• Asian Pacific Journal of Cancer Prevention
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• 제17권2호
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• pp.631-638
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• 2016

Radiation proctitis is a common complication after radiotherapy for pelvic malignant tumors. This study was conducted to assess the efficacy of novel almagate enemas in hemorrhagic chronic radiation proctitis (CRP) and evaluate risk factors related to rectal deep ulcer or fistula secondary to CRP. All patients underwent a colonoscopy to confirm the diagnosis of CRP and symptoms were graded. Typical endoscopic and pathological images, risk factors, and quality of life were also recorded. A total of 59 patients were enrolled. Gynecological cancers composed 93.1% of the primary malignancies. Complete or obvious reduction of bleeding was observed in 90% (53/59) patients after almagate enema. The mean score of bleeding improved from 2.17 to 0.83 (P<0.001) after the enemas. The mean response time was 12 days. No adverse effects were found. Moreover, long-term successful rate in controlling bleeding was 69% and the quality of life was dramatically improved (P=0.001). The efficacy was equivalent to rectal sucralfate, but the almagate with its antacid properties acted more rapidly than sucralfate. Furthermore, we firstly found that moderate to severe anemia was the risk factor of CRP patients who developed rectal deep ulcer or fistulas (P= 0.015). We also found abnormal hyaline-like thick wall vessels, which revealed endarteritis obliterans and the fibrosis underlying this disease. These findings indicate that almagate enema is a novel effective, rapid and well-tolerated method for hemorrhagic CRP. Moderate to severe anemia is a risk factor for deep ulceration or fistula.

• Nuclear Medicine and Molecular Imaging
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• 제42권sup1호
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• pp.101-109
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• 2008

Cervix cancer is one of common gynecological cancers in the world, and staged with FIGO or TNM system. However, these clinical staging systems lack information about lymph node or distant metastases, thus imaging modalities are considered to make an appropriate therapeutic plan and enhance overall survival rate. In this context, FDG PET is recommended to pre-treatment stating and prognosis prediction, for it could noninvasively evaluate the status of lymph nodes, especially abdominal paraaortic nodes which are closely related with prognosis. Moreover, the degree of FDG uptake is correlated with prognosis. Although there is no consistent method for surveillance of cervix cancer, FDG PET seems a very important tool in detecting tumor recurrence because it is much more advantageous than conventional imaging modalities such as MRI for discerning recurrent tumor from fibrosis caused by radiation or surgery. Furthermore, FDG PET could be used to evaluate treatment response. On the other hand, recently introduced PET/CT is expected to play an ancillary role to FIGO staging by adding anatomical information, and enhance diagnostic performance of PET by decreasing false positive findings.

• 대한한방부인과학회지
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• 제36권2호
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• pp.101-113
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• 2023

Objectives: The purpose of this case study is to report clinical effectiveness of the Boheo-tang-gagambang with acupuncture, moxa and physiotherapy treatments on the after-effects of myomectomy or hysterectomy. Methods: The subjects of this study were five women who were diagnosed with uterine myoma and underwent myomectomy or hysterectomy. They mainly complained of lower abdominal pain, back pain, and pelvic pain. They received combination treatment of Korean medicine and physiotherapy. The Korean medicine included Boheo-tang-gagambang, acupuncture and moxa. The effects were evaluated through Numeric Rating Scale (NRS). Results: In this study, patient's clinical symptoms, including lower abdominal pain, low back pain, and pelvic pain, improved after hospitalization treatment. Conclusions: This case report shows that the combination treatment of Korean medicine with Boheo-tang-gagambang, acupuncture and moxa may be effective for treating after-effects of myomectomy or hysterectomy.

• 대한한의학원전학회지
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• 제37권3호
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• pp.21-35
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• 2024

Objectives : The aim of this study is to establish foundation for applied research and clinical application of the treatment principle and imperativeness for Korean Medical treatment of recurrent pregnancy loss through the study of classical texts. Methods : The Donguibogam, Yixuerumen, Jingyuequanshu, together with gynecological texts such as the Fuqingzhunuke and the Nukejinglun were studied in terms of treatment, post-miscarriage cultivation methods and prevention for various types of pregnancy loss. Results : For cases of missed miscarriage, Foshousan is applied, while for recovery post surgery, Shenghuatang-based formulas are applied. For cases of imminent miscarriage, prescriptions should be selected based on major symptoms such as stomach pain, lower back pain and bleeding, while for cases of chemical miscarriages, treatment methods that cultivates the Liver and calms qi should be applied. After pregnancy loss, elimination of stagnant blood should be prioritized according to the principle of 'first eliminate blood, then tonify deficiency'. For prevention of pregnancy loss, Jinguidangguisan-based formulas should be applied according to medicinal administration principles of Korean Medicine. Conclusions : For an integrative treatment and prevention of recurrent pregnancy loss, Korean Medical treatment according to clinical representation is required.

• Journal of Yeungnam Medical Science
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• 제37권4호
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• pp.308-313
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• 2020

Background: Hysterectomy is one of the major gynecologic surgeries. Historically, several surgical procedures have been used for hysterectomy. The present study aims to evaluate the surgical trends and clinical outcomes of hysterectomy performed for benign diseases at the Yeungnam University Hospital. Methods: We retrospectively reviewed patients who underwent a hysterectomy for benign diseases from 2013 to 2018. Data included the patients' demographic characteristics, surgical indications, hysterectomy procedures, postoperative pathologies, and perioperative outcomes. Results: A total of 809 patients were included. The three major indications for hysterectomy were uterine leiomyoma, pelvic organ prolapse, and adenomyosis. The most common procedure was total laparoscopic hysterectomy (TLH, 45.2%), followed by open hysterectomy (32.6%). During the study period, the rate of open hysterectomy was nearly constant (29.4%-38.1%). The mean operative time was the shortest in the single-port laparoscopic assisted vaginal hysterectomy (LAVH, 89.5 minutes), followed by vaginal hysterectomy (VH, 96.8 minutes) and TLH (105 minutes). The mean decrease in postoperative hemoglobin level was minimum in single-port LAVH (1.8 g/dL) and VH (1.8 g/dL). Conversion to open surgery or multi-port surgery occurred in five cases (0.6%). Surgical complications including wound dehiscence, organ injuries, and conditions requiring reoperation were observed in 52 cases (6.4%). Conclusion: Minimally invasive approach was used for most hysterectomies for benign diseases, but the rate of open hysterectomy has mostly remained constant. Single-port LAVH and VH showed the most tolerable outcomes in terms of operative time and postoperative drop in hemoglobin level in selected cases.

• Asian Pacific Journal of Cancer Prevention
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• 제15권15호
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• pp.6357-6362
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• 2014

Background: Globally, the overall incidence of cancer is increasing as a result of ageing populations and changing lifestyles. Cancer is one of the leading causes of death, especially in the developed nations. Cancers affecting the young population are generally considered uncommon. This study assessed the demography and trends of cancers of the young in Brunei Darussalam, a small and developing Southeast Asia nation. Materials and Methods: All patients diagnosed with cancers between 2000 and 2012 were identified from the cancer registry maintained by the State Histopathology Laboratory. Cancers of the young was defined as any cancers diagnosed under the age of 40 years. Demographic data and the type of cancers were collected and analysed using SPSS Statistics 17.0. Results: Among the 6,460 patients diagnosed with cancer over the study period, 18.7% (n=1,205) were categorized as young with an overall decline in the proportion from 26.6% in 2000 to 18.8% in 2012 (p<0.001 for trend). Among all cancers of the young, the most common systems affected were gynecological (24.1%), hematological/lymphatic (15.8%), subcutaneous/dermatological/ musculoskeletal (10.5%), breast (10.5%) and gastrointestinal (9.9%). Overall, among the different systems, neurological (54.9%) had the highest proportion of cancers of the young followed by gynecological/reproductive (30.6%), hematological/lymphatic (39.9%), endocrine (38.7%), subcutaneous/dermatological/ musculoskeletal (22.3%) and the head and neck region (20.1%). There was a female predominance (66.9%) and the incidence was significantly higher among the Malays (20.1%) and expatriates (25.1%) groups compared to the Chinese (10.7%) and indigenous (16.8%) groups (p<0.001 for trend). Conclusions: Cancers of the young (<40 years) accounted for almost a fifth of all cancers in Brunei Darussalam with certain organ systems more strongly affected. There was a female preponderance in all racial groups. Over the years, there has been a decline in the overall proportion of cancers of the young. Selective screening programs should nevertheless be considered.

• 대한간호학회지
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• 제15권3호
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• pp.5-20
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• 1985

The purpose of this study was to assess the value-of post-operative treatment in terms of nursing care in the allevation of pain. More specifically, the effects of supportive touch and patient education were examined. On the date before each patient's operation, the Bevels of anxiety, depression and affiliation were examined. The post-operative treatment was adminis. tered after an initial measurement of the patient's fain, according to the experimental category for the three days following the operation. On the final day, the level of anxiety and depression were again measured. The subjects of this study were 138 patient from the general surgical and gynecological wards in H university Hospital in Seoul. The study was conducted over a three-month period from June 24, 1984 to September 18, 1984. All patients had undergone laparatomies. Various standard instruments were used to measure the pain, anxiety, depression and affiliation levels. for pain, 5 grate Simple Descriptive Scale, and the Mclachlan four-range Observational Pain Scale were employed. For anxiety and depression, respectively the Spielberger State Anxiety Inventory and Beck Depression Inventory (B.D.I.) were used. Lastly, the affiliation was determined by the Mehrabian Affiliation Scale. The outcome of the research was as follows: 1. The first hypothesis concerning the existence of lower pain levels of Experimental Group A and Experimental Group B than the pain levels of Control Croup C was not supported. 2. The second hypothesis concerning the existence if lower anxiety levels of Experimental Group A and Experimental Group B than the anxiety levels of Control Group C was supported at the level of F=3.58 (p=.03). 3. The third hypothesis concerning the existence of lower depression levels of Experimental Group A and Experimental Group B than the depression levels of Control Group C was not supported. 4. The fourth hypothesis concerning the existence of different levels of pain in accordance with the levels of affiliation in Experimental Group A was not supported. 5. A positive correlation did exist between pain and anxiety after surgery (r=.34, p=.0001). Thus, the fifth hypothesis was supported. 6. A positive correlation did exist between pain and depression following surgery(r=.36, p=.0001). Thus, the sixth hypothesis was supported. Based on the above results, it was found that supportive touch and patient education either through human sources or via tape recorder do influence the anxiety of a patient after surgery, that a Positive correlation between pain, anxiety and deparession exist, that affiliation does not alter the influence of supportive touch, and that the graph on which pain levels were depicted indicates the possibility of development even if the effects of supportive touch did not reach a meaningful level. Thus it can be concluded that patient education, regardless of its form, is essential for the patient after surgery and that supportive touch, when reasonably modified and supplemented, can be an effective method of alleviating pain.

• 대한간호학회지
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• 제25권2호
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• pp.372-389
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• 1995

The frequency with which administration of chemotherapy for gynecological cancer treatment is used has increased along with the use of surgery and radiotherapy Among the various side effects of chemotherapy, stomatitis causes a problem of function and sensation in the oral cavity. This oral discomfort can be categorized into two components ; perceived oral symptoms and observed oral symptoms. If the oral problem continues, it may cause infection, bleeding and nutritional deficiencies. As a result of this condition, compliance with the treatment process can be affected as well as the prognosis for the cancer patients. But as the oral discorrfort usually appears after chemotherapy, it is often not reported to the health care personnel as a patient problem. Without problem identification of the oral discomfort and ability to assess the problem, effective intervention cannot be planned. Therefore, this study was conducted to identify the pattern and the degree of oral discomfort due to cancer chemotherapy and thus to provide data for identification of the patient problem and for nursing assessment. The design of this study was a longitudinal de-scriptive study The subjects were in - patients who received chemotherapy under the diagnosis of gynecological cancer between Mar. 15, 1994 and May 15, 1994 at a general hospital in Seoul, Korea. The number of subjects was 64 and they were divided into two groups, one of 41 (A : 5FU & Neoplatin), the other of 23(B : Neoplatin, Cytoxan, Adriamycin), according to the treatment regimen. The data were collected for 24 days using self-re-port instruments. The instruments were the 「Perceived Oral Symptom Assessment Tool」 and 「Observed Oral Symptom Assessment Tool」 developed by this researcher. Data were analyzed using the SPSS-PC program, ANOVA, t-test, paired t-test and the Pearson Correlation Coefficient were applied. The results of this study are as follows : 1. In A regimen the peak time for perceived oral symptom scores was the fifth day after chemotherapy, and the tenth day for observed oral symptom scores. Both of the problems started on first day of chemotherapy and were not resolved completely until the 24th day after treatment. 2. In B regimen, the peak time for perceived oral symptom scores was on the seventh day after chemotherapy, and the eighth day for observed oral symptom scores. It was noted that perceived oral symptom scores were higher than observed oral symptom scores consistently for 24 days. Both also started on first day of chemotherapy, and were not resolved completely until the 24th day after chemotherapy. 3. There were no differences statistically in perceived oral symptom scores between A and B regimen. The loss of appetite and xerostomia caused the most severe discomfort in both of these two groups. 4. The were no differences statistically in observed oral symptom scores between the A and B regi moil. In the A regimen, the highest observed symptom scores were the lips, gingiva, tongue and buccal membrane in that order. But in the B regimen, the highest observed symptom scores were tongue, lips, buccal membrane and gingiva in that order. 5. In A regimen, the patients who had gingival edema and dentures had significantly higher perceived oral symptom scores. And those who had gingival edema and bleeding, foul odor and aphthous stomatitis had significantly higher observed oral symptom scores. 6. In B regimen, the patients who had the experience of stomatitis in the last course of chemotherapy had significantly higher perceived oral symptom scores. Those who had gingival edema had significantly higher observed oral symptom scores. 7. In the A regimen there was no correlation between lab values for lymphocytes and albumin with perceived oral symptom scores and observed oral symptom scores. In the B regimen, there was a significant negative correlation between lymphocytes and albumin with the observed oral symptom scores, but not between perceived oral symptom scores and lymphocytes and albumin values. In conclusion, the nurse should expect that the patient undergoing chemotherapy will complain severely about subjective discomfort and before objective physical change is observed. Also the patients who have chronic oral problems such as dentures, gingival edema and bleeding, foul odor, aphthous stomatitis will complain of severe oral discomfort due to chemotherapy.

• Asian Pacific Journal of Cancer Prevention
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• 제16권5호
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• pp.1817-1820
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• 2015

Background: Hemoglobin A1c(HgA1c) is a marker of poor gylcemic control and elevation HgA1c is associated with increased risk of many cancers. We aimed to determine the HgA1c levels in endometrial cancer cases and any relationship with stage and grade of disease. Materials and Methods: A retrospective data review was performed between June 2011 and October 2012 at a tertiary referral center in Turkey. The study included 35 surgically staged endometrial cancer patients and 40 healthy controls. Preoperative HgA1c levels drawn within 3 months before surgery were compared. Also the relationships between HgA1c levels and stage, grade and hystologic type of cancer cases were evaluated. Results: The mean HgA1c levels were statistically significantly higher at $6.19{\pm}1.44$ in endometrial cancer cases than the $5.61{\pm}0.58$ in controls (p=0.027). With endometrial cancer cases, the mean HgA1c level was found to be $6.62{\pm}1.40$ for stage I and $6.88{\pm}1.15$ for stages II-IV (p=0.07). The figures were $6.74{\pm}1.65$ for endometrioid and $6.63{\pm}1.41$ for non-endometrioid type tumors (p=0.56). Mean HgA1c levels of $6.72{\pm}1.14$ for grade 1 and $6.62{\pm}1.42$ for grade 2-3 were observed (p=0.57). Conclusions: HgA1c levels in endometrial cancer patients were statistically higher than healthy controls. However, HgA1c did not show any significant correlation with stage, grade and histologic type in endometrial cancer cases.

• The Korean Journal of Pain
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• 제6권1호
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• pp.55-59
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• 1993

Using a visual analogue scale, we compare the effect of patient-controlled analgesia and conventional intramuscular opioid regimen in 68 patients undergoing lower abdominal or gynecological surgery. We also recorded the incidence of side effects. We checked visual analogue scale 4 hours interval for 30 cases managed by patient-controlled analgesia and 38 cases of conventional intramuscular opioid group managed by obstetrician. We maintained fentanyl $0.33{\mu}g/kg/hr$ and set self administrable bolus dose $5.0{\mu}g$(lockout interval: 15 min) in patient-controlled analgesia group. Conventional intramuscular bolus injection group were administered meperidine 50 mg for 4 hour interval. Mean visual analogue scale scores obtained by patient-controlled analgesia group and intramuscular bolus injection group were $2.49{\pm}0.67$ and $4.53{\pm}1.28$(p<0.05). Side effects such as; no significant incidence of respiratory depression, urinary retention, postural hypotension, nausea, vomiting and pruritus were developed by either group. These results suggest that patient-controlled analgesia was more effective method compared with conventional intraumuscular opioid injection regimen for post-operative pain management.