• 제목/요약/키워드: obstetrics %26 gynecology

검색결과 289건 처리시간 0.023초

Impact of Treatment Strategies on Local Control and Survival in Uterine Carcinosarcomas in Turkey

  • Kucukoztas, Nadire;Dizdar, Omer;Rahatli, Samed;Dursun, Polat;Yalcin, Selim;Altundag, Ozden;Ozen, Ozlem;Reyhan, Nihan Haberal;Tarhan, Cagla;Yildiz, Ferah;Ayhan, Ali
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권5호
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    • pp.2959-2962
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    • 2013
  • Background: The purpose of this study was to determine the clinical characteristics, patterns of recurrence and survival outcomes in patients with uterine carcinosarcomas treated in our institution. Materials and Methods: Records of 26 patients diagnosed between 2007 and 2011 with uterine carcinosarcoma were retrospectively evaluated for demographic features, tumor characteristics, treatment regimens and patient outcomes in terms of DFS and OS Results: Median age was 61 (range 43-78). 10 patients (38%) had stage I disease at diagnosis, 3 (12%) had stage II, 4 (15%) had stage III and 9 (35%) had stage IV. Sixteen patients (62%) received chemotherapy with paclitaxel and carboplatin for 6 cycles. One patient underwent radiotherapy. Median follow up was 17 months. Sixteen patients relapsed and 13 died during follow up. Considering recurrence, 5 out of 16 patients had lung metastases, one had brain metastases and 9 had only intraabdominal recurrence. The 3 year DFS was 37% and the 3 year OS was 30%. Conclusions: Our data show that uterine carcinosarcomas tend to be at advanced stage at diagnosis and despite the use of chemotherapy, overall prognosis is poor. Surgery remains the mainstay of treatment. More effective adjuvant strategies are needed to reduce relapse and death rates.

Treatment outcome in patients with vulvar cancer: comparison of concurrent radiotherapy to postoperative radiotherapy

  • Lee, Ja-Young;Kim, Sung-Hwan;Kim, Gi-Won;Yu, Mi-Na;Park, Dong-Choon;Yoon, Joo-Hee;Yoon, Sei-Chul
    • Radiation Oncology Journal
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    • 제30권1호
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    • pp.20-26
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    • 2012
  • Purpose: To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy. Materials and Methods: The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy. Results: Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications. Conclusion: Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.

쌍태임신에 관한 임상적 고찰;I. 주산기 사망 (Clinical Study in Twin-Pregnancy;I. Perinatal Mortality)

  • 박찬규;곽현모
    • Clinical and Experimental Reproductive Medicine
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    • 제8권1호
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    • pp.23-34
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    • 1981
  • In order to study twin pregnancies, a retrospective survey was carried out in Yonsei University, Severance Hospital. Twin deliveries during 1967-1976 numbered altogether 264, and their relative frequency was 1.30%. Clinical palpation in addition to auscultation and roentgenologic technique had been used in the twin diagnosis. The diagnosis was made prior to delivery in 93.18% of the cases. The deliveries took place in the 37.26th (S.D. 3.95) gestational weeks on an average. The mean weights of the infants were-A (first baby) 2416.03g. (S.D. 802.61), and B (second baby) 2299.81g. (S.D. 190.31). The most common manner of twin delivery was spontaneous vaginal delivery. Cesarean section was done in 14.39%, of which the most common indication was hypotonic uterine dysfunction (34.21 %). Low one minute Apgar scores occured more often in B twins than among A twins. Breech delivery gave low one minute Apgar scores more often than did spontaneous vertex delivery in both twins. Full term twins and infants weighing more than 2500g. had fewer low one minute Apgar scores than the preterm infants and those with low birth weight. Perinatal mortality (PNM) in the total series was 14.77% (A 12.50% and B17.05%). The most common cause of perinatal mortality was prematurity in 44.87%. The worst outcome was recorded for the age groups 15-19 and ${\geqq}$40, in which perinatal mortality were 50.00%, respectively. The perinatal mortality of both A and B infants was lowest in the group diagnosed early during antenatal care before delivery. On the basis of our findings, we wish to emphasize particularly the importance of the early diagnosis of twins.

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산후조리원에 입원한 산모의 사상체질과 1회 유축한 모유량과의 상관성에 관한 연구 (A Study on Breast milk volume of Women according to Sasang Constitution)

  • 송호림;배경연;정재중;유상민;황진우;최인호;육상숙;임은미;이용현
    • 대한한방부인과학회지
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    • 제19권2호
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    • pp.271-281
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    • 2006
  • Purpose : Although the breast milk is the very important physiological function to women, there is no previous study on the breast milk volume of women according to Sasang Constitution. this study was to analyze the difference of breast milk volume pattern according to Sasang Constitution. Methods : This study investigated 109 breast feeding women who were treated by Spostpartum care center from March 2005 to November 2005. The result of survey was collected from the questionnaires that included postpartum pattern and QSCC H .Results : The results of Sasang Constitution analysis showed that 53 women in childbirth of 109 were classified into Soeumin(48.6%), 27 as Taeumin(24.8% ) and 29 as Soyangin(26.6% ). Mean milk volume according to the Sasang Constitution showed statistically no difference between Soeumin and Taeumin, but mean milk volume according to the Sasang Constitution showed statistically the significant difference between Soyangin and Soeumin, Soyangin and Taeumin. Conclusion These results suggest that milk volume of Soyangin is much larger than that of Soeumin and Taeumin.

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사물탕가미방(四物湯加味方)의 항산화 활성에 대한 실험적 연구 (Anti-oxidant Effects of Samultang-Gami on MEF Cells)

  • 정재중;구선영;고은비;성정석;김동일
    • 대한한방부인과학회지
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    • 제23권3호
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    • pp.26-37
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    • 2010
  • Purpose: This experiment is designed to find out anti-oxidant effects of Samultang-Gami which was composed of Rehmanniae Radix(RR), Angelicae Gigantis Radix, Cnidii Rhizoma(CR), Paeoniae Radix(PR), Cortex Moutan Radicis, Hedyotis Diffusa(HD) and Caesalpinia Sappan on MEF cells. Methods: In vitro antioxidant effects were measured by MTT assay, DPPH assay, cell cycle analysis, AnnexinV-FITC/PI assay and DAPI staining using MEF cells treated with various concentrations of 70% ethanol extract of Samultang-Gami. Results: 1. In the scavenging for DPPH radical, the each treated groups of PR, CR and HD showed positive effects. RR and CR increased the viability of oxidative damaged MEF cells in a dose-dependent manner. 2. 70% ethanol extract of Samultang-Gami was shown best antioxidative effect in the concentration of $0.5mg/m{\ell}$. 3. The treatment of Samultang-Gami in oxidative damaged MEF cells didn't have any effect on cell cycle restoration. but it could lower late apoptosis rate a little and be observed the protection of nucleus. Conclusion: It can be concluded that Samultang-Gami, RR and CR have antioxidant effects on MEF cells.

정상배란성 월경주기에서 혈청 인슐린유사 성장인자 결합단백질의 양상 (Serum Insulin-like Growth Factor Binding Proteins Profiles During the Normal Oulatory Menstrual Cycle)

  • 정재훈;김정구
    • Clinical and Experimental Reproductive Medicine
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    • 제26권1호
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    • pp.67-73
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    • 1999
  • The insulin-like growth factor (IGF)s are believed to one of several growth factors that play an adjunctive role in ovarian follicular development. These factors circulate bound to a family of IGF-binding protein (IGFBP)s. It is known that circulating IGFBPs are involved in the transport of IGFs to tissues and modulate IGFs actions at local tissue. The purposes of this study were to evaluate changes in serum IGFBPs profiles during normal ovulatory menstrual cylce and to compare serum IGFBPs profiles in periovulatory phase of between normal ovulatory menstrual cylce and controlled hyperstimulated cycle. Fasting blood samples were obtained from 15 normal healthy women throughout normal ovulatory menstural cyle and on the day of aspiration of oocyte from 10 patients undergoing ovarian hyperstimuation for in vito fertilization-embryo transfer. Serum IGFBP-1 - IGFBP-4 were measured by western ligand blot and immunoprecipitation. Serum $17{\beta}$-estradiol was determined by radioimmunoassay. Type and molecular weight of serum IGFBP did not changed during normal ovulatory menstural cycle. No significant variation in the relative proportion and level of each IGFBP was found throughout normal ovulatory menstural cyle. Also, the relative proportion and level of each IGFBP did not correlated with serum $17{\beta}$-estradiol level. There was no significant difference in the relative proportion and level of each serum IGFBP between on the day of ovulation in normal ovulatory menstrual cylce and on the day of aspiration of oocyte in controlled hyperstimulated cycle. Our data indicate that IGFBPs have regulatory functions in ovary through an paracrine and autocrine rather than endocrine mechanism during normal ovulatory menstural cycle.

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한의학(韓醫學)에서 사용되는 한약제제(韓藥製劑)의 혈관이완 효능검색 (Screening Herbal Decoction of the Vascular Relaxation in Korean Medicine)

  • 김혜윰;서창섭;신현규;홍미현;윤정주;안유미;은소영;이윤정;이호섭;강대길
    • 대한한방부인과학회지
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    • 제31권1호
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    • pp.43-56
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    • 2018
  • Objectives: This study was designed to investigate the basis for developing the herbal decoction that may help promote healthy blood vessels in accordance with the basic principles of Korean medicinal materials. Methods: In this study, we investigated the vascular relaxation effects of fifty herbal decoctions on vascular response in isolated thoracic aorta of phenylephrine-preconracted rats. Results: The results of identify the vascular relaxation effect of fifty herbal decoctions provided by Korea Institute of Korean Medicine, twenty-one herbal decoctions showed vascular relaxation effects. Among them, four herbal decoctions, Mahwang-tang (麻黃湯), Samchulgeonbi-tang (參朮健脾湯), Cheonwangbosim-dan (天王補心丹), and Socheonglyong-tang (小靑龍湯), with showed significantly concentration-dependent vasodilation was examined. Vascular relaxation level are $84.02{\pm}4.70$, $79.39{\pm}13.9$, $51.26{\pm}12.56$, and $54.73{\pm}15.8%$, respectively (P<0.05, 0.01, and 0.001). Conclusions: Thus these results provide a basic data for the treatment of the impairment of vascular function and blood pressure in traditional Oriental medicine.

사군자탕가미방(四君子湯加味方)이 난소적출 폐경 병태 모델의 자궁 및 난소 기능에 미치는 영향 (Effects of Sagunjatang-Gami on Uterine and Ovarian Function in the Ovariectomized Rat Postmenopause Model)

  • 맹유숙;최민선;안인숙;김동일
    • 대한한방부인과학회지
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    • 제25권4호
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    • pp.12-26
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    • 2012
  • Objectives: The purpose of this study is to examine the effects of Sagunjatang-Gami(SGJT) on uterine and ovarian function in the ovariectomized rat postmenopause model. Methods: SGJT was administered in ovariectomized Wister albino female rats for three month. After that, uterine weight, uterine index, serum estradiol-$17{\beta}$ levels and phosphorylation of ERK or AKT, and histological analysis of uterus were measured to assess the impact on uterine and ovarian function in ovariectomized rats. In addition, phosphorylation of $ER{\alpha}$, ERK, AKT by SGJT in MDA-MB-231 cells were measured. To identify safety of SGJT, the cell cytoxicity in MDA-MB-231 cells and serum GOT, GPT levels were measured in ovariectomized rats. Results: The results were as follows. 1. SGJT decreased the viability of MDA-MB-231 cells in a dose-dependent manner. 2. The level of serum GOT, GPT in SGJT-treated group showed significant decrease in comparison with control group. 3. Phosphorylation of $ER{\alpha}$, ERK, AKT by SGJT in MDA-MB-231 cells were increased. 4. Uterus index in SGJT-treated group showed significant increase in comparison with control group. The level of serum estradiol-$17{\beta}$ in SGJT-treated group showed significant increase in comparison with control group. Phosphorylation of ERK or AKT by SGJT in the uterus of ovariectomized rats was increased significantly. 5. Uterus index and the level of serum estradiol-$17{\beta}$ in SGJT-treated group increased at higher rates in comparison with estrogen-treated group. Conclusions: Taken together, we suggest that SGJT has been shown to be effective in preventing postmenopausal uterine and ovarian degeneration and curing postmenopausal low estrogen related symptoms.

평활화 알고리즘에 따른 자궁경부 분류 모델의 성능 비교 연구 (A Performance Comparison of Histogram Equalization Algorithms for Cervical Cancer Classification Model)

  • 김윤지;박예랑;김영재;주웅;남계현;김광기
    • 대한의용생체공학회:의공학회지
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    • 제42권3호
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    • pp.80-85
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    • 2021
  • We developed a model to classify the absence of cervical cancer using deep learning from the cervical image to which the histogram equalization algorithm was applied, and to compare the performance of each model. A total of 4259 images were used for this study, of which 1852 images were normal and 2407 were abnormal. And this paper applied Image Sharpening(IS), Histogram Equalization(HE), and Contrast Limited Adaptive Histogram Equalization(CLAHE) to the original image. Peak Signal-to-Noise Ratio(PSNR) and Structural Similarity index for Measuring image quality(SSIM) were used to assess the quality of images objectively. As a result of assessment, IS showed 81.75dB of PSNR and 0.96 of SSIM, showing the best image quality. CLAHE and HE showed the PSNR of 62.67dB and 62.60dB respectively, while SSIM of CLAHE was shown as 0.86, which is closer to 1 than HE of 0.75. Using ResNet-50 model with transfer learning, digital image-processed images are classified into normal and abnormal each. In conclusion, the classification accuracy of each model is as follows. 90.77% for IS, which shows the highest, 90.26% for CLAHE and 87.60% for HE. As this study shows, applying proper digital image processing which is for cervical images to Computer Aided Diagnosis(CAD) can help both screening and diagnosing.

Intraovarian platelet-rich plasma administration could improve blastocyst euploidy rates in women undergoing in vitro fertilization

  • Merhi, Zaher;Seckin, Serin;Mouanness, Marco
    • Clinical and Experimental Reproductive Medicine
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    • 제49권3호
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    • pp.210-214
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    • 2022
  • Objective: Platelet-rich plasma (PRP) therapy has received a considerable attention as an adjunct to fertility treatments, especially in women with very low ovarian reserve and premature ovarian insufficiency. Although recent studies have demonstrated that PRP led to improvements in folliculogenesis and biomarkers of ovarian reserve, the effect of intraovarian PRP administration on embryo genetics has not been studied. Methods: We report a pilot study of patients who had preimplantation genetic testing for aneuploidy (PGT-A) before and then within 3 months following PRP administration. Twelve infertile women with at least one prior failed in vitro fertilization (IVF) cycle underwent ovarian stimulation (cycle 1) with a gentle stimulation protocol and PGT-A performed at the blastocyst stage. Following cycle 1, autologous intraovarian PRP administration was performed. Within 3 months following PRP administration, the patients underwent cycle 2 and produced blastocysts for PGT-A. The percentage of euploid embryos between both cycles was compared. Results: The mean age of all participants was 40.08±1.46 years, and their mean body mass index was 26.18±1.18 kg/m2. The number of good-quality embryos formed at the blastocyst stage was similar between cycle 1 and cycle 2 (3.08±0.88 vs. 2.17±0.49, respectively; p=0.11). Among all patients in cycle 1, 3 of 37 embryos were euploid (8.11%) while in cycle 2, 11 out of 28 embryos were euploid (39.28%, p=0.002). Three clinical pregnancies were noted among this patient group. Conclusion: This novel study is the first to present an improvement in the embryo euploidy rate following intraovarian PRP application in infertile women with prior failed IVF cycles. The growth factors present in PRP may exhibit a local paracrine effect that could improve meiotic aberrations in human oocytes and thus improve euploidy rates. Whether PRP improves live birth rates and lowers miscarriage rates remains to be determined in large trials.