• 제목/요약/키워드: Gynecological Surgery

검색결과 56건 처리시간 0.031초

부인암에서 양전자방출단층촬영의 이용 (Utility of PET in Gynecological Cancer)

  • 최창운
    • 대한핵의학회:학술대회논문집
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    • 대한핵의학회 2002년도 춘계학술대회 및 총회
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    • pp.9-13
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    • 2002
  • Clinical application of positron emission tomography (PET) is rapidly increasing for the detection and staging of cancer at whole-body studios performed with 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG). Although many cancers can be detected by FDG-PET, there has been limited clinical experience with FDG-PET for the defection of gynecological cancers including malignancies in uterus and ovary. FDG-PET can show foci of metastatic disease that may not be apparent at conventional anatomic imaging and can and in the characterization of indeterminate soft-tissue masses. Most gynecological cancers need to surgical management. FDG-PET can improve the selection of patients for surgical treatment and thereby reduce the morbidity and mortality associated with inappropriate surgery. FDG-PET is also useful for the early detection of recurrence and the monitoring of therapeutic effect. In this review, I discuss the clinical feasibility and limitations of this imaging modality in patients with gynecological cancers.

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Modulation of Drug Resistance in Ovarian Cancer Cells by Inhibition of Protein Kinase C-alpha (PKC-α) with Small Interference RNA (siRNA) Agents

  • Zhao, Li-Jun;Xu, Heng;Qu, Jun-Wei;Zhao, Wan-Zhou;Zhao, Yi-Bing;Wang, Jin-Hua
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권8호
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    • pp.3631-3636
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    • 2012
  • Objective: To determine whether silence of $PKC-{\alpha}$ expression by small interference RNA (siRNA) might regulate MDR1 expression and reverse chemoresistance of ovarian cancer. Methods: We measured gene and protein expression of MDR1 and $PKC-{\alpha}$ in ovarian cancer cells and assessed their correlation with cell drug resistance. We also examined whether blocking $PKC-{\alpha}$ by RNA interference (RNAi) affected MDR1 expression and reversed drug resistance in drug sensitivity tests. Results: The drug resistance cell lines, OV1228/DDP and OV1228/Taxol, had higher gene and protein expression of MDR1 and $PKC-{\alpha}$ than their counterpart sensitive cell line, OV1228. SiRNA depressed $PKC-{\alpha}$ gene protein expression, as well as MDR1 and protein expression and improved the drug sensitivity in OV1228/DDP and OV1228/Taxol cells. Conclusion: These results indicated that decreasing $PKC-{\alpha}$ expression with siRNA might be an effective method to improve drug sensitivity in drug resistant cells with elevated levels of $PKC-{\alpha}$ and MDR1. A new siRNA-based therapeutic strategy targeting $PKC-{\alpha}$ gene could be designed to overcome the chemoresistance of ovarian cancer.

Effect of the pulmonary recruitment maneuver on pain after laparoscopic gynecological oncologic surgery: a prospective randomized trial

  • Gungorduk, Kemal;Asicioglu, Osman;Ozdemir, Isa Aykut
    • Journal of Gynecologic Oncology
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    • 제29권6호
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    • pp.92.1-92.9
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    • 2018
  • Objective: To evaluate the effectiveness of the pulmonary recruitment maneuver (PRM) at the end of the operation to decrease laparoscopy-induced abdominal or shoulder pain after gynecological oncologic surgery. Methods: In total, 113 women undergoing laparoscopic surgery for malignant or premalignant gynecological lesions were assigned randomly to two groups: the PRM group (the patient was placed in the Trendelenburg position ($30^{\circ}$) and the PRM, consisting of two manual pulmonary inflations to a maximum pressure of $40cmH_2O$) (n=54) and the control group (n=52). Postoperative shoulder and abdominal pain was assessed 12, 24, and 48 hours later using a visual analog scale (0-10). In addition, the incidence of post-discharge nausea and vomiting was recorded until 48 hours after discharge. Results: Postoperative shoulder pain at 12 and 24 hours was significantly less severe in the PRM group ($2.2{\pm}0.5$ and $2.0{\pm}0.4$) than in the control group ($4.0{\pm}0.5$ and $3.9{\pm}0.4$; both p<0.001). The PRM significantly reduced the severity of upper abdominal pain at 12 and 24 h compared with the control group ($3.1{\pm}0.4$ and $2.9{\pm}0.4$ vs. $2.9{\pm}0.5$ and $4.9{\pm}0.5$; both p<0.001). The analgesic requirement during the postoperative period was similar in the two groups (control group, 78.8%; PRM group, 75.9%; p=0.719). Conclusion: The PRM effectively and safely reduced postoperative shoulder and upper abdominal pain levels in patients undergoing laparoscopic gynecological oncologic surgery. Trial registry at ClinicalTrials.gov, NCT01940042.

일개 지역 부인과 수술환자가 인식하는 음악요법의 통증 조절효과 및 음악 선호도 : Pilot study (Pilot Study for Perceived Effectiveness of Music Therapy for Pain and Music Preference in Women following Gynecological Surgery in a Local Area)

  • 안숙희
    • 여성건강간호학회지
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    • 제11권4호
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    • pp.273-279
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    • 2005
  • Purpose: The purposes of this pilot study were to describe the perceived effectiveness of music therapy for pain control and to identify music preference for postoperative pain and anxiety control in Korean women who had a gynecological surgery. Sample: A convenience sample of 52 women was recruited from a gynecological unit at P University hospital and they were interviewed to assess their perception of music therapy and music preference using a structured study questionnaire. Results: Fifty-six percent of women reported that music therapy would be effective and 96% perceived it would be effective if combined with analgesics. The best music chosen for relieving postoperative pain and anxiety were Korean old pop and ballad song/music followed by Korean religious music, American pop songs, piano music, Korean classic songs, and Orchestra music. Conclusion: There was a cultural difference in music preference for the relief of post-operative pain in this sample. Therefore, effects of music for postoperative pain control need to be determined after considering musical preferences of postoperative women in Korea.

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부인과 질환관련 복강경 수술 후 발생한 복통 환자 10예의 임상적 고찰 (Clinical Study for Ten Cases, who Complains Abdominal Pain after Surgery -Laparoscopic Gynecological Surgery-)

  • 이자영;성준호;박영선;김동철
    • 대한한방부인과학회지
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    • 제22권3호
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    • pp.236-245
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    • 2009
  • Purpose: The purpose of this study was to report the effect of TKM (Traditional Korean Medicine) to abdominal pain after laparoscopic gynecological surgery(LGS). Methods: 10 patients who visited the department of gynecology in OO medical center from 1st August 2007 to 31st December 2008 with abdominal pains after laparoscopic operation. They complained abdominal pain and other pains such as back pain, shoulder pain and vaginal bleeding etc. We treated patients with herb medicine, acupuncture and moxibustion treatment. The progress of signs and symptoms was evaluated by checking the change of visual analog scale(VAS). Results: The mean age was 45.1 years(range 38-49), parity 2(0-3) and previous abdominal surgery case was 5. The mean of hospital admitting day was 20 days(range 9- 51) and taken for reducing VAS 10 to 3 were 10 days(range 4-24). After taking TKM, patient's signs and symptoms were alleviated or resolved and Hb, Hct were increased. Conclusion: After laparoscopic gynecological surgery, patients had taken pain such as abdominal pain, shoulder pain, back pain etc. TKM treatment is effective on the recovery after laparoscopic surgery.

The impact of magnesium sulfate as adjuvant to intrathecal bupivacaine on intra-operative surgeon satisfaction and postoperative analgesia during laparoscopic gynecological surgery: randomized clinical study

  • Mohamed, Khaled Salah;Abd-Elshafy, Sayed Kaoud;El Saman, Ali Mahmoud
    • The Korean Journal of Pain
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    • 제30권3호
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    • pp.207-213
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    • 2017
  • Background: Surgeon satisfaction and patient analgesia during the procedure of laparoscopic surgery are important issues. The aim of this work was to study if an intrathecal (IT) Bupivacaine combined with Magnesium sulfate may or may not provide good surgeon satisfaction in addition to improvement of intraoperative and postoperative analgesia. Methods: Sixty female patients were enrolled in this prospective, randomized, double-blind controlled clinical trial study. All patients were operated for gynecological laparoscopic surgery under spinal anesthesia. Patients were divided into two groups (Bupivacaine and Magnesium). Group Bupivacaine (30 patients) received intrathecal Bupivacaine 0.5% only (15 mg), while 30 patients in group Magnesium received intrathecal Bupivacaine (15 mg) in addition to intrathecal Magnesium sulfate (50 mg). The sensory block level, the intensity of motor block, the surgeon satisfaction, the intraoperative visual analog scale (VAS) for pain assessment, the postoperative VAS, and side effects were recorded during the intraoperative period and within the first 24 hours after surgery in the post-anesthesia care unit. Results: Surgeon satisfaction, intraoperative shoulder pain, postoperative pain after 2 h, and perioperative analgesic consumption (ketorolac) were significant better in group Magnesium than in group Bupivacaine. (P < 0.05). The onset of motor and sensory blocks was significant longer in group Magnesium than the other one. The incidence of PONV, pruritus and urinary retention was insignificant statistically between both groups. Conclusions: Magnesium sulfate if used intrathecally as an adjuvant to Bupivacaine would provide a better surgeon satisfaction and would improve the analgesic effect of spinal anesthesia used for gynecological laparoscopic surgery.

Ovarian Transposition for Stage Ib Squamous Cell Cervical Cancer - Lack of Effects on Survival Rates?

  • Turan, A. Taner;Keskin, H. Levent;Dundar, Betul;Gundogdu, Burcu;Ozgul, Nejat;Boran, Nurettin;Tulunay, Gokhan;Kose, M. Faruk
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권1호
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    • pp.133-137
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    • 2013
  • Background: To investigate the impact of ovarian transposition (OT) on survival rates of the patients with stage Ib squamous cell cervical cancer. Materials and Methods: Ninety-two subjects who underwent a radical hysterectomy including oophorectomy were evaluated. For nineteen (20.7%), OT was performed. Patients were divided into two groups, OT versus oophorectomy alone. The primary end-point of this study was to investigate the impact of OT on tumor recurrence rate and time, 5-year disease-free survival (DFS) and overall survival (OS). These comparisons were performed for subgroups including patients who received radiotherapy versus who did not. Statistical analyses were conducted using the Chi-square test, T-test and Mann-Whitney test. OS was examined using the Kaplan-Meier method. $P{\leq}0.05$ was considered to be statistically significant. Results: The median follow-up period was 89 months for OT and 81 months for the oophorectomy group (p>0.05). Both groups experienced similar recurrence rates (31.6% vs. 26.4%, p=0.181). The median duration from surgery to recurrence, and surgery to death were also similar between the groups (p>0.05). The 5-year DFS and OS rates were both 68.4% for the OT group, and 73.6% and 77.8% for the oophorectomy group (p=0.457 and p=0.307, respectively). While the 5-year DFS rate was not statistically significant between the OT and oophorectomy groups who did not receive radiotherapy (p=0.148), the 5-year OS rate was significantly higher in the oophorectomy group (95.4% vs 66.7%, respectively) without radiotherapy (p=0.05). The 5-year DFS and OS rates were statistically similar between the groups who received adjuvant radiotherapy (p>0.05). Conclusions: Ovarian transposition has not significantly negative effect on the survival rates when adjuvant radiotherapy will be applied, while 5-year OS may be less in OT group if radiotherapy is not mandatory.

동국대학교 일산한방병원 여성의학과에서의 귀비탕(歸脾湯) 임상 적용 사례 분석 연구 (An Analysis of Clinical Application of Guibi-tang for Obstetrics and Gynecological Disease)

  • 박장경;김동일
    • 대한한방부인과학회지
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    • 제24권2호
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    • pp.79-96
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    • 2011
  • Objectives: This study was to investigate clinical usage of Guibi-tang based on actual application in obstetrics and gynecology. Methods: This study investigated the number of patients who were prescribed Guibi-tang-gami-bang and what herbal medicines were adjusted according to their chief complaint from January 1st, 2007 to August 31th, 2008. Results: The number of patients who were prescribed Guibi-tang for obstetrics and gynecological diseases at the Department of Obstetrics and Gynecology was 721. Guibi-tang has been used to treat menstrual irregularity, postpartum general weakness, postpartum pantalgia, perimenopausal symptoms and postmenopausal syndrome most frequently. And Guibi-tang has been widely used in obstetric and gynecologic diseases such as general weakness after abortion or gynecological surgery, pelvic pain, dysmenorrhea, uterine myoma, endometriosis, infertility, premenstrual syndrome, urinary incontinence and breast disease. Conclusions: Guibi-tang can be used in obstetric and gynecologic diseases as described in classical oriental medicine literatures, and it is necessary to research clinical usage of Guibi-tang through randomized controlled trial.

부인과영역 질환 수술 후 한방입원치료를 받은 환자에 대한 전반적 현황분석 및 통계적 고찰 (A Study on Overall Status and Statistical Analysis of Hospitalized Patients after Gynecological Surgery)

  • 이진욱;강나훈;유은실;박남춘;박경선;이진무;이창훈;장준복;황덕상
    • 대한한방부인과학회지
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    • 제30권3호
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    • pp.40-53
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    • 2017
  • Objectives: This study aims to analyze the current status of hospitalized patients and effects of Korean medical treatment after gynecological surgery. Methods: We analyzed the medical records of patients admitted to our hospital from January 2015 to May 2017 and categorized the pre-operative and post-operative contents. We performed statistical analysis using SPSS ver.20 for the patients' pains among symptoms. Results: Among total 87, patients 82.8% had hysterectomy. The most cause of the surgery were adenomyosis. The average duration of hospitalization was $10.4{\pm}5.7days$ and all patients were treated with acupuncture. Gami-sibjeon-tang was used most frequently. Among the symptoms that occurred after the operation, abdominal pain, low back pain, pelvic pain were in the order of pain and statistically significant decrease in the mean NRS score. In the symptoms of system, general weakness, insomnia, digestive disorder were in the order of the frequency and were improved respectively. Conclusion: We were able to find out the effectiveness of post-operative Korean medical treatment through hospitalized patients. More data collection and systematic research designs are needed.

한 대학병원 산부인과 수술 환자의 수술 후 한방 치료에 대한 인식 조사 (Postoperative Traditional Korean Medicine Treatment - A Study on the Perception of Gynecological Surgery Patients on Traditional Korean Medicine Treatment in One University Hospital)

  • 이지영;이진무;이창훈;조정훈;장준복;이경섭
    • 대한한방부인과학회지
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    • 제22권2호
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    • pp.151-162
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    • 2009
  • Purpose: The purpose of this study is to analyze the perception that gynecological surgery patients have on Traditional Korean Medicine(TKM) treatment. Methods: We studied the perception of TKM treatment by questionnaire from August, 2008 to Febrary, 2009 in Kyung-Hee University East-West Neo medical center. A questionnaire was given to 180 women and 150 women answered. Results: Out of 150 women, 93 women(62%) had been given TKM treatment during the last 3 years, while 57 women(32%) hadn't. 53 women(35.5%) had taken herbal medicine within the last 2 weeks, while 97 women(64.7%) hadn't. 71 women(47.3%) reported that they had been given TKM treatment related to the causative disease for the operation, while 22 women(14.7%) hadn't. And 97 women(64.7%) indicated that they were willing to use TKM as a part of their postoperative medical care, 53 women(35.3%) indicated that they weren't. Conclusion: Many patients are willing to take TKM treatment as postoperative care. We need more accumulation of data for demonstrating the efficacy and safety of TKM treatment.