• Title/Summary/Keyword: Hysterectomy

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Association of osteoarthritis and bone mineral density in women -The health and nutritional examination survey in Kuri- (여성의 골관절염과 골밀도간의 관련성 분석 -구리시민 건강.영양진단 조사결과를 바탕으로-)

  • Sheen, Seung-Soo;Lee, Soon-Young;Min, Byung-Hyun;Suh, Il
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.4 s.59
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    • pp.669-685
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    • 1997
  • Previous studies, reporting the inverse relationship between osteoarthritis and osteoporosis suggest the existence of possible pathophysiologic mechanisms between them. To examinine the hypothesis that 'bone mineral densities of women with osteoarthritis are significantly higher than that of women without osteoarthritis in Korea', subjects from the health and nutritional examination survey in Kuri city were sampled. Samples were selected through multi-stage sampling frame using established clusters in Kuri city. From August 18 to September 10,1997, the survey was conducted. Among the. total number of selected sample population (1,656 people), response .ate was 52.4 percent (348 men and 519 women). 420 women who took BMD measurement, radiologic exam, and anthropometric exam were selected for the analysis. The analytic results are as follows. 1. General characteristics: Mean BMD was $0.493g/cm^2$, mean age was 43.0, mean BMI was $23.9kg/m^2$. The number of women who experienced menopause was 106, hysterectomy was 19. There were 0 case of osteoarthritis of hip, 64 cases of osteoarthritis of knee, and 2 cases of osteoarthritis of hand. 2. Univariate analysis results: Mean BMD of women with the osteoarthritis of knee was significantly lower than that of women without the osteoarthritis of knee(0.4269 vs. $0.5057g/cm^2$). But, there were too few cases of osteoarthritis of hip and hand, so comparative studies of BMD in osteoarthritis of hip and hand could not be conducted. There were significant differences of BMD among pre-menopause group(0.5204), post-menopause group(0.4206), and hysterectomy group(0.4881). Additionally, there were significant differences of BMD among diabetes group(0.4297), impaired glucose tolerance group(0.4874), and normal group(0.5057). Furthermore, age, parity, BMI, bioimpedance were significantly related with BMD. 3. Multivariate analysis results: To examinine the relationship between osteoarthritis and BMD while controlling the other variables' effects which were significant in the univariate analyses, multiple linear regression analysis was done. But, it was found that osteoarthritis of knee was not a significant variable to BMD anymore. While age and menopause had significant negative relationship with BMD. Diabetes, parity, BMI, and bioimpedance did not have significant relationships with BMD. After stratification of subjects according to menopause, multiple linear regression analyses were done to each strata. Consequently, age in post-menopause group, age and osteoarthritis of knee in hysterectomy group showed significant negative relationship with BMD. The results did not support the many results of other previous studies done with white men and women. further studies of biological plausibility to Korean women are recommended. Also it is suggested that longitudinal study to verify the relationship between osteoarthritis and BMD will be valuable.

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The Effects of Ketamine Preemptive Analgesia on Postoperative Pain in Patients undergoing a Hystrectomy (Ketamine에 의한 선행 진통법이 자궁적출술 환자의 수술 후 통증에 미치는 효과)

  • Kim, Hong-Yeon;Yoon, Hae-Sang
    • Journal of Korean Academy of Nursing
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    • v.36 no.1
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    • pp.114-126
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    • 2006
  • Purpose: This study was performed to evaluate the pre-emptive analgesic effects of a small dose of intravenous ketamine on postoperative pain in patients undergoing a hysterectomy. Method: Sixty patients undergoing a hystrectomy under general anesthesia were randomly allocated to 2 groups. The experimental group(30 patients) received 0.3mg/kg of ketamine after induction of anesthesia, approximately 5 min prior to surgery, but the control group(30 patients)did not receive ketamine. Data was collected in a double-blind manner from April 1st, to October 30th, 2004. Postoperatively, the patients used a patient-controlled analgesia(PCA) pump. Blood pressure, pulse rate, pain, anxiety, count of times pressing the PCA button, administeration of additional analgesics and side effects of ketamine were measured at 1 hour, 3 hours, 6 hours and 24 hours after the operation. Result: There were no statistical differences in blood pressure, pulse rate, pain and anxiety between the experimental and control groups. There were statistical differences in blood pressure, pulse rate, pain and anxiety during the 24 hours postoperatively. In the experimental group, the number of times pressing the PCA button and administering additional analgesic drugs were significantly lower than those of the control group. Conclusion: A 0.3 mg/kg dose of ketamine given at approximately 5 min before surgery resulted in decreasing the number of times pressing the PCA and the administration of additional analgesics.

Clinical Analysis of Cesarean Sections (제왕절개술환자의 임상적 고찰)

  • 오나미혜
    • Journal of Korean Academy of Nursing
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    • v.5 no.2
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    • pp.23-28
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    • 1975
  • One hundred and fifty seven cesarean sectioned patients among 2010 deliveries, were reviewed with the following clinical charts from January, 1973 to December, 1974 at Taegu Presby-terian medical Center. The results are as follows; 1) The section rate was 7.8% 2) In age distribution, the most frequent age was 26~30ys and it~s rate was 37%, and others were as follows : 31~35ys 24.2%, 21~25ys 21%, 36~40ys 10.8%, 41~45ys 7% respective]y- 3) In indication, the cephalopelvic disproportion was the most prevalent and it's rate was 29.3%, and others were as follows : malpresentation 14% previous cesarean section 10.8% uttering dysfunction 9.6%, totemic 4%, elderly primigravida 4%, fetal distress 2.5% post maturity 3.2%, wanted cesarean section 1, 9%, pelvic deformity 1.2% twin 1.9%, abruptio placenta 1.2%, Vaginal stricture 1.2%, and others 2.5%. 4) In type of operation, tower cervical transverse type was 82.1%, classical type 17%, ana cesarean hysterectomy was 0.9% respectively. 5) General Anesthesia was major type and it's rate was 63%, and spinal anesthesia 17.2%, epidermal anesthesia 14% and other combined type was 5.8%. 6) Percental mortality was 11.4%. 7) There was no maternal death. 8) Among the cesarean section complications, wound infection was 8,4%, headache 4.4%, urinary tract infection 1.2% and one case in endometritis. 9) In combined surgery, tubal legation was 31.2%, appenectomy 7.6%, posterior repair 1.2%, salpingoop-horectomy 1.9%, and one case in resection of uttering septum. 10) Cesarean section was performed 61.3% in multipara and 38.2% in primipara. 11) 47 (30%) had received artificial abortions. 12) 28 (17.8%) had previously experienced cesarean section.

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Treatment Outcomes of Epithelial Ovarian Cancers Following Maximum Cytoreduction and Adjuvant Paclitaxel-Carboplatin Chemotherapy: Egyptian NCI Experience

  • Nassar, Hanan Ramadan;Zeeneldin, Ahmed A;Helal, Amany Mohamed;Ismail, Yahia Mahmoud;Elsayed, Abeer Mohamed;Elbassuiony, Mohamed A;Moneer, Manar M
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.7237-7242
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    • 2015
  • Background: Epithelial ovarian cancer (EOC) is the commonest malignancy involving the ovaries. Maximum surgical cytoreduction (MCR) followed by adjuvant taxane-platinum chemotherapy are the standard of care treatments. Aims: To study treatment outcomes of EOC patients that were maximally cyto-reduced and received adjuvant paclitaxel-carboplatin (PC) chemotherapy. Materials and Methods: This retrospective cohort study included 174 patients with EOC treated at the Egyptian National Cancer Institute between 2006 and 2010. For inclusion, they should have had undergone MCR with no-gross residual followed by adjuvant PC chemotherapy. MCR was total abdominal hysterectomy/bilateral salpingo-oophorectomy [TAH/BSO] or unilateral salpingo-oophorectomy [USO] plus comprehensive staging. Results: The median age was 50 years. Most patients were married (97.1%), had offspring (92.5%), were postmenopausal (53.4%), presented with abdominal/pelvic pain and swelling (93.7%), had tumors involving both ovaries (45.4%) without extra-ovarian extension i.e. stage I (55.2%) of serous histology (79.9%) and grade II (87.4%). TAH/BSO was performed in 97.7% of cases. A total of 1,014 PC chemotherapy cycles were administered and were generally tolerable with 93.7% completing 6 cycles. Alopecia and numbness were the commonest adverse events. The median follow up period was 42 months. The 2-year rates for disease free survival (DFS) and overall survival (OS) were 70.7% and 94.8%, respectively. The respective 5-year rates were 52.6% and 81.3%. Advanced stage and high-grade were significantly associated with poor DFS and OS (p<0.001). Age >65 years was associated with poor OS (p =0.008). Using Cox-regression, stage was independent predictor of poor DFS and OS. Age was an independent predictor of poor OS.

Clinical and Pathological Factors Related to the Prognosis of Chinese Patients with Stage Ⅰb To Ⅱb Cervical Cancer

  • Xie, Xiu-Zhen;Song, Kun;Cui, Baoxia;Jiang, Jie;Zhang, You-Zhong;Wang, Bo;Yang, Xing-Sheng;Kong, Bei-Hua
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5505-5510
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    • 2012
  • Objective: The aim of this retrospective study is to analyze the clinical and pathological factors related to the prognosis of Chinese patients with stage Ib to IIb cervical cancer. Methods and Results: 13 clinical pathological factors in 255 patients with stage Ib to IIb cervical cancer undergoing radical hysterectomy and systematic lymphadenectomy were analyzed to screen for factors related to prognosis. The cumulative 5-year survival of the 255 patients was 75.7%. The result of the univariate analysis suggested that clinical stage, cell differentiation, depth of cervical stromal invasion, parametrial tissue involvement, and lymph node metastasis were prognostic factors for patients with stage Ib to IIb cervical cancer (P<0.05). Compared with cases with involvement of iliac nodes, obturator nodes, or inguinal lymph nodes, cases with metastasis to the common iliac lymph nodes had a poorer prognosis (P<0.05). Cases with involvement of four or more lymph nodes had a poorer prognosis than those with involvement of three or fewer lymph nodes (P<0.05). Using multivariate Cox proportional hazards model regression analysis, non-squamous histological type, poor differentiation, parametrial tissue involvement, and outer 1/3 stromal invasion were found to be independently related to patients poor prognosis (P<0.05). Conclusion: Non-squamous histological type, poor cell differentiation, parametrial tissue involvement, and outer 1/3 stromal invasion are the independent poor prognostic factors for patients with stage Ib to IIb cervical cancer.

Lack of Association between Herpes Simplex Virus Type 2 Infection and Cervical Cancer - Taq Man Realtime PCR Assay Findings

  • Farivar, Taghi Naserpour;Johari, Pouran;Shafei, Shilan;Najafipour, Reza;Reza, Najafipour
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.339-342
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    • 2012
  • Background: About one third of the human population suffer cancer during their lifetime and more than 20% of total morbidity is related to neoplasia. Cervical cancer is generally the most common cancer in developing countries and the second most common in women globally. The role of human papilloma viruses viruses in its induction is clear. However, the involvement of hepres simplex virus type 2 (HSV-2) is controversial. Therefore a survey was conducted of the prevalence of HSV-2 in patients with cervical cancer and also healthy people with sensitive and quantitative Taq Man real-time PCR assay. Materials and methods: Seventy six formaldehyde fixed paraffin embedded tissue specimens from patients with histologically proven history of cervical cancer as well as 150 control blocks were sectioned for deparaffinization and DNA extraction. Results: There was no HSV-2 DNA in our patient specimens but four control samples were positive, all with a history of hysterectomy. Conclusion: Considering the absence of any positive viral HSV-2 DNA in our patients and also the presence of four positive specimens among our controls, we did not find any relationship between the presence of HSV-2 DNA and cervical cancer.

The Effect of Geographic Units of Analysis on Measuring Geographic Variation in Medical Services Utilization

  • Kim, Agnus M.;Park, Jong Heon;Kang, Sungchan;Hwang, Kyosang;Lee, Taesik;Kim, Yoon
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.4
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    • pp.230-239
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    • 2016
  • Objectives: We aimed to evaluate the effect of geographic units of analysis on measuring geographic variation in medical services utilization. For this purpose, we compared geographic variations in the rates of eight major procedures in administrative units (districts) and new areal units organized based on the actual health care use of the population in Korea. Methods: To compare geographic variation in geographic units of analysis, we calculated the age-sex standardized rates of eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee-replacement surgery, caesarean section, hysterectomy, computed tomography scan, and magnetic resonance imaging scan) from the National Health Insurance database in Korea for the 2013 period. Using the coefficient of variation, the extremal quotient, and the systematic component of variation, we measured geographic variation for these eight procedures in districts and new areal units. Results: Compared with districts, new areal units showed a reduction in geographic variation. Extremal quotients and inter-decile ratios for the eight procedures were lower in new areal units. While the coefficient of variation was lower for most procedures in new areal units, the pattern of change of the systematic component of variation between districts and new areal units differed among procedures. Conclusions: Geographic variation in medical service utilization could vary according to the geographic unit of analysis. To determine how geographic characteristics such as population size and number of geographic units affect geographic variation, further studies are needed.

Can Ambient Temperature Change Affect the Efficacy of Acupuncture on the Postmenopausal Hot Flash? (기온 변화는 폐경후 안면홍조의 침 치료 효과에 영향을 미치는가?)

  • Roh, Jin-Ju;Ahn, Hong-Yup;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.20 no.4
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    • pp.123-131
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    • 2007
  • Purpose: To find the correlation between ambient temperature change and the efficacy of acupuncture on the postmenopausal hot flash. Methods: 52 patients entered a randomized clinical trial which was to verify the efficacy of acupuncture on postmenopausal hot flash. Participants were treated with optimal/minimal acupuncture in the course of 13 weeks. 34 of 52 visited for the temperature-rising period(Group 1), while 18 of 52 for the temperature-falling period(Group 2), 100mm hot flash VAS and average temperature were taken 18 times from each person. Linear mixed effects model was used to find the correlation between temperature and hot flash VAS score(p-value<0.05). Group1/2, optimal/minimal acupuncture, age, age of menarche, height, weight, percent body fat, BMI, waist-hip ratio, past history of hysterectomy and HRT were also examined. Results: Period of treatment had influence on the hot flash VAS. As time went by, hot flash decreased(p<.0000). Participants who underwent minimal acupuncture showed higher hot flash VAS(p=0.0479) and as waist-hip ratio rose, hot flash increased(p<.0000). As the temperature rose, hot flash VAS score became lower(p=0.0143) and it was because 34 of 52 participants were treated for the temperature-rising period. Group 1/2 had no interrelation with hot flash(p=0.5741). Conclusion: Hot flash diminished as participants were treated with acupuncture, independently of whether the ambient temperature rises or falls.

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Treatment of the chronic pelvic pain and complications of post-ovarian cystectomy with laparoscopy : a case report (난소낭종제거수술 후 내원한 만성골반통 환자 1례에 대한 증례보고)

  • Yang, Seoung-In;Han, In-Sun;Park, Hyun-Jae;Bae, Sang-Jin;Lee, Dong-Nyung;Yi, Youn-Ju
    • The Journal of Korean Obstetrics and Gynecology
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    • v.19 no.4
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    • pp.287-297
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    • 2006
  • Purpose : Chronic pelvic pain(CPP) is a common gynecologic symptoms. Recent research has been directed towards understanding the pathology of CPP, but many questions have existed. And the study for treating CPP has been tried by various manners. A Korean medicine(KM) also try to treat a various methods for treatment of CPP. It is often that a pelvic pain is continue a post-hysterectomy or a operating of gynecology. We have a case of CPP treatment by KM that is a patient continue pain after post-ovarian cystectomy with laparoscopy. So we report a case on pelvic pain and complication of post-ovarian cystectomy with laparoscopy. Methods : A 44 years old woman, who suffered from chronic pelvic pain, dizziness, nausea, dyspepsia, general weakness, insomnia after ovarian cystectomy, was enrolled in this study. She received KM therapies such as herbal medicine, moxibustion, acupuncture for 4 weeks. Results : CPP and symptoms after ovarian cystectomy were reduced by KM therapies. Conclusion : 'The present study suggests that KM therapies have a significant effect on CPP and complications of post-ovarian cystectomy with laparoscopy.

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Clinical Review of Ovarian Tumors in Children (소아 난소 종양의 임상적 고찰)

  • Cho, Sam-Jea;Yoon, Sang-Yong;Jung, Sung-Eun;Lee, Seong-Cheol;Park, Kwi-Won;Kim, Woo-Ki
    • Advances in pediatric surgery
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    • v.1 no.2
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    • pp.115-121
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    • 1995
  • We reviewed 45 cases of ovarian tumors treated at Seoul National University Children's Hospital from 1983 to 1993. Forty-five patients were operated upon for 52 ovarian tumors. The most common pathologic diagnosis was mature teratoma. The next were functional cyst, the tumors of epithelial cell origin, and those of stromal origin in order of frequency. Six patients(13%) had malignant tumor. There were one malignant teratoma, two dysgerminomas, one endodermal sinus tumor, and two granulosa cell tumors. Four cases were diagnosed as torsion of ovarian cyst preoperatively, and emergency exploratory laparotomy were performed. There were three cases of ovarian tumors associated with precocious puberty. The most widely used diagnostic tool was ultrasonography. In the treatment of these 45 patients, unilateral oophorectomy was done in 38 cases, unilateral oophorectomy with wedge resection of contralateral ovary was done in 5 cases, unilateral oophorectomy with contralateral simple cystectomy was done in one case and total abdominal hysterectomy with bilateral salpingooophorectomy was done in one case. Of the six cases of malignancy, five patients are alive 2 to 6 years after operation and one case was lost to be followed up.

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