• The Journal of Korean Medicine
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• v.30 no.2
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• pp.152-165
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• 2009

Objectives: We intended to identify differences of general symptoms related to existence & nonexistence of uterine myoma. Methods: We surveyed 948 women from 35 to 45 years old who had received Korean oriental medical questionnaires about general symptom patterns and abdominal & pelvic ultrasonography at Kyung-Hee University medical center from May 2007 to October 2008. After we divided the women into two (uterine myoma or normal) groups by ultrasonography result, we compared general symptom patterns of the uterine myoma group with those of the normal group. Results: In relation to digestion pattern, appetite showed statistically significant difference between the normal and uterine myoma groups. In relation to evacuation pattern, stool frequency showed statistically significant difference between the normal and uterine myoma groups. In relation to psychologic pattern, difference in oppression in the chest & palpitation showed statistical significance between the groups. In relation to the other patterns, differences in throat discomfort & hypertonicity of nape neck showed statistical significance between the normal and uterine myoma groups (p<0.05). Conclusions: The result showed that prevalence of uterine myoma should be considered in respect to digestion pattern, evacuation pattern, and psychologic pattern. We need further study after increasing the size of the uterine myoma group and improvement of general symptom questionnaires.

• Clinical and Experimental Reproductive Medicine
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• v.16 no.1
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• pp.57-68
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• 1989

Some infertile patients who need IVF-ET for conception have small ovarian cysts diagnosed in pelvic ultrasonography. It is well known that it is impossible or very difficult to perform controlled ovarian hyperstimulation(COH) for such patients because of the poor ovarian response or the possibility of ovarian hyperstimulation syndrome(OHSS). To remove or to decrease the size of ovarian cysts, estrogen and progesterone (E-P) therapy with oral contraceptives for 2 cycles and transvaginal aspiration of ovarian cysts using transvaginal ultrasonography were performed in 36 IVF-cancelled infertile patients with ovarian cysts from February to October, 1988 at Seoul National University Hospital. Thirty-nine ovarian cysts($32.8{\pm}9.6$mm in mean diameter) were treated with E-P therapy, and their size decreased to $28.2{\pm}11.0mm$ after 1 cycle and significantly to $24.8{\pm}14.7mm$ after 2 cycles. After E-P therapy for 2 cycles, 7(17.9%) ovarian cysts disappeared in ultrasonography, 9(23.1%) decreased in size significantly, 18(46.2%) had no change in size and 5(12.8%) increased in size. Thirty-two ovarian cysts($30.2{\pm}9.7mm$) in 30 patients were aspirated transvaginally, and there was no significant decrease in size after follow-up transvaginal ultrasonography($27.8{\pm}12.5mm$). After transvaginal aspiration, 3(9.4%) ovarian cysts disappeared and 28(87.5%) had no change in size. The mean amount of the transvaginally aspirated cystic fluids was $19.6{\pm}13.2ml$, and there was no malignant cells in aspiration cytology. Four endometrioid cysts, one dermoid cyst and one mucinous cyst could be diagnosed in consideration of the findings of transvaginal ultrasonography and the characteristics and cytology of aspirated fluids. Therefore E-P therapy and transvaginal aspiration of ovarian cysts had made it possible to restart IVF program earlier in the IVF-cancelled patients with ovarian cysts.

• Journal of Korean Neurosurgical Society
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• v.42 no.6
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• pp.484-486
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• 2007

The authors describe a case of pseudoaneurysm arising from internal iliac artery presented with radiculopathy mimicking the symptoms of lumbar disc disease or spinal cord tumor. Among the several preoperative evaluation including CT, MRI, electrophysiologic study and ultrasonography, important diagnostic clue was obtained by ultrasonographic findings of turbulence flow at the core of partially enhanced mass in the pelvic cavity. The patient was managed with endovascular coil embolization successfully. The current case makes us remind that assessment of neurological symptoms on lower extremity should include consideration of extraspinal cause in pelvis.

• Advances in pediatric surgery
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• v.15 no.1
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• pp.73-79
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• 2009

Sertoli-Leydig cell tumor is a rare sex-cord stromal tumor of the ovary. They make up less than 0.5 % of all ovarian tumors. We experienced a case of an ovarian Sertoli-Leydig cell tumor in a 4 year-old girl who presented with nausea, vomiting, and lower abdominal pain of 2 days' duration. On physical examination, there was mild tenderness in the right lower quadrant of the abdomen. Abdominal ultrasonography and computed tomography (CT) scan revealed a pelvic mass measuring $5{\times}3cm$ that appeared to arise from the right ovary. At exploratory laparotomy, a $6{\times}5{\times}3cm$ solid right ovarian mass without torsion was found. A right salpingo-oophorectomy was performed. The postoperative course was uneventful. The child was discharged 5 days after surgery.

• Advances in pediatric surgery
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• v.9 no.1
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• pp.57-60
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• 2003

A 4 year old female with acute lower abdominal pain was admitted with the diagnosis of periappendiceal abscess made by ultrasonography. At laparotomy, the appendix was normal, but the left ovary was twisted and necrotic. Appendectomy and left salpingo-oophorectomy were performed. The pathology of the appendix was normal, and the left tube and ovary were ischemic and had hemorrhagic necrosis. Pediatric adnexal torsion may be difficult to diagnosis clinically. Sonography is the preferred imaging study. It usually confirms a pelvic mass but may not establish the diagnosis. The correct diagnosis of adnexal torsion is often made at exploration. The most common erroneous diagnosis is acute appendicitis or periappendiceal abscess. Therapy for adnexal torsion remains controversial. While extirpation has been the standard of treatment in the past, there are current proponents of conservative therapy with adnexal sparing. Early diagnosis may lead to more frequent salvage of affected adnexa.

• Journal of Veterinary Clinics
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• v.40 no.2
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• pp.147-151
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• 2023

A 6-year-old female Chihuahua was presented to the Animal Medical Center for surgical resection of a perineal mass that had recently increased in size. Ultrasonography revealed a large, homogeneous fatty mass with irregular margins between the surrounding muscle layers due to infiltrating fatty tissues. Cytological findings from fine-needle aspirates revealed numerous sheets and clusters of adipocytes, which was consistent with the fatty mass. Based on ultrasonographic and cytological findings, an infiltrative lipoma was suspected. During the surgery, the perineal mass was found to be non-encapsulated, irregularly marginated, and extensively distributed into the surrounding muscles. The mass extended inside the pelvic cavity and left anal sac. The perineal mass was surgically removed and submitted for histopathologic examination. Histopathology confirmed that the mass was an infiltrative lipoma invading into the anal sac and surrounding muscles. The present report was an unusual presentation of infiltrative lipoma that invaded the anal sac in the perineum.

• Childhood Kidney Diseases
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• v.10 no.1
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• pp.33-39
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• 2006

Purpose : Neonatal hydronephrosis is diagnosed with an incidence of 4.5-7% of pregnancies. Recently, early detection of neonatal hydroneprosis with antenatal ultrasonography has be-come possible. But consensus about its management has not been reached, especially concerning surgical intervention. The purpose of this study is to analyze the natural course of neonatal hydronephrosis and to determine the guideline of surgical intervention and follow up study. Methods : Sixty nine hydronephrotic kidneys were confirmed from April 2001 to April 2005. All cases were rechecked by ultrasonography once at least and had a minimum follow-up of 6 months. We classified the patients into 4 groups according to the anterior posterior pelvic diameter(APPD) on perinatal ultrasonography. Ultrasonography to measure the APPD diameter and Society for Fetal Urology(SFU) grade, $^{99m}Tc-MAG3$ scan were done to a set protocol. Pyeloplasty was peformed according to the protocol. Results : Pyeloplasty was not needed in most cases where the APPD was below 10 mm and where the SFU grade were less than grade 3. Many cases with APPD 10 mm above or SFU grade III above had undergone pyeloplasty. We found a correlation between obstruction grade on MAG3 scan and whether surgery was performed or not. Conclusion : If APPD is above 10 mm, SFU grade is above grade 3 or urinary tract obstruction is suspected by MAG3 scan, pyeloplasty must be considered. In cases where APPD is below 10mm and SFU grade is less than grade 3, we can observe the natural course of neonatal hydronephrosis with consecutive follow-up. (J Korean Soc Pediatr Nephrol 2006;10:33-39)

• Physical Therapy Korea
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• v.26 no.3
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• pp.67-75
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• 2019

Background: Stress urinary incontinence (SUI) is an involuntary leakage of urine from the urethra when intra-abdominal pressure increases, such as from sneezing, coughing, or physical exertion. It is caused by insufficient strength of the pelvic floor and sphincter muscles, resulting from vaginal delivery, obesity, hard physical work, or aging. The pelvic floor electrical stimulator is a conservative treatment generally used to relieve the symptoms of urinary incontinence. it recommended to applied before surgery is performed. Objects: The purpose of this study was to determine if the transcutaneous electrical stimulation (TCES) would be effective for the physiological symptoms and psychological satisfaction of women with SUI for an 8-weeks intervention. Methods: Easy-K is a specially designed user-friendly TCES. Five female who were diagnosed with SUI by a gynecologist but who did not require surgical intervention were included in this study. Intervention was implemented over an 8-week period. Outcome measures included vaginal ultrasonography, Levator ani muscle (LAM) contraction strength, incontinence quality of life (I-QOL), and female sexual function index (FSFI) questionnaires. Results: The bladder neck position significantly decreased across assessment time. Funneling index and urethral width significantly decreased after 8 weeks of intervention (p<.05). The bladder necksymphyseal distance and posterior rhabdosphincter thickness statistically increased and the anterior rhabdosphincter thickness showed a tendency to increase. All participants demonstrated a significant increase in the LAM contraction score across three assessment times (p<.05). Although the total score of the I-QOL did not show significant improvement, it steadily increased and among I-QOL subscales, only the "avoidance" subscale showed statistical improvements (p<.05). The total score of the FSFI statistically improved and the "desire" score significantly changed (p<.05). Conclusion: The TCES is recommended for women who want to apply conservative treatments before surgery and who have suffered from SUI in aspects of sexual function and quality of life.

• Radiation Oncology Journal
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• v.31 no.1
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• pp.41-47
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• 2013

Purpose: To describe the early experience of analyzing variations and time trends in bladder volume of the rectal cancer patients who received bladder ultrasound scan. Materials and Methods: We identified 20 consecutive rectal cancer patients who received whole pelvic radiotherapy (RT) and bladder ultrasound scan between February and April 2012. Before simulation and during the entire course of treatment, patients were scanned with portable automated ultrasonic bladder scanner, 5 times consecutively, and the median value was reported. Then a radiation oncologist contoured the bladder inner wall shown on simulation computed tomography (CT) and calculated its volume. Results: Before simulation, the median bladder volume measured using simulation CT and bladder ultrasound scan was 427 mL (range, 74 to 1,172 mL) and 417 mL (range, 147 to 1,245 mL), respectively. There was strong linear correlation (R = 0.93, p < 0.001) between the two results. During the course of treatment, there were wide variations in the bladder volume and every time, measurements were below the baseline with statistical significance (12/16). At 6 weeks after RT, the median volume was reduced by 59.3% to 175 mL. Compared to the baseline, bladder volume was reduced by 38% or 161 mL on average every week for 6 weeks. Conclusion: To our knowledge, this study is the first to prove that there are bladder volume variations and a reduction in bladder volume in rectal cancer patients. Moreover, our results will serve as the basis for implementation of bladder training to patients receiving RT with full bladder.

• Clinical and Experimental Reproductive Medicine
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• v.32 no.3
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• pp.223-230
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• 2005

Objective: This study was performed to evaluate the accuracy of hysterosalpingography (HSG) for evaluating female infertility patients by comparison with hysteroscopic and laparoscopic examination. Methods and Material: Total 219 infertile patients were retrospectively analyzed between January 1, 2002 and December 31, 2003. Ninety seven patients (44.3%) were primary infertility, 122 patients (55.7%) were secondary infertility. We performed hysteroscopic and laparoscopic examination on next cycle when HSG revealed any abnormal finding, and 3~6 cycles later if HSG was normal. Results: The accuracy of HSG was 65.2% compared with hysteroscopic examination (sensitivity 88.4%, specificity 46.4%, false positive rate 53.6%, false negative rate 11.6%). The most common abnormal finding of hysteroscopy was uterine synechia (67.4%) followed by endometrial polyp, uterine anomaly (e.g. uterine septum), endometrial hyperplasia. Compared with laparoscopic examination, the accuracy of HSG was 76.9% (sensitivity 98.9%, specificity 70.6%, +LR 3.36, -LR 0.02). The positive predictive value of normal patent tube was excellent (99.6%) but that of proximal tubal blockage was only 46.7%. The unilateral tubal obstruction of HSG was poor accuracy (+LR 3.85 -LR 0.68) and 70% of those was patent by laparoscopic examination. Laparoscopic examination also revealed that 53% of patients had peritubal adhesion and 37% of patients has additional pelvic findings, especially endometriosis. Among the patients had normal HSG, 53.5% patients with normal ultrasonography was diagnosed endometriosis (25.6% of them had endometriosis stage I-II). Conclusion: Normal HSG shows a high negative predictive value. Nevertheless, the incidence of associated pelvic disease in the normal HSG group is high enough to warrant diagnostic laparoscopy if nonsurgical treatment is unsuccessful. Because HSG has poor accuracy in predicting distal tubal blockage and peritubal adhesion, and poor positive predictive value of proximal tubal blockage, laparoscopic examination could be considered in abnormal HSG group.