• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.651-658
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• 2013

Uterine leiomyomas (UL) are extremely common neoplasms in women of reproductive age, and are associated with a variety of characteristic choromosomal aberrations (CAs). The p53 gene has been reported to play a crucial role in suppressing the growth of a variety of cancer cells. Therefore, the present study investigated the effects of CAs and the p53 gene on ULs. We performed cytogenetic analysis by G-banding in 10 cases undergoing myomectomy or hysterectomy. Fluorescence in situ hybridization (FISH) with a p53 gene probe was also used on interphase nuclei to screen for deletions. In patients, CAs were found in 23.4% of 500 cells analysed, significantly more frequent than in the control group (p<0.001). In the patients, 76% of the abnormalities were structural aberrations (deletions, translocations and breaks), and only 24% were numerical. Deletions were the most common structural aberration observed in CAs. Among these CAs, specific changes in five loci 1q11, 1q42, 2p23, 5q31 and Xp22 have been found in our patients and these changes were not reported previously in UL. The chromosome breaks were more frequent in cases, from high to low, 1, 2, 6, 9, 3, 5, 10 and 12. Chromosome 22, X, 3, 17 and 18 aneuploidy was observed to be the most frequent among all numerical aberrations. We observed a low frequency of p53 losses (2-11%) in our cases. The increased incidence of autosomal deletions, translocations, chromatid breaks and aneuploidy, could contribute to the progression of the disease along with other chromosomal alterations.

• Tuberculosis and Respiratory Diseases
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• 제60권1호
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• pp.92-96
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• 2006

자궁근종으로 자궁절제술을 시행받은 과거력이 있는 43세 여자가 객혈을 주소로 내원하였다. 컴퓨터단층촬영에서 다발성 폐결절이 발견되어 흉강경하에서 조직검사 시행 후 양성 전이성 폐평활근종을 진단받았다. 폐경 전 환자로 GnRH analogues 치료를 시도하였고 3개월 후 추적검사에서 폐결절의 크기는 이전과 변화가 없는 상태를 확인하였고 객혈도 없는 안정된 상태로 경과 관찰중이다.

• Tuberculosis and Respiratory Diseases
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• 제76권3호
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• pp.131-135
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• 2014

Low-grade endometrial stromal sarcoma (ESS) is an uncommon gynecologic malignancy of mesodermal origin. Pulmonary metastasis of low-grade ESS can occur years and decades after the treatment of the primary disease. Low-grade ESS is frequently mistaken as benign uterine neoplasm like uterine leiomyoma, which can potentially lead to a misdiagnosis. We present a case of a 42-year-old woman with low-grade ESS, that initially presented as an incidental lung mass with multiple pulmonary nodules, seven years after an uterine myomectomy. A $6.9{\times}5.8cm-sized$ intrapelvic mass suspected of uterine origin was discovered while searching for potential extrathoracic primary origin. A pelviscopy and simultaneous thoracoscopic lung biopsy were conducted for pathologic diagnosis. Finally, the diagnosis was confirmed as low-grade ESS with lung metastasis based on the histopathologic examination with immunohistochemical stain, which was showed positive for CD10 and hormone receptor markers (estrogen and progesterone receptors) in both pelvic and lung specimens.

• Clinical and Experimental Reproductive Medicine
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• 제37권3호
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• pp.191-198
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• 2010

자궁근종은 환자마다 다양한 조성, 크기, 위치, 개수를 가지는 양성 종양으로 여러 가지 방법으로 생식력에 영향을 준다. 자궁근종이 생식률에 미치는 영향에 대한 연구는 많이 시행되어 왔지만 여전히 명확한 결론을 내리기는 어렵다. 자궁근종의 위치와 크기는 향후 임신에 영향을 미치는 가장 중요한 인자이다. 장막하근종은 임신에 거의 영향을 주지 않으나 자궁내강의 모양을 변형시키는 점막하근종과 근층내근종은 임신율을 감소시키며 자연 유산율을 증가시킨다. 그러므로 보조생식술을 시행하기 전에는 먼저 제거하는 치료가 충분히 상의되어야 한다. 자궁내강을 변형시키지 않은 근층내근종이 있는 환자도 임신율의 저하를 보였지만, 확실한 연구가 없기 때문에 결론을 내리기가 쉽지 않다. 근층내근종의 치료로 근종절제술이 생식력을 향상시킨다는 증거는 아직 불충분하므로 환자의 상태와 의사의 경험에 따라 치료 방법을 결정하여야 한다.

• 여성건강간호학회지
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• 제25권1호
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• pp.4-18
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• 2019

Purpose: The purpose of this study was to investigate the effects of thermotherapy on gas pain, post-operative resilience, and body temperature discomfort among patients who received laparoscopic myomectomies. Methods: The experimental group consisted of 62 patients with thermotherapy and the control group consisted of 60 patients. Thermotherapy was applied individually to the experimental group four hours after surgery. The collected data was analyzed using descriptive statistics, t-tests, ${\chi}^2$-tests, and repeated measures of analysis of variance, using IBM SPSS Statistics version 18. Results: The results showed no significant interaction effect between the group and time of measurement in gas-related pain in the experimental group. For gas-related pain, there was significant difference in right shoulder pain at 24 hours (t=-4.222, p=.000), 48 hours (t=-3.688, p=.000), 72 hours (t=-2.250, p=.028), and left at 24 hours (t=-3.727, p=.000), 48 hours (t=-4.150, p=.000), and 72 hours (t=-2.482, p=.016) and both shoulders at 24 hours (t=-2.722, p=.009) and 48 hours (t=-2.525, p=.014). There was no significant difference in epigastric pain, excluding both epigastric pain at 48 hours (t=2.908, p=.005), 72 hours (t=3.010, p=.004), but there was a significant difference in objective body temperature discomfort (t=2.895, p=.008). Conclusion: Thermotherapy relieved shoulder gas-related pain and objective body temperature discomfort. It needs to be developed and applied to improve post-operative discomfort in patients with laparoscopic hysterectomies.

• 대한영상의학회지
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• 제81권5호
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• pp.1083-1095
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• 2020

2019년 비뇨생식기 초음파와 MRI의 보험급여 범위가 확대되어 보다 많은 환자들이 급여로 영상검사를 받을 수 있게 되었다. 비뇨기계 초음파와 MRI는 암 환자 등 중증질환 환자에서 는 기존에도 급여 혜택을 받을 수 있었으나 이번 급여 범위 확대로 초음파의 경우 대부분의 질환, MRI의 경우에도 조직검사 전 전립선암이나 난소암 의증, 자궁근종절제술 시행 전 자궁 MRI, 각종 선천 기형 등 양성질환에서도 급여로 검사가 가능해졌다. 그러나 급여화로 인해 각 검사 별 적응증과 추적검사 가능 질환 및 횟수 등이 복잡해지고 획득하여야 할 표준영상과 언급하여야 하는 판독소견서의 양식이 정해져 있어 검사를 처방하고 시행하는 의사들이 주의해야 할 사항들이 생겼다. 건강보험 적용 기준에 대한 충분한 이해를 통한 진료는 환자들의 진료 결과를 증진시키는 데 도움이 될 것이다.

• Clinical and Experimental Reproductive Medicine
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• 제21권1호
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• pp.43-48
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• 1994

To evaluate the effectiveness of GnRH agonist for the treatment of uterine myoma as a cause of infertility, fourteen women were recruited to the study. The patients were treated with a delayed-release formulation of D-$Trp^6$-LHRH in biodegradable microcapsules(Decapeptyl-CR), administered intramuscularly at four week intervals for a period of six monthes. The first injection was given on day 21 of the cycle. Serum estradiol levels fell significantly to the mean value of 257.7pgjml 4 weeks after the first injection. Eleven patients in fourteen treated patients had a reduction in the size of uterine myoma as assessed by ultrasonography, two patients had no change of size and one patient had a increase of size. After the first or second injection, all patients became amenorrheic, then resumption of menstruation ocurred at 12 to 14 weeks after the last injection. Common side effects were hot flush, sweating and dyspareunia, whitch were acceptale. In Eleven patients who had a reduction in the size of uterine myoma by treatment with a delayed- release formulation of D-$Trp^6$-LHRH(Decapeptyl-CR), after above treatment with GnRH agonist, then four patients were treated with myomectomy, three patients had pregnancy and full term delivered by Cesarean section. These data suggest that administration of a delayed-release formulation of a GnRH agonist can be a worthwhile and convenient approach to the medical treatment of uterine myoma as a cause of infertility.

• Archives of Plastic Surgery
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• 제38권2호
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• pp.207-211
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• 2011

Purpose: Surgery for thyroid gland requires skin incisions that can result in postsurgical neck scar. To overcome this, many surgeons performed a endoscopic thyroidectomy. But, this approach had a some problems. One of postoperative problems, iatrogenic cervical dystonia (CD) may occur. At common, CD is defined as a syndrome characterized by prolonged muscle contraction causing twisting, repetitive movements or abnormal posture. Botulinum toxin A (BTA, Botox$^{(R)}$, Allergan, Irvine, CA, USA) is well known treatment agent in the treatment of CD. So, the authors applied BTA injection in rare case with iatrogenic CD resulting in endoscopic thyroidectomy. Methods: A 43-year-old female had endoscopic subtotal thyroidectomy operation 3 years ago. She had symptoms such as progressive cervical pain, abnormal neck posture, depression, and sleep difficulty. About 1 year later, the patient who had previous myomectomy of the clavicular head of sternocleidomastoid muscle, however, symptoms were not improved. And then the patient received BTA therapy in our department. The 2 units per 0.1 mL solution was administered in a 1 mL tuberculin syringe. Results: The dose of BTA used in the patient was 36 units for vertical platysmal bands, superficially, and 10 units for ipsilateral sternocleidomastoid muscle, intramuscularly. After 2 weeks, additional the dose of BTA used in the patient was 5 points for remained scar bands, superficially. Complications related to injection such as significant swallowing difficulties, neck muscle weakness, or sensory change were not observed. In 9 months follow-up, the patient maintained a good result from the method of BTA injection alone. Conclusion: The basic concept is selective denervation for the hyperactive individual muscles and scar bands. We conclude that BTA is an effective and safe treatment for CD despite the iatrogenic and complex presentation of this complication.

• Journal of Yeungnam Medical Science
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• 제3권1호
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• pp.249-260
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• 1986

1983년 5월부터 1986년 11월까지 영남대학교 의과대학 부속병원 산부인과에서 제절로 분만한 510예를 대상으로 임상적 관찰분석을 함으로써 다음과 같은 결론을 얻었다. 1. 제절발생빈도는 15.7%였으며 그중 일차제절은 10.9%, 반복제절은 4.7%였으며 제절수술이 점차 증가되는 경향이었다. 2. 연령분포는 26세에서 30세사이의 연령군에서 60.2%로 가장 높은 분포를 보였다. 3. 적응증은 기왕제절 30.2%, 아두골반불균형 26.9%, 이상태위 22.7%의 순이었으며, 일차초산 부제절은 아두골반균형이 일차경산부제절은 이상태위가 가장 많았다. 4. 제절시행 임신주수는 40주에 31.6%로 가장 많았다. 5. 신생아체중분포는 3,000~3,499gm군이 39.8%로 가장 많았으며 미숙아가 9.1%, 거대아는 5.6%였다. 6. 제절술식은 자궁협부횡절개술이 97.5%였다. 7. 제절술시 병행한 수술로는 난관결찰술, 난소낭종제거술, 자궁적출술, 충수제거술, 자궁근종제거술의 순이었다. 8. 마취방법으로 전신마취가 83.5%였다. 9. 모성이환율은 14.7%였으며 그 원인은 창상 감염, 요로감염, 불명열, 산후출혈의 순이었다. 10. 입원당시 빈혈의 정도별 모성이환율은 혈색소치가 10이하인 경우 18.4%의 모성이환율을 보였고, 낮을수록 모성이환율이 증가되었다. 11. 양수파막 24시간이상 경과군에서의 모성이환율이 44.4%였다. 12. 분만진통시간이 12시간이상군에서 24.6%의 모성이환율을 보였고, 진통시간이 길수록 되었다. 13. 자궁협부절개술에서 14.1%로서 가장 낮은 모성이환율을 보였다. 14. 응급수술시행군에서 선택적수술군보다 모성이환율이 2배정도 높았다. 15. 모성사망은 1예도 없었다.