• Title/Summary/Keyword: Cervical approach

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See-and-Treat Approach to Cervical Intraepithelial Lesions in HRH Princess Maha Chakri Sirindhorn Medical Center

  • Srisuwan, Siriwan;Hamontri, Suttha;Kongsomboon, Kittipong;Bhamarapravatana, Kornkarn;Suwannarurk, Komsun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3483-3486
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    • 2014
  • Background: To evaluate the overtreatment rate with the see and treat approach in the management of women with abnormal cervical cytology. Materials and Methods: A retrospective review of patients with abnormal cervical cytology who underwent S&T at MSMC between January 2008 and December 2012 was conducted. Loop electrosurgical excision procedure (LEEP), histological results, cytology and colposcopic impression were analyzed to evaluate overtreatment rate, cyto-histologic correlation and related factors. Results: Average age of S&T cases was 42 years. Ninety seven percents were referred from affiliated health care providers. The study revealed 83.2% patients had HSIL or higher from cervical cytology. Correlation between HSIL and final histology was relatively low at 75% compared to other studies. Overtreatment rate was 28%. Conclusions: S&T was done in 197 patients in a tertiary care health facility with patient satisfaction. Overtreatment occurred, but the rate can be reduced with appropriate recommendations. HSIL Pap smears should be reexamined before S&T while low grade and lesser colposcopic impression groups should obtain conventional colposcopic approach for patient future reproductive benefit.

Solitary Cervical Neurenteric Cyst in an Adolescent Patient

  • Choi, Doo Yong;Lee, Ho Jin;Shin, Myung Hoon;Kim, Jong Tae
    • Journal of Korean Neurosurgical Society
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    • v.57 no.2
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    • pp.135-139
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    • 2015
  • Spinal neurenteric cysts are uncommon congenital lesions, furthermore solitary neurenteric cysts of the upper cervical spine are very rare. A 15-year-old boy having an intraspinal neurenteric cyst located at cervical spine presented with symptoms of neck pain and both shoulders pain for 2 months. Cervical spine magnetic resonance (MR) imaging demonstrated an intradural extramedullary cystic mass at the C1-3 level without enhancement after gadolinium injection. There was no associated malformation on the MR imaging, computed tomography, and radiography. Hemilaminectomy at the C1-3 levels was performed and the lesion was completely removed through a posterior approach. Histological examination showed the cystic wall lined with ciliated pseudostratified columnar epithelium containing mucinous contents. Neurenteric cyst should be considered in the diagnosis of spinal solitary cystic mass.

Evidence-based Screening, Early Diagnosis and Treatment Strategy of Cervical Cancer for National Policy in Low-resource countries: Example of India

  • Saxena, Upma;Sauvaget, Catherine;Sankaranarayanan, Rengaswamy
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1699-1703
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    • 2012
  • Cervical cancer remains the most frequent cancer in women from the developing world. More than 88% of deaths occur in low-income countries, and it is predicted to climb to 91.5% by 2030. Although Pap-based screening programmes have shown to be effective in reducing the disease burden in high-resource countries, implementation and sustention of cytology-based programmes is quite challenging in low-resource settings. The present paper reviews evidence-based alternatives of screening methods, triaging algorithm, treatment of cervical precancerous lesions, and age-group at screening appropriate for low-income countries. Evidence shows that visual inspection methods using diluted acid acetic or Lugol's iodine, and HPV-DNA testing are more sensitive tests than the Pap-smear screening test. Visual inspection allows an immediate result and, when appropriate, may be immediately followed by cryotherapy, the so called "screen-and-treat" approach, achieved in a single visit, by trained nurses and midwives. Examples of cervical cancer prevention programmes in India and selected low-income countries are given.

Barriers and Facilitating Factors Perceived in Turkish Women's Behaviors Towards Early Cervical Cancer Detection: A Qualitative Approach

  • Ersin, Fatma;Bahar, Zuhal
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.4977-4982
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    • 2013
  • Background: The aim of the present study was to investigate perceived inhibiting and facilitating factors concerning cervical cancer early diagnosis behavior in Turkish women over the age of 40. Materials and Methods: The study was carried out by qualitative focus group interview with 35 participating women, in the period between April-June 2010. A semi-structured interview questionnaire based on the Health Belief Model and the Health Promotion Model was used. Content analysis was applied to the study data. Results: Barriers such as lack of knowledge of women as regards to the cervical cancer and early detection, lack of sensitivity-negligence, forgetting, fear, inadequacy of health insurance and transportation, financial problems, inability to get an appointment, lack of female doctors, embarassment, fatalist approach were frequently addressed. As for facilitating factors, these included provision of information, health professionals showing interest and tolerance, free services, provision of transportation means and reminding telephone calls. Conclusions: Focus group interviews were found to be effective in determining inhibiting and facilitating factors concerning cervical cancer early diagnosis behavior. In line with the results of the study, preparation of structured national and regional education programs and their addition to curriculum programs may be effective in realizing and maintaining positive early detection behavior.

Single Life Time Cytological Screening in High Risk Women as an Economical and Feasible Approach to Control Cervical Cancer in Developing Countries Like India

  • Misra, Jata Shankar;Srivastava, Anand Narain;Das, Vinita
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.859-862
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    • 2015
  • In view of funding crunches and inadequate manpower in cytology in developing countries like India, single lifetime screening for cervical cancer has been suggested. In this study, an attempt was made to cscreening to make it more effective for early detection. Cytological data were derived from the ongoing routine cervical cytology screening program for women attending Gynaecology Out Patient Department of Queen Mary's Hospital of K.G.Medical University, Lucknow, India during a span of 35 years (April 1971 - December 2005). Cervical smears in a total of 38,256 women were cytologically evaluated. The frequencies of squamous intraepithelial lesions of cervix (SIL) and carcinoma cervix were found to be 7.0% and 0.6%, respectively, in the series. Predisposing factors related to cervical carcinogenesis were analyzed in detail to establish the most vulnerable groups of women for single life time screening. The incidence of SIL and carcinoma cervix was found to be maximal in women above the age of 40 years irrespective of parity and in multiparous women (with three or more children) irrespective of age. The incidence of cervical cytopathologies was significantly higher in symptomatic women, the frequency of SIL being alarmingly higher in women complaining of contact bleeding and that of carcinoma cervix in older women with postmenopausal bleeding. It is consequently felt that single life time screening must include the three groups of women delineated above. Such selective screening appears to be the most economical, cost effective and feasible approach to affordably control the menace of cervical cancer in developing countries like India.

Posterior Cervical Inclinatory Foraminotomy for Spondylotic Radiculopathy Preliminary

  • Chang, Jae-Chil;Park, Hyung-Ki;Choi, Soon-Kwan
    • Journal of Korean Neurosurgical Society
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    • v.49 no.5
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    • pp.308-313
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    • 2011
  • Posterior cervical foraminotomy is an attractive therapeutic option in selected cases of cervical radiculopathy that maintains cervical range of motion and minimize adjacent-segment degeneration. The focus of this procedure is to preserve as much of the facet as possible with decompression. Posterior cervical inclinatory foraminotomy (PCIF) is a new technique developed to offer excellent results by inclinatory decompression with minimal facet resection. The highlight of our PCIF technique is the use of inclinatory drilling out for preserving more of facet joint. The operative indications are radiculopathy from cervical foraminal stenosis (single or multilevel) with persistent or recurrent root symptoms. The PCIFs were performed between April 2007 and December 2009 on 26 male and 8 female patients with a total of 55 spinal levels. Complete and partial improvement in radiculopathic pain were seen in 26 patients (76%), and 8 patients (24%), respectively, with preserving more of facet joint. We believe that PCIF allows for preserving more of the facet joint and capsule when decompressing cervical foraminal stenosis due to spondylosis. We suggest that our PCIF technique can be an effective alternative surgical approach in the management of cervical spondylotic radiculopathy.

Effective Management of Multiple Non-carious Cervical Lesions with Gingival Recession and Dentin Hypersensitivity: Two Cases Report of Combined Restorative and Periodontal Approach

  • Hyunkyung Kim;Sungtae Kim;Young-Dan Cho
    • Journal of Korean Dental Science
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    • v.17 no.2
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    • pp.92-104
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    • 2024
  • Managing multiple non-carious cervical lesions (NCCLs) with gingival recession and dentin hypersensitivity can be challenging. Herein, we present two cases of successful treatment procedure for multiple NCCLs with gingival recession and dentin hypersensitivity using an envelope coronally advanced flap with CTG and composite resin restoration. Through the combined approach of restorative and periodontal procedure, both patients showed adequate extent of gingival coverage and esthetic outcome based on the Modified Root Coverage Esthetic Score (MRES) at 6 months postoperatively. Also, dentin hypersensitivity was reduced effectively during the follow up period. Although the pocket depth slightly increased in patient 1, possibly due to the amount of restoration located sub-gingivally, pocket depth remained within 3 mm. This suggest that re-establishing the clinical CEJ and performing partial restoration is advantageous for periodontal tissue and is expected to contribute to maintain gingival height in the long term. These case reports emphasize the efficacy of the combined approach for treating multiple NCCLs with gingival recession and dentin hypersensitivity, highlighting the importance of careful restoration planning for optimal clinical and aesthetic outcomes.

A Case Study on Cervical Spondylotic Myelopathy (척수성 경수증에 대한 증례연구)

  • Lee, Young-Hwa;Kwon, Won-An
    • Journal of the Korean Society of Physical Medicine
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    • v.5 no.3
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    • pp.331-339
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    • 2010
  • Purpose : Cervical spondylotic myelopathy is a varied clinical syndromes and the most serious condition of cervical spondylosis. Spinal cord dysfunction is often caused by the compression on spinal cord. The purpose of this report was to describe physical examination and the process of disorders on cervical spondylotic myelopathy(CSM). Methods : Three cases with cervical myelopathy were presented with magnetic resonance image(MRI), Nurick's grade and Japanese Orthopaedic Association(JOA) score. Results : This studies showed a variable clinical course with gradual neurological deterioration in two cases. but one case was improved by operation and a regular aerobic exercise. MRI, Nurick's grade, JOA score are a useful adjunct for CSM evaluation. Conclusion : The state of CSM is variable, which may affect conservative treatments and surgery. It is needed to be a carefull approach and studies for a conservative treatment and management on CSM.

HPV Vaccine Knowledge and Perceived Risk of Cervical Cancer among Female College Students in Taiwan

  • Wang, Hsiu-Ho;Wu, Shiao-Ying
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7371-7374
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    • 2013
  • Aims: The study targeted the HPV vaccine knowledge and perceived risk of cervical cancer among female college students in Taiwan as well as the relationship between knowledge of the HPV vaccine and perceived risk of cervical cancer. Materials and Method: The results of this study on female college students are described using descriptive and correlation designs. A convenience sampling approach was employed with a self-filling structured questionnaire. Results: A total of 150 students completed the questionnaire. Values were 7.49 for the mean HPV vaccine knowledge scale and 18.0 for their mean perceived risk of cervical cancer scale. HPV vaccine knowledge was positively correlated with perceived risk of cervical cancer. Conclusions: The findings of this study can serve as a reference for future HPV prevention in Taiwan.

The Development of Cranial Cervical Ganglion Block in Beagle Dogs (비글견에서 앞쪽목신경절 차단술법의 개발)

  • Park, Woo-Dae
    • Journal of Life Science
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    • v.18 no.1
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    • pp.91-95
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    • 2008
  • In human, sympathetic nerve blocks with local anesthetics are widely used to treat a variety of diseases in the innervating regions. However, its procedure in dogs is difficult to approach and process repeatedly because of anatomically location. Therefore, this study was designed to develop a new technique of sympathetic nerve block in beagle dogs. Fifteen healthy beagle dogs, which did not show any neurologic abnormalities and disease, were used for the study. Radiograghs were taken after injected radiopaque material mixed with 2% lidocaine at the cranial cervical ganglion and injected methylene blue using the same percutaneous technique to verify the reliability of this newly developed technique. The successful block rate of the cranial cervical ganglion block was present in 80% of all dogs and the stained cranial cervical ganglions were shown in all dogs. The results show that this new technique of the cranial cervical ganglion block is a reliable and simple method that can be used for clinical studies in dogs.