• Title/Summary/Keyword: Rectovaginal Fistula

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A Study of Dose Distribution in Postoperative Radiotherapy in Uterine Cervical Cancer (자궁 경부암의 수술후 방사선 치료에서 선량 분포에 관한 연구)

  • Shin, Sei-One;Kim, Sung-Kyu;Kim, Myung-Se
    • Journal of Yeungnam Medical Science
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    • v.8 no.1
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    • pp.166-177
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    • 1991
  • Uterine cervical cancer is the most common malignancy in korean women. In spite of recent development of early diagnostic and therapeutic modalities, about 40% of treated patient will develop relapse. So more aggressive local treatment such as more extensive surgery and higher radiation dose and administration of systemic chemotherapy will promote the curability but treatment related complications can not be avoidable. We used 22 cases of early cervical cancer, treated with surgery and post-operative radiotherapy, clinical data of these patients were analized to determine relationship between clinical parameters and final outcome. Three out of 22 cases revealed relapse and one patient showed rectovaginal fistula and another patient showed small bowel obstruction and the other patient showed rectal obstruction. Two out of three recurrence were stage IIa and the other one case was stage Ib adenocarcinoma with lymphovascular involvement. Nineteen out of 22 cases were followed without remarkable side effect or treatment related complication or sequelae. We concluded that our treatment policy was safe and effective to eradicate high risk postoperative cervical cancer with acceptable side effects or complication.

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Radiotherapy Result of the Carcinoma of Uterine Cervix (자궁경부암의 방사선치료성적)

  • Park, Charn-Il;Ha, Sung-Whan;Kang, Soon-Beom;Lee, Hyo-Pyo;Shin, Myon-Woo
    • Radiation Oncology Journal
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    • v.2 no.1
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    • pp.107-113
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    • 1984
  • One hundred sixty one patients with the carcinoma of uterine cervix received curative radiotherapy at the Department of Therapeutic Radiology, Seoul National University Hospital between December, 1979 and December, 1982. According to FIGO classification; stage $I_a 1(0.6\%)\;1_b\;8(5.0\%),\;II_a\;31(19.3\%),\;II_b\;66(41.0\%),\;III_a\;3(1.8\;%),\;III_b\;46(28.6\%)\;and\;IV_a\;6(3.7\;%)$. The proportion of early stage cancer is too small because most of them treated by surgery. External beam whole pelvic irradiation was done first with 10MV x-ray or Co-60 gamma ray upto 4,000 or 5,000 rad for early and advanced cases, followed by one or two courses of intracavitary radiation using Fletcher-Suit Applicator loading c Cs-137. Supplementary external radiation to pelvic side wall to bring dose to 6,000 or 6,500 rads, if there is parametrial involvement or positive pelvic lymph node. Of the 161 Patients, 49 Patients were lost to follow-up but only 22 patients were lost in disease free state. And so, 86.3 percent of the patients were followed to time of recurrence or to date. The results are as follows ; 1. Locoregional control rates according to stage is: stage I $100\%,\;II_a\;90.3\;%,\;II_b\;75.8\%,\;III_a\;66.7\%,\;III_b\;58.7\%\;and\;IV_a\;16.7\%$, respectively. 2. Persistent or recurrent disease were localized in pelvic cavity in 32 of 50 patients and 6 had distant metastasis only. 3. Rectal bleeding was the most common complication and appeared mostly between 6 and 24 months after radiotherapy. Most of them had transient minor bleeding and only 2 patients needed transfusion and 1 patient needed colostomy due to rectovaginal fistula. 4. The 3 year disease free survival rate is: stage I $100\%,\;II_a\;78.0\%,\;II_b\;60.6\%,\;III_a\;66.7\;III_b\;46.3\%\;and\;IN_a\;16.7\%$, respectively.

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Reconstruction of the Defect in Perineum using Local perforator based flap (천공지 기저 국소 피판을 이용한 회음부 결손의 재건)

  • Lee, Joo Hong;Yun, In Sik;Lee, Dong Won;Lee, Won Jai;Rah, Dong Kyun
    • Archives of Plastic Surgery
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    • v.36 no.5
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    • pp.565-570
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    • 2009
  • Purpose: Numerous techniques have been introduced to reconstruct the perineal area in order to preserve function of both the recipient and the donor site while satisfying aesthetic results. There are several advantages of using the pudendal aretery perforator based flap in that it provides thin coverage of defect area and a relatively excellent circulation through perforators. The perineal region can be divided into two areas : the urogenital triangle and the anal triangle. Since each area differs in structure and function so does its reconstructive plan. The authors of this article report clinical results obtained from pudendal artery perforator based reconstructed cases according to each differrent triangles. Methods: A total of 15 patients who underwent perineal reconstruction were enrolled in our study between the year 2002 and 2006. There were 4 cases of vaginal cancer, 4 cases of extramammary Paget's disease, 1 case of rectovaginal fistula in females and 2 cases of Paget's disease and 4 cases of Fournier's gangrene in male cases. The follow up period was on average 6 month. In female, superfical pudendal artery perforator based local flap were used to reconstruct the urogenital triangle defects, while internal pudendal artery perfoator based local flaps were used to reconstruct the anal traingle defects. In males the gracilis myocutaneous flap and internal pudendal artery perforator based local flaps were used in reconstruction of the scrotum and perineal defect. Result: In females, there was 1 case of partial flap necorsis that employed the superficial pudendal artery perforator but secondary repair through the internal pudendal artery perforator based local flap was done. In addition, there were 4 wound dehiscence cases in females and 2 cases in males. Conclusion: We believe that a better aesthetic and functional outcome can be achieved in perineal reconstruction if discrete surgical planning is carried out systematically categorizing the choice of flap employed acccording to distinct anatomical regions : the urogenital and the anal triangle.

Studies on Diagnosis and Treatment of Major Reproductive Failures in Dairy Cows (젖소 번식장애 주요 유형별 치료방법에 관한 연구)

  • 조성우;김용준;이해이;김용수
    • Korean Journal of Animal Reproduction
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    • v.25 no.3
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    • pp.207-217
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    • 2001
  • Diagnosis and treatment of major reproductive failures were carried out for 836 dairy cows of 12 farms in Kimje area from May 1999 to May 2000. Reproductive failures were classified into four categories: uterine diseases, ovarian diseases, combination of uterine and ovarian diseases, and anestrus with corpus luteum (CL), based on the diagnosis by both rectal palpation and ultrasonography (SA 600, Medison, 5.OMHz transducer). 1. Of 102 cows examined, 15 cows were diagnosed as pregnant. Cows with real reproductive failures were therefore 87 cows and the rate of reproductive failures far all the cows of 12 farms was 10.4% (87/836). 2. Of 57 cows with reproductive failures, the cows with uterine diseases were 33 heads (37.9%), with ovarian diseases: 30 heads (34.5%), with combination form: 16 heads (18.4%), and with anestrus with CL: 8 heads (9.2%). 3. Of 87 cows with reproductive failures, 7 cows were slaughtered and 80 cows were treated by hormone or douche. The cows expressed estrus were 74 cows (92.5%, 74/80 heads) and 56 cows were pregnant (70.0%, 56/80 heads) following treatment. 4. The reproductive failures tended to be increased as the period proceeded from 30 days (2.3%, 2/87 heads) to over 120 days (56.3%, 49/87 heads) after parturition. 5. Associated other diseases to reproductive failures were foot diseases(5 cows), joint diseases (5 heads), urovagina (6 heads), and rectovaginal fistula (2 cows) and the rate of occurrence of associated diseases was 20.7% (18/87 heads). 6. No reproductive record was used in 7 farms of 12 farms and 5 farms had no play ground or not used for the cows. These results indicated that diagnosis fur reproductive failures by rectal palpation along with ultrasonography was more accurate than the conventional rectal palpation and brought better result of treatment for major types of reproductive failures. It was also indicated that non-uses of reproductive record and play ground were also important factors in occurrence of reproductive failures.

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