• Title/Summary/Keyword: Myomectomy

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Chromosome Imbalances and Alterations in the p53 Gene in Uterine Myomas from the Same Family Members: Familial Leiomyomatosis in Turkey

  • Hakverdi, Sibel;Demirhan, Osman;Tunc, Erdal;Inandiklioglu, Nihal;Uslu, Inayet Nur;Gungoren, Arif;Erdem, Duygu;Hakverdi, Ali Ulvi
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.651-658
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    • 2013
  • Uterine leiomyomas (UL) are extremely common neoplasms in women of reproductive age, and are associated with a variety of characteristic choromosomal aberrations (CAs). The p53 gene has been reported to play a crucial role in suppressing the growth of a variety of cancer cells. Therefore, the present study investigated the effects of CAs and the p53 gene on ULs. We performed cytogenetic analysis by G-banding in 10 cases undergoing myomectomy or hysterectomy. Fluorescence in situ hybridization (FISH) with a p53 gene probe was also used on interphase nuclei to screen for deletions. In patients, CAs were found in 23.4% of 500 cells analysed, significantly more frequent than in the control group (p<0.001). In the patients, 76% of the abnormalities were structural aberrations (deletions, translocations and breaks), and only 24% were numerical. Deletions were the most common structural aberration observed in CAs. Among these CAs, specific changes in five loci 1q11, 1q42, 2p23, 5q31 and Xp22 have been found in our patients and these changes were not reported previously in UL. The chromosome breaks were more frequent in cases, from high to low, 1, 2, 6, 9, 3, 5, 10 and 12. Chromosome 22, X, 3, 17 and 18 aneuploidy was observed to be the most frequent among all numerical aberrations. We observed a low frequency of p53 losses (2-11%) in our cases. The increased incidence of autosomal deletions, translocations, chromatid breaks and aneuploidy, could contribute to the progression of the disease along with other chromosomal alterations.

Benign Metastasizing Pulmonary Leiomyoma with Hemoptysis (객혈을 동반한 양성 전이성 폐 평활근종 1예)

  • Park, So Young;Lim, Eun Ju;Jang, Ji-Sun;Kim, Chang-Hwan;Jee, Hyun Keun;Cho, Sung Jin;Park, Yong Bum;Lee, Jae Young;Mo, Eun Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.1
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    • pp.92-96
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    • 2006
  • A benign metastasizing pulmonary leiomyoma(BMPL) is a rare disease that is usually detected years after a hysterectomy or myomectomy. Despite the benign pathological appearance, these tumors can metastasize and become clinically malignant. Recently, we experienced case of BMPL with hemoptysis. A 43-year-old woman, who had undergone a hysterectomy due to uterine leiomyoma 8 years ago, visited our department complaining of intermittent hemoptysis. A chest CT showed bilateral multiple nodular lesions. Video-associated thoracoscopy was performed. The resected small nodular lesion revealed the proliferation of spindle cells without mitosis or nuclear atypism. The lesions tested positive to the smooth muscle marker (actin) by immunohistochemical staining. Therefore, the multiple nodules were considered as benign metastasizing pulmonary leiomyoma from a uterine leiomyoma. GnRH analogue therapy was initiated. A chest CT showed that the size and number of pulmonary lesions did not change after 3 months, and the patient was symptom free.

Endometrial Stromal Sarcoma Presented as an Incidental Lung Mass with Multiple Pulmonary Nodules

  • Kang, Dong Oh;Choi, Sue In;Oh, Jee Youn;Sim, Jae Kyeom;Choi, Jong Hyun;Choo, Ji Yung;Hwang, Jin Wook;Lee, Seung Heon;Lee, Ju-Han;Lee, Ki Yeol;Shin, Chol;Kim, Je Hyeong
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.3
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    • pp.131-135
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    • 2014
  • Low-grade endometrial stromal sarcoma (ESS) is an uncommon gynecologic malignancy of mesodermal origin. Pulmonary metastasis of low-grade ESS can occur years and decades after the treatment of the primary disease. Low-grade ESS is frequently mistaken as benign uterine neoplasm like uterine leiomyoma, which can potentially lead to a misdiagnosis. We present a case of a 42-year-old woman with low-grade ESS, that initially presented as an incidental lung mass with multiple pulmonary nodules, seven years after an uterine myomectomy. A $6.9{\times}5.8cm-sized$ intrapelvic mass suspected of uterine origin was discovered while searching for potential extrathoracic primary origin. A pelviscopy and simultaneous thoracoscopic lung biopsy were conducted for pathologic diagnosis. Finally, the diagnosis was confirmed as low-grade ESS with lung metastasis based on the histopathologic examination with immunohistochemical stain, which was showed positive for CD10 and hormone receptor markers (estrogen and progesterone receptors) in both pelvic and lung specimens.

Fertility Issues in Patients with Myoma (자궁근종과 생식력)

  • Kim, So-Ra;Chae, Hee-Dong
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.3
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    • pp.191-198
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    • 2010
  • Uterine myomas are heterogeneous tumors in composition, size, location, and number; variation in any of these factors could possibly alter the effect on a woman's fertility status. The effect of myomas on fertility has been the subject of many studies. However, a definitive answer is still missing. The location and size of the myomas are the two parameters that influence the success of a future pregnancy. Subserosal myomas seem to have little effect on reproductive outcome. Myomas that compress the uterine cavity with an intramural portion and submucosal myomas significantly reduce pregnancy rates, and should be removed before assisted reproductive techniques are performed. Patients with intramural myomas also may have a poorer reproductive outcome, but the lacks of quality evaluations make this conclusion tenuous at best. Removal of myomas with an intra-cavitary component seems to be of benefit. However there are as yet no data to support myomectomy in the treatment of intramural myomas to improve fertility outcomes. Treatment modality for myomas located at intramural sites should be determined according to clinical status of the patient and doctor's experience.

Influence of Gas Pain, Post-operative Resilience, and Body Temperature Discomfort in Laparoscopic Myomectomy Patients after Thermotherapy (복강경하 자궁근종절제술 후 적용한 온열요법이 가스 통증, 수술 후 회복력 및 체온불편감에 미치는 효과)

  • Lee, JeongAe;Jeon, MyoungHwa;Park, EunJu;Lee, JinAh;Ahn, GonMyoung;Lee, SeungShin;Kim, JiIn
    • Women's Health Nursing
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    • v.25 no.1
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    • pp.4-18
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    • 2019
  • Purpose: The purpose of this study was to investigate the effects of thermotherapy on gas pain, post-operative resilience, and body temperature discomfort among patients who received laparoscopic myomectomies. Methods: The experimental group consisted of 62 patients with thermotherapy and the control group consisted of 60 patients. Thermotherapy was applied individually to the experimental group four hours after surgery. The collected data was analyzed using descriptive statistics, t-tests, ${\chi}^2$-tests, and repeated measures of analysis of variance, using IBM SPSS Statistics version 18. Results: The results showed no significant interaction effect between the group and time of measurement in gas-related pain in the experimental group. For gas-related pain, there was significant difference in right shoulder pain at 24 hours (t=-4.222, p=.000), 48 hours (t=-3.688, p=.000), 72 hours (t=-2.250, p=.028), and left at 24 hours (t=-3.727, p=.000), 48 hours (t=-4.150, p=.000), and 72 hours (t=-2.482, p=.016) and both shoulders at 24 hours (t=-2.722, p=.009) and 48 hours (t=-2.525, p=.014). There was no significant difference in epigastric pain, excluding both epigastric pain at 48 hours (t=2.908, p=.005), 72 hours (t=3.010, p=.004), but there was a significant difference in objective body temperature discomfort (t=2.895, p=.008). Conclusion: Thermotherapy relieved shoulder gas-related pain and objective body temperature discomfort. It needs to be developed and applied to improve post-operative discomfort in patients with laparoscopic hysterectomies.

A New Healthcare Policy in Korea Part 3: Ultrasound and MRI in Urogenital Disorders (새로운 건강보험 보장성 강화 대책 3부: 비뇨생식기 초음파 및 MRI 급여 확대)

  • Young Sup Shim;Kye Jin Park
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1083-1095
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    • 2020
  • Since 2019, ultrasound and magnetic resonance imaging for evaluation of urogenital disorders have been covered by the National Health Insurance (NHI) in Korea. Patients with urogenital malignancies were already insured by NHI for ultrasound and MRI. With the expansion of NHI coverage, patients with suspected prostate or gynecologic cancer, uterine fibroids before myomectomy and some other benign disease such as congenital anomaly can receive benefits of NHI. In consideration of these changes, radiologists and other clinicians should be aware of the indications and standard images of each examination and the required reporting forms. Clinical application based upon thorough understanding of the NHI guidelines will aid in improving the standard care of patients.

Treatment of Uterine Myoma as a Cause of infertility, with a Delayed-Release Formulation of a Gonadotropin-Releasing Hormone Agonist(D-$Trp^6$-LHRH) (불임의 원인으로서의 자궁근종 치료에 있어 GnRH agonist (D-$Trp^6$-LHRH)의 효용에 관한 연구)

  • Park, Sae-Chul;Kwon, Kyung-Ik;Nam, Dong-Ho;Lee, Min-Yong;Lim, Chun-Kun;Yang, Sook-Kyung;Choi, Jong-Moo;Lee, Du-Ryong
    • Clinical and Experimental Reproductive Medicine
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    • v.21 no.1
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    • pp.43-48
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    • 1994
  • To evaluate the effectiveness of GnRH agonist for the treatment of uterine myoma as a cause of infertility, fourteen women were recruited to the study. The patients were treated with a delayed-release formulation of D-$Trp^6$-LHRH in biodegradable microcapsules(Decapeptyl-CR), administered intramuscularly at four week intervals for a period of six monthes. The first injection was given on day 21 of the cycle. Serum estradiol levels fell significantly to the mean value of 257.7pgjml 4 weeks after the first injection. Eleven patients in fourteen treated patients had a reduction in the size of uterine myoma as assessed by ultrasonography, two patients had no change of size and one patient had a increase of size. After the first or second injection, all patients became amenorrheic, then resumption of menstruation ocurred at 12 to 14 weeks after the last injection. Common side effects were hot flush, sweating and dyspareunia, whitch were acceptale. In Eleven patients who had a reduction in the size of uterine myoma by treatment with a delayed- release formulation of D-$Trp^6$-LHRH(Decapeptyl-CR), after above treatment with GnRH agonist, then four patients were treated with myomectomy, three patients had pregnancy and full term delivered by Cesarean section. These data suggest that administration of a delayed-release formulation of a GnRH agonist can be a worthwhile and convenient approach to the medical treatment of uterine myoma as a cause of infertility.

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Botulinum Toxin A Treatment for Cervical Dystonia Resulting in Endoscopic Thyroidectomy: A Case Report (내시경 갑상샘 절제술 후 발생한 경부 근긴장이상증의 보툴리늄 A 독소를 이용한 치료: 증례보고)

  • Oh, Hwa-Young;Choi, Hwan-Jun;Nam, Doo-Hyun;Kim, Jun-Hyuk;Lee, Young-Man
    • Archives of Plastic Surgery
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    • v.38 no.2
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    • pp.207-211
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    • 2011
  • Purpose: Surgery for thyroid gland requires skin incisions that can result in postsurgical neck scar. To overcome this, many surgeons performed a endoscopic thyroidectomy. But, this approach had a some problems. One of postoperative problems, iatrogenic cervical dystonia (CD) may occur. At common, CD is defined as a syndrome characterized by prolonged muscle contraction causing twisting, repetitive movements or abnormal posture. Botulinum toxin A (BTA, Botox$^{(R)}$, Allergan, Irvine, CA, USA) is well known treatment agent in the treatment of CD. So, the authors applied BTA injection in rare case with iatrogenic CD resulting in endoscopic thyroidectomy. Methods: A 43-year-old female had endoscopic subtotal thyroidectomy operation 3 years ago. She had symptoms such as progressive cervical pain, abnormal neck posture, depression, and sleep difficulty. About 1 year later, the patient who had previous myomectomy of the clavicular head of sternocleidomastoid muscle, however, symptoms were not improved. And then the patient received BTA therapy in our department. The 2 units per 0.1 mL solution was administered in a 1 mL tuberculin syringe. Results: The dose of BTA used in the patient was 36 units for vertical platysmal bands, superficially, and 10 units for ipsilateral sternocleidomastoid muscle, intramuscularly. After 2 weeks, additional the dose of BTA used in the patient was 5 points for remained scar bands, superficially. Complications related to injection such as significant swallowing difficulties, neck muscle weakness, or sensory change were not observed. In 9 months follow-up, the patient maintained a good result from the method of BTA injection alone. Conclusion: The basic concept is selective denervation for the hyperactive individual muscles and scar bands. We conclude that BTA is an effective and safe treatment for CD despite the iatrogenic and complex presentation of this complication.

Clinical Survey of Cesarean Section (제왕절개술에 대한 임상적 고찰)

  • Kim, Jae-Wung;Lee, Young-Gi;Kim, Jong-Wook;Lee, Tae-Hyung;Park, Wan-Seok;Lee, Sung-Ho;Chung, Wun-Yong
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.249-260
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    • 1986
  • Recent reports have noted the increase of and questioned the justification for cesarean section rate in the past decade. This study was carried out retrospectively based on the clinical charts of 510 patients who had been performed cesarean section among 3,357 deliveries at Yeungnam University Hospital from May, 9, 1983 through Nov., 30, 1986. The results were as follows : 1. Overall incidence of cesarean section was 15.7% of total deliveries. Of these, 10.9% were by primary cesarean section and 4.7% by repeat operation. There has been a gradual increase in the cesarean section rate. 2. In the distribution of age, the 26-30 aged group was the most prevalent(60.2%). 3. The most common indications for cesarean section were previous cesarean section(30.2%), CPD (26.9%), Malpresentation(22.7%), and fetal distress(3.5%). In primipara, CPD was the most frequent and in multipara malpresentation. 4. A great proportion(31.6%) was done at 40th gestational week. 5. In the weight distribution of infants, the group of 3,000-3,499gm was the most prevalent(39.8%), premature baby was 9.1%, and giant baby was 5.6%. 6. In the type of operation, lower segment transverse cesarean section was the most(97.5%). 7. In the combined surgery, sterilization was the most prevalent and the next was ovarian cystectomy, hysterectomy, and myomectomy in order. 8. In the type of the anesthesia, general anesthesia was 83.5%. 9. Maternal morbidity was 14.7%. Among the causes of this morbidity, wound infection was the most and the next was urinary tract infection, fever of unknown origin, and atonic bleeding in order. 10. It was found that 18.4% was maternal morbidity in the patients below 10gm Hb. In this group, maternal morbidity was markedly increased as the level of Hb was decreased. 11. Maternal morbidity was increased as the duration of ruptured membrane was prolonged. In the group of over 24 hours after rupture of membrane, it was markedly increased(44.4%). 12. Maternal morbidity was increased as the duration of labor was prolonged. In the group of over 12 hours after the onset of labor, it was 24.6%. 13. Maternal morbity of lower segment transverse cesarean section was the least(14.1%). 14. Maternal morbidity of emergency cesarean section was about two times as much as elective cesarean section.

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