettage procedure and the NLR was defined as the absolute neutrophil count divided by the absolute lymphocyte count; similarly, PLR was defined as the absolute platelet count divided by the absolute lymphocyte count. Results: The white blood cell count was significantly higher in patients with cancer than in those with hyperplasia (p=0.005). The platelet count and neutrophil to lymphocyte ratio were significantly higher in patients with cancer than in control patients, but there was significantly no difference between patients with hyperplasia and other groups (p=0.001 and p=0.025 respectively). PLR was significantly lower in control subjects than in other groups (p<0.001), but there was no significant difference between patients with hyperplasia and those with cancer. Conclusions: PLR was significantly lower in control subjects than in other groups. Thus both hyperplasia and cancer may be differentiated from pathologically normal patients by using PLR. White blood cell count was significantly higher in patients with cancer than in those with hyperplasia and pathologically normal patients. Therefore white blood cell count may be used for discriminate hyperplasia to cancer. By using multiple inflammation parameters, discrimination may be possible among endometrial cancer, endometrial precancerous lesions and pathologically normal patients.

• The Journal of Korean Obstetrics and Gynecology
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• v.33 no.3
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• pp.198-211
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• 2020

Objectives: The purpose of this study is to report the effect of Haedoksamul-tang on three patients with heavy menstrual bleeding. Methods: Three patients took Haedoksamul-tang for 3 months 5 cycles and got electric needle and infrared therapy. The Pictorial Blood loss Assessment Chart was used to evaluate menstrual index that shows the menstrual bleeding loss. We also assessed dysmenorrhea using the Numerical Rating Scale during the treatment. Results: The Menstrual Index has decreased and the symptoms of dysmenorrhea have relieved after treating with Haedoksamul-tang. Conclusions: The case report shows that Haedoksamul-tang is effective on patients with heavy menstrual bleeding.

• Journal of Yeungnam Medical Science
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• v.22 no.1
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• pp.81-89
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• 2005

Background: Hysteroscopy is considered to be the gold standard not only for visualizing the cervical canal and the uterine cavity, but also for treating many different types of benign pathologies localized to those regions. The advent and evolution of endoscopic imaging and surgery during the last two decades has added new dimensions to the armamentarium of a gynecologist to combat intrauterine lesions. Office hysteroscopy is increasingly being used as a first line investigation for abnormal uterine bleeding and other diseases involving the uterine cavity. The aim of our study is to assess the diagnostic and operative efficacy of office hysteroscopy. Materials and Methods: In our department, 140 patients underwent a hysteroscopy examination and 18 of these underwent an office based hysteroscopy examination from September 1995 to March 2005. The cases who underwent an office based hysteroscopy examination were reviewed in order to assess the clinical usefulness and significance in the management of intrauterine lesions. Results: Major indication was abnormal uterine bleeding(12 cases, 66.7%). The others were a missed IUD and infertility. The hysteroscopic findings were a normal uterine cavity(6 cases, 33.3%), IUD in situ, polyp, submucosal myoma, endometrial hyperplasia and a placenta remnant. Conclusion: Office hysteroscopy is a safe, quick and effective method for making an intrauterine evaluation. In addition, it provides immediate results, offers the capacity of direct targeted biopsies of suspicious focal lesions, and offers the direct treatment of some intrauterine conditions.