• 제목/요약/키워드: diagnostic curettage

검색결과 13건 처리시간 0.026초

Comparison the Diagnostic Value of Dilatation and Curettage Versus Endometrial Biopsy by Pipelle - a Clinical Trial

  • Sanam, Moradan;Majid, Mir Mohammad Khani
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권12호
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    • pp.4971-4975
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    • 2015
  • Background: Several methods have been presented for the evaluation of the endometrium in patients with abnormal uterine bleeding, which include minimal invasive and invasive approaches such as diagnostic curettage or endometrial biopsy by Pipelle. Many studies have been performed in order to compare two methods; diagnostic curettage and outpatient endometrial biopsy. This investigation compared sampling adequacy, endometrial histopathology, failure rates, duration and costs between diagnostic curettage in a hospital and endometrial biopsy. Materials and Methods: This single blind clinical trial was performed on 130 patients older than 35 years who was referred to Amir training hospital in 2013 for elective diagnostic curettage because of abnormal uterine bleeding. For all patients eligible for the study, an endometrial sample by Pipelle was taken without anesthesia or dilatation. Then under general anesthesia diagnostic curettage was performed by sharp curette. Sampling duration was calculated and both samples were sent to the same pathologist. The diagnostic values of two methods in the diagnosis of normal endometrium, endometrial hyperplasia and carcinoma were compared. The costs of these two methods were also compared. Data analysis was performed by SPSS (version 16.0) software. Chi-Square, Fisher, and Pearson tests were used and were considered statistically significant at P values less than 0.05. Results: Two methods were agreed upon 88% of sampling adequacy and 94% of pathological results. Specificity of 100% and sensitivity of 90% for detection of proliferative endometrium, secretory endometrium, simple hyperplasia without atypia and 100% for cancer were recorded. Pipelle diagnostic accuracy in comparison with curettage, have been reported over 97%, so the failure rate in this study was below 5%. Sensitivity of Pipelle for detection of atrophic endometrium was reported below 50%. Duration and cost was lower in Pipelle versus curettage. Conclusions: It is concluded that due to high agreement and cohesion coefficient between curettage and Pipelle on the issue of sampling adequacy, histopathology finding (except atrophic endometrium), low failure rate, duration of sampling and cost, Pipelle can be introduced as a suitable alternative of diagnostic curettage.

Recurrence Analysis of Giant Cell Tumor after Curettage and Cementation (거대 세포종에서 골 소파술 및 시멘트 충전술 후의 재발 분석)

  • Hahn, Soo-Bong;Lee, Won-Jun;Shin, Kyoo-Ho
    • The Journal of the Korean bone and joint tumor society
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    • 제10권2호
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    • pp.71-78
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    • 2004
  • Purpose: The purpose of this study is to investigate the characteristic of recurred giant cell tumor after bony curettage and cementation, and to review a way to prevent the recurrence. Materials and Methods : Thirty seven cases were analyzed, which were pathologically diagnosed giant cell tumor after diagnostic biopsy or surgical excision, followed by curative curettage, burring and cementation. Location, character, and time interval to recurrence were reviewed. Results: Thirteen out of thirty seven analyzed cases(35%) showed recurrence after primary curettage and cementation. The mean interval to recurrence was sixteen months(5 months to 43 months). Most of recurrence happened within the first two years except two cases. Among the recurred cases, eleven showed recurrence in the vicinity of window area. Two cases recurred in the depth of bone marrow, where cementation was made. The advantage of curettage and cementation is the immediate stability of the operation site, early rehabilitation, and early detection of recurrence. Furthermore, cementation is beneficial in that the cement-producing heat can eradicate the residual tumor burden. In this study, 85% of cases with insufficient curettage (for example, in cases where too small surgical window was made, or where there were anatomical difficulty in approaching the target tumor burden) showed recurrence. Conclusion: Bony curettage, burring and cementation is widely used as the primary curative modality for giant cell tumor. A few other modalities such as chemical cautery using phenol and $H_2O_2$; cryotherapy; and anhydroalcohol have also been introduced, but the benefit of these are still questionable. For some cases that relatively small surgical window was made due to anatomically complicated structures (such as ligament insertion or origin site) over the target tumor burden, unsatisfactory curettage and burring was made. This study showed high chance of recurrence after unsatisfactory curettage, and 85% of recurrence developed in the vicinity of the small window area. Most of the recurrence occurred within the first two years. It is concluded that sufficient window opening, extensive curettage and eradicative burring are key factors to prevent recurrence. Also, it should be reminded that careful and close observation should be made for at least the first two years after initial treatment for early detection of recurrence.

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Diagnostic Value of Endocervical Curettage for Detecting Dysplastic Lesions in Women with Atypical Squamous Cells of Undetermined Significance (ASC-US) and Low Grade Squamous Intraepithelial Lesion (LSIL) Papanicolaou Smears

  • Poomtavorn, Yenrudee;Suwannarurk, Komsun;Thaweekul, Yuthadej;Maireang, Karicha
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권8호
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    • pp.3461-3464
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    • 2014
  • Background: To determine the frequency of dysplastic lesions in the endocervical curettage (ECC) specimens of women with ASC-US and LSIL Pap and to evaluate the possible factors associated with high grade dysplasia in those ECC specimens. Materials and Methods: Two hundred and sixty patients with ASC-US and LSIL cytologic smears who underwent an ECC at the time of colposcopic examination during January 2010 and December 2012 were reviewed. Demographic and clinicopathologic data were collected. Multivariate analysis using binary logistic regression was used to identify factors that might be associated with high grade endocervical dysplasia. Results: The frequency of endocervical dysplasia was 7.7% (20 out of 260 patients). Cervical intraepithelial neoplasia (CIN) 1 and CIN 2-3 lesions in the endocervical canal were observed in 12 and 8 patients, respectively. No microinvasive or invasive cervical cancers were identified. There was no difference in the frequency of high grade endocervical dysplasia between the patients with satisfactory and unsatisfactory colposcopic examinations (1.4% vs 5.1%, respectively, p=0.087). A multivariate logistic regression analysis demonstrated a significant association between high grade CIN on ectocervical biopsy as well as LSIL cytologic smears and high grade dysplasia in endocervical canal (OR=0.046, 95%CI=0.007-0.288; p=0.001 and OR=0.154, 95%CI=0.025-0.942; p=0.043, respectively). Conclusions: The frequency of high grade endocervical dysplasia in women with ASC-US and LSIL cytologic smears was low. Therefore, routine performance of ECC in those women is debatable. High grade ectocervical dysplasia and LSIL cytologic smears may be used as predictors for high grade dysplasia in endocervical canal and ECC in these patients is reasonable.

Endometrial Curettage in Abnormal Uterine Bleeding and Efficacy of Progestins for Control in Cases of Hyperplasia

  • Mesci-Haftaci, Simender;Ankarali, Handan;Yavuzcan, Ali;Caglar, Mete
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권8호
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    • pp.3737-3740
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    • 2014
  • Background: Abnormal uterine bleeding (AUB) is the most important symptom of endometrial hyperplasia and endometrial curettage (EC) is the gold standard diagnostic procedure. We present the results of patients who underwent EC for AUB and the efficacy of progestin administration in those with endometrial hyperplasia. Materials and Methods: A total of 415 female patients who presented to Duzce Public Hospital in 2011-2012 for AUB and who underwent EC were included. We determined the reasons for AUB, and females with hyperplasia were treated with 10 mg/day medroxyprogesterone acetate for 14 days/month or 160 mg/day megestrol acetate continuously for 3 months. We evaluated the efficacy of progestins for periods of three and/or six cycles by repeating EC. A statistical analysis of specific endometrial causes according to age of presentation was conducted using the chi-square test. Results: Among the 415 females (average age, 53.5 years) followed for 6 months, 186 had physiological changes (44.8%), 89 had simple hyperplasia (21.44%), 1 had atypical hyperplasia (0.2%), 6 had (1.44%) complex hyperplasia, 3 had (0.72%) atypical complex hyperplasia, and 5 had adenocarcinoma (1.2%). Regression rates were 72.7-100%, and the optimum results were observed after 6 months of hormonal therapy. Conclusions: The main cause of AUB was physiological change. Progestin therapy resulted in significant regression even in females with atypical hyperplasia.

CEMENTOMAS OF THE MANDIBLE;REPORT OF TWO CASES & DISCUSSION (하악골에 발생된 백아종 2예)

  • Yoo, Jae-Ha;Ryu, Soo-Jang
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제12권1호
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    • pp.148-157
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    • 1990
  • The cementomas are derived from the periodontal ligament and a diversified group of nonrelated lesions producing cementum-like material. The diagnostic term, Cementoma, has encompassed several unrelated lesions : periapical cemental dysplasia, benign (true) cementoblastoma, cementifying fibroma and familial multifle (gigantiform) cementoma. The authors treated one case of benign cementoblastoma & the other of cementifying fibroma by conservative enucleation & curettage. By follow up check of the patient, We obtained of good result without any signs of recurrence of the lesions.

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A Case of Aneurysmal Bone Cyst on the Thoracic Spine - A Case Report - (흉추에 발생한 동맥류성 골낭종 - 증례보고 -)

  • Hong, Chang Ki;Hyun, Dong Keun;Park, Chong Oon;Ha, Young Soo
    • Journal of Korean Neurosurgical Society
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    • 제29권5호
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    • pp.675-679
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    • 2000
  • Aneurysmal bone cyst is a benign, highly vascular bony lesion of unknown origin that may present difficult diagnostic and therapeutic problems. It is usually located on long bones, but rarely on the spine. The lesion is usually treated successfully by curettage and bone grafting when it involves bones of the extremities, but there are special considerations in the management of the lesion when located on the spine. We report a case of aneurysmal bone cyst in on the 8th thoracic spine treated with surgical treatment.

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Reverse Total Shoulder Replacement for an Enchondroma with Concomitant Rotator Cuff Tear Arthropathy: A Case Report

  • Park, Bong-Ju;An, Ki-Yong;Choi, Yong-Suk
    • Clinics in Shoulder and Elbow
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    • 제20권2호
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    • pp.100-104
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    • 2017
  • Enchondromas generally occur in the hand and uncommonly in the long bones. Because enchondromas are usually asymptomatic, most are discovered during diagnostic radiology for another disease. Here, we describe a case of enchondroma in the right humerus in a 79-year-old female patient with concomitant rotator cuff tear arthropathy. The patient was initially hospitalized for prolonged pain and pseudoparalysis of the right shoulder. The condition, which was histologically confirmed as an enchondroma in the proximal humerus, was treated with curettage and reverse total shoulder arthroplasty. In this case report, we present a rare case of an enchondroma with combined rotator cuff tear arthropathy.

Surgical Treatment of Giant Cell Tumor of the Spine (척추 거대세포종의 수술적 치료)

  • Kang, Yong-Koo;Rhyu, Kee-Won;Rhee, Seung-Koo;Bahk, Won-Jong;Chung, Yang-Guk;Park, Chang-Goo
    • The Journal of the Korean bone and joint tumor society
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    • 제15권2호
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    • pp.138-145
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    • 2009
  • Purpose: Giant cell tumor of the spine is very rare, and the treatment is very difficult. However, surgical techniques and diagnostic modalities are developed, and postoperative functional results are improved. To evaluate the efficacy of total spondylectomy for giant cell tumor of the spine, the clinical results of the surgical treatments for the giant cell tumor of the spine with intralesional curettage or total spondylectomy were evaluated. Materials and Methods: From April 1987 to March 2006, 10 patients who were underwent surgical treatments using total spondylectomy or intralesional curettage were studied. There were 3 men and 7 women. The mean age of the patients was 32 years (range, 25~44 years). The mean duration of follow-up was 8 years (range, 3~15 years). Locations of the tumor were 2 cervical spines, 4 thoracic spines, 2 lumbar spines and 2 sacrum. Initial main symptom of 10 patients was pain, and 7 patients had neurologic impairments too. Four patients were treated with total spodylectomy using anterior and posterior combined approach, 1 patient was treated with total sacrectomy using posterior approach only, and 5 patients were treated with intralesional curettage using anterior approach. Results: Nine patients improved pain and neurologic impairments. Local recurrences developed in 4(40%) patients (2 cervical spines, 1 thoracic spine, 1 sacrum). While a local recurrence developed from 5 total spondylectomy, 3 local recurrences developed from 5 intralesional curettage. Conclusion: Local recurrence rate after surgical treatment with intralesional curettage for the giant cell tumor of the spine was very high. Total spondylectomy using anterior and posterior approach is advisable to prevent the local recurrence after surgical treatment.

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Intramural Pregnancy after in vitro Fertilization and Embryo Transfer (체외수정 시술 후 발생한 자궁벽내 임신 1예)

  • Cha, Sun-Hwa;Park, Chong-Taik;Kim, Hae-Suk;Song, Hyun-Jung;Kang, Eun-Hee;Song, Hyun-Jin;Kang, Inn-Soo
    • Clinical and Experimental Reproductive Medicine
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    • 제31권4호
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    • pp.273-277
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    • 2004
  • Intramural pregnancy is an unusual ectopic gestation located within the uterine wall, completely surrounded by myometrium and separate from the uterine cavity, fallopian tube, or round ligament. It is known to be difficult to diagnose, and associated with a high rate of uterine rupture. We report a case of intramural pregnancy in which early diagnosis was made and successful treatment was done by dilatation and curettage. Diagnostic laparoscopy confirmed the absence of uterine rupture during the procedure. Therefore, conservation of fertility can be possible with early diagnosis of intramural pregnancy. To our knowledge, this is the first case report of intramural pregnancy following IVF-ET in Korea.

Diagnostic Imaging of Nasal Adenocarcinoma in Four Dogs (개에서 비강 샘암종의 영상 진단 증례)

  • Jung, Joo-Hyun;Chang, Jin-Hwa;Oh, Sung-Kyoung;Kim, Kyoung-Min;Lee, Sung-Ok;Lee, Jung-Min;Kim, Hak-Sang;Yoon, Jung-Hee;Choi, Min-Cheol
    • Journal of Veterinary Clinics
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    • 제23권3호
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    • pp.355-360
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    • 2006
  • Four dogs with similar respiratory signs were referred to Veterinary Medical Teaching Hospital, Seoul National University. The clinical signs observed in these cases were anorexia, nasal discharge, sneezing, epistaxis, ocular discharge, and exophthalmoses. The routine laboratory tests revealed leukocytosis in two cases. On the skull radiographs, soft tissue density filled nasal cavity with loss of turbinate detail and increased density in frontal sinuses were found in all cases. Lysis of nasal bone was seen in two cases. Lysis of zygomatic arch was seen in one case. On computed tomography scan images, asymmetrical destruction of turbinate and nasal septum, and the superimposition of a soft tissue mass over the turbinate with peripheral contrast enhanced effect were identified in all cases. Destruction of ipsilateral orbital bone and invasion to retrobulbar region were visualized in all cases. In addition, all cases had lysis of cribriform plate. Lysis of nasal bone and destruction of hard palate were seen in two cases. Swelling of submandibular lymph node and salivary gland was seen in a case. Invasion to brain was identified in a case. All cases were diagnosed as nasal adenocarcinoma by cytology with fine needle aspiration and curettage.