• 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.

• 대한골관절종양학회지
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• 제10권2호
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• pp.71-78
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• 2004

목적: 최근 체험한 59례의 거대 세포종 중 골 소파술 및 시멘트 충전술을 시행한 37례의 재발의 특성과 이를 예방할 수 있는 방법에 대해 알아 보고자 한다. 대상 및 방법: 1995년 1월부터 2000년 3월까지 본원 정형외과에 입원하여 진단적 생검 또는 수술적 치료에 의하여 병리학적으로 거대 세포종으로 확진되고, 그 치료로 골 소파술과 Burring 후 시멘트 충전술을 시행했던 3 7례의 재발의 위치, 특성, 시기에 관하여 분석하였다. 결과: 총 37례 환자 중 일차 치료(Curettage & Cementation) 후 13례에서 재발하여 35%의 재발율을 보였다. 일차 치료 후 재발까지의 기간은 평균 16 개월로 분석되었으며, 최단 5개월에서 최장 3년 7개월이었다. 2례를 제외하고는 모두 2년 내에 재발하였다. 재발 부위는 수술적 접근 후 창(Window)을 만든 부위의 인접한 피질골에서 대부분 관찰되었으며(11례), 2례는 수술적 접근을 한 골 시멘트의 심부(골수강측)에 발생하였다. 골 소파 술 후의 시멘트 충전술은 즉각적 안정성과 빠른 재활, 재발의 조기 발견의 유용성이 있다. 또한 이론적으로 주변의 남아있는 종양세포를 사멸시킬 수 있는 장점을 가지고 있다. 수술을 시행한 실제 임상 례에서 재발의 부위가 수술시 충분한 소파가 안된 부위(Window를 작게 내어 불충분한 소파가 된 부위, 주위 해부학적 구조상 건, 인대의 기시부나 종지부로 소파가 안된 부위)에서 대부분(85%)이 재발하였다. 결론: 거대 세포종의 치료에 있어서 골 소파술과 Burring 후 시멘트 충전술이 많이 사용되고 있다. 또한 소파술 후 보조적인 치료로서 페놀, $H_2O_2$를 이용한 화학적 소작, 냉동요법, 무수 알코올 등이 소개 되었지만, 아직 그 효과가 입증된 것이 없다. 많은 경우 주위의 인대나 건의 기시부나 종지부 또는 다른 해부학적 구조로 불충분한 창(Window)으로 인해, 수술적 접근을 한 부위의 골 소파술 및 Burring 이 불완전하게 되는 경향이 발생할 수 있다. 본 연구에서 재발의 부위는 대부분(85%)에서 불충분한 개창술이 된 부위에서 발생하였다. 즉, 중요한 해부학적 구조가 있더라도 충분한 개창술과 광범위한 소파와 Burring이 재발을 방지하는 가장 중요한 요소가 되리라 사료된다. 본 연구에서 거대세포종의 재발은 대부분 2년 이내에 발생하였다. 특히 이 기간에는 철저한 추적검사를 통하여 재발에 유의해야 한다.

• 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.

• 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.

• 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.

• 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.

• 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.

• 대한골관절종양학회지
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• 제15권2호
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• pp.138-145
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• 2009

목적: 척추 거대세포종은 매우 드문 질환으로, 종양이 추체 내에 확산이 될 때까지는 증상이 나타나지 않아, 진단이 늦어지는 경우가 대부분으로 치료가 매우 힘든 질환으로 알려지고 있다. 최근 척추수술 술기의 발전과 진단기기의 발달로 척추종양을 척추 전절제술(total spondylectomy)로 치료하여 좋은 치료결과를 보고하고 있는바, 전절제술로 치료한 증례와 소파술로 치료한 증례를 분석하여, 척추 전절제술의 효용성을 알아보기 위하여 본 연구를 하였다. 대상 및 방법: 1987년 4월부터 2006년 3월까지 척추의 거대세포종에 대한 수술적 치료를 받은 환자 중에서 3년 이상 추시가 된 10례를 분석하였다. 남자 3명, 여자 7명이었으며, 평균나이는 32세(25-44세)이었다. 경추 2례, 흉추 4례, 요추 2례, 천추 2례이었다. 전례에서 동통이 주소이었으며 7례는 신경학적 증상도 동반되었다. 4례는 전후방 도달에 따른 척추 전절제술, 1례는 후방도달에 따른 천추전절제술 수술을 시술받았으며, 경추 2례를 포함한 5례에서는 소파술 및 전방추체유합술로 치료를 받았다. 결과: 수술적 치료 후 9례에서 동통과 신경학적 증상의 호전이 있었다. 그러나 4례(40%)에서 국소재발이 합병하였는데 2례가 경추에서, 흉추와 천추에서 각 1례가 발생하였다. 국소재발은 소파술로 치료한 3례와 전절제술로 치료 받은 1례이었다. 결론: 거대세포종은 수술적인 치료 후에도 국소재발이 많이 합병하는 바, 초기 치료에서 척추에 대한 전후방 도달법을 이용한 전절제술과 같은 완전 절제술이 필수적임을 알 수 있었다.

• 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.

• 한국임상수의학회지
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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.