• Asian Pacific Journal of Cancer Prevention
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• 제15권13호
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• pp.5355-5358
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• 2014

Background: To assess the role of sonographic endometrial thickness and hysteroscopic polyp size in predicting premalignant and malignant polyps in postmenopausal women. Materials and Methods: A total of 328 postmenopausal women with abnormal uterine bleeding and thickened endometrium underwent operative hysteroscopy due to detection of endometrial polyps were included in this retrospective study. Preoperative endometrial thickness measured by transvaginal ultrasonography and polyp size on hysteroscopy were noted. Hysteroscopic resection with histology was performed for endometrial polyps. Endometrial thickness and polyp size were evaluated on the basis of final diagnosis established by histologic examination. Receiver operator characteristic curves were calculated to assess the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of endometrial thickness and polyp size for detecting pemalignant and malignant polyps. Results: Premalignant and malignant polyps were identified in 26 (7.9%) of cases. Sonographic measurement showed a greater endometrial thickness in cases of premalignant and malignant polyps when compared to benign polyps. On surgical hysteroscopy, premalignant and malignant polyps were also larger. Endometrial thickness demonstrated a sensitivity of 53.8%, specificity of 85.8%, PPV of 24.6% and NPV of 95.6% at a cut-off limit of 11.5 mm with diagnostic accuracy of 83.2%. Polyp size has a diagnostic accuracy of 94.8% with a sensitivity of 92.3%, specificity of 95.0%, PPV of 61.5% and NPV of 99.3% at a cut-off point of 19.5mm. Conclusions: Endometrial thickness measured by transvaginal ultrasonography is not sufficient in predicting premalignant and malignant endometrial polyps in postmenopausal women with abnormal uterine bleeding and thickened endometrium. Polyp size on hysteroscopy is a more accurate parameter, because of better sensitivity and specificity. However, while polyp size ${\geq}19.5mm$ seems to have a great accuracy for predicting premalignancy and malignancy, histologic evaluation is still necessary to exclude premalignant and malignant polyps.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.1759-1767
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• 2016

Background: Uterine sarcoma is a group of rare gynecologic tumors with various natures, and different lines of treatment. Most have a poor treatment outcome. This study targeted clinical characteristics, treatment, overall survival (OS), progression-free survival (PFS), and prognostic factors in uterine sarcoma patients in one tertiary center for cancer care. Materials and Methods: Uterine sarcoma patients who were treated at the Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital between January 1994 and December 2014 were identified. Clinico-pathological data were analyzed. Prognostic outcomes were examined by Kaplan-Meier curves and Cox regression analysis. Results: We identified 46 uterine sarcoma patients: 25 carcinosarcoma (CS) (54.3%), 15 leiomyosarcoma (LMS) (32.6%), and 6 undifferentiated uterine sarcoma (UUS) (13.1%) cases. Mean age was $54.0{\pm}11.9years$ (range 25-82 years). Abnormal uterine bleeding was the most common presenting symptom (63.0%). Among 33 patients (71.7%) who had pre-operative tissue collected, diagnosis of malignancy was correct in 29 (87.9%). All patients received primary surgery and retroperitoneal lymph nodes were resected in 34 (73.9%). After surgery, 5 (10.9%) had gross residual tumors. Stage I disease was most commonly found (56.5%). Adjuvant treatment was given to 27 (58.7%), most commonly chemotherapy. After a median follow-up of 16.0 months (range 0.8-187.4 months), recurrence was encountered in 22 patients (47.8%). Median time to recurrence was 5.8 months (range1.0-105.5 months). Distant metastasis was more common than local or locoregional failure. The 2-year PFS was 45.2% (95% confidence interval [CI], 30.6%-59.7%) and the 2-year OS was 48.3% (95% CI, 33.3%-60.7%). Multivariable analyses found residual disease after surgery as a significant factor only for PFS. Conclusions: Uterine sarcoma is a rare tumor entity. Even with multimodalities of treatment, the prognosis is still poor. Successful cytoreductive surgery is a key factor for a good survival outcome.

• Asian Pacific Journal of Cancer Prevention
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• 제15권23호
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• pp.10067-10070
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• 2015

Background: Unopposed estrogen has a central role in development of endometrial benign, premalignant and malignant lesions. The aim of this study was to evaluate the anti-estrogenic effect of metformin on endometrial histology in comparison with progesterone. Materials and Methods: A total of 43 patients who were referred to our center for abnormal uterine bleeding and had a histologic diagnosis were disordered proliferative endometrium or simple endometrial hyperplasia were included and randomly distributed in two groups treated with metformin (500mg Bid) or megestrol (40mg daily), respectively, for three months. After this period the patients were evaluated by another endometrial biopsy to assess the impact of the two drugs in restoring normal endometrial histology. Results: Our findings revealed that metformin could induce endometrial atrophy in 21 out of 22 patients (95.5%) while this positive response was achieved in only 13 out of 21 patients (61.9%) in the megstrol group. In addition two low grade endometrial carcinomas in the metformin group responded very well. Conclusions: We conclude that metformin could be used as an effective antiestrogenic agent in control of abnormal endometrial proliferative disorders.

• Asian Pacific Journal of Cancer Prevention
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• 제17권2호
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• pp.713-717
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• 2016

Background: To evaluate the prevalence and features of other gynecologic or surgical lesions in endometrial cancer (EMC) patients. Materials and Methods: Clinico-pathological data of EMC patients who were treated in the institution from 1995 to 2012 were collected. Data collected were age, stage of disease according to the FIGO 2009 criteria (FIGO), histopathology, tumor grade, adjuvant therapy, other gynecologic or surgical lesions, follow-up period, and living status. Results: The mean age of 396 patients was $56.7{\pm}10.64years$. Abnormal uterine bleeding was the most common presenting symptom (90.1%). Bleeding was accompanied with pelvic mass in 7.7% and 5.4% had only a pelvic mass. Abnormal cervical cytology was found in 3.8%. Approximately 75% had early stage diseases and 86% had endometrioid histology. We found 55.8% of EMC patients had other gynecologic lesions: 89.6% benign and 9.5% malignant. Some 4.5% had pre-invasive cervical/vulva/vagina lesions. The two most common gynecologic lesions were myoma uteri and ovarian tumors. Focusing on the latter, approximately 14% were benign while 8% were malignant. Among 364 patients with available data, surgical lesions were found in 11.8%, 5.7% benign and 9.2% malignant. The most common benign surgical condition was chronic appendicitis while breast and colon cancers were the two most common malignant lesions found. Conclusions: More than half of EMC patients had other gynecologic lesions including benign and malignant tumors. Surgical lesions were also found in more than one-tenth of patients. Careful pre-operative evaluation and intra-operative inspection are advised for proper management and better prognosis.

• 부모자녀건강학회지
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• 제21권1호
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• pp.1-10
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• 2018

Purpose: This study was to identify factors associated with premenstrual syndromes based on women's subjective assessment and investigate problems related to menstruation in female college students. Methods: The data was collected by questionnaires from 558 nursing students in a university in Gyeonggi, Korea. The data were analyzed with the IBM SPSS 21.0 program, using descriptive statistics, independent t-test, one-way ANOVA, multiple response and multiple logistic regression. Results: The problems related to menstruation included irregular menstrual cycle, severe dysmenorrhea, no menstruation, abnormal uterine bleeding, and menorrhagia. Influential factors on premenstrual syndrome revealed dysmenorrhea (${\beta}=.467$, p<.001), perceived stress status (very high) (${\beta}=.155$, p<.001), perceived stress status (high) (${\beta}=.119$. p=.002), perceived health status (very poor) (${\beta}=.102$, p=.006), and smoking (${\beta}=.087$, p=.016) in female college students. Conclusion: The findings suggest that active management and intervention regarding menstruation disorders and premenstrual syndrome are required.

• Asian Pacific Journal of Cancer Prevention
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• 제15권1호
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• pp.195-198
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• 2014

Aim: To evaluate precancerous lesions such as hyperplasia and endometrial polyps in obese postmenopausal women. Materials and Methods: Women who were referred with abnormal uterine bleeding in postmenopausal period or the presence of endometrial cells on cervical cytology in our department were investigated. Anthropometric measurements such as height, weight, body mass index, waist/hip ratio and endometrial thickness were compared between a precancerous lesion (hyperplasia and endometrial polyp) group and a pathologically normal group. Results: We detected statistically significant thickening of endometrium in patients with precancerous lesions. Moreover patients with precancerous lesions had higher body mass index than the pathologically normal group. Conclusions: We found elevated precancerous lesion rates in overweight and obese women in the postmenopausal period, of interest given that the prevalence of obesity is increasing in most parts of the world. Although screening for endometrial cancer is not recommended for the general population, in high-risk populations like obese postmenopausal women, it may be very important.

• 대한한방부인과학회지
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• 제33권4호
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• pp.127-142
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• 2020

Objectives: The purpose of this study is to analyze the research trends using manual therapy in obstetrics and gynecological diseases. Methods: We searched for studies that performed manual therapy on diseases related to obstetrics and gynecology. All relevant papers were selected and extracted to be analyzed. Results: 12 Randomized controlled trials, 8 cases, 3 pilot studies, 3 non-comparative studies, and 1 before-after comparative study were collected. The study subjects, results, techniques of manual therapy used were analyzed. There were studies related to pregnancy-related symptoms, postpartum pain, dysmenorrhea, chronic pelvic pain, abnormal uterine bleeding, sexual dysfunction, and childbirth. Conclusions: It has been found that various manual therapies can be used for obstetrics and gynecological diseases.

• 셀메드
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• 제13권14호
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• pp.19.1-19.16
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• 2023

Objectives: To compare the efficacy of polyherbal Unani formulations in heavy menstrual bleeding due to endometrial hyperplasia. Methodology: A prospective, randomized comparative trial was conducted at Govt. Nizamia Tibbi College. Group A (n=20) received Itrifal Aftimoon 5g orally BID from menstruation day 3 to day 21 plus suprapubic Marham Dakhilyun application and per vaginally Marham Dakhilyun (5g) and Roghan Gul (10ml) application from menstruation day 5 to day 14. Group B (n=20) received Gulnar Farsi (2g), Phitakri Biryan (0.25g), Dammul Aqwain (0.25g), and Geru (2g), 2.5g powder orally BID, menstruation day 3 for 20 days plus Douche Bargh Sambhalu then Ḥamūl of Safuf Mazu (2g), Kalijiri (2g) and Roghan Gul (10ml) from menstruation day 3 to day 12 for 3 consecutive cycles. The primary outcome was pelvic ultrasound findings of endometrial thickness. The secondary outcome measures were improvement in haemoglobin percentage, change in menstrual flow and menstrual pattern. The level of significance was 5%. Results and conclusion: The intragroup comparison showed that the mean endometrial thickness at baseline and after treatment in groups A and B was extremely significantly different (P<0.0001). The intragroup comparison showed the mean haemoglobin percent at baseline and after treatment in group, A was significantly different (P<0.0001). After treatment, 50% and 60% of participants had normal duration and menstrual blood loss after treatment from baseline in Groups A and B respectively. However, further, phase II and III randomized standard controlled trials in larger samples are recommended to assess the efficacy of these group medicines.

• 한방비만학회지
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• 제7권1호
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• pp.31-38
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• 2007

Objective : Women's obesity brings prblems not only appearance but also health which men do not have. This study was conducted to investigate the different factors of obesity between men and women. Materials and Methods : We searched papers usin key words (women, gender, and obesity) on pubmed and obesity journal. Result : Women's obesity leads to amenorrhea, abnormal uterine bleeding, infertility, poly cystic ovarian syndrome, abortion, and luteal phase inadequacy. Obesity induces metabolic syndrome, type-2 diabetes, cardiovascular problems, hypertension, cancer, and psychophysiologic diseases. The difference in body morphology and in particular fat distribution between the sexes leads to gender-specific differences in prevalence of chronic diseases, and unique problems for each sex including infertility, problems during pregnancy, polycystic ovarian syndrome, and endometrial carcinoma in women, and prostate and testicular cancer in men. The influence of gender on obesity is had by genetic view, hormones, pregnancy, delivery, and menopause. Conclusion : Obese women have higher risk factors than men by the influence of gender.

• 셀메드
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• 제5권3호
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• pp.15.1-15.12
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• 2015

Comparative studies have established that the North-Eastern (NE) region of India which is a part of the Eastern Himalayan region is affluent in both traditional knowledge based phytomedicine and biodiversity. About 1953 ethno-medicinal plants are detailed from the NE region of India out of which 1400 species are employed both as food and ethnopharmacological resources. Nearly 70% of species diversity has been reported from the two Indian biodiversity hotspots-The Western Ghats and the Eastern Himalayas and these hotspots are protected by tribal communities and their ancient traditional knowledge system. Paris polyphylla Smith belongs to the family Melanthiaceae and is a traditional medicinal herb which is known to cure some major ailments such as different types of Cancer, Alzheimer's disease, abnormal uterine bleeding, leishmaniasis etc. The major phytoconstituents are dioscin, polyphyllin D, and balanitin 7. Phylogeny of Paris was inferred from nuclear ITS and plastid psbA-trnH and trnL-trnF DNA sequence data. Results indicated that Paris is monophyletic in all analyses. Rhizoma Paridis, which is the dried rhizome of Paris polyphylla is mainly used in Traditional Chinese Medicine and its mode of action is known for only a few cancer cell lines. The current review determines to sketch an extensive picture of the potency, diversity, distribution and efficacy of Paris polyphylla from the Eastern Himalayan region and the future validation of its phytotherapeutical and molecular attributes by recognizing the Intellectual Property Rights of the Traditional Knowledge holders.