• 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 Journal of the Korean bone and joint tumor society
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• v.5 no.1
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• pp.23-28
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• 1999

Between Sep. 1986 and Mar. 1996, twenty four patients with recurrent giant cell tumor of their long bones were treated and followed up for more than two years. We applied three different modalities for treatment: curettage with bone graft, curettage and packing with polymethylmethacrylate, wide excision with or without reconstruction. During the average 51.5 months after operation(24-97 months), two of three patients who underwent curettage with bone graft showed recurrence. Patients who underwent wide excision showed no recurrence. Five of fifteen patients who underwent curettage and packing with polymethylmethacrylate showed recurrence. Four of seven who showed recurrence were treated with reapplication of curettage and packing with polymethylmethacrylate. All four patients showed no recurrence, and two of them have been followed up for more than two years. We suggest that the curettage and packing with polymethylmethacrylate is an effective treatment modality of the recurrent giant cell tumor.

• Journal of Periodontal and Implant Science
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• v.29 no.1
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• pp.81-93
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• 1999

Non-surgical therapy is still an important technique in periodontal treatment. In this study, scaling and root planing(SRP) with or without concomitant subgingival curettage were compared clinically and microbiologically. 14 moderate adult periodontitis patients were included in this study. After 2 weeks from screening visit, with split mouth design, one quadrant was treated by SRP, and the opposite side was treated by SRP with subgingival curettage. Clinical measurement and microbiological analysis was taken at baseline, 1 month, 3 month post-treatment. Clinical parameters used in this study was probing depth, gingival recession, gingival index, bleeding on probing, plaque index, tooth mobility(Periotest Value). Microbiological analysis consisted of determination of the percentages of 4 bacterial groups according to morphologic type with phase-contrast microscope and measuring Black-pigmented Bacteroides after anaerobic culture. 1. There were significant changes in probing depth and gingival recession at 1 month(P<0.05), and these changes remained through 3 month. However, no significant differences were observed between two groups(P<0.05). 2. There were also significant reductions in gingival index and bleeding on probing at 1 month(P<0.05),and these reduced levels were maintained through 3 month with no significant differences between two groups(P<0.05). 3. In both groups, motile bacteria decreased significantly at 1 months(P<0.05), but increased nearly to baseline level at 3 month. 4. The percentages of Black-pigmented Bacteroides, in both groups, decreased significantly at 1 month(P<0.05), and in the subgingival curettage group, significant more reductions were observed than in the root planing group(P<0.05). At 3 month, significant reduction was found in subgingival curettage group only(P<0.05). According to these results, we surmised that concomitant subgingival curettage and root planing give some advantageous effect on bacterial recolonization.

• The Journal of the Korean dental association
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• v.22 no.1 s.176
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• pp.25-28
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• 1984

• Journal of Periodontal and Implant Science
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• v.26 no.2
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• pp.511-521
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• 1996

Periodontal pocket is one of the most frequently developed clinical feature on the teeth with periodontal disease. In order to determine the gingival curettage effect of intrapocket irradiation of a pulsed Nd : YAG laser on periodontally involved teeth, bilateral 60 teeth with $4{\sim}6mm$ in probing pocket depth 1 week after supragingival scaling were selected. On half of them the intrapocket irradiation($300{\mu}m$ fiber optic, 1.5W power, for 2min.) of a pulsed-Nd : YAG laser(EL.EN.EN06O, Italy) was applied as the lased group. On the contralateral 30 teeth the subgingival curettage was accomplished by Gracey curettes as the curattage group. The periodontal pocket tissues were surgically excised by the modified Widman flap technique immediately after the intrapocket irradiation or subgingival curettage, subsequently fixed with 10% neutral formalin, sectioned in $4{\sim}6{\mu}m$ thickness, and stained with hematoxylin-eosin. Surface characteristics and incomplete removal of the pocket epithelium were evaluated under light microscope. And the difference between the lased group and the curettage group was statistically analyzed by Chi-square test in Microstat program. The results were as follows ; 1. The plane surface was observed more frequently in the curettage group(73.3%) than in the lased group(23.3%), and the rough surface was observed more frequently in the lased grOoup(63.3%) than in the curettage group(6.7%)(p<0.05). 2. The rate of incomplete removal of the pocket epithelium was relatively high in both the lased group(76.6%) and the curettage group(86.6%), and there was no significant difference between the lased group and the curettage group(p>0.l). The results suggest that the further studies including various power control of laser should be succeeded in order to obtain more favorable results by the intrapocket irradiation of a pulsed Nd:YAG laser than the subgingival curettage with Gracey curettes.

• The Journal of the Korean bone and joint tumor society
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• v.2 no.1
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• pp.65-71
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• 1996

Twenty-nine cases of unicameral bone cyst developed in long bone of children have been treated and followed up for 4.5 years in average form Department of Orthopaedic Surgery, Guro Hospital, Korea University, College of Medicine since September, 1983, Treatment for those lesions differed to form largely two groups, one of which consised of insillation of Methyl-prednisolone for non-weight bearing bones(12 humeri) and the other of curettage and autogenous bone graft for weight-bearing bones(7 femur). Methl-prednisolone group required repetition of instillation for 3.5 time in average spanning over 4 years until cloudy obliteration occurs. Curettage and bone graft had healed in 3 year 6 months' time in average. There were neither recurrence nor pathologic fractures of the lesions with the latter group. Immobilization period was virtually non with Methyl-prednisolone group and 4-6 weeks by hip spica with curettage and bone graft group. As conclusions, It seems confirmed that treatment strategy of unicameral bone cyst consisted of Methyl-prednisolone instillation for humerus lesions and early curettage and bone graft for femur lesions is applicable as guideline having solid ground in clinical experiences.

• The Journal of the Korean bone and joint tumor society
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• v.14 no.2
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• pp.182-186
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• 2008

Simple bone cysts are common, benign bone tumor and for the treatment, curettage with bone grafting, resection and intralesional steroid or autogenic bone marrow injections were usually performed. Simple bone cysts of the calcaneus are relatively uncommon and curettage with autologous bone grafting were proposed for management rather than intralesional steroid injections. We would like to report 9 year-old male with calcaneal simple bone cyst treated satisfactorily by minimally invasive endoscopic curettage and autologous bone grafting with review of the relevant literature.

• Journal of the Korean Arthroscopy Society
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• v.16 no.1
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• pp.52-55
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• 2012

An intraosseous ganglion typically exists in periarticular epiphysis or subchondral area, and is usually treated with open curettage of cyst or curettage and bone graft. We report a case of intraosseous ganglion of talus treated by endoscopic curettage and bone grafting with a review of the literature.

• The Journal of the Korean bone and joint tumor society
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• v.10 no.2
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• pp.71-78
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• 2004

Purpose: The purpose of this study is to investigate the characteristic of recurred giant cell tumor after bony curettage and cementation, and to review a way to prevent the recurrence. Materials and Methods : Thirty seven cases were analyzed, which were pathologically diagnosed giant cell tumor after diagnostic biopsy or surgical excision, followed by curative curettage, burring and cementation. Location, character, and time interval to recurrence were reviewed. Results: Thirteen out of thirty seven analyzed cases(35%) showed recurrence after primary curettage and cementation. The mean interval to recurrence was sixteen months(5 months to 43 months). Most of recurrence happened within the first two years except two cases. Among the recurred cases, eleven showed recurrence in the vicinity of window area. Two cases recurred in the depth of bone marrow, where cementation was made. The advantage of curettage and cementation is the immediate stability of the operation site, early rehabilitation, and early detection of recurrence. Furthermore, cementation is beneficial in that the cement-producing heat can eradicate the residual tumor burden. In this study, 85% of cases with insufficient curettage (for example, in cases where too small surgical window was made, or where there were anatomical difficulty in approaching the target tumor burden) showed recurrence. Conclusion: Bony curettage, burring and cementation is widely used as the primary curative modality for giant cell tumor. A few other modalities such as chemical cautery using phenol and $H_2O_2$; cryotherapy; and anhydroalcohol have also been introduced, but the benefit of these are still questionable. For some cases that relatively small surgical window was made due to anatomically complicated structures (such as ligament insertion or origin site) over the target tumor burden, unsatisfactory curettage and burring was made. This study showed high chance of recurrence after unsatisfactory curettage, and 85% of recurrence developed in the vicinity of the small window area. Most of the recurrence occurred within the first two years. It is concluded that sufficient window opening, extensive curettage and eradicative burring are key factors to prevent recurrence. Also, it should be reminded that careful and close observation should be made for at least the first two years after initial treatment for early detection of recurrence.

• The Journal of the Korean bone and joint tumor society
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• v.1 no.2
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• pp.145-153
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• 1995

Giant cell tumor is most frequently found in juxtaarticular region, and difficult to treat because of local recurrence. Although primary resections reduce recurrence, the joint function will be markedly impaired. Techniques involving physical adjuncts(high speed burr and electric cauterization), acrylic cement or en bloc resection with VFG(vascularized fibular graft) have been employed to reduce local recurrence. From October 1984 to April 1994, twenty-nine patients diagnosed as giant cell tumor were treated at department of Orthopaedic Surgery, School of Medicine, Kyung Hee University. There were eleven men and 18 women, ranging in age from 17 to 52 years(mean: 34 years). The average follow-up period was four years and five months. The location of the lesion was around the knee in 15, distal radius in three, femoral head in three, and others in eight patients. Fifteen patients around the knee joint were treated with several modalities; curettage with bone graft in five, curettage with cement filling in three, curettage with bone graft and physical adjuncts in five, en bloc resection with VFG in one and en bloc resection with arthroplasty in one patient. The functional results, according to the Marshall's knee score, were excellent in one, good in two, and fair in two after the curettage with bone graft, good in three after the curettage with bone cement filling, excellent in one, good in four after the curettage with bone graft and physical adjuncts, and good in two after the en bloc resection with VFG or arthroplasty. Three patients had local recurrence among 15 patients with giant cell tumor around knee. Vascularized fibular graft around wrist joint provided good functional restoration without local recurrence in all three patients who had giant cell tumor in distal radius. Although there is no statistical significance, it seems that curettage with bone graft using physical adjuncts or acrylic cement reveals better results than simple curettage with bone graft. Excellent functional result were obtained without local recurrence by using vascularized fibular graft after en bloc resection.